Association between Amygdala Hyperactivity to Harsh Faces and Severity of Social Anxiety in Generalized Social Phobia

Phan, K. Luan; Fitzgerald, Daniel A.; Nathan, Pradeep J.; Tancer, Manuel E.

doi:10.1016/j.biopsych.2005.08.012

Cited by 468 publications

(380 citation statements)

References 45 publications

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“…Increased amygdala responsiveness to emotional face processing has been a typical finding in fMRI studies of social anxiety patients (Stein et al 2002; Veit et al 2002; Straube et al 2004, 2005; Phan et al 2006; Yoon et al 2007). Nevertheless, it was not always obvious whether fusiform gyrus showed an abnormal activation, as few authors have specifically investigated fusiform gyrus activation in SAD.…”

Section: Discussionmentioning

confidence: 96%

“…Consistent with our findings, an fMRI study reported that children with this disorder tended to show reduced right fusiform gyrus activation, particularly in response to ‘forward’ faces compared to ‘angled’ faces, with no increase in amygdala activation (Garrett et al 2004). Specifically in social phobia, several studies did not find abnormal fusiform gyrus response to faces (Phan et al 2006; Campbell et al 2007; Stein et al 2007 b ), whereas Straube et al (2004) observed greater fusiform gyrus activation relative to control subjects for implicit, and not explicit, processing of angry faces. In another study, fusiform gyrus response to faces was larger in social phobic patients with high anxiety scores (Straube et al 2005).…”

Section: Discussionmentioning

confidence: 97%

“…Functional imaging studies of emotional face perception have shown increased amygdala activation in anxiety-prone subjects (Rauch et al 2000; Hariri et al 2002; Stein et al 2007 b ) and patients with social anxiety disorders (Stein et al 2002; Veit et al 2002; Straube et al 2004, 2005; Phan et al 2006; Yoon et al 2007). However, this increase in activation may depend on precise task conditions (Straube et al 2004), may be relatively modest in effect size (Cooney et al 2006; Yoon et al 2007) and may not be sustained throughout assessment (Campbell et al 2007).…”

Section: Introductionmentioning

confidence: 99%

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Influence of the fusiform gyrus on amygdala response to emotional faces in the non-clinical range of social anxiety

et al. 2009

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“…In non-ASD populations, including both non-clinical populations and in those diagnosed with social anxiety disorder (SAD) or generalized social phobia, increased amygdala activation in response to faces is well established. This has been observed in adults (Bishop, Duncan, & Lawrence, 2004; Brühl, Delsignore, Komossa, & Weidt, 2014; Phan, Fitzgerald, Nathan, & Tancer, 2006) and in children and adolescents (Killgore & Yurgelun-Todd, 2005; Monk et al, 2008), with results pointing to right amygdala activation being uniquely associated with internalizing symptoms. For example, in participants with SAD relative to controls, those with SAD showed increased right amygdala activation and decreased left amygdala activation to neutral faces relative to oval stimuli (Cooney, Atlas, Joormann, Eugène, & Gotlib, 2006).…”

Section: Proposed Model Of Etiological Factors Associated With the Dementioning

confidence: 86%

“…For example, in participants with SAD relative to controls, those with SAD showed increased right amygdala activation and decreased left amygdala activation to neutral faces relative to oval stimuli (Cooney, Atlas, Joormann, Eugène, & Gotlib, 2006). Further, amygdala activation to interpersonal threat (i.e., fearful faces) has been found to be positively correlated with severity of social anxiety symptoms (Phan et al, 2006). However, the type of internalizing condition and stimulus may determine the direction or presence of activation.…”

Section: Proposed Model Of Etiological Factors Associated With the Dementioning

confidence: 99%

A conceptual model of risk and protective factors associated with internalizing symptoms in autism spectrum disorder: A scoping review, synthesis, and call for more research

Yarger

Redcay

2020

Dev Psychopathol

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This paper reviews and synthesizes key areas of research related to the etiology, development, and maintenance of internalizing symptoms in children, adolescents, and adults with autism spectrum disorder (ASD). In developing an integrated conceptual model, we draw from current conceptual models of internalizing symptoms in ASD and extend the model to include factors related to internalizing within other populations (e.g., children that have experienced early life stress, children with other neurodevelopmental conditions, typically developing children) that have not been systematically examined in ASD. Our review highlights the need for more research to understand the developmental course of internalizing symptoms, potential moderators, and the interplay between early risk and protective factors. Longitudinal studies incorporating multiple methods and both environmental and biological factors will be important in order to elucidate these mechanisms.

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“…Instead, they show hyperscanning as reflected by increased scanpath length and short fixation periods also on non-diagnostic features such as hair or ears [47]. Interestingly, these patients show hyperactivation of the amygdala [48]–[50]. In line with the above mentioned hypothesized functional role of the amygdala, one may speculate that patients with social phobia initially show enhanced reflexive gaze shifts toward the eye region but subsequently avoid scanning this feature to reduce an upcoming fear of being observed and evaluated by others.…”

Section: Discussionmentioning

confidence: 97%

Diagnostic Features of Emotional Expressions Are Processed Preferentially

2012

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Diagnostic features of emotional expressions are differentially distributed across the face. The current study examined whether these diagnostic features are preferentially attended to even when they are irrelevant for the task at hand or when faces appear at different locations in the visual field. To this aim, fearful, happy and neutral faces were presented to healthy individuals in two experiments while measuring eye movements. In Experiment 1, participants had to accomplish an emotion classification, a gender discrimination or a passive viewing task. To differentiate fast, potentially reflexive, eye movements from a more elaborate scanning of faces, stimuli were either presented for 150 or 2000 ms. In Experiment 2, similar faces were presented at different spatial positions to rule out the possibility that eye movements only reflect a general bias for certain visual field locations. In both experiments, participants fixated the eye region much longer than any other region in the face. Furthermore, the eye region was attended to more pronouncedly when fearful or neutral faces were shown whereas more attention was directed toward the mouth of happy facial expressions. Since these results were similar across the other experimental manipulations, they indicate that diagnostic features of emotional expressions are preferentially processed irrespective of task demands and spatial locations. Saliency analyses revealed that a computational model of bottom-up visual attention could not explain these results. Furthermore, as these gaze preferences were evident very early after stimulus onset and occurred even when saccades did not allow for extracting further information from these stimuli, they may reflect a preattentive mechanism that automatically detects relevant facial features in the visual field and facilitates the orientation of attention towards them. This mechanism might crucially depend on amygdala functioning and it is potentially impaired in a number of clinical conditions such as autism or social anxiety disorders.

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“…However, the amygdala was not activated in response to our stimuli. This may be due to the nature of our stimuli, which were neutral or happy, and contrasted with the harsh and angry expressions used in previous studies that reported amygdala hyperactivation (Davies et al, 2017; Gentili et al, 2008; Phan et al, 2006; Stein et al, 2002). Insula activation was observed in our study, consistent with the finding of other studies (Boehme et al, 2014; Choi et al, 2016; Gentili et al, 2008; Kim et al, 2018; Straube et al, 2004).…”

Section: Discussionmentioning

confidence: 97%

“…The distress task measured attitudes toward social cues by asking whether participants felt distress while viewing a set of facial images of people as a simulated audience. Previous studies have frequently focused on negative stimuli, such as angry faces, to evoke social anxiety (Phan et al, 2006; Stein et al, 2002). In ordinary social situations, however, the audience is not expressing anger because the speaker is clumsy, and can maintain a neutral expression or rather smile.…”

Section: Introductionmentioning

confidence: 99%

“…The neural basis of these characteristic manifestations has been explored using neuroimaging studies, which have suggested hyperactivation of the fear circuit (Bruhl, Delsignore, Komossa, & Weidt, 2014; Freitas-Ferrari et al, 2010). For example, typical social cues such as other people's faces or speech anticipation induce excessive activation of limbic emotion-related regions, including the amygdala (Davies et al, 2017; Gentili et al, 2008; Kim et al, 2018; Kraus et al, 2018; Phan, Fitzgerald, Nathan, & Tancer, 2006; Stein, Goldin, Sareen, Zorrilla, & Brown, 2002) and insula (Boehme et al, 2014; Choi, Shin, Ku, & Kim, 2016; Gentili et al, 2008; Kim et al, 2018; Straube, Kolassa, Glauer, Mentzel, & Miltner, 2004), and decreased activity of visual cortices related to processing of facial stimuli, including the fusiform gyrus and intraparietal sulcus (Binelli et al, 2016; Gentili et al, 2008). Because of the consciousness of other people's eyes, activation of regions related to theory of mind (ToM), including the superior temporal sulcus, middle temporal gyrus, and temporoparietal junction, is another characteristic (Brühl et al, 2011; Choi et al, 2016; Gentili et al, 2008; Kim et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Neural effects of a short-term virtual reality self-training program to reduce social anxiety

et al. 2020

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Background Social anxiety disorder (SAD) is characterized by anxiety regarding social situations, avoidance of external social stimuli, and negative self-beliefs. Virtual reality self-training (VRS) at home may be a good interim modality for reducing social fears before formal treatment. This study aimed to find neurobiological evidence for the therapeutic effect of VRS. Methods Fifty-two patients with SAD were randomly assigned to a VRS or waiting list (WL) group. The VRS group received an eight-session VRS program for 2 weeks, whereas the WL group received no intervention. Clinical assessments and functional magnetic resonance imaging scanning with the distress and speech evaluation tasks were repeatedly performed at baseline and after 3 weeks. Results The post-VRS assessment showed significantly decreased anxiety and avoidance scores, distress index, and negative evaluation index for ‘self’, but no change in the negative evaluation index for ‘other’. Patients showed significant responses to the distress task in various regions, including both sides of the prefrontal regions, occipital regions, insula, and thalamus, and to the speech evaluation task in the bilateral anterior cingulate cortex. Among these, significant neuronal changes after VRS were observed only in the right lingual gyrus and left thalamus. Conclusions VRS-induced improvements in the ability to pay attention to social stimuli without avoidance and even positively modulate emotional cues are based on functional changes in the visual cortices and thalamus. Based on these short-term neuronal changes, VRS can be a first intervention option for individuals with SAD who avoid society or are reluctant to receive formal treatment.

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“…Based on animal models of fear of learning (Davis & Whalen, 2001;LeDoux, 2000), one hypothesis predicts that amygdalar dysfunction is common to a variety of anxiety disorders. Indeed, amygdalar hyperactivity has been observed during symptom provocation or negative emotional processing in patients with posttraumatic stress disorder (PTSD) (Rauch et al, 2000;Shin et al, 2004Shin et al, , 2005, social anxiety disorder (Phan, Fitzgerald, Nathan, & Tancer, 2006;Stein, Goldin, Sareen, Zorrilla, & Brown, 2002), panic disorder (van den Heuvel et al, 2005) and obsessive-compulsive disorder (van den Heuvel et al, 2004) as well as specific phobia (Dilger et al, 2003;Schienle, Schäfer, Walter, Stark, & Vait, 2005;Straube, Mentzel, & Miltner, 2006;Veltman et al, 2004). Shared symptoms of anxiety disorders, such as an exaggerated fear response, might be reflected in shared neurobiology (Etkin & Wager, 2007).…”

Section: Discussionmentioning

confidence: 97%

The prevalence of specific phobia and associated co-morbid features in children and adolescents

Kim¹,

Kim²,

Cho³

et al. 2010

Journal of Anxiety Disorders

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“…We hypothesized that childhood trauma would be most strongly associated with anger and fear processing as manifested by heightened amygdala and blunted DLPFC activation, and we did not observe either of these patterns. Amygdala activation appears to have prominent state-dependent (including with active depression) and individual differences effects that can be ascribed to processes other than excessive childhood trauma exposure or trait-based effects of MDD (61)(62)(63)(64)(65). Another surprising finding was that results yielded a positive rather than negative relation between activation within the MFG and childhood trauma.…”

Section: Discussionmentioning

confidence: 97%

Human emotion processing accuracy, negative biases, and fMRI activation are associated with childhood trauma

Reisch,

Bessette,

Jenkins

et al. 2023

Front. Psychiatry

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IntroductionEmerging literature suggests that childhood trauma may influence facial emotion perception (FEP), with the potential to negatively bias both emotion perception and reactions to emotion-related inputs. Negative emotion perception biases are associated with a range of psychiatric and behavioral problems, potentially due or as a result of difficult social interactions. Unfortunately, there is a poor understanding of whether observed negative biases are related to childhood trauma history, depression history, or processes common to (and potentially causative of) both experiences.MethodsThe present cross-sectional study examines the relation between FEP and neural activation during FEP with retrospectively reported childhood trauma in young adult participants with remitted major depressive disorder (rMDD, n = 41) and without psychiatric histories (healthy controls [HC], n = 34). Accuracy of emotion categorization and negative bias errors during FEP and brain activation were each measured during exposure to fearful, angry, happy, sad, and neutral faces. We examined participant behavioral and neural responses in relation to total reported severity of childhood abuse and neglect (assessed with the Childhood Trauma Questionnaire, CTQ).ResultsResults corrected for multiple comparisons indicate that higher trauma scores were associated with greater likelihood of miscategorizing happy faces as angry. Activation in the right middle frontal gyrus (MFG) positively correlated with trauma scores when participants viewed faces that they correctly categorized as angry, fearful, sad, and happy.DiscussionIdentifying the neural mechanisms by which childhood trauma and MDD may change facial emotion perception could inform targeted prevention efforts for MDD or related interpersonal difficulties.

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“…Behavioural inhibition and introversion have been linked with hyper-reactivity of brain structures such as the amygdala and insular cortices (Stein et al 2002(Stein et al , 2007Schwartz et al, 2003;Phan et al 2006;Hooker et al 2008). Therefore, Smoller and colleagues investigated the relationship between the RGS2 variant and functional reactivity of the amygdala and the insulae via neuroimaging.…”

Section: Discussionmentioning

confidence: 98%

Amygdala hypersensitivity in response to emotional faces in Tourette's patients

Neuner

Kellermann

Stöcker

et al. 2010

The World Journal of Biological Psychiatry

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We will discuss these findings as a result of either deficient frontal inhibition due to structural changes or a desynchronization in the interaction of the cortico-striato-thalamo-cortical network within structures of the limbic system. Our data show an altered pattern of implicit emotion discrimination and emphasize the need to consider motor and non-motor symptoms in Tourette's syndrome in the choice of both behavioural and pharmacological treatment.

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“…Wang, 2010). Of interest, data indicate that deliberately diminishing negative affective responses yields increased activation in lateral and dorsal regions of the prefrontal cortex (PFC) and=or decreased activation in the amygdala (Phan, Fitzgerald, Nathan, & Tancer, 2006) suggesting that the PFC exerts a top-down, inhibitory influence through the medial PFC (e.g., BA 10 and 9) given its connections with the dorsolateral PFC and amygdala (Price, 2005). Studies of social stress have also shown a potential modulator role for the left PFC (BA 9 and 10) on the right amygdala (J.…”

Section: Discussionmentioning

confidence: 98%

sLORETA and fMRI Detection of Medial Prefrontal Default Network Anomalies in Adult ADHD

Cannon¹,

Kerson²,

Hampshire³

2011

Journal of Neurotherapy

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Attention deficit hyperactivity disorder (ADHD) is a developmental psychiatric disorder thought to affect approximately 5 to 10% of school-age children, of whom 30 to 65% continue to exhibit symptoms into adulthood. The prevalence of ADHD in adults is also an estimated 4%, second only to depression. Across studies there appear to be significant network dysfunctions involved in ADHD. Typically the foci of interest in ADHD included the insular cortices, frontal lobes, basal ganglia, and cerebellum. More recently, attention has been directed to the default network of the brain and its functional integrity in ADHD with focus on the precuneus and parietal lobes and interactions with medial prefrontal cortices. Functional magnetic resonance imaging (fMRI) measures neurovascular coupling as measured by the blood oxygenated level dependent signal (BOLD). Electroencephalogram (EEG) measures brain electrical information. Because fMRI is an indirect measure of neuronal activity and EEG is a direct measure, combining the results from these two imaging modalities under the same task conditions may provide a more complete story as to the what (EEG) and where (fMRI) activity exists. This article discusses the benefits of using standardized low resolution electromagnetic tomography (sLORETA) analysis of the EEG as compared to fMRI. The goal of the study, the data from which we use for our justification, was to discover the functional differences in ADHD and non-ADHD brains with different brain imaging modalities. We hoped to elucidate functional connectivity patterns by interpreting the data acquired with the EEG using sLORETA and the data acquired with the fMRI scans. We further hoped to find correlation with the sLORETA and fMRI interpretations so as to confirm that EEG is an adequate stand-alone methodology to evaluate ADHD. Participants included 6 ADHD and 7 non-ADHD subjects. They were initially interviewed by phone and administered the Connors Rating Scale and the Mini International Neuropsychiatric Interview to determine accuracy of symptom reporting and to rule out psychological comorbidities. Exclusion criteria consisted of previous head trauma, recent drug or alcohol abuse (14 days), or neurological syndromes. We recorded sequential 19-channel EEG and fMRI during the eyes-open and eyes-closed states and while performing the Stroop test. The QEEG results were evaluated with comparison to a normative database and with sLORETA analysis.Functional connectivity was assessed using the seed-based approach in sLORETA. The fMRI results were evaluated using Brain Voyager TM and other neuroimaging software packages. sLORETA and fMRI data identify a region in medial Brodmann Area (BA) 10 of the default network. Furthermore, regional frontal differences extend to medial BA 32 with more emphasis to left prefrontal. sLORETA determines there is less current source density at BA 10 in the ADHD participants than controls. sLORETA is adequate in localizing the sources of the EEG in the default network as contrasted with fMRI. It is impor...

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“…5). This finding is surprising, as various neuroimaging studies typically associate SAD with amygdala hyperactivity during task or rest (Birbaumer et al 1998;Schneider et al 1999;Stein et al 2002;Phan et al 2006) and enhanced coupling with cognitive control regions (Brühl et al 2014).…”

Section: Discussionmentioning

confidence: 98%

Reappraisal of Interpersonal Criticism in Social Anxiety Disorder: A Brain Network Hierarchy Perspective

et al. 2018

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Emotion regulation is thought to involve communication between and within large-scale brain networks that underlie emotion reactivity and cognitive control. Aberrant network interaction might therefore be a key neural feature of mental disorders that involve emotion dysregulation. Here we tested whether connectivity hierarchies within and between emotion reactivity and cognitive reappraisal networks distinguishes social anxiety disorder (SAD) patients (n = 70) from healthy controls (HC) (n = 25). To investigate network organization, we implemented a graph-theory method called Dependency Network Analysis. Participants underwent fMRI while watching or reappraising video clips involving interpersonal verbal criticism. During reappraisal, the reappraisal network exerted less influence on the reactivity network in SAD participants. Specifically, the influence of the right inferior frontal gyrus on both reappraisal and reactivity networks was significantly reduced in SAD compared with HC, and correlated negatively with negative emotion ratings among SAD participants. Surprisingly, the amygdala exhibited reduced influence on the reappraisal network in SAD relative to HC. Yet, during the watch condition, the left amygdala's influence on the reactivity network increased with greater social anxiety symptoms among SAD participants. These findings refine our understanding of network organization that contributes to efficient reappraisal or to disturbances in applying this strategy in SAD.

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“…At the same time, deficiencies in emotion identification and discrimination skills negatively affect the communication skills of individuals with SAD (Valença et al 2005). Despite studies in the literature (Straube et al 2004, Phan et al 2006, Yoon et al 2007, it was found that there was no difference in emotion identification and discrimination social cognition skills of individuals with social anxiety problems compared to those without social anxiety. There are also studies (Campbell et al 2009, Garner et al 2009, Arrais et al 2010 showing that social anxiety has low emotion identification and discrimination skills.…”

Section: Discussionmentioning

confidence: 99%

Predictive Effect of Social Cognitive Skills on Social Anxiety

KAVAL>

Arkar

2022

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry

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Bu çalışmanın temel amacı sosyal kaygı ile sosyal biliş becerileri (duygu tanıma/ayırt etme, zihin kuramı, atıf yanlılığı, sosyal işlevsellik) arasındaki ilişkiyi incelemek ve sosyal biliş becerilerinin sosyal kaygıyı yordama gücünü araştırmaktır. Çalışmada ayrıca sosyal kaygı, sosyal biliş becerileri ve depresyon puanlarının cinsiyet, yaş, bildirilen tanı durumu ve sosyal kaygı düzeyine göre farklılaşıp farklılaşmadığı araştırılmıştır. Çalışmanın örneklemini, 18-60 yaşları arasında bulunan toplam 385 kişi oluşturmuştur. Araştırma verileri çevrimiçi olarak Liebowitz Sosyal Anksiyete Ölçeği, Yüzde Dışavuran Duyguların Tanınması ve Ayırt Edilmesi Testi, Gözlerden Zihin Okuma Testi, İçsel, Kişisel ve Durumsal Atıflar Ölçeği, Sosyal İşlevsellik Ölçeği, Beck Depresyon Envanteri ve Sosyodemografik Bilgi Formu kullanılarak katılımcılardan toplanmıştır. Sosyal kaygı ile duygu tanıma, duygu ayırt etme ve gözlerden zihin okuma arasında negatif, dışsallaştırma yanlılığı ve depresyon ile ise pozitif yönde anlamlı ilişki olduğu belirlenmiştir. Depresyon, duygu tanıma ve ayırt etme, gözlerden zihin okuma ve öncül sosyal etkinlikler ölçek puanlarının sosyal kaygıyı anlamlı düzeyde yordadığı bulunmuştur. Bu değişkenler sosyal kaygıya ilişkin toplam varyansın %52’sini açıklamaktadır. Ayrıca, depresyon etkisi kontrol edildiğinde sosyal biliş becerilerinin sosyal kaygıya ilişkin varyansın %32’sini açıkladığı görülmüştür. Sosyal biliş becerilerindeki bozulmanın ve depresyon puanlarının sosyal kaygının artışıyla ilişkili olduğu belirlenmiştir. Araştırmadan elde edilen sonuçlara göre, sosyal kaygıyı önlemeye yönelik önerilerde bulunulmuştur. Müdahale programları içerisinde bireylerin kişilerarası iletişimi için önemli olan sosyal biliş becerilerini geliştirmeye yönelik etkinliklere yer verilmesinin yararlı olacağı önerilmektedir.

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Association between Amygdala Hyperactivity to Harsh Faces and Severity of Social Anxiety in Generalized Social Phobia

Cited by 468 publications

References 45 publications

Influence of the fusiform gyrus on amygdala response to emotional faces in the non-clinical range of social anxiety

A conceptual model of risk and protective factors associated with internalizing symptoms in autism spectrum disorder: A scoping review, synthesis, and call for more research

Diagnostic Features of Emotional Expressions Are Processed Preferentially

Neural effects of a short-term virtual reality self-training program to reduce social anxiety

The prevalence of specific phobia and associated co-morbid features in children and adolescents

Human emotion processing accuracy, negative biases, and fMRI activation are associated with childhood trauma

Amygdala hypersensitivity in response to emotional faces in Tourette's patients

sLORETA and fMRI Detection of Medial Prefrontal Default Network Anomalies in Adult ADHD

Reappraisal of Interpersonal Criticism in Social Anxiety Disorder: A Brain Network Hierarchy Perspective

Predictive Effect of Social Cognitive Skills on Social Anxiety

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