Neural activity during self-referential working memory and the underlying role of the amygdala in social anxiety disorder

Yoon, Hongsik; Kim, Jin-Seong; Shin, Yu Bin; Choi, Seong Hee; Lee, Seung Koo; Kim, Jae Jin

doi:10.1016/j.neulet.2016.05.068

Cited by 23 publications

(15 citation statements)

References 62 publications

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“…A recent fMRI study found increased activation in the ToM-related regions as well as the CMS and insula during self-referential working memory tasks in SAD 86). In this study, subjects underwent fMRI scanning while performing a working memory task consisting of faces with self-referential positive or negative evaluative comments.…”

Section: Main Findingsmentioning

confidence: 96%

“…Considering the excessive preoccupation with the evaluation by others in SAD, these patients may excessively monitor not only their performance or mental representations but also the mental state of others, indicating the dysfunction of brain regions involved in ToM. Several fMRI studies on SAD examining the mentalizing or SRP reported abnormal activation of the ToM-related regions 78,85,86)…”

Section: Main Findingsmentioning

confidence: 99%

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Neural Correlates of Self-referential Processing and Their Clinical Implications in Social Anxiety Disorder

Yoon

Seo

Kim

et al. 2019

Clin Psychopharmacol Neurosci

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Social anxiety disorder (SAD) is associated with aberrant self-referential processing (SRP) such as increased self-focused attention. Aberrant SRP is one of the core features of SAD and is also related to therapeutic interventions. Understanding of the underlying neural correlates of SRP in SAD is important for identifying specific brain regions as treatment targets. We reviewed functional magnetic resonance imaging (fMRI) studies to clarify the neural correlates of SRP and their clinical implications for SAD. Task-based and resting fMRI studies have reported the cortical midline structures including the default mode network, theory of mind-related regions of the temporo-parietal junction and temporal pole, and the insula as significant neural correlates of aberrant SRP in SAD patients. Also, these neural correlates are related to clinical improvement on pharmacological and cognitive-behavioral treatments. Furthermore, these could be candidates for the development of novel SAD treatments. This review supports that neural correlates of SAD may be significant biomarkers for future pathophysiology based treatment.

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Section: Main Findingsmentioning

confidence: 96%

Section: Main Findingsmentioning

confidence: 99%

Neural Correlates of Self-referential Processing and Their Clinical Implications in Social Anxiety Disorder

Yoon

Seo

Kim

et al. 2019

Clin Psychopharmacol Neurosci

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“…Additionally, as hypothesized, negative self-referential processing (negative>neutral) was associated with stronger activation of the left insula in social anxiety disorder. This hyperactivation seems to reflect the aversive response or hypervigilance to negative self-referential stimuli [44][45][46].…”

Section: Xsl • Fomentioning

confidence: 99%

Virtual Reality–Based Psychotherapy in Social Anxiety Disorder: fMRI Study Using a Self-Referential Task

Hur¹,

Shin²,

Jung³

et al. 2021

JMIR Ment Health

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Background Although it has been well demonstrated that the efficacy of virtual reality therapy for social anxiety disorder is comparable to that of traditional cognitive behavioral therapy, little is known about the effect of virtual reality on pathological self-referential processes in individuals with social anxiety disorder. Objective We aimed to determine changes in self-referential processing and their neural mechanisms following virtual reality treatment. Methods We recruited participants with and without a primary diagnosis of social anxiety disorder to undergo clinical assessments (Social Phobia Scale and Post-Event Rumination Scale) and functional magnetic resonance imaging (fMRI) scans. Participants with social anxiety disorder received virtual reality–based exposure treatment for 6 sessions starting immediately after baseline testing. After the sixth session, participants with social anxiety disorder completed follow-up scans during which they were asked to judge whether a series of words (positive, negative, neutral) was relevant to them. Results Of 25 individuals with social anxiety disorder who participated in the study, 21 completed the sessions and follow-up; 22 control individuals also participated. There were no significant differences in age (P=.36), sex (P=.71), or handedness (P=.51) between the groups. Whole-brain analysis revealed that participants in the social anxiety disorder group had increased neural responses during positive self-referential processing in the medial temporal and frontal cortexes compared with those in the control group. Participants in the social anxiety disorder group also showed increased left insular activation and decreased right middle frontal gyrus activation during negative self-referential processing. After undergoing virtual reality–based therapy, overall symptoms of the participants with social anxiety disorder were reduced, and these participants exhibited greater activity in a brain regions responsible for self-referential and autobiographical memory processes while viewing positive words during postintervention fMRI scans. Interestingly, the greater the blood oxygen level dependent changes related to positive self-referential processing, the lower the tendency to ruminate on the negative events and the lower the social anxiety following the virtual reality session. Compared with that at baseline, higher activation was also found within broad somatosensory areas in individuals with social anxiety disorder during negative self-referential processing following virtual reality therapy. Conclusions These fMRI findings might reflect the enhanced physiological and cognitive processing in individuals with social anxiety disorder in response to self-referential information. They also provide neural evidence of the effect of virtual reality exposure therapy on social anxiety and self-derogation.

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“…Video-feedback may combat distorted mental representations by providing corrective learning experiences (Harvey et al, 2000). While several investigations have explored self-referential processing in response to language cues (i.e., criticism and praise; Blair et al, 2008;Abraham et al, 2013;Yoon et al, 2016) or in subclinical samples (Abraham et al, 2013), the neural mechanisms of self-referential processing in regard to videos of the self in SAD are not well understood. Given the importance of self-referential video feedback for treatment, it is important to further understand the neural mechanisms underlying this task.…”

Section: Introductionmentioning

confidence: 99%

Self-referential processing during observation of a speech performance task in social anxiety disorder from pre- to post-treatment: Evidence of disrupted neural activation

Brown

Young

Goldin

et al. 2019

Psychiatry Research: Neuroimaging

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Neural activity during self-referential working memory and the underlying role of the amygdala in social anxiety disorder

Cited by 23 publications

References 62 publications

Neural Correlates of Self-referential Processing and Their Clinical Implications in Social Anxiety Disorder

Neural Correlates of Self-referential Processing and Their Clinical Implications in Social Anxiety Disorder

Virtual Reality–Based Psychotherapy in Social Anxiety Disorder: fMRI Study Using a Self-Referential Task

Self-referential processing during observation of a speech performance task in social anxiety disorder from pre- to post-treatment: Evidence of disrupted neural activation

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