The Pathology of Social Phobia Is Independent of Developmental Changes in Face Processing

Abstract

Objective While social phobia (SP) in adolescence predicts risk for SP in adulthood, no work has directly compared neural responses in SP adults and adolescents. The current study examines neural response to facial expressions in adult and adolescent SP to determine whether the neural correlates of adult SP during face processing also manifest in adolescent SP. Method Blood oxygen level-dependent (BOLD) was compared in 39 medication-free individuals with SP (25 adults and 14 adolescents), and 39 healthy comparison individuals (23 adult and 16 adolescent) matched on age, IQ, and gender using functional magnetic resonance imaging (fMRI). During fMRI scans, individuals saw angry, fearful, and neutral expression stimuli while making a gender judgment. Results Hypothesized significant diagnosis-by-emotion interactions were observed within the amygdala and rostral anterior cingulate cortex (rACC). In these regions, the adolescent and adult SP patients both showed significantly increased BOLD responses, relative to their respective age-matched comparison groups, with no evidence of age-related modulation of between-group differences. These enhanced responses occurred specifically to angry (rACC) and fearful (amygdala and rACC) but not neutral expressions. In addition, SP severity correlated significantly with this enhanced rACC response in the adults. Conclusions The neural correlates of adult SP during face processing also manifest in adolescents. As such, neural correlates observed in adult SP may represent the persistence of profiles established earlier in life, rather than adaptive responses to such earlier perturbations or maturational changes. These cross-sectional observations might encourage longitudinal fMRI studies of adolescent SP.

Overview of Cognitive Function in ALS, with Special Attention to the Temporal Lobe: Semantic Fluency and Rating the Approachability of Faces

“…Baron-Cohen et al, 2001), or patients with anxiety disorder or social phobia, which have both been linked to hyperactivity of the amygdala (e.g. Freitas-Ferrari et al, 2010;Blair et al, 2011). Clinically, this patient population might not be easily recognized if not specifically probed by the examiner during history taking.…”

Common and distinct neural correlates of facial emotion processing in social anxiety disorder and Williams syndrome: A systematic review and voxel-based meta-analysis of functional resonance imaging studies

“…In general, most of the available studies found greater response of the amygdala to threat-related facial expressions in SAD individuals compared to HC (Blair et al, 2011(Blair et al, , 2008Cooney, Atlas, Joormann, Eugène, & Gotlib, 2006;Evans et al, 2008;Gentili et al, 2008;Klumpp, Angstadt, & Phan, 2012;Klumpp, Angstadt, Nathan, & Phan, 2010;Phan, Fitzgerald, Nathan, & Tancer, 2006;Stein, Goldin, Sareen, Zorrilla, & Brown, 2002;Straube, Kolassa, Glauer, Mentzel, & Miltner, 2004;Straube, Mentzel, & Miltner, 2005;Yoon, Fitzgerald, Angstadt, McCarron, & Phan, 2007); but see (Goldin, Manber, Hakimi, Canli, & Gross, 2009;Ziv, Goldin, Jazaieri, Hahn, & Gross, 2013). However, other paralimbic regions such as the insula and the parahippocampal gyrus also appeared to exhibit greater activation in SAD subjects (Amir et al, 2005;Blair et al, 2008Blair et al, , 2011Evans et al, 2008;Gentili et al, 2008;Goldin et al, 2009;Klumpp et al, 2010Klumpp et al, , 2012Klumpp, Post, Angstadt, Fitzgerald, & Phan, 2013;Phan et al, 2006;Yoon et al, 2007).…”

Beyond emotions: A meta-analysis of neural response within face processing system in social anxiety

“…As far as the HC > SAD, 12 out of the 23 included studies explicitly stated that they had performed the comparison HC > SAD. Among these studies the comparison yielded significant differences in only six studies 8,28,33,[35][36][37] and non-significant results in the other six. For the studies that did not explicitly report the contrast, we asked authors for the results of the contrast.…”