Neural bases of social anxiety disorder: emotional reactivity and cognitive regulation during social and physical threat

Feasibility and acceptability of an online group dialectical behavioural therapy skills training in a Transdiagnostic group with Anxiety and Depression

Transdiagnostic approaches offers a paradigm shift in managing psychiatric disorders. Emotion regulation difficulties are a transdiagnostic prevalent across various mood and personality disorders. Dialectical Behavioural Therapy Skills Training (DBT-ST), initially designed as part of treatment for borderline personality disorder, targets emotion regulation and has shown promise in diverse psychiatric conditions. In lower middle-income countries with resource-constrained settings, online delivery of evidence-based interventions holds potential to bridge treatment gaps. This study assesses the feasibility and acceptability of online group DBT skills training for individuals with depression or anxiety disorders in India. Mental health professionals practising in India referred twenty-four eligible participants currently not engaged in psychotherapy. Of these, 18 initiated the 8-week virtual group DBT-ST program, with 12 completing it (66 % female, 18-35 years of age, 5 on concurrent medication). They provided feedback on therapy content's usefulness. Baseline, post-intervention, and one-month follow-up assessments measured changes in emotion regulation difficulties, depression, and anxiety symptoms. Treatment retained 66.7 % of participants, all participants found the intervention beneficial. Repeated measures ANOVA indicates significant reductions in self-reported difficulties in emotion regulation, depression, and anxiety symptoms post-intervention. These findings highlight the promise of transdiagnostic interventions like DBT-ST that merit further evaluations using RCTs with larger sample sizes.

The effect of working memory load on selective attention to emotional faces for social anxiety individuals

Research has confirmed that individuals with social anxiety (SA) show an attentional bias towards threat-related stimuli. However, the extent to which this attentional bias depends on top-down cognitive control processes remains controversial. The present study investigated the effect of working memory (WM) load on selective attention to emotional faces in both high social anxiety (HSA) and low social anxiety (LSA) groups by manipulating WM load through the inclusion of forward counting in multiples of two (low load) or backward counting in multiples of seven (high load) within a modified flanker task. In the flanker task, emotional faces (angry, happy, or neutral faces) were used as targets and distractors. A total of 70 participants (34 HSA participants; 36 LSA participants) completed the flanker task in the laboratory. The results showed that the HSA individuals performed worse when responding to angry targets. Relative to LSA individuals, HSA individuals showed interference from angry distractors in the flanker task, resulting in significantly lower accuracy in identifying angry targets compared to happy targets. These results were unaffected by the manipulation of WM load. The findings imply HSA individuals have impaired attentional control, and that their threat-related attentional bias relies more on the bottom-up automatic attentional process.

Zinc oxide nanoparticles damage the prefrontal lobe in mouse: Behavioral impacts and key mechanisms

Zinc Oxide nanoparticles (ZnO NPs) have dualistic properties due to their advantage and toxicity. However, the impact and mechanisms of ZnO NPs on the prefrontal lobe have limited research. This study investigates the behavioral changes following exposure to ZnO NPs (34 mg/kg, 30 days), integrating multiple behaviors and bioinformatics analysis to identify critical factors and regulatory mechanisms. The essential differentially expressed genes (DEGs) were identified, including ORC1, DSP, AADAT, SLITRK6, and STEAP1. Analysis of the DEGs based on fold change reveals that ZnO NPs primarily regulate cell survival, proliferation, and apoptosis in neural cells, damaging the prefrontal lobe. Moreover, disruption of cell communication, mineral absorption, and immune pathways occurs. Gene set enrichment analysis (GSEA) further shows enrichment of behavior, neuromuscular process, signal transduction in function, synapses-related, cAMP signaling, and immune pathways. Furthermore, alternative splicing (AS) genes highlight synaptic structure/function, synaptic signal transduction, immune responses, cell proliferation, and communication.

Neural correlates of individual differences in moral identity and its positive moral function

Moral identity is an important moral variable which has positive moral functions, such as contributing to prosocial behaviours, reducing antisocial behaviours, and resisting the risk factors of antisocial behaviours. However, little is known about the neural correlates of moral identity and the neural basis of the effect of moral identity on the risk factors of antisocial behaviours, including moral disengagement. In this study, we explored these issues in 142 college students by estimating the regional homogeneity (ReHo) through resting-state functional magnetic resonance imaging (fMRI). The whole-brain correlation analyses found that higher internalized moral identity was correlated with higher ReHo in the precuneus. Furthermore, the ReHo in the precuneus was negatively correlated with moral disengagement, suggesting positive moral functions of the neural mechanisms of moral identity. These findings deepen our understanding of individual differences in moral identity and provide inspiration for the education of moral identity and the intervention for moral disengagement from the perspective of the brain.

Connection of social anxiety to impaired pattern of cognitive control and underlying motivational deficiencies: Evidence from event-related potentials

Numerous studies have established a correlation between social anxiety and poor cognitive control. However, little is known about the cognitive control pattern of individuals with high social anxiety (HSAs) and the underlying mechanisms. Based on the Dual Mechanisms of Control framework and the Expected Value of Control theory, this study explored whether HSAs have an impaired cognitive control pattern (Experiment 1) and whether motivational deficiencies underlie the impaired control pattern (Experiment 2). In Experiment 1, 21 individuals with low social anxiety (LSAs) and 21 HSAs completed an AX-Continuous Performance Task. Results showed that HSAs had a smaller P3b amplitude than LSAs, indicating their weakened proactive control in the cue processing stage, but a larger contingent negative variation (CNV) on cue B as compensation for the negative effects of anxiety in the response preparation stage. No group difference was found in N2 and P3a amplitude on probes, suggesting that reactive control in HSAs was not affected compared to LSAs. In Experiment 2, 21 LSAs and 21 HSAs completed a cued-flanker task, where the likelihood of proactive control engagement was manipulated. The results revealed that HSAs exhibited motivation deficiencies in engaging in proactive control, as evidenced by P3b, CNV amplitude, and response times. These findings shed light on the impaired cognitive control pattern of HSAs and suggest that motivational deficiencies may be the crucial underlying factor.

Brain oscillations during emotion regulation and the two-dimensional model of adult attachment

Emotion Regulation (ER) refers to the processes by which individuals influence their own emotions. It is a crucial aspect of human behavior, affecting everything from interpersonal relationships to mental health. The relationship between ER and Attachment Theory (AT) is pivotal. AT suggests that early bonds with primary caregivers influence future relationship expectations and behaviors. These initial experiences shape internal models of self and others, affecting how individuals regulate their emotions. Understanding the interplay between ER and AT is essential for comprehending the human affective system. In this study, we explored the neural underpinnings of ER, focusing on two distinct strategies: cognitive reappraisal and expressive suppression. Using electroencephalography (EEG), we examined changes in neural oscillations from 52 adults during an ER task. Specifically, we observed increased frontal theta activity (3-6 Hz) during reappraisal compared to suppression strategies. This frontal theta activity suggests enhanced cognitive control engagement. Conversely, during suppression, we noted a decrease in beta frequency (15-30 Hz) activity from central electrodes, indicative of differing neural processes. Further integrating psychological theories, we explored the relationship between these neural markers and dimensions of human attachment. Employing the Experiences in Close Relationships-12 scale (ECR-12), we identified a negative correlation between attachment anxiety and frontal theta activity. Lower levels of attachment anxiety were associated with increased theta activity, reflecting potentially more effective emotion regulation. Additionally, we found that higher theta activity corresponded with fewer difficulties in emotional control measured by the Difficulties in Emotion Regulation Scale (DERS). Regarding central beta activity, our findings revealed an interesting correlation with Emotional Inattention, a concept tied to Attachment Avoidance. This suggests that central beta activity may serve as a neural marker for specific attachment-related ER processing. These results highlight the distinct neural pathways involved in different ER strategies and their relationship with the AT and neural responses during emotional processing.

Emotion regulation unveiled through the categorical lens of attachment

BACKGROUND

Emotion regulation, the process by which individuals manage and modify their emotional experiences, expressions, and responses to adaptively navigate and cope with various situations, plays a crucial role in daily life. Our study investigates the variations in emotion regulation strategies among individuals with different attachment styles (AS). Specifically, we examine how individuals with secure, anxious, avoidant, and fearful attachment styles effectively utilize cognitive reappraisal and expressive suppression to regulate their emotions.

METHODS

A total of n = 98 adults were instructed to attend, reappraise, or suppress their emotions while viewing negative and neutral images from the International Affective Picture System (IAPS) in an experimental emotion regulation task. After completing the task, participants rated the valence and arousal elicited by the images. Attachment styles were measured using the ECR-12 questionnaire and then categorized into four AS.

RESULTS

Our study revealed that individuals with secure AS (n = 39) effectively reduced displeasure through cognitive reappraisal but experienced levels of displeasure with expressive suppression. Anxious AS (n = 16) individuals successfully reduced displeasure using cognitive reappraisal but struggled to regulate arousal and effectively use expressive suppression. Avoidant AS (n = 24) individuals could reduce displeasure with both strategies but experienced high arousal during suppression attempts. Fearful AS (n = 19) individuals effectively regulated both displeasure and arousal using either strategy. However, Secure AS individuals showed superior reappraisal efficacy, significantly reducing arousal levels compared to the Fearful AS group. Both Secure and Avoidant AS groups experienced higher valence during reappraisal relative to a baseline, indicating a decrease in displeasure.

CONCLUSIONS

Individuals with different AS exhibit variations in the effectiveness of their use of emotion regulation strategies. Our findings reinforce the significance of AS in shaping emotion regulation processes and emphasize the need for tailored approaches to support individuals with different attachment orientations.

Resting-state neural correlates of individual differences in ignored experience and its deleterious effect

Uncovering the neural mechanisms of ostracism experience (including its subclasses of excluded and ignored experiences) is important. However, the resting-state functional brain substrates responsible for individual differences in ostracism experience and its negative effects remain largely undefined. This study explored these issues in a sample of 198 Chinese college students by assessing the amplitude of low-frequency fluctuations and functional connectivity. The findings indicated a positive correlation between ignored experience and the amplitude of low-frequency fluctuations in the right superior frontal gyrus and the functional connectivity between the right superior frontal gyrus and left cerebellum posterior lobe. Additionally, a negative correlation was found between ignored experience and the functional connectivity between the right superior frontal gyrus and the bilateral insula as well as the bilateral inferior parietal lobule. Moreover, the mediation analysis demonstrated that the effects of the functional connectivities of right superior frontal gyrus-left cerebellum posterior lobe and right superior frontal gyrus-right inferior parietal lobule on revenge intention were mediated by ignored experience. Our study offers novel insights into the neural correlates of both individual variations in ignored experience and its typical deleterious effect. These results could deepen our understanding of individual differences in negative experiences and inspire the development of targeted interventions for social stress from the perspective of the brain.

Can dialectical behavior therapy skills group treat social anxiety disorder? A brief integrative review

The purposes of this brief integrative review are to identify and critically evaluate recent work in the area of Dialectical Behavior Therapy-Skills Group (DBT-SG) for Social Anxiety Disorder (SAD) with suicidal ideation (SI) and to suggest further how DBT-based skills may be applied to cognitive maintenance factors of SAD. Accordingly, we first evaluate the relevance of DBT in treating SI in other disorders. Second, we evaluate the relationship between SI and SAD, providing considerations for the complexity of comorbid disorders and presentations. Finally, we extend this knowledge to discuss considerations for the use of DBT-SG skills to target specific etiological and maintenance elements of SAD, with a focus on four themes (interpersonal effectiveness, mindfulness, emotion regulation, and distress tolerance). Overall, we conclude that DBT-SG may prove beneficial in reducing SI and symptoms in SAD that impact social and emotional functioning.

The role of interpretation biases and safety behaviours in social anxiety: an intensive longitudinal study

BACKGROUND

Interpretation bias and safety behaviours (Safe-B) have been proposed as factors perpetuating social anxiety (SA). However, longitudinal research on how they contribute to SA in everyday life is scarce.

AIM

The aim was to examine whether interpretation bias predicts daily Safe-B and SA. A mediated moderation was hypothesized, where the relationship between daily social stressors and Safe-B would be moderated by interpretation bias, and Safe-B, in turn, would mediate the association between stressors and SA levels. In addition, it was hypothesized that prior levels of SA would predict higher Safe-B use, especially in co-occurrence with stressors.

METHOD

An intensive longitudinal design was employed, with 138 vocational training students (51% men, mean age 20.15 years). They completed initial measures of SA and interpretation bias and 7-day diaries with measures of social stressors, Safe-B, and SA. They reported SA levels two months later.

RESULTS

Both stressors and interpretation bias in ambiguous situations predicted Safe-B, which in turn predicted daily SA levels. However, neither interpretation bias nor Safe-B predicted SA levels at the follow-up, and interpretation bias did not moderate the association between stressors and daily SA. In addition, the relationship between stressors and Safe-B was stronger in people with higher initial SA levels.

CONCLUSIONS

The results suggest that Safe-B are a mechanism through which earlier SA levels and interpretation bias contribute to higher SA levels in daily life.

Neural correlates of social interaction anxiety and their relation to emotional intelligence: A resting-state fMRI study

Social interaction anxiety refers to a state of anxiety resulting from the prospect or presence of interpersonal evaluation in real or imagined social settings. Previous neuroimaging studies have revealed neural basis of social anxiety disorder. However, little is known about the neural correlates of individual differences in social interaction anxiety in nonclinical population. In the present study, we used resting-state functional magnetic resonance imaging to explore the relationship between individual's spontaneous neural activity and social interaction anxiety, and the role that emotional intelligence played in the relationship. To this end, the correlation between the regional fractional amplitude of low-frequency fluctuations (fALFF) of the brain and individuals' social interaction anxiety scores was examined. We found that social interaction anxiety was correlated with the fALFF in the insula, parahippocampal gyrus, bilateral superior temporal gyrus, and superior parietal lobule. Furthermore, we also found that emotional intelligence partially mediated the association between the fALFF in these regions and social interaction anxiety. Taken together, our study provided the first evidence for the spontaneous neural basis of social interaction anxiety in normal population, and highlighted the neural substrates through which emotional intelligence might play an important role in social interaction anxiety.

Understanding Mental Health Issues in Different Subdomains of Social Networking Services: Computational Analysis of Text-Based Reddit Posts

BACKGROUND

Users increasingly use social networking services (SNSs) to share their feelings and emotions. For those with mental disorders, SNSs can also be used to seek advice on mental health issues. One available SNS is Reddit, in which users can freely discuss such matters on relevant health diagnostic subreddits.

OBJECTIVE

In this study, we analyzed the distinctive linguistic characteristics in users' posts on specific mental disorder subreddits (depression, anxiety, bipolar disorder, borderline personality disorder, schizophrenia, autism, and mental health) and further validated their distinctiveness externally by comparing them with posts of subreddits not related to mental illness. We also confirmed that these differences in linguistic formulations can be learned through a machine learning process.

METHODS

Reddit posts uploaded by users were collected for our research. We used various statistical analysis methods in Linguistic Inquiry and Word Count (LIWC) software, including 1-way ANOVA and subsequent post hoc tests, to see sentiment differences in various lexical features within mental health-related subreddits and against unrelated ones. We also applied 3 supervised and unsupervised clustering methods for both cases after extracting textual features from posts on each subreddit using bidirectional encoder representations from transformers (BERT) to ensure that our data set is suitable for further machine learning or deep learning tasks.

RESULTS

We collected 3,133,509 posts of 919,722 Reddit users. The results using the data indicated that there are notable linguistic differences among the subreddits, consistent with the findings of prior research. The findings from LIWC analyses revealed that patients with each mental health issue show significantly different lexical and semantic patterns, such as word count or emotion, throughout their online social networking activities, with P<.001 for all cases. Furthermore, distinctive features of each subreddit group were successfully identified through supervised and unsupervised clustering methods, using the BERT embeddings extracted from textual posts. This distinctiveness was reflected in the Davies-Bouldin scores ranging from 0.222 to 0.397 and the silhouette scores ranging from 0.639 to 0.803 in the former case, with scores of 1.638 and 0.729, respectively, in the latter case.

CONCLUSIONS

By taking a multifaceted approach, analyzing textual posts related to mental health issues using statistical, natural language processing, and machine learning techniques, our approach provides insights into aspects of recent lexical usage and information about the linguistic characteristics of patients with specific mental health issues, which can inform clinicians about patients' mental health in diagnostic terms to aid online intervention. Our findings can further promote research areas involving linguistic analysis and machine learning approaches for patients with mental health issues by identifying and detecting mentally vulnerable groups of people online.

Pre-COVID brain network topology prospectively predicts social anxiety alterations during the COVID-19 pandemic

Background

Social anxiety (SA) is a negative emotional response that can lead to mental health issues, which some have experienced during the coronavirus disease 2019 (COVID-19) pandemic. Little attention has been given to the neurobiological mechanisms underlying inter-individual differences in SA alterations related to COVID-19. This study aims to identify neurofunctional markers of COVID-specific SA development.

Methods

110 healthy participants underwent resting-state magnetic resonance imaging and behavioral tests before the pandemic (T1, October 2019 to January 2020) and completed follow-up behavioral measurements during the pandemic (T2, February to May 2020). We constructed individual functional networks and used graph theoretical analysis to estimate their global and nodal topological properties, then used Pearson correlation and partial least squares correlations examine their associations with COVID-specific SA alterations.

Results

In terms of global network parameters, SA alterations (T2-T1) were negatively related to pre-pandemic brain small-worldness and normalized clustering coefficient. In terms of nodal network parameters, SA alterations were positively linked to a pronounced degree centrality pattern, encompassing both the high-level cognitive networks (dorsal attention network, cingulo-opercular task control network, default mode network, memory retrieval network, fronto-parietal task control network, and subcortical network) and low-level perceptual networks (sensory/somatomotor network, auditory network, and visual network). These findings were robust after controlling for pre-pandemic general anxiety, other stressful life events, and family socioeconomic status, as well as by treating SA alterations as categorical variables.

Conclusions

The individual functional network associated with SA alterations showed a disrupted topological organization with a more random state, which may shed light on the neurobiological basis of COVID-related SA changes at the network level.

Large-scale brain functional network abnormalities in social anxiety disorder

BACKGROUND

Although aberrant brain regional responses are reported in social anxiety disorder (SAD), little is known about resting-state functional connectivity at the macroscale network level. This study aims to identify functional network abnormalities using a multivariate data-driven method in a relatively large and homogenous sample of SAD patients, and assess their potential diagnostic value.

METHODS

Forty-six SAD patients and 52 demographically-matched healthy controls (HC) were recruited to undergo clinical evaluation and resting-state functional MRI scanning. We used group independent component analysis to characterize the functional architecture of brain resting-state networks (RSNs) and investigate between-group differences in intra-/inter-network functional network connectivity (FNC). Furtherly, we explored the associations of FNC abnormalities with clinical characteristics, and assessed their ability to discriminate SAD from HC using support vector machine analyses.

RESULTS

SAD patients showed widespread intra-network FNC abnormalities in the default mode network, the subcortical network and the perceptual system (i.e. sensorimotor, auditory and visual networks), and large-scale inter-network FNC abnormalities among those high-order and primary RSNs. Some aberrant FNC signatures were correlated to disease severity and duration, suggesting pathophysiological relevance. Furthermore, intrinsic FNC anomalies allowed individual classification of SAD v. HC with significant accuracy, indicating potential diagnostic efficacy.

CONCLUSIONS

SAD patients show distinct patterns of functional synchronization abnormalities both within and across large-scale RSNs, reflecting or causing a network imbalance of bottom-up response and top-down regulation in cognitive, emotional and sensory domains. Therefore, this could offer insights into the neurofunctional substrates of SAD.

Emotion regulation of social pain: double dissociation of lateral prefrontal cortices supporting reappraisal and distraction

The dorsolateral prefrontal cortex (DLPFC) and ventrolateral prefrontal cortex (VLPFC) are both crucial regions involved in voluntary emotion regulation. However, it remains unclear whether the two regions show functional specificity for reappraisal and distraction. This study employed transcranial magnetic stimulation (TMS) to explore, in a real social interactive scenario, whether different lateral prefrontal regions play relatively specific roles in downregulating social pain via reappraisal and distraction. Participants initially took part in a social interactive game, followed by receiving either active (the DLPFC- or VLPFC-activated group, n = 100 per group) or control (the vertex-activated group, n = 100) TMS session. They were then instructed to use both distraction and reappraisal strategies to downregulate any negative emotions evoked by the social evaluation given by their peers who interacted with them previously. Results demonstrated that the TMS-activated DLPFC has a greater beneficial effect during distraction, whereas the activated VLPFC has a greater beneficial effect during reappraisal. This result investigated the direct experience of social pain and extended previous findings on empathy-related responses to affective pictures while also controlling for confounding factors such as empathic concern. Therefore, we are now confident in the double dissociation proposal of the DLPFC and VLPFC in distraction and reappraisal.

Disrupted brain gray matter connectome in social anxiety disorder: a novel individualized structural covariance network analysis

Phenotyping approaches grounded in structural network science can offer insights into the neurobiological substrates of psychiatric diseases, but this remains to be clarified at the individual level in social anxiety disorder (SAD). Using a recently developed approach combining probability density estimation and Kullback-Leibler divergence, we constructed single-subject structural covariance networks (SCNs) based on multivariate morphometry (cortical thickness, surface area, curvature, and volume) and quantified their global/nodal network properties using graph-theoretical analysis. We compared network metrics between SAD patients and healthy controls (HC) and analyzed the relationship to clinical characteristics. We also used support vector machine analysis to explore the ability of graph-theoretical metrics to discriminate SAD patients from HC. Globally, SAD patients showed higher global efficiency, shorter characteristic path length, and stronger small-worldness. Locally, SAD patients showed abnormal nodal centrality mainly involving left superior frontal gyrus, right superior parietal lobe, left amygdala, right paracentral gyrus, right lingual, and right pericalcarine cortex. Altered topological metrics were associated with the symptom severity and duration. Graph-based metrics allowed single-subject classification of SAD versus HC with total accuracy of 78.7%. This finding, that the topological organization of SCNs in SAD patients is altered toward more randomized configurations, adds to our understanding of network-level neuropathology in SAD.

Comparing reappraisal and acceptance strategies to understand the neural architecture of emotion regulation: a meta-analytic approach

Introduction

In the emotion regulation literature, the amount of neuroimaging studies on cognitive reappraisal led the impression that the same top-down, control-related neural mechanisms characterize all emotion regulation strategies. However, top-down processes may coexist with more bottom-up and emotion-focused processes that partially bypass the recruitment of executive functions. A case in point is acceptance-based strategies.

Method

To better understand neural commonalities and differences behind different emotion regulation processes, in the present study, we applied the Activation Likelihood Estimation (ALE) method to perform a meta-analysis on fMRI studies investigating task-related activity of reappraisal and acceptance. Both increased and decreased brain activity was taken into account in the contrast and conjunction analysis between the two strategies.

Results

Results showed increased activity in left-inferior frontal gyrus and insula for both strategies, and decreased activity in the basal ganglia for reappraisal, and decreased activity in limbic regions for acceptance.

Discussion

These findings are discussed in the context of a model of common and specific neural mechanisms of emotion regulation that support and expand the previous dual-routes models. We suggest that emotion regulation may rely on a core inhibitory circuit, and on strategy-specific top-down and bottom-up processes distinct for different strategies.

Associations between resting-state neural connectivity and positive affect in social anxiety disorder

INTRODUCTION

Social anxiety disorder (SAD) has been characterized by deficits in social motivation and lack of reactivity to pleasurable stimuli (i.e., positive affect; [PA]). Recent neuroimaging work has shifted toward examining positively valenced motivational systems in SAD focused on reward responses. However, little is known about the associations of reward connectivity and PA in individuals with SAD. As such, the purpose of the current study was to determine whether connectivity among key units of reward neurocircuitry meaningfully relate to PA and whether these key units are more heterogeneous in SAD as compared to controls.

METHODS

Thirty-one participants who met diagnostic criteria for SAD and 33 control participants were included (Mage = 24.8, SD = 6.9; 55% cisgender man). Seed-based timeseries correlations were conducted in NiTime to extract region of interest (ROI) coupling correlation strength values. ANOVAs were carried out to assess whether individuals with SAD differed in ROI-to-ROI connectivity strength as compared to controls. Correlations and variance analyses were also conducted to examine the relationship between ROI-to-ROI connectivity strength and PA, as well as heterogeneity in connectivity strength and PA expression.

RESULTS

Weaker connectivity between the left and right orbital frontal cortex was observed when comparing the SAD to the control group. Within the SAD group, PA was associated with several reward-related ROI couplings; however, these links were not observed among controls. Results further demonstrated that individuals with SAD had significantly more variability in reward connectivity strength as compared to controls.

CONCLUSION

Overall, these results provide emergent evidence for the association between reward regions and PA in individuals with SAD. Additionally, these findings show that individuals with SAD demonstrate greater heterogeneity in reward connectivity.

Topography of the Anxious Self: Abnormal Rest-Task Modulation in Social Anxiety Disorder

Social anxiety disorder (SAD) is characterized by social anxiety/fear, self-attention, and interoception. Functional magnetic resonance imaging studies demonstrate increased activity during symptom-sensitive tasks in regions of the default-mode network (DMN), amygdala (AMG), and salience network (SN). What is the source of this task-unspecific symptom-sensitive hyperactivity in DMN? We address this question by probing SAD resting state (rs) changes in DMN including their relation to other regions as possible source of task-unspecific hyperactivity in the same regions. Our findings show the following: (1) rs-hypoconnectivity within-DMN regions; (2) rs-hyperconnectivity between DMN and AMG/SN; (3) task-evoked hyperactivity in the abnormal rs-regions of DMN and AMG/SN during different symptom-sensitive tasks; (4) negative relationship of rest and task changes in especially anterior DMN regions as their rs-hypoconnectivity is accompanied by task-unspecific hyperactivity; (5) abnormal top-down/bottom-up modulation between anterior DMN regions and AMG during rest and task. Findings demonstrate that rs-hypoconnectivity among DMN regions is negatively related to task-unspecific hyperactivity in DMN and AMG/SN. We propose a model of "Topography of the Anxious Self" in SAD (TAS-SAD). Abnormal DMN-AMG/SN topography during rest, as trait feature of an "unstable social self", is abnormally aggravated during SAD-sensitive situations resulting in task-related hyperactivity in the same regions with an "anxious self" as state feature.

Functional Connectivity Between Basal Forebrain and Superficial Amygdala Negatively Correlates with Social Fearfulness

Social anxiety is characterized by an intense fear of evaluation from others and/or withdrawal from social situations. Extreme social anxiety can lead to social anxiety disorder. There remains an urgent need to investigate the neural substrates of subclinical social anxiety for early diagnosis and intervention to reduce the risk to develop social anxiety disorder. Twenty-nine young adults were recruited (10 males/19 females; mean age (SD) = 20.34 (2.29)). Trait-like social anxiety was assessed by Liebowitz Social Anxiety Scale. Functional magnetic resonance imaging was used with an emotional face-matching paradigm to probe brain activation in response to emotional stimuli including angry, fearful, and happy faces, with shape-matching as a control condition. Behavioral results showed positive correlations between Liebowitz Social Anxiety Scale scores and the reaction time in both angry and fearful conditions. The activation of superficial amygdala and the deactivation of basal forebrain in response to angry condition showed positive correlations with the level of social anxiety. In addition, the resting-state functional connectivity between these two regions was negatively correlated with the level of social anxiety. These results may help to understand the individual difference and corresponding neural underpinnings of social anxiety in the subclinical population, and might provide some insight to develop strategies for early diagnosis and interventions of social anxiety to reduce the risk of deterioration from subclinical to clinical level of social anxiety.

A transdiagnostic evaluation of contrast avoidance across generalized anxiety disorder, major depressive disorder, and social anxiety disorder

BACKGROUND

The contrast avoidance model (CAM) proposes that persons with generalized anxiety disorder (GAD) are sensitive to sharp increases in negative emotion or decreases in positive emotion (i.e., negative emotional contrasts; NEC) and use worry to avoid NEC. Sensitivity to and avoidance of NEC could also be a shared feature of major depressive disorder (MDD) and social anxiety disorder (SAD).

METHODS

In a large college sample (N = 1409), we used receiver operating characteristics analysis to examine the accuracy of a measure of emotional contrast avoidance in detecting probable GAD, MDD, and SAD.

RESULTS

Participants with probable GAD, MDD, and SAD all reported higher levels of contrast avoidance than participants without the disorder (Cohen's d = 1.32, 1.62 and 1.53, respectively). Area under the curve, a measure of predictive accuracy, was 0.81, 0.87, and 0.83 for predicting probable GAD, MDD, and SAD, respectively. A cutoff score of 48.5 optimized predictive accuracy for probable GAD and SAD, and 50.5 optimized accuracy for probable MDD.

CONCLUSION

A measure of emotional contrast avoidance demonstrated excellent ability to predict probable GAD, MDD, and SAD. Sensitivity to and avoidance of NEC appears to be a transdiagnostic feature of these disorders.

Neural Reactivity to Social Punishment Predicts Future Engagement in Nonsuicidal Self-injury Among Peer-Rejected Adolescents

BACKGROUND

Rates of nonsuicidal self-injury (NSSI) increase dramatically in adolescence. Affective reactivity and adverse social experiences have been linked to NSSI, but less is known about whether these factors may separately or interactively predict NSSI, especially longitudinally. This study combined functional magnetic resonance imaging and a sociometric measure to test whether a combination of neural (e.g., amygdala) reactivity to social punishment and peer-nominated peer acceptance/rejection predicts NSSI longitudinally in adolescence. Amygdala reactivity was examined as a potential neural marker of affective reactivity to social punishment, which may heighten NSSI risk in contexts of social adversity.

METHODS

One hundred twenty-five adolescents (63 female) completed a social incentive delay task during neuroimaging and school-based peer nominations to measure peer acceptance/rejection. NSSI engagement was assessed at baseline and 1-year follow-up.

RESULTS

Greater amygdala reactivity to social punishment predicted greater NSSI engagement 1 year later among adolescents with high peer rejection. This effect for the amygdala was specific to social punishment (vs. reward) and held when controlling for biological sex and pubertal development. Exploratory analyses found that ventral striatum reactivity to social reward and punishment similarly interacted with peer rejection to predict NSSI but that amygdala connectivity with salience network regions did not.

CONCLUSIONS

Amygdala reactivity to social punishment, in combination with high peer rejection, may increase NSSI risk in adolescence, possibly via heightened affective reactivity to adverse social experiences. Objective measures of neurobiological and social risk factors may improve prediction of NSSI, while therapeutic approaches that target affective reactivity and increase prosocial skills may protect against NSSI in adolescence.

The brain activation of anxiety disorders with emotional stimuli-an fMRI ALE meta-analysis

Numerous studies have analyzed the state of brain activation about anxiety disorders under emotional stimuli. However, there is no meta-analysis to assess the commonality and specificity activation concerning different subtypes of anxiety. Here, we used ALE to assess this. 29 studies revealed increased bilateral amygdala, anterior cingulate gyrus, parahippocampal gyrus activation in anxiety disorders during emotional stimuli. Moreover, we observed decreased activations in the posterior cingulate, lingual gyrus, and precuneus. In sub-analysis, although different anxiety showed dissimilar activations, the principal activations were observed in limbic lobe, which might indicate the limbic circuit was the main neural reflection of anxiety symptoms.

Functional neural changes associated with psychotherapy in anxiety disorders - A meta-analysis of longitudinal fMRI studies

Successful psychotherapy for anxiety disorders is thought to be linked to functional neural changes in prefrontal control areas and fear-related limbic regions. Thus, discovering such therapy-associated neural changes might point to relevant mechanisms of action. Using AES-SDM, we conducted a coordinate-based meta-analysis of 22 whole-brain datasets (n = 419 anxiety patients) from 18 studies identified by our systematic literature search following PRISMA criteria (preregistration available at OSF: https://osf.io/dgc4p). In these studies, fMRI data was collected in response to negative stimuli during cognitive-emotional tasks before and after psychotherapy. Post-psychotherapy, activation decreased in the right insula, the anterior cingulate cortex, and the dorsolateral prefrontal cortex; no region had increased activation. A subgroup analysis for CBT revealed additional decrease in the supplementary motor area. Reduced activation in limbic and frontal regions might indicate therapy-associated normalization regarding the perception of internal and external threat, subsequent allocation of cognitive resources, and changes in effortful cognitive control. Due to the integration of diverse treatments and experimental tasks, these changes presumably reflect global effects of successful psychotherapy.

Don't be afraid, try to meditate- potential effects on neural activity and connectivity of psilocybin-assisted mindfulness-based intervention for social anxiety disorder: A systematic review

BACKGROUND

Current first-line treatment for social anxiety disorder (SAD), one of the most prevalent anxiety disorders, is limited in its efficacy. Hence, novel treatment approaches are urgently needed. The current review suggests a combination of meditation-based interventions and the administration of a psychedelic as a future alternative treatment approach. While both separate treatments show promise in the treatment of (other) clinical conditions, their combination has not yet been investigated in the treatment of psychopathologies.

AIM

With a systematic literature review, we aim to identify the potential mechanisms by which combined psilocybin and mindfulness treatment could adjust anomalous neural activity underlying SAD and exert therapeutic effects.

RESULTS

Thirty experimental studies investigating the neural effects of meditation or psilocybin treatment in healthy and patient samples were included. Findings suggest that psilocybin-assisted meditation interventions might change cognitive processes like biased attention to threat linked to SAD by modulating connectivity of the salience network, balancing the activity and connectivity of cortical-midline structures, and increasing frontoparietal control over amygdala reactivity.

CONCLUSIONS

Future studies should investigate whether psilocybin-assisted mindfulness-based intervention can provide therapeutic benefits to SAD patients who are do not remit following conventional therapy.

Generalization of reappraisal to novel negative stimuli as evidenced by the LPP

Cognitive reappraisal is a well-studied emotion regulation technique that involves changing the meaning of stimuli. To be useful in everyday life, reappraisal's effects would ideally generalize from previously reappraised stimuli to novel, but similar stimuli, saving individuals from needing to generate novel interpretations for similar stimuli. Here, 41 participants were asked to use reappraisal to down-regulate their response to negative pictures from one category (e.g., snakes), and to view negative pictures from another category (e.g., guns) as well as neutral pictures (e.g., plants). In a subsequent task, participants passively viewed novel pictures from all three categories (e.g., snakes, guns, and plants). EEG and subjective ratings of valence and arousal were collected in both tasks. In the reappraisal task, we did not find an effect of reappraisal on the LPP or arousal ratings, but reappraisal reduced ratings of picture unpleasantness. In the second task, negative pictures from the previously reappraised category elicited smaller LPPs than negative pictures from the previously viewed category, though there was no evidence that reappraisal generalized to subjective ratings of pictures. Therefore, at the electrocortical level, cognitive reappraisal may generalize to similar but novel stimuli encountered outside of the reappraisal context. Moreover, meaning change might be more effective in modulating electrocortical response following a delay and in the absence of deliberate attempts to down-regulate emotional response. Nonetheless, reappraisal's effects appear to differ across levels of affective response when similar stimuli are encountered in the absence of willful attempts at reappraisal.

Resting-state functional connectivity of the sensory/somatomotor network associated with sleep quality: evidence from 202 young male samples

Previous neuroimaging studies have demonstrated that sleep is associated with brain functional changes in some specific brain regions. However, few studies have examined the relationship between all possible functional connectivities (FCs) within the sensory/somatomotor network (SSN) and the sleep quality of young male samples. The SSN consists of two motor cortices and is known to play a critical role in sleep. Poor sleep quality may be associated with increased sensory/somatomotor functional connectivity during rest. Hence, 202 young male participants underwent a resting-state functional magnetic resonance imaging (fMRI) scan and completed the Pittsburgh Sleep Quality Index (PSQI). Results indicated that increased functional connectivity within the SSN was associated with poor sleep quality. Specifically, the total PSQI score was positively correlated with the increased functional connectivity of the left paracentral lobule (PCL), bilateral precentral gyrus (PreCG), supplementary motor area (SMA) and bilateral postcentral gyrus (PoCG). Additionally, our findings also exhibited that (a) the subjective sleep quality factor of PSQI was positively correlated with FC between the bilateral PoCG and the bilateral PCL as well as between the left PreCG and the right SMA; (b) the sleep latency factor of PSQI was positively correlated with FC between the left PoCG and the right precuneus (PCUN); (c) the sleep disturbances factor of PSQI was positively correlated with FC between the left PCL and the right PoCG, and (d) the daytime dysfunction factor of PSQI was positively correlated with FC between the bilateral PoCG and the left PCL as well as between the bilateral PreCG and the SMA. In short, our findings can be comprehensively understood as neural mechanisms of intrinsic SSN connectivity are associated with sleep quality of man. Meanwhile, it may expand our knowledge and provide new insight into a deeper understanding of the neurobiological mechanisms of sleep or sleep problems.

Neural Circuits Underlying Social Fear in Rodents: An Integrative Computational Model

Social avoidance in rodents arises from a complex interplay between the prefrontal cortex and subcortical structures, such as the ventromedial hypothalamus and the dorsal periaqueductal gray matter. Experimental studies are revealing the contribution of these areas, but an integrative view and model of how they interact to produce adaptive behavior are still lacking. Here, we present a computational model of social avoidance, proposing a set of integrated hypotheses on the possible macro organization of the brain system underlying this phenomenon. The model is validated by accounting for several different empirical findings and produces predictions to be tested in future experiments.

Sliding Scale Theory of Attention and Consciousness/Unconsciousness

Attention defined as focusing on a unit of information plays a prominent role in both consciousness and the cognitive unconscious, due to its essential role in information processing. Existing theories of consciousness invariably address the relationship between attention and conscious awareness, ranging from attention is not required to crucial. However, these theories do not adequately or even remotely consider the contribution of attention to the cognitive unconscious. A valid theory of consciousness must also be a robust theory of the cognitive unconscious, a point rarely if ever considered. Current theories also emphasize human perceptual consciousness, primarily visual, despite evidence that consciousness occurs in diverse animal species varying in cognitive capacity, and across many forms of perceptual and thought consciousness. A comprehensive and parsimonious perspective applicable to the diversity of species demonstrating consciousness and the various forms—sliding scale theory of attention and consciousness/unconsciousness—is proposed with relevant research reviewed. Consistent with the continuous organization of natural events, attention occupies a sliding scale in regards to time and space compression. Unconscious attention in the form of the “cognitive unconscious” is time and spaced diffused, whereas conscious attention is tightly time and space compressed to the present moment. Due to the special clarity derived from brief and concentrated signals, the tight time and space compression yields conscious awareness as an emergent property. The present moment enhances the time and space compression of conscious attention, and contributes to an evolutionary explanation of conscious awareness.

Effects of Cognitive Reappraisal on Subjective and Neural Reactivity to Angry Faces in Children with Social Anxiety Disorder, Clinical Controls with Mixed Anxiety Disorders and Healthy Children

Cognitive models of social anxiety suggest that social anxiety disorder (SAD) is characterized by both enhanced emotional reactivity and deficits in emotion regulation. Emotional reactivity to socially threatening children's faces and their modulation through reappraisal were measured via subjective ratings and electrocortical responses in children (age 10-13) with SAD (n = 28), clinical controls with mixed anxiety disorders (n = 28), and healthy controls (n = 29). Children with SAD showed higher subjective reactivity to the images of angry children's faces while all children reported reduced reactivity in their subjective ratings following reappraisal. Reduced electrocortical reactivity after reappraisal was only evident in older children and boys and was unrelated to anxiety. The present study indicates that cognitive reappraisal may be beneficial in reducing subjective reactivity in children with anxiety disorders, while neural effects of reappraisal may emerge at older ages.

Attentional processes during emotional face perception in social anxiety disorder: A systematic review and meta-analysis of eye-tracking findings

Background In recent years, a growing body of eye-tracking research has investigated gaze behavior in individuals with social anxiety during the visual perception of emotional stimuli. The aim of this article was to review and synthesize studies examining attention orientation in patients with clinical social anxiety by means of eye-tracking methodology. Methods Through a systematic search, 30 articles were identified, including 11 studies in which single emotional faces were used as stimuli and seven eligible studies in which threatening faces were paired with neutral stimuli. Meta-analyses were conducted to compare prolonged eye-contact behavior and early attentional biases to threats in individuals with social anxiety disorder (SAD) and healthy controls. Results Moderate group differences were revealed for single face viewing studies, with SAD patients showing significantly reduced eye contact with negative (Hedges' g = -0.67) and positive emotional faces (g = -0.49) compared to that of healthy participants. Type of task and duration of stimulus presentation were (marginally) significant moderators of between-study variance in effect size. Small but significant group differences were found for early attentional biases toward angry faces versus neutral stimuli (g = 0.21) but not toward happy faces versus neutral stimuli (g = 0.05). Preliminary evidence for a hyperscanning strategy in SAD patients relative to healthy controls emerged (g = 0.42). Limitations The number of included studies with face pairings was low, and two studies were excluded due to unavailable data. Conclusions Our results suggest that eye contact avoidance with emotional faces is a prominent feature in SAD patients. Patients might benefit from guidance to learn to make adequate eye contact during therapeutic interventions, such as exposure therapy. SAD patients demonstrated slightly heightened attention allocation toward angry faces relative to that of healthy participants during early processing stages. Threat biases can be potential targets for attention modification training as an adjuvant to other treatments. Future research on early attentional processes may benefit from improved arrangements of paired stimuli to increase the psychometric properties of initial attention indices.

Socioeconomic and Cognitive Roots of Trait Anxiety in Young Adults

In 54 participants (41% women) from the Czech arm of the European Longitudinal Study of Pregnancy and Childhood, a national birth cohort with prospectively collected data from their birth until young adulthood, we aimed to study the association between early-life socioeconomic deprivation (ELSD), cognitive ability in adolescence, trait anxiety and resting state functional connectivity of the lateral prefrontal cortex (LPFC) in young adulthood. We found that ELSD was associated with lower cognitive ability in adolescence (at age 13) as well as higher trait anxiety in young adulthood (at age 23/24). Higher cognitive ability in adolescence predicted lower trait anxiety in young adulthood. Resting state functional connectivity between the right LPFC and a cluster of voxels including left precentral gyrus, left postcentral gyrus and superior frontal gyrus mediated the relationship between lower cognitive ability in adolescence and higher trait anxiety in young adulthood. These findings indicate that lower cognitive ability and higher trait anxiety may be both consequences of socioeconomic deprivation in early life. The recruitment of the right LPFC may be the underlying mechanism, through which higher cognitive ability may ameliorate trait anxiety.

ISIEA: An image database of social inclusion and exclusion in young Asian adults

Human beings have a fundamental need to belong. Evaluating and dealing with social exclusion and social inclusion events, which represent negative and positive social interactions, respectively, are closely linked to our physical and mental health. In addition to traditional paradigms that simulate scenarios of social interaction, images are utilized as effective visual stimuli for research on socio-emotional processing and regulation. Since the current mainstream emotional image database lacks social stimuli based on a specific social context, we introduced an open-access image database of social inclusion/exclusion in young Asian adults (ISIEA). This database contains a set of 164 images depicting social interaction scenarios under three categories of social contexts (social exclusion, social neutral, and social inclusion). All images were normatively rated on valence, arousal, inclusion score, and vicarious feeling by 150 participants in Study 1. We additionally examined the relationships between image ratings and the potential factors influencing ratings. The importance of facial expression and social context in the image rating of ISIEA was examined in Study 2. We believe that this database allows researchers to select appropriate materials for socially related studies and to flexibly conduct experimental control.

Emotional intelligence mediates the association between middle temporal gyrus gray matter volume and social anxiety in late adolescence

As a common mental health problem, social anxiety refers to the fear and avoidance of interacting in social or performance situations, which plays a crucial role in many health and social problems. Although a growing body of studies has explored the neuroanatomical alterations related to social anxiety in clinical patients, far fewer have examined the association between social anxiety and brain morphology in the general population, which may help us understand the neural underpinnings of social anxiety more comprehensively. Here, utilizing a voxel-based morphometry approach via structural magnetic resonance imaging, we investigated brain gray matter correlates of social anxiety in 231 recent graduates of the same high school grade. We found that social anxiety was positively associated with gray matter volume in the right middle temporal gyrus (MTG), which is a core brain area for cognitive processing of emotions and feelings. Critically, emotional intelligence mediated the impact of right MTG volume on social anxiety. Notably, our results persisted even when controlling for the effects of general anxiety and depression. Altogether, our research reveals right MTG gray matter volume as a neurostructural correlate of social anxiety in a general sample of adolescents and suggests a potential indirect effect of emotional intelligence on the association between gray matter volume and social anxiety.

In search of convergent regional brain abnormality in cognitive emotion regulation: A transdiagnostic neuroimaging meta-analysis

Ineffective use of adaptive cognitive strategies (e.g., reappraisal) to regulate emotional states is often reported in a wide variety of psychiatric disorders, suggesting a common characteristic across different diagnostic categories. However, the extent of shared neurobiological impairments is incompletely understood. This study, therefore, aimed to identify the transdiagnostic neural signature of disturbed reappraisal using the coordinate‐based meta‐analysis (CBMA) approach. Following the best‐practice guidelines for conducting neuroimaging meta‐analyses, we systematically searched PubMed, ScienceDirect, and Web of Science databases and tracked the references. Out of 1,608 identified publications, 32 whole‐brain neuroimaging studies were retrieved that compared brain activation in patients with psychiatric disorders and healthy controls during a reappraisal task. Then, the reported peak coordinates of group comparisons were extracted and several activation likelihood estimation (ALE) analyses were performed at three hierarchical levels to identify the potential spatial convergence: the global level (i.e., the pooled analysis and the analyses of increased/decreased activations), the experimental‐contrast level (i.e., the analyses of grouped data based on the regulation goal, stimulus valence, and instruction rule) and the disorder‐group level (i.e., the analyses across the experimental‐contrast level focused on increasing homogeneity of disorders). Surprisingly, none of our analyses provided significant convergent findings. This CBMA indicates a lack of transdiagnostic convergent regional abnormality related to reappraisal task, probably due to the complex nature of cognitive emotion regulation, heterogeneity of clinical populations, and/or experimental and statistical flexibility of individual studies.

Reappraisal-related neural predictors of treatment response to cognitive behavior therapy for post-traumatic stress disorder

BACKGROUND

Although trauma-focused cognitive behavior therapy (TF-CBT) is the frontline treatment for post-traumatic stress disorder (PTSD), one-third of patients are treatment non-responders. To identify neural markers of treatment response to TF-CBT when participants are reappraising aversive material.

METHODS

This study assessed PTSD patients (n = 37) prior to TF-CBT during functional magnetic brain resonance imaging (fMRI) when they reappraised or watched traumatic images. Patients then underwent nine sessions of TF-CBT, and were then assessed for symptom severity on the Clinician-Administered PTSD Scale. FMRI responses for cognitive reappraisal and emotional reactivity contrasts of traumatic images were correlated with the reduction of PTSD severity from pretreatment to post-treatment.

RESULTS

Symptom improvement was associated with decreased activation of the left amygdala during reappraisal, but increased activation of bilateral amygdala and hippocampus during emotional reactivity prior to treatment. Lower connectivity of the left amygdala to the subgenual anterior cingulate cortex, pregenual anterior cingulate cortex, and right insula, and that between the left hippocampus and right amygdala were also associated with symptom improvement.

CONCLUSIONS

These findings provide evidence that optimal treatment response to TF-CBT involves the capacity to engage emotional networks during emotional processing, and also to reduce the engagement of these networks when down-regulating emotions.

The relationship between test anxiety and emotion regulation: the mediating effect of psychological resilience

BACKGROUND

Test anxiety has been widely found in medical students. Emotion regulation and psychological resilience have been identified as key factors contributing to anxiety. However, studies on relationships were limited. This study investigated the links between psychological resilience, emotion regulation, and test anxiety in addition to exploring the differences about socio-demographic factors.

METHODS

A sample of 1266 medical students was selected through cross-sectional survey from a medical university in China during 2019. Data were obtained by network technique using designed questionnaire, which assesses the level of test anxiety, emotion regulation and psychological resilience, respectively.

RESULTS

Medical students experienced test anxiety at different levels, 33.7% of these were seriously. It revealed significant effects of the gender and academic performance on test anxiety. Results of logistic regression indicated that test anxiety was significantly associated with emotion regulation and psychological resilience (p < 0.01). Psychological resilience played a mediating role on the relationship between emotion regulation and test anxiety.

CONCLUSIONS

These findings highlight the importance of psychological resilience and emotion regulation in understanding how psychological resilience relates to test anxiety in medical students. Resilience-training intervention may be developed to support students encountering anxiety during the exam.

Identifying resting state differences salient for resilience to chronic pain based on machine learning multivariate pattern analysis

Studies have documented behavior differences between more versus less resilient adults with chronic pain (CP), but the presence and nature of underlying neurophysiological differences have received scant attention. In this study, we attempted to identify regions of interest (ROIs) in which resting state (Rs) brain activity discriminated more from less resilient CP subgroups based on multiple kernel learning (MKL). More and less resilient community-dwellers with chronic musculoskeletal pain (70 women, 39 men) engaged in structural and functional magnetic resonance imaging (MRI) scans, wherein MKL assessed Rs activity based on amplitude of low frequency fluctuations (ALFF), fractional amplitudes of low frequency fluctuations (fALFF), and regional homogeneity (ReHo) modalities to identify ROIs most salient for discriminating more versus less resilient subgroups. Compared to classification based on single modalities, multi-modal classification based on combined fALFF and ReHo features achieved a substantially higher classification accuracy rate (79%). Brain regions with the best discriminative power included those implicated in pain processing, reward, executive function, goal-directed action, emotion regulation and resilience to mood disorders though variation trends were not consistent between more and less resilient subgroups. Results revealed patterns of Rs activity that serve as possible biomarkers for resilience to chronic musculoskeletal pain.

Frontoparietal and Default Mode Network Contributions to Self-Referential Processing in Social Anxiety Disorder

Social anxiety disorder (SAD) is characterized by negative self-referential processing, which triggers excessive emotional reactivity. In healthy individuals, positive self-views typically predominate and are supported by regions of the default mode network (DMN) that represent self-related information and regions of the frontoparietal control network (FPCN) that contribute to metacognitive awareness and emotion regulation. The current study used functional magnetic resonance imaging (fMRI) to examine patterns of DMN and FPCN activation during positive and negative self-referential judgments in SAD patients (N = 97) and controls (N = 34). As expected, SAD patients demonstrated a striking difference in self-beliefs compared with non-anxious healthy controls, endorsing fewer positive traits and more negative traits. However, SAD patients and controls demonstrated largely similar patterns of DMN and FPCN recruitment during self-referential judgements. No significant group differences were observed. However, equivalence testing identified numerous regions demonstrating effect sizes that were not small enough to conclude that they were practically equivalent to zero, despite the nonsignificant null hypothesis test. These regions may be key targets to investigate in future studies using larger samples.

Neural mechanisms and predictors of SSRI and CBT treatment of anxiety: A randomized trial focused on emotion and cognitive processing

Anxiety disorders (ADs) are common and difficult to treat. While research suggests ADs are characterized by an imbalance between bottom-up and top-down attention processes and that effective treatments work by correcting this dysfunction, there is insufficient data to explain how and for whom treatments work. The late positive potential (LPP), an event-related potential reflecting elaborative processing of motivationally salient stimuli, is sensitive to both bottom-up and top-down processes. The present study examines the LPP in healthy controls (HC) and patients with ADs under low and high working memory (WM) load to assess its utility as a predictor and index of symptom reduction in patients who underwent cognitive behavioral therapy (CBT) or selective serotonin reuptake inhibitor (SSRI) treatment. The LPP when viewing negative and neutral distractor images and WM performance were assessed in 96 participants (40 HC, 32 CBT, 24 SSRI) during a letter recall task at Week 0 and in a subset of the study sample (23 CBT, 16 SSRI) at Week 12. Patients were randomly assigned to twelve weeks of CBT or SSRI treatment. Participants completed self-reported symptom measures at each time point. Greater Week 0 LPP to negative images under low WM load predicted greater symptom reduction in the SSRI, but not the CBT, group. Regression analyses examining the LPP to negative images as an index of symptom reduction revealed a smaller decrease in the LPP to negative images under low WM load was associated with less anxiety reduction across treatment modalities. Findings suggest the LPP during low WM load may serve as a cost-effective predictor and index of treatment outcome in ADs. Clinical Trials Registration: ClinicalTrials.gov (Identifier: NCT01903447).

Neurophysiological Responses to Interpersonal Emotional Images: Associations with Symptoms of Depression and Social Anxiety

Affective neuroscience research using electrocortical event-related potentials has provided valuable insights on alterations in emotion processing in internalizing disorders. However, internalizing disorders are accompanied by additional impairments in social cognition and functioning, and most extant research examines neural responses to broad categories of emotional scenes or faces presented irrespective of context. Examining neural reactivity specifically to interpersonal emotional scenes may more precisely capture and disentangle processes involved in depression and social anxiety, two highly comorbid forms of psychopathology. The current study validated a novel set of positive and threatening interpersonal emotional stimuli in a sample of emerging adults (N = 114) who completed a modified emotional interrupt paradigm while electroencephalogram and behavioral data were recorded. Participant ratings of valence and arousal supported the validity of the emotional images. Consistent with prior research, sustained neurophysiological processing indexed by the late positive potential (LPP) was observed for interpersonal emotional images, especially positive, compared with neutral images. Elevated LPP reactivity to both positive and threatening interpersonal images moderated the effects of chronic interpersonal stress on social anxiety symptoms, such that enhanced LPP reactivity in conjunction with higher levels of chronic interpersonal stress was associated with elevated social anxiety symptoms. These results were unique to social anxiety symptoms and not symptoms of depression, suggesting sustained neural processing of interpersonal stimuli may differentiate social anxiety from depression. Future research on emotional reactivity specifically within the interpersonal domain is needed to inform our understanding of developmental pathways to internalizing psychopathology.

Altered gray matter volume and structural co-variance in adolescents with social anxiety disorder: evidence for a delayed and unsynchronized development of the fronto-limbic system

BACKGROUND

Social anxiety disorder (SAD) is a prevalent mental disorder diagnosed in childhood and adolescence. Theories regarding brain development and SAD suggest a close link between neurodevelopmental dysfunction at the adolescent juncture and SAD, but direct evidence is rare. This study aims to examine brain structural abnormalities in adolescents with SAD.

METHODS

High-resolution T1-weighted images were obtained from 31 adolescents with SAD (15-17 years) and 42 matching healthy controls (HC). We evaluated symptom severity with the Social Anxiety Scale for Children (SASC) and the Screen for Child Anxiety Related Emotional Disorders (SCARED). We used voxel-based morphometry analysis to detect regional gray matter volume abnormalities and structural co-variance analysis to investigate inter-regional coordination patterns.

RESULTS

We found significantly higher gray matter volume in the orbitofrontal cortex (OFC) and the insula in adolescents with SAD compared to HC. We also observed significant co-variance of the gray matter volume between the OFC and amygdala, and the OFC and insula in HC, but these co-variance relationships diminished in SAD.

CONCLUSIONS

These findings provide the first evidence that the brain structural deficits in adolescents with SAD are not only in the core regions of the fronto-limbic system, but also represented by the diminished coordination in the development of these regions. The delayed and unsynchronized development pattern of the fronto-limbic system supports SAD as an adolescent-sensitive developmental mental disorder.

Intrinsic functional connectivity in families genetically enriched for social anxiety disorder - an endophenotype study

BACKGROUND

Social anxiety disorder (SAD) is a serious psychiatric condition with a high prevalence, and a typical onset during childhood/adolescence. The condition runs in families, but it is largely unknown which neurobiological characteristics transfer this genetic vulnerability ('endophenotypes'). Using data from the Leiden Family Lab study on SAD, including two generations of families genetically enriched for SAD, we investigated whether social anxiety (SA) co-segregated with changes in intrinsic functional connectivity (iFC), and examined heritability.

METHODS

Functional MRI data were acquired during resting-state in 109 individuals (56 males; mean age: 31·5, range 9·2-61·5 years). FSL's tool MELODIC was used to perform independent component analysis. Six networks of interest (default mode, dorsal attention, executive control, frontoparietal, limbic and salience) were identified at the group-level and used to generate subject-specific spatial maps. Voxel-wise regression models, with SA-level as predictor and voxel-wise iFC as candidate endophenotypes, were performed to investigate the association with SA, within masks of the networks of interest. Subsequently, heritability was estimated.

FINDINGS

SA co-segregated with iFC within the dorsal attention network (positive association in left middle frontal gyrus and right postcentral gyrus) and frontoparietal network (positive association within left middle temporal gyrus) (cluster-forming-threshold z>2·3, cluster-corrected extent-threshold p<0·05). Furthermore, iFC of multiple voxels within these clusters was at least moderately heritable.

INTERPRETATION

These findings provide initial evidence for increased iFC as candidate endophenotype of SAD, particularly within networks involved in attention. These changes might underlie attentional biases commonly present in SAD.

FUNDING

Leiden University Research Profile 'Health, Prevention and the Human Lifecycle'.