Learning from other people's fear: amygdala-based social reference learning in social anxiety disorder

Neurocognitive Model of Schema-Congruent and -Incongruent Learning in Clinical Disorders: Application to Social Anxiety and Beyond

Negative schemas lie at the core of many common and debilitating mental disorders. Thus, intervention scientists and clinicians have long recognized the importance of designing effective interventions that target schema change. Here, we suggest that the optimal development and administration of such interventions can benefit from a framework outlining how schema change occurs in the brain. Guided by basic neuroscientific findings, we provide a memory-based neurocognitive framework for conceptualizing how schemas emerge and change over time and how they can be modified during psychological treatment of clinical disorders. We highlight the critical roles of the hippocampus, ventromedial prefrontal cortex, amygdala, and posterior neocortex in directing schema-congruent and -incongruent learning (SCIL) in the interactive neural network that comprises the autobiographical memory system. We then use this framework, which we call the SCIL model, to derive new insights about the optimal design features of clinical interventions that aim to strengthen or weaken schema-based knowledge through the core processes of episodic mental simulation and prediction error. Finally, we examine clinical applications of the SCIL model to schema-change interventions in psychotherapy and provide cognitive-behavior therapy for social anxiety disorder as an illustrative example.

Role of Parenting and Psychosocial Correlates Contributing to Social Anxiety in Asian Adolescents: A Systematic Review

Background

The purpose of the study was to explore social anxiety in adolescents as well as associated factors, such as parenting styles, self-esteem, quality of life, emotional intelligence, and brain activity, in social anxiety.

Methods

A systematic review of articles related to social anxiety in adolescents, associated factors, and brain activity from 2012 to 2022 was performed. Google Scholar, PubMed, and Science Direct were used as research gates to find the relevant articles.

Results

Ten articles were sorted among 50 articles according to inclusion criteria. The included studies were based in Pakistan, India, and China, which indicated similar results. Social anxiety was directly related to low self-esteem, authoritarian parenting style, interbrain synchrony between parents and adolescents, low quality of life, weak emotional intelligence, and higher activity in the amygdala of the brain.

Conclusion

Social anxiety is common in male-dominant (patriarchal) societies where authoritarian parenting is practiced, which leads to low self-esteem, weak emotional intelligence, and low quality of life in adolescents. Social anxiety is also associated with higher activity in the amygdala and lower gamma interbrain synchrony.

Impaired probabilistic reversal learning in anxiety: Evidence from behavioral and ERP findings

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High and low anxious participants finish a probabilistic reversal learning task.

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High anxious participants showed a worse performance and less likely to lose-shift.

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Feedback-related negativity (FRN) was correlated with the frequency of lose-shift.

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High anxious participants showed a smaller FRN in response to lose-shift.

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Anxious people’s reversal learning is affected by impaired sensitivity to losses.

Background

Reversal learning reflects an individual’s capacity to adapt to a dynamic environment with changing stimulus–reward contingencies. This study focuses on the potential influence of anxiety on reversal learning skills.

Methods

We asked 40 participants with a high level of trait anxiety (HTA) and 40 counterparts with a low anxiety level (LTA) to finish a probabilistic reversal learning task with event-related potential (ERP) recording, during which stimulus–reward contingencies are reversed after players have learned the optimal choice.

Results

We found that compared to their LTA counterparts, the HTA participants showed worse learning performance and were less likely to make lose-shift choices. The FRN amplitude might help interpret these behavioral results, which is suggested to be associated with punishment sensitivity and was positively correlated with the number of lose-shift in this study. Seeing that anxiety level predicted the FRN amplitude for lose-shift, we explain that anxious individuals’ inflexible behavioral responses to losses are due to their impaired sensitivity to negative feedback.

Conclusions

A higher level of anxiety is associated with weaker reversal learning performance, possibly because of abnormal sensitivity to negative outcomes. These findings have implications for the understanding of behavioral symptoms in anxiety.

Reduced top-down attentional control in adolescents with generalized anxiety disorder

BACKGROUND

Generalized anxiety disorder (GAD) can significantly impair quality of life and is associated with a relatively poor long-term prognosis. Anxiety disorders are often associated with hyper-responsiveness to threat, perhaps coupled with impaired executive functioning. However, GAD, particularly adolescent GAD, has been the focus of little functional neuroimaging work compared to other anxiety disorders. Here, we examine the neural association of adolescent GAD with responsiveness to threat and response control.

METHODS

The study involved 35 adolescents with GAD and 34 healthy comparison individuals (N = 69) matched on age, gender, and IQ. Participants were scanned during an affective number Stroop task.

RESULTS

We found significant Group-by-Task Condition interactions in regions involved in response control/motor responding (bilateral precentral gyri and cerebellum) and/or cognitive control/attention (dorsomedial and lateral frontal cortex, posterior cingulate cortex, cuneus, and precuneus). In line with predictions, the youth with GAD showed significantly less recruitment during task trials than the healthy comparison individuals. However, no indications of specific heightened responses to threat were seen.

CONCLUSIONS

GAD involves reduced capacity for engaging regions involved in response control/motor responding and/or cognitive control/attention. This might reflect either a secondary consequence of the patient's worry or an early risk factor for the development of worry.

Amygdala hyperreactivity to faces conditioned with a social-evaluative meaning- a multiplex, multigenerational fMRI study on social anxiety endophenotypes

Social anxiety disorder (SAD) runs in families, but the neurobiological pathways underlying the genetic susceptibility towards SAD are largely unknown. Here, we employed an endophenotype approach, and tested the hypothesis that amygdala hyperreactivity to faces conditioned with a social-evaluative meaning is a candidate SAD endophenotype. We used data from the multiplex, multigenerational Leiden Family Lab study on Social Anxiety Disorder (eight families, n = 105) and investigated amygdala activation during a social-evaluative conditioning paradigm with high ecological validity in the context of SAD. Three neutral faces were repeatedly presented in combination with socially negative, positive or neutral sentences. We focused on two endophenotype criteria: co-segregation of the candidate endophenotype with the disorder within families, and heritability. Analyses of the fMRI data were restricted to the amygdala as a region of interest, and association analyses revealed that bilateral amygdala hyperreactivity in response to the conditioned faces co-segregated with social anxiety (SA; continuous measure) within the families; we found, however, no relationship between SA and brain activation in response to more specific fMRI contrasts. Furthermore, brain activation in a small subset of voxels within these amygdala clusters was at least moderately heritable. Taken together, these findings show that amygdala engagement in response to conditioned faces with a social-evaluative meaning qualifies as a neurobiological candidate endophenotype of social anxiety. Thereby, these data shed light on the genetic vulnerability to develop SAD.

Sexual Abuse in Adolescents Is Associated With Atypically Increased Responsiveness Within Regions Implicated in Self-Referential and Emotional Processing to Approaching Animate Threats

Childhood sexual abuse is associated with significant subsequent pathology and neurodevelopmental disruption. In particular, childhood sexual abuse has been associated with heightened threat sensitivity. However, little work has directly investigated this issue. In this study, we examine the association of childhood sexual abuse to neural and behavioral responses to looming, threatening face stimuli. The study involved 23 adolescents with significant past sexual abuse and 24 comparison individuals matched on IQ, age, and sex. Participants were scanned during a looming threat task that involved negative and neutral, human faces and animals that appeared to either loom toward or recede from the participant. We found that adolescents who had been previously subjected to sexual abuse, relative to comparison adolescents, showed increased neural responses to threatening looming stimuli in regions including rostral and superior frontal gyrus as well as posterior cingulate gyrus. In addition, they were significantly more slowed by looming stimuli, particularly if these were human faces, than adolescents who had not been exposed. These data demonstrate that prior sexual abuse was associated with heightened neural responsiveness to looming threats in a series of regions beyond the amygdala. These data are interpreted within models of rostromedial frontal and posterior cingulate cortices that stress their role in self-referential emotional processing and emotional maintenance.

What's in a word? How instructions, suggestions, and social information change pain and emotion

Instructions, suggestions, and other types of social information can have powerful effects on pain and emotion. Prominent examples include observational learning, social influence, placebo, and hypnosis. These different phenomena and their underlying brain mechanisms have been studied in partially separate literatures, which we discuss, compare, and integrate in this review. Converging findings from these literatures suggest that (1) instructions and social information affect brain systems associated with the generation of pain and emotion, and with reinforcement learning, and that (2) these changes are mediated by alterations in prefrontal systems responsible for top-down control and the generation of affective meaning. We argue that changes in expectation and appraisal, a process of assessing personal meaning and implications for wellbeing, are two potential key mediators of the effects of instructions and social information on affective experience. Finally, we propose a tentative model of how prefrontal regions, especially dorsolateral and ventromedial prefrontal cortex may regulate affective processing based on instructions and socially transmitted expectations more broadly.

Functional Redundancy Between Canonical Endocannabinoid Signaling Systems in the Modulation of Anxiety

BACKGROUND

Increasing the available repertoire of effective treatments for mood and anxiety disorders represents a critical unmet need. Pharmacological augmentation of endogenous cannabinoid (eCB) signaling has been suggested to represent a novel approach to the treatment of anxiety disorders; however, the functional interactions between two canonical eCB pathways mediated via anandamide (N-arachidonylethanolamine [AEA]) and 2-arachidonoylglycerol (2-AG) in the regulation of anxiety are not well understood.

METHODS

We utilized pharmacological augmentation and depletion combined with behavioral and electrophysiological approaches to probe the role of 2-AG signaling in the modulation of stress-induced anxiety and the functional redundancy between AEA and 2-AG signaling in the modulation of anxiety-like behaviors in mice.

RESULTS

Selective 2-AG augmentation reduced anxiety in the light/dark box assay and prevented stress-induced increases in anxiety associated with limbic AEA deficiency. In contrast, acute 2-AG depletion increased anxiety-like behaviors, which was normalized by selective pharmacological augmentation of AEA signaling and via direct cannabinoid receptor 1 stimulation with Δ⁹-tetrahydrocannabinol. Electrophysiological studies revealed 2-AG modulation of amygdala glutamatergic transmission as a key synaptic correlate of the anxiolytic effects of 2-AG augmentation.

CONCLUSIONS

Although AEA and 2-AG likely subserve distinct physiological roles, a pharmacological and functional redundancy between these canonical eCB signaling pathways exists in the modulation of anxiety-like behaviors. These data support development of eCB-based treatment approaches for mood and anxiety disorders and suggest a potentially wider therapeutic overlap between AEA and 2-AG augmentation approaches than was previously appreciated.

Social Fear Learning: from Animal Models to Human Function

Learning about potential threats is critical for survival. Learned fear responses are acquired either through direct experiences or indirectly through social transmission. Social fear learning (SFL), also known as vicarious fear learning, is a paradigm successfully used for studying the transmission of threat information between individuals. Animal and human studies have begun to elucidate the behavioral, neural and molecular mechanisms of SFL. Recent research suggests that social learning mechanisms underlie a wide range of adaptive and maladaptive phenomena, from supporting flexible avoidance in dynamic environments to intergenerational transmission of trauma and anxiety disorders. This review discusses recent advances in SFL studies and their implications for basic, social and clinical sciences.