Neural response to the observable self in social anxiety disorder

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Publication Details

Author list: Soriano-Mas C
Publisher: Cambridge University Press (CUP): STM Journals
Publication year: 2013
Journal: Psychological Medicine (0033-2917)
Volume number: 43
Issue number: 4
Start page: 721
End page: 731
Number of pages: 11
ISSN: 0033-2917
eISSN: 1469-8978
Languages: English-Great Britain (EN-GB)


Abstract

BACKGROUND: Distorted images of the observable self are considered
crucial in the development and maintenance of social anxiety. We
generated an experimental situation in which participants viewed
themselves from an observer's perspective when exposed to scrutiny and
evaluation by others. Method Twenty patients with social anxiety
disorder (SAD) and 20 control subjects were assessed using functional
magnetic resonance imaging (fMRI) during the public exposure of
pre-recorded videos in which they were each shown performing a verbal
task. The examiners acted as the audience in the experiment and rated
performance. Whole-brain functional maps were computed using Statistical
Parametric Mapping. RESULTS: Robust activation was observed in regions
related to self-face recognition, emotional response and general arousal
in both study groups. Patients showed significantly greater activation
only in the primary visual cortex. By contrast, they showed significant
deactivation or smaller activation in dorsal frontoparietal and anterior
cingulate cortices relevant to the cognitive control of negative
emotion. Task-related anxiety ratings revealed a pattern of negative
correlation with activation in this frontoparietal/cingulate network.
Importantly, the relationship between social anxiety scores and neural
response showed an inverted-U function with positive correlations in the
lower score range and negative correlations in the higher range.
CONCLUSIONS: Our findings suggest that exposure to scrutiny and
evaluation in SAD may be associated with changes in cortical systems
mediating the cognitive components of anxiety. Disorder severity seems
to be relevant in shaping the neural response pattern, which is
distinctively characterized by a reduced cortical response in the most
severe cases.


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Last updated on 2019-13-08 at 00:45