Neurobiological mechanisms of social anxiety disorder.
OBJECTIVE
The authors critically surveyed several preclinical and clinical neurobiological models of social anxiety disorder.


METHODS
The authors reviewed the recent literature regarding three animal models of particular relevance to social anxiety. They then examined the recent literature concerning clinical neurobiological aspects of social anxiety disorder, including the developmental neurobiology of anxiety, the genetics of fear and social anxiety, and challenge and imaging studies.


RESULTS
The available animal models are useful paradigms for understanding the features of social subordination stress, attachment behavior, and environmental rearing, but they incompletely account for the known neurobiology of human social anxiety disorder. The clinical neurobiology literature surveyed implicates specific neurotransmitter system abnormalities, most notably of the dopamine system, but largely ignores neurodevelopmental processes and the functional interactions between neurotransmitters. Both heritable factors and environmental stress factors appear to be responsible for the onset of social anxiety disorder.


CONCLUSIONS
Social anxiety disorder should be conceptualized as a chronic neurodevelopmental illness that might represent a fully compensated state in adulthood. Future investigations from this perspective are discussed.
Mathew
S J
SJ
New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. sjmathew@hotmail.com
Coplan
J D
JD
Gorman
J M
JM
D000328:Adult; D000818:Animals; D001522:Behavior, Animal / Q000502:physiology; D002648:Child; D003952:Diagnostic Imaging / Q000706:statistics & numerical data; D004195:Disease Models, Animal; D004298:Dopamine / Q000502:physiology; D006801:Humans; D008252:Macaca fascicularis; D009422:Nervous System Diseases / Q000503:physiopathology; D009473:Neuronal Plasticity / Q000502:physiology; D018377:Neurotransmitter Agents / Q000502:physiology*; D009638:Norepinephrine / Q000502:physiology; D009769:Object Attachment; D010215:Papio; D010698:Phobic Disorders / Q000235:genetics / Q000503:physiopathology*
D018377:Neurotransmitter Agents; D004298:Dopamine; D009638:Norepinephrine