title: Neural bases of social anxiety disorder: emotional reactivity and cognitive regulation during social and physical threat.
abstract: BACKGROUND
  Social anxiety disorder is thought to involve emotional hyperreactivity, cognitive distortions, and ineffective emotion regulation. While the neural bases of emotional reactivity to social stimuli have been described, the neural bases of emotional reactivity and cognitive regulation during social and physical threat, and their relationship to social anxiety symptom severity, have yet to be investigated.
  
  
  OBJECTIVE
  To investigate behavioral and neural correlates of emotional reactivity and cognitive regulation in patients and controls during processing of social and physical threat stimuli.
  
  
  METHODS
  Participants were trained to implement cognitive-linguistic regulation of emotional reactivity induced by social (harsh facial expressions) and physical (violent scenes) threat while undergoing functional magnetic resonance imaging and providing behavioral ratings of negative emotion experience.
  
  
  METHODS
  Academic psychology department.
  
  
  METHODS
  Fifteen adults with social anxiety disorder and 17 demographically matched healthy controls.
  
  
  METHODS
  Blood oxygen level-dependent signal and negative emotion ratings.
  
  
  RESULTS
  Behaviorally, patients reported greater negative emotion than controls during social and physical threat but showed equivalent reduction in negative emotion following cognitive regulation. Neurally, viewing social threat resulted in greater emotion-related neural responses in patients than controls, with social anxiety symptom severity related to activity in a network of emotion- and attention-processing regions in patients only. Viewing physical threat produced no between-group differences. Regulation during social threat resulted in greater cognitive and attention regulation-related brain activation in controls compared with patients. Regulation during physical threat produced greater cognitive control-related response (ie, right dorsolateral prefrontal cortex) in patients compared with controls.
  
  
  CONCLUSIONS
  Compared with controls, patients demonstrated exaggerated negative emotion reactivity and reduced cognitive regulation-related neural activation, specifically for social threat stimuli. These findings help to elucidate potential neural mechanisms of emotion regulation that might serve as biomarkers for interventions for social anxiety disorder.
authors.affiliation: Department of Psychology, Stanford University, Stanford, CA 94305-2130, USA. pgoldin@stanford.edu
authors.forename: Philippe R
authors.initials: PR
authors.lastname: Goldin
authors.forename: Tali
authors.initials: T
authors.lastname: Manber
authors.forename: Shabnam
authors.initials: S
authors.lastname: Hakimi
authors.forename: Turhan
authors.initials: T
authors.lastname: Canli
authors.forename: James J
authors.initials: JJ
authors.lastname: Gross
mesh_terms: D000328:Adult; D000679:Amygdala / Q000503:physiopathology; D001143:Arousal / Q000502:physiology*; D001288:Attention / Q000502:physiology; D001364:Awareness / Q000502:physiology*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000503:physiopathology; D003071:Cognition / Q000502:physiology*; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008032:Limbic System / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009415:Nerve Net / Q000503:physiopathology; D010100:Oxygen / Q000097:blood; D010698:Phobic Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D055815:Young Adult
chemical_list: D010100:Oxygen