title: They are laughing at me: cerebral mediation of cognitive biases in social anxiety.
abstract: The fear of embarrassment and humiliation is the central element of social anxiety. This frequent condition is associated with cognitive biases indicating increased sensitivity to signals of social threat, which are assumed to play a causal role in the maintenance of social anxiety. Here, we employed laughter, a potent medium for the expression of acceptance and rejection, as an experimental stimulus in participants selected for varying degrees of social anxiety to identify cerebral mediators of cognitive biases in social anxiety using functional magnetic resonance imaging in combination with mediation analysis. We directly demonstrated that cerebral activation patterns within the dorsal attention network including the left dorsolateral and dorsomedial prefrontal cortex mediate the influence of social anxiety on laughter perception. This mediation proved to be specific for social anxiety after correction for measures of general state and trait anxiety and occurred most prominently under bimodal audiovisual laughter presentation when compared with monomodal auditory or visual laughter cues. Considering the possibility to modulate cognitive biases and cerebral activity by neuropsychological trainings, non-invasive electrophysiological stimulation and psychotherapy, this study represents a starting point for a whole line of translational research projects and identifies promising targets for electrophysiological interventions aiming to alleviate cognitive biases and symptom severity in social anxiety.
authors.affiliation: Department of Psychiatry and Psychotherapy, Eberhard Karls University of Tübingen, Tübingen, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Kreifelts
authors.affiliation: Department of Psychiatry and Psychotherapy, Eberhard Karls University of Tübingen, Tübingen, Germany.
authors.forename: Carolin
authors.initials: C
authors.lastname: Brück
authors.affiliation: Department of Psychiatry and Psychotherapy, Eberhard Karls University of Tübingen, Tübingen, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Ritter
authors.affiliation: Department of Psychiatry and Psychotherapy, Eberhard Karls University of Tübingen, Tübingen, Germany; Department of Biomedical Magnetic Resonance, Eberhard Karls University of Tübingen, Tübingen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ethofer
authors.affiliation: Department for Diagnostic Radiology and Neuroradiology, University of Greifswald, Greifswald, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Domin
authors.affiliation: Department for Diagnostic Radiology and Neuroradiology, University of Greifswald, Greifswald, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Lotze
authors.affiliation: Department of Psychiatry and Psychotherapy, Eberhard Karls University of Tübingen, Tübingen, Germany.
authors.forename: Heike
authors.initials: H
authors.lastname: Jacob
authors.affiliation: Department of Psychiatry and Psychotherapy, Eberhard Karls University of Tübingen, Tübingen, Germany.
authors.forename: Sarah
authors.initials: S
authors.lastname: Schlipf
authors.affiliation: Department of Psychiatry and Psychotherapy, Eberhard Karls University of Tübingen, Tübingen, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Wildgruber
mesh_terms: D000328:Adult; D001007:Anxiety / Q000503:physiopathology / Q000523:psychology*; D001008:Anxiety Disorders / Q000503:physiopathology / Q000523:psychology*; D001288:Attention / Q000502:physiology; D001931:Brain Mapping / Q000379:methods; D003071:Cognition / Q000502:physiology*; D003463:Cues; D005239:Fear / Q000502:physiology / Q000523:psychology; D005260:Female; D006801:Humans; D007845:Laughter / Q000523:psychology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D017008:Negotiating / Q000523:psychology; D017397:Prefrontal Cortex / Q000503:physiopathology*