title: Impact of cognitive-behavioral therapy for social anxiety disorder on the neural bases of emotional reactivity to and regulation of social evaluation.
abstract: We examined whether Cognitive-Behavioral Therapy (CBT) for social anxiety disorder (SAD) would modify self-reported negative emotion and functional magnetic resonance imaging brain responses when reacting to and reappraising social evaluation, and tested whether changes would predict treatment outcome in 59 patients with SAD who completed CBT or waitlist groups. For reactivity, compared to waitlist, CBT resulted in (a) increased brain responses in right superior frontal gyrus (SFG), inferior parietal lobule (IPL), and middle occipital gyrus (MOG) when reacting to social praise, and (b) increases in right SFG and IPL and decreases in left posterior superior temporal gyrus (pSTG) when reacting to social criticism. For reappraisal, compared to waitlist, CBT resulted in greater (c) reductions in self-reported negative emotion, and (d) increases in brain responses in right SFG and MOG, and decreases in left pSTG. A linear regression found that after controlling for CBT-induced changes in reactivity and reappraisal negative emotion ratings and brain changes in reactivity to praise and criticism, reappraisal of criticism brain response changes predicted 24% of the unique variance in CBT-related reductions in social anxiety. Thus, one mechanism underlying CBT for SAD may be changes in reappraisal-related brain responses to social criticism.
  
  
  BACKGROUND
  NCT00380731. http://www.clinicaltrials.gov/ct2/show/NCT00380731?term=social+anxiety+cognitive+behavioral+therapy+Stanford&rank=1.
authors.affiliation: Stanford University, Department of Psychology, Jordan Hall, Stanford, CA 94305, USA. Electronic address: pgoldin@ucdavis.edu.
authors.forename: Philippe R
authors.initials: PR
authors.lastname: Goldin
authors.affiliation: Stanford University, Department of Psychology, Jordan Hall, Stanford, CA 94305, USA.
authors.forename: Michal
authors.initials: M
authors.lastname: Ziv
authors.affiliation: Stanford University, Department of Psychology, Jordan Hall, Stanford, CA 94305, USA.
authors.forename: Hooria
authors.initials: H
authors.lastname: Jazaieri
authors.affiliation: Ohio University, Department of Psychology, 249 Porter Hall, Athens, OH 45701, USA.
authors.forename: Justin
authors.initials: J
authors.lastname: Weeks
authors.affiliation: Temple University, Department of Psychology, Weiss Hall, 1701 North 13th Street, Philadelphia, PA 19122, USA.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Heimberg
authors.affiliation: Stanford University, Department of Psychology, Jordan Hall, Stanford, CA 94305, USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: Gross
mesh_terms: D000328:Adult; D001007:Anxiety / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D001921:Brain / Q000503:physiopathology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004644:Emotions / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010698:Phobic Disorders / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D012919:Social Behavior; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cognitive-behavioral therapy; Emotion; Emotion regulation; Neuroimaging; Reappraisal; Social anxiety