Neuroendocrine models of social anxiety disorder.
Social anxiety disorder (SAD) is a highly prevalent and disabling disorder with key behavioral traits of social fearfulness, social avoidance, and submissiveness. Here we argue that hormonal systems play a key role in mediating social anxiety, and so may be important in SAD. Hormonal alterations, often established early in development through the interaction between biological and psychological factors (eg, genetic predisposition x early trauma), predispose to socially fearful, avoidant, and submissive behavior. However, whereas gene variants and histories of trauma persist, hormonal systems can be remodeled over the course of life. Hormones play a key role during the periods of all sensitive developmental windows (ie, prenatal, neonatal, puberty, aging), and are capable of opening up new developmental windows in adulthood. Indeed, the developmental plasticity of our social brain, and thus of social behavior in adulthood, critically depends on steroid hormones such as testosterone and peptide hormones such as oxytocin. These steroid and peptide hormones in interaction with social experiences may have potential for reprogramming the socially anxious brain. Certainly, single administrations of oxytocin and testosterone in humans reduce socially fearful, avoidant, and submissive behavior. Such work may ultimately lead to new approaches to the treatment of SAD.
Department of Psychiatry, University of Cape Town, South Africa; Department of Psychology, Utrecht University, the Netherlands; Institute of Infectious Diseases, and Molecular Medicine, University of Cape Town, South Africa.
Jack
J
van Honk
Department of Psychiatry, University of Cape Town, South Africa; Department of Psychology, Utrecht University, the Netherlands.
Peter A
PA
Bos
Department of Psychiatry, University of Cape Town, South Africa; Department of Psychology, Utrecht University, the Netherlands.
David
D
Terburg
Department of Psychiatry, University of Cape Town, South Africa.
Sarah
S
Heany
Department of Psychiatry, University of Cape Town, South Africa; MRC Unit on Anxiety & Stress Disorders, Cape Town, South Africa.
Dan J
DJ
Stein
D000818:Animals; D001008:Anxiety Disorders / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D005239:Fear; D006801:Humans; D009490:Neurosecretory Systems / Q000503:physiopathology*; D012919:Social Behavior
SAD; hormonal system; hormone; oxytocin; social anxiety disorder; testosterone