title: Looking at the self in front of others: Neural correlates of attentional bias in social anxiety.
abstract: In social anxiety disorder (SAD), anxiety reactions are triggered by attentional bias to social threats that automatically appear in social situations. The present study aimed to investigate the neural basis and underlying resting-state pathology of attentional bias toward internal and external social threats as a core element of SAD. Twenty-two patients with SAD and 20 control subjects scanned functional magnetic resonance imaging during resting-state and while performing the visual search task. During the task, participants were exposed to internal threat (hearing participants' own pulse-sounds) and external threat (crowds in facial matrices). Patients showed activations in the lateral orbitofrontal cortex, rostral anterior cingulate cortex and insula in response to internal threat and activations in the posterior cingulate cortex and middle temporal gyrus in response to external threat. In patients, neural activity related to combined internal and external threats in the posterior cingulate cortex was inversely correlated with the functional connectivity strengths with the default mode network during resting-state. These findings suggest that attentional bias may stem from limbic and paralimbic pathology, and the interactive process of internally- and externally-focused attentional bias in SAD is associated with the self-referential function of resting-state.
authors.affiliation: Department of Psychiatry, Seoul National University College of Medicine and Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea.
authors.forename: Soo-Hee
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Republic of Korea.
authors.forename: Jung-Eun
authors.initials: JE
authors.lastname: Shin
authors.affiliation: Department of Biomedical Engineering, Keimyung University, Daegu, Republic of Korea.
authors.forename: Jeonghun
authors.initials: J
authors.lastname: Ku
authors.affiliation: Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Republic of Korea; Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: jaejkim@yonsei.ac.kr.
authors.forename: Jae-Jin
authors.initials: JJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001288:Attention / Q000502:physiology*; D000070379:Attentional Bias / Q000502:physiology*; D001931:Brain Mapping; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D010100:Oxygen / Q000097:blood; D000072861:Phobia, Social / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology; D010775:Photic Stimulation; D012146:Rest; D012649:Self Concept; D013223:Statistics as Topic; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: Attentional bias; Lateral orbitofrontal cortex; Posterior cingulate cortex; Social anxiety disorder