title: Prefrontal mediation of emotion regulation in social anxiety disorder during laughter perception.
abstract: Social anxiety disorder (SAD) is characterized by negatively biased perception of social cues and deficits in emotion regulation. While negatively biased perception is thought to maintain social anxiety, emotion regulation represents an ability necessary to overcome both biased perception and social anxiety. Here, we used laughter as a social threat in a functional magnetic resonance imaging (fMRI) study to identify cerebral mediators linking SAD with attention and interpretation biases and their modification through cognitive emotion regulation in the form of reappraisal. We found that reappraisal abolished the negative laughter interpretation bias in SAD and that this process was directly mediated through activation patterns of the left dorsolateral prefrontal cortex (DLPFC) serving as a cerebral pivot between biased social perception and its normalization through reappraisal. Connectivity analyses revealed reduced prefrontal control over threat-processing sensory cortices (here: the temporal voice area) during cognitive emotion regulation in SAD. Our results indicate a central role for the left DLPFC in SAD which might represent a valuable target for future research on interventions either aiming to directly modulate cognitive emotion regulation in SAD or to evaluate its potential as physiological marker for psychotherapeutic interventions relying on emotion regulation.
authors.affiliation: Department of Psychiatry and Psychotherapy, Eberhard Karls University of Tübingen, Tübingen, Germany. Electronic address: benjamin.kreifelts@med.uni-tuebingen.de.
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; Department of Biomedical Magnetic Resonance, Eberhard Karls University of Tübingen, Tübingen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ethofer
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.
authors.forename: Lena
authors.initials: L
authors.lastname: Weigel
authors.affiliation: Department of Biomedical Magnetic Resonance, Eberhard Karls University of Tübingen, Tübingen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Erb
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: D000161:Acoustic Stimulation; D000328:Adult; D000704:Analysis of Variance; D015982:Bias; D003463:Cues; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007845:Laughter; D008279:Magnetic Resonance Imaging; D008297:Male; D010100:Oxygen / Q000097:blood; D000072861:Phobia, Social / Q000000981:diagnostic imaging / Q000473:pathology* / Q000523:psychology*; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011930:Reaction Time / Q000502:physiology; D012938:Social Perception; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: Dorsolateral prefrontal cortex; FMRI; Interpretation bias; Laughter; Mediation analysis; Reappraisal