Association between Amygdala Hyperactivity to Harsh Faces and Severity of Social Anxiety in Generalized Social Phobia

SK2 potassium channel overexpression in basolateral amygdala reduces anxiety, stress-induced corticosterone secretion and dendritic arborization

“…In humans, amygdala activation is a reliable predictor of anxiety (39-43). Activation of the amygdala is positively correlated with severity of social anxiety symptoms (44). Moreover, amygdala volume is increased in generalized anxiety disorders (45, 46).…”

Role of flupirtine in reducing preoperative anxiety of patients undergoing craniotomy procedure

“…[89] Various experimental models have observed similar hyperactivity in amygdala under the state of anxiety. [610] Hence, flupirtine as a neuronal Kv7 channel opener probably inhibited this hyperactivity by hyperpolarization of neuronal membrane and thus, reduced the severity of preoperative anxiety. [4] These findings are further supported by a previous trail demonstrating anxiolytic effects of flupirtine in albino rats without untoward side effects.…”

Emotion Potentiated Startle in Fragile X Syndrome

“…Individuals with social phobia, for example, demonstrate increased amygdala reactivity in response to social stimuli and this hyperactivity is correlated with increased severity in anxiety symptoms (Phan et al 2006; Thomas et al 2001). FXS, which brings with it a host of anxiety-related clinical problems, might be expected to mimic these findings.…”

Hypersensitivity to low intensity fearful faces in autism when fixation is constrained to the eyes

“…It is not excluded that anxiety played a role in our finding that ASD participants are oversensitive to low intensity fear. Indeed, amygdala activation in response to fearful emotions was previously shown to be increased in participants with clinical anxiety [Phan et al, ; Shin and Liberzon, ]. In contrast, here, amygdala activity and anxiety did not correlate in either group.…”

“…Finally, trait anxiety is highly comorbid of ASD [van Steensel et al, ] and dramatically influences the processing of facial emotions [e.g., Rossignol et al, ]. In particular, trait anxiety was shown to correlate with amygdala activity in previous studies [Phan et al, ; Shin and Liberzon, ]. Thus, in this experiment, measured trait anxiety in a subsample of participants and assessed the difference in anxiety level between our two groups.…”

Intensified Neuronal Investment in the Processing of Chemosensory Anxiety Signals in Non-Socially Anxious and Socially Anxious Individuals

“…[49]), negative (e.g. [50]), or angry faces (e.g. [51]) in social phobia requires an increased neuronal activity within the amygdala.…”

Virtual reality exposure therapy for social anxiety disorder: a systematic review and meta-analysis

“…There are also a few methods to regulate anxiety. For example, patients with SAD are more likely to be anxious about the negative expressions of others (Phan, Fitzgerald, Nathan, & Tancer, 2006; Stein, Goldin, Sareen, Zorrilla, & Brown, 2002; Straube, Mentzel, & Miltner, 2005), so patients' anxiety levels can be controlled by varying the facial expressions on VR avatars used in VRET (Qu, Brinkman, Ling, Wiggers, & Heynderickx, 2014). Additionally, in public speaking settings, there have been attempts to control patients' anxiety levels by adjusting the number of audience members they see (Kampmann et al, 2016a; North, North, & Coble, 1998; Stupar-Rutenfrans, Ketelaars, & van Gisbergen, 2017).…”

Automatic Neural Processing of Disorder-Related Stimuli in Social Anxiety Disorder: Faces and More

“…The processing of threat-related stimuli in different anxiety disorders might differ in the extent of automatic processing. For example, Phan et al (2006) show a correlation of the activation of the amygdala to negative faces with severity of social anxiety symptoms but not with state or trait anxiety, and Rossignol et al (2012b) show that heightened P2 and P3 to angry faces is associated with social anxiety but not with trait anxiety, indicating differences in early automatic processing. Other studies suggest a dissociation between SAD and generalized anxiety disorder (Blair et al, 2008b).…”

“…Yoon et al (2007) conducted a further analysis of the data by Phan et al (2006) and found higher activation of the amygdala and the insula to high vs. low arousing emotional (i.e., angry, disgusted, fearful, sad, and happy) faces. In line with these studies, studies assessing valence judgments show higher activation of the amygdala to negative (angry, fearful, and disgusted) faces (Klumpp et al, 2010), higher activation of the anterior cingulate cortex (ACC) and insula to disgusted faces (Amir et al, 2005), and higher activation of the ACC and MPFC to sad faces (Labuschagne et al, 2012).…”

“…Studies assessing emotion classification show higher activation of the amygdala even to neutral faces (Birbaumer et al, 1998) or higher activation of the amygdala to negative (i.e., angry, disgusted, and fearful) vs. happy faces (Phan et al, 2006) in SAD vs. healthy controls. Yoon et al (2007) conducted a further analysis of the data by Phan et al (2006) and found higher activation of the amygdala and the insula to high vs. low arousing emotional (i.e., angry, disgusted, fearful, sad, and happy) faces.…”

Subliminal cues bias perception of facial affect in patients with social phobia: evidence for enhanced unconscious threat processing

“…One limitation concerns our stimulus material, which included only one emotional expression, namely varying intensities of anger. Several studies have shown that socially anxious individuals exhibit alterations in the processing of facial expressions exhibiting not only overt aggression (anger) but also milder forms of hostile expression that signal disapproval, such as disgust and contempt (Stein et al, 2002; Amir et al, 2005; Phan et al, 2006). Hence, future studies should attempt to investigate how the present findings extend to other forms of hostile facial expression.…”

“…These results may reflect alterations in early visual processing, which possibly stem from hypersensitivity to threatening cues in associated subcortical structures (Straube et al, 2005; Phan et al, 2006; Stein et al, 2007). Accordingly, subliminal threat cues have been shown to elicit a robust neural response, particularly in anxiety-prone individuals (Li et al, 2008; Ball et al, 2012; Brooks et al, 2012).…”

“…Although numerous studies have examined subliminal threat processing in other anxiety disorders (Brooks et al, 2012), only few studies have addressed this issue in socially anxious populations using disorder-specific stimuli, i.e., threatening faces. Empirical evidence, which mostly stems from analogous group studies, supports the notion that (social) anxiety is associated with altered early visual processing (Li et al, 2008), engagement and guidance of attentional resources (Mogg and Bradley, 2002; Holmes et al, 2009), enhanced subcortical response (Bishop et al, 2004; Phan et al, 2006; Vizueta et al, 2011) and may affect subsequent social judgments (Li et al, 2008) when the threatening stimuli are presented under conditions of restricted awareness.…”

“…It has been suggested that social stimuli, especially faces signaling threat or disapproval, are particularly salient for individuals with social anxiety (Rapee and Heimberg, 1997), possibly as a result of the inherent biological preparedness (Öhman and Mineka, 2001b) and aversive learning experiences. Accordingly, socially anxious individuals have been shown to exhibit an attentional bias toward angry faces in visual attention paradigms (Horley et al, 2004; Pineles and Mineka, 2005; Klumpp and Amir, 2009) as well as enhanced neural reactivity toward angry expressions in limbic and extrastriate visual areas compared to healthy controls (Stein et al, 2002; Straube et al, 2005; Phan et al, 2006; Klumpp et al, 2012). …”

Effects of alcohol on brain responses to social signals of threat in humans

“…Acute alcohol consumption has been shown to diminish subjective anxiety (Levenson et al, 1980; Sher et al, 2007), impair recognition of threatening/angry faces (Borrill et al, 1987), and reduce the attentional bias towards and negative perception of threatening faces (Stevens et al, 2008; Stevens et al, 2009). Interestingly, it has been proposed that alcohol is used by patients with social phobia, who have consistently been shown to exhibit exaggerated amygdala reactivity to threatening faces (Etkin and Wager, 2007; Phan et al, 2006; Stein et al, 2002), as a coping strategy in order to dampen the effect of anxiety (Carrigan and Randall, 2003). The current study provides evidence in humans that alcohol's effects on fear/threat processing and anxiety may be mediated by its attenuation of reactivity of the amygdala to threat signals.…”

Impact of transcranial direct current stimulation on attentional bias for threat: a proof-of-concept study among individuals with social anxiety disorder

“…A wealth of data has demonstrated that the amygdala and its functionally related subcortical limbic regions are involved in early threat detection mechanisms (Davis & Whalen, 2001; Öhman, 2005). Because individuals with SAD exhibit heightened amygdala activation in response to social threat (Stein et al , 2002; Phan et al , 2006), the tDCS-induced boost within dlPFC might have triggered the shrinkage of this amygdala-based early threat detection mechanism. In turn, individuals with SAD may no longer exhibit difficulty filtering out task-irrelevant threatening distractors.…”