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

A Functional Magnetic Resonance Imaging Predictor of Treatment Response to Venlafaxine in Generalized Anxiety Disorder

“…This finding adds to existing experimental data assessing amygdala responsivity to fearful face stimuli across different anxiety disorders. To date, exaggerated amygdala responsivity to emotional facial expressions has been documented in PTSD (13,14,16) and social phobia (20,23) but not in simple phobia (43) or GAD (present study). More complex fMRI response patterns have been observed in other studies, perhaps owing to differences in the acuteness of the disorder (PTSD) (44), stimulus presentation parameters (i.e., masked vs. unmasked, PTSD) (16,44), and medication status (panic disorder) (45).…”

“…Of specific relevance to the present experiment are data showing that greater rostral ACC (rACC) reactivity in response to facial expressions of emotion is correlated with lesser amygdala reactivity (6,7). Thus, facial expressions represent simple stimuli for assessing amygdalaprefrontal reactivity and provide a basis to assess amygdalaprefrontal function in psychopathology (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23).…”

Association between level of emotional intelligence and severity of anxiety in generalized social phobia

“…Within the framework offered by Mayer and colleagues, Strategic EI is thought to involve the ability to reason about emotions and their management and is considered to index the more higher-level, conscious processing of emotions. Interestingly, the neuroimaging literature on GSP, at least, has consistently stressed an anomalous emotional (amygdala) response to social/ emotional stimuli rather than an anomalous ability to understand or reason about their emotional responses (Phan et al, 2006;Stein et al, 2002;Straube et al, 2004). This is, of course, in contrast to the literature on other emotional disorders such as Posttraumatic Stress Disorder where a reduced regulatory (prefrontal) ability has been also been stressed (Bremner, 2002;Shin et al, 2005).…”

“…Thus, studies examining the neural response to emotional expressions in patients with GSP have reported increased activity in several regions including the amygdala and anterior cingulate cortex to a variety of facial expressions including harsh (Phan, Fitzgerald, Nathan, & Tancer, 2006), angry (Blair et al, under revision-a;Stein, Goldin, Sareen, Zorrilla, & Brown, 2002;Straube, Kolassa, Glauer, Mentzel, & Miltner, 2004;Straube, Mentzel, & Miltner, 2005), fearful (Blair et al, under revision-a;Stein et al, 2002), disgusted (Amir et al, 2005), happy (Straube et al, 2005) as well as neutral (Birbaumer et al, 1998;Stein et al, 2002) expressions. Moreover, individuals with GSP appear to 'scan' facial expressions atypically, showing decreased scanning of selected facial features (particularly the eyes), and increased scanning of non-features, compared to non-anxious controls (Horley, Williams, Gonsalvez, & Gordon, 2003;Horley, Williams, Gonsalvez, & Gordon, 2004).…”

Altered neural correlates of affective processing after internet-delivered cognitive behavior therapy for social anxiety disorder

“…The amygdala is held to be an important fear processing hub and exaggerated amygdala responses have been reported in individuals with anxiety disorders including SAD (Etkin and Wager, 2007), as well as in anxiety-prone subjects . Amygdala reactivity seems to alter in relation to self-reported level of anxiety (Evans et al, 2008;Phan et al, 2006), and it can be modulated by SSRIs (Faria et al, 2012;Furmark et al, 2005), rapidly absorbed anxiolytic medication (Paulus et al, 2005) as well as fronto-cortical emotion regulation strategies (Eippert et al, 2007). Although we found support for the hypothesis of reduced anxiety related amygdala reactivity with successful treatment, we can not rule out that iCBT may reduce social anxiety via a separate mechanism.…”

“…Viewing emotionally valenced faces has been shown to reliably activate the amygdala in patients with SAD (Lira Yoon et al, 2007;Stein et al, 2002;Straube et al, 2004), and severity of symptoms predicts the amygdala activation to negative faces (Evans et al, 2008;Goldin et al, 2009a;Phan et al, 2006). Affective face processing tasks have also been used as predictors for outcome of CBT for SAD (Doehrmann et al, 2013;Klumpp et al, 2013), and the pharmacological treatment of anxiety (Whalen et al, 2008).…”

Topography of the Anxious Self: Abnormal Rest-Task Modulation in Social Anxiety Disorder

“…Yet another widely used paradigm are emotional faces. This showed consistent hyperactivation of amygdala and insula in SAD (Etkin and Wager 2007) during especially negative-emotional faces, that is, fearful, angry, disgusted (Amir and others 2005; Blair and others 2008b; Blair and others 2011a; Evans and others 2008; Fonzo and others 2015; Gentili and others 2008; Klumpp and others 2010; Klumpp and others 2012; Klumpp and others 2013; Phan and others 2006; Phan and others 2013; Stein and others 2002b; Straube and others 2005; Yoon and others 2007). Various studies also report abnormal activity in the frontal regions: an increased activity following negative-emotional faces have been found in anterior midline DMN regions like DMPFC, VMPFC, PGACC, SGACC, and also DACC (Amir and others 2005; Blair and others 2008b; Blair and others 2011a; Evans and others 2008; Goldin and others 2009b; Klumpp and others 2012; Labuschagne and others 2012; Wheaton and others 2014; Ziv and others 2013; Fig.…”

Fear of Negative Evaluation Moderates the Effect of Subliminal Fear Priming on Rejection of Unfair Offers in the Ultimatum Game

“…Moreover, causality of the rejection of unfair offers and the function of the amygdala has been revealed32; thus, the amygdala plays an important role in warning against social threats, such as acquiring negative reputation. According to research on social anxiety, people who have high social anxiety show overactivation of the amygdala when faced with evaluation from others252637 and when watching fearful face272829. If the function of the amygdala and responsiveness to fearful faces is significantly higher in people who have high, vs. low, social anxiety, then the results observed in the current study can be explained by the function of the amygdala.…”

“…Social anxiety is characterised by the fear of negative evaluation from others, and many studies have shown that people with high social anxiety feel excessive fear and anxiety during or prior to public speaking242526, and that their autonomic nervous system responses (e.g., heart rate and skin conductance response) increase significantly more than those of people with low social anxiety. Furthermore, in relation to facial recognition abilities, people with high social anxiety show overactivation of fear-related brain areas when they view a negative emotional expression on a face272829. Interestingly, people with high social anxiety were found to show an autonomic nervous system response when a photograph of a fearful face was displayed in subliminal presentation27.…”

Written threat: Electrophysiological evidence for an attention bias to affective words in social anxiety disorder

“…Stein, Goldin, Sareen, Zorrilla, and Brown (2002) found greater amygdala activations to harsh (angry, fearful, contemptuous) than to neutral faces in subjects with generalised social phobia compared to healthy controls, suggesting a general activation of the threat processing system in reaction to interpersonal threat cues. So far, these findings have been reported relatively stable over different studies (e.g., Phan, Fitzgerald, Nathan, & Tancer, 2006) using emotional facial expressions. However, the studies by Stein et al (2002) and Phan et al (2006) used facial expressions as stimuli making it hard to generalise their results.…”

“…So far, these findings have been reported relatively stable over different studies (e.g., Phan, Fitzgerald, Nathan, & Tancer, 2006) using emotional facial expressions. However, the studies by Stein et al (2002) and Phan et al (2006) used facial expressions as stimuli making it hard to generalise their results. Considering the use of emotional words one possible explanation for the absence of a specific effect for swear words in the current study might be the lack of self-reference.…”

Increased Neural Habituation in the Amygdala and Orbitofrontal Cortex in Social Anxiety Disorder Revealed by fMRI

“…In social cognition, the amygdala plays a central role in social reward anticipation and processing of ambiguity [87]. Consistent with these findings, amygdala involvement has been outlined as central in the pathophysiology of social anxiety disorders [27], [88]. A number of studies have investigated the processing of emotional faces in social anxiety disorder and identified and retrieved hyperactivity of the amygdala in response to negatively valenced (harsh or angry) and neutral in SAD patients compared to healthy volunteers [28], [89], [90].…”

“…This study used emotional faces to provoke activations within the emotion processing network. While sensitivity towards emotional faces has been reported before [27], this paradigm was not designed to put the patients in an actual stress situations where they would fully experience symptoms of their anxiety disorder. While not in a social threat situation, SAD patients showed concurrent habituation of the medial orbitofrontal cortex and bilateral amygdalae.…”

Neuroimaging in anxiety disorders

“…Stein et al ( 2002 ) however, investigated a signal increase in amygdalae, uncus, and gyrus parahippocampalis in patients in the fMRI on presentation of faces expressing negative affectivity, exclusively. This could be confirmed by Evans et al ( 2007 ) and Phan et al ( 2006 ) in generalized SAD patients who were shown aversive faces displaying higher amygdalae activation. The extent of activation correlated with SAD severity and was reversible after antidepressant treatment (Norbury et al 2007 ).…”

Socially anxious individuals perform better using low spatial frequency information to process facial expressions and objects

“…Our account for the smaller cost shown by HSAi (with respect to LSAi) in processing LSFs images of everyday objects and neutral faces vs. unfiltered images of everyday objects and neutral faces find some support in neuroimaging studies of anxiety disorders which have demonstrated that there is greater activation of the amygdala when socially anxious individuals are presented with emotional faces (Stein, Goldin, Sereen, Eyler Zorrilla, & Brown, 2002;Phan, Fitzgerald, Nathan, & Tancer, 2006), during speech anticipation (Lorberbaum et al, 2004) or criticism (Blair et al, 2008).…”

Cannabinoid Modulation of Amygdala Reactivity to Social Signals of Threat in Humans

“…Activation in the amygdala increases with exposure to faces that convey threat, such as fearful and angry faces, but diminished with faces that convey acceptance, such as happy faces (Morris et al, 1996;Whalen et al, 1998). Consistent with this, individuals with social phobias exhibit exaggerated amygdala reactivity to threatening faces (Stein et al, 2002;Phan et al, 2006), whereas those who eagerly engage in social interactions (social fearlessness) show diminished amygdala reactivity to the same types of faces . Amygdala hyperactivity to threatening faces has also consistently been observed in patients with anxiety disorders (Etkin and Wager, 2007).…”

“…On perception of threat, the lateral nucleus of the amygdala is thought to integrate inputs and excite the central nucleus to evoke fear responses (LeDoux, 2000). In humans, detection of social signals of threat (e.g., fearful/angry faces) enhances amygdala reactivity (Morris et al, 1996;Whalen et al, 1998), and individuals with pathological anxiety exhibit exaggerated amygdala reactivity to threatening faces (Rauch et al, 2000;Phan et al, 2006). In both monkeys and humans, discrete lesions to the amygdala lead to altered fear responses and perception (Kalin et al, 2001;Adolphs et al, 2005).…”