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

Phan, K. Luan; Fitzgerald, Daniel A.; Nathan, Pradeep J.; Tancer, Manuel E.

doi:10.1016/j.biopsych.2005.08.012

Cited by 462 publications

(363 citation statements)

References 45 publications

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“…In non-ASD populations, including both non-clinical populations and in those diagnosed with social anxiety disorder (SAD) or generalized social phobia, increased amygdala activation in response to faces is well established. This has been observed in adults (Bishop, Duncan, & Lawrence, 2004; Brühl, Delsignore, Komossa, & Weidt, 2014; Phan, Fitzgerald, Nathan, & Tancer, 2006) and in children and adolescents (Killgore & Yurgelun-Todd, 2005; Monk et al, 2008), with results pointing to right amygdala activation being uniquely associated with internalizing symptoms. For example, in participants with SAD relative to controls, those with SAD showed increased right amygdala activation and decreased left amygdala activation to neutral faces relative to oval stimuli (Cooney, Atlas, Joormann, Eugène, & Gotlib, 2006).…”

Section: Proposed Model Of Etiological Factors Associated With the Dementioning

confidence: 86%

“…For example, in participants with SAD relative to controls, those with SAD showed increased right amygdala activation and decreased left amygdala activation to neutral faces relative to oval stimuli (Cooney, Atlas, Joormann, Eugène, & Gotlib, 2006). Further, amygdala activation to interpersonal threat (i.e., fearful faces) has been found to be positively correlated with severity of social anxiety symptoms (Phan et al, 2006). However, the type of internalizing condition and stimulus may determine the direction or presence of activation.…”

Section: Proposed Model Of Etiological Factors Associated With the Dementioning

confidence: 99%

A conceptual model of risk and protective factors associated with internalizing symptoms in autism spectrum disorder: A scoping review, synthesis, and call for more research

Yarger

Redcay

2020

Dev Psychopathol

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This paper reviews and synthesizes key areas of research related to the etiology, development, and maintenance of internalizing symptoms in children, adolescents, and adults with autism spectrum disorder (ASD). In developing an integrated conceptual model, we draw from current conceptual models of internalizing symptoms in ASD and extend the model to include factors related to internalizing within other populations (e.g., children that have experienced early life stress, children with other neurodevelopmental conditions, typically developing children) that have not been systematically examined in ASD. Our review highlights the need for more research to understand the developmental course of internalizing symptoms, potential moderators, and the interplay between early risk and protective factors. Longitudinal studies incorporating multiple methods and both environmental and biological factors will be important in order to elucidate these mechanisms.

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“…Instead, they show hyperscanning as reflected by increased scanpath length and short fixation periods also on non-diagnostic features such as hair or ears [47]. Interestingly, these patients show hyperactivation of the amygdala [48]–[50]. In line with the above mentioned hypothesized functional role of the amygdala, one may speculate that patients with social phobia initially show enhanced reflexive gaze shifts toward the eye region but subsequently avoid scanning this feature to reduce an upcoming fear of being observed and evaluated by others.…”

Section: Discussionmentioning

confidence: 97%

Diagnostic Features of Emotional Expressions Are Processed Preferentially

2012

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Diagnostic features of emotional expressions are differentially distributed across the face. The current study examined whether these diagnostic features are preferentially attended to even when they are irrelevant for the task at hand or when faces appear at different locations in the visual field. To this aim, fearful, happy and neutral faces were presented to healthy individuals in two experiments while measuring eye movements. In Experiment 1, participants had to accomplish an emotion classification, a gender discrimination or a passive viewing task. To differentiate fast, potentially reflexive, eye movements from a more elaborate scanning of faces, stimuli were either presented for 150 or 2000 ms. In Experiment 2, similar faces were presented at different spatial positions to rule out the possibility that eye movements only reflect a general bias for certain visual field locations. In both experiments, participants fixated the eye region much longer than any other region in the face. Furthermore, the eye region was attended to more pronouncedly when fearful or neutral faces were shown whereas more attention was directed toward the mouth of happy facial expressions. Since these results were similar across the other experimental manipulations, they indicate that diagnostic features of emotional expressions are preferentially processed irrespective of task demands and spatial locations. Saliency analyses revealed that a computational model of bottom-up visual attention could not explain these results. Furthermore, as these gaze preferences were evident very early after stimulus onset and occurred even when saccades did not allow for extracting further information from these stimuli, they may reflect a preattentive mechanism that automatically detects relevant facial features in the visual field and facilitates the orientation of attention towards them. This mechanism might crucially depend on amygdala functioning and it is potentially impaired in a number of clinical conditions such as autism or social anxiety disorders.

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“…However, the amygdala was not activated in response to our stimuli. This may be due to the nature of our stimuli, which were neutral or happy, and contrasted with the harsh and angry expressions used in previous studies that reported amygdala hyperactivation (Davies et al, 2017; Gentili et al, 2008; Phan et al, 2006; Stein et al, 2002). Insula activation was observed in our study, consistent with the finding of other studies (Boehme et al, 2014; Choi et al, 2016; Gentili et al, 2008; Kim et al, 2018; Straube et al, 2004).…”

Section: Discussionmentioning

confidence: 97%

“…The distress task measured attitudes toward social cues by asking whether participants felt distress while viewing a set of facial images of people as a simulated audience. Previous studies have frequently focused on negative stimuli, such as angry faces, to evoke social anxiety (Phan et al, 2006; Stein et al, 2002). In ordinary social situations, however, the audience is not expressing anger because the speaker is clumsy, and can maintain a neutral expression or rather smile.…”

Section: Introductionmentioning

confidence: 99%

“…The neural basis of these characteristic manifestations has been explored using neuroimaging studies, which have suggested hyperactivation of the fear circuit (Bruhl, Delsignore, Komossa, & Weidt, 2014; Freitas-Ferrari et al, 2010). For example, typical social cues such as other people's faces or speech anticipation induce excessive activation of limbic emotion-related regions, including the amygdala (Davies et al, 2017; Gentili et al, 2008; Kim et al, 2018; Kraus et al, 2018; Phan, Fitzgerald, Nathan, & Tancer, 2006; Stein, Goldin, Sareen, Zorrilla, & Brown, 2002) and insula (Boehme et al, 2014; Choi, Shin, Ku, & Kim, 2016; Gentili et al, 2008; Kim et al, 2018; Straube, Kolassa, Glauer, Mentzel, & Miltner, 2004), and decreased activity of visual cortices related to processing of facial stimuli, including the fusiform gyrus and intraparietal sulcus (Binelli et al, 2016; Gentili et al, 2008). Because of the consciousness of other people's eyes, activation of regions related to theory of mind (ToM), including the superior temporal sulcus, middle temporal gyrus, and temporoparietal junction, is another characteristic (Brühl et al, 2011; Choi et al, 2016; Gentili et al, 2008; Kim et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Neural effects of a short-term virtual reality self-training program to reduce social anxiety

et al. 2020

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Background Social anxiety disorder (SAD) is characterized by anxiety regarding social situations, avoidance of external social stimuli, and negative self-beliefs. Virtual reality self-training (VRS) at home may be a good interim modality for reducing social fears before formal treatment. This study aimed to find neurobiological evidence for the therapeutic effect of VRS. Methods Fifty-two patients with SAD were randomly assigned to a VRS or waiting list (WL) group. The VRS group received an eight-session VRS program for 2 weeks, whereas the WL group received no intervention. Clinical assessments and functional magnetic resonance imaging scanning with the distress and speech evaluation tasks were repeatedly performed at baseline and after 3 weeks. Results The post-VRS assessment showed significantly decreased anxiety and avoidance scores, distress index, and negative evaluation index for ‘self’, but no change in the negative evaluation index for ‘other’. Patients showed significant responses to the distress task in various regions, including both sides of the prefrontal regions, occipital regions, insula, and thalamus, and to the speech evaluation task in the bilateral anterior cingulate cortex. Among these, significant neuronal changes after VRS were observed only in the right lingual gyrus and left thalamus. Conclusions VRS-induced improvements in the ability to pay attention to social stimuli without avoidance and even positively modulate emotional cues are based on functional changes in the visual cortices and thalamus. Based on these short-term neuronal changes, VRS can be a first intervention option for individuals with SAD who avoid society or are reluctant to receive formal treatment.

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“…Based on animal models of fear of learning (Davis & Whalen, 2001;LeDoux, 2000), one hypothesis predicts that amygdalar dysfunction is common to a variety of anxiety disorders. Indeed, amygdalar hyperactivity has been observed during symptom provocation or negative emotional processing in patients with posttraumatic stress disorder (PTSD) (Rauch et al, 2000;Shin et al, 2004Shin et al, , 2005, social anxiety disorder (Phan, Fitzgerald, Nathan, & Tancer, 2006;Stein, Goldin, Sareen, Zorrilla, & Brown, 2002), panic disorder (van den Heuvel et al, 2005) and obsessive-compulsive disorder (van den Heuvel et al, 2004) as well as specific phobia (Dilger et al, 2003;Schienle, Schäfer, Walter, Stark, & Vait, 2005;Straube, Mentzel, & Miltner, 2006;Veltman et al, 2004). Shared symptoms of anxiety disorders, such as an exaggerated fear response, might be reflected in shared neurobiology (Etkin & Wager, 2007).…”

Section: Discussionmentioning

confidence: 97%

The prevalence of specific phobia and associated co-morbid features in children and adolescents

Kim¹,

Kim²,

Cho³

et al. 2010

Journal of Anxiety Disorders

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“…Behavioural inhibition and introversion have been linked with hyper-reactivity of brain structures such as the amygdala and insular cortices (Stein et al 2002(Stein et al , 2007Schwartz et al, 2003;Phan et al 2006;Hooker et al 2008). Therefore, Smoller and colleagues investigated the relationship between the RGS2 variant and functional reactivity of the amygdala and the insulae via neuroimaging.…”

Section: Discussionmentioning

confidence: 98%

Amygdala hypersensitivity in response to emotional faces in Tourette's patients

Neuner

Kellermann

Stöcker

et al. 2010

The World Journal of Biological Psychiatry

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We will discuss these findings as a result of either deficient frontal inhibition due to structural changes or a desynchronization in the interaction of the cortico-striato-thalamo-cortical network within structures of the limbic system. Our data show an altered pattern of implicit emotion discrimination and emphasize the need to consider motor and non-motor symptoms in Tourette's syndrome in the choice of both behavioural and pharmacological treatment.

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“…Wang, 2010). Of interest, data indicate that deliberately diminishing negative affective responses yields increased activation in lateral and dorsal regions of the prefrontal cortex (PFC) and=or decreased activation in the amygdala (Phan, Fitzgerald, Nathan, & Tancer, 2006) suggesting that the PFC exerts a top-down, inhibitory influence through the medial PFC (e.g., BA 10 and 9) given its connections with the dorsolateral PFC and amygdala (Price, 2005). Studies of social stress have also shown a potential modulator role for the left PFC (BA 9 and 10) on the right amygdala (J.…”

Section: Discussionmentioning

confidence: 98%

sLORETA and fMRI Detection of Medial Prefrontal Default Network Anomalies in Adult ADHD

Cannon¹,

Kerson²,

Hampshire³

2011

Journal of Neurotherapy

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Attention deficit hyperactivity disorder (ADHD) is a developmental psychiatric disorder thought to affect approximately 5 to 10% of school-age children, of whom 30 to 65% continue to exhibit symptoms into adulthood. The prevalence of ADHD in adults is also an estimated 4%, second only to depression. Across studies there appear to be significant network dysfunctions involved in ADHD. Typically the foci of interest in ADHD included the insular cortices, frontal lobes, basal ganglia, and cerebellum. More recently, attention has been directed to the default network of the brain and its functional integrity in ADHD with focus on the precuneus and parietal lobes and interactions with medial prefrontal cortices. Functional magnetic resonance imaging (fMRI) measures neurovascular coupling as measured by the blood oxygenated level dependent signal (BOLD). Electroencephalogram (EEG) measures brain electrical information. Because fMRI is an indirect measure of neuronal activity and EEG is a direct measure, combining the results from these two imaging modalities under the same task conditions may provide a more complete story as to the what (EEG) and where (fMRI) activity exists. This article discusses the benefits of using standardized low resolution electromagnetic tomography (sLORETA) analysis of the EEG as compared to fMRI. The goal of the study, the data from which we use for our justification, was to discover the functional differences in ADHD and non-ADHD brains with different brain imaging modalities. We hoped to elucidate functional connectivity patterns by interpreting the data acquired with the EEG using sLORETA and the data acquired with the fMRI scans. We further hoped to find correlation with the sLORETA and fMRI interpretations so as to confirm that EEG is an adequate stand-alone methodology to evaluate ADHD. Participants included 6 ADHD and 7 non-ADHD subjects. They were initially interviewed by phone and administered the Connors Rating Scale and the Mini International Neuropsychiatric Interview to determine accuracy of symptom reporting and to rule out psychological comorbidities. Exclusion criteria consisted of previous head trauma, recent drug or alcohol abuse (14 days), or neurological syndromes. We recorded sequential 19-channel EEG and fMRI during the eyes-open and eyes-closed states and while performing the Stroop test. The QEEG results were evaluated with comparison to a normative database and with sLORETA analysis.Functional connectivity was assessed using the seed-based approach in sLORETA. The fMRI results were evaluated using Brain Voyager TM and other neuroimaging software packages. sLORETA and fMRI data identify a region in medial Brodmann Area (BA) 10 of the default network. Furthermore, regional frontal differences extend to medial BA 32 with more emphasis to left prefrontal. sLORETA determines there is less current source density at BA 10 in the ADHD participants than controls. sLORETA is adequate in localizing the sources of the EEG in the default network as contrasted with fMRI. It is impor...

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“…5). This finding is surprising, as various neuroimaging studies typically associate SAD with amygdala hyperactivity during task or rest (Birbaumer et al 1998;Schneider et al 1999;Stein et al 2002;Phan et al 2006) and enhanced coupling with cognitive control regions (Brühl et al 2014).…”

Section: Discussionmentioning

confidence: 98%

Reappraisal of Interpersonal Criticism in Social Anxiety Disorder: A Brain Network Hierarchy Perspective

et al. 2018

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Emotion regulation is thought to involve communication between and within large-scale brain networks that underlie emotion reactivity and cognitive control. Aberrant network interaction might therefore be a key neural feature of mental disorders that involve emotion dysregulation. Here we tested whether connectivity hierarchies within and between emotion reactivity and cognitive reappraisal networks distinguishes social anxiety disorder (SAD) patients (n = 70) from healthy controls (HC) (n = 25). To investigate network organization, we implemented a graph-theory method called Dependency Network Analysis. Participants underwent fMRI while watching or reappraising video clips involving interpersonal verbal criticism. During reappraisal, the reappraisal network exerted less influence on the reactivity network in SAD participants. Specifically, the influence of the right inferior frontal gyrus on both reappraisal and reactivity networks was significantly reduced in SAD compared with HC, and correlated negatively with negative emotion ratings among SAD participants. Surprisingly, the amygdala exhibited reduced influence on the reappraisal network in SAD relative to HC. Yet, during the watch condition, the left amygdala's influence on the reactivity network increased with greater social anxiety symptoms among SAD participants. These findings refine our understanding of network organization that contributes to efficient reappraisal or to disturbances in applying this strategy in SAD.

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“…At the same time, deficiencies in emotion identification and discrimination skills negatively affect the communication skills of individuals with SAD (Valença et al 2005). Despite studies in the literature (Straube et al 2004, Phan et al 2006, Yoon et al 2007, it was found that there was no difference in emotion identification and discrimination social cognition skills of individuals with social anxiety problems compared to those without social anxiety. There are also studies (Campbell et al 2009, Garner et al 2009, Arrais et al 2010 showing that social anxiety has low emotion identification and discrimination skills.…”

Section: Discussionmentioning

confidence: 99%

Predictive Effect of Social Cognitive Skills on Social Anxiety

KAVAL>

Arkar

2022

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry

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Bu çalışmanın temel amacı sosyal kaygı ile sosyal biliş becerileri (duygu tanıma/ayırt etme, zihin kuramı, atıf yanlılığı, sosyal işlevsellik) arasındaki ilişkiyi incelemek ve sosyal biliş becerilerinin sosyal kaygıyı yordama gücünü araştırmaktır. Çalışmada ayrıca sosyal kaygı, sosyal biliş becerileri ve depresyon puanlarının cinsiyet, yaş, bildirilen tanı durumu ve sosyal kaygı düzeyine göre farklılaşıp farklılaşmadığı araştırılmıştır. Çalışmanın örneklemini, 18-60 yaşları arasında bulunan toplam 385 kişi oluşturmuştur. Araştırma verileri çevrimiçi olarak Liebowitz Sosyal Anksiyete Ölçeği, Yüzde Dışavuran Duyguların Tanınması ve Ayırt Edilmesi Testi, Gözlerden Zihin Okuma Testi, İçsel, Kişisel ve Durumsal Atıflar Ölçeği, Sosyal İşlevsellik Ölçeği, Beck Depresyon Envanteri ve Sosyodemografik Bilgi Formu kullanılarak katılımcılardan toplanmıştır. Sosyal kaygı ile duygu tanıma, duygu ayırt etme ve gözlerden zihin okuma arasında negatif, dışsallaştırma yanlılığı ve depresyon ile ise pozitif yönde anlamlı ilişki olduğu belirlenmiştir. Depresyon, duygu tanıma ve ayırt etme, gözlerden zihin okuma ve öncül sosyal etkinlikler ölçek puanlarının sosyal kaygıyı anlamlı düzeyde yordadığı bulunmuştur. Bu değişkenler sosyal kaygıya ilişkin toplam varyansın %52’sini açıklamaktadır. Ayrıca, depresyon etkisi kontrol edildiğinde sosyal biliş becerilerinin sosyal kaygıya ilişkin varyansın %32’sini açıkladığı görülmüştür. Sosyal biliş becerilerindeki bozulmanın ve depresyon puanlarının sosyal kaygının artışıyla ilişkili olduğu belirlenmiştir. Araştırmadan elde edilen sonuçlara göre, sosyal kaygıyı önlemeye yönelik önerilerde bulunulmuştur. Müdahale programları içerisinde bireylerin kişilerarası iletişimi için önemli olan sosyal biliş becerilerini geliştirmeye yönelik etkinliklere yer verilmesinin yararlı olacağı önerilmektedir.

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“…A large body of literature among typically developing adults points to functional differences in brain activity, in particular among those with anxiety disorders compared to those without [Phan, Fitzgerald, Nathan, & Tancer, 2006;Sato, Yoshikawa, Kochiyama, & Matsumura, 2004;Whalen et al, 2001]. Specifically, high levels of social anxiety have been robustly linked with greater amygdala activation in these studies.…”

Section: Central Nervous Systemmentioning

confidence: 89%

The neurobiological presentation of anxiety in autism spectrum disorder: A systematic review

McVey

2019

Autism Research

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Anxiety is common among people with autism and is associated with unique and additive challenges. Anxiety is thought to have neurobiological components, and measures of arousal in typical development have long been studied. Recently, neurobiological measures of anxiety in autism have begun to receive empirical evaluation, but results have not yet been examined together. This systematic review, therefore, summarizes the state of the research of the neurobiology of anxiety in autism. Studies published between 1999 and June 2017 were reviewed. Results across measures of arousal point to inconsistencies in results and a lack of synthesis in the literature. Considerations regarding these inconsistencies are discussed, recommendations for future studies are offered, and clinical implications for this work are presented. Autism Res 2019, 12: 346–369 © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary Anxiety is common among people with autism. Because anxiety has been linked with a variety of differences in physiological (bodily) and neurophysiological (brain) functioning in people without autism, research has begun to examine these processes in autism as well. This literature, however, has not yet been examined as a whole. Therefore, this paper begins to address that gap to provide the field with a better understanding of how anxiety affects people with autism and discusses implications for future research and clinical practice.

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“…[15] as evidence for this statement. According to scite [16], this reference has received 259 mentioning citation statements, 23 supporting citation statements, and three contradicting citation statements (Fig. 2).…”

Section: Introductionmentioning

confidence: 84%

“…The Wikipedia article on "Amygdala" states, "In 2006, researchers observed hyperactivity in the amygdala when patients were shown threatening faces or confronted with frightening situations. Patients with severe social phobia showed a correlation with increased response in the amygdala" citing Phan et al [14] as evidence for this statement. According to scite [15], this reference has received 259 mentioning citation statements, 23 supporting citation statements, and 3 contradicting citation statements (Figure 2).…”

Section: Accepted Articlementioning

confidence: 99%

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Measuring the quality of scientific references in Wikipedia: an analysis of more than 115M citations to over 800 000 scientific articles

Nicholson¹,

Uppala²,

Sieber³

et al. 2020

The FEBS Journal

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Wikipedia is a widely used online reference work which cites hundreds of thousands of scientific articles across its entries. The quality of these citations has not been previously measured, and such measurements have a bearing on the reliability and quality of the scientific portions of this reference work. Using a novel technique, a massive database of qualitatively described citations, and machine learning algorithms, we analyzed 1,923,575 Wikipedia articles which cited a total of 824,298 scientific articles in our database, and found that most scientific articles cited by Wikipedia articles are uncited or untested by subsequent studies, and the remainder show a wide variability in contradicting or supporting evidence. Additionally, we analyzed 51,804,643 scientific articles from journals indexed in the Web of Science and found that similarly most were uncited or untested by subsequent studies, while

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

Cited by 462 publications

References 45 publications

A conceptual model of risk and protective factors associated with internalizing symptoms in autism spectrum disorder: A scoping review, synthesis, and call for more research

Diagnostic Features of Emotional Expressions Are Processed Preferentially

Neural effects of a short-term virtual reality self-training program to reduce social anxiety

The prevalence of specific phobia and associated co-morbid features in children and adolescents

Amygdala hypersensitivity in response to emotional faces in Tourette's patients

sLORETA and fMRI Detection of Medial Prefrontal Default Network Anomalies in Adult ADHD

Reappraisal of Interpersonal Criticism in Social Anxiety Disorder: A Brain Network Hierarchy Perspective

Predictive Effect of Social Cognitive Skills on Social Anxiety

The neurobiological presentation of anxiety in autism spectrum disorder: A systematic review

Measuring the quality of scientific references in Wikipedia: an analysis of more than 115M citations to over 800 000 scientific articles

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