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Neural response to the observable self in social anxiety disorder

Published online by Cambridge University Press:  16 August 2012

J. Pujol ,
M. Giménez ,
H. Ortiz ,
C. Soriano-Mas ,
M. López-Solà ,
M. Farré ,
J. Deus ,
E. Merlo-Pich ,
B. J. Harrison  and
N. Cardoner
...Show all authors
J. Pujol*
Affiliation:
Institut d'Alta Tecnologia-PRBB, CRC Mar, Hospital de Mar, Barcelona, Spain
M. Giménez
Affiliation:
Institut d'Alta Tecnologia-PRBB, CRC Mar, Hospital de Mar, Barcelona, Spain
H. Ortiz
Affiliation:
Institut d'Alta Tecnologia-PRBB, CRC Mar, Hospital de Mar, Barcelona, Spain
C. Soriano-Mas
Affiliation:
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain Carlos III Health Institute, Ministry of Science and Innovation, CIBERSAM, Spain
M. López-Solà
Affiliation:
Institut d'Alta Tecnologia-PRBB, CRC Mar, Hospital de Mar, Barcelona, Spain Carlos III Health Institute, Ministry of Science and Innovation, CIBERSAM, Spain
M. Farré
Affiliation:
Human Pharmacology and Neurosciences, Hospital del Mar Research Institute (IMIM), Red RTA, Barcelona, Spain Department of Pharmacology, Therapeutics, and Toxicology, School of Medicine, Autonomous University of Barcelona, Spain
J. Deus
Affiliation:
Institut d'Alta Tecnologia-PRBB, CRC Mar, Hospital de Mar, Barcelona, Spain Department of Clinical and Health Psychology, Autonomous University of Barcelona, Spain
E. Merlo-Pich
Affiliation:
Neuronal Targets DPU, Respiratory CEDD, GlaxoSmithKline SpA, King of Prussia, PA, USA
B. J. Harrison
Affiliation:
Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia
N. Cardoner
Affiliation:
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain Carlos III Health Institute, Ministry of Science and Innovation, CIBERSAM, Spain
R. Navinés
Affiliation:
Human Pharmacology and Neurosciences, Hospital del Mar Research Institute (IMIM), Red RTA, Barcelona, Spain Clinical Institute of Neuroscience, Hospital Clínic-IDIBAPS, CIBERSAM, Barcelona, Spain
R. Martín-Santos
Affiliation:
Clinical Institute of Neuroscience, Hospital Clínic-IDIBAPS, CIBERSAM, Barcelona, Spain Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain
*
*Address for correspondence: Dr J. Pujol, Department of Magnetic Resonance, CRC Mar, Hospital del Mar, Passeig Marítim 25–29, 08003 Barcelona, Spain. (Email: [email protected])
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Abstract

Background

Distorted images of the observable self are considered crucial in the development and maintenance of social anxiety. We generated an experimental situation in which participants viewed themselves from an observer's perspective when exposed to scrutiny and evaluation by others.

Method

Twenty patients with social anxiety disorder (SAD) and 20 control subjects were assessed using functional magnetic resonance imaging (fMRI) during the public exposure of pre-recorded videos in which they were each shown performing a verbal task. The examiners acted as the audience in the experiment and rated performance. Whole-brain functional maps were computed using Statistical Parametric Mapping.

Results

Robust activation was observed in regions related to self-face recognition, emotional response and general arousal in both study groups. Patients showed significantly greater activation only in the primary visual cortex. By contrast, they showed significant deactivation or smaller activation in dorsal frontoparietal and anterior cingulate cortices relevant to the cognitive control of negative emotion. Task-related anxiety ratings revealed a pattern of negative correlation with activation in this frontoparietal/cingulate network. Importantly, the relationship between social anxiety scores and neural response showed an inverted-U function with positive correlations in the lower score range and negative correlations in the higher range.

Conclusions

Our findings suggest that exposure to scrutiny and evaluation in SAD may be associated with changes in cortical systems mediating the cognitive components of anxiety. Disorder severity seems to be relevant in shaping the neural response pattern, which is distinctively characterized by a reduced cortical response in the most severe cases.

Keywords

Cognitive anxietyemotionfMRIpublic exposureself-recognition
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 4 , April 2013 , pp. 721 - 731
Copyright
Copyright © Cambridge University Press 2012

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