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

doi:10.1016/j.biopsych.2005.08.012

Biological Psychiatry

Volume 59, Issue 5, 1 March 2006, Pages 424-429

https://doi.org/10.1016/j.biopsych.2005.08.012 Get rights and content

Background

Previous functional brain imaging studies of social anxiety have implicated amygdala hyperactivity in response to social threat, though its relationship to quantitative measures of clinical symptomatology remains unknown. The primary aim of this study was to examine the association between response to emotionally harsh faces in the amygdala, a region implicated in social and threat-related processing, and severity of social anxiety symptoms in patients with generalized social phobia (GSP).

Methods

Ten subjects with GSP naive to psychotropic medications and without psychiatric comorbidity and ten healthy comparison subjects matched on age, gender, ethnicity, and education completed the Liebowitz Social Anxiety Scale and underwent high-field (4Tesla) functional magnetic resonance imaging while viewing blocks of emotionally salient faces.

Results

Relative to happy faces, activation of the amygdala in response to harsh (angry, disgusted, fearful) faces was greater in GSP patients than in controls, and the extent of amygdala activation was positively correlated with severity of social anxiety symptoms, but not general state or trait anxiety levels.

Conclusions

Our findings suggest that amygdala activation to interpersonal threat can be specifically linked to the severity of social anxiety symptoms of individual GSP patients, and thus, may serve as a useful functional marker of disease severity.

Section snippets

Subjects

Ten subjects with GSP, based on DSM-IV criteria (≥7 of 12 social fears) as verified by the Structured Clinical Interview for DSM-IV (First et al 1995) with additional probes from the self-administered Liebowitz Social Anxiety Scale (LSAS-SR) (Fresco et al 2001, Heimberg et al 1999), and ten healthy comparison (HC) subjects participated in the study. None of the GSP patients had a current/recent depressive episode (within 12 months of study entry) or a lifetime history of any other Axis I

Results

Subjects with GSP and HCs did not differ significantly in the overall mean accuracy (e.g., across emotions) of face emotion recognition (GSP: 76.2 ± 11.2% correct vs. HC: 76.2 ± 11.7% correct, p > .7), or overall response times (GSP: 3.1 ± 1.2 sec vs. HC: 2.8 ± .7 sec, p > .6). Similarly, the emotion recognition and reaction times for each emotional expression were not significantly different between-groups (all p > .2).

Relative to healthy controls, subjects with GSP had greater brain

Discussion

To our knowledge, this is the first report of an association between amygdala responsivity to aversive faces and severity of social anxiety symptoms in generalized social phobia. The findings support those of recent similar studies (Stein et al 2002, Straube et al 2004) and suggest that amygdala hyper-responsivity to socially salient (e.g., emotional faces with aversive expressions) stimuli can be reliably measured in this population. They also extend previous findings in a group of patients

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

Background

Methods

Results

Conclusions

Section snippets

Subjects

Results

Discussion

Curr Opin Neurobiol

Clin Psychol Rev

Behav Res Ther

Biol Psychiatry

Neuron

Trends Cogn Sci

Biol Psychiatry

Comput Biomed Res

J Anxiety Disord

Neurosci Lett

J Neurosci Methods

Trends Pharmacol Sci

Neurosci Lett

Neuroimage

Biol Psychiatry

Biol Psychiatry

Biol Psychiatry

Biol Psychiatry

Biol Psychiatry

Biol Psychiatry

Brain Res Brain Res Rev

Is the human amygdala specialized for processing social information?

Ann N Y Acad Sci

fMRI reveals amygdala activation to human faces in social phobics

Neuroreport

Prefrontal cortical function and anxietycontrolling attention to threat-related stimuli

Nat Neurosci

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