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Abstract

Relative to their respective age-matched healthy comparison groups, both adolescents and adults with social phobia showed a significantly increased response to emotional, but not neutral, facial expressions in the amygdala and the rostral anterior cingulate cortex. The observation of significant diagnosis-by-emotion interactions, but not diagnosis-by-age or diagnosis-by-age-by-emotion interactions, suggests that neural perturbations in adult social phobia, at least to emotional facial expressions, may represent persistent manifestations of abnormalities present in adolescence rather than the result of perturbed development.

Abstract

Objective:

While social phobia in adolescence predicts the illness in adulthood, no study has directly compared the neural responses in social phobia in adults and adolescents. The authors examined neural responses to facial expressions in adults and adolescents with social phobia to determine whether the neural correlates of adult social phobia during face processing also manifest in adolescent social phobia.

Method:

Blood-oxygen-level-dependent (BOLD) responses were compared in 39 medication-free participants with social phobia (25 adults and 14 adolescents) and 39 healthy comparison subjects (23 adults and 16 adolescents) matched on age, IQ, and gender. During fMRI scans, participants saw angry, fearful, and neutral expression stimuli while making a gender judgment.

Results:

Significant diagnosis-by-emotion interactions were observed within the amygdala and the rostral anterior cingulate cortex, as has previously been hypothesized. In these regions, both the adolescent and adult social phobia patients showed significantly increased BOLD responses relative to their respective age-matched comparison subjects, and there was no evidence of age-related modulation of between-group differences. These enhanced responses occurred specifically when viewing angry (rostral anterior cingulate cortex) and fearful (amygdala and rostral anterior cingulate cortex) expressions but not when viewing neutral expressions. In addition, the severity of social phobia was significantly correlated with the enhanced rostral anterior cingulate cortex response in the adults.

Conclusions:

The neural correlates of adult social phobia during face processing also manifest in adolescents. Neural correlates that are observed in adult social phobia may represent the persistence of profiles established earlier in life rather than adaptive responses to such earlier perturbations or maturational changes. These cross-sectional observations might encourage longitudinal fMRI studies of adolescent social phobia.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 1202 - 1209
PubMed: 21632650

History

Received: 9 December 2010
Revision received: 11 February 2011
Accepted: 23 March 2011
Published online: 1 November 2011
Published in print: November 2011

Authors

Details

Karina S. Blair, Ph.D.
From the Mood and Anxiety Program, National Institute of Mental Health.
Marilla Geraci, M.S.N.
From the Mood and Anxiety Program, National Institute of Mental Health.
Katherine Korelitz, B.S.
From the Mood and Anxiety Program, National Institute of Mental Health.
Marcela Otero, B.A.
From the Mood and Anxiety Program, National Institute of Mental Health.
Ken Towbin, M.D.
From the Mood and Anxiety Program, National Institute of Mental Health.
Monique Ernst, M.D., Ph.D.
From the Mood and Anxiety Program, National Institute of Mental Health.
Ellen Leibenluft, M.D.
From the Mood and Anxiety Program, National Institute of Mental Health.
R.J.R. Blair, Ph.D.
From the Mood and Anxiety Program, National Institute of Mental Health.
Daniel S. Pine, M.D.
From the Mood and Anxiety Program, National Institute of Mental Health.

Notes

Address correspondence and reprint requests to Dr. Blair ([email protected]).

Funding Information

The authors report no financial relationships with commercial interests.Supported by the NIMH Intramural Research Program.

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