Cited by 169Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentMemory and Neural Mechanisms

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Fearful Imagery in Social Phobia: Generalization, Comorbidity, and Physiological Reactivity

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McTeague, Lisa M., Lang, Peter J., Laplante, Marie-Claude, Cuthbert, Bruce N., Strauss, Cyd C., Bradley, Margaret M.·2009·Biological Psychiatry

DOI 10.1016/j.biopsych.2008.09.023PMC PMC2735121

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Abstract

Background Social phobia has been characterized as a disorder of exaggerated fear of social threat and heightened sensitivity to imagery of social failure.Methods To assess the physiological basis of this description, social phobia patients (n=75) and demographically matched control participants (n=75) imagined neutral and fearful events while acoustic startle probes were occasionally presented and eye-blink responses (orbicularis occuli) recorded. Changes in heart rate, skin conductance level, and facial expressivity were also indexed. In addition to comparing control participants and social phobia patients, the influences of diagnostic subtype (circumscribed, generalized), comorbid depression, and chronicity were assessed.Results Patients exceeded control participants in startle reflex and autonomic responding during imagery of social threat, whereas the groups evinced commensurate reactivity to contents depicting commonly shared fears (survival threat). Individuals with circumscribed performance phobia were similar to control participants, with the exception of more robust reactions to idiographic, performance fear imagery. In contrast, generalized phobic patients were characterized by longer disorder chronicity and demonstrated heightened sensitivity to a broader range of fear contents. Those with generalized phobia plus comorbid depression showed attenuation of fear-potentiated startle and reported the most protracted social anxiety.Conclusions Subtypes of social phobia can be objectively distinguished in patterns of physiological reactivity. Furthermore, subtypes vary systematically in chronicity and defensive engagement with the shortest disorder duration (circumscribed phobia) associated with the most robust and focal physiological reactivity, followed by broader defensive sensitivity in more chronic generalized phobia, and finally attenuation of the formerly exaggerated fear potentiation in the comorbidly depressed, the most chronic form.

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Authors: McTeague, L. M., Lang, P. J., Laplante, M.-C., Cuthbert, B. N., Strauss, C. C., & Bradley, M. M.
Affiliations: University of Florida (US)
University of Minnesota (US)
Corresponding author: Lang, Peter J.
ORCID: McTeague, Lisa M.
Lang, Peter J.
Cuthbert, Bruce N.
Bradley, Margaret M.
Venue: Biological Psychiatry
Publisher: Elsevier BV
Published: 2009-03
Volume: 65
Issue: 5
Pages: 374-382
ISSN: 0006-3223 (ISSN-L)
DOI: 10.1016/j.biopsych.2008.09.023
PMC: PMC2735121
OpenAlex: W2070583390
Cited by: 169
References: 60
Citations by year: 2026: 1 · 2025: 3 · 2024: 7 · 2023: 8 · 2022: 6 · 2021: 11 · 2020: 3 · 2019: 4 · 2018: 8 · 2017: 9 · 2016: 13 · 2015: 14 · 2014: 19 · 2013: 17 · 2012: 12
FWCI: 14.78
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Biological Psychiatry (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (P50MH052384, P50MH072850, F31MH069048)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
Keywords: social anxiety disorder, fear potentiation, acoustic startle response, autonomic reactivity, skin conductance, heart rate, facial expressivity, generalized social phobia, comorbid depression, fear generalization, survival threat, social anxiety
MeSH terms: Adult, Depression, Fear, Female, Galvanic Skin Response, Heart Rate, Humans, Imagination, Male, Phobic Disorders, Psychiatric Status Rating Scales, Severity of Illness Index, Reflex, Startle, Case-Control Studies, Age of Onset

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Fearful Imagery in Social Phobia: Generalization, Comorbidity, and Physiological Reactivity

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