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Neural mechanisms of cognitive reappraisal of negative self-beliefs in social anxiety disorder.
Open accessAbstract
Background Social anxiety disorder (SAD) is characterized by distorted negative self-beliefs (NSBs) which are thought to enhance emotional reactivity, interfere with emotion regulation, and undermine social functioning. Cognitive reappraisal is a type of emotion regulation used to alter NSBs, with the goal of modulating emotional reactivity. Despite its relevance, little is known about the neural bases and temporal features of cognitive reappraisal in patients with SAD. Methods Twenty-seven patients with SAD and 27 healthy controls (HC) were trained to react and to implement cognitive reappraisal in order to down-regulate negative emotional reactivity to NSBs while undergoing functional magnetic resonance imaging and providing ratings of negative emotion experience. Results Behaviorally, compared with HC, patients with SAD reported greater negative emotion both while reacting to and reappraising NSBs. However, when cued, participants in both groups were able to use cognitive reappraisal to decrease emotion. Neurally, reacting to NSBs resulted in early amygdala response in both groups. Reappraising NSBs resulted in greater early cognitive control, language, and visual processing in HC, but greater late cognitive control, visceral, and visual processing in patients with SAD. Functional connectivity analysis during reappraisal identified more regulatory regions inversely related to left amygdala in HCs than in patients with SAD. Reappraisal-related brain regions that differentiated patients and controls were associated with negative emotion ratings and cognitive reappraisal self-efficacy. Conclusions Findings regarding cognitive reappraisal suggest neural timing, connectivity, and brain-behavioral associations specific to patients with SAD, and elucidate neural mechanisms that might serve as biomarkers of interventions for SAD.
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InfluentialSelf-citationGoldin, P. R., Ziv, M., Jazaieri, H., Werner, K., Kraemer, H., Heimberg, R. G., & Gross, J. J. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0028555 · Cited by 332
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ResultBeliefs About Emotion: Links to Emotion Regulation, Well-Being, and Psychological Distress
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Self-citationTHE ANXIETY SPECTRUM AND THE REFLEX PHYSIOLOGY OF DEFENSE: FROM CIRCUMSCRIBED FEAR TO BROAD DISTRESS
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A cognitive-behavioral model of social anxiety disorder
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BackgroundResultInfluentialSelf-citationGroup CBT versus MBSR for social anxiety disorder: A randomized controlled trial.
Goldin, P. R., Morrison, A., Jazaieri, H., Brozovich, F., Heimberg, R., & Gross, J. J. (2016) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000092 · Cited by 202
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The Role of Emotion and Emotion Regulation in Social Anxiety Disorder
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InfluentialMBSR vs aerobic exercise in social anxiety: fMRI of emotion regulation of negative self-beliefs
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BackgroundResultInfluentialSelf-citationEmotion Regulation and Posttraumatic Stress Disorder: A Prospective Investigation
Boden, M. T., Westermann, S., McRae, K., Kuo, J. R., Alvarez, J., Kulkarni, M. R., Gross, J. J., & Bonn‐Miller, M. O. (2013) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2013.32.3.296 · Cited by 167
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“The location of the cluster in the insula shows striking overlap with findings from social anxiety patients during reap-praisal of negative self-beliefs ( Goldin et al., 2009 ) as well as findings in a range of anxiety disorders ( Etkin and Wager, 2007 ).”
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Self-citationfMRI neurofeedback facilitates anxiety regulation in females with spider phobia
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“This method targets negative, anxiety-provoking beliefs, which undermine regulation and prevent an adaptive response to the perceived threat (Gross, 1998; Amstadter, 2008).”
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Self-citationAcceptance versus reappraisal: Behavioral, autonomic, and neural effects
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“To date, research suggests that people diagnosed with SAD endorse more use of suppression (Werner et al. 2011), and less use of cognitive reappraisal compared with healthy adults (Goldin et al. 2009a, b).”
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“…valenced faces has been shown to reliably activate the amygdala in patients with SAD (Lira Yoon et al., 2007; Stein et al., 2002; Straube et al., 2004), and severity of symptoms predicts the amygdala activation to negative faces (Evans et al., 2008; Goldin et al., 2009a; Phan et al., 2006).”
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“The midline PFC seems to be connected to negativemood induction [59] and exposure to negative-self beliefs [60].”
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“Impaired emotion regulation is found in anxiety (Goldin et al. 2009a; Hermann et al. 2009) and depression (Johnstone et al. 2007; Kanske et al. 2012).”
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“In accordance with previous findings (Goldin et al., 2008, 2009), brain activations in the present study were mainly found during the early time interval (0–4 s) across all groups, indicating that responses related to emotion regulation are rather brief.”
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BackgroundSex differences in the functional connectivity of the amygdalae in association with cortisol
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“Such research is consistent with the view that the neural timing of brain–behavioral associations may elucidate biomarkers for various interventions (Goldin et al. 2009).”
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“2009) and general poor well-being (Gross and John 2003). Furthermore, experiential avoidance has been found to be associated with amplification of various types of anxiety-related pathology and poor quality of life (Kashdan et al. 2006). Specifically related to social anxiety, Kashdan and Collins (2010) in an experien…”
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Self-citationThe pathology of social phobia is independent of developmental changes in face processing
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“68,69 .”
Emotion Regulation in Social Anxiety Disorder: Reappraisal and Acceptance of Negative Self-beliefs
Dixon, M. L., Moodie, C. A., Goldin, P. R., Farb, N. A. S., Heimberg, R. G., & Gross, J. J. (2019) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2019.07.009 · Cited by 75
“Prior fi ndings have produced mixed results as to whether SAD is associated with altered frontoparietal activation during reappraisal (14 – 16, 22 Beyond reappraisal, the neural signature of other adaptive regulation strategies that mitigate social anxiety is largely unknown.”
InfluentialSelf-citationZiv, M., Goldin, P. R., Jazaieri, H., Hahn, K. S., & Gross, J. J. (2013) · Biology of Mood & Anxiety Disorders · doi:10.1186/2045-5380-3-20 · Cited by 74
“Overall, this result confirms previous findings of increased activity in visual attention-related regions in SAD when reacting to social relevant stimuli [3].”
BackgroundMethodResultInfluentialSelf-citationOxytocin selectively moderates negative cognitive appraisals in high trait anxious males
Alvares, G. A., Chen, N. T. M., Balleine, B. W., Hickie, I. B., & Guastella, A. J. (2012) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2012.04.018 · Cited by 71
“There is also evidence that distorted negative self-beliefs associated with social anxiety are associated with decreased early recruitment of regions associated with cognitive reappraisal, such as the dorsal anterior cingulate cortex, left dorsolateral prefrontal cortex, and medial prefrontal cortex (Goldin et al., 20…”
BackgroundDetaching from the negative by reappraisal: the role of right superior frontal gyrus (BA9/32)
Falquez, R., Couto, B., Ibáñez, A. M., Freitag, M. T., Berger, M. C., Arens, E. A., Lang, S., & Barnow, S. (2014) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2014.00165 · Cited by 76
“For instance, previous studies have emphasized that an impaired ER constitutes a core feature of affective (Goldin et al., 2009; Hermann et al., 2009; New et al., 2009; Abler et al., 2010) and personality disorders (Slee et al., 2008; Lang et al., 2012).”
BackgroundGoldin, P. R., Thurston, M., Allende, S., Moodie, C., Dixon, M. L., Heimberg, R. G., & Gross, J. J. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2021.1862 · Cited by 69
Self-citationZhang, Y.-X., Zhu, C.-Y., Chen, H., Duan, X.-J., Lu, F.-M., Li, M., Liu, F., Ma, X., Wang, Y.-F., Zeng, L., et al. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.12.001 · Cited by 75
Social anxiety disorder: a critical overview of neurocognitive research
Cremers, H. R., & Roelofs, K. (2016) · Wiley Interdisciplinary Reviews Cognitive Science · doi:10.1002/wcs.1390 · Cited by 77
Negativity-bias in forming beliefs about own abilities
Müller-Pinzler, L., Czekalla, N., Mayer, A. V., Stolz, D. S., Gazzola, V., Keysers, C., Paulus, F. M., & Krach, S. (2019) · Scientific Reports · doi:10.1038/s41598-019-50821-w · Cited by 68
Kim, P., Dufford, A. J., & Tribble, R. C. (2018) · Brain Structure and Function · doi:10.1007/s00429-018-1688-z · Cited by 68
“Although little is understood about brain region(s) responsible for parental self-efficacy, previous work observed associations between self-efficacy in other domains such as emotion regulation and prefrontal cortex function (Goldin et al. 2009).”
Young, K. S., Burklund, L. J., Torre, J. B., Saxbe, D., Lieberman, M. D., & Craske, M. G. (2017) · Psychiatry Research - Neuroimaging · doi:10.1016/j.pscychresns.2017.01.005 · Cited by 64
“…to social or emotional cues (Birbaumer et al., 1998; Cooney et al., 2006; Evans et al., 2008; Phan et al., 2006; Stein et al., 2002), the extent of which has been shown to correlate with symptom severity (Cooney et al., 2006; Goldin et al., 2009b; Phan et al., 2006; Shah and Angstadt, 2009).”
BackgroundBlair, K. S., Geraci, M., Hollon, N., Otero, M., DeVido, J., Majestic, C., Jacobs, M., Blair, R. J. R., & Pine, D. S. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.09121797 · Cited by 65
Behavioural and neural correlates of self-focused emotion regulation in social anxiety disorder
Gaebler, M., Daniels, J. K., Lamke, J.-P., Fydrich, T., & Walter, H. (2014) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.130080 · Cited by 64
“However, there is evidence that, when instructed, individ uals with SAD show the same degree of reduction in negative emotion as controls.(13,14)”
BackgroundBrozovich, F. A., Goldin, P., Lee, I., Jazaieri, H., Heimberg, R. G., & Gross, J. J. (2015) · Journal of Clinical Psychology · doi:10.1002/jclp.22132 · Cited by 64
Self-citationNeural correlates of negative expectancy and impaired social feedback processing in social anxiety
Gu, R., Ao, X., Mo, L., & Zhang, D. (2020) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsaa038 · Cited by 65
Neural correlates of a computerized attention modification program in anxious subjects
Taylor, C. T., Aupperle, R. L., Flagan, T., Simmons, A. N., Amir, N., Stein, M. B., & Paulus, M. P. (2013) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nst128 · Cited by 65
“Although evidence regarding the direction and specific location of PFC dysfunction in anxiety differs across experimental paradigms (Etkin and Wager, 2007; Simmons and Matthews, 2012), attenuated activity is often revealed in medial and dorsolateral PFC regions under conditions requiring attentional or inhibitory cont…”
BackgroundCaumo, W., Alves, R. L., Serrano, P. V., Alves, C. F. D. S., Ramalho, L., Sanches, P. R. S., Silva, D. P., Torres, I. L. D. S., & Fregni, F. (2021) · Journal of Pain · doi:10.1016/j.jpain.2021.11.002 · Cited by 63
Gootjes, L., Franken, I. H. A., & Van Strien, J. W. (2011) · Journal of Psychophysiology · doi:10.1027/0269-8803/a000043 · Cited by 61
Klumpp, H., Fitzgerald, J. M., Kinney, K. L., Kennedy, A. E., Shankman, S. A., Langenecker, S. A., & Phan, K. L. (2017) · NeuroImage: Clinical · doi:10.1016/j.nicl.2017.04.006 · Cited by 59
“…et al., 2007; Frank et al., 2014; Ochsner et al., 2012) along with reports of inefficient or impoverished ACC activity during regulation in SAD (Goldin et al., 2009; Wheaton et al., 2014; Klumpp et al., 2013b), the absence of preCBT inverse ACC-amygdala relationships to threat signals during…”
InfluentialGrezellschak, S., Lincoln, T. M., & Westermann, S. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.05.103 · Cited by 58
Transdiagnostic neural correlates of volitional emotion regulation in anxiety and depression
Fitzgerald, J. M., Klumpp, H., Langenecker, S., & Phan, K. L. (2018) · Depression and Anxiety · doi:10.1002/da.22859 · Cited by 59
“Individuals with GAD report more negative affective state when using reappraisal than HCs (Fitzgerald et al., 2017), whereas those with SAD have a similar decrease in negative response as healthy participants (Goldin et al., 2009; Goldin, McRae, Ramel, & Gross, 2008).”
Influential. Neural response to the observable self in social anxiety disorder
Pujol, J., Giménez, M., Ortiz, H., Soriano-Mas, C., López-Solà, M., Farré, M., Deus, J., Merlo-Pich, E., Harrison, B. J., Cardoner, N., et al. (2013) · Psychological Medicine · doi:10.1017/s0033291712001857 · Cited by 52
“The effect of cognitive-linguistic regulation of emotional reactivity to social threat (Goldin et al. 2009a) and to negative self-beliefs (Goldin et al. 2009b) was explicitly assessed in two different experiments.”
BackgroundMethodInfluentialKatzir, M., & Eyal, T. (2013) · Journal of Experimental Social Psychology · doi:10.1016/j.jesp.2013.07.006 · Cited by 57
Social comparisons and social anxiety in daily life: An experience-sampling approach.
Goodman, F. R., Kelso, K. C., Wiernik, B. M., & Kashdan, T. B. (2021) · Journal of Abnormal Psychology · doi:10.1037/abn0000671 · Cited by 68
Klumpp, H., & Fitzgerald, J. M. (2018) · Current Psychiatry Reports · doi:10.1007/s11920-018-0948-1 · Cited by 55
Price, R. B., Paul, B., Schneider, W., & Siegle, G. J. (2012) · Cognitive Therapy and Research · doi:10.1007/s10608-012-9508-x · Cited by 53
“…in comparison to previous studies which have (1) primarily used normative negative scenes (Johnstone et al. 2007; Ochsner et al. 2002, 2004), c.f. (Goldin et al. 2009), (2) instructed participants to reappraise using non-clinically relevant methods (e.g., imagining that the negative scenes are…”
BackgroundResultNEUROCIRCUITRY UNDERLYING RISK AND RESILIENCE TO SOCIAL ANXIETY DISORDER
Clauss, J. A., Avery, S. N., VanDerKlok, R. M., Rogers, B. P., Cowan, R. L., Benningfield, M. M., & Blackford, J. U. (2014) · Depression and Anxiety · doi:10.1002/da.22265 · Cited by 55
“During emotion regulation, the anterior cingulate and dorsolateral prefrontal cortex (dlPFC) show increased activation in healthy controls,[28] but less activation in patients with social anxiety disorder.[29, 30] Based on these findings, we propose that inhibited individuals who have not developed social anxiety diso…”
BackgroundNeural activity associated with self-reflection
Herwig, U., Kaffenberger, T., Schell, C., Jäncke, L., & Brühl, A. B. (2012) · BMC Neuroscience · doi:10.1186/1471-2202-13-52 · Cited by 50
“There is evidence that, for example, depression and social anxiety disorder are both associated with a heightened cognitive, mostly ruminative self-focus, pointing to dysfunctional activation of brain areas involved in self-related processing [1,76,77].”
BackgroundGoldin, P. R., Jazaieri, H., Ziv, M., Kraemer, H., Heimberg, R. G., & Gross, J. J. (2013) · Clinical Psychological Science · doi:10.1177/2167702613476867 · Cited by 50
“This pattern converges with prior reports of maladaptive selfviews in SAD (Goldin et al., 2009; Hofmann et al., 2004) and more generally with self-critical cognitive styles that reflect a fundamental cognitive diathesis in anxiety and mood disorders (Moscovitch, Hofmann, Suvak, & In-Albon, 2005).”
ResultSelf-citationAttenuated modulation of brain activity accompanies emotion regulation deficits in alexithymia
Pollatos, O., & Gramann, K. (2012) · Psychophysiology · doi:10.1111/j.1469-8986.2011.01348.x · Cited by 50
Altered emotion regulation capacity in social phobia as a function of comorbidity
Burklund, L. J., Craske, M. G., Taylor, S. E., & Lieberman, M. D. (2015) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsu058 · Cited by 46
Metadata
- Authors
- Goldin, P. R., Manber-Ball, T., Werner, K., Heimberg, R., & Gross, J. J.
- Affiliations
- Stanford University (US)
- Temple University (US)
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2009-12
- Volume
- 66
- Issue
- 12
- Pages
- 1091-1099
- ISSN
- 0006-3223 (ISSN-L)
- PMC
- PMC2788040
- OpenAlex
- W2073584643
- Semantic Scholar
- 4dd91909ee96aeb1faf1c176a22e1c70d8bc061a
- Cited by
- 305
- References
- 76
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 6 · 2023: 18 · 2022: 8 · 2021: 20 · 2020: 12 · 2019: 13 · 2018: 24 · 2017: 15 · 2016: 23 · 2015: 20 · 2014: 38 · 2013: 39 · 2012: 26
- FWCI
- 19.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH076074)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- social anxiety disorder, cognitive reappraisal, negative self-beliefs, emotion regulation, amygdala, functional connectivity, cognitive control, negative emotions, neural timing, biomarkers
- MeSH terms
- Adult, Brain Mapping, Cognition Disorders, Emotions, Female, Humans, Image Processing, Computer-Assisted, Individuality, Interpersonal Relations, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Oxygen, Phobic Disorders, Self Concept, Young Adult
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