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An integrative network approach to social anxiety disorder: The complex dynamic interplay among attentional bias for threat, attentional control, and symptoms
Open accessAbstract
Cognitive models posit that social anxiety disorder (SAD) is associated with and maintained by biased attention allocation vis-à-vis social threat. However, over the last decade, there has been intense debate regarding whether AB in SAD results from preferential engagement with or difficulty in disengaging from social threat. Further, recent evidence suggests that AB may merely result from top-down attentional impairments vis-à-vis non-emotional material. Consequently, uncertainty still abounds regarding both the relative importance and the mutual interactions of these different processes and SAD symptoms. Inspired by novel network approaches to psychopathology that conceptualize symptoms as complex dynamic systems of mutually interacting variables, we computed weighted directed networks to investigate potential causal relations among laboratory measures of attentional components and symptoms of social anxiety disorder. Global and local connectivity of network structures revealed that the three most central variables were the orienting component of attention as well as both avoidance and fear of social situations. Neither preferential attention engagement with threat nor difficulty disengaging from threat exhibited high relative importance as predictors of symptoms in the network. Together, these findings suggest the value of extending the network approach beyond self-reported clinical symptoms to incorporate process-level measures from laboratory tasks to gain new insight into the mechanisms of SAD.
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“Anxiety and ABs may emerge from an imbalance between threat salience evaluation and cognitive control processes, described at both cognitive and neural network levels [115,118-121].”
From Anxiety and Threat-Related Attention: Cognitive-Motivational Framework and Treatment (2018) · cites this paper as [120]
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Metadata
- Authors
- Heeren, A., & McNally, R. J.
- Affiliations
- Harvard University (US)
- Corresponding author
- Heeren, Alexandre
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2016-08
- Volume
- 42
- Pages
- 95-104
- ISSN
- 0887-6185 (ISSN-L)
- OpenAlex
- W2469879789
- Cited by
- 170
- References
- 113
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 11 · 2023: 11 · 2022: 16 · 2021: 25 · 2020: 28 · 2019: 18 · 2018: 19 · 2017: 19 · 2016: 9
- FWCI
- 30.76
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Journal of Anxiety Disorders (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Libraries (submittedVersion, other-oa)
- DIAL (Catholic University of Leuven) (submittedVersion)
- Funders
- Belgian National Fund (#FC78142)
- Belgian Foundation for Vocation
- “WBI World Excellence Grant” (sub/2015/228106243177)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- social anxiety disorder, attentional control, directed weighted networks, orienting, avoidance, top-down attention, symptom mechanisms
- MeSH terms
- Attentional Bias, Phobia, Social, Adolescent, Adult, Anxiety, Attention, Fear, Female, Humans, Male, Young Adult, Self Report, Symptom Assessment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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