Neural responses to social threat and predictors of cognitive behavioral therapy and acceptance and commitment therapy in social anxiety disorder

Classified as probably not a substantial claim. May combine two claims.

The amygdala, insula, and ACC regions were defined a priori by the AAL anatomical atlas, with ACC additionally constrained to dorsal anterior, pregenual, and subgenual portions associated with rejection in a recent meta-analysis (y>4.5 in Talairach space).

“The amygdala, insula, and ACC regions were defined a priori by the AAL anatomical atlas (Tzourio-Mazoyer et al., 2002), with ACC additionally constrained to the regions specifically associated with rejection in a recent meta-analysis which include the dorsal anterior, pregenual, and subgenual portions (i.e., y>4.5 in Talairach space; Rotge et al., 2014).”

• cites Tzourio-Mazoyer et al., 2002 sourceSupported
• cites Rotge et al., 2014 sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

There is growing emphasis on stimuli with putatively greater ecological validity, such as imagining feared social situations, anticipation of public speaking, performance evaluation, and exposure to social criticism.

“there has been a growing emphasis on other types of stimuli with putatively greater ecological validity such as imagining feared social situations (Blair et al., 2010; Boehme et al., 2014; Nakao et al., 2011), anticipation of public speaking (Boehme et al., 2013; Cremers et al., 2015), performance evaluation (Gimenez et al., 2012; Koric et al., 2012; Pujol et al., 2013), and exposure to social cr”

• cites Blair et al., 2010 sourceSupported
• cites Boehme et al., 2014 sourceSupported
• cites Nakao et al., 2011 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Specific results on regional activity differences in SAD vary considerably across studies.

“However, specific results vary considerably across studies (Brühl et al., 2014; Etkin & Wager, 2007).”

• cites Brühl et al., 2014Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Etkin & Wager, 2007 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Both CBT and ACT involved twelve weekly one-hour, manualized, individual therapy sessions.

“Both CBT and ACT treatments involved twelve weekly one-hour, manualized, individual therapy sessions (for details see Craske et al., 2014).”

• cites Craske et al., 2014 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Subgenual and pregenual regions of the anterior cingulate cortex also play a role in social pain and rejection.

“Recent work highlights a similar role in social pain and rejection for subgenual and pregenual regions of the ACC as well (Rotge et al., 2014; Wager et al., 2009).”

• cites Rotge et al., 2014 sourceNot checked — no full text of the source
• cites Wager et al., 2009 sourcePartly supported

  The Results (‘Brain responses to SET’) report pregenual ACC activation during social evaluative threat, supporting a role in a related social-stress response. The Discussion says subgenual involvement is only possible and identifies the activated region primarily as pregenual. The study used speech preparation as a threat task; it does not establish a role for both regions in social pain or rejection specifically. Page numbers are unavailable in our copy. (LLM, conf=0.84)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Pre-treatment neural activity in amygdala, dACC, prefrontal, occipital, and temporal regions during simple perceptual matching tasks has predicted CBT responses in SAD participants.

“A handful of emerging studies have found that pre-treatment neural activity in amygdala, dACC, prefrontal, occipital, and temporal regions during simple perceptual matching tasks has predicted responses to CBT in SAD participants (Doehrmann et al., 2013; Klumpp et al., 2013, 2014).”

• cites Doehrmann et al., 2013 sourcePartly supported

  The Comment reports that pretreatment responses to angry versus neutral faces in two occipitotemporal regions predicted CBT outcome in patients with SAD. The Results say prefrontal correlations did not survive correction for multiple comparisons, and found no predictive association in the amygdala; this paper does not establish the claimed dACC prediction. The Methods describe a simple 1-back repetition task during scanning. (LLM, conf=0.88)

  Experimental — accuracy not yet measured
• cites Klumpp et al., 2013 sourcePartly supported

  The Discussion (section 4) reports that pre-treatment activity in temporal, dorsal ACC, and prefrontal regions during the perceptual face-matching task predicted CBT improvement in participants with generalized SAD. It explicitly says amygdala activity did not emerge as a marker of recovery. The paper discusses occipitotemporal prediction as a finding from Doehrmann et al., rather than from its own results. (LLM, conf=0.89)

  Experimental — accuracy not yet measured
• cites Klumpp et al., 2014 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Numerous studies have found greater amygdala activity in SAD compared to healthy controls in response to socially threatening stimuli.

“Numerous studies have found greater amygdala activity in SAD compared to healthy controls in response to socially threatening stimuli (see Brühl et al., 2014; Etkin & Wager, 2007; and Freitas-Ferrari et al., 2010 for reviews and meta-analyses)”

• cites Brühl et al., 2014Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Etkin & Wager, 2007 sourceSupported
• cites Freitas-Ferrari et al., 2010 sourceSupported

May combine two claims.

Facial expressions have been shown to predict vulnerability to developing mental disorders and treatment response in SAD.

“They have proven to be a powerful research tool with the ability to predict important outcomes including vulnerability to developing mental disorders (e.g., Pezawas et al., 2005) and even treatment response in SAD (e.g., Doehrmann et al., 2013).”

• cites Pezawas et al., 2005 sourceNot checked — no full text of the source
• cites Doehrmann et al., 2013 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

ACT is generally as effective as CBT.

“which, although generally as effective as CBT (Craske et al., 2014)”

• cites Craske et al., 2014 sourcePartly supported

  The Discussion says people with social phobia respond, on average, as well to ACT as to CBT, and describes ACT as a viable alternative. The claim omits the social-phobia context and thus states the comparison more broadly than this study establishes. (LLM, conf=0.82)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

The insula is central to integrating perceptual, emotional, and cognitive information into subjective experiences.

“The insula is central to the integration of perceptual, emotional, and cognitive information into subjective experiences (Craig, 2011; Kurth et al., 2010).”

• cites Craig, 2011 sourceNot checked — no full text of the source
• cites Kurth et al., 2010 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

The dACC is involved in monitoring and appraisal of potential threat and emotion conflict.

“The dACC has been shown to be involved in monitoring and appraisal of potential threat and emotion conflict (Etkin et al., 2011).”

• cites Etkin et al., 2011 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Anterior insula is involved in social and emotional experiences, including elicited emotion and recognizing emotions in others.

“anterior insula, which was observed here, has been shown to be involved in social and emotional experiences, including both elicited emotion as well as recognizing emotions in others (Kurth et al., 2010).”

• cites Kurth et al., 2010 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Pregenual ACC has been implicated in social pain and rejection, regulation of emotional conflicts, and responses to social-evaluative threat.

“Like dACC, pregenual ACC has been implicated in social pain and rejection (Rotge et al., 2014), as well as during the regulation of emotional conflicts (Etkin et al., 2011), and responses to social-evaluative threat (Wager et al., 2009).”

• cites Rotge et al., 2014 sourceNot checked — no full text of the source
• cites Etkin et al., 2011 sourceSupported
• cites Wager et al., 2009 sourceSupported

May combine two claims.

dACC and anterior insula are involved in experiences of social rejection, social evaluation, and exposure to nonverbal cues of rejection.

“dACC and anterior insula have been shown to be involved in experiences of social rejection (e.g., Eisenberger et al., 2003), social evaluation (e.g., Eisenberger et al., 2011; Takahashi et al., 2009; Wager et al., 2009), and exposure to nonverbal cues of rejection (e.g., Burklund et al., 2007).”

• cites Eisenberger et al., 2003 sourceNot checked — no full text of the source
• cites Eisenberger et al., 2011 sourceNot checked — no full text of the source
• cites Burklund et al., 2007 sourcePartly supported

  The Discussion reports greater dACC activity while rejection-sensitive participants viewed disapproving faces, supporting the citation for nonverbal cues of rejection. It also says rejection sensitivity did not correlate with insula activity in response to those faces, so Burklund et al. do not support the anterior-insula part of that attribution. The other citations in the sentence, rather than Burklund et al., are attached to social rejection and social evaluation. (LLM, conf=0.90)

  Experimental — accuracy not yet measured

May combine two claims.

Ziv and colleagues (2013) found no group differences for either task in the amygdala or insula using an ROI approach.

“Ziv and colleagues (2013) examined responses to dynamic social rejection stimuli and to viewing personalized phrases reflecting negative self-beliefs, and found no group differences for either task in the amygdala or insula using an ROI approach.”

• cites Ziv et al., 2013 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Sensitivity to neutral or safe stimuli has been suggested to reflect an inability to appropriately inhibit aversive responding in situations involving both threatening and non-threatening (safety) stimuli, which may have played a role in this study.

“Such findings of sensitivity to neutral or safe stimuli have been suggested to reflect an inability to appropriately inhibit aversive responding in situations involving both threatening and non-threatening (safety) stimuli (Craske et al., 2012), which may have played a role in this study.”

• cites Craske et al., 2012 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Group differences may be more of a function of differential timing.

“Another issue is that group differences may be more of a function of differential timing (e.g., Campbell et al., 2007; Goldin et al., 2009; Sladky et al., 2012).”

• cites Campbell et al., 2007 sourceNot checked — no full text of the source
• cites Goldin et al., 2009Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Sladky et al., 2012 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Although emerging evidence suggests ACT is as effective as CBT for anxiety disorders, including in this sample, ACT is relatively newer and is supported by less evidence than CBT with respect to outcomes and mediators.

“Although emerging evidence suggests that ACT is as effective as CBT for anxiety disorders (Craske et al., 2014), including in this sample, ACT is relatively newer and is supported by less evidence than CBT with respect to outcomes and mediators.”

• cites Craske et al., 2014 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

SAD participants (N=70) and healthy controls (N=17) were similar on demographic variables.

“SAD Participants (N=70) and HCs (N=17) were similar on demographic variables, as shown in Table 1.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Success ratings for imagining the videos as real showed no significant effects of group, condition, or their interaction, including simple main effects.

“A group (HC vs SAD) by condition (Rejection vs. Neutral) ANOVA of these success ratings did not yield any significant effects, including interactions, main effects, or simple main effects”

May combine two claims.

Within-group t-tests on bilateral amygdala ROIs revealed significantly greater activity during Neutral relative to Rejection in the SAD group for both left and right amygdala, but no differences within the HC group.

“Within-group t-tests conducted on mean parameter estimates extracted from bilateral amygdala ROIs revealed significantly greater activity during Neutral relative to Rejection in the SAD group for both left (t(66)=-3.41; p=.001) and right (t(66)=-3.38; p=.001) amygdala but no differences within the HC group.”

May combine two claims.

In direct between-group comparisons of Rejection vs Neutral focused on early or late periods, there were no differences in amygdala activity for the early period, and a marginal effect for the later period in the right amygdala, driven by greater amygdala activity in the SAD group during the later half of Neutral videos relative to Rejection.

“we found no differences in amygdala activity for the early period, and a marginal effect for the later period in the right amygdala (p=.052), which was driven specifically by greater amygdala activity in the SAD group during the later half of Neutral videos relative to Rejection.”

May combine two claims.

The differences between Rejection and Neutral for each group were significantly different from each other for both dACC and insula, with greater differences for healthy controls.

“the differences between Rejection and Neutral for each group were significantly different from each other for both dACC (t(43.40)=2.76; p=.008) and insula (t(45.62)=2.99; p=.004), with greater differences for HCs as expected.”

May combine two claims.

In summary, the study found few statistically significant differences between SAD and healthy control groups, despite qualitatively distinct experiences with the task.

“In summary, we used fMRI to investigate responses to novel dynamic socially-threatening stimuli in individuals with SAD and healthy controls, finding few statistically significant differences between groups, despite qualitatively distinct experiences with the task.”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

SAD participants met DSM-IV criteria for a current principal or co-principal diagnosis of SAD with a clinical severity rating of at least 4.

“SAD participants met DSM-IV criteria for a current principal or co-principal diagnosis of SAD with a clinical severity rating ≥4 (on a scale of 0-8) which indicates clinically significant symptoms, distress, or impairment.”

Probably not a substantial claim: may not pass S3 (load-bearing).

All analyses were corrected for serially correlated errors by fitting a first-order autoregressive process (AR(1)) to the error term.

“All analyses were corrected for serially correlated errors by fitting a first-order autoregressive process (AR(1)) to the error term.”

Classified as probably not a substantial claim.

Diagnostic evaluation was conducted using the ADIS-IV by trained and reliability-certified clinicians.

“Participants underwent diagnostic evaluation using the Anxiety Disorders Interview Schedule-IV (ADIS-IV; Brown et al., 1994), conducted by trained and reliability-certified clinicians.”

• cites Brown et al., 1994Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

Of the 70 SAD participants with baseline fMRI data, 25 were randomized to CBT with a completion rate of 68% (N=17), and 25 to ACT with a completion rate of 76% (N=19).

“Of the 70 SAD participants with baseline fMRI data, 25 were randomized to receive CBT, with a completion rate of 68% (N=17), and 25 were randomized to receive ACT, with a completion rate of 76% (N=19).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Three random orders of the conditions were generated and counterbalanced across participants.

“Three random orders of the conditions were generated and counterbalanced across participants.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Voxels with missing data from some participants were analyzed using adjusted degrees of freedom, with reported p-values adjusted automatically within GLM Flex.

“Voxels with missing data from some participants were analyzed using adjusted degrees of freedom, with reported p-values adjusted automatically within GLM Flex to reflect the equivalent p-value dependent upon the full model.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Voxels missing data from more than 10% of participants were eliminated from analyses.

“Voxels missing data from more than 10% of participants were eliminated from analyses.”

Probably not a substantial claim: may not pass S3 (load-bearing).

For completeness, activations beyond regions of interest were also reported, thresholded at p<.005 and 42 contiguous voxels, corresponding to a false-positive discovery rate of 5% across the whole brain as estimated by 10,000 Monte Carlo simulations using AlphaSim.

“For completeness, activations beyond our regions of interest were also reported, thresholded at p<.005 and 42 (1,134mm3) contiguous voxels, corresponding to a false-positive discovery rate of 5% across the whole brain as estimated by 10,000 Monte Carlo simulations using AlphaSim.”

May combine two claims.

Dorsal anterior cingulate cortex plays a role in general appraisal and monitoring of emotional information and in experiences of social pain and rejection.

“dACC would seem to represent a key target for investigation of maladaptive neural functioning in SAD given its role in general appraisal and monitoring of emotional information, and experiences of social pain and rejection (Eisenberger, 2012; Rotge et al., 2014)”

• cites Eisenberger, 2012 sourceNot checked — no full text of the source
• cites Rotge et al., 2014 sourceNot checked — no full text of the source

Classified as probably not a substantial claim. May combine two claims.

First-level contrast images were thresholded at p<.005 and corrected for multiple comparisons using a restricted search approach with extent thresholds of 5, 16, and 18 contiguous voxels for bilateral amygdala, insula, and ACC, respectively, each corresponding to a false-positive discovery rate of 5% in each region as estimated by 10,000 Monte Carlo simulations using AlphaSim.

“First-level contrast images were pooled together for within- and between-group voxel-wise t-tests, thresholded at p<.005 and corrected for multiple comparisons using a restricted search approach involving extent thresholds of 5 (135mm3), 16 (432mm3), and 18 (486mm3) contiguous voxels for activations observed in bilateral amygdala, insula, and ACC, respectively, each corresponding to a false-pos”

Classified as probably not a substantial claim.

The Neutral condition was designed as a comparison condition for the Rejection videos by controlling for non-emotional aspects of the stimuli, including visual, language, social, and auditory processing, thereby isolating neural processes specific to social rejection.

“The Neutral condition was designed as a comparison condition for the Rejection videos by controlling for the non-emotional aspects of the stimuli, including visual, language, social, and auditory processing, thereby isolating neural processes specific to social rejection.”

• AssumptionThe authors state this as an assumption: The rejection stimuli used in this study tap into the fears that lie at the core of SAD and evoke distress.

Classified as probably not a substantial claim.

Functional ROIs were defined by significant clusters of activation in the HC within-group analysis contrasting Rejection vs. Neutral, representing functional ROIs of normative rejection responses.

“functional ROIs were defined by significant clusters of activation in these regions observed in the HC within-group analysis contrasting Rejection vs. Neutral described above, thereby representing functional ROIs of normative rejection responses.”

Probably not a substantial claim: may not pass S3 (load-bearing).

ACT involves a very different theoretical approach from CBT.

“involves a very different theoretical approach (Arch & Craske, 2008)”

• cites Arch & Craske, 2008 sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

Regression analyses examining baseline neural activity associated with treatment responses controlled for baseline LSAS scores.

“we completed regression analyses within the SAD group examining activations that correlated with LSAS difference scores (i.e., LSASpre − LSASpost), controlling for baseline LSAS scores.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Individuals with SAD frequently avoid social situations or endure them with anxiety and distress, which can adversely affect quality of life and social, academic, and occupational functioning.

“afflicted individuals will frequently avoid social situations and/or endure them with anxiety and distress, which can have significant adverse consequences on quality of life, and social, academic, and occupational functioning (Mendlowicz & Stein, 2000).”

• cites Mendlowicz & Stein, 2000 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Healthy control participants had no current or past psychiatric disorders.

“Healthy control (HC) participants had no current or past psychiatric disorders.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The amygdala is integral to fear learning and memory and functions as a primitive threat-detection system that helps protect the individual from harm.

“The amygdala is integral to fear learning and memory and has been characterized as representing a primitive threat-detection system designed to help protect the individual from harm (Amaral, 2002; LeDoux, 1998; Phelps & LeDoux, 2005).”

• cites Amaral, 2002 sourceNot checked — no full text of the source
• cites LeDoux, 1998Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Phelps & LeDoux, 2005 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Three SAD participants with missing questionnaire data were excluded from related analyses.

“All participants were included in baseline (pre-treatment) analyses except that 3 SAD participants with missing questionnaire data were excluded from related analyses”

Classified as probably not a substantial claim.

SAD participants were randomized to 12 weeks of CBT (N=25), 12 weeks of ACT (N=25), or a 12-week waitlist period (N=20).

“SAD participants were then randomized to either 12 weeks of CBT (N=25), 12 weeks of ACT (N=25), or a 12-week waitlist period (N=20).”

Classified as probably not a substantial claim. May combine two claims.

CBT and ACT were matched on the extent of exposure practice but differed in the theoretical framing of the intent of exposure.

“CBT and ACT were matched on the extent of exposure practice but differed in the theoretical framing of the intent of exposure”

Classified as probably not a substantial claim.

Analyses relating baseline neural activity to treatment outcomes included only participants randomized to active treatment who completed all necessary assessments (N=36).

“Analyses examining how neural activity at baseline related to treatment outcomes included only those participants who were randomized to receive an active treatment (CBT or ACT) and completed all necessary assessments (N=36)”

May combine two claims.

Maladaptive biases in SAD include hyperreactivity to threatening or potentially threatening social information and excessively negative interpretations of such information, which contribute to the development and maintenance of SAD.

“multiple maladaptive biases in SAD involving hyperreactivity to threatening or potentially-threatening social information as well as excessively negative interpretations of such information that contribute to the development and maintenance of SAD (Clark & Wells, 1995; Craske et al., 2009; Rapee & Heimberg, 1997).”

• cites Clark & Wells, 1995Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Craske et al., 2009 sourceNot checked — no full text of the source
• cites Rapee & Heimberg, 1997 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

These findings are consistent with decades of research characterizing SAD as largely a function of distortions and biases in the processing of social/evaluative information.

“These findings are consistent with decades of research characterizing SAD as being largely a function of distortions and biases in the processing of social/evaluative information, (e.g., Craske et al., 2009; Rapee & Heimberg, 1997).”

• cites Craske et al., 2009 sourceNot checked — no full text of the source
• cites Rapee & Heimberg, 1997 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

A more focused investigation of previous research specifically examining rejection-related experiences suggests that our findings are consistent with closely related work.

“a more focused investigation of previous research specifically examining rejection-related experiences suggests that our findings are consistent with closely related work.”

May combine two claims.

In Blair et al.'s first study, SAD participants exhibited greater activity in MPFC and bilateral amygdala relative to healthy controls, but amygdala results were seen only at a liberal threshold of p<.05, uncorrected.

“In the first study, relative to healthy controls, SAD participants exhibited greater activity in MPFC and bilateral amygdala but amygdala results were seen only at a liberal threshold of p<.05, uncorrected (Blair et al., 2008a).”

• cites Blair et al., 2008aNot matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

Some of the same actors were included in rejection and neutral videos, and previous exposure to a rejecting individual may have contaminated a subsequent neutral encounter for SAD participants or created further ambiguity.

“some of the same actors were included in rejection and neutral videos and therefore, previous exposure to a “rejecting” individual may have contaminated a subsequent “neutral” encounter with the individual for SAD participants or created further ambiguity.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Maladaptive responses to the neutral video stimuli may have reflected discomfort with its ambiguity; clearly negative communications may be easier to deal with than ambiguous statements that may or may not represent a threat.

“maladaptive responses to the neutral video stimuli may have reflected discomfort with its ambiguity; clearly negative communications may be easier to deal with than ambiguous statements that may or may not represent a threat.”

• AssumptionRests on an assumption: Clearly negative communications may be easier to deal with than ambiguous statements that may or may not represent a threat.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The amygdala is central to fear responding, is commonly observed in response to cues of potential threat, and is often hyperactive in anxiety disorders.

“While the amygdala is central to fear responding, is commonly observed in response to cues of potential threat, and is often seen to be hyperactive in anxiety disorders (LeDoux, 1998), its role in experiences of rejection and social pain is less clear.”

• cites LeDoux, 1998Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

These results may also illustrate the contribution of intolerance of uncertainty in SAD to the extent the neutral stimuli were interpreted as ambiguous.

“These results may also illustrate the contribution of intolerance of uncertainty in SAD to the extent the neutral stimuli were interpreted as ambiguous.”

May combine two claims.

The observed neural patterns may reflect an attentional or appraisal process of greater discrimination between what is safe and what is dangerous, and this may have benefitted participants throughout exposure therapy as they had to learn to associate safety with cues that were previously erroneously perceived as dangerous.

“The observed neural patterns may reflect an attentional or appraisal process of greater discrimination between what is safe and what is dangerous, and this may have benefitted participants throughout exposure therapy as they had to learn to associate “safety” with cues that were previously erroneously perceived as dangerous.”

Probably not a substantial claim: may not pass S3 (load-bearing).

One potential explanation for greater activations to neutral stimuli in SAD is that the neutral social stimuli were not actually neutral and instead may have represented a more complex and subtle social threat requiring more extensive processing.

“One potential explanation for the counterintuitive findings of relatively greater activations to the neutral stimuli in SAD is that the neutral social stimuli were not actually “neutral” and instead may have represented a more complex and subtle social threat that required more extensive processing in order to fully ascertain its threat value.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

To the extent that increased processing of neutral stimuli reflected increased focus on neutral faces, this provides a possible explanation for increased amygdala activity seen for neutral videos, given research suggesting attended faces yield greater amygdala activity than unattended faces.

“to the extent that the generally increased processing of the neutral stimuli reflected increased focus on the neutral faces, this also provides a possible explanation for the increased amygdala activity seen for neutral videos, given research suggesting that attended faces yield greater amygdala activity than unattended faces (Pessoa et al., 2002).”

• cites Pessoa et al., 2002 sourceNot checked — no full text of the source

May combine two claims.

In Blair et al.'s second study, SAD participants exhibited greater activity in a similar region of MPFC and mid frontal gyrus relative to healthy controls, but no group differences were observed in the amygdala or insula, or any other regions.

“In the second study (Blair et al., 2011b), SAD participants exhibited greater activity in a similar region of MPFC and mid frontal gyrus relative to healthy controls, but no group differences were observed in the amygdala or insula, or any other regions.”

• cites Blair et al., 2011bNot matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Intolerance of uncertainty has been shown to explain a significant proportion of variance in social anxiety symptoms and may be related to catastrophizing and other maladaptive interpretive biases in SAD in the context of ambiguous social situations.

“intolerance of uncertainty has been shown to explain a significant proportion of variance in social anxiety symptoms (e.g., Boelen & Reijntjes, 2009; Carleton et al., 2010) and may be related to catastrophizing and other maladaptive interpretive biases in SAD in the context of ambiguous social situations.”

• cites Boelen & Reijntjes, 2009 sourceNot checked — no full text of the source
• cites Carleton et al., 2010 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

These findings are reminiscent of psychophysiological research in which anxious individuals exhibit elevated threat responding to safety signals in the context of threat, with such heightened responding predicting subsequent onset of anxiety disorders.

“these findings are also reminiscent of psychophysiolgoical research in which anxious individuals have been shown to exhibit elevated threat responding to safety signals in the context of threat (Craske et al., 2008; Grillon et al., 1998; Lissek et al., 2010), with such heightened responding predicting the subsequent onset of anxiety disorders (Craske et al., 2012).”

• cites Craske et al., 2008 sourceNot checked — no full text of the source
• cites Grillon et al., 1998 sourceNot checked — no full text of the source
• cites Lissek et al., 2010 sourceNot checked — no full text of the source

May combine two claims.

Some neutral expressions signified a need for a response and may have represented a potential threat in the form of implied performance or interaction expectations.

“some of the neutral expressions signified a need for a response (e.g., “I need a pen”) and this may have represented a potential threat in the form of implied performance/interaction expectations.”

May combine two claims.

In our study, participants with SAD and healthy controls reported different levels of explicit distress and therefore also likely had differential spontaneous regulation needs and/or tendencies.

“In our study, participants with SAD and healthy controls reported different levels of explicit distress and therefore also likely had differential spontaneous regulation needs and/or tendencies.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Both dACC and anterior insula play a central role in social pain.

“much previous work has implicated both dACC and anterior insula as playing a central role in social pain (see Eisenberger 2012 for a review).”

• cites Eisenberger 2012 sourceNot checked — no full text of the source

May combine two claims.

In analyses examining early and late periods separately, results suggested a general pattern of increased amygdala activity over time for both groups, arguing against habituation as a primary factor obscuring group differences.

“In analyses examining the early and late periods of rejection and neutral videos separately, results suggested a general pattern of increased amygdala activity over time for both groups, arguing against habituation as a primary factor obscuring group differences.”

May combine two claims.

Together, the findings imply that there may be an impairment in differentiating between rejection and neutral (harmless/ambiguous) stimuli, as well as heightened sensitivity to neutral/ambiguous stimuli in SAD.

“Together, these findings imply that there may be an impairment in differentiating between rejection and neutral (i.e, harmless/ambiguous) stimuli, as well as heightened sensitivity to neutral/ambiguous stimuli in SAD.”

May combine two claims.

With a blocked design, differences in the timing of responses are not readily apparent, and differences between SAD and healthy control participants at specific time points following exposure to social threat would be obscured.

“with this approach, differences in the timing of responses are not readily apparent, and differences between SAD and healthy control participants at specific time points following exposure to social threat would be obscured.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Limitations of this study include the lack of data obtained from participants regarding their interpretations and responses to the videos beyond fMRI signal and self-reported distress and experiential success.

“Limitations of this study include the lack of data obtained from participants regarding their interpretations and responses to the videos beyond fMRI signal and self-reported distress and experiential success.”

The quote only partly states this claim.

The pattern of neural activity associated with greater treatment response to ACT was quite different from that for CBT.

“the pattern of neural activity associated with greater treatment response to ACT was quite different.”