. Neural response to the observable self in social anxiety disorder
Open accessAbstract
Background: Distorted images of the observable self are considered crucial in the development and maintenance of social anxiety. We generated an experimental situation in which participants viewed themselves from an observer's perspective when exposed to scrutiny and evaluation by others. Method: Twenty patients with social anxiety disorder (SAD) and 20 control subjects were assessed using functional magnetic resonance imaging (fMRI) during the public exposure of pre-recorded videos in which they were each shown performing a verbal task. The examiners acted as the audience in the experiment and rated performance. Whole-brain functional maps were computed using Statistical Parametric Mapping. Results: Robust activation was observed in regions related to self-face recognition, emotional response and general arousal in both study groups. Patients showed significantly greater activation only in the primary visual cortex. By contrast, they showed significant deactivation or smaller activation in dorsal frontoparietal and anterior cingulate cortices relevant to the cognitive control of negative emotion. Task-related anxiety ratings revealed a pattern of negative correlation with activation in this frontoparietal/cingulate network. Importantly, the relationship between social anxiety scores and neural response showed an inverted-U function with positive correlations in the lower score range and negative correlations in the higher range. Conclusions: Our findings suggest that exposure to scrutiny and evaluation in SAD may be associated with changes in cortical systems mediating the cognitive components of anxiety. Disorder severity seems to be relevant in shaping the neural response pattern, which is distinctively characterized by a reduced cortical response in the most severe cases.
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When people with SAD and healthy controls watched a video of their own working memory task performance versus another person's performance, differential fusiform activation was observed in those with higher SAD severity.
“When individuals with SAD and HC observed a video recording of their own working memory task performance, compared to others’ performance, differential activation in the fusiform was observed for those with higher SAD severity (Pujol et al., 2013).”
From Self-referential processing during observation of a speech performance task in social anxiety disorder from pre- to post-treatment: Evidence of disrupted neural activation (2019) · cites this paper as Pujol et al., 2013
The Experimental task section describes videos of participants recalling stories, viewed against videos of other people doing the same task; it calls this a memory task, not a working-memory task. In Correlation of brain activation with social anxiety scores (page unavailable), greater fusiform activation relative to controls was reported for the lower-severity SAD group. The higher-severity group instead showed reduced activation in anterior regions and the thalamus, so the claimed fusiform finding for those with higher SAD severity is not supported. (LLM, conf=0.88)
Experimental — accuracy not yet measuredPrior research found differential activation of the fusiform face area during self-observation of a working memory task based on severity of social anxiety symptoms.
“prior research in which differential activation of the fusiform face area was observed during self-observation of a working memory task based on severity of social anxiety symptoms (Pujol et al., 2013).”
From Self-referential processing during observation of a speech performance task in social anxiety disorder from pre- to post-treatment: Evidence of disrupted neural activation (2019) · cites this paper as Pujol et al., 2013
The Correlation of brain activation with social anxiety scores section reports greater fusiform gyrus activation in patients with lower-severity social anxiety than in controls. The Experimental task section describes viewing recordings of participants recalling verbal narratives, but does not identify the task as a working-memory task; the reported region is the fusiform gyrus, not specifically the fusiform face area. No page numbers were available in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe only prior study comparing self- versus other-referential processing of videos in SAD and healthy controls did not use a speech performance task.
“To our knowledge, this is the only study comparing self- to other-referential processing of videos in SAD and HC, and this study did not include observation of a speech performance task, a common therapeutic tool in SAD treatment.”
From Self-referential processing during observation of a speech performance task in social anxiety disorder from pre- to post-treatment: Evidence of disrupted neural activation (2019) · cites this paper as Pujol et al., 2013
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- Authors
- Pujol, J., Giménez, M., Ortiz, H., Soriano-Mas, C., López-Solà, M., Farré, M., Deus, J., Merlo-Pich, E., Harrison, B. J., Cardoner, N., Navinés, R., & Martín-Santos, R.
- Affiliations
- Barcelona Biomedical Research Park (ES)
- Universitat Autònoma de Barcelona (ES)
- The University of Melbourne (AU)
- Instituto de Salud Carlos III (ES)
- Centro de Investigación Biomédica en Red de Salud Mental (ES)
- Corresponding author
- Pujol, J.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2012-08-16
- Volume
- 43
- Issue
- 4
- Pages
- 721-731
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2129902541
- Cited by
- 52
- References
- 58
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 8 · 2020: 3 · 2019: 3 · 2018: 2 · 2017: 4 · 2016: 7 · 2015: 3 · 2014: 9 · 2013: 4
- FWCI
- 6.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (publishedVersion)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion)
- Funders
- Medical Research Council
- National Health and Medical Research Council (628509)
- Instituto de Salud Carlos III (PI09/01331, CP10/00604)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Face Recognition and Perception
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- social anxiety disorder, self-face recognition, observer perspective, anterior cingulate cortex, primary visual cortex, anxiety levels, neural responses
- MeSH terms
- Adolescent, Adult, Anxiety Disorders, Arousal, Brain Mapping, Cerebral Cortex, Emotions, Face, Female, Heart Rate, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Psychiatric Status Rating Scales, Self Concept, Severity of Illness Index, Case-Control Studies, Recognition, Psychology, Young Adult
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