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Response to Emotional Expressions in Generalized Social Phobia and Generalized Anxiety Disorder: Evidence for Separate Disorders
Open accessAbstract
OBJECTIVE: Generalized social phobia involves fear/avoidance, specifically of social situations, whereas generalized anxiety disorder involves intrusive worry about diverse circumstances. It remains unclear the degree to which these two, often comorbid, conditions represent distinct disorders or alternative presentations of a single, core underlying pathology. Functional magnetic resonance imaging assessed the neural response to facial expressions in generalized social phobia and generalized anxiety disorder. METHOD: Individuals matched on age, IQ, and gender with generalized social phobia without generalized anxiety disorder (N=17), generalized anxiety disorder (N=17), or no psychopathology (N=17) viewed neutral, fearful, and angry expressions while ostensibly making a simple gender judgment. RESULTS: The patients with generalized social phobia without generalized anxiety disorder showed increased activation to fearful relative to neutral expressions in several regions, including the amygdala, compared to healthy individuals. This increased amygdala response related to self-reported anxiety in patients with generalized social phobia without generalized anxiety disorder. In contrast, patients with generalized anxiety disorder showed significantly less activation to fearful relative to neutral faces compared to the healthy individuals. They did show significantly increased response to angry expressions relative to healthy individuals in a lateral region of the middle frontal gyrus. This increased lateral frontal response related to self-reported anxiety in patients with generalized anxiety disorder. CONCLUSIONS: These results suggest that neural circuitry dysfunctions differ in generalized social phobia and generalized anxiety disorder.
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“Thus, regulation using emotion acceptance resulted in both a dampening down of early limbic and salience-related responses and less recruitment of the VLPFC, a region previously identified as hyperactivated in response to negative emotional stimuli in patients with GAD (Monk et al., 2006; Blair et al., 2008).”
From Neural correlates of emotion acceptance vs worry or suppression in generalized anxiety disorder (2017) · cites this paper as Blair et al., 2008
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Metadata
- Authors
- Blair, K., Shaywitz, J., Smith, B. W., Rhodes, R., Geraci, M., Jones, M., McCaffrey, D., Vythilingam, M., Finger, E., Mondillo, K., Jacobs, M., Charney, D. S., Blair, R. J. R., Drevets, W. C., & Pine, D. S.
- Affiliations
- National Institutes of Health (US)
- ORCID
- Venue
- American Journal of Psychiatry
- Published
- 2008-09
- Volume
- 165
- Issue
- 9
- Pages
- 1193-1202
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC2855133
- OpenAlex
- W2102269062
- Cited by
- 282
- References
- 32
- Citations by year
- 2025: 6 · 2024: 9 · 2023: 9 · 2022: 7 · 2021: 15 · 2020: 8 · 2019: 18 · 2018: 14 · 2017: 27 · 2016: 32 · 2015: 15 · 2014: 23 · 2013: 21 · 2012: 25
- FWCI
- 23.18
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (ZIA‐MH002781)
- National Institute of Mental Health (ZIAMH002780, ZIAMH002782)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Face Recognition and Perception
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- generalized social phobia, generalized anxiety disorder, facial emotion recognition, amygdala, angry facial expressions, middle frontal gyrus, self-reported anxiety, comorbidities
- MeSH terms
- Adult, Affect, Anxiety Disorders, Demography, Diagnosis, Differential, Facial Expression, Fear, Female, Frontal Lobe, Humans, Magnetic Resonance Imaging, Male, Phobic Disorders, Severity of Illness Index, Visual Perception, Comorbidity
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