Social norm processing in adult social phobia: atypically increased ventromedial frontal cortex responsiveness to unintentional (embarrassing) transgressions
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OBJECTIVE: Little is known about the neural underpinnings of generalized social phobia, which is defined by a persistent heightened fear of social disapproval. Using event-related functional MRI (fMRI), the authors examined whether the intent of an event, which mediates the neural response to social disapproval in healthy individuals, differentially affects response in generalized social phobia. METHOD: Sixteen patients with generalized social phobia and 16 healthy comparison subjects group-matched on age, gender, and IQ underwent fMRI scans while reading stories that involved neutral social events, unintentional social transgressions (e.g., choking on food at a party and coughing it up), or intentional social transgressions (e.g., disliking food at a party and spitting it out). RESULTS: Significant group-by-transgression interactions were observed in ventral regions of the medial prefrontal cortex. Healthy individuals tended to show increased blood-oxygen-level-dependent responses to intentional relative to unintentional transgressions. Patients with generalized social phobia, however, showed significantly increased responses to the unintentional transgressions. They also rated the unintentional transgressions as significantly more embarrassing than did the comparison subjects. Results also revealed significant group main effects in the amygdala and insula bilaterally, reflecting elevated generalized social phobia responses in these regions to all event types. CONCLUSIONS: These results further implicate the medial prefrontal cortex in the pathophysiology of generalized social phobia, specifically through its involvement in distorted self-referential processing. These results also further underscore the extended role of the amygdala and insula in the processing of social stimuli more generally in generalized social phobia.
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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”
From Neural responses to social threat and predictors of cognitive behavioral therapy and acceptance and commitment therapy in social anxiety disorder (2017) · cites this paper as Blair et al., 2010
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Blair, K. S., Geraci, M. F., Hollon, N. G., Otero, M. C., DeVido, J. J., Majestic, C. M., Jacobs, M., Blair, J., & Pine, D. S. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.10121800r · Cited by 2 · see citing works
Self-citationGenetic Vulnerability to Social Anxiety Disorder
Bas‐Hoogendam, J. M. (2024) · Current topics in behavioral neurosciences · doi:10.1007/7854_2024_544 · Cited by 2 · see citing works
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Goodkind, M. S., & Etkin, A. (2017) · Oxford University Press eBooks · doi:10.1093/med/9780190681425.003.0034 · Cited by 2 · see citing works
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Hubbeling, D. A. A. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.10121800
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- Authors
- Blair, K. S., Geraci, M., Hollon, N., Otero, M., DeVido, J., Majestic, C., Jacobs, M., Blair, R. J. R., & Pine, D. S.
- Affiliations
- National Institute of Mental Health (US)
- From the Mood and Anxiety Program, NIMH.
- Venue
- American Journal of Psychiatry
- Published
- 2010-12
- Volume
- 167
- Issue
- 12
- Pages
- 1526-1532
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC3175630
- OpenAlex
- W2167835436
- Cited by
- 65
- References
- 38
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 5 · 2020: 5 · 2019: 4 · 2018: 5 · 2017: 3 · 2016: 7 · 2015: 2 · 2014: 8 · 2013: 2 · 2012: 6
- FWCI
- 5.86
- 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 (Z99 MH999999)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Keywords
- generalized social phobia, ventromedial prefrontal cortex, embarrassment, social disapproval, amygdala, insula, self-referential processing, social rejection
- MeSH terms
- Adult, Amygdala, Emotions, Female, Frontal Lobe, Humans, Magnetic Resonance Imaging, Male, Phobic Disorders, Self Concept
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