Background
Generalized social phobia (GSP) and generalized anxiety disorder (GAD) are both associated
with emotion dysregulation. Research implicates dorsal anterior cingulate cortex in
both explicit emotion regulation (EER) and top-down attentional control (TAC). Although
studies have examined these processes in GSP or GAD, no work compares findings across
the two disorders or examines functioning in cases comorbid for both disorders (GSP/GAD).
Here we compare the neural correlates of EER and TAC in GSP, GAD, and GSP/GAD.
Methods
Medication-free adults with GSP (EER n = 19; TAC n = 18), GAD (EER n = 17; TAC n = 17), GSP/GAD (EER n = 17; TAC n = 15), and no psychopathology (EER n = 18; TAC n = 18) participated. During EER, individuals alternatively viewed and upregulated and
downregulated responses to emotional pictures. During TAC, they performed an emotional
Stroop task.
Results
For both tasks, significant group × condition interactions emerged in dorsal anterior
cingulate cortex and parietal cortices. Healthy adults showed significantly increased
recruitment during emotion regulation, relative to emotion-picture viewing. GAD, GSP,
and GSP/GAD subjects showed no such increases, with all groups differing from healthy
adults but not from each other. Evidence of emotion-related disorder-specificity emerged
in medial prefrontal cortex and amygdala. This disorder-specific responding varied
as a function of emotion content but not emotion-regulatory demands.
Conclusions
GSP and GAD both involve reduced capacity for engaging emotion-regulation brain networks,
whether explicitly or via TAC. A reduced ability to recruit regions implicated in
top-down attention might represent a general risk factor for anxiety disorders.
Key Words
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References
- What is an anxiety disorder?.Depress Anxiety. 2009; 26: 1066-1085
- The neurobiology of anxiety disorders: Brain imaging, genetics, and psychoneuroendocrinology.Clin Lab Med. 2010; 30: 865-891
- Applying an emotion regulation framework to integrative approaches to Generalized Anxiety Disorder.Clin Psychol Sci Prac. 2002; 9: 85-90
- Social anxiety and emotion regulation: A model for developmental psychopathology perspectives on anxiety disorders.in: Cicchetti D. Cohen D.J. Developmental Psychopathology: Theory and Method. Wiley, New York2006
- Explicit and implicit emotion regulation: A dual-process framework.Cogn Emot. 2011; 25: 400-412
- The cognitive control of emotion.Trends Cogn Sci. 2005; 9: 242-249
- Neurobiology of emotion perception II: Implications for major psychiatric disorders.Biol Psychiatry. 2003; 54: 515-528
- Failure of anterior cingulate activation and connectivity with the amygdala during implicit regulation of emotional processing in generalized anxiety disorder.Am J Psychiatry. 2010; 167: 545-554
- Neural mechanisms of selective visual attention.Annu Rev Neurosci. 1995; 18: 193-222
- Rethinking feelings: An FMRI study of the cognitive regulation of emotion.J Cogn Neurosci. 2002; 14: 1215-1229
- Fate of unattended fearful faces in the amygdala is determined by both attentional resources and cognitive modulation.Neuroimage. 2005; 28: 249-255
- Neural processing of emotional faces requires attention.Proc Natl Acad Sci U S A. 2002; 99: 11458-11463
- Modulation of emotion by cognition and cognition by emotion.Neuroimage. 2007; 35: 430-440
- The functional neuroanatomy of reappraisal: Time matters.Neurosci Biobehav Rev. 2009; 33: 1215-1226
- The impact of processing load on emotion.Neuroimage. 2007; 34: 1299-1309
- Neural bases of social anxiety disorder: Emotional reactivity and cognitive regulation during social and physical threat.Arch Gen Psychiatry. 2009; 66: 170-180
- Neural mechanisms of cognitive reappraisal of negative self-beliefs in social anxiety disorder.Biol Psychiatry. 2009; 66: 1091-1099
- Functioning of neural systems supporting emotion regulation in anxiety-prone individuals.Neuroimage. 2011; 54: 689-696
- How do emotion and motivation direct executive control.Trends Cogn Sci. 2009; 13: 160-166
- Structured Clinical Interview for DSM-IV.American Psychiatric Press, Washington, DC1997
- For better or for worse: Neural systems supporting the cognitive down- and up-regulation of negative emotion.Neuroimage. 2004; 23: 483-499
- AFNI: Software for analysis and visualization of functional magnetic resonance neuroimages.Comput Biomed Res. 1996; 29: 162-173
- Neural response to self- and other referential praise and criticism in generalized social phobia.Arch Gen Psychiatry. 2008; 65: 1176-1184
- Social norm processing in adult Social Phobia: Atypically increased ventromedial frontal cortex responsiveness to unintentional (embarrassing) transgressions.Am J Psychiatry. 2010; 167: 1526-1532
- Response to emotional expressions in Generalized Social Phobia (GSP) and Generalized Anxiety Disorder (GAD): Evidence for separate disorders.Am J Psychiatry. 2008; 165: 1193-1202
- Anxiety and anxiety disorders in children and adolescents: Developmental issues and implications for DSM-V.Psychiatr Clin North Am. 2009; 32: 483-524
- Trait anxiety and impoverished prefrontal control of attention.Nat Neurosci. 2009; 12: 92-98
- Increased activation of the anterior cingulate cortex during processing of disgust faces in individuals with social phobia.Biol Psychiatry. 2005; 57: 975-981
- Association between amygdala hyperactivity to harsh faces and severity of social anxiety in generalized social phobia.Biol Psychiatry. 2006; 59: 424-429
- The pathology of social phobia is independent of developmental changes in face processing.Am J Psychiatry. 2011; 168: 1202-1209
- Attenuated responses to emotional expressions in women with generalized anxiety disorder.Psychol Med. 2010; 41: 1-11
- Anticipatory activation in the amygdala and anterior cingulate in generalized anxiety disorder and prediction of treatment response.Am J Psychiatry. 2009; 166: 302-310
- A functional magnetic resonance imaging predictor of treatment response to venlafaxine in generalized anxiety disorder.Biol Psychiatry. 2008; 63: 858-863
- Cognitive control mechanisms, emotion and memory: A neural perspective with implications for psychopathology.Neurosci Biobehav Rev. 2009; 33: 613-630
- Functional dissociation of attentional selection within PFC: Response and non-response related aspects of attentional selection as ascertained by fMRI.Cereb Cortex. 2006; 16: 827-834
- Atypically reduced modulation of medial prefrontal cortex to self-referential comments in Generalized Social Phobia.Psychiatry Res. 2011; 193: 38-45
- Stimulus-reinforcement based decision-making and anxiety: Impairment in Generalized Anxiety Disorder (GAD), but not in Generalized Social Phobia (GSP).Psychol Med. 2008; 39: 1153-1161
- A cognitive neuroscience approach to Generalized Anxiety Disorder and Social Phobia.Emot Review. 2012; 4: 133-138
- Effects of mindfulness-based stress reduction (MBSR) on emotion regulation in social anxiety disorder.Emotion. 2010; 10: 83-91
- Functional neuroimaging of mentalizing during the trust game in social anxiety disorder.Neuroreport. 2009; 20: 984-989
- fMRI of patients with social anxiety disorder during a social situation task.Neurosci Res. 2011; 69: 67-72
- Amygdala and ventrolateral prefrontal cortex function during anticipated peer evaluation in pediatric social anxiety.Arch Gen Psychiatry. 2008; 65: 1303-1312
- Effects of citalopram on worry and brain activation in patients with generalized anxiety disorder.Psychiatry Res. 2004; 131: 11-21
- Effect of worry on regional cerebral blood flow in nonanxious subjects.Psychiatry Res. 2005; 140: 259-269
- Attention regulation and monitoring in meditation.Trends Cogn Sci. 2008; 12: 163-169
- Neural correlates of using distancing to regulation emotional responses to social situations.Neuropsychologia. 2009; 48: 1813-1822
- Cognitive reappraisal in trauma-exposed women with borderline personality disorder.Neuroimage. 2012; 59: 1727-1734
- A functional magnetic resonance imaging study of deliberate emotion regulation in resilience and posttraumatic stress disorder.Biol Psychiatry. 2009; 66: 656-664
Blair KS, Vythilingam M, Crowe SL, McCaffrey DE, Ng P, Scaramozza M, et al. (in press): Vulnerability and resilience to PTSD are both associated with cognitive control of attention. Psych Medicine.
Article info
Publication history
Published online: May 17, 2012
Accepted:
April 1,
2012
Received in revised form:
March 13,
2012
Received:
November 16,
2011
Identification
Copyright
© 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
