Mood & Anxiety Program, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA.
Psychiatry Res. 2011 Jul 30;193(1):38-45. doi: 10.1016/j.pscychresns.2010.12.016. Epub 2011 May 20.
Generalized social phobia (GSP) involves the fear of being negatively evaluated. Previous work suggests that self-referentiality, mediated by the medial prefrontal cortex (MFPC), plays an important role in the disorder. However, it is not clear whether this anomalous MPFC response to self-related information in patients with GSP concerns an increased representation of their own or others' opinions. In this article, we examine whether GSP is associated with increased response to own (1st person) or other individuals' (2nd person) opinions relative to healthy individuals. Unmedicated individuals with GSP (n=15) and age-, IQ-, and gender-matched comparison individuals (n=15) read 1st (e.g., I'm ugly), and 2nd (e.g., You're ugly) person viewpoint comments during functional magnetic resonance imaging. We observed significant group-by-viewpoint interactions within the ventral MPFC. Whereas the healthy comparison individuals showed significantly increased (or less decreased) BOLD responses to 1st relative to 2nd person viewpoints, the patients showed significantly increased responses to 2nd relative to 1st person viewpoints. The reduced BOLD responses to 1st person viewpoint comments shown by the patients correlated significantly with severity of social anxiety symptom severity. These results underscore the importance of dysfunctional self-referential processing and MPFC in GSP. We believe that these data reflect a reorganization of self-referential reasoning in the disorder with a self-concept perhaps atypically related to the view of others.
广泛性社交恐惧症（GSP）涉及对负面评价的恐惧。先前的研究表明，内侧前额叶皮层（MPFC）介导的自我参照在该障碍中起着重要作用。然而，目前尚不清楚 GSP 患者对自身相关信息的异常 MPFC 反应是否涉及对自身或他人意见的代表性增加。在本文中，我们研究了 GSP 是否与对自身（第一人称）或他人（第二人称）意见的反应增加有关，而不是与健康个体有关。未接受药物治疗的 GSP 患者（n=15）和年龄、智商和性别匹配的对照组个体（n=15）在功能磁共振成像期间阅读第一人称（例如，我很丑）和第二人称（例如，你很丑）观点评论。我们观察到腹侧 MPFC 内存在显著的组-观点交互作用。相比之下，健康对照组个体对第一人称观点的 BOLD 反应明显增加（或减少较少），而患者对第二人称观点的反应明显增加。患者对第一人称观点评论的 BOLD 反应减少与社交焦虑症状严重程度显著相关。这些结果强调了自我参照处理和 GSP 中 MPFC 功能障碍的重要性。我们认为这些数据反映了该障碍中自我参照推理的重新组织，自我概念可能与他人的观点异常相关。
