Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania.
Division of Psychiatry, Geisinger Health System, Danville, Pennsylvania.
Depress Anxiety. 2019 Aug;36(8):690-700. doi: 10.1002/da.22941.
Clinical levels of a social anxiety disorder (SAD) often appear during childhood and rise to a peak during late adolescence. The temperament trait behavioral inhibition (BI), evident early in childhood, has been linked to increased risk for SAD. Functional and structural variations in brain regions associated with the identification of, and response to, fear may support the BI-SAD relation. Whereas relevant functional studies are emerging, the few extant structural studies have focused on adult samples with mixed findings.
A moderated-mediation model was used to examine the relations between BI, SAD symptoms, and brain-volume individual differences in a sample of children at risk for anxiety (ages 9-12; N = 130, 52 BI).
Our findings indicate that at higher levels of BI, children with smaller anterior insula volumes showed stronger correlations between BI and SAD. In addition, larger ventrolateral prefrontal cortex (vlPFC) volumes were associated with fewer SAD symptoms.
These findings support previous reports linking SAD levels with variations in volume and reactivity in both limbic (insula) and prefrontal (vlPFC) regions. These findings set the foundation for further examination of networks of neural structures that influence the transition from BI to SAD across development, helping further clarify mechanisms of risk and resilience.
临床水平的社交焦虑障碍（SAD）通常出现在儿童期，并在青春期后期达到高峰。气质特征行为抑制（BI），在儿童早期就很明显，与 SAD 的风险增加有关。与识别和应对恐惧相关的大脑区域的功能和结构变化可能支持 BI-SAD 关系。虽然相关的功能研究正在出现，但为数不多的现有结构研究集中在有混合发现的成年样本上。
在一个有焦虑风险的儿童样本（年龄 9-12 岁；N=130，52 名 BI）中，使用调节中介模型来检验 BI、SAD 症状和大脑体积个体差异之间的关系。
我们的研究结果表明，在更高水平的 BI 中，前岛叶体积较小的儿童 BI 和 SAD 之间的相关性更强。此外，更大的腹外侧前额叶皮层（vlPFC）体积与较少的 SAD 症状相关。
这些发现支持了先前的报告，即 SAD 水平与边缘（岛叶）和前额叶（vlPFC）区域的体积和反应性变化有关。这些发现为进一步研究影响从 BI 到 SAD 发展过渡的神经结构网络奠定了基础，有助于进一步阐明风险和恢复力的机制。
