Hur Juyoen, Tillman Rachael M, Kim Hyung Cho, Didier Paige, Anderson Allegra S, Islam Samiha, Stockbridge Melissa D, De Los Reyes Andres, DeYoung Kathryn A, Smith Jason F, Shackman Alexander J
Department of Psychology, Yonsei University.
Department of Neuropsychology, Children's National Hospital.
J Psychopathol Clin Sci. 2025 Jan;134(1):41-56. doi: 10.1037/abn0000940. Epub 2024 Nov 7.
Social anxiety-which typically emerges in adolescence-lies on a continuum and, when extreme, can be devastating. Socially anxious individuals are prone to heightened fear, anxiety, and the avoidance of contexts associated with potential social scrutiny. Yet most neuroimaging research has focused on acute social threat. Much less attention has been devoted to understanding the neural systems recruited during the uncertain anticipation of potential encounters with social threat. Here we used a novel functional magnetic resonance imaging paradigm to probe the neural circuitry engaged during the anticipation and acute presentation of threatening faces and voices in a racially diverse sample of 66 adolescents selectively recruited to encompass a range of social anxiety and enriched for clinically significant levels of distress and impairment. Results demonstrated that adolescents with more severe social anxiety symptoms experience heightened distress when anticipating encounters with social threat, and reduced discrimination of uncertain social threat and safety in the bed nucleus of the stria terminalis, a key division of the central extended amygdala (EAc). Although the EAc-including the bed nucleus of the stria terminalis and central nucleus of the amygdala-was robustly engaged by the acute presentation of threatening faces and voices, the degree of EAc engagement was unrelated to the severity of social anxiety. Together, these observations provide a neurobiologically grounded framework for conceptualizing adolescent social anxiety and set the stage for the kinds of prospective-longitudinal and mechanistic research that will be necessary to determine causation and, ultimately, to develop improved interventions for this often-debilitating illness. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
社交焦虑——通常在青春期出现——处于一个连续体上，极端情况下可能具有毁灭性。社交焦虑个体容易产生高度恐惧、焦虑，并回避与潜在社会审视相关的情境。然而，大多数神经影像学研究都集中在急性社会威胁上。对于理解在对潜在社会威胁遭遇的不确定预期过程中所招募的神经系统，关注则少得多。在这里，我们使用了一种新颖的功能磁共振成像范式，以探究在一个有66名青少年的种族多样化样本中，在预期和急性呈现威胁性面孔及声音时所涉及的神经回路。这些青少年是经过选择性招募的，涵盖了一系列社交焦虑程度，且在临床上具有显著水平的痛苦和功能损害。结果表明，社交焦虑症状更严重的青少年在预期遭遇社会威胁时会经历更高程度的痛苦，并且在终纹床核（中央杏仁核扩展部的一个关键部分）中对不确定社会威胁和安全的辨别能力降低。尽管包括终纹床核和杏仁核中央核在内的中央杏仁核扩展部在急性呈现威胁性面孔和声音时被强烈激活，但中央杏仁核扩展部的激活程度与社交焦虑的严重程度无关。总之，这些观察结果为理解青少年社交焦虑提供了一个基于神经生物学的框架，并为确定因果关系以及最终为这种常常使人衰弱的疾病开发改进干预措施所需的前瞻性纵向研究和机制性研究奠定了基础。（PsycInfo数据库记录（c）2025美国心理学会，保留所有权利）
