Impact of cognitive-behavioral therapy for social anxiety disorder on the neural bases of emotional reactivity to and regulation of social evaluation
Philippe R Goldin, Michal Ziv, Hooria Jazaieri, Justin Weeks, Richard G Heimberg, James J Gross, Philippe R Goldin, Michal Ziv, Hooria Jazaieri, Justin Weeks, Richard G Heimberg, James J Gross
Abstract
We examined whether Cognitive-Behavioral Therapy (CBT) for social anxiety disorder (SAD) would modify self-reported negative emotion and functional magnetic resonance imaging brain responses when reacting to and reappraising social evaluation, and tested whether changes would predict treatment outcome in 59 patients with SAD who completed CBT or waitlist groups. For reactivity, compared to waitlist, CBT resulted in (a) increased brain responses in right superior frontal gyrus (SFG), inferior parietal lobule (IPL), and middle occipital gyrus (MOG) when reacting to social praise, and (b) increases in right SFG and IPL and decreases in left posterior superior temporal gyrus (pSTG) when reacting to social criticism. For reappraisal, compared to waitlist, CBT resulted in greater (c) reductions in self-reported negative emotion, and (d) increases in brain responses in right SFG and MOG, and decreases in left pSTG. A linear regression found that after controlling for CBT-induced changes in reactivity and reappraisal negative emotion ratings and brain changes in reactivity to praise and criticism, reappraisal of criticism brain response changes predicted 24% of the unique variance in CBT-related reductions in social anxiety. Thus, one mechanism underlying CBT for SAD may be changes in reappraisal-related brain responses to social criticism.
Clinicaltrialsgov identifier: NCT00380731. http://www.clinicaltrials.gov/ct2/show/NCT00380731?term=social+anxiety+cognitive+behavioral+therapy+Stanford&rank=1.
Keywords: Cognitive-behavioral therapy; Emotion; Emotion regulation; Neuroimaging; Reappraisal; Social anxiety.
Conflict of interest statement
None of the authors of this manuscript have any biomedical financial interests or potential conflicts of interest.
Copyright © 2014 Elsevier Ltd. All rights reserved.
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Source: PubMed