Dysregulated Neural Response to Unpredictable Peer Feedback In Adolescents with Social Anxiety Disorder

Authors

• BI Rappaport
• LH Russell
• EE Nelson
• DS Pine
• JM Jarcho

Abstract

Background: Social anxiety disorder (SAD) increases during adolescence, when the salience of social rejection peaks. Prior studies demonstrate that social rejection engages neural circuits implicated in threat and discomfort among socially anxious adolescents. However, SAD symptoms are typically elicited by unpredictable social contexts. We aimed to determine whether dysregulated neural response in SAD-vs-healthy adolescents varies for predictable and unpredictable social rejection. Methods: Healthy and SAD adolescents were told they would visit a Virtual School and interact with purported “Other Students”. Before completing the fMRI paradigm, participants learned each student had a reputation for being ‘nice,’ ‘unpredictable,’ or a ‘bully.’ While scanning, participants entered classrooms with the Other Students and were cued to anticipate social evaluation when “Typing...” appeared above one of them. Unpredictable peers provided 50% positive and negative feedback, while Nice and Bully peers respectively provided 100% positive or negative feedback. Results: Participants learned Other Student reputations and believed they interacted with real peers. Group differences in brain activity emerged during negative feedback from Unpredictable, relative to Bully peers. Specifically, SAD-vs-healthy adolescents exhibited heightened activity in anterior cingulate cortex, insula, striatum, and dorsolateral prefrontal cortex (p’s

Scientific Focus Area: Social and Behavioral Sciences

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