Amygdala and Ventrolateral Prefrontal Cortex Function During Anticipated Peer Evaluation in Pediatric Social Anxiety

Abstract

Context Amygdala and ventrolateral prefrontal cortex (vlPFC) dysfunction manifests in adolescents with anxiety disorders when they view negatively valenced stimuli in threatening contexts. Such fear-circuitry dysfunction may also manifest when anticipated social evaluation leads socially anxious adolescents to misperceive peers as threatening. Objective To determine whether photographs of negatively evaluated smiling peers viewed during anticipated social evaluation engage the amygdala and vlPFC differentially in adolescents with and without social anxiety. Design Case-control study. Setting Government clinical research institute. Participants Fourteen adolescents with anxiety disorders associated with marked concerns of social evaluation and 14 adolescents without a psychiatric diagnosis matched on sex, age, intelligence quotient, and socioeconomic status. Main Outcome Measures Blood oxygenation level–dependent signal measured with event-related functional magnetic resonance imaging. Before and during neuroimaging scans, participants anticipating social evaluation completed peer- and self-appraisals. Event-related analyses were tailored to participants’ ratings of specific peers. Results Participants classified 40 pictures of same-age peers as ones with whom they did or did not want to engage in a social interaction. Anxious adolescents showed greater amygdala activation than healthy adolescents when anticipating evaluation from peers previously rated as undesired for an interaction. Psychophysiological interaction connectivity analyses also revealed a significant positive association between amygdala and vlPFC activation in anxious vs healthy adolescents in response to these stimuli. Conclusions Anticipating social evaluation from negatively perceived peers modulates amygdala and vlPFC engagement differentially in anxious and healthy adolescents. Amygdala and vlPFC dysfunction manifests in adolescent anxiety disorders in specific contexts of anticipated peer evaluation.

Get Aroused and Be Stronger: Emotional Facilitation of Physical Effort in the Human Brain

“…Indeed, the VLPFC, often accompanied by the amygdala and insula, was recently shown to be activated in relation to the intensity of IAPS pictures, anticipation of negative pictures, negative facial expressions, affect naming, emotional distraction, reappraisal and regulation, and experienced or self-induced sadness and happiness Pelletier et al, 2003;Habel et al, 2005;Dolcos and McCarthy, 2006;Drabant et al, 2006;Grimm et al, 2006;Lieberman et al, 2007;Mataix-Cols et al, 2008;Onoda et al, 2008;Wager et al, 2008). Abnormal activity in the same regions during emotional processing has been reported in a variety of psychiatric conditions involving emotional dysfunction such as mania, depression, negative psychotic symptoms, stress, anxiety, and obsessive compulsive disorders (Fahim et al, 2005;Monk et al, 2006;Taylor et al, 2006;Johnstone et al, 2007;Lawrence et al, 2007;Pavuluri et al, 2007;Foland et al, 2008;Guyer et al, 2008).…”

Neural Function Before and After Mindfulness-Based Cognitive Therapy in Anxious Adolescents at Risk for Developing Bipolar Disorder

“…These two structures were examined given their central role in the pathophysiology of anxiety. In this regard, most fMRI studies of youth with anxiety disorders suggest increased activation of the VLPFC (Monk et al 2006;McClure et al 2007;Guyer et al 2008;Monk et al 2008;Beesdo et al 2009;Strawn et al 2012a) and also suggest structural deficits in this region in children and adolescents with anxiety disorders . The VLPFC subserves a number of regulatory functions, including modulation of amygdala activity (Monk et al 2008) and is responsible for conscious regulation of affect (Phillips et al 2008).…”

Pediatric anxiety disorders: from neuroscience to evidence-based clinical practice

“…In particular, a set of dysfunctional mental processes has been linked to pediatric anxiety and associated traits, such as the early-childhood temperament of behavioral inhibition. These dysfunctional processes can be classified into five groups of information-processing functions: 1) threatattention interaction (a tendency for anxious children to automatically orient their attention towards or away from threats) 72 ; 2) threat appraisal (a tendency for anxious children to classify and respond to neutral or harmless stimuli as if they are dangerous) 73 ; 3) memory and learning processes (a tendency for anxious individuals to learn different associations among safe and dangerous stimuli, as presented in fear conditioning and extinction experiments) [73][74][75] ; 4) social evaluative processes (a tendency for anxious children to become concerned about peer evaluation) 76 ; 5) increased sensitivity to rewards (a tendency for anxiety children to more strongly alter their behavior when trying to achieve rewards). 77,78 This set of findings suggests that anxiety disorders involve dysfunctional processes in various emotional and cognitive processes, each of which is in turn regulated by several brain regions that may support anxiety disorder pathophysiology.…”