Facial affect processing in social anxiety disorder with early onset: evidence of an intensity amplification bias

Abstract

The present event-related potential (ERP) study investigated for the first time whether children with early-onset social anxiety disorder (SAD) process affective facial expressions of varying intensities differently than non-anxious controls. Participants were 15 SAD patients and 15 nonanxious controls (mean age of 9 years). They were presented with schematic faces displaying anger and happiness at four intensity levels (25%, 50%, 75%, and 100%), as well as with neutral faces. ERPs in early and later time windows (P100, N170, late positivity [LP]), as well as affective ratings (valence and arousal) for the faces, were recorded. SAD patients rated the faces as generally more arousing, regardless of the type of emotion and intensity. Moreover, they displayed enhanced right-parietal LP (350-650 ms). Both arousal ratings and LP reflect stimulus intensity. Therefore, this study provides first evidence of an intensity amplification bias in pediatric SAD during facial affect processing. ARTICLE HISTORY

Effects of Cognitive Reappraisal on Subjective and Neural Reactivity to Angry Faces in Children with Social Anxiety Disorder, Clinical Controls with Mixed Anxiety Disorders and Healthy Children

“…To date, however, only a handful of ERP studies have examined emotional reactivity specifically in children with SAD. No differences have been reported between children with SAD and healthy controls via early ERP reactivity in response to emotional faces [16][17][18]. However, a recent study found enhanced P100 and N170 in children with mixed anxiety disorders (including SAD; [19]).…”

“…It is also the first study to compare the responses of children with SAD to healthy and clinical control populations (children with mixed anxiety disorders (MAD)). First, we hypothesized that children with SAD would show heightened subjective and late ERP reactivity (LPP; [17,18,20]) in response to angry faces with socially threatening interpretations, but no differences in early ERPs (P100, N1700, EPN; [16][17][18]) when compared to HC children. Second, based on previous findings reporting reappraisal difficulties in adult SAD [6], we hypothesized that, compared to HC children, children with SAD would show smaller reappraisal effects on subjective and LPP responses (i.e.…”

“…However, a recent study found enhanced P100 and N170 in children with mixed anxiety disorders (including SAD; [ 19 ]). In late ERPs (LPP), by contrast, the findings are also mixed: some studies report increased LPPs in response to threatening faces in children with SAD [ 17 , 18 ] and in mixed anxiety disorder groups (including SAD; [ 20 ]), while another study did not find amplified LPPs in response to angry faces in children with SAD [ 16 ].…”

“…While previous research has provided important information regarding emotional reactivity and regulation in childhood SAD, there are several notable limitations, which may also account for some inconsistencies in previous ERP studies on emotional reactivity in childhood anxiety. First, some studies investigated relatively small samples [ 17 , 18 ] and may have been statistically underpowered to capture small or medium sized group differences in neural indices. Furthermore, due to the lack of clinical control groups, little is known about transdiagnostic or disorder-specific effects of emotion regulation processes [ 26 ].…”

Review of EEG, ERP, and Brain Connectivity Estimators as Predictive Biomarkers of Social Anxiety Disorder

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