Sensitivity shift theory: A developmental model of positive affect and motivational deficits in social anxiety disorder

Reward Circuitry and Motivational Deficits in Social Anxiety Disorder: What Can Be Learned From Mouse Models?

“…These findings collectively highlight both the general utility of the SDS paradigm in interrogating social stress-reward interactions in mice as well as the potential to inform developmental theories of SAD in humans (e.g., Richey et al, 2019). The particularly pronounced and longer-lasting effects on DA circuitry following the experience of SDS during adolescence may specifically relate to epidemiologic findings in humans that suggest a potentially sensitive period for SAD development (i.e., a median age of onset at or around 13 years of age; Wittchen et al, 1999;Gregory et al, 2007).…”

“…This gap in efficacy has motivated new research aimed at identifying alternative intervention approaches that may enhance clinical outcomes. One potentially promising avenue has identified dysfunction in the mesolimbic dopamine (DA) system, which has been linked to observations of motivational deficits in SAD, and consistent with a social anhedonic phenotype, which has been linked as a correlate of SAD (Tiihonen et al, 1997;Schneier et al, 2000Schneier et al, , 2008Cremers et al, 2015;Richey et al, 2013Richey et al, , 2017Richey et al, , 2019; but see also Schneier et al, 2009), but not other anxiety disorders such as generalized anxiety disorder (Brown et al, 1998). Dysfunction in the ventral striatum (VS) is central to this model, with a number of studies demonstrating reduced activity in the VS in relation to social but not non-social incentives (Richey et al, 2013(Richey et al, , 2017Maresh et al, 2014).…”

Mindfulness-Based Interventions for Adolescent Social Anxiety: A Unique Convergence of Factors

“…By eroding motivation to pursue social interactions (including social behaviors with the potential for a gratifying or rewarding outcome; Insel, 2003;Ottenbreit et al, 2014), behavioral avoidance may also exacerbate social skills deficits observed in SAD. Mindfulness practice may interrupt this cycle of avoidance and de-motivation by promoting non-judgmental observation of thoughts, feelings, and sensations, thus recoupling social interaction behaviors with the experience of rewarding or otherwise gratifying outcomes that may result from socializing (Richey et al, 2019).…”

“…For example, periods of transient social stress (including apprehension about future social events) activate negative and ruminative patterns of thinking, principally including anticipatory fear of negative evaluation ( Mellings and Alden, 2000 ; Nolen-Hoeksema, 2000 ; Fresco et al, 2002 ; Harrington and Blankenship, 2002 ; Robinson and Alloy, 2003 ). Over time, these patterns of repetitive negative thinking lead to behavioral avoidance of feared situations and as a secondary effect may also uncouple the experience of social interaction from its normally rewarding consequences ( Klemanski et al, 2017 ; Richey et al, 2019 ). By eroding motivation to pursue social interactions (including social behaviors with the potential for a gratifying or rewarding outcome; Insel, 2003 ; Ottenbreit et al, 2014 ), behavioral avoidance may also exacerbate social skills deficits observed in SAD.…”

“…However, there is no current research examining a comparison of efficacy rates between CBT and MBIs in adolescents with SAD. Although outcomes are comparable with CBT, MBIs target different mechanisms of change (e.g., positive emotionality and reward-based learning) that appear to be unique to SAD relative to other anxiety disorders and may lead to certain advantages in socially anxious adolescent populations (for full review, see Richey et al, 2019 ). Further, RCTs in adults with SAD have shown that treatment with MBIs resulted in increased mindfulness skills, social adjustment, self-compassion, attention regulation, self-esteem, better overall functioning, and quality of life ( Goldin et al, 2009 , 2013 ; Goldin and Gross, 2010 ; Cassin and Rector, 2011 ).…”