Social anxiety disorder: looking back and moving forward

Abstract

Fifty years have passed since social anxiety disorder (SAD) was first differentiated from other phobias. In the years since research has largely aligned with the zeitgeist of categorical classificatory frameworks, and has spanned identifying causes, maintenance factors and innovative interventions. Despite significant advances in the field, the capacity to conceptualise SAD as an independent entity is limited given the heterogeneity and dimensionality of diagnostic criteria, high rates of comorbidity, and non-specificity of aetiological mechanisms, maintaining factors and approaches to treatment. The Research Domain Criteria (RDoC) initiative was developed in an effort to overcome the inherent limitations posed by descriptive diagnostic systems - particularly in terms of reliability and validity - and in doing so seeks to facilitate research into underlying pathophysiological and behavioural mechanisms that cut across traditional diagnostic boundaries. The RDoC framework is furnished with a 'matrix', which in essence corresponds to a set of research principles that attempt to reconcile neuroscience and psychopathology. This review outlines a rationale for integrating SAD research with the RDoC approach, and offers examples of how future studies may wish to frame hypotheses and design experiments as the field moves towards classifying dimensions of psychopathology through a mechanistic understanding of underlying neurobiological and behavioural processes.

Subcortical brain volumes, cortical thickness and cortical surface area in families genetically enriched for social anxiety disorder – A multiplex multigenerational neuroimaging study

“…Secondly, as this was a cross-sectional study, the trait stability of the GM characteristics (endophenotype criterion 2) could not be investigated. Third, we should mention the issue of psychiatric comorbidity, which was present in the LFLSAD sample as could be expected based on the comorbidity associated with SAD [ [21] , [22] , [23] , 41 ]. We performed two sensitivity analyses to address this issue; in the first analysis, we excluded participants with past and/or present (comorbid) psychopathology other than SAD, in the second we added the level of depressive symptoms as a covariate.…”

“…First of all, SAD is a polygenic disorder, and it is widely assumed that various genetic variants, influenced by environmental factors, are involved in its development [ [37] , [38] , [39] ]. Furthermore, SAD is a heterogeneous disorder, and the diagnosis is based on clinical interviews and not on biologically-based parameters [ 40 , 41 ]. Thus, investigating endophenotypes might facilitate in unravelling the genetic vulnerability for complex psychiatric disorders like SAD [ 42 ].…”

Fear of Uncertainty Makes You More Anxious? Effect of Intolerance of Uncertainty on College Students’ Social Anxiety: A Moderated Mediation Model

“…Social anxiety (SA) refers to individuals' strong, persistent, and irrational fear of being exposed to social situations (Hyett and McEvoy, 2018) and is one of the most common forms of anxiety. Chinese researchers emphasized college students are the main group affected by SA in China (Guo, 2000), because this age group has the highest interpersonal sensitivity (Peng et al, 2003).…”

Attenuated Psychophysiological Reactivity following Single-Session Group Imagery Rescripting versus Verbal Restructuring in Social Anxiety Disorder: Results from a Randomized Controlled Trial

“…Whilst not completely independent from sympathetic nervous system activity HRV indices are a sensitive indictor of emotion regulation [29]. This ability to ascribe dimensions of emotional functioning from autonomic parameters is of significant appeal as psychiatry moves towards modeling psychopathology on the basis of observable behavioral and biological signals [30, 31]. Evidence to date suggests that physiological differences emerge between subtypes of SAD when fear imagery is manipulated [25].…”