Frontoparietal and Default Mode Network Contributions to Self-Referential Processing in Social Anxiety Disorder

Scale for time and space experience in anxiety (STEA): Phenomenology and its clinical relevance

Anxiety is a pervasive emotional state where, phenomenologically, subjects often report changes in their experience of time and space. However, a systematic and quantified examination of time and space experience in terms of a self-report scale is still missing which eventually could also be used for clinical differential diagnosis. Based on historical phenomenological literature and patients' subjective reports, we here introduce, in a first step, the Scale for Time and Space Experience of Anxiety (STEA) in a smaller sample of 19 subjects with anxiety disorders and, in a second step, validate its shorter clinical version (cSTEA) in a larger sample of 48 anxiety subjects. The main findings are (i) high convergent and divergent validity of STEA with both Beck Anxiety Inventory (BAI) (r = 0.7325; p < 0.001) and Beck Depression Inventory (BDI) (r = 0.7749; p < 0.0001), as well as with spontaneous mind wandering (MWS) (r = 0.7343; p < 0.001) and deliberate mind wandering (MWD) (r = 0.1152; p > 0.05), (ii) statistical feature selection shows 8 key items for future clinical usage (cSTEA) focusing on the experience of temporal and spatial constriction, (iii) the effects of time and space experience (i.e., for both STEA and cSTEA scores) on the level of anxiety (BAI) are mediated by the degree of spontaneous mind wandering (MWS), (iv) cSTEA allows for differentiating high levels of anxiety from the severity of comorbid depressive symptoms, and (v) significant reduction in the cSTEA scores after a therapeutic intervention (breathing therapy). Together, our study introduces a novel fully quantified and highly valid self-report instrument, the STEA, for measuring time-space experiences in anxiety. Further we develop a shorter clinical version (cSTEA) which allows assessing time space experience in a valid, quick, and simple way for diagnosis, differential diagnosis, and therapeutic monitoring of anxiety.

Changes in Spatiotemporal Dynamics of Default Network Oscillations between 19 and 29 Years of Age

The exploration of functional resting-state brain developmental parameters and measures can help to improve scientific, psychological, and medical applications. The present work focussed on both traditional approaches, such as topographical power analyses at the signal space level, and advanced approaches, such as the exploration of age-related dynamics of source space data. The results confirmed the expectation that the third life decade would show a kind of stability in oscillatory signal and source-space-related parameters. However, from a source dynamics perspective, different frequency ranges appear to develop quite differently, as reflected in age-related sequential network communication profiles. Among other discoveries, the left anterior cingulate source location could be shown to reduce bi-directional network communication in the lower alpha band, whereas it differentiated its uni- and bidirectional communication dynamics to sub-cortical and posterior brain locations. Higher alpha oscillations enhanced communication dynamics between the thalamus and particularly frontal areas. In conclusion, resting-state data appear to be, at least in part, functionally reorganized in the default mode network, while quantitative measures, such as topographical power and regional source activity, did not correlate with age in the third life decade. In line with other authors, we suggest the further development of a multi-perspective approach in biosignal analyses.

Oxytocin and social learning in socially anxious men and women

OBJECTIVE

This study extended a classic self-referential learning paradigm by investigating the effects of intranasally-administered oxytocin in high and low socially anxious participants during social learning, as a function of social anxiety levels and sex.

METHODS

In a randomized double-blinded design, 160 participants were either given intranasal oxytocin (24 I.U.) or placebo. Subsequently, while lying in an MR scanner, participants were shown neutral faces that were paired with positively, neutrally, or negatively valenced self-referential sentences, during which we measured self-reported arousal and sympathy of the facial stimuli, pupil dilation, and changes in the brain-oxygen-level dependent signal. Four-factor mixed analyses of variance with the between-subjects factors group (high socially anxious vs. low socially anxious), substance (oxytocin vs. placebo), and sex (male vs. female) and the within-subjects factor sentence valence (positive vs. neutral vs. negative) were conducted for each measure, respectively.

RESULTS

Administration of intranasal oxytocin yielded an increase in sympathy ratings in high socially anxious compared to low socially anxious individuals and decreased arousal ratings for positively-conditioned faces in low socially anxious participants. As an objective physiological measure of arousal, pupil dilation mirrored the behavioral results. Oxytocin effects on neural activation in the insula interacted with anxiety levels and sex: low socially anxious individuals yielded lower activation under oxytocin than placebo; the converse was observed in high socially anxious individuals. This interaction also differed between sexes, as men yielded higher activation levels than women. These findings were more prominent for positively- and negatively-conditioned faces. Within the amygdala, high socially anxious men yielded higher activation than high socially anxious women in the left hemisphere, and low socially anxious men yielded higher activation than low socially anxious women from positively- and negatively-conditioned faces, though no influence of oxytocin was detected.

CONCLUSION

These results suggest oxytocin-induced behavioral, physiological, and neural changes as a function of social learning in socially low and high anxious individuals. These findings challenge the amygdalocentric view of the role of emotions in social learning, instead contributing to the growing body of findings implicating the insula therein, revealing an interaction between oxytocin, sex, and emotional valence. Such discoveries raise an interesting set of questions regarding the computational goals of regions such as the insula in emotional learning and how neural activity can play a diagnostic or prognostic role in social anxiety, potentially leading to new treatment opportunities that may combine oxytocin and neurofeedback differentially for men and women.

Different emotion regulation strategies mediate the relations of corresponding connections within the default-mode network to sleep quality

Despite a long history of interest in the relation of emotion regulation to sleep quality, how different strategies link with sleep quality at the neural level is still poorly understood. Thus, we utilized the process model of emotion regulation as an organizing framework for examining the neurological underpinning of the links between the two emotion regulation strategies and sleep quality. 183 young adults (51.7% females, Mage = 22.16) were guided to undergo the MRI scans and then complete the Pittsburgh Sleep Quality Index (PSQI) and the emotion regulation Questionnaire (ERQ) formed by two dimensions: cognitive reappraisal and expressive suppression. Results found that emotion regulation mediated the association between functional connectivity within the intrinsic default-mode network (DMN) and sleep quality. Specifically, rsFC analysis showed that cognitive reappraisal was positively correlated with rsFC within DMN, including left superior temporal gyrus (lSTG)-left lateral occipital cortex (lLOC), lSTG-left anterior cingulate gyrus (lACG), right lateral occipital cortex (rLOC)-left middle frontal gyrus (lMFG), and rLOC-lSTG. Further mediation analysis indicated a mediated role of cognitive reappraisal in the links between the four connectivity within the DMN and sleep quality. In addition, expressive suppression was positively correlated with rsFC within DMN, including left precuneus cortex (lPrcu)-right Temporal Pole (rTP) and lPrcu- lSTG. Further mediation analysis indicated a mediated role of expressive suppression in the links between the two connectivity within the DMN and sleep quality. Overall, this finding supports the process model of emotion regulation in that the effects of reappraisal and suppression have varying neural circuits that impact that strategy's effect on sleep quality.

Sex differences in the effects of individual anxiety state on regional responses to negative emotional scenes

BACKGROUND

Men and women are known to show differences in the incidence and clinical manifestations of mood and anxiety disorders. Many imaging studies have investigated the neural correlates of sex differences in emotion processing. However, it remains unclear how anxiety might impact emotion processing differently in men and women.

METHOD

We recruited 119 healthy adults and assessed their levels of anxiety using State-Trait Anxiety Inventory (STAI) State score. With functional magnetic resonance imaging (fMRI), we examined regional responses to negative vs. neutral (Neg-Neu) picture matching in the Hariri task. Behavioral data were analyzed using regression and repeated-measures analysis of covariance with age as a covariate, and fMRI data were analyzed using a full-factorial model with sex as a factor and age as a covariate.

RESULTS

Men and women did not differ in STAI score, or accuracy rate or reaction time (RT) (Neg-Neu). However, STAI scores correlated positively with RT (Neg-Neu) in women but not in men. Additionally, in women, STAI score correlated positively with lingual gyrus (LG) and negatively with medial prefrontal cortex (mPFC) and superior frontal gyrus (SFG) activity during Neg vs. Neu trials. The parameter estimates (βs) of mPFC also correlated with RT (Neg-Neu) in women but not in men. Generalized psychophysiological interaction (gPPI) analysis in women revealed mPFC connectivity with the right inferior frontal gyrus, right SFG, and left parahippocampal gyrus during Neg vs. Neu trials in positive correlation with both STAI score and RT (Neg-Neu). In a mediation analysis, mPFC gPPI but not mPFC activity fully mediated the association between STAI scores and RT (Neg-Neu).

CONCLUSION

With anxiety affecting the behavioral and neural responses to negative emotions in women but not in men and considering the known roles of the mPFC in emotion regulation, we discussed heightened sensitivity and regulatory demands during negative emotion processing as neurobehavioral markers of anxiety in women.

Sex differences in the effects of individual anxiety state on regional responses to negative emotional scenes

Background

Men and women are known to show differences in the incidence and clinical manifestations of mood and anxiety disorders. Many imaging studies have investigated the neural correlates of sex differences in emotion processing. However, it remains unclear how anxiety might impact emotion processing differently in men and women.

Method

We recruited 119 healthy adults and assessed their levels of anxiety using State-Trait Anxiety Inventory (STAI) State score. With functional magnetic resonance imaging (fMRI), we examined regional responses to negative vs. neutral (Neg-Neu) picture matching in the Hariri task. Behavioral data were analyzed using regression and repeated-measures analysis of covariance with age as a covariate, and fMRI data were analyzed using a full-factorial model with sex as a factor and age as a covariate.

Results

Men and women did not differ in STAI score, or accuracy rate or reaction time (RT) (Neg-Neu). However, STAI scores correlated positively with RT (Neg-Neu) in women but not in men. Additionally, in women, STAI score correlated positively with lingual gyrus (LG) and negatively with medial prefrontal cortex (mPFC) and superior frontal gyrus (SFG) activity during Neg vs. Neu trials. The parameter estimates (β's) of mPFC also correlated with RT (Neg-Neu) in women but not in men. Generalized psychophysiological interaction (gPPI) analysis in women revealed mPFC connectivity with the right inferior frontal gyrus, right SFG, and left parahippocampal gyrus during Neg vs. Neu trials in positive correlation with both STAI score and RT (Neg-Neu). In a mediation analysis, mPFC gPPI but not mPFC activity fully mediated the association between STAI scores and RT (Neg-Neu).

Conclusion

With anxiety affecting the behavioral and neural responses to negative emotions in women but not in men and considering the known roles of the mPFC in emotion regulation, we discussed heightened sensitivity and regulatory demands during negative emotion processing as neurobehavioral markers of anxiety in women.

The Neural Separability of Emotion Reactivity and Regulation

One foundational distinction in affective science is between emotion reactivity and regulation. This conceptual distinction has long been assumed to be instantiated in spatially separable brain systems (a typical example: amygdala/insula for reactivity and frontoparietal areas for regulation). In this research, we begin by reviewing previous findings that support and contradict the neural separability hypothesis concerning emotional reactivity and regulation. Further, we conduct a direct test of this hypothesis with empirical data. In five studies involving healthy and clinical samples (total n = 336), we assessed neural responses using fMRI while participants were asked to either react naturally or regulate their emotions (using reappraisal) while viewing emotionally evocative stimuli. Across five studies, we failed to find support for the neural separability hypothesis. In univariate analyses, both presumptive "reactivity" and "regulation" brain regions demonstrated equal or greater activation for the reactivity contrast than for the regulation contrast. In multivariate pattern analyses (MVPA), classifiers decoded reactivity (vs. neutral) trials more accurately than regulation (vs. reactivity) trials using multivoxel data in both presumptive "reactivity" and "regulation" regions. These findings suggest that emotion reactivity and regulation-as measured via fMRI-may not be as spatially separable in the brain as previously assumed. Our secondary whole-brain analyses revealed largely consistent results. We discuss the two theoretical possibilities regarding the neural separability hypothesis and offer thoughts for future research.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42761-023-00227-9.

A brain model of altered self-appraisal in social anxiety disorder

The brain's default mode network has a central role in the processing of information concerning oneself. Dysfunction in this self-referential processing represents a key component of multiple mental health conditions, particularly social anxiety disorder (SAD). This case-control study aimed to clarify alterations to network dynamics present during self-appraisal in SAD participants. A total of 38 adolescents and young adults with SAD and 72 healthy control participants underwent a self-referential processing fMRI task. The task involved two primary conditions of interest: direct self-appraisal (thinking about oneself) and reflected self-appraisal (thinking about how others might think about oneself). Dynamic causal modeling and parametric empirical Bayes were then used to explore differences in the effective connectivity of the default mode network between groups. We observed connectivity differences between SAD and healthy control participants in the reflected self-appraisal but not the direct self-appraisal condition. Specifically, SAD participants exhibited greater excitatory connectivity from the posterior cingulate cortex (PCC) to medial prefrontal cortex (MPFC) and greater inhibitory connectivity from the inferior parietal lobule (IPL) to MPFC. In contrast, SAD participants exhibited reduced intrinsic connectivity in the absence of task modulation. This was illustrated by reduced excitatory connectivity from the PCC to MPFC and reduced inhibitory connectivity from the IPL to MPFC. As such, participants with SAD showed changes to afferent connections to the MPFC which occurred during both reflected self-appraisal as well as intrinsically. The presence of connectivity differences in reflected and not direct self-appraisal is consistent with the characteristic fear of negative social evaluation that is experienced by people with SAD.

The Impact of Sleep Deprivation on Brain Networks in Response to Social Evaluation Tasks

Sleep loss may lead to negative bias during social interaction. In the current study, we conducted a revised social evaluation task experiment to investigate how sleep deprivation influences the self-referential and cognitive processes of social feedback. The experiment consisted of a first impression task and a social feedback task. Seventy-eight participants completed the first impression task and were divided into normal and poor sleep groups. The results of an independent samples t-test showed that participants who slept worse were less likely to socialize with others but did not evaluate others as less attractive. Afterward, 22 of the participants from the first impression task were recruited to complete the social feedback task during functional magnetic resonance imaging (fMRI) on the mornings following two different sleep conditions at night: one night of normal sleep and one night of sleep deprivation. The results of this within-subject design study showed that participants who experienced the latter condition showed increased activation within the default mode network (i.e. superior parietal lobule, precuneus, inferior parietal lobule, inferior temporal gyrus, and medial frontal gyrus) and anterior cingulate cortex (ACC) and stronger negative insula functional connectivity (FC) with the precuneus to negative feedback than positive feedback. The altered activation and behavioral pattern may indicate a negative bias for social cues. However, stronger negative coupling may indicate stronger cognitive control, which may protect against potential damage to self-concept. Our study suggested that sleep impairs most social functions, but may protect against impairment of important ones, such as self-concept.

A dorsomedial prefrontal cortex-based dynamic functional connectivity model of rumination

Rumination is a cognitive style characterized by repetitive thoughts about one's negative internal states and is a common symptom of depression. Previous studies have linked trait rumination to alterations in the default mode network, but predictive brain markers of rumination are lacking. Here, we adopt a predictive modeling approach to develop a neuroimaging marker of rumination based on the variance of dynamic resting-state functional connectivity and test it across 5 diverse subclinical and clinical samples (total n = 288). A whole-brain marker based on dynamic connectivity with the dorsomedial prefrontal cortex (dmPFC) emerges as generalizable across the subclinical datasets. A refined marker consisting of the most important features from a virtual lesion analysis further predicts depression scores of adults with major depressive disorder (n = 35). This study highlights the role of the dmPFC in trait rumination and provides a dynamic functional connectivity marker for rumination.

Behavioral and ERP indices of self-schematic processing show differential associations with emerging symptoms of depression and social anxiety in late childhood: Evidence from a community-dwelling sample

Symptoms of depression and social anxiety elevate in late childhood. An identified cognitive risk to both depression and social anxiety is maladaptive self-schemas (or self-schematic processing). Beyond the behavioral indices of this construct, event-related potentials (ERPs) during self-schematic processing have also been observed to be associated with depression or depressive symptoms. However, no study has examined the ERPs underlying self-schematic processing in relation to social anxiety. More importantly, it was unclear to what extent behavioral and ERP indices of self-schematic processing were differentially associated with depression and social anxiety, especially in typical-risk youth with emerging symptoms. A hundred and fifteen community-dwelling children (66 girls; Mean age=10.91 years, SD=1.45) completed a self-referent encoding task (SRET) with EEG recorded. A Principal Component Analysis identified a late positive potential (LPP) component elicited in both the positive and negative SRET conditions. Multivariate multiple regression showed that in both conditions, behavioral SRET scores were associated with depressive symptoms while partialling out social anxiety symptoms, but not with social anxiety symptoms with depressive symptoms partialled out. The LPP amplitude elicited in both conditions showed marginally positive associations with social anxiety symptoms while partialling out depressive symptoms, but not with depressive symptoms while accounting for social anxiety. This study provides novel evidence concerning the ERP correlates of self-schematic processing in relation to social anxiety symptoms. More importantly, our findings for the first time speak to the differential associations between the behavioral SRET scores and SRET-elicited LPP and emerging symptoms of depression and social anxiety in late childhood.

Computational Modeling of Self-Referential Processing Reveals Domain General Associations with Adolescent Anxiety Symptoms

What an adolescent thinks about themselves, commonly termed self-referential processing, has significant implications for youth long-term psychological well-being. Self-referential processing plays an important role in anticipatory and reactive processing in social contexts and contributes to symptoms of social anxiety. Previous work examining self-referential processing largely focuses on child and adolescent depression, relying on endorsement and reaction time for positive and negative self-describing adjectives in a self-referential encoding task (SRET). Here, we employ computational methods to interrogate the latent processes underlying choice reaction times to evaluate the fit of several drift-diffusion models of youth SRET performance. A sample of 106 adolescent, aged 12-17 (53% male; M_age = 14.49, SD = 1.70) completed the SRET and self-report measures of anxiety and depression. Our results support the utility of modeling the SRET, where the rate of evidence accumulation (i.e., drift rate) during negative self-referential processing was related to social anxiety above-and-beyond mean task performance. Our regression analyses indicated that youth efficiency in processing of self-referential views was domain general to anxiety, highlighting the importance of assessing both social and physiological anxiety symptoms when predicting SRET performance. The computational modeling results revealed that self-referential views are not uniquely related to depression-related constructs but also facets of anxiety.

Two modes of being together: The levels of intersubjectivity and human relatedness in neuroscience and psychoanalytic thinking

The notion of intersubjectivity has achieved a primary status in contemporary psychoanalytic debate, stimulating new theoretical proposals as well as controversies. This paper presents an overview of the main contributions on inter-subjectivity in the field of neurosciences. In humans as well as-probably-in other species, the ability for emotional resonance is guaranteed early in development. Based on this capacity, a primary sense of connectedness is established that can be defined inter-subjective in that it entails sharing affective states and intentions with caregivers. We propose to define such a form of inter-subjectivity as contingent, since the infant's early abilities for resonance do not imply the more generalized capacity to permanently conceive of the relationship outside the realm of current interactions and the infant-caregiver's mutual correspondence of internal states. This form of connection, hence, results in a self-referential, bodily, and affectively codified, context- and time dependent, like-me experience of interactions. The gradual maturation of brain structures and processes as well as interactive experiences allow proper intersubjectivity exchanges, grounded on new intentional and representational capacities, to evolve. In this more mature form of intersubjectivity, the individual is allowed to conceive of her own psychic space both as distinct and as possibly connected with the other's contents and experience, even in the absence of current behavioral indicators of such correspondence. This multi-layered model of intersubjectivity, which is embraced by current neuroscience research, seems to allow for new interpretations of psychoanalytic models of human relatedness based upon classic clinical observations.

Predicting social anxiety in young adults with machine learning of resting-state brain functional radiomic features

Social anxiety is a symptom widely prevalent among young adults, and when present in excess, can lead to maladaptive patterns of social behavior. Recent approaches that incorporate brain functional radiomic features and machine learning have shown potential for predicting certain phenotypes or disorders from functional magnetic resonance images. In this study, we aimed to predict the level of social anxiety in young adult participants by training machine learning models with resting-state brain functional radiomic features including the regional homogeneity, fractional amplitude of low-frequency fluctuation, fractional resting-state physiological fluctuation amplitude, and degree centrality. Among the machine learning models, the XGBoost model achieved the best performance with balanced accuracy of 77.7% and F1 score of 0.815. Analysis of input feature importance demonstrated that the orbitofrontal cortex and the degree centrality were most relevant to predicting the level of social anxiety among the input brain regions and the input type of radiomic features, respectively. These results suggest potential validity for predicting social anxiety with machine learning of the resting-state brain functional radiomic features and provide further understanding of the neural basis of the symptom.

Meta-analytic evidence that mindfulness training alters resting state default mode network connectivity

This meta-analysis sought to expand upon neurobiological models of mindfulness through investigation of inherent brain network connectivity outcomes, indexed via resting state functional connectivity (rsFC). We conducted a systematic review and meta-analysis of rsFC as an outcome of mindfulness training (MT) relative to control, with the hypothesis that MT would increase cross-network connectivity between nodes of the Default Mode Network (DMN), Salience Network (SN), and Frontoparietal Control Network (FPCN) as a mechanism of internally-oriented attentional control. Texts were identified from the databases: MEDLINE/PubMed, ERIC, PSYCINFO, ProQuest, Scopus, and Web of Sciences; and were screened for inclusion based on experimental/quasi-experimental trial design and use of mindfulness-based training interventions. RsFC effects were extracted from twelve studies (mindfulness n = 226; control n = 204). Voxel-based meta-analysis revealed significantly greater rsFC (MT > control) between the left middle cingulate (Hedge's g = .234, p = 0.0288, I2 = 15.87), located within the SN, and the posterior cingulate cortex, a focal hub of the DMN. Egger's test for publication bias was nonsignificant, bias = 2.17, p = 0.162. In support of our hypothesis, results suggest that MT targets internetwork (SN-DMN) connectivity implicated in the flexible control of internally-oriented attention.