Category: Adult Anxiety - Social
Keywords: Social Anxiety | Social Relationships | fMRI (Function Magnetic Resonance Imaging)
Presentation Type: Symposium
Introduction: The human brain has evolved mechanisms for attributing positive reward value to social interaction, and in particular for motivating the establishment of reciprocal relationships based on trust (Montague et al., 2013; Phan et al., 2010). Alterations in the neurocircuitry of reward, such as those previously demonstrated by our group (Richey et al., 2016; Richey et al., 2014; Dichter, Richey et al., 2012) may therefore be particularly relevant to disorders marked by alterations in reciprocal social interaction. In this study, we seek to test the hypothesis that adults with SAD either ignore or discount the positive social behaviors of an interaction partner when establishing a new relationship. We also predict that this pattern is based on a concurrent decrease in the activity of reward-related regions of the brain. To provide a quantitative test of this hypothesis, we apply the principles of game theory to a dynamic and ecologically relevant social interaction during fMRI.
Methods: All subjects completed the ADIS-IV and several self-report measures of social anxiety. Adults with SAD (n=19) and matched control subjects (N=20) underwent fMRI while playing a 2 player economic game called the “trust game” (King-Casas et al., 2005). The trust game involves turn-based exchange of money, and provides a quantitative benchmark of mutual trust, because partners can hoard money for a lower payoff, or exchange money for a greater payoff.
Results: Behavioral results indicated that when a partner made a generous monetary offer, SAD participants paradoxically followed this up with a decrease in generosity. Conversely, SAD subjects increased in hostility in response to low offers from partners. Consistent with study hypotheses, fMRI results indicated that generous offers from partners resulted in significantly diminished activation bilaterally in the ventral striatum of SAD patients, suggesting that neural mechanisms of reward may go temporarily offline in response to a partner’s prosocial behaviors.
Discussion: We found that 1) reward-related value of positive social maneuvers may be reduced in SAD, and 2) that this effect may be due to reduced neural activity in regions of the brain responsible for assigning value to action. Consequently, CBT and related interventions may benefit from focusing on increasing the perceived value of prosocial behaviors. It is noteworthy that no treatments for SAD focus on restoring sensitivity to positive emotions and that this may be a particularly promising avenue for treatment development.
Saturday, November 18
2:00 PM – 3:30 PM
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