Impact of cognitive-behavioral therapy for social anxiety disorder on the neural bases of emotional reactivity to and regulation of social evaluation

Philip R Goldin, Michal Ziv, Hooria Jazaieri, Justin Weeks, Richard G. Heimberg, James J. Gross

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

We examined whether Cognitive-Behavioral Therapy (CBT) for social anxiety disorder (SAD) would modify self-reported negative emotion and functional magnetic resonance imaging brain responses when reacting to and reappraising social evaluation, and tested whether changes would predict treatment outcome in 59 patients with SAD who completed CBT or waitlist groups. For reactivity, compared to waitlist, CBT resulted in (a) increased brain responses in right superior frontal gyrus (SFG), inferior parietal lobule (IPL), and middle occipital gyrus (MOG) when reacting to social praise, and (b) increases in right SFG and IPL and decreases in left posterior superior temporal gyrus (pSTG) when reacting to social criticism. For reappraisal, compared to waitlist, CBT resulted in greater (c) reductions in self-reported negative emotion, and (d) increases in brain responses in right SFG and MOG, and decreases in left pSTG. A linear regression found that after controlling for CBT-induced changes in reactivity and reappraisal negative emotion ratings and brain changes in reactivity to praise and criticism, reappraisal of criticism brain response changes predicted 24% of the unique variance in CBT-related reductions in social anxiety. Thus, one mechanism underlying CBT for SAD may be changes in reappraisal-related brain responses to social criticism. copy; 2014 Elsevier Ltd.

Original languageEnglish (US)
Pages (from-to)97-106
Number of pages10
JournalBehaviour Research and Therapy
Volume62
DOIs
StatePublished - Nov 1 2014
Externally publishedYes

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Keywords

  • Cognitive-behavioral therapy
  • Emotion
  • Emotion regulation
  • Neuroimaging
  • Reappraisal
  • Social anxiety

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Developmental and Educational Psychology
  • Clinical Psychology
  • Arts and Humanities (miscellaneous)
  • Psychiatry and Mental health

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