Social anxiety disorder in childhood: Attentional, neurophysiological and cognitive correlates of emotional reactivity and emotion regulation

社交焦虑症（SAD）是儿童和青少年中最常见的精神障碍之一，通常会持续到成年。由于大多数SAD病例首先发生在儿童和青少年，因此对这一年龄组的研究对于了解与疾病维持有关的因素至关重要。理论模型表明，sad患者的注意力和认知过程功能失调会导致在引发焦虑的情况下情绪过度反应（如强烈焦虑）。以第一个资助阶段的发现为起点，目前的提案旨在评估10至15岁儿童和青少年的大样本（n=180）的情绪反应和情绪调节。除健康对照组外，还将对患有特定恐惧症的临床对照组进行评估，以在感兴趣的过程中捕捉可能的跨诊断特征。在研究1中，儿童和青少年将观看情绪激动的面孔照片和中性的家庭照片，同时评估脑电图（EEG）。我们认为，sad组表现出一种神经生理上的过度警惕-回避模式，这种模式在青少年中更为突出。此外，我们预计，与男性面孔相比，SAD组中性地表现出对女性面孔的优先处理。在第二项研究中，通过瞳孔测量和眼球追踪测量来评估自由观看任务中对面部刺激的情绪反应和注意力处理。我们期望患有SAD的儿童和青少年在面对面部刺激时瞳孔光反射减弱。此外，我们预计SAD组表现出与情绪面部的眼睛区域相关的过度警惕-回避模式，这种模式在患有SAD的女孩中最为明显。在第三项研究中，我们将调查社会刺激下认知评价的主观上和神经生理上的相关性。在重新评价训练后，孩子们会将中性的孩子的脸评价为消极的、中性的或积极的。我们预计，与两个对照组相比，SAD组在神经和主观测量方面表现出较小的积极评价效果。与对照组相比，消极评价会导致SAD组更强的回避神经模式和更消极的主观评价。重要的是，该提案的研究将允许调查患有SAD的儿童和青少年在兴趣过程中可能存在的发展差异，并允许评估SAD的性别特征。除了纳入健康对照组外，研究还将纳入患有特定恐惧症的儿童和青少年临床组，根据最近的研究领域标准方法（RDoc），在感兴趣的过程中评估可能的转诊断特性。

Social Anxiety Disorder (SAD) is one of the most prevalent mentaldisorders in childhood and youth, often persisting into adulthood.Since most cases of SAD first develop in children and adolescents,research in this age group is crucial to understand the factors that areinvolved in the disorder maintenance. Theoretical models suggest thatdysfunctional attentional and cognitive processes in individuals withSAD lead to an emotional hyperreactivity (e.g. intensive anxiety)within anxiety provoking situations. Taking findings of the first fundingphase as a starting point, the current proposal aims to assessemotional reactivity and emotion regulation in a large sample (n=180)of both children and adolescents, aged 10 to 15 years. Beside ahealthy control group, a clinical control group with specific phobia willbe assessed to capture possible transdiagnostic qualities in theprocesses of interest. In study 1, children and adolescents will watchpictures of emotional faces and neutral house hold pictures, whileelectrocencephalography (EEG) is assessed. We expect that the SADgroup shows a neurophysiological hypervigilance-avoidance patternand that his pattern is more prominent in adolescents. Further, weexpect the SAD group neutrally shows a priorized processing offemale when compared to male faces. In a second study, emotionalreactivity to facial stimuli and attentional processing in a free viewingtask is assessed through pupillometry and eye-tracking measures.We expect children and adolescent with SAD to show an attenuatedpupillary light reflex in response to facial stimuli. Further, we expectthe SAD group to show a hypervigilance-avoidance pattern related tothe eye-region of emotional faces and that this pattern is mostpronounced in girls with SAD. In a third study, we will investigatesubjective and neurophysiological correlates of cognitive appraisal inresponse to social stimuli. After a reappraisal training, children willappraise neutral children’s faces as either socially negative, neutral,or positive. We expect that the SAD group will show a smaller effect ofpositive appraisal on neural and subjective measures when comparedto the two control groups. Negative appraisal will lead to a strongerneural pattern of avoidance and more negative subjective ratings inthe SAD group when compared to controls. Importantly, the studies ofthe proposal will allow to investigate possible developmental differences in the processes of interest between children andadolescents with SAD, and will allow for the assessment of genderspecific features of SAD. Beside the inclusion of a health controlgroup, the studies will include a clinical group of children andadolescents with specific phobia, to assess possible transdiagnosticqualities, according to the recent Research Domain Criteria approach(RDoc), in the processes of interest.