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

社交焦虑障碍（Social Anxiety Disorder，SAD）是儿童和青少年时期最常见的精神障碍之一，通常持续到成年。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障碍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障碍会导致焦虑激发情境中的情绪过度反应（例如，强烈焦虑）。以第一阶段的研究结果为起点，目前的建议旨在评估情绪反应和情绪调节的大样本（n=180）的儿童和青少年，年龄在10至15岁。除了一个健康的对照组外，一个患有特定恐惧症的临床对照组将被评估，以捕获感兴趣的过程中可能的转诊断质量。在研究1中，儿童和青少年将观看情绪化面孔的图片和中性家庭图片，同时评估脑电图（EEG）。我们预期SAD组表现出一种神经生理学的警觉性过高-回避模式，他的模式在青少年中更为突出。此外，我们预计SAD组中性显示优先处理女性相比，男性的面孔。在第二项研究中，通过瞳孔测量和眼动追踪测量评估了自由观看任务中对面部刺激的情绪反应和注意力处理。我们预计患有SAD的儿童和青少年对面部刺激的瞳孔光反射会减弱。此外，我们预计SAD组会表现出与情绪面孔相关的高度警惕-回避模式，这种模式在SAD女孩中最为明显。在第三项研究中，我们将调查对社会刺激的认知评价的主观和神经生理学相关性。经过重新评价训练后，孩子们会将中性儿童的面孔评价为社会负面、中性或积极。我们预计，与两个对照组相比，SAD组在神经和主观测量方面的积极评价效果较小。与对照组相比，SAD组的负面评价会导致更强的回避神经模式和更多的负面主观评级。重要的是，该提案的研究将允许调查SAD儿童和青少年之间感兴趣的过程中可能存在的发展差异，并将允许评估SAD的性别特异性特征。除了纳入一个健康对照组外，研究还将包括一个患有特定恐惧症的儿童和青少年的临床组，以根据最近的研究领域标准方法（RDoc）评估可能的跨诊断质量。

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.