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

社交焦虑障碍(SAD)是儿童和青少年中最常见的心理障碍之一，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，因此对这一年龄段的研究对于了解参与障碍维持的因素至关重要。理论模型表明，SAD患者的注意和认知过程功能障碍会导致焦虑引发情景中的情绪高反应(如强烈的焦虑)。以第一个资助阶段的结果为起点，目前的建议旨在评估大样本(n=180)10至15岁的儿童和青少年的情绪反应和情绪调节。除了健康对照组外，还将评估有特定恐惧症的临床对照组，以捕捉感兴趣过程中可能的跨诊断特征。在研究1中，儿童和青少年将观看情绪面孔的图片和中性家庭的图片，同时评估脑电(EEG)。我们预计，SAD组表现出神经生理学的过度警惕-回避模式，他的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组中性地表现出优先处理女性。在第二项研究中，通过瞳孔测量和眼球跟踪测量来评估自由观看任务中对面部刺激和注意力处理的情绪反应。我们希望患有SAD的儿童和青少年对面部刺激表现出减弱的瞳孔光反射。此外，我们预计SAD组会表现出与情绪面孔的眼睛区域相关的高度警惕-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，我们将调查认知评估对社会刺激的反应的主观和神经生理学相关性。经过重新评估培训后，孩子们会将中性儿童的面孔评价为社交消极、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上表现出的积极评价效应较小。与对照组相比，负面评价会导致SAD组更强的神经回避模式和更多的负面主观评分。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的性别特征。除了纳入健康对照组外，这些研究还将包括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)，在感兴趣的过程中评估可能的转诊质量。

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.