Positive Emotional Processing: Exploring Novel Treatment Targets in Social Phobia

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Social anxiety disorder (SAD) is a highly prevalent and debilitating condition, marked by significant impairments in social relationship functioning and a diminished quality of life. Current treatment approaches for SAD emphasize heightened negative emotions (anxiety and fear), cognitions (preoccupation with negative evaluation), and avoidance behaviors as the central treatment targets. However, these treatments are removed from research suggesting that SAD is also characterized by a dysregulation of basic regulatory systems that govern responses to positive stimuli and situations with reward potential. Although currently available treatments for SAD are efficacious, many individuals fail to achieve full recovery and continue to experience impairments in positive social functioning following treatment. These deficiencies are notable given that positive social and emotional experiences are fundamental for psychological and physical wellbeing. To address this critical gap, the proposed project will combine a cognitive neuroscience-informed experimental procedure (cognitive bias modification, CBM)^with functioning neuroimaging to investigate how modifying implicit approach tendencies for positive social cues effects behavioral, affective, and brain mechanisms that are important for positive social relationships and well-being. Work accomplished by the applicant during the K99 phase demonstrated that (1) an approach/avoidance CBM procedure reliably modifies implicit approach tendencies and influences indices of positive social functioning in the latxiratory, and (2) CBM procedures modulate functioning in brain regions that are important for emotion processing. Building on these studies, the specific aims of this proposal are:. (1) To examine the effects of a brief multisession approach-positive CBM procedure on change in positive affect and social approach behaviors in individuals meeting diagnostic criteria for generalized SAD; (2) To examine the neural correlates of social reward processing in GSAD relative to healthy controls; and (3) To examine functional changes in reward neurodrcuitry following the approach-positive CBM procedure: The goal of this project is to identify novel treatment targets and approaches that can augment existing interventions in GSAD patients.