Ecological Assessment of Cognitive Control in Individuals with Social Anxiety

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PROJECT SUMMARY Social anxiety disorder is an impairing condition that typically emerges during adolescence, affecting about 10% of the population. Models of social anxiety (SA) elucidate excessive self-focus and sensitivity to mistakes as factors that negatively impact quality of life. Using traditional cognitive neuroscience paradigms, prior work has identified neural measures associated with enhanced self-detection of errors (Error Monitoring), that predicts SA, as well as anxiety more generally. However, a major challenge with translational interventions developed from cognitive neuroscience paradigms is the transfer to ecologically valid settings. There is a critical need for the design and validation of novel tasks/protocols to identify and reliably measure brain-based therapeutic targets for SA within ecologically valid, “real-world” settings that are applicable to youth. In line with our long-term goal of developing brain-based interventions for adolescent SA, the purpose of this proposal is to optimize and validate a novel, ecologically-valid task that will reliably assess neural and behavioral measures associated with social anxiety. We propose a sequential, multi-study project that leverages a mixed-methods approach to optimize and validate our novel Natural Reading task and demonstrate its utility in predicting SA. By developing an ecologically-valid paradigm early in the experimental therapeutics process, we increase the probability of successful transfer of effects in future interventions that target measures captured by this novel task; in this way, our proposal is strongly aligned with the Institute’s mission to transform the understanding and treatment of mental illnesses. We propose two aims: (1) a pilot study to optimize the design of our novel Natural Reading task and (2) a second study to establish the reliability and predictive power of the Natural Reading task in relation to SA. In Study 1, 10 youths (13-17 yrs., 5 high and 5 low SA) will perform the Natural Reading task and a traditional Flanker task, both alone and while under social observation by a peer. To investigate experiential aspects of task completion, including participants' perceptions and self-assessed task performance, qualitative methods will be employed in the analysis of semi-structured interview data. Qualitative results will be leveraged to optimize design of the Natural Reading task prior to proceeding with Study 2 data collection (Aim 2). For Study 2, within a second sample of 80 youth (13-17 yrs.), participants will perform an optimized version of the Natural Reading task and a traditional Flanker task, alone and under peer observation. Neural measures of Error Monitoring, along with associated behavioral measures, will be extracted to perform quantitative analyses. Hypothesis 2A: Both tasks will exhibit acceptable levels of reliability in neural and behavioral measures. Hypothesis 2B: Within each task, measures of Error Monitoring extracted from the peer (vs. alone) condition will predict additional variance in trait SA and state anxiety levels. Hypothesis 2C: Focusing on the peer condition, measures of Error Monitoring extracted from the Natural Reading Task will predict additional variance in SA, above and beyond measures of Error Monitoring extracted from the traditional Flanker task.