J Psychiatry Neurosci 2014;39(4):249-58
Michael Gaebler, PhD*; Judith K. Daniels, PhD*; Jan-Peter Lamke, MSc; Thomas Fydrich, PhD; Henrik Walter, MD, PhD
Gaebler, Daniels, Lamke, Walter — Charité – Universitätsmedizin Berlin, Department of Psychiatry & Psychotherapy, Division of Mind and Brain Research, Berlin; Gaebler — Max Planck Institute for Human Cognitive and Brain Sciences, Department of Neurology, Leipzig; Daniels — Department of Psychosomatic Medicine and Psychotherapy, Otto-von-Guericke-University, Magdeburg; Gaebler, Lamke, Fydrich — Humboldt-Universität zu Berlin, Department of Psychology, Berlin, Germany
Background: In healthy individuals, voluntary modification of self-relevance has proven effective in regulating subjective emotional experience as well as physiologic responses evoked by emotive stimuli. As social anxiety disorder (SAD) is characterized by both altered emotional and self-related processing, we tested if emotion regulation through self-focused reappraisal is effective in individuals with SAD.
Methods: While undergoing 3 T functional magnetic resonance imaging, individuals with SAD and matched healthy controls either passively viewed neutral and aversive pictures or actively increased or decreased their negative emotional experience through the modification of selfrelevance or personal distance to aversive pictures. Participants rated all pictures with regard to the intensity of elicited emotions and self-relatedness.
Results: We included 21 individuals with SAD and 23 controls in our study. Individuals with SAD reported significantly stronger emotional intensity across conditions and showed a nonsignificant tendency to judge pictures as more self-related than controls. Compared with controls, individuals with SAD showed an overactivation in bilateral temporoparietal regions and in the posterior midcingulate cortex during the passive viewing of aversive compared with neutral pictures. During instructed emotion regulation, activation patterns normalized and no significant group differences were detected.
Limitations: As no positive pictures were presented, results might be limited to the regu lation of negative emotion.
Conclusion: During passive viewing of aversive images, individuals with SAD showed evidence of neural hyperreactivity that may be interpreted as increased bodily self-consciousness and heightened perspective-taking. During voluntary increase and decrease of negative emotional intensity, group differences disappeared, suggesting self-focused reappraisal as a successful emotion regulation strategy for individuals with SAD.
*These authors contributed equally to the work.
Submitted Apr. 30, 2013; Revised Nov. 22, 2013; Accepted Jan. 6, 2014.
Acknowledgements: The work of M. Gaebler, J.K. Daniels and J.-P. Lamke was funded by the VW-foundation grant no. II/84051. We thank Dina Wittfoth-Schardt for providing source code for task presentation.
Competing interests: None declared.
Contributors: M. Gaebler, J.K. Daniels and H. Walter designed the study. M. Gaebler and J.-P. Lamke acquired the data, which M. Gaebler, J.K. Daniels, T. Fydrich and H. Walter analyzed. M. Gaebler and J.K.Daniels wrote the article, which all authors reviewed and approved for publication.
Correspondence to: J.K. Daniels or H. Walter, Division of Mind and Brain Research, Department of Psychiatry & Psychotherapy, Charité —
Universitätsmedizin Berlin Charitéplatz 1, D-10117 Berlin, Germany; email@example.com or firstname.lastname@example.org