Social anxiety disorder in adolescence: How developmental cognitive neuroscience findings may shape understanding and interventions for psychopathology

Abstract

Social anxiety disorder represents a debilitating condition that has large adverse effects on the quality of social connections, educational achievement and wellbeing. Age-of-onset data suggests that early adolescence is a developmentally sensitive juncture for the onset of social anxiety. In this review, we highlight the potential of using a developmental cognitive neuroscience approach to understand (i) why there are normative increases in social worries in adolescence and (ii) how adolescence-associated changes may 'bring out' neuro-cognitive risk factors for social anxiety in a subset of individuals during this developmental period. We also speculate on how changes that occur in learning and plasticity may allow for optimal acquisition of more adaptive neurocognitive strategies through external interventions. Hence, for the minority of individuals who require external interventions to target their social fears, this enhanced flexibility could result in more powerful and longer-lasting therapeutic effects. We will review two novel interventions that target information-processing biases and their neural substrates via cognitive training and visual feedback of neural activity measured through functional magnetic resonance imaging.

Keywords: Adolescence; Cognitive bias; Neurocognitive development; SAD; Social anxiety; fMRI.

Fig. 1

Adolescence as a period of vulnerability for SAD. Red shaded region highlights risk for onset or amplification of neurocognitive risk factors through interplay of adolescence-associated changes. As socio-affective networks are thought to develop across adolescence with complex linear and quadratic changes we suggest greater plasticity to socio-affective stimuli across the teenage years (relative to adults). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of the article.)