Advancing clinical neuroscience through enhanced tools: Pediatric social anxiety as an example

Abstract

Background: Clinical researchers face challenges when trying to quantify diverse processes engaged during social interactions. We report results from two studies, each demonstrating the potential utility of tools for examining processes engaged during social interactions.

Method: In the first study, youth (n = 57) used a smartphone-based tool to rate mood and responses to social events. A subset (n = 20) completed the second, functional magnetic resonance imaging study. This second study related anxiety to error-evoked brain responses in two social conditions-while being observed and when alone. We also combined these tools to bridge clinical, social-contextual, and neural levels of measurement.

Results: Results from the first study showed an association between negatively-perceived social experiences and a range of negative emotions. In the second study there was a positive correlation during error monitoring between social-anxiety severity and context-specific activation of the pregenual anterior cingulate cortex. Finally, during imaging, the perceived quality of peer interactions as assessed using the smartphone-based tool, interacted with social context to predict levels of activation in the hippocampus and superior frontal gyrus.

Conclusions: By improving measurement, enhanced tools may provide new means for studying relationships among anxiety, brain function, and social interactions.

Keywords: adolescent; anxiety; ecological momentary assessment; neuroimaging; social phobia.

FIGURE 1

Relations between EMA-rated anxiety in treatment-seeking anxious patients (Since the last beep, I felt worried or scared) and self-reported anxiety (a), parent-rated anxiety (b), clinician-rated anxiety (c), and clinician-rated anxiety within the same measurement week (d). EMA, ecological momentary assessment

FIGURE 2

A significant social anxiety × social context × trial type interaction emerged in the pgACC (11, 54, 4) (a). When extracted data from this cluster revealed greater activation during the peer, compared to alone, a condition when participants made errors. This relationship correlated positively with social anxiety scores (b). There were no relations among brain response, social context, and social anxiety following correct responses (c). pgACC, pregenual anterior cingulate cortex

FIGURE 3

A significant peer interaction × social context interaction emerged in the (a) hippocampus (24, 61, 21) and (b) superior frontal gyrus (−26, −11, −9). Data from these clusters revealed greater activation during the peer, compared to alone, a condition in participants who perceived their real-world peer interactions as more negative (c/d). This relationship was not related to task performance