Neural Mechanisms Implicated in the Development of Social Anxiety Disorder

During adolescence, a developmentally normative increase in the desire for social acceptance corresponds with peak onset rates of social anxiety disorder (SAD).  While available treatments for SAD can reduce symptoms, they rarely result in full remission. Interventions that target neural circuits dysregulated in adolescent SAD may enhance treatment efficacy. An important first step toward developing such interventions is to isolate dysregulated neural circuits shared by early adolescents with, and at risk for developing, SAD. Progress toward this goal has been hindered by limitations in neuroimaging paradigms, which bear little resemblance to contexts that precipitate the primary symptoms of adolescent SAD.  We developed an fMRI-based Virtual School paradigm (Jarcho et al., 2013, 2016), which models real-time, ongoing peer interactions, to approximate these contexts. I will first describe our current and ongoing work using this paradigm among adolescents with, and at risk for SAD due to early childhood social reticence.  I will then discuss future directions aimed at isolating the mechanisms that support the dysregulated brain function we observe.