Social Anxiety and Daily Peer Interactions Affect Brain Response to Errors Under Virtual Peer Observation

• In Event: From Brain to Behavior to Daily Life: Cross-Level Assessments of Emotional Response to Peer Interactions

Abstract

Pediatric social anxiety (SA) is a common disorder that involves a fear of negative evaluation. SA youth report concerns about making mistakes in the presence of peers, yet the neural correlates underlying this common worry remain unclear. Further, while self-report measures reliably quantify SA symptoms, they fail to account for potentially important person-specific factors, such as the quality of recent peer interactions. Given the salience of such interactions during adolescence, we must account for them to understand how adolescents process socially stressful experiences, such as making an error in the presence of peers. Using a novel paradigm, we test associations among SA symptoms, the quality of recent peer interactions measured using ecological momentary assessment (EMA), social context (i.e., peer observation), and error-related brain response.

In the current analysis, 48 youth (8-18 years old, M=14.06 ± 2.67) with SA symptoms ranging from none to clinically severe, completed a cognitive control task during fMRI. Participants completed half of the task while they believed they were being observed by a same-age, same-sex peer and half of the task when alone. All participants completed 1-week of smartphone-based EMA to assess the quality of recent peer interactions from “very positive” to “very negative.” SA was measured using the SCARED-SA subscale. For the analysis, SA and interaction quality (averaged across the week) were continuous, between-subject variables while social context (peer, alone) and trial type (error, correct) were repeated, within-subject variables. Age was a covariate.

Whole brain analyses (p<.005, k>50) revealed a significant SA X interaction quality X social context X trial type interaction in several prefrontal regions (e.g., IFG, dlPFC), cingulate cortex, amygdala (see Figure 3), and superior temporal gyrus (STG) - regions implicated in error monitoring (cingulate, IFG), responses to threat (amygdala), and social cognitions (STG), among others. Follow-up tests revealed that youth with higher SA and more negatively rated peer interactions showed greater activation in these regions when committing an error in the presence of a peer, compared to alone.

These findings suggest that making a mistake in front of a peer may be a particularly salient event for SA youth who experience more negative, compared to positive, interactions with peers. Importantly, person-specific social experiences are needed to frame our understanding of SA-related differences in brain response to common social worries during adolescence, such as making an error in front of peers.

Authors

• Ashley R Smith, National Institute of Mental Health
  Presenting Author

• Emily Jones, University of Denver
  Non-Presenting Author

• Jessica Bezek, National Institutes of Health
  Non-Presenting Author

• Anni Subar, University of Denver
  Non-Presenting Author

• Marissa Yetter
  Non-Presenting Author

• Quyen B. Do, University of Pittsburgh
  Non-Presenting Author

• Ellen Leibenluft, National Institutes of Health
  Non-Presenting Author

• Katharina Kircanski, National Institutes of Health
  Non-Presenting Author

• Melissa Brotman, National Institutes of Health
  Non-Presenting Author

• Daniel S. Pine, National Institutes of Health
  Non-Presenting Author