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Neurobiological correlates of social anxiety disorder: an update

  • Donatella Marazziti (a1), Marianna Abelli (a1), Stefano Baroni (a1), Barbara Carpita (a1), Carla E. Ramacciotti (a1) and Liliana Dell'Osso (a1)...

Social anxiety disorder (SAD) is a condition characterized by pervasiveness and impairment in social functioning, with a prevalence in the general population between 1.9% and 12.1%. The most consistent findings on its neurobiological underpinnings involve a wide range of neurotransmitters (serotonin, norepinephrine, glutamate, and GABA) and neuropeptides (oxytocin), but no comprehensive hypothesis is yet available. In particular, oxytocin is becoming increasingly established as a “prosocial neuropeptide” and, as such, is a major focus of current research, with a great range of therapeutic applications including SAD treatment. Specifically, the amygdala plays a pivotal role in conditioning and processing of fear, and exaggerated amygdala responses in SAD patients have been observed during various social-emotional stimuli. In addition to the amygdala, other brain areas of interest in SAD-related circuitry are represented by the medial prefrontal cortex, dorsal raphe, striatum, locus coeruleus, prefrontal cortex, insular cortex, and anterior cingulate cortex. The aim of this review is to provide an update on neurobiological correlates of SAD, with a special focus on neurotransmitters and brain areas possibly involved, and suggestions for future research that could lead to more specific therapeutic interventions.

Corresponding author
*Address for correspondence: Donatella Marazziti, MD, Dipartimento di Medicina Clinica e Sperimentale Section of Psychiatry, University of Pisa, Via Roma 67, Pisa 56100, Italy. (Email:
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1. Janet, P. Les obsessions et la psychasthenie. Paris: Alcan; 1903.
2. Liebowitz, MR, Gorman, JM, Fyer, AJ, etal. Social phobia: review of a neglected anxiety disorder. Arch Gen Psychiatry. 1985; 42(7): 729736.
3. Marks, IM, Gelder, MG. Different ages of onset in varieties of phobia. Am J Psychiatry. 1966; 123(2): 218221.
4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. Washington, DC: American Psychiatric Association; 1980.
5. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., rev. Washington, DC: American Psychiatric Association; 1987.
6. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: American Psychiatric Association; 1994.
7. Furmark, T. Social phobia: from epidemiology to brain function. In: Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences. Uppsala, Sweden: Acta Universitatis Upsaliensis; 2000.
8. Liebowitz, MR, Heimberg, RG, Fresco, DM, etal. Social phobia or social anxiety disorder: what's in name? Arch Gen Psychiatry. 2000; 57(2): 191192.
9. Stein, MB, Gorman, JM. Unmasking social anxiety disorder. J Psychiatry Neurosci. 2001; 26(3): 185189.
10. Van Roy, B, Kristense, H, Groholt, B, etal. Prevalence and characteristics of significant social anxiety in children aged 8–13 years: a Norwegian cross-sectional population study. Soc Psychiatry Psychiatr Epidemiol. 2009; 44(5): 407415.
11. Pietrini, F, Lelli, L, Lo Sauro, C, etal. Epidemiologia della fobia sociale. Rivista di Psichiatria. 2009; 44(4): 203213.
12. Dell'Osso, L, Rucci, P, Cassano, GB, etal. Measuring social anxiety and obsessive-compulsive spectra: comparison of interviews and self-report instruments. Compr Psychiatry. 2002; 43(2): 8187.
13. Dell'Osso, L, Rucci, P, Ducci, F, etal. Social anxiety spectrum. Eur Arch Psychiatry Clin Neurosci. 2003; 253(6): 286291.
14. Stein, DJ. Social anxiety disorder in the West and in the East. Ann Clin Psychiatry. 2009; 21(2): 109117.
15. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev. Washington, DC: American Psychiatric Association; 2000.
16. Bogels, SM, Alden, L, Beidel, DC, etal. Social anxiety disorder: question and answers for the DSM-V. Depress Anxiety. 2010; 27(2): 168189.
17. El-Gabalawy, R, Cox, B, Mackenzie, C, etal. Assessing the validity of social anxiety disorder subtypes using a nationally representative sample. J Anxiety Disord. 2010; 24(2): 244249.
18. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Arlington, VA: American Psychiatric Publishing; 2013.
19. Kerns, CE, Comer, JS, Pincus, DB, etal. Evaluation of the proposed social anxiety disorder specific change for DSM-5 in a treatment-seeking sample of anxious youth. Depress Anxiety. 2013; 30(8): 709715.
20. Assunção, MC, Costa, DL, de Mathis, MA, etal. Social phobia in obsessive-compulsive disorder: prevalence and correlates. J Affect Disord. 2012; 143(1–3): 138147.
21. Rodriguez, BF, Bruce, SE, Pagano, ME, etal. Relationships among psychosocial functioning, diagnostic comorbidity, and the recurrence of generalized anxiety disorder, panic disorder, and major depression. J Anxiety Disord. 2005; 19(7): 752766.
22. Talati, A, Ponniah, K, Strug, LJ, etal. Stress, anxiety, and post-traumatic stress disorder, panic disorder, social anxiety disorder and a possible medical syndrome previously linked to Chromosome 13. Biol Psychiatry. 2008; 63(6): 594601.
23. Fang, A, Hofmann, SH. Relationship between social anxiety disorder and body dysmorphic disorder. Clin Psychol Rev. 2010; 30(8): 10401048.
24. Pini, S, Cassano, GB, Simonini, E, etal. Prevalence of anxiety disorders comorbidity in bipolar depression, unipolar depression and dysthymia. J Affect Disord. 1997; 42(2–3): 145153.
25. Pini, S, Maser, JD, Dell'Osso, L. Social anxiety disorder comorbidity in patients with bipolar disorder: a clinical replication. J Anxiety Disord. 2006; 20(8): 11481157.
26. Behrendt, S, Beesdo-Baum, K, Zimmermann, P, etal. The role of mental disorders in the risk and speed of transition to alcohol use disorders among community youth. Psychol Med. 2011; 41(5): 10731085.
27. Blier, P, de Montigny, C. Serotonin and drug-induced therapeutic responses in major depression, obsessive-compulsive and panic disorders. Neuropsychopharmacology. 1999; 21(2 Suppl): 91S98S.
28. Lanzenberger, RR, Mitterhauser, M, Spindelegger, C, etal. Reduced serotonin-1A receptor binding in social anxiety disorder. Biol Psychiatry. 2007; 61(9): 10811089.
29. Akimova, E, Lanzenberger, R, Kasper, S. The serotonin-1A receptor in anxiety disorders. Biol Psychiatry. 2009; 66(7): 627635.
30. Van Veen, JF, van Vliet, IM, de Rijk, RH, etal. Tryptophan depletion affects the autonomic stress response in generalized social anxiety disorder. Psychoneuroendocrinology. 2009; 34(10): 15901594.
31. Holmes, A, Yang, RJ, Lesch, KP, etal. Mice lacking the serotonin transporter exhibit 5-HT(1A) receptor-mediated abnormalities in tests for anxiety-like behavior. Neuropsychopharmacology. 2003; 28(12): 20772088.
32. Ansorge, MS, Zhou, M, Lira, A, etal. Early-life blockade of the 5-HT transporter alters emotional behavior in adult mice. Science. 2004; 306(5697): 879881.
33. Lohmueller, KE, Pearce, CL, Pike, M, etal. Meta-analysis of genetic association studies supports a contribution of common variants to susceptibility to common disease. Nat Genet. 2003; 33(2): 177182.
34. Caspi, A, Sugden, K, Moffitt, TE, etal. Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science. 2003; 301(5631): 386389.
35. Heils, A, Teufel, A, Petri, S, etal. Allelic variation of human serotonin transporter gene expression. J Neurochem. 1996; 66(6): 26212624.
36. Lesch, KP, Bengel, D, Heils, A, etal. Association of anxiety-related traits with a polymorphism in the serotonin transporter gene regulatory region. Science. 1996; 274(5292): 15271531.
37. Borsini, F, Podhorna, J, Marazziti, D. Do animal models of anxiety predict anxiolytic-like effects of antidepressants? Psychopharmacology (Berl). 2002; 163(2): 121141.
38. Furmark, T, Tillfors, M, Garpenstrand, H, etal. Serotonin transporter polymorphism related to amygdala excitability and symptom severity in patients with social phobia. Neurosci Lett. 2004; 362(3): 189192.
39. Hariri, AR, Mattay, VS, Tessitore, A, etal. Serotonin transporter genetic variation and the response of the human amygdala. Science. 2002; 297(5580): 400403.
40. Davis, M, Whalen, PJ. The amygdala: vigilance and emotion. Mol Psychiatry. 2001; 6(1): 1334.
41. Harley, CW. A role for norepinephrine in arousal, emotion and learning? Limbic modulation by norepinephrine and the Kety hypothesis. Prog Neuropsychopharmacol Biol Psychiatry. 1987; 11(4): 419448.
42. Ressler, KJ, Nemeroff, CB. Role of norepinephrine in the pathophysiology and treatment of mood disorders. Biol Psychiatry. 1999; 46(9): 12191233.
43. Tanaka, M, Yoshida, M, Emoto, H, etal. Noradrenaline systems in the hypothalamus, amygdala and locus coeruleus are involved in the provocation of anxiety: basic studies. Eur J Pharmacol. 2000; 405(1–3): 397406.
44. Stein, MB, Heuser, IJ, Juncos, JL, etal. Anxiety disorders in patients with Parkinson's disease. Am J Psychiatry. 1990; 147(2): 217220.
45. Rosen, JB, Hamerman, E, Sitcoske, M, etal. Hyperexcitability and exaggerated fear-potentiated startle produced by partial amygdala kindling. Behav Neurosci. 1996; 110(1): 4350.
46. Heimberg, RG, Hope, DA, Dodge, CS, etal. DSM-III-R subtypes of social phobia: Comparison of generalized social phobics and public speaking phobics. J Nerv Ment Dis. 1990; 178(3): 172179.
47. Potts, NL, Davidson, JR, Krishnan, KR, etal. Levels of urinary free cortisol in social phobia. J Clin Psychiatry. 1991; 52: Suppl:4142.
48. Potts, NL, Book, S, Davidson, JR. The neurobiology of social phobia. Int Clin Psychopharmacol. 1996; 11(Suppl 3): 4348.
49. Girault, JA, Greengard, P. The neurobiology of dopamine signaling. Arch Neurol. 2004; 61(5): 641644.
50. Sareen, J, Campbell, DW, Leslie, WD, etal. Striatal function in generalized social phobia: a functional magnetic resonance imaging study. Biol Psychiatry. 2007; 61(3): 396404.
51. Tiihonen, J, Kuikka, J, Bergstrom, K, etal. Dopamine reuptake site densities in patients with social phobia. Am J Psychiatry. 1997; 154(2): 239242.
52. Schneier, FR, Liebowitz, MR, Abi-Dargham, A, etal. Low dopamine D2 receptor binding potential in social phobia. Am J Psychiatry. 2000; 157(3): 457459.
53. Ohman, A. Face the beast and fear the face: animal and social fears as prototypes for evolutionary analyses of emotion. Psychophysiology. 1986; 23(2): 123145.
54. Grant, KA, Shively, CA, Nader, MA, etal. Effect of social status on striatal DA D2 receptor binding characteristics in cynomolgus monkeys assessed with positron emission tomography. Synapse. 1998; 29(1): 8083.
55. Schneier, FR, Abi-Dargham, A, Martinez, D, etal. Dopamine transporters, D2 receptors, and dopamine release in generalized social anxiety disorder. Depress Anxiety. 2009; 26(5): 411418.
56. Cervenka, S, Hedman, E, Ikoma, Y, etal. Changes in dopamine D2-receptor binding are associated to symptom reduction after psychotherapy in social anxiety disorder. Transl Psychiatry. 2012; 2(5): e120.
57. Blair, K, Geraci, M, Devido, J, etal. Neural response to self- and other referential praise and criticism in generalized social phobia. Arch Gen Psychiatry. 2008; 65(10): 11761184.
58. Sotres-Bayon, F, Cain, CK, LeDoux, JE. Brain mechanisms of fear extinction: historical perspectives on the contribution of prefrontal cortex. Biol Psychiatry. 2006; 60(4): 329336.
59. Milad, MR, Quirk, GJ. Neurons in medial prefrontal cortex signal memory for fear extinction. Nature. 2002; 420(6911): 7074.
60. Marazziti, D, Catena Dell'osso, M. The role of oxytocin in neuropsychiatric disorders. Curr Med Chem. 2008; 15(7): 698704.
61. Guastella, AJ, Einfeld, SL, Gray, KM, etal. Intranasal oxytocin improves emotion recognition for youth with autism spectrum disorders. Biol Psychiatry. 2010; 67(7): 692694.
62. Hollander, E, Bartz, J, Chaplin, W, etal. Oxytocin increases retention in social cognition in autism. Biol Psychiatry. 2007; 61(4): 498503.
63. Bakermans-Kranenburg, MJ, van I Jzendoorn, MH. Sniffing around oxytocin: review and meta-analyses of trials in healthy and clinical groups with implications for pharmacotherapy. Transl Psychiatry. 2013; 3: 258267.
64. Domes, G, Heinrichs, M, Kumbier, E, etal. Effects of intranasal oxytocin on the neural basis of face processing in autism spectrum disorder. Biol Psychiatry. 2013; 74(3): 164171.
65. Hall, SS, Lightbody, AA, McCarthy, BE, etal. Effects of intranasal oxytocin on social anxiety in males with fragile X syndrome. Psychoneuroendocrinology. 2012; 37(4): 509518.
66. Eisenstein, M. Treatments: in the waiting room. Nature. 2012; 491(7422): S14S16.
67. Stevens, FL, Wiesman, O, Feldman, R, etal. Oxytocin and behavior: evidence for effects in the brain. J Neuropsychiatry Clin Neurosci. 2013; 25(2): 96102.
68. Bartz, JA, Zaki, J, Bolger, N, etal. Oxytocin selectively improves empathic accuracy. Psychol Sci. 2010; 21(10): 14261428.
69. Meyer-Lindenberg, A, Domes, G, Kirsch, P, etal. Oxytocin and vasopressin in the human brain: social neuropeptides for translational medicine. Nat Rev Neurosci. 2011; 12(9): 524538.
70. Heim, C, Owens, MJ, Plotsky, PM, etal. Persistent changes in corticotropin-releasing factor systems due to early life stress: relationship to the pathophysiology of major depression and post-traumatic stress disorder. Psychopharmacol Bull. 1997; 33(2): 185192.
71. Mirescu, C, Peters, JD, Gould, E. Early life experience alters response of adult neurogenesis to stress. Nat Neurosci. 2004; 7(8): 841846.
72. Carter, CS. Developmental consequences of oxytocin. Physiol Behav. 2003; 79(3): 383397.
73. Wismer Fries, AB, Ziegler, TE, Kurian, JR, Jacoris, S, Pollak, SD. Early experience in humans is associated with changes in neuropeptides critical for regulating social behavior. Proc Natl Acad Sci U S A. 2005; 102(47): 1723717240.
74. Heim, C, Young, LJ, Newport, DJ, etal. Lower CSF oxytocin concentrations in women with a history of childhood abuse. Mol Psychiatry. 2009; 14(10): 954958.
75. Meinlschmidt, G, Heim, C. Sensitivity to intranasal oxytocin in adult men with early parental separation. Biol Psychiatry. 2007; 61(9): 11091111.
76. Ditzen, B, Schaer, M, Gabriel, B, etal. Intranasal oxytocin increases positive communication and reduces cortisol levels during couple conflict. Biol Psychiatry. 2009; 65(9): 728731.
77. Kirsch, P, Esslinger, C, Chen, Q, etal. Oxytocin modulates neural circuitry for social cognition and fear in humans. J Neurosci. 2005; 25(49): 1148911493.
78. Kosfeld, M, Heinrichs, M, Zak, PJ, etal. Oxytocin increases trust in humans. Nature. 2005; 435(7042): 673676.
79. Prather, MD, Lavenex, P, Mauldin-Jourdain, ML, etal. Increased social fear and decreased fear of objects in monkeys with neonatal amygdala lesions. Neuroscience. 2001; 106(4): 653658.
80. Meyer-Lindenberg, A, Hariri, AR, Munoz, KE, etal. Neural correlates of genetically abnormal social cognition in Williams syndrome. Nat Neurosci. 2005; 8(8): 991993.
81. Marazziti, D, Dell'Osso, B, Baroni, S, etal. Relationship between oxytocin and anxiety of romantic attachment. Clin Pract Epidemiol Ment Health. 2006; 2: 2836.
82. Carter, CS. Oxytocin and sexual behavior. Neurosci Biobehav Rev. 1992; 16(2): 131144.
83. Uvnås-Moberg, K. Oxytocin linked antistress effects—the relaxation and growth response. Acta Physiol Scand Suppl. 1997; 640: 3842.
84. Insel, TR, Young, LJ. The neurobiology of attachment. Nat Rev Neurosci. 2001; 2(2): 129136.
85. Heinrichs, M, Baumgartner, T, Kirschbaum, C, etal. Social support and oxytocin interact to suppress cortisol and subjective responses to psychosocial stress. Biol Psychiatry. 2003; 54(12): 13891398.
86. Jezova, D, Skultetyova, I, Tokarev, DI, etal. Vasopressin and oxytocin in stress. Ann N Y Acad Sci. 1995; 771: 192203.
87. McCarthy, MM, McDonald, CH, Brooks, PJ, etal. An anxiolytic action of oxytocin is enhanced by estrogen in the mouse. Physiol Behav. 1996; 60(5): 12091215.
88. Marazziti, D, Bani, A, Casamassima, F, etal. Oxytocin: an old hormone for new avenues. Clinical Neuropsychiatry. 2006; 3(5): 302321.
89. Hoge, EA, Pollack, MH, Kaufman, RE, Zak, PJ, Simon, NM. Oxytocin levels in social anxiety disorder. CNS Neurosci Ther. 2008; 14(3): 165170.
90. Papadopoulos, V, Baraldi, M, Guilarte, TR, etal. Translocator protein (18kDa): new nomenclature for the peripheral type benzodiazepine receptor based on its structure and molecular function. Trends Pharmacol Sci. 2006; 27(8): 402409.
91. Drugan, RC, Basile, AS, Crawley, JN, etal. Inescapable shock reduces [3H]Ro 5-4864 binding to “peripheral-type” benzodiazepine receptors in the rat. Pharmacol Biochem Behav. 1986; 24(6): 16731677.
92. Weizman, R, Laor, N, Karp, L, etal. Alteration of platelet benzodiazepine receptors by stress of war. Am J Psychiatry. 1994; 151(5): 766767.
93. Marazziti, D, Rotondo, A, Martini, C, etal. Changes in peripheral benzodiazepine receptors in patients with panic disorder and obsessive-compulsive disorder. Neuropsychobiology. 1994; 29(1): 811.
94. Gavish, M, Laor, N, Bidder, M, etal. Altered platelet peripheral-type benzodiazepine receptor in posttraumatic stress disorder. Neuropsychopharmacology. 1996; 14(3): 181186.
95. Ferrarese, C, Appollonio, I, Frigo, M, etal. Decreased density of benzodiazepine receptors in lymphocytes of anxious patients: reversal after chronic diazepam treatment. Acta Psychiatr Scand. 1990; 82(2): 169173.
96. Rocca, P, Ferrero, P, Gualerzi, A, etal. Peripheral-type benzodiazepine receptors in anxiety disorders. Acta Psychiatr Scand. 1991; 84(6): 537544.
97. Weizman, R, Tanne, Z, Granek, M, etal. Peripheral benzodiazepine binding sites on platelet membranes are increased during diazepam treatment of anxious patients. Eur J Pharmacol. 1987; 138(2): 289292.
98. Johnson, MR, Marazziti, D, Brawman-Mintzer, O, etal. Abnormal peripheral benzodiazepine receptor density associated with generalized social phobia. Biol Psychiatry. 1998; 43(4): 306309.
99. Heydari, B, Le Melledo, JM. Low pregnenolone sulphate plasma concentrations in patients with generalized social phobia. Psychol Med. 2002; 32(5): 929933.
100. Harmer, CJ. Have no fear: the neural basis of anxiolytic drug action in generalized social phobia. Biol Psychiatry. 2013; 73(4): 300301.
101. Schüle, C, Nothdurfter, C, Rupprecht, R. The role of allopregnanolone in depression and anxiety. Prog Neurobiol. In press. DOI: 10.1016/j.pneurobio.2013.09.003.
102. Carta, MG, Bhat, KM, Preti, A. GABAergic neuroactive steroids: a new frontier in bipolar disorders? Behav Brain Funct. 2011, 19; 8(1): 6168.
103. Cannistraro, PA, Rauch, SL. Neural circuitry of anxiety: evidence from structural and functional neuroimaging studies. Psychopharmacol Bull. 2003; 37(4): 825.
104. Adolphs, R. Neural systems for recognizing emotion. Curr Opin Neurobiol. 2002; 12(2): 169177.
105. Tillfors, M, Furmark, T, Marteinsdottir, I, etal. Cerebral blood flow during anticipation of public speaking in social phobia: a PET study. Biol Psychiatry. 2002; 52(11): 11131119.
106. Lorberbaum, JP, Kose, S, Johnson, MR, etal. Neural correlates of speech anticipatory anxiety in generalized social phobia. Neuroreport. 2004; 15(18): 27012705.
107. Yoon, KL, Fitzgerald, DA, Angstadt, M, etal. Amygdala reactivity to emotional faces at high and low intensity in generalized social phobia: a 4-Tesla functional MRI study. Psychiatry Res. 2007; 154(1): 9398.
108. Stein, JL, Wiedholz, LM, Bassett, DS, etal. A validated network of effective amygdala connectivity. Neuroimage. 2007; 36(3): 736745.
109. Stein, MB, Goldin, PR, Sareen, J, etal. Increased amygdala activation to angry and contemptuous faces in generalized social phobia. Arch Gen Psychiatry. 2002; 59(11): 10271034.
110. Cooney, RE, Atlas, LY, Joormann, J, etal. Amygdala activation in the processing of neutral faces in social anxiety disorder: is neutral really neutral? Psychiatry Res. 2006; 148(1): 5559.
111. Frazer, A, Hensler, J. Serotonin. In: Siegal G, Agranoff B, Albers R, etal., eds. Basic Neurochemistry, 5th ed. New York: Raven Press Ltd.; 1994: 283308.
112. Hajós, M, Richards, CD, Székely, AD, Sharp, T. An electrophysiological and neuroanatomical study of the medial prefrontal cortical projection to the midbrain raphe nuclei in the rat. Neuroscience. 1998; 87(1): 95108.
113. Aston-Jones, G, Akaoka, H, Charlety, P, etal. Serotonin selectively attenuates glutamate-evoked activation of noradrenergic locus coeruleus neurons. J Neurosci. 1991; 11(3): 760769.
114. Gorman, JM, Kent, JM, Sullivan, GM, etal. Neuroanatomical hypothesis of panic disorder, revised. Am J Psychiatry. 2000; 157(4): 493505.
115. Chalmers, DT, Lovenberg, TW, De Souza, EB. Localization of novel corticotropin-releasing factor receptor (CRF2) mRNA expression to specific subcortical nuclei in rat brain: comparison with CRF1 receptor mRNA expression. J Neurosci. 1995; 15(10): 63406350.
116. Price, ML, Lucki, I. Regulation of serotonin release in the lateral septum and striatum by corticotropin-releasing factor. J Neurosci. 2001; 21(8): 28332841.
117. Marcin, MS, Nemeroff, CB. The neurobiology of social anxiety disorder: the relevance of fear and anxiety. Acta Psychiatr Scand Suppl. 2003; 108(417): 5164.
118. Graeff, FG, Guimaraes, FS, De Andrade, TG, etal. Role of 5-HT in stress, anxiety, and depression. Pharmacol Biochem Behav. 1996; 54(1): 129141.
119. Robbins, TW, Everitt, BJ. Central norepinephrine neurons and behavior. In: Bloom FE, Kupfer DJ, eds. Psychopharmacology: The Fourth Generation of Progress. New York: Raven Press; 1995: 363372.
120. Valentino, RJ, Foote, SL, Page, ME. The locus coeruleus as a site for integrating corticotropin-releasing factor and noradrenergic mediation of stress responses. Ann N Y Acad Sci. 1993; 697(1): 173188.
121. Fitzgerald, KD, Liu, Y, Stern, ER, etal. Reduced error-related activation of dorsolateral prefrontal cortex across pediatric anxiety disorders. J Am Acad Child Adolesc Psychiatry. 2013; 52(11): 11831191.
122. Moscovitch, DA, Santesso, DL, Miskovic, V, etal. Frontal EEG asymmetry and symptom response to cognitive behavioral therapy inpatients with social anxiety disorder. Biol Psychol. 2011; 87(3): 379385.
123. Amir, N, Klumpp, H, Elias, J, etal. Increased activation of the anterior cingulate cortex during processing of disgust faces in individuals with social phobia. Biol Psychiatry. 2005; 57(9): 975981.
124. Quadflieg, S, Mohr, A, Mentzel, HJ, Miltner, WH, Straube, T. Modulation of the neural network involved in the processing of anger prosody: the role of task-relevance and social phobia. Biol Psychol. 2008; 78(2): 129137.
125. Van Ameringen, M, Mancini, C, Szechtman, H, etal. A PET provocation study of generalized social phobia. Psychiatry Res. 2004; 132(1): 1318.
126. Evans, KC, Simon, NM, Dougherty, DD, etal. A PET study of tiagabine treatment implicates ventral medial prefrontal cortex in generalized social anxiety disorder. Neuropsychopharmacology. 2009; 34(2): 390398.
127. Phan, KL, Fitzgerald, DA, Cortese, BM, etal. Anterior cingulate neurochemistry in social anxiety disorder: 1H-MRS at 4 Tesla. Neuroreport. 2005; 16(2): 183186.
128. Kilts, CD, Kelsey, JE, Knight, B, etal. The neural correlates of social anxiety disorder and response to pharmacotherapy. Neuropsychopharmacology. 2006; 31(10): 22432253.
129. Campbell, DW, Sareen, J, Paulus, MP, etal. Time-varying amygdala response to emotional faces in generalized social phobia. Biol Psychiatry. 2007; 62(5): 455463.
130. Blanco, C, Bragdon, LB, Schneier, FR, etal. The evidence-based pharmacotherapy of social anxiety disorder. Int J Neuropsychopharmacol. 2013; 16(1): 235249.
131. Schneier, FR. Pharmacotherapy of social anxiety disorder. Expert Opin Pharmacother. 2011; 12(4): 615625.
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