Social anxiety disorder (SAD), an impairing and often chronic psychiatric disorder (1), has a lifetime prevalence between 6 and 13% (2–5) and is prevailing worldwide (6). At present, treatment for... Show moreSocial anxiety disorder (SAD), an impairing and often chronic psychiatric disorder (1), has a lifetime prevalence between 6 and 13% (2–5) and is prevailing worldwide (6). At present, treatment for SAD is often suboptimal (7–10). Insight in the neurobiological changes underlying the socially-anxious brain is of utmost importance to improve preventive and therapeutic interventions.Until now, several studies have examined alterations in brain structure associated with SAD, by using magnetic resonance imaging (MRI). This method enables investigating changes in gray matter (GM) (11). Results of MRI studies on GM characteristics related to SAD show, however, little consistency and have small effect sizes (12–14).Recently, Wang et al. (15) described a voxel-based meta-analysis on GM volume (GMV) differences between SAD-patients and healthy participants. Such a meta-analytic review is very welcome in order to quantitatively summarize the results of previously published studies and to further increase our understanding of SAD-related GMV alterations. Unfortunately, the paper did not live up to its promise. Wang et al. state that SAD is associated with increased cortical and decreased subcortical GMVs, but these conclusions cannot be deduced from their data. Here, we want to point out several shortcomings that seriously affect this work. Show less
Background: Physiological hyperarousal in social situations is a characteristic of individuals with social anxiety disorder (SAD), but so far it has been rarely studied as a biological risk for SAD... Show moreBackground: Physiological hyperarousal in social situations is a characteristic of individuals with social anxiety disorder (SAD), but so far it has been rarely studied as a biological risk for SAD. Here, we investigate whether children at high risk for SAD (because of their parents' SAD) display physiological hyperarousal while interacting with a stranger. Also, we examine whether early physiological hyperarousal is related to later child social anxiety. Method: One hundred and seventeen children took part in the stranger-approach task when they were 2.5 and 4.5 years old. Heart rate (HR), heart rate variability (HRV), and electrodermal activity (EDA) were measured before, during, and after the conversation with a stranger. Both parents' lifetime SAD status and SAD severity were assessed before the birth of the child. Both parents and children reported on children's social anxiety symptoms when children were 7.5. Results: Children of parents with the lifetime SAD diagnosis did not differ in their physiological activity from children of parents without lifetime SAD. However, children of parents with more severe SAD displayed heightened EDA throughout the task procedure. Increased HR and reduced HRV during the stranger-approach and elevated EDA throughout the task phases were linked to later child social anxiety. Conclusions: Parents' severity of SAD is related to child physiological hyperarousal early in their childhood. In addition, physiological hyperarousal in early childhood predicts later child social anxiety. Together, these findings suggest that early physiological hyperarousal in social situations may pose a risk for later child social anxiety and that physiological hyperarousal, and EDA in particular, may be a biological mechanism in the intergenerational transmission of SAD. Show less
