BACKGROUND Previous studies of patients with social anxiety have demonstrated abnormal early processing of facial stimuli in social contexts. In other words, patients with social anxiety disorder (SAD) tend to exhibit enhanced early facial processing when compared to healthy controls. Few studies have examined the temporal electrophysiological event-related potential (ERP)-indexed profiles when an individual with SAD compares faces to objects in SAD. Systematic comparisons of ERPs to facial/object stimuli before and after therapy are also lacking. We used a passive visual detection paradigm with upright and inverted faces/objects, which are known to elicit early P1 and N170 components, to study abnormal early face processing and subsequent improvements in this measure in patients with SAD. METHODS Seventeen patients with SAD and 17 matched control participants performed a passive visual detection paradigm task while undergoing EEG. The healthy controls were compared to patients with SAD pre-therapy to test the hypothesis that patients with SAD have early hypervigilance to facial cues. We compared patients with SAD before and after therapy to test the hypothesis that the early hypervigilance to facial cues in patients with SAD can be alleviated. RESULTS Compared to healthy control (HC) participants, patients with SAD had more robust P1-N170 slope but no amplitude effects in response to both upright and inverted faces and objects. Interestingly, we found that patients with SAD had reduced P1 responses to all objects and faces after therapy, but had selectively reduced N170 responses to faces, and especially inverted faces. Interestingly, the slope from P1 to N170 in patients with SAD was flatter post-therapy than pre-therapy. Furthermore, the amplitude of N170 evoked by the facial stimuli was correlated with scores on the interaction anxiousness scale (IAS) after therapy. CONCLUSIONS Our results did not provide electrophysiological support for the early hypervigilance hypothesis in SAD to faces, but confirm that cognitive-behavioural therapy can reduce the early visual processing of faces. These findings have potentially important therapeutic implications in the assessment and treatment of social anxiety. Trial registration HEBDQ2014021.

中文翻译：

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认知行为疗法减弱了社交焦虑症中增强的早期面部刺激处理：一项ERP调查。

背景技术先前对社交焦虑症患者的研究已证明社交环境中面部刺激的异常早期处理。换句话说，与健康对照相比，患有社交焦虑症（SAD）的患者倾向于表现出增强的早期面部加工能力。当患有SAD的人将面部与SAD中的对象进行比较时，很少有研究检查与时间电生理事件相关的电位（ERP）索引的配置文件。也缺乏ERP与治疗前后面部/物体刺激的系统比较。我们使用具有直立和倒置的面部/物体的被动视觉检测范例，已知可以诱发早期的P1和N​​170成分，以研究异常的早期面部处理以及SAD患者在此方面的后续改进。方法17名SAD患者和17名匹配的对照参与者在接受EEG时执行了被动视觉检测范例任务。将健康对照者与SAD治疗前的患者进行比较，以检验SAD患者对面部线索早期超警觉的假设。我们比较了治疗前后的SAD患者，以检验可以减轻SAD患者早期对面部线索的过度警觉的假设。结果与健康对照（HC）参与者相比，SAD患者的P1-N170斜率更强健，但对直立和倒置的面部和物体均无振幅影响。有趣的是，我们发现SAD患者在治疗后对所有物体和面部的P1反应降低，但对面部，尤其是倒立面部的N170反应选择性降低。有趣的是，SAD患者从P1到N170的斜率在治疗后比治疗前更平坦。此外，面部刺激引起的N170的振幅与治疗后相互作用焦虑量表（IAS）的得分相关。结论：我们的结果并没有提供在SAD早期警觉假说面孔电支持，但证实，认知行为疗法可减少脸部的早期视觉处理。这些发现对社交焦虑的评估和治疗具有潜在的重要治疗意义。试用注册HEBDQ2014021。面部刺激引起的N170振幅与治疗后的互动焦虑量表（IAS）得分相关。结论：我们的结果并没有提供在SAD早期警觉假说面孔电支持，但证实，认知行为疗法可减少脸部的早期视觉处理。这些发现对社交焦虑的评估和治疗具有潜在的重要治疗意义。试用注册HEBDQ2014021。面部刺激引起的N170振幅与治疗后的互动焦虑量表（IAS）得分相关。结论：我们的结果并没有提供在SAD早期警觉假说面孔电支持，但证实，认知行为疗法可减少脸部的早期视觉处理。这些发现对社交焦虑的评估和治疗具有潜在的重要治疗意义。试用注册HEBDQ2014021。这些发现对社交焦虑的评估和治疗具有潜在的重要治疗意义。试用注册HEBDQ2014021。这些发现对社交焦虑的评估和治疗具有潜在的重要治疗意义。试用注册HEBDQ2014021。