Social anxiety disorder (SAD) has been linked to maladaptive forms of fear regulation, including flexibly distinguishing between learned threat and safety signals. Few studies have examined this in young, unmedicated SAD patients, including its neural basis. We aimed to characterize the neural, subjective, and autonomic correlates of reversal learning in patients with SAD and compare them to matched patients with major depressive disorder and to healthy control participants. All participants completed a threat-safety reversal learning task during functional magnetic resonance imaging. Successful threat-safety updating was associated with significant activation of primary regions of interest (anterior cingulate, insula and ventromedial prefrontal cortex), however, no significant differences were observed between them, consistent with subjective reports of task-evoked anxiety and affect. Contrary to expectations, we did not observe threat and safety reversal learning to be significantly impaired in young people with SAD.

社交焦虑症（SAD）与不良的恐惧调节形式有关，包括灵活地区分已获悉的威胁和安全信号。很少有研究在未接受药物治疗的年轻SAD患者中对其进行检查，包括其神经基础。我们旨在表征SAD患者逆向学习的神经，主观和自主神经相关性，并将其与匹配的重度抑郁症患者和健康对照者进行比较。所有参与者均在功能磁共振成像过程中完成了威胁安全性逆转学习任务。成功的威胁安全更新与感兴趣的主要区域（前扣带状，岛状和腹膜前额叶皮层）的显着激活相关，但是，在它们之间没有观察到显着差异，与任务引起的焦虑和影响的主观报告一致。与期望相反，我们没有发现威胁和安全逆转学习在SAD年轻人中显着受损。