Reduced dorsal anterior cingulate cortical activity during emotional regulation and top-down attentional control in Generalized Social Phobia (GSP), Generalized Anxiety Disorder (GAD) and comorbid GSP/GAD

Background—Generalized Social Phobia (GSP) and Generalized Anxiety Disorder (GAD) are both associated with emotion dysregulation. In healthy subjects, research implicates dorsal anterior cingulate (dACC) in both explicit emotion regulation and top-down attentional control. While studies have examined these processes in GSP or GAD, no work compares findings across the two disorders. Moreover, no work examines functioning in cases comorbid for both disorders (GSP/GAD). Here we compare the neural correlates of explicit emotion regulation (EER) and topdown attentional control (TAC) in GSP, GAD, and GSP/GAD. Method—Medication-free adults with GSP (EER n=19; TAC n=18), GAD (EER n=17; TAC n =17), GSP/GAD (EER n=17; TAC=15), or no psychopathology (EER n=18; TAC n=18). During EER, individuals alternatively viewed, up-regulated, and down-regulated responses to emotional pictures. During TAC, they performed an emotional Stroop task. Results—For both tasks, significant group-by-condition interactions emerged in dACC and parietal cortices. Healthy adults showed significantly increased recruitment during emotion regulation, relative to emotion-picture viewing. GAD, GSP, and GSP/GAD subjects showed no such increases, with all three groups differing from healthy adults but not from each other. Evidence of emotion-related disorder-specificity emerged in medial prefrontal cortex (MPFC) and amygdala. This disorder-specific responding varied as a function of stimulus emotion content but not emotion-regulatory demands. Conclusions—GSP and GAD both involve reduced capacity for engaging emotion-regulation brain networks, whether explicitly or via top-down attentional control. A reduced ability to recruit © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved. Correspondence concerning the article should be addressed to Karina S Blair, Ph.D., National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, 15K North Drive, Rm 115A, MSC 2670, Bethesda, Maryland 20892-2670. peschark@mail.nih. gov. FINANCIAL DISCLOSURES All authors declare no biomedical financial interests or potential conflicts of interest. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author Manuscript Biol Psychiatry. Author manuscript; available in PMC 2013 September 15. Published in final edited form as: Biol Psychiatry. 2012 September 15; 72(6): 476–482. doi:10.1016/j.biopsych. 2012.04. 013. N IH PA Athor M anscript N IH PA Athor M anscript N IH PA Athor M anscript regions implicated in top-down attention might represent a general risk factor for anxiety disorders.