Ecological Assessment of Cognitive Control in Individuals with Social Anxiety

PROJECT SUMMARY
Social anxiety disorder is an impairing condition that typically emerges during adolescence, affecting about 10%
of the population. Models of social anxiety (SA) elucidate excessive self-focus and sensitivity to mistakes as
factors that negatively impact quality of life. Using traditional cognitive neuroscience paradigms, prior work has
identified neural measures associated with enhanced self-detection of errors (Error Monitoring), that predicts SA,
as well as anxiety more generally. However, a major challenge with translational interventions developed from
cognitive neuroscience paradigms is the transfer to ecologically valid settings. There is a critical need for the
design and validation of novel tasks/protocols to identify and reliably measure brain-based therapeutic targets
for SA within ecologically valid, “real-world” settings that are applicable to youth. In line with our long-term goal
of developing brain-based interventions for adolescent SA, the purpose of this proposal is to optimize and
validate a novel, ecologically-valid task that will reliably assess neural and behavioral measures associated with
social anxiety. We propose a sequential, multi-study project that leverages a mixed-methods approach to
optimize and validate our novel Natural Reading task and demonstrate its utility in predicting SA. By developing
an ecologically-valid paradigm early in the experimental therapeutics process, we increase the probability of
successful transfer of effects in future interventions that target measures captured by this novel task; in this way,
our proposal is strongly aligned with the Institute’s mission to transform the understanding and treatment of
mental illnesses. We propose two aims: (1) a pilot study to optimize the design of our novel Natural Reading task
and (2) a second study to establish the reliability and predictive power of the Natural Reading task in relation to
SA. In Study 1, 10 youths (13-17 yrs., 5 high and 5 low SA) will perform the Natural Reading task and a traditional
Flanker task, both alone and while under social observation by a peer. To investigate experiential aspects of
task completion, including participants' perceptions and self-assessed task performance, qualitative methods will
be employed in the analysis of semi-structured interview data. Qualitative results will be leveraged to optimize
design of the Natural Reading task prior to proceeding with Study 2 data collection (Aim 2). For Study 2, within
a second sample of 80 youth (13-17 yrs.), participants will perform an optimized version of the Natural Reading
task and a traditional Flanker task, alone and under peer observation. Neural measures of Error Monitoring,
along with associated behavioral measures, will be extracted to perform quantitative analyses. Hypothesis 2A:
Both tasks will exhibit acceptable levels of reliability in neural and behavioral measures. Hypothesis 2B: Within
each task, measures of Error Monitoring extracted from the peer (vs. alone) condition will predict additional
variance in trait SA and state anxiety levels. Hypothesis 2C: Focusing on the peer condition, measures of Error
Monitoring extracted from the Natural Reading Task will predict additional variance in SA, above and beyond
measures of Error Monitoring extracted from the traditional Flanker task.

Grant Number: 1R21MH131928-01A1
NIH Institute/Center: NIH
Principal Investigator: George Buzzell