Neural evidence of face processing in social anxiety disorder: A systematic review with meta-analysis

• Published in: Neuroscience and biobehavioral reviews Vol. 152; p. 105283
• Main Authors: Pei, Guanxiong, Xiao, Qin, Pan, Yu, Li, Taihao, Jin, Jia
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.09.2023
• Subjects: Attentional bias; Emotions; Event-related potentials; Evoked Potentials; Face processing; Facial Expression; Facial Recognition; Fear; Humans; Meta-analysis; Phobia, Social - psychology; Social anxiety disorder; Event-related potentials; Attentional bias; Social anxiety disorder; Face processing; Meta-analysis
• ISSN: 0149-7634; 1873-7528; 1873-7528
• DOI: 10.1016/j.neubiorev.2023.105283

Numerous previous studies have used event-related potentials (ERPs) to examine facial processing deficits in individuals with social anxiety disorder (SAD). However, researchers still need to determine whether the deficits are general or specific and what the dominant factors are behind different cognitive stages. Meta-analysis was performed to quantitatively identify face processing deficits in individuals with SAD. Ninety-seven results in 27 publications involving 1032 subjects were calculated using Hedges’ g. The results suggest that the face itself elicits enlarged P1 amplitudes, threat-related facial expressions induce larger P2 amplitudes, and negative facial expressions lead to enhanced P3/LPP amplitudes in SAD individuals compared with controls. That is, there is face perception attentional bias in the early phase (P1), threat attentional bias in the mid-term phase (P2), and negative emotion attentional bias in the late phase (P3/LPP), which can be summarized into a three-phase SAD face processing deficit model. These findings provide an essential theoretical basis for cognitive behavioral therapy and have significant application value for the initial screening, intervention, and treatment of social anxiety. •Compared with controls, SAD individuals show general deficits of face processing.•SAD Individuals have enlarged P1 amplitudes regardless of emotional valence.•Threat-related facial expressions induce larger P2 amplitudes in SAD individuals.•Negative facial expressions lead to enhanced P3/LPP amplitudes in SAD individuals.•The specificity of face processing in SAD is mainly caused by attentional bias.