Facial emotion processing in pediatric social anxiety disorder: Relevance of situational context

- Processing of negative facial expression in pediatric social anxiety disorder was investigated by means of ERP.
- Moreover, the impact of additional social background or context information on face processing was examined.
- Socially anxious children showed heightened motivated attention to negative facial expressions with and without context.
- Socially anxious children showed avoidance of integration of additional context information.

Social anxiety disorder (SAD) typically begins in childhood. Previous research has demonstrated that adult patients respond with elevated late positivity (LP) to negative facial expressions. In the present study on pediatric SAD, we investigated responses to negative facial expressions and the role of social context information. Fifteen children with SAD and 15 non-anxious controls were first presented with images of negative facial expressions with masked backgrounds. Following this, the complete images which included context information, were shown. The negative expressions were either a result of an emotion-relevant (e.g., social exclusion) or emotion-irrelevant elicitor (e.g., weight lifting). Relative to controls, the clinical group showed elevated parietal LP during face processing with and without context information. Both groups differed in their frontal LP depending on the type of context. In SAD patients, frontal LP was lower in emotion-relevant than emotion-irrelevant contexts. We conclude that SAD patients direct more automatic attention towards negative facial expressions (parietal effect) and are less capable in integrating affective context information (frontal effect).