Toward a framework for defective emotion processing in social phobia

This paper explores and outlines an evolutionary approach to understanding social phobia (SP) as a developmental disorder in brain mechanisms that regulate socioemotional behaviour.

A literature review of cognitive, neuronal, and endocrine correlates of SP is presented using an integrative approach.

Social phobia patients present with a specific and developmentally stable functional neuroanatomical and neuroendocrine profile that can be linked to findings of cognitive attentional abnormalities.

It is argued that SP is the human counterpart to primate sub-ordination stress and develops from clearly identifiable precursors in early child-hood, the understanding of which requires fundamental insights into the regulation of socioemotional behaviour. The current state of knowledge speaks strongly in favour of a diathesis model, in which distorted cognitions that are characteristic of SP are secondary to hyperexcitability of fear circuits that set off at least as early as at preverbal ages and ultimately may lead to the development of SP.