Reappraisal as a mediator in the link between 5-HTTLPR and social anxiety symptoms

Social anxiety symptoms have been related to (a) polymorphisms in the serotonin-transporter gene-promoter region (also, serotonin-transporter-linked polymorphic region; 5-HTTLPR) and (b) reduced use of adaptive forms of emotion regulation such as reappraisal. It is not known, however, whether reappraisal functions as a mediator in the link between 5-HTTLPR and social anxiety. To address this issue, 182 unselected community volunteers were tested for 5-HTTLPR status, and self-report measures of social anxiety symptoms and reappraisal use were obtained. Relative to other participants, those with two low-expressing alleles displayed increased social anxiety and decreased reappraisal. As predicted, the influence of 5-HTTLPR on social anxiety symptoms was transmitted via reappraisal, and this effect of 5-HTTLPR was observed using two different measures of reappraisal. These findings suggest that cognitive reappraisal may be an intermediate phenotype of the social anxiety spectrum, and that individuals with low-expressing 5-HTTLPR genotypes may benefit the most from cognitive-behavioral psychotherapy because they do not appear to engage as frequently as others in reappraisal.