Social Anxiety Disorder

Social anxiety disorder (SAD) is a serious psychiatric condition, which typically evolves during late childhood and early adolescence. Patients are ‘extremely shy’: they are afraid of a negative evaluation by others and avoid social situations as much as possible, leading to significant adverse effects on important areas of functioning. As SAD is characterized by a chronic course, insight in the factors that make children and adolescents vulnerable to develop SAD is pivotal to get grip on the disorder and to prevent its lifelong negative consequences.

Genetic vulnerability

Previous work on SAD has identified several biological, psychological, and social factors that play a role in the development and the maintenance of SAD. In the LFLSAD, we build upon the results of family- and twin studies, which demonstrated that the genetic makeup of individuals is one of the contributing factors to the development of SAD: being ‘genetically close’ to a patient with SAD leads to an enhanced risk to develop the disorder. Previous studies reported heritability estimates of SAD around 50 %, but little is known about the genetic variations underlying the susceptibility to SAD.

Candidate endophenotypes

The Leiden Family Lab study on Social Anxiety Disorder (LFLSAD), a collaboration between the Leiden University (Institute of Psychology, Developmental and Educational Psychology) and the Leiden University Medical Center (Department of Psychiatry) was designed to examine the genetic vulnerability to develop SAD. In this two-generation family study, more than 100 family-members from eight families genetically enriched for SAD were investigated. Using magnetic resonance imaging (MRI) and electroencephalograohy (EEG), we explore within the LFLSAD sample which brain characteristics are associated with social anxiety, and have a genetic background. In multiple research papers , we already summarized several promising candidate endophenotypes of SAD: measurable characteristics on the pathway from genotype to phenotype, which shed light on the genetic vulnerability to develop the disorder. These endophenotypes involve alterations in the structure (anatomy) and function of the brain (for example enhanced activity in response to faces with a neutral expression and increased responses to unintentional social norm violations). Thereby, the LFLSAD provides new insights in the neurobiological vulnerability to develop SAD.

Within the LFLSAD, Janna Marie Bas-Hoogendam is responsible for the acquisition and analyses of the MRI data. In January 2020, she successfully defended her thesis ‘Extremely Shy & Genetically Close’ (cum laude), summarizing several neurobiological endophenotypes of SAD; in the coming year, she will analyze the remaining MRI data of the LFLSAD, and supervise a PhD student who works on data of the LFLSAD.

• endophenotypes
• fmri
• social anxiety disorder