The social regulation of threat-related attentional disengagement in highly anxious individuals

Social support may normalize stress reactivity among highly anxious individuals, yet little research has examined anxious reactions in social contexts. We examined the role of both state and trait anxiety in the link between social support and the neural response to threat. We employed an fMRI paradigm in which participants faced the threat of electric shock under three conditions: alone, holding a stranger's hand, and holding a friend's hand. We found significant interactions between trait anxiety and threat condition in regions including the hypothalamus, putamen, precentral gyrus, and precuneus. Analyses revealed that highly trait anxious individuals were less active in each of these brain regions while alone in the scanner—a pattern that suggests the attentional disengagement associated with the perception of high intensity threats. These findings support past research suggesting that individuals high in anxiety tend to have elevated neural responses to mild or moderate threats but paradoxically lower responses to high intensity threats, suggesting a curvilinear relationship between anxiety and threat responding. We hypothesized that for highly anxious individuals, shock cues would be perceived as highly threatening while alone in the scanner, possibly due to attentional disengagement, but this perception would be mitigated if they were holding someone's hand. The disengagement seen in highly anxious people under conditions of high perceived threat may thus be alleviated by social proximity. These results suggest a role for social support in regulating emotional responses in anxious individuals, which may aid in treatment outcomes.