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Browsing by Author "Carlton, Corinne N."

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    5-year follow-up of adolescents with social anxiety disorder: Current functioning during COVID-19
    Carlton, Corinne N.; Garcia, Katelyn M.; Honaker, Makayla; Richey, John A.; Ollendick, Thomas H. (Elsevier, 2023-04)
    The present study followed-up adolescents with social anxiety disorder (SAD) during the COVID-19 pandemic, approximately 5-years following their participation in an Attention Bias Modification Training (ABMT) program (Ollendick et al., 2019). The current study aimed to evaluate current functioning and quality of life (QoL) during the emerging adulthood period. Participants included 27 young adults who completed a randomized controlled trial of ABMT and were available for follow-up. Participants filled out self-report measures of QoL and functioning and underwent a clinical interview to assess current severity of social anxiety. Clinician-rated symptoms of SAD significantly decreased from post-treatment to 5-year follow-up. Additionally, results demonstrated that social anxiety severity was significantly related to poorer self-reported physical and psychological health as well as poorer functioning with regard to social distancing fears during COVID-19. Lastly, when evaluating change in symptoms over time, increases in social anxiety severity over a 5-year period significantly predicted worsened social distancing fears during COVID-19.
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    Associations between resting-state neural connectivity and positive affect in social anxiety disorder
    Carlton, Corinne N.; Antezana, Ligia; Richey, John A. (Wiley, 2023-04)
    Introduction: Social anxiety disorder (SAD) has been characterized by deficits in social motivation and lack of reactivity to pleasurable stimuli (i.e., positive affect; [PA]). Recent neuroimaging work has shifted toward examining positively valenced motivational systems in SAD focused on reward responses. However, little is known about the associations of reward connectivity and PA in individuals with SAD. As such, the purpose of the current study was to determine whether connectivity among key units of reward neurocircuitry meaningfully relate to PA and whether these key units are more heterogeneous in SAD as compared to controls.Methods: Thirty-one participants who met diagnostic criteria for SAD and 33 control participants were included (M-age = 24.8, SD = 6.9; 55% cisgender man). Seed-based timeseries correlations were conducted in NiTime to extract region of interest (ROI) coupling correlation strength values. ANOVAs were carried out to assess whether individuals with SAD differed in ROI-to-ROI connectivity strength as compared to controls. Correlations and variance analyses were also conducted to examine the relationship between ROI-to-ROI connectivity strength and PA, as well as heterogeneity in connectivity strength and PA expression.Results: Weaker connectivity between the left and right orbital frontal cortex was observed when comparing the SAD to the control group. Within the SAD group, PA was associated with several reward-related ROI couplings; however, these links were not observed among controls. Results further demonstrated that individuals with SAD had significantly more variability in reward connectivity strength as compared to controls.Conclusion: Overall, these results provide emergent evidence for the association between reward regions and PA in individuals with SAD. Additionally, these findings show that individuals with SAD demonstrate greater heterogeneity in reward connectivity.
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    Functional Connectivity of Reward Networks: Characterizing Mechanistic Underpinnings Involved in Positive Affect Deficits within Social Anxiety Disorder
    Carlton, Corinne N. (Virginia Tech, 2020)
    Social Anxiety Disorder (SAD) is characterized by excessive concern or fear of negative evaluation in one or more social situations and ranks as one of the most common psychiatric disorders. SAD has also been characterized by significant deficits in social motivation and a lack of reactivity to pleasurable stimuli (i.e., positive affect; [PA]), particularly within social contexts. Recent neuroimaging work has shifted towards examining positively-valenced motivational systems in SAD focused on reward responses to social and nonsocial stimuli. These studies have revealed aberrant reward processing during social reward tasks in individuals with SAD. However, not all individuals with SAD exhibit reward circuitry dysfunction. Therefore, the current study aimed to examine if functional patterns of connectivity in the brain underlie heterogeneity in PA differences in individuals with SAD. Results revealed several functional connectivity strength differences between SAD and control groups within reward regions. Additionally, associations between regions of interest (ROIs)-couplings (i.e., OFC and insula, OFC and subgenual cingulate, insula and cingulate, and cingulate and subgenual cingulate) and diminished PA were present in individuals with SAD, but not controls. Lastly, results demonstrated that individuals with SAD had higher variability in their reward connectivity strength presentations and reports of PA as compared to controls. These results hold significance for the development of interventions for SAD that focus on the enhancement of PA to bolster social reward responsivity.
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    Mindfulness-Based Interventions for Adolescent Social Anxiety: A Unique Convergence of Factors
    Carlton, Corinne N.; Sullivan-Toole, Holly; Strege, Marlene V.; Ollendick, Thomas H.; Richey, John A. (2020-07-22)
    Social anxiety disorder (SAD) is a debilitating and often chronic psychiatric disorder that typically onsets during early adolescence. Cognitive behavior therapy (CBT), the current "gold-standard" treatment for SAD, tends to focus on threat- and fear-based systems hypothesized to maintain the disorder. Despite this targeted approach, SAD ranks among the least responsive anxiety disorders to CBT in adolescent samples, with a considerable proportion of individuals still reporting clinically significant symptoms following treatment, suggesting that the CBT-family of interventions may not fully target precipitating or maintaining factors of the disorder. This gap in efficacy highlights the need to consider new therapeutic modalities. Accordingly, this brief review critically evaluates the emergent literature supporting the use of mindfulness-based interventions (MBIs) for treating adolescent SAD. MBIs may be particularly relevant for addressing maintaining factors within this diagnosis, as they may target and interrupt cycles of avoidance and de-motivation. Despite limitations in the relative lack of randomized controlled trials (RCTs) on this topic, a unique convergence of factors emerge from the extant literature that support the notion that MBIs may hold particular promise for attenuating symptoms of SAD in adolescents. These factors include: (1) MBIs demonstrate the ability to directly engage symptoms of SAD; (2) MBIs also show consistent reduction of anxiety, including symptoms of social anxiety in adolescent populations; and (3) MBIs demonstrate high rates of feasibility and acceptability in anxious adolescent samples. We briefly review each topic and conclude that MBIs are an encouraging treatment approach for reducing symptoms of social anxiety in adolescents. However, given the lack of research within MBIs for adolescent SAD in particular, more research is needed to determine if MBIs are more advantageous than other current treatment approaches.
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    Parenting Characteristics among Adults With Social Anxiety and their Influence on Social Anxiety Development in Children: A Brief Integrative Review
    Garcia, Katelyn M.; Carlton, Corinne N.; Richey, John A. (Frontiers Media, 2021-04-28)
    The purposes of this brief integrative review are to identify and critically evaluate recent work in the area of parenting processes that are disproportionately observed among parents with social anxiety disorder (SAD) that may ultimately increase risk among offspring, and to further link these processes to specific targets for intervention. Accordingly, we first evaluate the relevance of specific parenting styles as they pertain to increased risk of developing SAD among offspring. Second, we link these parenting processes to observations of certain unfavorable consequences among socially anxious youth, such as low perceived autonomy and poorer social skills. Finally, in light of these consequences we extend our conclusions into potentially modifiable targets among parents with SAD, focusing on the enhancement of autonomy and facilitating offspring’s normative period of transition into independence during adolescence. Overall, we conclude that parenting behaviors commonly observed among adults with SAD, such as overcontrol and low parental warmth, likely have a direct impact on the development of social anxiety symptoms among their children. However, these parenting behaviors are plausibly modifiable and therefore repurposing existing interventions for use among parents with SAD in conjunction with interventions with their offspring is likely to provide direct clinical benefit.
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    Reward Circuitry and Motivational Deficits in Social Anxiety Disorder: What Can Be Learned From Mouse Models?
    Carlton, Corinne N.; Sullivan-Toole, Holly; Ghane, Merage; Richey, John A. (2020-02-26)
    Social anxiety disorder (SAD) is a common and serious psychiatric condition that typically emerges during adolescence and persists into adulthood if left untreated. Prevailing interventions focus on modulating threat and arousal systems but produce only modest rates of remission. This gap in efficacy suggests that most mainstream treatment concepts do not sufficiently target core processes involved in the onset and maintenance of SAD. This idea has further driven the development of new theoretical models that target dopamine (DA)-driven reward circuitry and motivational deficits that appear to be systematically altered in SAD. Most of the available data linking systemic alterations in DA neurobiology to SAD in humans, although abundant, remains at the level of correlational evidence. Accordingly, the purpose of this brief review is to critically evaluate the relevance of experimental work in rodent models that link details of DA function to symptoms of social anxiety. We conclude that, despite certain systematic limitations inherent in animal models, these approaches provide useful insights into human biomarkers of social anxiety including that (1) adolescence may serve as a critical period for the convergence of neurobiological and environmental factors that modify future expectations about social reward through experience dependent changes in DA-ergic circuitry, (2) females may show unique susceptibility to social anxiety symptoms when encountering relational instability that influences DA-related neural processes, and (3) separate from fear and arousal systems, the functional neurobiology of central DA systems contribute uniquely to susceptibility and maintenance of anhedonic factors relevant to human models of SAD.
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    Validation of a novel method of ultraviolet-induced cutaneous inflammation and its associations with anhedonia
    Sullivan-Toole, Holly; Feng, Shengchuang; Carlton, Corinne N.; Ghane, Merage; Olino, Thomas M.; Allen, Irving C.; Richey, John A. (Nature Portfolio, 2022-11)
    Affective immunology of the skin is a growing area; however, established protocols for measuring individual differences in cutaneous inflammation are lacking. To address this, we present a preliminary validation of Precision Implementation of Minimal Erythema Dose (PI-MED) testing as a method for measuring cutaneous inflammation. PI-MED is a recently adapted protocol, optimized for reproducibility and individual differences research, that uses ultraviolet (UV) light to evoke cutaneous erythema, or inflammatory skin reddening. PI-MED's novel UV dosage schedule produces standardized erythema responses across different skin pigmentation types and shows strong internal consistency within person and good test-retest reliability across 8-10 weeks. In line with predictions, increased PI-MED erythema was associated with heightened anhedonia, across several measures, beyond influences of non-affective covariates. While future work should further refine the dosage schedule for the lightest and darkest skin types, overall, evidence supports PI-MED as a protocol for inducing and measuring individual differences in cutaneous inflammation. Further, PI-MED-induced erythema can expand psychoneuroimmunology research by offering a complementary assessment for general inflammatory tone. This work adds to a growing body of evidence demonstrating a distinct relationship between inflammation and anhedonia.