Neurocognitive Mechanisms of Social Anxiety and Interoception

  • Yuri Terasawa
  • Satoshi UmedaEmail author


Social anxiety disorder (SAD) is characterized by fear or anxiety about social situations. These symptoms are characteristic of enhanced self-referential processing. In this chapter, we reviewed neuroimaging studies, focusing on the similarities between self-referential thought and interoception, which are important for understanding SAD. In the reviewed studies, enhanced insular activation was consistently reported. Next, we looked at our fMRI studies to examine whether SAD is related to insular activation duration or attention to interoception. Levels of social fear were positively correlated with activation in the right anterior insular cortex, middle/superior prefrontal cortex, cuneus, parahippocampal gyrus, and inferior frontal gyrus. Mediation analysis revealed that activation in this area mediated social anxiety and activation in the left thalamus, which is related to somatic perception. These findings support our hypothesis that the anterior insular cortex represents the process of attention to interoceptive information, not only bodily perception, and that interoceptive processing is important to a subject’s awareness of their emotions. Finally, we defined the subcategories of interoception and explain how these factors are associated with SAD.


Social anxiety disorder (SAD) Interoception Self-referential thought Insular cortex fMRI 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PsychologyKeio UniversityTokyoJapan

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