Toward quantitative cognitive-behavioral modeling of psychopathology: An active inference account of social anxiety disorder.

Abstract

Understanding psychopathological mechanisms is a central goal in clinical science. While existing theories have demonstrated high research and clinical utility, they have provided limited quantitative explanations of mechanisms. Previous computational modeling studies have primarily focused on isolated factors, posing challenges for advancing clinical theories holistically. To address this gap and leverage the strengths of clinical theories and computational modeling in a synergetic manner, it is crucial to develop quantitative models that integrate major factors proposed by comprehensive theoretical models. In this study, using social anxiety disorder (SAD) as an example, we present a novel approach to formalize conceptual models by combining cognitive-behavioral theory (CBT) with active inference modeling, an innovative computational approach that elucidates human cognition and action. This CBT-informed active inference model integrates multiple mechanistic factors of SAD in a quantitative manner. Through a series of simulations, we systematically examined the effects of these factors on the belief about social threat and tendency of engaging in safety behaviors. The resultant model inherits the conceptual comprehensiveness of CBT and the quantitative rigor of active inference modeling, delineating previously elusive pathogenetic pathways and enabling the formulation of concrete model predictions for future research. Overall, this research presents a novel quantitative model of SAD that unifies major mechanistic factors proposed by CBT and active inference modeling. It highlights the feasibility and potential of integrating clinical theory and computational modeling to advance our understanding of psychopathology. (PsycInfo Database Record (c) 2025 APA, all rights reserved).