Journal of mood and anxiety disorders最新文献

{"title":"An examination of symptoms, function and quality of life as conjoint clinical outcome domains for treatment-resistant depression","authors":"Charles R. Conway ,&nbsp;A. John Rush ,&nbsp;Charles Gordon ,&nbsp;Sheldon H. Preskorn ,&nbsp;Harold A. Sackeim ,&nbsp;Scott T. Aaronson ,&nbsp;Roger S. McIntyre ,&nbsp;Ying-Chieh (Lisa) Lee ,&nbsp;Olivia Shy ,&nbsp;Quyen Tran ,&nbsp;Jeffrey Way ,&nbsp;Mark T. Bunker","doi":"10.1016/j.xjmad.2025.100121","DOIUrl":"10.1016/j.xjmad.2025.100121","url":null,"abstract":"<div><h3>Objective</h3><div>The treatment of depression aims to improve depressive symptoms, daily function and quality of life (QoL). These exploratory analyses of a database of convenience from the RECOVER trial evaluated how a “tripartite” metric based on these 3 outcome domains might perform in treatment-resistant depression (TRD).</div></div><div><h3>Methods</h3><div>Outcome domains included depressive symptoms (MADRS, QIDS-C, QIDS-SR), function (WPAI item-6) and QoL (Mini-Q-LES-Q) obtained at months 3, 6, 9 and 12 in outpatients with markedly TRD in the double-blind RECOVER trial that compared sham to active adjunctive vagus nerve stimulation (VNS). For each domain, clinically meaningful differences were defined <em>a priori</em>. Analyses addressed 3 questions: 1) Does each domain detect meaningful benefits undetected by the other domains? 2) Is the tripartite metric validated by an independent clinician-rated global index of improvement (CGI-I)? 3) How well does the tripartite metric detect treatment group differences in the RECOVER trial?</div></div><div><h3>Results</h3><div>Clinically meaningful reductions in depressive symptoms alone missed 25–51 % of all participants who evidenced clinically meaningful benefits in depressive symptoms, function or QoL. The tripartite metric strongly correlated with CGI-I ratings (tetrachoric r = 0.73–0.85), with stronger relationships than each component individually. The tripartite metric successfully separated active from sham adjunctive VNS in a 1-year trial of patients with markedly TRD.</div></div><div><h3>Conclusion</h3><div>Symptoms, function and QoL capture distinct, clinically significant and valid outcomes that identify persons with markedly TRD with a range of clinically meaningful benefits. Whether these results pertain to other major depressive disorder patient groups and treatments deserves study.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"10 ","pages":"Article 100121"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interacting immediate and long-term action regulation in suicidal behavior","authors":"Nicholas Murphy ,&nbsp;George Kypriotakis ,&nbsp;Marijn Lijffijt ,&nbsp;Sidra Iqbal ,&nbsp;Tabish Iqbal ,&nbsp;Dania Amarneh ,&nbsp;Brittany O’Brien ,&nbsp;Amanda Tamman ,&nbsp;Ynhi Thomas ,&nbsp;Nidal Moukaddam ,&nbsp;Thomas R. Kosten ,&nbsp;Lynnette A. Averill ,&nbsp;Sanjay Mathew ,&nbsp;Alan C. Swann","doi":"10.1016/j.xjmad.2025.100118","DOIUrl":"10.1016/j.xjmad.2025.100118","url":null,"abstract":"<div><h3>Background</h3><div>Suicide is a prominent cause of death across the lifespan, especially between 10 and 34 years old. Most suicides are first attempts, during crises with unpredictably fluctuating risk, arising insidiously from mechanisms related to long-term exposure to psycho-bio-social risk factors. Identifying susceptibility from interacting immediate and long-term mechanisms of action regulation could prevent suicidal crises.</div></div><div><h3>Methods</h3><div>We investigated interacting immediate and long-term regulation of action in risk for suicide. Immediate processes were assessed through affective and behavioral symptoms and a computer measure of impaired action-regulation, the Immediate Memory Task (IMT). Long-term processes included history of trauma, stress, and addictive behaviors. We used Beck Suicidal Ideation at its Worst (SSI-W) to measure global suicidal behavior. Participants were 28 survivors of medically severe suicide attempt (MSSA) within the previous 9 months compared to 23 age, sex, and diagnosis-similar psychiatric controls with previous suicidal ideation but without attempt (NA).</div></div><div><h3>Results</h3><div>MSSA was related, independent of SSI-W, to IMT impulsive responses, Internal State Scale (ISS) activation, and Lifetime Cumulative Adversity (LCA). MSSA was indirectly related, through SSI-W, to depression, aggression, alcohol-use severity and IMT stimulus discrimination. Minimization-denial of childhood trauma directly increased MSSA,but indirectly reduced apparent MSSA through reduced SSI-W reporting.</div></div><div><h3>Discussion</h3><div>MSSA combines characteristics independent of and dependent on SSI-W, reinforced by minimization/denial of childhood trauma. Stress-related hyperarousal and denial of early trauma facilitate MSSA through ISS activation, LHA, and impulsive IMT responses. These characteristics can identify individuals who, without previous suicide attempt or conventional psychiatric diagnosis, need preventive treatment of suicide risk.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"10 ","pages":"Article 100118"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and longitudinal associations with obsessive-compulsive disorder in youth exposed to trauma","authors":"Caitlin M. Pinciotti ,&nbsp;Paul J. Rathouz ,&nbsp;Andrew G. Guzick ,&nbsp;Jeffrey D. Shahidullah ,&nbsp;Emily J. Bivins ,&nbsp;David B. Riddle ,&nbsp;Ogechi “Cynthia” Onyeka ,&nbsp;Eric A. Storch ,&nbsp;Wayne K. Goodman ,&nbsp;Kelli Franco ,&nbsp;Justin F. Rousseau ,&nbsp;D. Jeffrey Newport ,&nbsp;Karen Dineen Wagner ,&nbsp;Charles B. Nemeroff","doi":"10.1016/j.xjmad.2025.100117","DOIUrl":"10.1016/j.xjmad.2025.100117","url":null,"abstract":"<div><div>Childhood trauma exposure is associated with posttraumatic stress symptoms (PTSS) and suicidality, however it is also a risk factor for obsessive-compulsive disorder (OCD) in adults. Research examining the relationship between childhood trauma and OCD in youth is mixed, and there is a dearth of research examining the associations among OCD, PTSS, and suicidality. As a result, conclusions have been drawn from primarily cross-sectional adult samples. No study has examined the clinical characteristics associated with OCD in trauma-exposed youth, nor its associations with PTSS and suicidality over time. To address this gap, the present study used logistic regressions and generalized estimating equations in 2068 trauma-exposed youth aged 8—20 who completed assessments at baseline, 6-month, and 12-month follow-ups. In total, trauma-exposed youth with OCD (<em>n</em> = 222, 10.7 %) were more likely to be female (OR = 0.646), had more severe PTSS (OR = 1.032), and more psychiatric comorbidities (OR = 1.391) compared to trauma-exposed youth without OCD. Interpersonal traumas (OR = 1.549) and bullying (OR = 1.294) were associated with a greater likelihood of having OCD; however, these effects were nonsignificant when adjusting for other mental health symptoms. There was no evidence that OCD was associated with the trajectory of PTSS nor suicidality at 6- and 12-month follow-ups. Trauma-exposed youth with OCD may cross-sectionally have more severe clinical presentations overall, but OCD may not be related to the trajectory of these symptoms over time. Future research is needed to understand the directionality of clinical characteristics associated with pediatric OCD and whether interpersonal traumas convey risk uniquely for OCD or for distress in general.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"10 ","pages":"Article 100117"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weighing the predictive role of neural factors for adolescent anhedonia in the presence of demographic and clinical factors","authors":"Anisha Reddy ,&nbsp;Michele Bertocci ,&nbsp;Tina Gupta ,&nbsp;Kristen L. Eckstrand ,&nbsp;Manivel Rengasamy ,&nbsp;Erika E. Forbes","doi":"10.1016/j.xjmad.2025.100116","DOIUrl":"10.1016/j.xjmad.2025.100116","url":null,"abstract":"<div><div>Anhedonia, a transdiagnostic symptom of psychopathology associated with pernicious clinical course, has putative mechanisms in neural reward systems and emerges during adolescence. However, the relative contributions of neural, demographic, and clinical factors to its development are unclear. 73 adolescents (13–19 years) at varying familial risk for developing anhedonia reported demographic and clinical characteristics at study entry, reported anhedonia up to three times annually, and underwent fMRI during a monetary reward paradigm. Least absolute shrinkage and selection operator (LASSO) regression, which allows for a large number of intercorrelated predictors for feature selection, revealed that among demographic, clinical, and neural factors, 10 features predicted peak anhedonia over two years: impulsivity; activation in dorsal caudate, sub-gyral temporal lobe, and cuneus; and negative FC between the ventral striatum and six regions implicated in motor and/or decision-making aspects of reward. Neural factors explained an additional 40 % of variance above impulsivity. Findings indicate that in adolescents at risk for severe mental illness, disrupted motor and decision-making reward pathways could contribute to the development of anhedonia. Additionally, anhedonia should be defined in multiple domains, beyond mere phenomenology.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"10 ","pages":"Article 100116"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"de novo KDM5B Mutation in a Patient with Autism Spectrum Disorder and Obsessive-Compulsive Disorder: Case Report","authors":"Niki P. Sabetfakhri,&nbsp;Stephen J. Guter Jr,&nbsp;Sandra H. Reyes Pinzon,&nbsp;Olusola A. Ajilore,&nbsp;Edwin H. Cook,&nbsp;Fedra Najjar","doi":"10.1016/j.xjmad.2025.100114","DOIUrl":"10.1016/j.xjmad.2025.100114","url":null,"abstract":"<div><h3>Background</h3><div>The <em>KDM5B</em> gene encodes a lysine histone demethylase that is essential in epigenetic regulation and human development. Homozygous and compound heterozygous variants of <em>KDM5B</em> have been associated with a distinct syndrome characterized by developmental delay, intellectual disability, and dysmorphic features. However, phenotypic presentations associated with heterozygous (HET) protein-truncating variants (PTVs) have been inconsistent, ranging from moderate to severe autism spectrum disorder (ASD) and intellectual disability (ID), to some individuals being unaffected with ASD or ID.</div></div><div><h3>Case presentation</h3><div>We report a <em>de novo</em> HET PTV (NM_006618.5 c.1708 C&gt;T; p.R570X) in <em>KDM5B</em> in an 18-year-old Caucasian female patient, who presented with ASD, and then developed severe obsessive-compulsive disorder (OCD) and leading to depression and emotion dysregulation</div></div><div><h3>Conclusions</h3><div>This case suggests a potential role for HET PTVs in the <em>KDM5B</em> gene in OCD pathogenesis and marks the first report of co-occurring ASD and OCD associated with a <em>KDM5B</em> variant.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"10 ","pages":"Article 100114"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rollercoaster of obsessive-compulsive disorder: How chronotype and time of day affect behavioral inhibition in adults with OCD","authors":"Eyal Kalanthroff ,&nbsp;Yuval Seror ,&nbsp;Noa Sagi ,&nbsp;Shachar Hochman ,&nbsp;Omer Linkovski ,&nbsp;Hadar Naftalovich ,&nbsp;Helen Blair Simpson","doi":"10.1016/j.xjmad.2025.100113","DOIUrl":"10.1016/j.xjmad.2025.100113","url":null,"abstract":"<div><div>Chronotype, a person's circadian preference, reflects individuals’ natural pattern of alertness levels throughout the day. It has been shown that chronotype contributes to within-day symptom fluctuations in obsessive-compulsive disorder (OCD). However, the underlying mechanism of this effect is not yet clear. Inhibitory control, an executive function crucial for suppressing unwanted behaviors and thoughts, is essential for managing OCD symptoms and is highly influenced by alertness levels. Hence, the current study investigated the impact of chronotype and time of day on inhibitory control in OCD patients, particularly in response to individually tailored symptom-provoking images, using a novel version of the stop signal task. Ninety-three treatment-seeking OCD patients completed an individually tailored Symptom-Provocation Stop-Signal Task, every morning and evening for four consecutive days. Chronotype was assessed using the Morningness-Eveningness Questionnaire (MEQ). Stop-signal reaction time (SSRT) was assessed for neutral and individually tailored symptom-provoking images separately. Patients exhibited longer SSRTs (worse inhibition) to symptom-provoking trials compared to neutral trials. Most importantly, chronotype and time of day significantly interacted to affect SSRTs in the symptom-provocation condition: A significant correlation was found between optimal alertness periods and improved inhibitory control in the symptom-provocation condition. Taken together, these results indicate that inhibitory control in OCD varies with chronotype and time of day. These findings suggest that aligning treatment sessions with patients' chronotype may enhance therapeutic outcomes and that heightening alertness—by increasing the chances of successful inhibition—might be a way to mitigate the vicious cycle of OCD.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"10 ","pages":"Article 100113"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial discrimination and anxiety in African American youth: Risk, resilience, and intervention","authors":"Joya N. Hampton-Anderson ,&nbsp;Briana Woods-Jaeger ,&nbsp;Troy B. Maxwell ,&nbsp;W. Edward Craighead","doi":"10.1016/j.xjmad.2025.100115","DOIUrl":"10.1016/j.xjmad.2025.100115","url":null,"abstract":"<div><div>Among African American youth, experiences of discrimination are related to having an anxiety disorder with significant impairment. Although incorporating culturally relevant treatment components (e.g., race socialization) that address experiences of discrimination might better serve minority youth, current evidence based interventions for anxiety in outpatient settings typically fail to include those culturally relevant components. This manuscript, noting the role of racial discrimination, outlines indicators of risk and resilience for diagnosis and prognosis of anxiety disorders among African American youth. Qualitative examples, provided from a sample of community stakeholders and African American youth seeking services for an anxiety disorder, describe specific associations between experiences of racial discrimination and anxiety. We conclude that identification and inclusion of culturally specific risk and protective factors in the development, implementation, and evaluation of anxiety-focused intervention programs in outpatient settings that target culturally specific protective factors will better serve African American youth experiencing anxiety disorders.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"10 ","pages":"Article 100115"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric properties and socio-demographic correlates of the Connor-Davidson Resilience Scale in three large population-based cohorts including Danish and Icelandic adults","authors":"Maria Didriksen ,&nbsp;Hilda Daníelsdottir ,&nbsp;Marín Dögg Bjarnadóttir ,&nbsp;Cassie Overstreet ,&nbsp;Karmel W. Choi ,&nbsp;Lea Arregui Nordahl Christoffersen ,&nbsp;Christina Mikkelsen ,&nbsp;Thor Aspelund ,&nbsp;Arna Hauksdóttir ,&nbsp;Edda Bjork Thordardottir ,&nbsp;Jóhanna Jakobsdóttir ,&nbsp;Gunnar Tómasson ,&nbsp;Christian Erikstrup ,&nbsp;Bitten Aagaard ,&nbsp;Mie T. Bruun ,&nbsp;Henrik Ullum ,&nbsp;Erik Sørensen ,&nbsp;Ian C. Fischer ,&nbsp;Robert H. Pietrzak ,&nbsp;Joel Gelernter ,&nbsp;Andrew J. Schork","doi":"10.1016/j.xjmad.2025.100112","DOIUrl":"10.1016/j.xjmad.2025.100112","url":null,"abstract":"<div><div>Identifying specific factors affecting psychological resilience could be instrumental in developing new therapeutic strategies for improving and maintaining mental and physical health. To achieve this, an adequate measure of psychological resilience is essential. We studied the psychometric properties of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) across three population-based cohorts. The study included adult Danish individuals in the Danish Blood Donor Study (DBDS, N = 57,031), and the Icelandic cohorts Stress-And-Gene Analysis cohort (SAGA, N = 27,236), and COVID-19 National Resilience cohort (C19-Resilience, N = 20,373). Exploratory factor analysis revealed a consistent one-factor fit across cohorts. The scale demonstrated good internal consistency (Cronbach's alpha: 0.88–0.90) and longitudinal stability (Spearman correlation coefficients in DBDS: 0.71 across 1.5 years, 0.66 across two years). Mean CD-RISC-10 scores were consistent with previously reported scores in European populations. Lower scores were observed among participants with probable major depressive disorder, and higher scores were found with increasing age. Further evidence for construct validity was revealed as CD-RISC-10 scores moderated the association between financial trouble and depressive symptoms across all cohorts. Psychometric properties of the CD-RISC-10 were similar among women and men. Our findings support the use of the CD-RISC-10 as a reliable and valid unidimensional measure of psychological resilience in Danish and Icelandic populations.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"10 ","pages":"Article 100112"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between pre- and postpartum posttraumatic stress symptoms and maternal functioning in Black trauma-exposed women","authors":"Rebecca Lipschutz ,&nbsp;Meghna Ravi ,&nbsp;Emma C. Lathan ,&nbsp;Monica Duan ,&nbsp;Sriya Karra ,&nbsp;Shimarith Wallace ,&nbsp;Merom Arthur ,&nbsp;Abby Britt ,&nbsp;Abigail Powers ,&nbsp;Vasiliki Michopoulos","doi":"10.1016/j.xjmad.2025.100111","DOIUrl":"10.1016/j.xjmad.2025.100111","url":null,"abstract":"","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"10 ","pages":"Article 100111"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced neural activation during positive social approach is associated with better response to approach avoidance training for social anxiety disorder","authors":"Christopher Hunt ,&nbsp;Morgan M. Caudle ,&nbsp;Martin P. Paulus ,&nbsp;Murray B. Stein ,&nbsp;Charles T. Taylor ,&nbsp;Jessica Bomyea","doi":"10.1016/j.xjmad.2025.100110","DOIUrl":"10.1016/j.xjmad.2025.100110","url":null,"abstract":"<div><h3>Introduction</h3><div>Accumulating evidence suggests that social anxiety disorder (SAD) is characterized by diminished approach of positive social stimuli. Approach-positive approach-avoidance training (AP-AAT) may reduce this bias, but its results have been mixed. AP-AAT might be more effective for patients with deficits in the neural approach processes AP-AAT targets. Here, we attempted to identify neural areas underlying reduced approach of positive social stimuli in SAD and explore whether activity in such areas predicted response to AP-AAT.</div></div><div><h3>Method</h3><div>This was a secondary analysis of an AP-AAT clinical trial involving 40 SAD participants and 22 healthy controls (HCs). A social approach-avoidance task was completed during fMRI to identify neural activation differences between SAD and HC subjects when approaching positive social cues. SAD participants were then randomized to AP-AAT (<em>n</em> = 18) or sham training (<em>n</em> = 22). Treatment response was assessed by changes in positive affect and social connection from pre-to-post treatment.</div></div><div><h3>Results</h3><div>Compared to HCs, SAD patients exhibited significantly less activation in the left paracentral lobule (PCL), right superior parietal lobule (SPL), and left lingual gyrus (LG) when approaching relative to avoiding positive social cues. Lower activation in the right SPL (b=-7.15, p = .022) and left LG (b=-6.93, p = .007) during social approach versus avoidance predicted greater improvement in positive affect (but not social connection) in the AP-AAT group relative to sham.</div></div><div><h3>Conclusions</h3><div>Lower neural activation during positive social approach at baseline predicted better AP-AAT response. AP-AAT may be particularly well-suited to SAD patients exhibiting the neural approach deficits that the treatment putatively targets.</div></div><div><h3>ClinicalTrials.gov Identifier</h3><div>NCT02136212</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"10 ","pages":"Article 100110"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}