Social concerns about anxious arousal explain the association between neural responses to anxious arousal pictures and social anxiety

Cognitive theories propose that social anxiety disorder involves heightened attention to anxious arousal symptoms due to worries that they may evoke rejection from others. Supporting this, studies have shown that social anxiety is related to greater attention to representations of anxious arousal and to anxiety sensitivity social concerns, which refers to sensitivity to feelings of anxious arousal during social situations. However, this has not yet been tested using neural indices of attention to images depicting anxious arousal. To examine these associations, the current study examined early and sustained attentional bias to anxious arousal images using the P2 and the late positive potential (LPP), respectively. Electroencephalogram data were collected while a non-clinical sample of undergraduate students (N = 106) viewed images of people exhibiting anxious arousal in addition to blocks of negative and neutral images from the IAPS. The neural response to anxious arousal images was isolated using residual scores (e.g., using linear regression to predict the P2 elicited by anxious arousal images from the P2 elicited by neutral images (P2_neutral→AA) or negative images (P2_{negative→AA}), then saving the unstandardized residuals). There was an indirect effect of the P2_neutral→AA and P2_{negative→AA} waveforms that was explained by anxiety sensitivity social concerns. Additionally, there was an indirect effect of both LPP waveforms on social anxiety symptoms during the early time window of the LPP (400–700 ms). At the later time window of the LPP (700–1000 ms), there was an indirect effect of the LPP_neutral→AA residual waveform, but not the LPP_{negative→AA}, on social anxiety symptoms.