Neurocognitive Heterogeneity in Social Anxiety Disorder: The Role of Self-Referential Processing and Childhood Maltreatment

Anat Talmon*, Matthew Luke Dixon, Philippe R. Goldin, Richard G. Heimberg, James J. Gross

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Social anxiety disorder (SAD) is characterized by negative self-beliefs and altered brain activation in the default-mode network (DMN). However, the extent to which there is neurocognitive heterogeneity in SAD remains unclear. We had two independent samples of patients perform a self-referential encoding task and complete self-reports of childhood maltreatment, subjective well-being, and emotion regulation. In the replication sample, we also measured DMN activation using functional MRI. We used k-means clustering, which revealed two distinct subgroups of patients with SAD in the discovery sample. Cluster 1 demonstrated higher levels of negative self-referential trait endorsement, lower levels of positive self-referential trait endorsement, and significantly higher levels of childhood emotional maltreatment, lower subjective well-being, and altered emotion-regulation-strategy use. A similar pattern was observed in the replication sample, which further demonstrated higher DMN activation during negative trait judgments in Cluster 1. Participants in the SAD clusters, from both the discovery and replication samples, were significantly distinct from samples of control participants. These findings reveal neurocognitive heterogeneity in SAD and its relationship to emotional maltreatment.

Original languageAmerican English
Pages (from-to)1045-1058
Number of pages14
JournalClinical Psychological Science
Issue number6
StatePublished - Nov 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© The Author(s) 2021.


  • brain activation
  • childhood emotional abuse
  • childhood emotional neglect
  • default-mode network
  • negative self-beliefs


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