The relevance of social-emotional learning processes for the development, maintenance, and therapy of social anxiety

Social Anxiety Disorder (SAD) is with 6 – 12 % highly prevalent in the general population and social anxiety affects many people, restricting their personal, social, and professional life (Fehm, Pelissolo, Furmark, & Wittchen, 2005; Kessler et al., 2005; Kessler, Petukhova, Sampson, Zaslavsky, & Wittchen, 2012). Women develop an SAD nearly twice as often as men (Fehm et al., 2005; Ohayon & Schatzberg, 2010). Learning models like fear conditioning may depict a significant pathogenesis in anxiety disorders (LeDoux, 2014; Lissek et al., 2005; Mineka & Oehlberg, 2008; Mineka & Zinbarg, 2006). Investigating the underlying mechanisms of the development and maintenance of SAD, virtual reality (VR) as new research utilization is a promising tool for fear conditioning (Diemer, Mühlberger, Pauli, & Zwanzger, 2014; Mühlberger, Herrmann, Wiedemann, Ellgring, & Pauli, 2001; Mühlberger, Wiedemann, & Pauli, 2003; Shiban et al., 2017; Shiban et al., 2016b; Shiban, Schelhorn, Pauli, & Mühlberger, 2015b). Shiban, Reichenberger, Neumann, and Mühlberger (2015a) established a useful social fear conditioning (SFC) paradigm to investigate the underlying mechanisms in learning and unlearning social anxiety in humans. The present dissertation project has four main research goals. The first research aim is to examine if a social threat (e.g., spitting and verbal insult) triggers sensitively more fear responses than an unspecific threat (e.g., electrical stimulation) as unconditioned stimulus (US) in socially anxious participants. The second research goal is to unravel the underlying mechanisms of the gender differences in social anxiety. The third research aim is to investigate the effect of induced and extinguished social fears on gaze behavior (e.g., hypervigilance and attentional avoidance) towards ecological valid socially relevant stimuli in high and low socially anxious individuals. The fourth research goal is to validate virtual social interaction scenarios for psychotherapeutic interventions like social skills training in VR. To this end, four empirical studies were conducted. The first three SFC studies provide new insights into social fear conditioning and extinction of LSA and HSA participants in VR. The validation study suggests that social skills training in VR is a possible psychotherapeutic intervention for socially anxious individuals. All four studies of the dissertation project showed that social-emotional learning processes in social anxiety can be measured reliably using ecological valid socially relevant stimuli in immersive virtual environment. Prospective SFC studies should focus on comparing patients with SAD to healthy participants to examine possible discrepancies in social-emotional learning and to further develop efficient treatments for SAD