How does gaze direction affect facial processing in social anxiety? —An ERP study

Abstract Previous behavioral studies have demonstrated an effect of eye gaze direction on the processing of emotional expressions in adults with social anxiety. However, specific brain responses to the interaction between gaze direction and facial expressions in social anxiety remain unclear. The present study aimed to explore the time course of such interaction using event-related potentials (ERPs) in participants with social anxiety. High socially anxiousindividuals and low socially anxious individuals were asked to identify the gender of angry or neutral faces with direct or averted gaze while their behavioral performance and electrophysiological data were monitored. We found that identification of angry faces with direct but not averted gaze elicited larger N2 amplitude in high socially anxious individuals compared to low socially anxious individuals, while identification of neutral faces did not produce any gaze modulation effect. Moreover, the N2 was correlated with increased anxiety severity upon exposure to angry faces with direct gaze. Therefore, our results suggest that gaze direction modulates the processing of threatening faces in social anxiety. The N2 component elicited by angry faces with direct gaze could be a state-dependent biomarker of social anxiety and may be an important reference biomarker for social anxiety diagnosis and intervention.