Although Social Phobia has been recognised for centuries in comparison with
other anxiety disorders, relatively little work has been done to understan
d its neural basis. The present review attempts to redress this balance by
giving an overview of the current state of knowledge in this disorder. By p
utting together data from the treatment responses to specific agents, the e
ffects of chemical challenges which have been used in other anxiety disorde
rs and by reviewing data on central and peripheral neurotransmitter and end
ochrine abnormalities, it is possible to begin to generate some potentially
testable theories of aetiology and mechanisms. Finally, we review the pote
ntial use of neuroimaging techniques to better detail the brain circuits an
d possibly neurotransmitters involved in social phobia, showing some of our
preliminary work using O-15 water blood flow PET activation studies to det
ermine the brain circuits in which metabolism is changed during the experie
nce of social anxiety.