While a phobic waits: Regional brain electrical and autonomic activity in social phobics during anticipation of public speaking

Background: Recent studies have highlighted the role of right-sided anterio r temporal and prefrontal activation during anxiety, yet no study has been performed with social phobics that assesses regional brain and autonomic fu nction. This study compared electroencephalograms (EEGs) and autonomic acti vity in social phobics and controls while they anticipated making a public speech. Methods: Electroencephalograms from 14 scalp locations, heart rate, and blo od pressure were recorded while 18 DSM-IV social phobics and 10 controls an ticipated making a public speech, as well as immediately after the speech w as made. Self-reports of anxiety and affect were also obtained. Results: Phobics showed a significantly greater increase in anxiety and neg ative affect during the anticipation condition compared with controls. Hear t rate was elevated in the phobics relative to the controls in most conditi ons. Phobics showed a marked increase in right-sided activation in the ante rior temporal and lateral prefrontal scalp regions. These heart rate and EE G changes together accounted for > 48% of the variance in the increase in n egative affect during the anticipation phase. Conclusions: These findings support the hypothesis of right-sided anterior cortical activation during anxiety and indicate that the combination of EEG and heart rate changes during anticipation account for substantial varianc e in reported negative affect. (C) 2000 Society of Biological Psychiatry.