The pursuit of social acceptance: Aberrant conformity in social anxiety disorder

The defining pathological features of social anxiety disorder primarily concern the social landscape, yet few empirical studies have examined the potentially aberrant behavioral and neural patterns in this population using socially interactive paradigms. We addressed this issue by investigating the behavioral and neural patterns associated with social conformity in patients with social anxiety disorder. We recorded event-related potentials (ERPs) when healthy subjects (n = 19), and patients with social anxiety disorder (n = 20) made attractiveness judgements of unfamiliar others, while at the same time, being exposed to congruent/incongruent peer ratings. Afterwards, participants were asked to rerate the same faces without the presence of peer ratings. Compared to healthy controls, social anxiety disorder patients exhibited more positive attitudes to unfamiliar others and conformed more with peers-higher feedback. These behavioral effects were in parallel with neural responses associated with social conflict in the N400 signal, showing higher conformity to peers-higher feedback compared to peers-lower or peers-agree feedback among social anxiety disorder patients. Our findings provide evidence on the behavioral and neural patterns of social anxiety disorder during social interactions, and support the hypothesis that individuals with social anxiety disorder are more motivated to pursue social acceptance and possibly avoid social rejection.