Summary: During social interactions, we look into the face of another person and in the blink of an eye infer that person’s emotional state and their intentions. These perceptions inform decisions about what to do or say next. Generalized Social Anxiety Disorder (GSAD) is characterized by exaggerated concerns about negative evaluation and rejection in social situations. These symptoms have been quantified with signal detection theory (SDT). The application of SDT has led to novel approaches within anxiety research; a primary hypothesis, supported by several studies, has been that the “over-reactive” nature of the anxious state can be characterized as a bias to respond to or remember situations as more threatening than they in fact are. In spite of SDT’s power, its conventional use has been limited to simply quantifying differences in sensitivity, bias, and accuracy among perceivers. Left unanswered are questions of particular relevance to research and treatment: what causes the observed differences in bias and sensitivity? A critical barrier to answering this question is the current understanding of SDT in clinical research, which lacks a framework to predict or explain behavior, or in which to pose experimental questions about how mood and anxiety disorders influence the underlying mechanisms involved in threat perception. To bridge this barrier, we introduce a mathematical model of perceptual decision making that incorporates key insights from behavioral economics-utility and optimality- into a signal detection framework. Our primary objective is to use this novel framework to explain differences in threat perception among individuals with GSAD, anxious controls with generalized anxiety disorder (GAD), and non-psychiatrically-ill participants. Our secondary objective is to assess whether our framework could be used to improve interventions to reduce misperceptions of threat in GSAD. Our model is a unique conceptualization of perception (e.g., optimal detection, subjective miscalibration to underlying environmental parameters that influence overt behavior) that could eventually lead to improvements in cognitive-behavioral therapies by tailoring them to a patient’s individual perceptual decision-making impairment. To achieve our aims, we will recruit 100 individuals with GSAD and 100 individuals each from age- and gender-matched GAD and healthy populations. Participants will complete a suite of perceptual tasks to isolate which of several perceptual decision parameters cause misperceptions of social threat in GSAD. Successful characterization of GSAD along such lines will take the field in new directions by framing social threat perception as a decision made by attempting to optimize detection in the presence ambiguous sensory information and conflicting, risky consequences. As well, the novel theoretical developments represented by our model will broaden SDT’s usefulness deepening the insights it affords into the nature of cognitive processes.
Public Health Relevance: Generalized social anxiety disorder (GSAD) is characterized by frequent, debilitating misperceptions of threat and disapproval in non-threatening social circumstances. This research uses a novel theory and method for characterizing various pathways for disordered threat detection in GSAD. The findings will enable clinicians to build more effective behavioral and cognitive therapies by tailoring therapy to target an individual patient’s particular pathways to perceptual impairments.