Social anxiety disorder (SAD) is common among the population, 7.3-12.1%. The first characteristics appear in late childhood and adolescence.

A period of an age-related increase in social anxiety and fear

Adolescent changes are characterized by hormonal changes. Typical neurological developments that increase 'emotionality' during development are varied. The amygdala and the striatum are mentioned, which are involved in the basic processing of threat and reward. FMRI research revealed the differences in medial and lateral functional subdivisions of the prefrontal cortex. This is due to the response to emotionally provocative stimuli between adolescents and adults.

The involvement of the prefrontal area together with an increased reactivity of the limbic systems to threatening and rewarding stimuli may be responsible for increased emotional responses in adolescence. Typical neurological developments that increase 'sociability' during development are less divergent. A relative decrease in the anterior dorsal medial prefrontal cortex area and an increase in the posterior temporal areas when adolescents are compared with adults is found.

Changes in the brain network due to social-affective stimuli during adolescence can result in greater affective responses and greater involvement and understanding of interpersonal situations. This makes the adolescent flexible in the choice of behavior, and also makes him or her more susceptible to social fears and and anxiety.

A period of declining individual differences in social anxiety

Where the above confirms that adolescence increases the risk of social anxiety and fear, there is a small proportion of adolescents in who these symptoms are very severe and persistent. How does this type of adolescent differ from a normative developing adolescent? The answer is, there are developmental changes in both the emotional brain and the social brain. An emphasis is placed on biases during information processing (including attention bias, interpretation bias and expectation bias). Recent fMRI studies show that cognitive biases are associated with individual differences in brain activity.

Young people with an existing tendency to pay attention to (or expect) negative aspects of social cues or situations appear to experience these experiences more often and may start to behave in a mal-adaptive way, such as avoidance to avoid this situation. Because adolescents are better able to mentalize, there is an increase in the complexity and ambiguity of situations. One can explain these situations in several ways, but also with a greater chance of a negative interpretation. In future studies, it is important to look at what neurocognitive factors play a role per age group.