Improved Accuracy, Higher Reward Totals, and Faster Evidence Accumulation After Gaze-Contingent Music Reward Therapy in Adults with Social Anxiety Disorder

Dan Dillon, PhD

McLean Hospital – Faculty
Dillon_Dan poster

Scientific Abstract

Background: Social anxiety disorder (SAD) involves biased attention to threat. Therefore, we treated SAD with gaze-contingent music reward therapy (GCMRT), in which gaze is tracked as participants view face matrices and music plays only when gaze is directed towards neutral (vs. threatening) faces. Here, we explored the impact of GCMRT on performance in a three-block “social” probabilistic reward task (PRT), with smiling actors serving as rewards.

Methods: Usable PRT data were collected from adults with SAD before (Session 1, n = 74) and after (Session 2, n = 38) four sessions of GCMRT. Healthy controls also completed the PRT twice (Session 1, n = 17; Session 2, n = 15). The PRT required discrimination between schematic faces with short vs. long mouths, and correct responses of one type were disproportionately rewarded. Analyses examined response bias and discriminability, and the Hierarchical Drift Diffusion Model (HDDM) quantified underlying cognitive processes.

Results: In Session 2, a group difference (HC > SAD) in block 3 response bias emerged (p = 0.04). However, in SAD discriminability improved across sessions (p = 0.002), such that there was also a group difference (SAD > HC) in Session 2 response accuracy (p = 0.01). Moreover, the HDDM revealed faster evidence accumulation (higher drift rates) in SAD vs. controls in Session 2 (q = 0.048). Because discriminability and drift rate predicted cumulative reward, the SAD group earned more rewards than controls in Session 2 (p = 0.01).

Conclusions: After GCMRT, adults with SAD outperformed controls in the social PRT.


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research Areas


Daniel G. Dillon, PhD, Amit Lazarov, PhD, Diego A. Pizzagalli, PhD, Franklin R. Schneier, MD

Principal Investigator

Daniel G. Dillon, PhD