Recent progress in the study on conditioned fear memory has shown us a neural circuit mechanism underlying this fear (fear circuit). It is thought that fear circuit participates in particular anxiety disorders. From this point of view, elucidation of the biological mechanism controlling fear circuit is also significant. In the first half of this review, I would like to mainly introduce recent topics on the fear circuit studies. In the second half, our studies on the biological system that controls fear circuit are illustrated. It is expected that the elucidation of the fear circuit and its control systems opens a new venue for development of an effective treatment of anxiety disorders.

In 1999, a selective serotonin reuptake inhibitor (SSRI) was introduced to the clinic in Japan. This introduction greatly improved the treatment of anxiety disorder and understanding of its pathology. Since SSRI with high selectivity and no other mechanism of action is effective for treating anxiety disorder, increasing extracellular serotonin concentrations in the brain is concluded to directly alleviate the symptoms of anxiety disorder. In addition, on the basis of the details of neural circuits of anxiety and fear, which have been elucidated since 1993, several animal studies have shown that the mechanism of anxiolytic action of SSRIs is suppressing the neural function of the amygdala and their action is mediated through the stimulation of the 5-HT_1A receptor. The hypotheses obtained from these animal experiments are also supported by human imaging studies using fMRI. By elucidating the mechanism of action of SSRI, it is expected that it will become possible in the future to understand the pathology of anxiety disorders and develop the new treatment of anxiety disorders from the viewpoints of neural circuits and neurotransmitters.

Background: Patients with social anxiety disorder (SAD) have heightened self-reflection. In the self-focused cognition, they ruminate negative self-image or evaluation both by themselves and others. It leads to self-conscious emotions, such as embarrassment. Previous functional magnetic resonance imaging (fMRI) studies with healthy subjects revealed that anterior rostral medial prefrontal cortex (arMPFC) plays a key role in self-reflection. However, neural basis of self-reflection in patients with SAD has not been studied in detail. This study aimed to investigate the neural basis of self-reflection in patients with SAD using self-face images. We hypothesized that patients with SAD would show excessive embarrassment and it would cause aberrant neural hyperactivity in arMPFC as compared to controls (CTL).

Methods: Thirteen outpatients with SAD and 17 CTLs enrolled in this study. fMRI was acquired while participants reported the degree of their embarrassment by the visually presented their self-face image and images of others' with and without an observer.

Results: The SAD group reported significantly greater embarrassment for self-face images than the CTL regardless of observation. The SAD group showed enhanced self-related activation in the left arMPFC as compared with the CTL. Furthermore, positive correlation between the self-related activity and Liebowitz Social Anxiety Scale was observed only in the arMPFC.

Conclusion: We suggest that the arMPFC takes charge of their elevated-level of self-reflection in patients with SAD, and the level of the neural activity was correlated to the severity of the symptom.

Onset of mental disorders sharply increases during adolescence. Since young people are reluctant to seek help for their mental health problems, they may need the help of adults around them for seeking appropriate help. Teachers may be a good candidate of the adults encouraging young people seek appropriate help, considering that young people spend most of their time in schools. The aim of this study is to conduct a systematic review of studies investigating teachers’ ability to recognize students with anxious and/or depressive symptoms. We included studies which report concordance between students’ mental health problems recognized by teachers and those identified using interviews and/or self-report questionnaires. We searched PubMed, ERIC, CINAHL, PsycInfo, Web of Science, CiNii and ICHUSHI, and identified 13,442 studies in the initial search of databases; 8 studies out of them met the inclusion criteria. Teachers recognized anxious and depressive symptoms in 38–75 and 19–41％, respectively, of students identified being with the symptoms according to interviews and/or questionnaires. Mental health education of teachers may need to be well focused on anxiety and anxiety disorders, not only on depression.

The Short Fear of Negative Evaluation Scale (SFNE) for the Japanese assesses their fear of negative evaluation using a single-factor structure. However, a recent study suggested that this scale includes two factors: forward and reversed items. Therefore, this study examined the SFNE’s factor structure, reliability, and validity, using data collected from 500 adult participants recruited from an Internet survey and 82 undergraduate or vocational school students. Results of the exploratory factor analysis determined two factors: the first comprised eight forward items, and the second comprised four reversed items. Each subscale showed good internal consistency and test-retest reliability. The forward-item factor showed better convergent and incremental validity than the reversed-item factor. These results indicated the forward-item factor was more precise than the reversed-item factor in assessing the fear of negative evaluation. The use of forward items is therefore recommended for the evaluation of FNE. We discuss the contributions to the assessment in these results and the limitations of the current study.

The purpose of this study was to examine the validity and reliability of the short Japanese version of Children’s Anxiety Scale (Short-CAS), which was developed based on the Spence Children’s Anxiety Scale (SCAS). Two hundred students (95 boys and 105 girls; mean age＝14.01, SD＝0.87) and their parents completed a questionnaire including the scales of anxiety, depression, temperament, and test anxiety. A factor analysis supported single factor structure of the scale. Item Response Theory (IRT) revealed that the Short-CAS have stable and accurate measurements for examinees with high anxiety symptoms. Anxiety symptoms assessed by the scale were significantly correlated with depressive mood, avoidance temperament, and test anxiety. Furthermore, the score of the Short CAS were related with parents-rated scores of depressive mood and test anxiety. Finally, clinical applicability of the Short-CAS was discussed.