Social anxiety is marked by a persistent fear of social scrutiny, yet its neurocognitive mechanisms remain incompletely understood. We tested whether social anxiety is associated with altered engagement of Theory of Mind (ToM) systems supporting inferences about others’ thoughts and emotions, or with broader interpretive tendencies biasing social information processing toward more internally guided responses. Functional MRI, heart rate, and pupil diameter were recorded from 43 individuals with elevated social anxiety and 43 low-anxiety controls during viewing of a nonverbal animated film. ToM engagement was assessed via scene-specific neural activation, while broader interpretive processing was indexed using dynamic intersubject correlation (ISC), quantifying the degree to which neural responses were shared versus idiosyncratic across viewers over time. Socially anxious participants showed reduced activation in the left posterior superior temporal sulcus (pSTS) during ToM-relevant scenes, alongside preserved engagement of the broader ToM network. Dynamic ISC analyses revealed increased alignment in early sensory regions and reduced alignment in higher-order regions outside the ToM network, consistent with more individualized processing at higher levels. These effects occurred without group differences in autonomic arousal or pupil-linked attention, and an exploratory comparison with an autism cohort revealed opposite alignment patterns in overlapping higher-order regions. Social anxiety is associated with focal alterations in ToM-related processing and broader shifts in movie-driven neural alignment across the cortical hierarchy. Divergent alignment patterns in social anxiety and autism suggest that movie-driven neural alignment may serve as a transdiagnostic marker distinguishing mechanistically distinct forms of atypical social cognition.
Koch et al. (2026) studied this question.