In one sentence
While watching a nonverbal animated film in an MRI scanner, adults with elevated social anxiety showed reduced activity in a key theory-of-mind region during social scenes and more individualized higher-order brain responses — a pattern that looked opposite to an exploratory autism comparison in overlapping areas.
What the researchers did
Forty-three adults with elevated social anxiety and forty-three with low social anxiety watched a nonverbal animated film during functional MRI. Researchers also recorded heart rate and pupil size. They examined theory-of-mind engagement (how the brain supports inferences about others’ thoughts and emotions) during relevant scenes, and dynamic intersubject correlation — how similarly different viewers’ brains tracked the film over time. An exploratory analysis compared alignment patterns with a separate autism cohort that had watched the same film in prior work.
What they found
During theory-of-mind scenes, the high social-anxiety group showed reduced activation in the left posterior superior temporal sulcus, while broader theory-of-mind network engagement was largely preserved. Dynamic correlation analyses showed more shared responses in early sensory regions and less shared responses in higher-order regions outside the theory-of-mind network — consistent with more idiosyncratic, internally guided interpretation at later processing stages. Autonomic arousal and pupil-linked attention did not differ between groups. In the exploratory autism comparison, overlapping higher-order regions showed the opposite alignment pattern relative to the social-anxiety group.
What this means for families and therapists
Social anxiety is not only “nerves in the room.” It can involve subtle differences in how social meaning is assembled from the same cues. For autistic people who also live with social anxiety — a common overlap — therapists should not assume one brain pattern explains both. Supports that reduce evaluation threat, slow social demand, and separate sensory load from social inference may help more than generic “read the face” drills.
Parents can use this as language with clinicians: ask how social anxiety versus autistic social processing is being distinguished in assessment and therapy. Pair with our anxiety complete guide and CBT for social anxiety in autistic adults.
Limitations and what we don't know yet
Participants were adults selected by questionnaire elevation, not necessarily a full clinical diagnosis of social anxiety disorder. The film is a controlled laboratory stimulus, not everyday conversation. The autism comparison is exploratory and cross-study. License metadata in our ingest is incomplete, so we summarise conceptually. The study does not test a treatment. Causal direction — whether brain patterns cause anxiety or follow from it — remains open.
This is a plain-language summary of Altered Theory of Mind Engagement and Neural Alignment in Social Anxiety During Movie Viewing by Koch S.B., Mangnus M., Devillers R. et al., Biological Psychiatry Global Open Science (2026). Source license: unknown. It is not medical advice — talk to a qualified clinician before changing therapy.