Self-consciousness in adolescent and adult social anxiety: A systematic review of fMRI and EEG findings.

Social anxiety often emerges during adolescence, marked by heightened self-consciousness and sensitivity to social evaluation, then persists in adulthood. This systematic review synthesizes findings from studies using functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) to examine self-conscious processing in socially anxious adolescents and adults. Following PRISMA guidelines, we reviewed 47 studies (2008-July 2025) and conducted a narrative synthesis with a descriptive synthesis restricted to personally evaluative fear of negative evaluation tasks. fMRI studies most commonly reported heightened activation in brain regions associated with self-evaluation and social threat processing, including the medial prefrontal cortex, anterior cingulate cortex, and insula. EEG event-related potential (ERP) studies identified enhanced amplitudes in early (P2) and late (late positive potential) components in response to negative self-descriptors, suggesting increased attentional and emotional reactivity. Many findings came from studies using the self-referential encoding task (SRET), which prompts self-processing and social evaluation. While fMRI provides spatial precision, ERP methods capture the temporal dynamics of self-related threat sensitivity. Together, the findings support altered self-conscious processing as a neurobiological feature of social anxiety in adolescents and adults. fMRI and EEG offer complementary strengths for identifying potential diagnostic markers and treatment targets. Future research should integrate both methods and examine developmental trajectories to improve mechanistic understanding and inform personalized interventions.