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Yet, human paradigms that model approach-avoidance conflict and link it to brain function remain scarce. In particular, it has been emphasized the need for studying this conflict in social contexts. We developed a Social Approach-Avoidance Conflict (SAAC) task that involved a social evaluative demand manipulation, and combined it with functional magnetic resonance imaging (fMRI) in 135 young adults. On each trial, participants decided whether to accept a variable reward at the cost of increasing the presence of more or less demanding judges in a future public speaking evaluation, or to avoid and receive a minimal default reward. Depression and social anxiety (D-SA) symptoms were summarized into a single continuous dimension derived from principal component analysis of psychological questionnaires. Behaviourally, higher payments increased approach, whereas higher judge ranks increased negative affect and avoidance. Higher D-SA scores were associated with reduced positive and heightened negative emotional responses to higher-rank judges, stronger preferences for low-rank judges, and greater avoidance of high-rank judges. Neurally, increasing judge rank recruited the dmPFC\/dACC during approach decisions, and higher D-SA symptoms were associated with stronger responses in these regions. Increasing payment during approach engaged dmPFC\/vmPFC, PCC, and posterior insula, and these reward-related responses were attenuated at higher D-SA levels. In conclusion, internalizing symptoms of depression and social anxiety are associated with a bias in emotional and behavioural responses when a reward competes with a social evaluative threat. At the neural level, internalizing symptoms were associated with an enhanced aversive\/conflict signalling in the dmPFC\/dACC, and with reduced reward-related activity. Findings shed light on the mechanisms underlying costly social avoidance in internalizing disorders.<\/jats:p>","DOI":"10.1162\/imag.a.1363","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T20:01:45Z","timestamp":1787256105000},"update-policy":"https:\/\/doi.org\/10.1162\/mitpressjournals.corrections.policy","source":"Crossref","is-referenced-by-count":0,"title":["Social approach-avoidance conflict: Behavioural, emotional, and neural correlates along a depression\u2013social anxiety spectrum"],"prefix":"10.1162","volume":"4","author":[{"given":"Francisco","family":"Cervantes Constantino","sequence":"first","affiliation":[{"name":"Center for Basic Research in Psychology (CIBPsi), Facultad de Psicolog\u00eda, Universidad de la Rep\u00fablica, Montevideo, Uruguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejo","family":"Acu\u00f1a","sequence":"additional","affiliation":[{"name":"Center for Basic Research in Psychology (CIBPsi), 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