Reward Processing and Exposure Therapy for Social Anxiety Disorder

Inclusion Criteria:

* Diagnosis of social anxiety disorder from the Structural Clinical Interview for DSM 5.
* Elevated fear of public speaking, defined as a score of \>= 66 (+1SD from the mean of population norms on a scale of 17-85) on the Public Speaking Anxiety Scale (PSAS; Bartholomay, E. M., \& Houlihan, D. D. (2016). Public Speaking Anxiety Scale: Preliminary psychometric data and scale validation. Personality and individual differences, 94, 211-215), which is a self-report scale measuring anxiety of public speaking.
* Low reward processing, defined as a score of \<56 (less than the population mean) on the Dimensional Anhedonia Rating Scale (DARS) (Rizvi, S. J., Quilty, L. C., Sproule, B. A., Cyriac, A., Bagby, R. M., \& Kennedy, S. H. (2015). Dimensional Anhedonia Rating Scale (DARS) \[Database record\]. APA PsycTests).
* Medication-free or stabilized on psychotropic medications for a minimum standard length of time (1 month for benzodiazepines and beta blockers, 3 months for SRIs/SNRIs and heterocyclics).
* Psychotherapy-free or stabilized on alternative psychotherapies other than cognitive or behavioral therapies that were not focused on their anxiety disorder for at least 6 months prior to study entry.
* Age 18-60.
* Fluent in English.
* To conduct MRI version of fear conditioning task, must have no MRI contraindications.

Exclusion Criteria (none of the following):

* Recent suicidal ideation with intent or plan - defined as suicidal ideation with intent or plan in the past year.
* Lifetime history of suicide attempts.
* History of bipolar disorder, psychosis, intellectual disability, or organic brain damage.
* Substance use disorder within the last 6 months.
* Major respiratory, cardiovascular, pulmonary, neurological, or muscular-skeletal diseases.
* Pregnant or planning to become pregnant for next 6 months.