The error-related negativity (ERN) and psychopathology: toward an endophenotype

The error-related negativity (ERN) moderates the association between interpersonal stress and anxiety symptoms six months later

Anxiety disorders are often preceded by interpersonal stress; however, most individuals who experience stress do not develop anxiety, making it difficult to predict who is most susceptible to stress. One proposed trans-diagnostic neural risk marker for anxiety is the error-related negativity (ERN), a negative deflection in the event-related potential waveform occurring within 100 ms of error commission. The present study sought to investigate whether interpersonal stress experienced over the course of a year interacts with ERN magnitude to prospectively predict anxiety symptoms. A sample of 57 emerging adults performed an arrow flanker task to elicit the ERN at the start of the academic school year (time one). Toward the end of the academic year (time two), participants reported on past-year interpersonal stress and anxiety symptoms. Stress interacted with ERN magnitude to predict anxiety symptoms, whereby, for individuals with an enhanced ERN at time one, greater interpersonal stress over the course of a year was significantly associated with increased anxiety symptoms at time two, even controlling for anxiety symptoms at time one. These findings suggest that enhanced performance monitoring may render individuals more susceptible to the adverse effects of interpersonal stress, thereby increasing risk for heightened anxiety.

Establishing norms for error-related brain activity during the arrow Flanker task among young adults

Psychological assessments typically rely on self-report and behavioral measures. Augmenting these with neurophysiological measures of the construct in question may increase the accuracy and predictive power of these assessments. Moreover, thinking about neurophysiological measures from an assessment perspective may facilitate under-utilized research approaches (e.g., brain-based recruitment of participants). However, the lack of normative data for most neurophysiological measures has prevented the comparison of individual responses to the general population, precluding these approaches. The current work examines the distributions of two event-related potentials (ERPs) commonly used in individual differences research: the error-related negativity (ERN) and error positivity (Pe). Across three lab sites, 800 unselected participants between the ages of 18 and 30 performed the arrow version of a Flanker task while EEG was recorded. Percentile scores and distributions for ERPs on error trials, correct trials, and the difference (ΔERN, ΔPe; error minus correct) at Fz, Cz and Pz are reported. The 25th, 50th, and 75th percentile values for the ΔERN at Cz were -2.37 ​μV, -5.41 ​μV, and -8.65 ​μV, respectively. The same values for ΔPe at Cz were 7.51 ​μV, 11.18 ​μV, and 15.55 ​μV. Females displayed significantly larger ΔPe magnitudes and smaller ΔERN magnitudes than males. Additionally, normative data for behavioral performance (accuracy, post-error slowing, and reaction time) on the Flanker task is reported. Results provide a means by which ERN and Pe amplitudes of young adults elicited by the arrow Flanker task can be benchmarked, facilitating the classification of neural responses as 'large,' 'medium,' or 'small'. The ability to classify responses in this manner is a necessary step towards expanded use of these measures in assessment and research settings. These norms may not apply to ERPs elicited by other tasks, and future work should establish similar norms using other tasks.

The Utility of Event-Related Potentials in Clinical Psychology

Event-related potentials (ERPs) are direct measures of brain activity that can be leveraged for clinically meaningful research. They can relate robustly both to continuous measures of individual difference and to categorical diagnoses in ways that clarify similarities and distinctions between apparently related disorders and traits. ERPs can be linked to genetic risk, can act as moderators of developmental trajectories and responses to stress, and can be leveraged to identify those at greater risk for psychopathology, especially when used in combination with other neural and self-report measures. ERPs can inform models of the development of, and risk for, psychopathology. Finally, ERPs can be used as targets for existing and novel interventions and prevention efforts. We provide concrete examples for each of these possibilities by focusing on programmatic research on the error-related negativity and anxiety, and thus show that ERPs are poised to make greater contributions toward the identification, prediction, treatment, and prevention of mental disorders.

Infant behavioral inhibition predicts personality and social outcomes three decades later

Does infant temperament predict adult personality and life-course patterns? To date, there is scant evidence examining relations between child temperament and adult outcomes, and extant research has relied on limited methods for measuring temperament such as maternal report. This prospective longitudinal study followed a cohort of infants (n = 165) for three decades to examine whether infant behavioral inhibition, a temperament characterized by cautious and fearful behaviors to unfamiliar situations, shapes long-term personality, social relationships, vocational/education, and mental health outcomes in adulthood. At age 14 mo, behavioral inhibition was assessed using an observation paradigm. In adolescence (15 y; n = 115), error monitoring event-related potentials were measured in a flanker task. In adulthood (26 y; n = 109), personality, psychopathology, and sociodemographics were self-reported using questionnaires. We found that infants with higher levels of behavioral inhibition at 14 mo grew up to become more reserved and introverted adults (β = 0.34) with lower social functioning with friends and family (β = -0.23) at age 26. Infant behavioral inhibition was also a specific risk factor for adult internalizing (i.e., anxiety and depression, β = 0.20) psychopathology, rather than a transdiagnostic risk for general and externalizing psychopathology. We identified a neurophysiologic mechanism underlying risk and resilience for later psychopathology. Heightened error monitoring in adolescence moderated higher levels of adult internalizing psychopathology among behaviorally inhibited individuals. These findings suggest meaningful continuity between infant temperament and the development of adult personality. They provide the earliest evidence suggesting that the foundation of long-term well-being is rooted in individual differences in temperament observed in infancy.

The erring brain: Error-related negativity as an endophenotype for OCD-A review and meta-analysis

Obsessive-compulsive disorder (OCD) is a complex and heterogeneous disorder that is associated with high personal and societal costs. Feelings of doubt, worry, and repetitive behavior, key symptoms of OCD, have been linked to hyperactive error signals in the brain. The error-related negativity (ERN) represents a validated marker of error processing in the ERP. Increased ERN amplitudes in OCD have been reported very robustly over the last 20 years. This article integrates results from 38 studies analyzing the ERN in OCD, using a quantitative meta-analysis. Meta-regressions were used to examine potential moderators such as task type, symptom severity, age, and sample size. The meta-analysis reveals a robust increase of ERN in OCD patients compared to healthy participants in response-conflict tasks (SMD -0.55) that is not modulated by symptom severity and age. No increase in ERN in OCD was observed in tasks that do not induce response conflict (SMD -0.10). In addition to the meta-analysis, the current article reviews evidence supporting that increased ERN amplitudes in OCD fulfill central criteria for an endophenotype. Further, the specificity of increased ERN amplitudes for OCD and its suitability as a potential transdiagnostic endophenotype is discussed. Finally, the clinical utility and clinical applications are examined. Overall, the evidence that increased ERN amplitudes represent a promising endophenotype indicating vulnerability for OCD is compelling. Furthermore, alterations in ERN are not limited to OCD and may constitute a transdiagnostic endophenotype. Altered neural error signals might serve as a diagnostic or predictive marker and represent a promising target for interventions.

Intolerance of uncertainty, depression and the error-related negativity

Prior work has yielded contradictory findings regarding the association between depression and the error-related negativity (ERN), an event-related potential thought to reflect individual variation in sensitivity to internal threat (i.e., errors), and the error positivity (Pe), which is thought to reflect more elaborative, conscious processing of errors. One possibility is that variation in transdiagnostic dimensional constructs related to threat processing might help explain inconsistencies in the relationship between depression and the ERN and Pe. Here, we used a large, unselected sample (N = 100) to determine whether variation in intolerance of uncertainty (IU), a transdiagnostic trait dimension that is implicated in both depression and anxiety, might moderate associations between depressive symptomatology and error processing. Results showed that greater levels of depressive symptomatology were associated with larger ΔERNs (error minus correct trials) when IU was low, but were unrelated to ΔERN when IU was high; main effects of depression and IU on ΔERN were not observed. The Pe was not associated with IU or depression. Additionally, IU, but not depression, was associated with faster response times on error and correct trials. Overall, results suggest that error processing may differ for individuals with elevated depression with versus without elevated IU. Moreover, prior failures to observe associations between depression and the ERN might stem from failure to account for related transdiagnostic constructs.

Endophenotypes of executive functions in obsessive compulsive disorder? A meta-analysis in unaffected relatives

Endophenotypes are mediator traits between genetic influences and clinical phenotypes. Meta-analyses have consistently shown modest impairments of executive functioning in obsessive compulsive disorder (OCD) patients compared to healthy controls. Similar deficits have also been reported in unaffected relatives of OCD patients, but have not been quantified. We conducted the first meta-analysis combining all studies investigating executive functioning in unaffected relatives of individuals with OCD to quantify any deficits. A search of Pubmed, Medline and PsychInfo databases identified 21 suitable papers comprising 707 unaffected relatives of OCD patients and 842 healthy controls. Effect sizes were calculated using random effects models. Unaffected relatives displayed a significant impairment in global executive functioning. Analyses of specific executive functioning subdomains revealed impairments in: planning, visuospatial working memory and verbal fluency. Deficits in executive functioning are promising endophenotypes for OCD. To identify further biomarkers of disease risk/resilience in OCD, we suggest examining specific executive functioning domains.

Treatment-related changes towards normalization of the abnormal external signal processing in panic disorder

Despite the scientific consensus on the efficacy of psychotherapy for the treatment of psychological disorders, the evidence of treatment-related changes towards normalization of abnormal brain functions in patients is mixed. In the present experiment, we investigated whether treatment can affect early information processing, by testing abnormal event-related potentials (ERPs) evoked by internal and external signals in panic disorder. Sixteen patients with panic disorder and comorbid personality disorder and sixteen control participants performed a response-choice task and a passive viewing task in two testing sessions, separated by around 14 months. During this period, patients received psychological treatment. In agreement with previous studies of performance monitoring, the abnormal amplitude of the Ne/ERN–an index of error processing based on internal signals—did not change between the first and second testing session. However, treatment-related changes were evident for the abnormal vertex positive potential (VPP) evoked by external signals in the response-choice task and the passive viewing task. In patients, the VPP was smaller in the second session compared to the first session, whereas no significant changes occurred in controls. This result supplies evidence of treatment-related changes towards normalization in the early information processing of external visual stimuli in panic disorder.

Electrophysiological responses to appetitive and aversive outcomes: A comparison of college drinkers and non-drinkers

The current study compared electrophysiological responses (the feedback-related negativity [FRN]) to appetitive and aversive outcomes between a group of college drinkers and non-drinkers. 50 undergraduate students completed a passive, slot machine-like task while their electroencephalographic data was recorded to extract the FRN to unexpected appetitive and aversive outcomes. In the appetitive condition, participants could expectedly or unexpectedly win $1 or not win $1 and in the aversive condition participants could expectedly or unexpectedly be exposed to a loud noise burst or silence. The FRN was recorded in response to a cue indicating the outcome. Participants also reported on the number of drinks they consumed in a typical week to establish drinking status (drinker/non-drinker). Results showed that non-drinkers had a larger FRN in the aversive task compared to the appetitive task while drinkers had similar FRNs between the tasks. Drinkers had a significantly smaller aversive outcome related FRN compared to non-drinkers. Neural sensitivity to aversive outcomes might be a marker of decreased punishment sensitivity in college drinkers compared to non-drinkers, contributing to unhealthy drinking behavior.

Enhanced error-related brain activations for mistakes that harm others: ERP evidence from a novel social performance-monitoring paradigm

Our mistakes often have negative consequences for ourselves, but may also harm the people around us. Continuous monitoring of our performance is therefore crucial for both our own and others' well-being. Here, we investigated how modulations in responsibility for other's harm affects electrophysiological correlates of performance-monitoring, viz. the error-related negativity (ERN) and error positivity (Pe). Healthy participants (N = 27) performed a novel social performance-monitoring paradigm in two responsibility contexts. Mistakes made in the harmful context resulted in a negative consequence for a co-actor, i.e., hearing a loud aversive sound, while errors in the non-harmful context were followed by a soft non-aversive sound. Although participants themselves did not receive auditory feedback in either context, they did experience harmful mistakes as more distressing and reported higher effort to perform well in the harmful context. ERN amplitudes were enhanced for harmful compared to non-harmful mistakes. Pe amplitudes were unaffected. The present study shows that performing in a potentially harmful social context amplifies early automatic performance-monitoring processes and increases the impact of the resulting harmful mistakes. These outcomes not only further our theoretical knowledge of social performance monitoring, but also demonstrate a novel and useful paradigm to investigate aberrant responsibility attitudes in various clinical populations.

Diagnostic Utility of Sodium Lactate Infusion and CO2-35% Inhalation for Panic Disorder

Laboratory measures have played an integral role in diagnosing pathology; however, compared to traditional medicine, psychiatric medicine has lagged behind in using such measures. A growing body of literature has begun to examine the viability and development of different laboratory measures in order to diagnose psychopathologies. The present review examines the current state of development of both sodium lactate infusion and CO2-35% inhalation as potential ancillary measures to diagnose panic disorder (PD). A previously established 3-step approach to identifying laboratory-based diagnostic tests was applied to available literature assessing the ability of both sodium lactate infusion or CO2-35% inhalation to induce panic attacks in PD patients, healthy controls, and individuals with other psychiatric conditions. Results suggest that across the literature reviewed, individuals with PD were more likely to exhibit panic attacks following administration of sodium lactate or CO2-35% compared to control participants. The majority of the studies examined only compared individuals with PD to healthy controls, suggesting that these ancillary measures are underdeveloped. In order to further determine the utility of these ancillary measures, research is needed to determine if panic attacks following administration of these chemical agents are unique to PD, or if individuals with related pathologies also respond, which may be indicative of transdiagnostic characteristics found across disorders.

Error-Related Neural Responses Recorded by Electroencephalography During Post-stroke Rehabilitation Movements

Error-related potential (ErrP) based assist-as-needed robot-therapy can be an effective rehabilitation method. To date, several studies have shown the presence of ErrP under various task situations. However, in the context of assist-as-needed methods, the existence of ErrP is unexplored. Therefore, the principal objective of this study is to determine if an ErrP can be evoked when a subject is unable to complete a physical exercise in a given time. Fifteen stroke patients participated in an experiment that involved performing a physical rehabilitation exercise. Results showed that the electroencephalographic (EEG) response of the trials, where patients failed to complete the exercise, against the trials, where patients successfully completed the exercise, significantly differ from each other, and the resulting difference of event-related potentials resembles the previously reported ErrP signals as well as has some unique features. Along with the highly statistically significant difference, the trials differ in time-frequency patterns and scalp distribution maps. In summary, the results of the study provide a novel basis for the detection of the failure against the success events while executing rehabilitation exercises that can be used to improve the state-of-the-art robot-assisted rehabilitation methods.

Funny kittens: Positive mood induced via short video-clips affects error processing but not conflict control

The interplay of performance monitoring functions and affective variables labeled as moods or emotions has been investigated within different theoretical frameworks including conflict adaptation and reinforcement learning. However, results regarding the electrophysiological underpinnings of performance monitoring such as the error-related negativity (ERN), the N200 or the error positivity (Pe) remain largely inconsistent. While some studies report ERN enhancements after positive mood induction, others find reductions due to positive affect. An additional source of complexity regards the manifold induction methods across studies. Here, we investigated whether performance-independent, blocked mood inductions via mini-clips alter electrophysiological markers of performance monitoring. Positive clips consisted of a pre-rated collection of human and animal funny/fail videos, while neutral clips showed natural scenes of humans and animals or sport events. The main task was a modified flanker paradigm. The effectivity of mood induction was confirmed via recorded skin conductance response (SCR), facial-muscle electromyogram (EMG) and intermittent subjective mood questionnaires. Regarding interference control neither reaction times nor error rates were influenced by mood induction, similarly no mood effects of the N2 component were observed. In contrast, we found enhanced ERN as well as Pe amplitudes in the positive compared to the neutral condition. Additional to post error slowing we found increased interference effects after errors in positive blocks on the behavioral level. The results suggest a specific receptiveness of evaluative control components to positive affect that will be discussed regarding their possible neuronal underpinnings.

Differentiating electrophysiological indices of internal and external performance monitoring: Relationship with perfectionism and locus of control

The impact of individual differences on performance monitoring and psychopathology is a question of active debate. Personality traits associated with psychopathology may be related to poor internal performance monitoring (as measured by the error-related negativity [ERN]) but intact external performance monitoring (as measured by the reward positivity [RewP]), suggesting that there are underlying neural differences between internal and external performance monitoring processes. We tested the relationships between individual difference measures of perfectionism, locus of control, and ERN, error-positivity (Pe), and RewP component difference amplitude in a healthy undergraduate sample. A total of 128 participants (69 female, M(SD)age = 20.6(2.0) years) completed two tasks: a modified version of the Eriksen Flanker and a doors gambling task along with the Frost Multidimensional Perfectionism scale, the Rotter Locus of Control scale, and the Levenson Multidimensional Locus of Control scale to quantify perfectionism and locus of control traits, respectively. Linear regressions adjusting for age and gender showed that neither ΔERN nor ΔRewP amplitude were significantly moderated by perfectionism or locus of control scores. Findings suggest that, in psychiatrically-healthy individuals, there is not a strong link between perfectionism, locus of control, and ERN or RewP amplitude. Future research on individual difference measures in people with psychopathology may provide further insight into how these personality traits affect performance monitoring.

Punishment has a persistent effect on error-related brain activity in highly anxious individuals twenty-four hours after conditioning

The ability to detect and respond to errors, and to subsequently recruit cognitive control to remediate those errors, is critical to successful adaptation in a changing environment. However, there is also evidence that, for anxious individuals, this error signal is enhanced, highlighting affective and motivational influences on error monitoring. These individual differences arise as a function of both genetic influences and learning experiences. In this study, we examined punishment-based modulation of the error-related negativity (ERN) in high and low anxious individuals across two days. Twenty-two low- and 25 high-anxious participants performed a Flanker task in a standard and punishment condition in three phases (Day one: acquisition and extinction 1, Day two: extinction 2). During the acquisition phase, errors in one condition were punished by a loud noise. This was followed by an immediate extinction phase (extinction 1), during which errors were no longer punished, and an identical extinction phase 24 h later (extinction 2). Only high anxious individuals showed increased ERN amplitudes in the punishment compared to the standard condition. This effect was not modulated by phase and was observed across acquisition and both extinction phases, such that anxious individuals appeared not to learn that the threat value of formerly-punished errors had changed in the course of the experiment. These data suggest that environmental factors (i.e., punishment) can have a persistent effect on the magnitude of the ERN, particularly for anxious individuals. This may point to a pathogenic mechanism linking learning experiences with the development of overactive error-monitoring in anxiety.

Efficient but less active monitoring system in individuals with high aggressive predispositions

Aggressive behaviors in pathological and healthy populations have been largely related to poor cognitive control functioning. However, few studies have investigated the influence of aggressive traits (i.e., aggressiveness) on cognitive control. In the current study, we investigated the effects of aggressiveness on cognitive control abilities and particularly, on performance monitoring. Thirty-two participants performed a Simon task while electroencephalography (EEG) and electromyography (EMG) were recorded. Participants were classified as having high and low levels of aggressiveness using the BPAQ questionnaire (Buss and Perry, 1992). EMG recordings were used to reveal three response types by uncovering small incorrect muscular activations in ~15% of correct trials (i.e., partial-errors) that must be distinguished from full-error and pure-correct responses. For these three response types, EEG recordings were used to extract fronto-central negativities indicative of performance monitoring, the error and correct (-related) negativities (ERN/Ne and CRN/Nc). Behavioral results indicated that the high aggressiveness group had a larger congruency effect compared to the low aggressiveness group, but there were no differences in accuracy. EEG results revealed a global reduction in performance-related negativity amplitudes in all the response types in the high aggressiveness group compared to the low aggressiveness group. Interestingly, the distinction between the ERN/Ne and the CRN/Nc components was preserved both in high and low aggressiveness groups. In sum, high aggressive traits do not affect the capacity to self-evaluate erroneous from correct actions but are associated with a decrease in the importance given to one's own performance. The implication of these findings are discussed in relation to pathological aggressiveness.

Moderation of the relationship between the error-related negativity and anxiety by age and gender in young children: A preliminary investigation

The error-related negativity (ERN) is a neurophysiologic response to errors that associates with anxiety. Despite the potential relevance of the ERN for understanding mechanisms of early anxiety problems in the developing brain, the relation between ERN and anxious symptoms in young children remains poorly understood. Emerging evidence suggests that ERN-anxiety associations could vary by developmental stage, but this work requires replication and consideration of gender effects, given earlier maturation of the ERN and higher rates of anxiety problems in girls relative to boys. To address this gap, the ERN was collected in 49 preschool- to school-aged children (ages 4-9; 26 girls) sampled across a wide range of anxiety severity. Regression analyses revealed that ERN - anxiety associations depended on age and gender. Specifically, larger (more negative) ERN associated with more anxiety in older girls, whereas smaller ERN associated with more anxiety symptoms in younger girls. No ERN-anxiety association was found in boys. These findings suggest that age and gender moderate the direction of the relation between ERN and anxiety in early childhood and could have important implications for the development of ERN-based risk identification and targeted treatment strategies tailored to individual children.

The Relation Between Trait Anger and Impulse Control in Forensic Psychiatric Patients: An EEG Study

Inhibitory control is considered to be one of the key factors in explaining individual differences in trait anger and reactive aggression. Yet, only a few studies have assessed electroencephalographic (EEG) activity with respect to response inhibition in high trait anger individuals. The main goal of this study was therefore to investigate whether individual differences in trait anger in forensic psychiatric patients are associated with individual differences in anger-primed inhibitory control using behavioral and electrophysiological measures of response inhibition. Thirty-eight forensic psychiatric patients who had a medium to high risk of recidivism of violent and/or non-violent behaviors performed an affective Go/NoGo task while EEG was recorded. On the behavioral level, we found higher scores on trait anger to be accompanied by lower accuracy on NoGo trials, especially when anger was primed. With respect to the physiological data we found, as expected, a significant inverse relation between trait anger and the error related negativity amplitudes. Contrary to expectation, trait anger was not related to the stimulus-locked event related potentials (i.e., N2/P3). The results of this study support the notion that in a forensic population trait anger is inversely related to impulse control, particularly in hostile contexts. Moreover, our data suggest that higher scores on trait anger are associated with deficits in automatic error-processing which may contribute the continuation of impulsive angry behaviors despite their negative consequences.

The relationship between chronic perceived stress and error processing: evidence from event-related potentials

Prolonged exposure to stress has a wide effect on the brain and cognition. Error processing, as one of the crucial components of executive function, plays an important role in cognitive and behavior control. However, to date, there is little research addressing the relationship between chronic perceived stress and error processing. The present study aims to explore the relationship between chronic perceived stress by the Cohen Perceived Stress Scale (PSS) and different stages of error processing by the method of Event-Related Potential (ERP). The error processing was tested in a classical auditory Go/NoGo paradigm, and ERP components including early Error-related Negativity (ERN) and late Error Positivity (Pe) were computed as the indices of error processing. The results showed that the PSS score was positively correlated with the Pe amplitude but not with the ERN amplitude. The correlation between PSS and the Pe amplitude holds true even after controlling the trait anxiety and depression symptoms. These results suggest that the higher the chronic stress level, the more sensitive the individuals are to their own errors as well as the more emotional/motivated attention the individuals distributed to their own errors.

Error-related neural activity and alcohol use disorder: Differences from risk to remission

Studies suggest that individuals with alcohol use disorder (AUD) display abnormal neural error-processing, measured via the error-related negativity (ERN). The nature of the error-related abnormalities in AUD is unclear, however, as prior research has yielded discrepant findings. In addition, no study to date has attempted to characterize the dispositional nature of the ERN in AUD and directly test to what extent ERN amplitude reflects a risk factor, disease marker, and/or scar of AUD psychopathology. The current study compared ERN amplitude across 244 adult volunteers in the following five groups: 1) current AUD (n = 39), 2) AUD in remission (n = 60), 3) at-risk for AUD (n = 43), 4) psychiatric controls with comparable rates of internalizing psychopathology as the AUD groups (n = 53), and 5) healthy controls with no lifetime history of psychopathology (n = 49). Risk for AUD was defined as a positive, first-degree family history. All participants completed a well-validated flanker task, designed to robustly elicit the ERN, during continuous electroencephalographic (EEG) data collection. Results indicated that individuals with current AUD displayed smaller ERNs compared with individuals at-risk for AUD, with AUD in remission, psychiatric controls, and healthy controls. There were no differences amongst any of the other groups. This suggests that a blunted ERN may be concomitant with current AUD psychopathology and relatedly, a novel neurobiological AUD treatment target and/or objective marker of AUD disease status.

Effects of menstrual cycle phase on associations between the error-related negativity and checking symptoms in women

The menstrual cycle is known to impact mood and cognitive function and has been shown to lead to variability in symptoms of obsessive-compulsive disorders and anxiety. Using a within-subject design, the present study examined ovarian hormones, the error-related negativity (ERN), and self-reported checking symptoms in both the mid-follicular and mid-luteal phases of the menstrual cycle. ERN amplitude and checking symptom severity did not vary between the follicular and luteal phases. However, a more negative ERN was associated with greater checking symptoms in the luteal phase of the menstrual cycle, even when controlling for ERN amplitude in the follicular phase. Moreover, changes in checking symptoms between phases were associated with phase-related changes in the ERN. Finally, a significant mediation model was found such that the ERN measured in the luteal phase mediated the association between progesterone in the luteal phase and checking symptoms in the luteal phase. Collectively, the present findings suggest that levels of progesterone in the luteal phase could impact checking symptoms by modulating response monitoring and sensitivity to errors, and that fluctuation in the ERN between menstrual cycle phases may play an important role in the expression of anxious and obsessive-compulsive symptoms.

Overprotective/authoritarian maternal parenting is associated with an enhanced error-related negativity (ERN) in emerging adult females

Error monitoring is crucial for survival and adaptation, and can be indexed by the error-related negativity (ERN), a fronto-centrally located negative deflection in the event-related potential (ERP) waveform that differentiates erroneous from correct responses within 100 ms of a response. The ERN is seen as an early neural signal indicating the need to adjust performance and increase executive control. Previous findings indicate that punishing errors increases ERN magnitude, and that punitive parenting predicts an enhanced ERN in children. If punitive parenting can in fact sensitize children to error commission over the long term, an enhanced ERN should be seen in adults who experienced harsh parenting as children. The present study thus sought to establish whether punitive parenting is associated with an enhanced ERN in emerging adulthood. A sample of 70 emerging adult females reported on their mothers' and fathers' parenting styles separately and performed a flanker task to elicit the ERN. Higher reported overprotective/authoritarian maternal behavior was associated with an enhanced ERN. These results provide further support for the hypothesis that punitive parenting may lead to long-term sensitization of neural networks involved in performance monitoring.

Social context effects on error-related brain activity are dependent on interpersonal and achievement-related traits

Brain correlates of performance monitoring, such as the Error-Related Negativity (ERN), are considerably influenced by situational factors. For instance, errors committed during social interaction typically elicit enhanced ERNs. While individual differences in ERN magnitude have been implicated in a wide variety of psychopathologies, it remains unclear how individual dispositions may interact with situational incentives to influence performance monitoring. Here, we analysed how interpersonal (Affiliation) and achievement-related (Agency) traits moderated the effects of interpersonal competition and interpersonal cooperation on the ERN. For this purpose, electroencephalography was collected from 78 participants while they performed a Flanker Task either in a competitive or in a cooperative social context (i.e., between-subjects design). We found that competition predicted enhanced error-related activity patterns compared to cooperation. Furthermore, participants who scored high in Affiliation elicited enhanced error-related activity. Conversely, high Agency scores were associated with reduced error-related activity, but this was only observed in the competitive context. These results indicate that the brain's response to error commission is not only sensitive to social incentives. Rather, the activity of the evaluative system that produces error signals appears to be crucially determined by the personal relevance of the incentives present in the context in which performance is evaluated.

Practitioner Review: Emotional dysregulation in attention-deficit/hyperactivity disorder - implications for clinical recognition and intervention

BACKGROUND

Because emotional symptoms are common in attention-deficit/hyperactivity disorder (ADHD) patients and associate with much morbidity, some consider it to be a core feature rather than an associated trait. Others argue that emotional symptoms are too nonspecific for use as diagnostic criteria. This debate has been difficult to resolve due, in part, to the many terms used to describe emotional symptoms in ADHD and to concerns about overlap with mood disorders.

METHODS

We sought to clarify the nature of emotional symptoms in ADHD by reviewing conceptual and measurement issues and by examining the evidence base regarding specificity of such symptoms for ADHD. We reviewed the various terms used to define emotional symptoms in ADHD, clarify how these symptoms are demarcated from mood disorders, and assess the possibility that symptoms of emotional impulsivity and deficient emotional self-regulation should be considered as core symptoms. We addressed psychiatric comorbidities, the effects of ADHD treatments on associated emotional dysregulation, and the utility of current rating scales to assess emotional symptoms associated with ADHD.

RESULTS

Emotional symptoms are common and persistent in youth and adults with ADHD. Although emotional symptoms are common in other psychiatric disorders, emotional impulsivity (EI), and deficient emotional self-regulation (DESR) may be sufficiently specific for ADHD to function as diagnostic criteria.

CONCLUSIONS

Emotional symptoms in ADHD cause clinically significant impairments. Although there is a solid theoretical rationale for considering EI and DESR to be core symptoms of ADHD, there is no consensus about how to define these constructs sin a manner that would be specific to the disorder. An instrument to measure EI and DESR which demarcates them from irritability and other emotional symptoms could improve the accuracy of diagnostic criteria for ADHD.

Gender differences in the relation between the late positive potential in response to anxiety sensitivity images and self-reported anxiety sensitivity

Anxiety sensitivity (AS), or the fear of anxious arousal, is a transdiagnostic risk factor predictive of a wide variety of affective disorders. Whereas AS is widely studied via self-report, the neurophysiological correlates of AS are poorly understood. One specific issue this may help resolve is well-established gender differences in mean levels of AS. The current study evaluated late positive potential (LPP) for images designed to target AS during an emotional picture viewing paradigm. Structural equation modeling was used to examine convergent and discriminant validity for self-report AS and the LPP for AS images, considering gender as a potential moderator. Analyses were conducted in an at-risk sample of 251 community adults (M age = 35.47, SD = 15.95; 56.2% female; 53.6% meeting for a primary Axis I anxiety or related disorder). Findings indicated that the AS image LPP was significantly, uniquely associated with self-report AS, controlling for the LPP for unpleasant images, in females only. Mean levels of AS self-report as well as the AS image LPP were higher in females than in males. These findings provide initial support for the AS image LPP as a useful neurophysiological correlate of AS self-report in females. These findings also provide support for a biological cause for gender differences in AS. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Single-Neuron Correlates of Error Monitoring and Post-Error Adjustments in Human Medial Frontal Cortex

Humans can self-monitor errors without explicit feedback, resulting in behavioral adjustments on subsequent trials such as post-error slowing (PES). The error-related negativity (ERN) is a well-established macroscopic scalp EEG correlate of error self-monitoring, but its neural origins and relationship to PES remain unknown. We recorded in the frontal cortex of patients performing a Stroop task and found neurons that track self-monitored errors and error history in dorsal anterior cingulate cortex (dACC) and pre-supplementary motor area (pre-SMA). Both the intracranial ERN (iERN) and error neuron responses appeared first in pre-SMA, and ∼50 ms later in dACC. Error neuron responses were correlated with iERN amplitude on individual trials. In dACC, such error neuron-iERN synchrony and responses of error-history neurons predicted the magnitude of PES. These data reveal a human single-neuron correlate of the ERN and suggest that dACC synthesizes error information to recruit behavioral control through coordinated neural activity.

Forging Neuroimaging Targets for Recovery in Opioid Use Disorder

The United States is in the midst of an opioid epidemic and lacks a range of successful interventions to reduce this public health burden. Many individuals with opioid use disorder (OUD) consume drugs to relieve physical and/or emotional pain, a pattern that may increasingly result in death. The field of addiction research lacks a comprehensive understanding of physiological and neural mechanisms instantiating this cycle of Negative Reinforcement in OUD, resulting in limited interventions that successfully promote abstinence and recovery. Given the urgency of the opioid crisis, the present review highlights faulty brain circuitry and processes associated with OUD within the context of the Three-Stage Model of Addiction (1). This model underscores Negative Reinforcement processes as crucial to the maintenance and exacerbation of chronic substance use together with Binge/Intoxication and Preoccupation/Anticipation processes. This review focuses on cross-sectional as well as longitudinal studies of relapse and treatment outcome that employ magnetic resonance imaging (MRI), functional near-infrared spectroscopy (fNIRs), brain stimulation methods, and/or electroencephalography (EEG) explored in frequency and time domains (the latter measured by event-related potentials, or ERPs). We discuss strengths and limitations of this neuroimaging work with respect to study design and individual differences that may influence interpretation of findings (e.g., opioid use chronicity/recency, comorbid symptoms, and biological sex). Lastly, we translate gaps in the OUD literature, particularly with respect to Negative Reinforcement processes, into future research directions involving operant and classical conditioning involving aversion/stress. Overall, opioid-related stimuli may lessen their hold on frontocingulate mechanisms implicated in Preoccupation/Anticipation as a function of prolonged abstinence and that degree of frontocingulate impairment may predict treatment outcome. In addition, longitudinal studies suggest that brain stimulation/drug treatments and prolonged abstinence can change brain responses during Negative Reinforcement and Preoccupation/Anticipation to reduce salience of drug cues, which may attenuate further craving and relapse. Incorporating this neuroscience-derived knowledge with the Three-Stage Model of Addiction may offer a useful plan for delineating specific neurobiological targets for OUD treatment.

Examination of evaluative threat in worry: Insights from the Error-Related Negativity (ERN)

Recent research suggests atypical error-monitoring is important to understanding pathological anxiety. Because uncertainty is a transdiagnostic factor associated with anxiety and related disorders, recent research has begun to examine the influence of uncertainty in error-monitoring. Moreover, task irrelevant threat has been shown to influence cognitive performance in individuals with maladaptive anxiety. The current study aims to merge these literatures by examining the influence of task-irrelevant uncertain evaluative threat on error-monitoring using an event-related brain potential, the error-related negativity (ERN). Considering extensive literature indicating a relationship between worry and the ERN, worry was included as a continuous predictor in the analyses. Participants were randomly assigned to either a condition of negative or uncertain evaluative threat to determine their influence on error-monitoring in a Flankers task. Results for the ERN suggest that the ERN was significantly reduced only for the uncertain evaluative threat condition. The current study suggests that uncertain evaluative threat distractors result in a subsequent reduction in error-monitoring. This is consistent with literature suggesting that anxiety impairs inhibition of attentional processing of task irrelevant threatening information. This study adds to the burgeoning literature on the malleability of the ERN. Future research is needed to determine the mechanisms underlying this effect.

Differential engagement of cognitive control regions and subgenual cingulate based upon presence or absence of comorbid anxiety with depression

BACKGROUND

Major depressive disorder (MDD) and anxiety disorders are highly comorbid, sharing many similar symptoms, including impairments in cognitive control. Deficits in cognitive control could be a potential mechanism underlying impaired emotion regulation in mood disorders.

METHODS

Participants were 44 individuals with no history of mental illness (healthy controls, HC), 31 individuals in the remitted state of MDD (rMDD), and 18 individuals who met lifetime DSM-IV-TR criteria for rMDD and an anxiety disorder in remission (Comorbid). Participants completed a Parametric Go/No-Go (PGNG) test during fMRI. Event-related analyses modeled activity for cognitive control successes (Hits for Targets, Rejections for Lures) and failures (Commissions on Lures) on the PGNG task.

RESULTS

The rMDD group showed significantly reduced activity within the cognitive control network (CCN) during Commission errors, including the middle frontal gyrus and inferior parietal lobule (IPL). The Comorbid group showed significantly reduced activity in several clusters within the CCN during correct Rejections, including the left IPL and right inferior frontal gyrus and greater subgenual cingulate. Notably, during correct Rejections, 60% of activation for the Comorbid group was within the Salience and Emotion Network (SEN), with 0% within the CCN.

LIMITATIONS

The size of the Comorbid subgroup was modest, preventing subanalysis of the different AD subtypes.

CONCLUSIONS

There is evidence that CCN activity declines in rMDD and that there may be compensatory SEN activity in individuals with Comorbid rMDD and anxiety. Our findings support the identification of comorbid anxiety as a meaningful subtype of MDD that may obscure group differences between rMDD and HCs.

Internal and external signal processing in patients with panic disorder: An event-related potential (ERP) study

Self-absorption describes a pathological tendency towards the internal mental world (internalization) that often conflicts with the accurate monitoring of the external world. In performance monitoring, an augmented electrophysiological response evoked by internal signals in patients with anxiety or depressive disorder seems to reflect this tendency. Specifically, the error-related negativity (Ne/ERN), an index of error processing based on internal signals, is larger in patients compared to controls. In the present experiment, we investigated whether the preferential processing of internal signals in patients is linked to diminished and inflexible external signal processing. To this end, the electrophysiological response evoked by external signals was analysed in patients with panic disorder and healthy controls. Participants performed a choice-response task, where informative or uninformative feedback followed each response, and a passive viewing task. As a replication of previous studies, patients presented an augmented Ne/ERN, indexing enhanced processing of internal signals related to errors. Furthermore, the vertex positive potential (VPP) evoked by visual stimuli was larger in patients than in controls, suggesting enhanced attention to external signals. Moreover, patients and controls showed similar sensitivity to the feedback information content, indicating a normal flexibility in the allocation of monitoring resources to external signals depending on how informative these signals are for performance monitoring. These results suggest that the tendency towards internal signals in patients with panic disorder does not hinder the flexible processing of external signals. On the contrary, external signals seem to attract enhanced processing in patients compared to controls.

Depressive symptoms and error-related brain activity in CPS-referred children

Early adversity such as maltreatment is associated with increased risk for psychopathology and atypical neurological development in children. The present study examined associations between depressive symptoms and error-related brain activity (the error-related negativity, or ERN) among children involved with Child Protective Services (CPS) and among comparison children. Results indicate that the relation between depressive symptoms and ERN amplitude depends on CPS involvement, such that depressive symptoms were associated with blunted ERNs only for CPS-referred children. The present study can inform future research investigating the mechanisms by which experiences of adversity affect the association between symptoms and error-related brain activity.

Examining the relationships between error-related brain activity (the ERN) and anxiety disorders versus externalizing disorders in young children: Focusing on cognitive control, fear, and shyness

OBJECTIVE

We examine the relationship between individual differences in temperament (cognitive control, fear, and shyness) and the error-related negativity (i.e., the ERN) in a large sample of young children. Furthermore, we explore to what extent variation in temperament may underlie the associations between the ERN and anxiety disorders versus externalizing disorders.

METHOD

Using the Children's Behavior Questionnaire (CBQ), we focus on scales related to cognitive control (attentional focusing, attentional shifting, and inhibitory control) and a fearful/anxious temperament (fearfulness and shyness). We use diagnostic interviews to assess anxiety (specific phobia, separation anxiety disorder, social phobia, generalized anxiety disorder, obsessive-compulsive disorder, and agoraphobia) and externalizing disorders (attention deficit hyperactivity disorder; ADHD, and oppositional defiant disorder; ODD). A go/no-go task was used to measure the ERN.

RESULTS

Results suggest that while shyness was related to an increased ERN, fearfulness was associated with a decreased ERN. Moreover, increased cognitive control was related to an increased ERN, and an exploratory model suggested that while shyness displayed an independent relationship with the ERN, the relationship between fear and the ERN was accounted for by deficits in cognitive control. Additionally, we found that the ERN was increased in children with anxiety disorders, and that this association was explained by shyness, but not fear or cognitive control. In contrast, the ERN was blunted in children with externalizing disorders (ADHD or ODD), and this association was accounted for by lower levels of both shyness and cognitive control.

CONCLUSIONS

Overall, these results are novel insofar as they suggest that the temperamental factors of shyness and cognitive control may underlie the associations between the ERN and internalizing versus externalizing disorders.

A neural biomarker, the error-related negativity, predicts the first onset of generalized anxiety disorder in a large sample of adolescent females

OBJECTIVE

An increased neural response to making mistakes has emerged as a potential biomarker of anxiety across development. The error-related negativity (ERN) is an event-related potential elicited when people make mistakes on simple laboratory-based reaction time tasks that has been associated with risk for anxiety. This study examined whether the ERN prospectively predicted the first onset of generalized anxiety disorder (GAD) over 1.5 years in adolescent girls.

METHODS

The sample included 457 girls between the ages of 13.5 and 15.5 years, with no history of GAD. At baseline, the ERN was measured using a flankers task. Psychiatric history of the adolescent and biological parent was assessed with diagnostic interviews, and the adolescent completed a self-report questionnaire regarding anxiety symptoms. Approximately 1.5 years later, adolescents completed the same interview.

RESULTS

An increased neural response to errors at baseline predicted first-onset GAD over 1.5 years. The ERN was a significant predictor independent of other prominent risk factors, including baseline anxiety and depression symptoms and parental lifetime psychiatric history. Jointly the ERN and social anxiety symptoms provided the greatest power for predicting first-onset GAD.

CONCLUSIONS

This study provides evidence for the utility of the ERN as a biomarker of risk for GAD during a key developmental period.

The relationship between naturalistic sleep variation and error monitoring in young adults: An event-related potential (ERP) study

Sleep deprivation studies have highlighted the importance of adequate sleep for optimal daytime functioning. However, there is limited research exploring whether variations in natural sleep patterns produce similar difficulties to those seen in sleep deprivation studies. The aim of the current study was to explore whether naturalistic reductions in sleep duration and/or sleep quality were associated with behavioural and electrophysiological measures of cognitive control. Sixty undergraduate students were asked to wear an actigraph for 7 consecutive nights before completing a hybrid Flanker-Go/NoGo task whilst continuous EEG data were recorded. Participants were assigned to high or low sleep quality and short or long sleep duration groups using the National Sleep Foundation guidelines. Results indicated that individuals who, on average, slept <7 h each night showed inefficiencies in error-monitoring, as reflected by a reduction in amplitude of the error-related negativity (ERN) in comparison to those with longer sleep duration. These findings suggest that natural variations in sleep quantity are associated with atypical error detection.

Variation in reward- and error-related neural measures attributable to age, gender, race, and ethnicity

Event-related potentials (ERPs) have been widely applied to the study of individual differences in reward and error processing, including recent proposals of several ERPs as possible biomarkers of mental illness. A criterion for all biomarkers, however, is that they be generalizable across the relevant populations, something which has yet to be demonstrated for many commonly studied reward- and error-related ERPs. The aim of this study was to examine variation in reward and error-related ERPs across core demographic variables: age, gender, race, and ethnicity. Data was drawn from three studies with relatively large samples (N range 207-527). Results demonstrated that ERPs varied across the demographic variables of interest. Several examples include attenuated reward-related ERPs with increasing age, larger error-related ERPs for men than women, and larger ERPs to feedback after losses for individuals who identified as Hispanic/Latino. Overall, these analyses suggest systematic variation in ERPs that is attributable to core demographic variables, which could give rise to seemingly inconsistent results across studies to the extent that these sample characteristics differ. Future psychophysiological studies should include these analyses as standard practice and assess how these differences might exacerbate, mask, or confound relationships of interest.

Response Inhibition Deficits in Insomnia Disorder: An Event-Related Potential Study With the Stop-Signal Task

Background: Response inhibition is a hallmark of executive function, which was detected impaired in various psychiatric disorders. However, whether insomnia disorder (ID) impairs response inhibition has caused great controversy.

Methods: Using the auditory stop-signal paradigm coupled with event-related potentials (ERPs), we carried out this study to examine whether individuals with ID presented response inhibition deficits and further investigated the neural mechanism correlated to these deficits. Twelve individuals with ID and 13 matched good sleepers (GSs) had participated in this study, and then they performed an auditory stop-signal task (SST) in the laboratory setting with high density EEG recordings.

Results: The behavioral results revealed that compared to GSs, patients with ID presented significantly longer stop-signal reaction time (SSRT), suggesting the impairment of motor inhibition among insomniacs. Their reaction time in go trials, however, showed no significant between-group difference. Considering the electrophysiological correlate underlying the longer SSRT, we found reduced P3 amplitude in patients with insomnia in the successful stop trials, which might reflect their poor efficiency of response inhibition. Finally, when we performed exploratory analyses in the failed stop and go trials, patients with ID presented reduced Pe and N1 amplitude in the failed sop trials and go trials respectively.

Discussion: Taken together, these findings indicate that individuals with ID would present response inhibition deficits. Moreover, the electrophysiological correlate underlying these deficits mainly revolves around the successful stop P3 component. The present study is the first to investigate the electrophysiological correlate underlying the impaired response inhibition among insomniacs.