A review examining the relationship between individual differences in the error-related negativity and cognitive control

Family study of the error-related negativity in adolescent and young adult females and their parents

The error-related negativity (ERN) has been identified as a potential endophenotype of psychopathology. However, there is limited research investigating familial transmission of the ERN, particularly across developmental phases that are associated with increased risk for psychopathology. The present study included a sample of one hundred thirty-one adolescent and young adult females (Mage = 17.77, SD = 1.84) and their biological parents at a first assessment and 75 females (Mage = 20.48, SD = 1.75) and their biological parents at a second assessment. Participants and their parents completed a flanker task while electroencephalography was recorded to examine parent-daughter associations of the ERN, correct response negativity (CRN), and ΔERN (i.e., ERN-CRN) at two assessments that were separated by approximately 3 years (Myears = 2.84, SD = 0.60). The daughters also completed self-report measures of generalized anxiety and depression symptoms. Results indicated that the ΔERN, but not the ERN or CRN, was positively correlated between parents and their daughters at both assessments. Furthermore, the parent-daughter correlation strength did not differ between assessments. Finally, both daughter and parent ∆ERNs were associated with daughter generalized anxiety and depression symptoms. The present study suggests that, like psychiatric disorders, the ERN runs in families and is associated with both concurrent and familial psychopathology, supporting its conceptualization as an endophenotype of psychopathology.

Disentangling associations between impulsivity, compulsivity, and performance monitoring

Disorders marked by high levels of impulsivity and compulsivity have been linked to changes in performance monitoring, specifically the error-related negativity (ERN). We investigated the relationship between performance monitoring and individual differences in impulsivity and compulsivity. A total of 142 participants were recruited into four groups, each with different combinations of impulsivity and compulsivity, and they performed a flanker task to assess error-related brain activity. We defined error-related brain activity as ERN amplitude and theta power. Single-trial regression was employed to analyze the amplitude differences between incorrect and correct trials within the ERN time window. The findings revealed that impulsivity, compulsivity, and different measures of response processing exhibited distinct interactions, which were influenced by the configuration of impulsivity and compulsivity, but also depended on the measure of response processing. Specifically, high compulsivity predicted larger ERN amplitudes in individuals with low impulsivity, whereas high impulsivity had no significant effect on ERN amplitude in individuals with low compulsivity. Furthermore, when both impulsivity and compulsivity were high, no significant increase in ERN amplitude was observed; instead, there was a reduced difference between incorrect and correct trials. No significant differences were found for theta power. While the association between error-related brain activity and transdiagnostic markers or psychopathology may be smaller than generally assumed, considering the interaction between different transdiagnostic markers and their facets can enhance our understanding of the complex associations that arise during the investigation of neural correlates of performance monitoring, specifically the ERN.

Multiple Adaptive Attention-Bias-Modification Programs to Alter Normative Increase in the Error-Related Negativity in Adolescents

In the current article, we examined the impact of two home-delivered attentional-bias-modification (ABM) programs on a biomarker of anxiety (i.e., the error-related negativity [ERN]). The ERN is sensitivity to ABM-related changes; however, it is unclear whether ABM exerts its influence on the ERN and anxiety by increasing general attentional control or by disengaging spatial allocation of attention. In this study, we measured the ERN, anxiety, attention bias, and attention control before and after two versions of ABM training and a waitlist control group in 546 adolescents. An ABM designed to increase attention control modulated the ERN but had no impact on anxiety. An ABM designed to reduce attentional bias changed bias and self-reported anxiety in youths but had no impact on the ERN or parent-reported anxiety. These results suggest that the ERN and normative anxiety may be modified using attention training.

The Relationship Between Emotion Dysregulation and Error Monitoring in Adolescents with ADHD

Attention-deficit/hyperactivity disorder (ADHD) is emblematic of the limitations of existing diagnostic categories. One potential solution, consistent with the Research Domain Criteria (RDoC) initiative, is to interrogate psychological mechanisms at the behavioral and physiological level together to try and identify meaningful subgroups within existing categories. Such approaches provide a way to revise diagnostic boundaries and clarify individual variation in mechanisms. Here, we illustrate this approach to help resolve heterogeneity in ADHD using a combination of behaviorally-rated temperament measures from the Early Adolescent Temperament Questionnaire; cognitive performance on three difference conditions of an emotional go/no-go task; and electroencephalogram (EEG)-measured variation in multiple stages of error processing, including the error-related negativity (ERN) and positivity (Pe). In a large (N = 342), well-characterized sample of adolescents with ADHD, latent profile analysis identified two ADHD temperament subgroups: 1) emotionally regulated and 2) emotionally dysregulated (with high negative affect). Cognitive and EEG assessment in a subset of 272 adolescents (nADHD = 151) found that the emotionally dysregulated group showed distinct patterns of change in early neural response to errors (ERN) across emotional task conditions as compared to emotionally-regulated ADHD adolescents and typically-developing controls. Both ADHD groups showed blunted later response to errors (Pe) that was stable across emotional task conditions. Overall, neural response patterns identified important differences in how trait and state emotion interact to affect cognitive processing. Results highlight important temperament variation within ADHD that helps clarify its relationship to the ERN, one of the most prominent putative neural biomarkers for psychopathology.

Response monitoring in math-anxious individuals in an arithmetic task

We examine whether math anxiety is related to altered response monitoring in an arithmetic task. Response-locked event-related brain potentials (ERPs) were evaluated in 23 highly (HMA) and 23 low math-anxious (LMA) individuals while they performed an arithmetic verification task. We focused on two widely studied ERPs elicited during error processing: error-related negativity (ERN) and error positivity (Pe). Correct-related negativity (CRN), an ERP elicited after a correct response, was also studied. The expected ERN following errors was found, but groups did not differ in its amplitude. Importantly, LMA individuals showed less negative CRN and more positive Pe amplitudes than their more anxious peers, suggesting more certainty regarding response accuracy and better adaptive behavioral adjustment after committing errors in an arithmetic task in the LMA group. The worse control over response performance and less awareness of correct responses in the HMA group might reduce their ability to 'learn from errors'.

To err is human- to understand error-processing is divine: Contributions of working memory and anxiety to error-related brain and pupil responses

Both anxiety and working memory capacity appear to predict increased (more negative) error-related negativity (ERN) amplitudes, despite being inversely related to one another. Until the interactive effects of these variables on the ERN are clarified, there may be challenges posed to our ability to use the ERN as an endophenotype for anxiety, as some have suggested. The compensatory error monitoring hypothesis suggests that high trait-anxiety individuals have larger ERN amplitudes because they must employ extra, compensatory efforts to override the working memory demands of their anxiety. Yet, to our knowledge, no ERN study has employed direct manipulation of working memory demands in conjunction with direct manipulations of induced (state) anxiety. Furthermore, little is known about how these manipulations affect other measures of error processing, such as the error-related pupil dilation response and post-error behavioral adjustments. Therefore, we manipulate working memory load and anxiety in a 2 × 2 within-subjects design to examine the interactive effects of working memory load and anxiety on ERN amplitude, error-related pupil dilation response amplitude, and post-error behavior. There were no effects of our manipulations on ERN amplitude, suggesting a strong interpretation of compensatory error-processing theory. However, our worry manipulation affected post-error behavior, such that worry caused a reduction in post-error accuracy. Additionally, our working memory manipulation affected error-related PDR magnitude and the amplitude of the error-related positivity (Pe), such that increased working memory load decreased the amplitude of these responses. Implications of these results within the context of the compensatory error processing framework are discussed.

The relation between executive functions, error-related brain activity, and ADHD symptoms in clinically evaluated school-aged children

Two event-related potentials (ERPs) elicited following errors, the error-related negativity (ERN) and error positivity (Pe), have been proposed to reflect cognitive control, though the specific processes remain debated. Few studies have examined the ERN and Pe's relations with individual differences in cognitive control/executive functioning using well-validated tests administered separately from the inhibition tasks used to elicit the ERN/Pe. Additionally, neurocognitive tests of executive functions tend to strongly predict ADHD symptoms, but the extent to which task-based and EEG-based estimates of executive functioning/cognitive control account for the same variance in ADHD symptoms remains unclear. The current study addressed these limitations by examining relations between the ERN/Pe and three core executive functions (working memory, inhibitory control, set shifting) in a clinically-evaluated sample of 53 children ages 8-12 (Mage = 10.36, SD = 1.42; 77.4% White/Non-Hispanic; 16 girls) with and without ADHD. Results demonstrated that neither the ERN nor Pe were related to overall cognitive control/executive functioning, or to working memory or set shifting specifically (all 95%CIs include 0.0). In contrast, a larger Pe was associated with better-developed inhibitory control (β=-.35, 95%CI excludes 0.0), but did not capture aspects of inhibitory control that are important for predicting ADHD symptoms. Neither the ERN nor Pe predicted ADHD symptoms (95%CIs include 0.0). Results were generally robust to control for age, sex, SES, ADHD symptom cluster, and anxiety, and emphasize the need for caution when interpreting the ERN/Pe as indices of broad-based cognitive control/executive functioning, as well as using the ERN/Pe to examine cognitive processes contributing to ADHD symptomatology.

Updating the relationship of the Ne/ERN to task-related behavior: A brief review and suggestions for future research

The error negativity/error-related negativity (Ne/ERN) is one of the most well-studied event-related potential (ERP) components in the electroencephalography (EEG) literature. Peaking about 50 ms after the commission of an error, the Ne/ERN is a negative deflection in the ERP waveform that is thought to reflect error processing in the brain. While its relationships to trait constructs such as anxiety are well-documented, there is still little known about how the Ne/ERN may subsequently influence task-related behavior. In other words, does the occurrence of the Ne/ERN trigger any sort of error corrective process, or any other behavioral adaptation to avoid errors? Several theories have emerged to explain how the Ne/ERN may implement or affect behavior on a task, but evidence supporting each has been mixed. In the following manuscript, we review these theories, and then systematically discuss the reasons that there may be discrepancies in the literature. We review both the inherent biological factors of the neural regions that underlie error-processing in the brain, and some of the researcher-induced factors in analytic and experimental choices that may be exacerbating these discrepancies. We end with a table of recommendations for future researchers who aim to understand the relationship between the Ne/ERN and behavior.

The effect of traffic noise on cognitive performance with regard to personality traits: A laboratory experiment study

BACKGROUND: Exposure to traffic noise could play an important part in inducing psychological disorders which in turn can affect individuals’ cognitive and mental performance. OBJECTIVE: The aim of this study was to determine the effect of traffic noise exposure on the cognitive performance with regard to subjects’ personality traits. METHODS: Sixty students with normal hearing and vision took part in this experimental study. In order to simulate the traffic noise condition of Tehran, the noise from several busy streets was first carefully recorded. Later on, the subjects were exposed to this recorded noise in an anechoic chamber. Also, the NEO-five factor inventory questionnaire and the continuous performance test were used to assess personality traits and cognitive performance of participants respectively. RESULTS: The results showed that the cognitive features of the study, such as reaction time and the number of commission/omission errors in continuous performance testing increased significantly after exposure to the traffic noise (p < 0.05), and among the personality traits, only the neuroticism has a significant correlation with response time in the continuous performance tests (p < 0.05). CONCLUSIONS: Apart from the effect of traffic noise on cognitive function, the findings of this study confirmed that Neuroticism (one of the personality traits) also significantly affect the cognitive performance of individuals when they are exposed to traffic noise in laboratory conditions.

A randomized trial of aerobic exercise for major depression: examining neural indicators of reward and cognitive control as predictors and treatment targets

BACKGROUND

Aerobic exercise has demonstrated antidepressant efficacy among adults with major depression. There is a poor understanding of the neural mechanisms associated with these effects. Deficits in reward processing and cognitive control may be two candidate targets and predictors of treatment outcome to exercise in depression.

METHODS

Sixty-six young adults aged 20.23 years (s.d. = 2.39) with major depression were randomized to 8 weeks of moderate-intensity aerobic exercise (n = 35) or light stretching (n = 31). Depressive symptoms were assessed across the intervention to track symptom reduction. Reward processing [reward positivity (RewP)] and cognitive control [error-related negativity (ERN)] were assessed before and after the intervention using event-related brain potentials.

RESULTS

Compared to stretching, aerobic exercise resulted in greater symptom reduction (gs = 0.66). Aerobic exercise had no impact on the RewP (gav = 0.08) or ERN (gav = 0.21). In the aerobic exercise group, individuals with a larger pre-treatment RewP [odds ratio (OR) = 1.45] and increased baseline depressive symptom severity (OR = 1.18) were more likely to respond to an aerobic exercise program. Pre-treatment ERN did not predict response (OR = 0.74).

CONCLUSIONS

Aerobic exercise is effective in alleviating depressive symptoms in adults with major depression, particularly for those with increased depressive symptom severity and a larger RewP at baseline. Although aerobic exercise did not modify the RewP or ERN, there is preliminary support for the utility of the RewP in predicting who is most likely to respond to exercise as a treatment for depression.

On the relationship between the error-related negativity and anxiety in children and adolescents: From a neural marker to a novel target for intervention

The current review focuses on our work on the relationship between the error-related negativity (i.e., ERN) and anxiety in children and adolescents. The ERN is an event-related potential (ERP) that appears as a negative deflection in the ERP waveform when individuals make errors and has been found to be increased in anxious individuals. We, and others, have extended this work into developmental populations, finding that the ERN can be measured reliably in children and that the ERN is increased among clinically anxious youth. Furthermore, we have found that the ERN predicts risk for increases in anxiety across development, among healthy and clinically anxious children. We have done work to elucidate what psychological phenomena the increased ERN among anxious children may reflect by creating a self-report measure of error sensitivity (i.e., the Child Error Sensitivity Index) that relates to the ERN. Moreover, we review our work on parenting and the ERN, which suggests that harsh or critical parenting styles may potentiate the ERN in offspring. And, building on these findings, we discuss our recent work to develop novel, computerized intervention strategies to reduce the ERN and thereby risk for anxiety.

Non-invasive brain stimulation modulates neural correlates of performance monitoring in patients with obsessive-compulsive disorder

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Effects of tDCS on performance monitoring examined in OCD and healthy individuals.

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A preregistered, randomized, sham-controlled tDCS–EEG study was conducted.

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Cathodal tDCS over the pre-SMA reduced the error-related negativity (ERN).

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Correct-response negativity was enhanced, error positivity reduced by cathodal tDCS.

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The findings substantiate the role of the ERN as a target for new interventions.

Overactive performance monitoring, as reflected by enhanced neural responses to errors (the error-related negativity, ERN), is considered a biomarker for obsessive-compulsive disorder (OCD) and may be a promising target for novel treatment approaches. Prior research suggests that non-invasive brain stimulation with transcranial direct current stimulation (tDCS) may reduce the ERN in healthy individuals, yet no study has investigated its efficacy in attenuating the ERN in OCD. In this preregistered, randomized, sham-controlled, crossover study, we investigated effects of tDCS on performance monitoring in patients with OCD (n = 28) and healthy individuals (n = 28). Cathodal and sham tDCS was applied over the presupplementary motor area (pre-SMA) in two sessions, each followed by electroencephalogram recording during a flanker task. Cathodal tDCS reduced the ERN amplitude compared to sham tDCS, albeit this effect was only marginally significant (p = .052; mean difference: 0.86 μV). Additionally, cathodal tDCS reduced the correct-response negativity and increased the error positivity. These neural modulations were not accompanied by behavioral changes. Moreover, we found no evidence that the tDCS effect was more pronounced in the patient group. In summary, our findings indicate that tDCS over the pre-SMA modulates neural correlates of performance monitoring across groups. Therefore, this study represents a valuable starting point for future research to determine whether repeated tDCS application induces a more pronounced ERN attenuation and normalizes aberrant performance monitoring in the long term, thereby potentially alleviating obsessive-compulsive symptoms and providing a psychophysiological intervention strategy for individuals who do not benefit sufficiently from existing interventions.

Investigating the consistency of ERPs across threatening situations among children and adolescents

Threat sensitivity is thought to be a precursor for anxiety. Yet it remains unknown whether individuals have consistently high neural activation to different threatening situations. The current study (N = 161, M_age = 11.26, SD = 1.79) used three ERPs from different threat-related events: 1) the P3 to receiving negative feedback; 2) the ERN to making mistakes; 3) the N170 to viewing angry faces. Participants also completed self-report measures of threat sensitivity, impulsivity, and demographics. In a follow-up analysis, we also investigated whether the results replicate when using the difference score for each ERP. Youth with higher self-reported sensitivity to threats and lower self-reported impulsivity had consistently higher neural activation to threatening situations. Males also had consistently higher neural activation to threats compared with females. When using the difference score, we found that youth with higher self-reported threat sensitivity had consistently higher neural activation to threats than nonthreats. Although it is common for youth to have high neural activation during at least one threatening situation (e.g., making mistakes), only ~12% of youth have consistently high neural activation across a variety of different threats. Thus, detecting youth who are sensitive to a variety of different threats may be an important avenue to investigate to identify youth most at risk for the development of anxiety.

Early neurophysiological stimulus processing during a performance-monitoring task differentiates women with bipolar disorder from women with ADHD

Adults with attention-deficit/hyperactivity disorder (ADHD) or bipolar disorder (BD) may display similar cognitive impairments and clinical symptoms, which might reflect shared mechanisms. Initial evidence indicates disorder-specific and overlapping neurophysiological alterations using event-related potentials (ERPs) in individuals with BD or ADHD during attentional tasks, but it is unknown whether impairments generalize across other processes and tasks. We conduct the first comparison between women with ADHD (n = 20), women with BD (n = 20) and control women (n = 20) on ERPs from a performance-monitoring flanker task. The BD group showed a significantly attenuated frontal ERP of conflict monitoring (N2) compared to the ADHD group across both low-conflict (congruent) and high-conflict (incongruent) task conditions, and compared to controls in the high-conflict condition. However, when controlling for an earlier attentional ERP (frontal N1), which was significantly reduced in participants with BD compared to participants with ADHD and controls, N2 group differences were no longer significant. These results indicate that ERP differences in conflict monitoring may be attributable to differences in earlier attentional processes. These findings identify neural differences in early attention between BD and ADHD which precede conflict monitoring processes, potentially pointing to distinct neural mechanisms implicated in the two disorders.

Event-related potential (ERP) measures of error processing as biomarkers of externalizing disorders: A narrative review

Previous studies have shown that electrophysiological measures of error processing are affected in patients at risk or diagnosed with internalizing disorders, hence, suggesting that error processing could be a suitable biomarker for internalizing disorders. In this narrative review, we will evaluate studies that address the role of event-related potential (ERP) measures of error-processing in externalizing disorders and discuss to what extend these can be considered a biomarker for externalizing disorders. Currently, there is evidence for the notion that electrophysiological indices of error processing such as the error-related negativity (ERN) and error positivity (Pe) are reduced in individuals with substance use disorders, attention-deficit/hyperactivity disorder, and in forensic populations. However, it remains unclear whether this is also the case for other understudied disorders such as behavioral addiction. Furthermore, to fully understand how these deficits affect day to day behavior, we encourage research to focus on testing current theories and hypotheses of ERN and Pe. In addition, we argue that within an externalizing disorder, individual differences in error processing deficits may be related to prognosis and gender of the patient, methodological issues and presence of comorbidity. Next, we review studies that have related treatment trajectories with ERP measures of error processing, and we discuss the prospect of improving error processing as a treatment option. We conclude that ERP measures of error processing are candidate biomarkers for externalizing disorders, albeit we strongly urge researchers to continue looking into the predictive value of these measures in the etiology and treatment outcome through multi-method and longitudinal designs.

Linking RDoC and HiTOP: A new interface for advancing psychiatric nosology and neuroscience

The Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP) represent major dimensional frameworks proposing two alternative approaches to accelerate progress in the way psychopathology is studied, classified, and treated. RDoC is a research framework rooted in neuroscience aiming to further the understanding of transdiagnostic biobehavioral systems underlying psychopathology and ultimately inform future classifications. HiTOP is a dimensional classification system, derived from the observed covariation among symptoms of psychopathology and maladaptive traits, which seeks to provide more informative research and treatment targets (i.e., dimensional constructs and clinical assessments) than traditional diagnostic categories. This article argues that the complementary strengths of RDoC and HiTOP can be leveraged in order to achieve their respective goals. RDoC's biobehavioral framework may help elucidate the underpinnings of the clinical dimensions included in HiTOP, whereas HiTOP may provide psychometrically robust clinical targets for RDoC-informed research. We present a comprehensive mapping between dimensions included in RDoC (constructs and subconstructs) and HiTOP (spectra and subfactors) based on narrative review of the empirical literature. The resulting RDoC-HiTOP interface sheds light on the biobehavioral correlates of clinical dimensions and provides a broad set of dimensional clinical targets for etiological and neuroscientific research. We conclude with future directions and practical recommendations for using this interface to advance clinical neuroscience and psychiatric nosology. Ultimately, we envision that this RDoC-HiTOP interface has the potential to inform the development of a unified, dimensional, and biobehaviorally-grounded psychiatric nosology.

The Error-Related Negativity Predicts Self-Control Failures in Daily Life

Adaptive behavior critically depends on performance monitoring (PM), the ability to monitor action outcomes and the need to adapt behavior. PM-related brain activity has been linked to guiding decisions about whether action adaptation is warranted. The present study examined whether PM-related brain activity in a flanker task, as measured by electroencephalography (EEG), was associated with adaptive behavior in daily life. Specifically, we were interested in the employment of self-control, operationalized as self-control failures (SCFs), and measured using ecological momentary assessment. Analyses were conducted using an adaptive elastic net regression to predict SCFs from EEG in a sample of 131 participants. The model was fit using within-subject averaged response-locked EEG activity at each electrode and time point within an epoch surrounding the response. We found that higher amplitudes of the error-related negativity (ERN) were related to fewer SCFs. This suggests that lower error-related activity may relate to lower recruitment of interventive self-control in daily life. Altered cognitive control processes, like PM, have been proposed as underlying mechanisms for various mental disorders. Understanding how alterations in PM relate to regulatory control might therefore aid in delineating how these alterations contribute to different psychopathologies.

Impaired Learning From Errors and Punishments and Maladaptive Avoidance-General Mechanisms Underlying Self-Regulation Disorders?

Self-regulation (SR) is an important human function that relates to quality of life in multiple domains including mental health. Previous studies have found important correlates of low SR including impulsivity and poor emotional regulation; however, underpinnings of low SR are incompletely understood. Individuals low in SR frequently engage in maladaptive behaviors (substance abuse, procrastination, etc.) despite negative consequences. This phenomenon suggests that impaired learning from errors and punishments may be important mechanisms underlying low SR. Consistently, previous studies observed impaired error processing in a wide spectrum of individuals with low SR and impaired learning from errors and punishments in SR-related disorders. We also note a possible role for poor emotional regulation and refer to concepts suggesting that engaging in maladaptive behaviors may serve as short term emotion regulation strategies aimed at avoiding or alleviating negative affect. We speculate on transdiagnostic factors underlying poor SR. We propose that impaired error processing (possibly related to striatal functioning) may prevent subjects with low SR from learning from errors and punishments and thus learning better SR skills or tendencies. Additionally, impaired coping in emotionally challenging situations, possibly related to prefrontal-cortical functioning, may lead to maladaptive avoidance. Moreover, maladaptive behaviors may be reinforced by the temporary decreases in negative affect and rewarding values of behaviors. Given existing knowledge gaps, we call for more extensive research and describe possible directions and challenges for future studies.

A person-centered examination of emotion dysregulation, sensitivity to threat, and impulsivity among children and adolescents: An ERP study

Objectives

Adolescence often is characterized by the onset of social anxiety and risk taking; yet, not all youth are anxious and/or risk takers. There are several factors that may help differentiate youth with anxiety (e.g., threat sensitivity and emotion dysregulation) and youth who take risks (e.g., impulsivity and emotion dysregulation). We conducted a latent class analysis to identify groups of youth who differ in these processes, and then investigated group differences on the error-related negativity, an ERP that has been differentially associated with threat sensitivity and impulsivity.

Method

Youth (N = 1313, M_age = 11, range = 8–15 years) completed a survey assessing their emotion dysregulation, sensitivity to threat, and impulsivity. A subsample (N = 424) also completed a go/no-go task while EEG was recorded.

Results and conclusions

Four groups were identified with differential levels of emotion dysregulation, sensitivity to threat, and impulsivity. Adolescents had greater odds than children of being in the High_Dysregulation/ThreatSensitivity or ModerateDysregulation/HighImpulsivity Groups in comparison to two other groups with lower scores. The High_Dysregulation/ThreatSensitivity Group had the largest ERN, while the ModerateDysregulation/HighImpulsivity Group had the smallest ERN. The ERN may be a potential biomarker to help distinguish between different profiles of adolescents who may be at risk for either anxiety or risk taking.

Overcontrol and neural response to errors in pediatric anxiety disorders

Multiple risk factors that may contribute to the development and severity of pediatric anxiety disorders, one of which is dimensional overcontrol. Overcontrol is a constellation of characteristics including heightened performance monitoring, inflexibility, perfectionism and aversion to making mistakes. In this study, we examined overcontrol in children with anxiety disorders and tested whether the underlying dimension of overcontrol specifically explains altered brain response to errors in pediatric anxiety disorders. Parent-reported scores of child overcontrol were collected in a sample of children (ages 8-12 years) with (n = 35) and without (n = 34) anxiety disorders and the relationship of overcontrol and anxiety symptoms to neural responding to errors during functional magnetic resonance imaging (fMRI) was examined. Results indicated childhood overcontrol was elevated in pediatric anxiety disorders and was significantly associated with anxiety severity, even when controlling for comorbid depression and ADHD. Additionally, overcontrol was associated with reduced neural response to errors versus correct responses in the bilateral dorsal anterior cingulate cortex (dACC) and insula, even when controlling for anxiety symptoms. Overcontrol may serve as an underlying mechanism associated with clinical pediatric anxiety that demonstrates significant associations with aberrant neural error responding. Overcontrol may be an underlying mechanism contributing to pediatric anxiety that could be targeted for early intervention.

Behavioral and Electrophysiological Correlates of Performance Monitoring and Development in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

The pathophysiology of attention-deficit/hyperactivity disorder (ADHD) involves deficits in performance monitoring and adaptive adjustments. Yet, the developmental trajectory and underlying neural correlates of performance monitoring deficits in youth with ADHD remain poorly understood. To address the gap, this study recruited 77 children and adolescents with ADHD and 77 age- and gender-matched healthy controls (HC), ages 8–18 years, who performed an arrow flanker task during electroencephalogram recording. Compared to HC, participants with ADHD responded more slowly and showed larger reaction time variability (RTV) and reduced post-error slowing; they also exhibited reduced error-related negativity (ERN) and error positivity effects, and reduced N2 and P3 congruency effects. Age effects were observed across groups: with increasing age, participants responded faster, with less variability, and with increased post-error slowing. They also exhibited increased ERN effects and increased N2 and P3 congruency effects. Increased RTV and reduced P3 amplitude in incongruent trials were associated with increased ADHD Problems Scale scores on the Child Behavior Checklist across groups. The altered behavioral and ERP responses in ADHD are consistent with the pattern associated with younger age across groups. Further research with a longitudinal design may determine specific aspects of developmental alteration and deficits in ADHD during performance monitoring.