Error-related negativity predicts increases in anxiety in a sample of clinically anxious female children and adolescents over 2 years

Abstract

Background: An increased neural response to making errors has emerged as a biomarker of anxiety. Error negativity (Ne) or errorrelated negativity (ERN) is an event-related potential generated when people commit errors; the Ne/ERN is greater among people with anxiety and predicts increases in anxiety. However, no previous study has examined whether the Ne/ERN can be used as a prognostic indicator among people with current anxiety. The present study addressed this gap by examining whether the Ne/ERN prospectively predicts increases in anxiety symptoms in clinically anxious children and adolescents. Methods: The sample included 34 female participants between the ages of 8 and 14 years who met the criteria for a clinical anxiety disorder based on clinical interview. The Ne/ERN was measured using a flanker task. Results: Increased Ne/ERN at baseline predicted increases in total anxiety symptoms 2 years later, even when accounting for baseline symptoms. The Ne/ERN predicted increases in the symptom domains of generalized anxiety, social anxiety and harm avoidance/perfectionism, but not panic, separation anxiety, school avoidance or physical symptoms. Limitations: The sample size was small, which may have inflated the false discovery rate. To mitigate this possibility, we used multiple self-report measures, and the results for the 2 measures (as well as their symptom domains) converged. Conclusion: These data suggest that the Ne/ERN can delineate specific risk trajectories, even among those who already meet the criteria for a clinical anxiety disorder. Considering the need for prognostic markers among people with clinical anxiety, the current findings are an important and novel extension of previous work.

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

“…We, and others, have examined the potential utility of the ERN as a risk marker in large, longitudinal samples. Results are consistent across all studies: a potentiated ERN relates to increased anxiety prospectively (Filippi et al, 2020;Lahat et al, 2014;McDermott et al, 2009;Meyer, Danielson, et al, 2017;Meyer et al, 2015Meyer et al, , 2021Meyer, Nelson, et al, 2018). One of our studies found that an increased ∆ERN predicted the onset of new anxiety disorders in children between the ages of 6 and 9 years old, even while controlling for baseline anxiety symptoms and maternal history of anxiety (Figure 5; Meyer et al, 2015).…”

“…Considering the fact that the ERN is increased in anxious individuals (Meyer, 2016(Meyer, , 2017, predicts risk for future increases in anxiety among healthy and anxious populations (Meyer et al, 2021), and may be elevated early in the course of development, (i.e., before anxiety has become impairing, (Meyer et al, 2015), it is important to better understand what factors contribute to the development of the ERN early in life. While some of the variance in the ERN is heritable, a large portion of the variance appears to be impacted environmental factors (40-60%; Anokhin et al, 2008).…”

The relationship between stressful life events and the error-related negativity in children and adolescents

“…Results suggested that for younger children, more frequent interpersonal dependent stressors predicted a larger ERN, but this effect was not significant in older children or adolescents. Additionally, as prior studies using this dataset have examined the associations between the ERN and anxiety ( Meyer et al, 2018 , Meyer et al, 2021 ) and puberty ( Gorday and Meyer, 2018 ), we assessed whether anxiety or pubertal stage moderated the association between interpersonal dependent stressors and the ERN. While anxiety was not found to significantly moderate the relationship between the ERN and stressors, child pubertal stage was a significant moderator, such that for less pubertally developed children, more frequent interpersonal stressors predicted a larger ERN, even when controlling for child age.…”

“…The present sample was drawn from a larger, NIMH-funded, longitudinal study (R01 MH097767) investigating neural risk markers for depression in females from a community sample. It is important to note that previous studies have been published using this dataset ( Chong et al, 2020 , Gorday and Meyer, 2018 , Meyer et al, 2018 , Meyer et al, 2021 ); however, none of the previous studies focused on the relationship between the ERN and stressful life events. Previous studies using this larger dataset have investigated the relationship between anxiety and the ERN ( Meyer et al, 2018 , Meyer et al, 2021 ), parenting styles and the ERN ( Chong et al, 2020 ), and puberty and the ERN ( Gorday and Meyer, 2018 ).…”

“…It is important to note that previous studies have been published using this dataset ( Chong et al, 2020 , Gorday and Meyer, 2018 , Meyer et al, 2018 , Meyer et al, 2021 ); however, none of the previous studies focused on the relationship between the ERN and stressful life events. Previous studies using this larger dataset have investigated the relationship between anxiety and the ERN ( Meyer et al, 2018 , Meyer et al, 2021 ), parenting styles and the ERN ( Chong et al, 2020 ), and puberty and the ERN ( Gorday and Meyer, 2018 ). The current study aims are novel insofar as they examine the relationship between stressful life events and the ERN.…”