Neural Biomarker and Early Temperament Predict Increased Internalizing Symptoms After a Natural Disaster

Abstract

Objective Although most people will experience a traumatic event, only some will develop significant psychological symptoms in the aftermath. In the current study, we utilize a preexisting longitudinal study located in Long Island to examine the impact of Hurricane Sandy on internalizing symptoms in a large sample of children. We focused on temperamental fear and a biomarker of risk for anxiety, the error-related negativity (ERN). The ERN is a negative deflection in the event-related potential (ERP) occurring when individuals make mistakes and is increased in anxious individuals. Method The final sample consisted of 223 children who had undergone an observational assessment of fear at age 3 and an electroencephalogram assessment of the ERN at age 6. At the age 9 assessment, internalizing symptoms were assessed, and then again after the hurricane (approximately 65 weeks later). Results A significant three-way interaction between fearfulness, hurricane stressors, and the ERN in predicting post-hurricane increases in internalizing symptoms suggested that children who were high in fear at age 3 and experienced elevated hurricane stressors were characterized by subsequent increases in internalizing symptoms, but only when they were also characterized by an increased ERN at age 6. Conclusion These findings support a diathesis-stress model, suggesting that early temperament and pre-stressor biological markers confer risk for increased psychological symptoms following environmental stressors.

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

“…Previous studies have found that among children high in behavioral inhibition, an increased ERN predicts anxiety symptoms later in development (Lahat et al, 2014;McDermott et al, 2009). Furthermore, we have extended this work and found that children with an elevated ERN are particularly prone to environmentally induced increases in anxiety symptomsin a large sample of children who experienced Hurricane Sandy, it was the children who were high in temperamental fear and had an increased ERN who displayed posthurricane symptom increases (i.e., Hurricane Sandy; Meyer, Danielson et al, 2017). Important to the validation of the ERN as a biomarker of clinical anxiety, we have also found that an increased ERN in 6 year old children predicts the onset of new anxiety disorders 3 years later, even when controlling for baseline anxiety symptoms (Meyer, Hajcak, Torpey-Newman, Kujawa, & Klein, 2015).…”

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

“…This suggests that individuals at familial risk for anxiety disorders also show increased ERN amplitudes. Additional support for increased ERN as a candidate endophenotype for anxiety comes from studies suggesting that ERN magnitude could be used to predict the onset of GAD (Meyer et al, ), social anxiety (Lahat et al, ), and anxiety symptoms collapsed across different DSM categories (McDermott et al, ; Meyer et al, ; Meyer, Hajcak et al, ). Collectively, these results support the idea that increased ERN amplitudes represent a shared endophenotype for OCD and anxiety (Olvet & Hajcak, ; Riesel et al, , in press).…”

“…Importantly, the clinical relevance of error‐related brain activity is supported by studies demonstrating its predictive validity for the onset of symptoms across various mental disorders (Anokhin & Golosheykin, ; Lahat et al, ; Meyer, Hajcak et al, ; Meyer et al, ). In longitudinal studies, ERN predicted the onset of anxiety symptoms in children and adolescents (Lahat et al, ; Lamm et al, ; Meyer, Hajcak et al, ; Meyer et al, ) and the development of symptoms in response to critical life events such as a natural disaster (Meyer et al, ). Further, in preschool‐aged individuals, observed hyperactive performance monitoring at the behavioral level predicted the onset of OCD and reduced ACC volume over 12 years (Gilbert, Barclay, Tillman, Barch, & Luby, ).…”

“…Nevertheless, even complex endophenotypes are presumably simpler than the clinical phenotype and may help to illuminate disorder mechanisms and familial environmental risk factors (Kendler & Neale, 2010). Further, the predictive validity of elevated neural error signals has not been demonstrated for OCD specifically but for anxiety symptoms and disorders more broadly (Lahat et al, 2014;Lamm et al, 2014;Meyer et al, 2017;Meyer, Hajcak, Torpey-Newman, Kujawa, & Klein, 2015;Meyer, Nelson, Perlman, Klein, & Kotov, 2018). Consistent with this, enhanced ERN amplitudes are not specific for OCD (e.g., Gillan, Fineberg, & Robbins, 2017;Riesel et al, 2017;Weinberg, Dieterich, & Riesel, 2015).…”

The Stony Brook Temperament Study: Early Antecedents and Pathways to Emotional Disorders

“…Furthermore, our findings extend the few studies showing that, consistent with diathesis-stress models, life stressors moderate associations of early temperamental and neural vulnerabilities with subsequent internalizing psychopathology (41, 42). Finally, our data suggest the importance of considering risk factors at many levels simultaneously because temperamental and neural diatheses can combine to create potent vulnerabilities to internalizing symptoms in the face of major stressors (38, 43). …”