The moderating role of externalizing problems on the association between anxiety and the error‐related negativity in youth

Abstract

The error‐related negativity (ERN) is an event‐related potential that reflects error monitoring. Enhanced ERN indicates sensitivity to performance errors and is a correlate of anxiety disorders. In contrast, youth with externalizing problems exhibit a reduced ERN, suggesting decreased error monitoring. Anxiety and externalizing problems commonly co‐occur in youth, but no studies have tested how comorbidity might modulate the ERN. In a sample of youth (N = 46, ages 7–19) with and without anxiety disorders, this preliminary study examined the interactive effect of anxiety and externalizing problems on ERN. Results suggest that externalizing problems moderate the relation between anxiety symptoms and ERN in youth. Anxious youth with less externalizing problems exhibited enhanced ERN response to errors. Conversely, anxious youth with greater externalizing problems demonstrated diminished ERN in response to errors. The regions of significance and proportion affected tests indicated that the moderating the effect of externalizing problems was only significant for youth with anxiety disorders. Findings suggest that enhanced neural error sensitivity could be a specific neurophysiological marker for anxiety disorders, whereas anxious individuals with comorbid externalizing problems demonstrate reduced error monitoring, similar to those with primary externalizing pathology. Results underscore the utility of examining neural correlates of pediatric anxiety comorbidity subtypes.

Associations between error-related negativity and childhood anxiety risk differ based on socioeconomic status.

“…Importantly, recent work has also identified moderators as of high potential importance for explaining inconsistent results and identifying early pathways of risk (Ip et al, 2019; Suor et al, 2020). Indeed, our previous work in this sample has suggested that SES can affect the pattern of development of the ERN itself (Brooker, 2018).…”

“…That is, it may be the case that a factor that is unmeasured and not hypothesized in the current study is differentiating specific types of risk. Certainly, other work has noted a need to attend to both syndrome type and overlap of symptoms when considering how the ERN relates to anxiety problems in children (Lo et al, 2017; Suor et al, 2020). Why distinct mechanisms may be involved in the manifestation of different types of anxiety symptoms, particularly given evidence for substantial overlap this early in development, is not entirely clear.…”

“…However, both enhanced and attenuated ERN have been linked to the presence of anxiety risk in children between 4 to 13 years of age (Brooker et al, 2011; Meyer et al, 2013; Torpey et al, 2013). These differences in findings have yet to be fully explained, though there are suggestions that the direction of association may differ based on overlap with externalizing symptoms (Suor et al, 2020), clinical vs. nonclinical levels of anxiety (Meyer, 2017), and/or the availability of other sources of cognitive control (Moser, 2017). Positive associations (smaller [less negative] ERN linked to greater anxiety problems) are most often visible for younger children (Ip et al, 2019) and children with nonclinical levels of anxiety (Brooker, 2018; DuPuis et al, 2015).…”

Evaluating the internal consistency of subtraction‐based and residualized difference scores: Considerations for psychometric reliability analyses of event‐related potentials

“…In many areas of neuroscience research, including ERP studies, a common approach for calculating difference scores is to subtract activity during one condition ( X , the subtrahend) from activity during another condition ( Y , the minuend; Y − X ). Another approach increasing in popularity is a residualized difference score (e.g., Crane et al., 2021; Hanna et al., 2020; Klawohn et al., 2020; Macatee et al., 2020; Meyer et al., 2017; Muir et al., 2020; Sandre et al., 2020; Schroder et al., 2020; Suor et al, in press). A residualized difference score is the difference between the actual score ( Y ) and predicted score () using a linear regression equation (), wherein Y scores are regressed on X .…”