Enhanced late positive potential to conditioned threat cue during delayed extinction in anxious youth.

BACKGROUND: Deficits in threat learning relate to anxiety symptoms. Since several anxiety disorders arise in adolescence, impaired adolescent threat learning could contribute to adolescent changes in risk for anxiety. This study compared threat learning among anxious and non-anxious youth using self-reports, peripheral psychophysiology measures, and event-related potentials. Because exposure therapy, the first-line treatment for anxiety disorders, is largely based on principles of extinction learning, the study also examined the link between extinction learning and treatment outcomes among anxious youth. METHODS: Clinically anxious (n = 28) and non-anxious (n = 33) youth completed differential threat acquisition and immediate extinction. They returned to the lab a week later to complete a threat generalization test and a delayed extinction task. Following these two experimental visits, anxious youth received exposure therapy for 12 weeks. RESULTS: Anxious as compared to non-anxious youth demonstrated elevated cognitive and physiological responses across acquisition and immediate extinction learning, as well as greater threat generalization. In addition, anxious youth showed enhanced late positive potential response to the conditioned threat cue compared to the safety cue during delayed extinction. Finally, aberrant neural response during delayed extinction was associated with poorer treatment outcomes. CONCLUSIONS: The study emphasizes differences between anxious and non-anxious youth in threat learning processes and provides preliminary support for a link between neural processing during delayed extinction and exposure-based treatment outcome in pediatric anxiety.

Induced error-related theta activity, not error-related negativity, predicts task performance as well as anxiety and worry during real-life stress in a youth sample.

OBJECTIVE: The study examined differences between induced error-related theta activity (4-7 Hz) and error-related negativity (ERN) in youth and their unique associations with task performance as well as anxiety and worry during real-life stress a year later. We hypothesized that induced theta, but not the ERN, would predict task performance. We also hypothesized that induced theta would predict less anxiety and worries during situational stress a year later, while ERN would predict more anxiety and worries. METHOD: Participants included 76 children aged 8-13 years who completed a flanker task while electroencephalogram (EEG) and behavioral data (t0 ) were collected. Approximately 1 year later (t1 ), during the first COVID-19 lockdown, 40 families from the original sample completed a battery of online questionnaires to assess the children's stress-related symptoms (anxiety, negative emotions and worries). We employed an analytical method that allowed us to differentiate between induced error-related theta and the evoked ERN. RESULTS: Induced error-related theta, but not ERN, was associated with behavioral changes during the task, such as post-error speeding. Furthermore, induced error-related theta, but not ERN, was prospectively associated with less anxiety, worries, and fewer negative emotions a year later during COVID-19 lockdown. CONCLUSIONS: Findings suggest ERN and error-related theta are dissociable processes reflecting error monitoring in youth. Specifically, induced error-related theta is more robustly associated with changes in behavior in the laboratory and with less anxiety and worries in real-world settings.