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The Heterogeneity of Anxious Phenotypes: Neural Responses to Errors in Treatment-Seeking Anxious and Behaviorally-Inhibited Youth.

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OBJECTIVE While behaviorally-inhibited (BI) temperament predicts risk for anxiety, anxiety in BI may involve distinct neural responses to errors. The current study examines the relations between anxiety and neural correlates… Click to show full abstract

OBJECTIVE While behaviorally-inhibited (BI) temperament predicts risk for anxiety, anxiety in BI may involve distinct neural responses to errors. The current study examines the relations between anxiety and neural correlates of error processing both in youth identified as BI in early childhood and in youth seeking treatment for an anxiety disorder. METHOD All participants underwent functional magnetic resonance imaging using a Flanker task to assess responses to errors. A study in healthy subjects assessed test-retest reliability to inform analyses in two other samples. For one sample, a cohort of BI youth (Low BI, n=28; High BI, n=27) was followed into adolescence. For the other, participants were recruited based on the presence or absence of an anxiety disorder. Using identical methods in medication-free subjects, analyses compared relations between anxiety and error processing across the two samples. RESULTS Error-processing exhibited acceptable reliability. Within a ventromedial-prefrontal-cortex (vmPFC) cluster, anxiety only related to error processing in youth whose early-life BI status was known. In the high BI group, anxiety related to reduced neural response to errors. No such associations manifested in treatment-seeking youth. Other analyses mapped relations between error-processing and anxiety in each sample on its own. However, only the vmPFC cluster statistically differentiated the neural correlates of anxiety in BI. CONCLUSION BI temperament may define a unique pathway into anxiety involving perturbed neural responding to errors. While BI is a risk factor for later anxiety, the neural and associated features of anxiety in BI youth may differ from those in treatment-seeking youth.

Keywords: treatment seeking; anxiety; responses errors; youth; error processing

Journal Title: Journal of the American Academy of Child and Adolescent Psychiatry
Year Published: 2019

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