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Neurophysiological Markers That Predict and Track Treatment Outcomes in Childhood Anxiety

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Abstract

The present study examined the cortical processes that mediate cognitive regulation in response to emotion-eliciting stimuli, before and after anxious children participated in a cognitive behavioral therapy program. Electroencephalographic activity was recorded from anxious children (n = 24, 8 males) and comparison children (n = 16, 7 males) at pre-and post-treatment sessions. The change in anxiety T-scores from pre- to post-treatment was used to signify clinical improvement among anxious children (Improvers: n = 11 vs. Non-improvers: n = 13). Event-related potential components were recorded while children performed a Go/No-go task using emotional facial expressions. For the P1 component, believed to reflect attention and/or arousal processes, Non-improvers had greater activation levels relative to Improver and comparison groups at both sessions. Greater P1 amplitudes at pre-treatment predicted non-improvement following treatment. For the frontal N2 component, thought to reflect cognitive control processing, Improvers recruited greater activation from pre- to post-treatment, a change in activation that was predictive of treatment outcome. Non-improvers showed increased cortical activation within the time window of the P1, whether at pre- or post-treatment. These data suggest that heightened perceptual vigilance may have led to poorer outcomes. Improvers showed increased prefrontal activation within the time window of the N2 from pre- to post-treatment. These data suggest that increased cognitive control may have led to improved treatment outcomes. In sum, P1 activation may serve as a predictor of treatment outcome, while N2 activation may serve as an indicator of treatment response.

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Acknowledgements

The authors would like to thank Dr. Maryanne Shaw for recruiting the clinical families to participate in the study, and Alex Lamey for his programming assistance. The present study was funded by grants from the Ontario Mental Health Foundation (MDL) and the Natural Sciences and Engineering Research Council of Canada (KMH).

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Authors and Affiliations

  1. Department of Human Development and Applied Psychology, University of Toronto, Toronto, Canada

    Kathryn M. Hum

  2. Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Toronto, Canada

    Katharina Manassis

  3. Behavioral Science Institute, Radboud University, Nijmegen, The Netherlands

    Marc D. Lewis

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  1. Kathryn M. Hum
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  2. Katharina Manassis
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  3. Marc D. Lewis
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Correspondence to Kathryn M. Hum.

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Hum, K.M., Manassis, K. & Lewis, M.D. Neurophysiological Markers That Predict and Track Treatment Outcomes in Childhood Anxiety. J Abnorm Child Psychol 41, 1243–1255 (2013). https://doi.org/10.1007/s10802-013-9755-7

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