title: Neurophysiological markers that predict and track treatment outcomes in childhood anxiety.
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.
authors.affiliation: Department of Human Development and Applied Psychology, University of Toronto, Toronto, Canada, kat.hum@gmail.com.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Hum
authors.forename: Katharina
authors.initials: K
authors.lastname: Manassis
authors.forename: Marc D
authors.initials: MD
authors.lastname: Lewis
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001008:Anxiety Disorders / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D001288:Attention / Q000502:physiology; D016022:Case-Control Studies; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004569:Electroencephalography; D056348:Emotional Intelligence / Q000502:physiology*; D004644:Emotions / Q000502:physiology; D005071:Evoked Potentials / Q000502:physiology*; D005149:Facial Expression; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D007266:Inhibition, Psychological; D007406:Interview, Psychological; D016015:Logistic Models; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D009778:Occipital Lobe / Q000503:physiopathology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome