Error-related brain activity in youth and young adults before and after treatment for generalized or social anxiety disorder

Autumn Kujawa, Anna Weinberg, Nora Bunford, Kate D. Fitzgerald, Gregory L. Hanna, Christopher S. Monk, Amy E. Kennedy, Heide Klumpp, Greg Hajcak, K. Luan Phan

Research output: Contribution to journalArticlepeer-review

70 Scopus citations


Increased error monitoring, as measured by the error-related negativity (ERN), has been shown to persist after treatment for obsessive-compulsive disorder in youth and adults; however, no previous studies have examined the ERN following treatment for related anxiety disorders. We used a flanker task to elicit the ERN in 28 youth and young adults (8–26 years old) with primary diagnoses of generalized anxiety disorder (GAD) or social anxiety disorder (SAD) and 35 healthy controls. Patients were assessed before and after treatment with cognitive-behavioral therapy (CBT) or selective serotonin reuptake inhibitors (SSRI), and healthy controls were assessed at a comparable interval. The ERN increased across assessments in the combined sample. Patients with SAD exhibited an enhanced ERN relative to healthy controls prior to and following treatment, even when analyses were limited to SAD patients who responded to treatment. Patients with GAD did not significantly differ from healthy controls at either assessment. Results provide preliminary evidence that enhanced error monitoring persists following treatment for SAD in youth and young adults, and support conceptualizations of increased error monitoring as a trait-like vulnerability that may contribute to risk for recurrence and impaired functioning later in life. Future work is needed to further evaluate the ERN in GAD across development, including whether an enhanced ERN develops in adulthood or is most apparent when worries focus on internal sources of threat.

Original languageEnglish (US)
Pages (from-to)162-168
Number of pages7
JournalProgress in Neuro-Psychopharmacology and Biological Psychiatry
StatePublished - Nov 3 2016

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Biological Psychiatry


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