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Neural Reactivity to Angry Faces Predicts Treatment Response in Pediatric Anxiety

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Abstract

Although cognitive-behavioral psychotherapy (CBT) and pharmacotherapy are evidence-based treatments for pediatric anxiety, many youth with anxiety disorders fail to respond to these treatments. Given limitations of clinical measures in predicting treatment response, identifying neural predictors is timely. In this study, 35 anxious youth (ages 7–19 years) completed an emotional face-matching task during which the late positive potential (LPP), an event-related potential (ERP) component that indexes sustained attention towards emotional stimuli, was measured. Following the ERP measurement, youth received CBT or selective serotonin reuptake inhibitor (SSRI) treatment, and the LPP was examined as a predictor of treatment response. Findings indicated that, accounting for pre-treatment anxiety severity, neural reactivity to emotional faces predicted anxiety severity post- CBT and SSRI treatment such that enhanced electrocortical response to angry faces was associated with better treatment response. An enhanced LPP to angry faces may predict treatment response insofar as it may reflect greater emotion dysregulation or less avoidance and/or enhanced engagement with environmental stimuli in general, including with treatment.

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Notes

  1. The results of independent samples t-tests also indicated no difference between males and females with regard to LPP or post-treatment anxiety severity (all ps > 0.18).

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Authors and Affiliations

  1. Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60608, USA

    Nora Bunford, Autumn Kujawa, David Simpson, Sucheta Connolly & K. Luan Phan

  2. Department of Psychology, Ohio University, Athens, OH, 45701, USA

    Nora Bunford

  3. Department of Psychiatry, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Rm. 277, Chicago, IL, 60612, USA

    Nora Bunford

  4. Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA

    Kate D. Fitzgerald, James E. Swain, Gregory L. Hanna, Elizabeth Koschmann & Christopher S. Monk

  5. Department of Psychology, University of Michigan, Ann Arbor, MI, 48109, USA

    James E. Swain, Christopher S. Monk & K. Luan Phan

  6. Departments of Psychology and Anatomy & Cell Biology, and Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, IL, 6012, USA

    K. Luan Phan

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  1. Nora Bunford
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  2. Autumn Kujawa
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  3. Kate D. Fitzgerald
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  4. James E. Swain
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  5. Gregory L. Hanna
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  6. Elizabeth Koschmann
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  7. David Simpson
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  8. Sucheta Connolly
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  9. Christopher S. Monk
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  10. K. Luan Phan
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Correspondence to Nora Bunford.

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Funding

This study was funded by T32MH067631 awarded to Dr. Autumn Kujawa and by R01MH086517 awarded to Drs. Christopher S. Monk and K. Luan Phan.

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The Authors declare that they have no conflict of interest.

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All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Bunford, N., Kujawa, A., Fitzgerald, K.D. et al. Neural Reactivity to Angry Faces Predicts Treatment Response in Pediatric Anxiety. J Abnorm Child Psychol 45, 385–395 (2017). https://doi.org/10.1007/s10802-016-0168-2

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