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Cited by 24Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentNeural and Behavioral Psychology Studies

A Diagnostic Biomarker for Pediatric Generalized Anxiety Disorder Using the Error-Related Negativity

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Hanna, Gregory L., Liu, Yanni, Rough, Haley E., Surapaneni, Mihir, Hanna, Barbara S., Arnold, Paul D., Gehring, William J.·2020·Child Psychiatry & Human Development
DOI 10.1007/s10578-020-01021-5PMC PMC7529976
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Abstract

The error-related negativity (ERN) is a negative deflection in the event-related potential following a mistake that is a putative biomarker of anxiety. The study assessed the ERN as a diagnostic biomarker using receiver operating characteristic (ROC) analyses in 96 cases with anxiety disorders (AD) and 96 matched healthy controls (HC) ages 8 to 18 years. Forty-one cases had generalized anxiety disorder (GAD); 55 cases had other anxiety disorders (OAD) without GAD. ERN amplitude was significantly increased in AD cases compared to HC. The area under the curve (AUC) in the ROC analysis was 0.64, indicating the ERN is an inadequate diagnostic test for AD altogether. The ERN was significantly increased in cases with either GAD or OAD compared to HC. The AUC in ROC analyses with GAD and OAD was 0.75 and 0.56, respectively, suggesting the ERN provides an adequate diagnostic test for GAD but not for OAD.

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  • The results support the hypothesis that an enlarged ERN may serve as a transdiagnostic biomarker for OCD and tic disorders as well as some anxiety disorders.

    “The results support the hypothesis that an enlarged ERN may serve as a transdiagnostic biomarker for OCD and tic disorders as well as some anxiety disorders [8, 17–22].”

    From Altered Error Monitoring and Decreased Flanker Task Accuracy in Pediatric Obsessive–Compulsive Disorder (2026) · cites this paper as [22]

    The Discussion (page unavailable) reports enlarged ERN amplitudes in children with generalized and other anxiety disorders, and compares the finding with an earlier OCD study. This supports the anxiety-disorder portion and provides some context for OCD, but the paper does not establish an enlarged ERN as a biomarker for tic disorders; tics are mentioned only in the participant exclusions. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • ERN and CRN standardized residual scores may be preferable to subtraction-based difference scores in separating error processing from response monitoring.

    “ERN and CRN standardized residual scores (ERNresid and CRNresid) were calculated based on measuring the variance leftover in a regression equation in which one score is modeled as a predictor of another score, because they may be preferable to subtraction-based difference scores in separating error processing from response monitoring [22, 40].”

    From Altered Error Monitoring and Decreased Flanker Task Accuracy in Pediatric Obsessive–Compulsive Disorder (2026) · cites this paper as [22]

  • We found normal flanker task accuracy in youth with anxiety disorders compared to healthy controls.

    “In contrast, we found augmented ERN amplitudes but normal flanker task accuracy in youth with anxiety disorders compared to HC [22] and no differences between youth with major depressive disorder and HC in either ERN amplitudes or flanker task accuracy [21].”

    From Altered Error Monitoring and Decreased Flanker Task Accuracy in Pediatric Obsessive–Compulsive Disorder (2026) · cites this paper as [22]

  • We found augmented ERN amplitudes in youth with anxiety disorders compared to healthy controls.

    “In contrast, we found augmented ERN amplitudes but normal flanker task accuracy in youth with anxiety disorders compared to HC [22] and no differences between youth with major depressive disorder and HC in either ERN amplitudes or flanker task accuracy [21].”

    From Altered Error Monitoring and Decreased Flanker Task Accuracy in Pediatric Obsessive–Compulsive Disorder (2026) · cites this paper as [22]

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Cited by

Sorted by citations

Authors
Hanna, G. L., Liu, Y., Rough, H. E., Surapaneni, M., Hanna, B. S., Arnold, P. D., & Gehring, W. J.
Affiliations
  • University of Michigan (US)
  • University of Calgary (CA)
Corresponding author
Hanna, Gregory L.
ORCID
Venue
Child Psychiatry & Human Development
Publisher
Springer Science and Business Media LLC
Published
2020-07-12
Volume
51
Issue
5
Pages
827-838
ISSN
  • 0009-398X (ISSN-L)
  • 1573-3327
DOI
10.1007/s10578-020-01021-5
PMC
PMC7529976
OpenAlex
W3041569606
Cited by
24
References
13
Citations by year
2026: 1 · 2025: 6 · 2024: 4 · 2023: 1 · 2022: 7 · 2021: 3 · 2020: 2
FWCI
2.96
Type
journal article
Language
en
Open access
Licence
Locations
  • Child Psychiatry & Human Development (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R01MH101493)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Keywords
error-related negativity, generalized anxiety disorder, childhood anxiety disorders, diagnostic biomarkers, event-related potentials, anxiety diagnosis, children and adolescents
MeSH terms
Adolescent, Anxiety Disorders, Child, Electroencephalography, Evoked Potentials, Female, Humans, Male, Biomarkers

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