Withdrawn/Depressed Behaviors and Error-Related Brain Activity in Youth With Obsessive-Compulsive Disorder
Open accessAbstract
Objective The pathophysiology of obsessive-compulsive disorder (OCD) involves increased activity in corticostriatal circuits connecting the anterior cingulate cortex with other brain regions. The error-related negativity (ERN) is a negative deflection in the event-related potential after an incorrect response that is believed to reflect anterior cingulate cortex activity. This study examined the relation of the ERN to OCD symptom dimensions and other childhood symptom dimensions.Method The ERN, correct response negativity, and accuracy were measured during a flanker task to assess performance monitoring in 80 youth with a lifetime diagnosis of OCD and 80 matched healthy comparison participants ranging from 8 to 18 years old. The relation of the ERN to OCD symptom dimension scores and Child Behavior Checklist Syndrome Scale scores was examined in multiple linear regression analyses.Results Accuracy was significantly decreased and ERN amplitude was significantly increased in patients compared with controls. ERN amplitude in patients was significantly correlated with accuracy, but not with OCD symptom dimensions, severity, comorbidity, or treatment. In a multiple linear regression analysis using age, accuracy, OCD, and Child Behavior Checklist Syndrome Scale scores as predictors of ERN amplitude, the ERN had significant associations only with Withdrawn/Depressed Scale scores and accuracy.Conclusion An enlarged ERN is a neural correlate of pediatric OCD that is independent of OCD symptom expression and severity. The finding of lower accuracy in pediatric cases requires replication. The relation between an enhanced ERN and withdrawn/depressed behaviors warrants further research in youth with OCD and other internalizing disorders.
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In most pediatric studies reviewed, only the amplitude of the ERN/CRN component was measured and statistically analyzed, but close examination of Pe/Pc tracings revealed that in most of them, the amplitude of the Pe component appeared substantially smaller in children with OCD than in control children or adolescents.
“In most cases, only the amplitude of the ERN/CRN component was measured and statistically analyzed. However, close examination of the Pe/Pc tracings obtained in these studies revealed that in most of them, the amplitude of the Pe component appeared to be substantially smaller in children with OCD than in control children or adolescents [25, 33–36, 64, 65].”
From Error-Related Brain Potentials as Biomarkers of Pathology Severity and Treatment Resistance in Patients With Obsessive-Compulsive Disorder (2026) · cites this paper as [64]
Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredThe 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 [20]
The Discussion proposes that an enlarged ERN could be a transdiagnostic liability index for OCD and social phobia, and the Results show an enlarged ERN in youth with OCD. The paper does not establish it as a biomarker for tic disorders: its tic-related finding concerns tic history among patients with OCD, not tic disorders independently. Page numbers were not available in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIn paediatric samples, youths with OCD repeatedly showed enlarged ERN amplitudes relative to healthy controls during modified Eriksen flanker tasks.
“In paediatric samples, youths with OCD repeatedly showed enlarged ERN amplitudes relative to healthy controls during modified Eriksen flanker tasks [33,34,37,38,39,40,45,50].”
The enlarged ERN effect in paediatric OCD was generally specific to error processing, because the correct-response negativity was often unchanged.
“This effect was generally specific to error processing, because the correct-response negativity was often unchanged, suggesting that the abnormality did not simply reflect a general increase in response-related activity [34,37,38,40,42].”
In paediatric OCD, larger ERN amplitudes were sometimes associated with better task accuracy or fewer errors.
“In paediatric OCD, larger ERN amplitudes were sometimes associated with better task accuracy or fewer errors [38,39,40,50].”
Our studies of older children and adolescents have shown decreased flanker task accuracy in youth with OCD compared to healthy controls.
“However, our studies of older children and adolescents have shown increased ERN amplitudes but decreased flanker task accuracy in youth with OCD compared to HC [20, 21].”
From Altered Error Monitoring and Decreased Flanker Task Accuracy in Pediatric Obsessive–Compulsive Disorder (2026) · cites this paper as [20]
Our studies of older children and adolescents have shown increased ERN amplitudes in youth with OCD compared to healthy controls.
“However, our studies of older children and adolescents have shown increased ERN amplitudes but decreased flanker task accuracy in youth with OCD compared to HC [20, 21].”
From Altered Error Monitoring and Decreased Flanker Task Accuracy in Pediatric Obsessive–Compulsive Disorder (2026) · cites this paper as [20]
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“However, close examination of the Pe/Pc tracings obtained in these studies revealed that in most of them, the amplitude of the Pe component appeared to be substantially smaller in children with OCD than in control children or adolescents [25, 33 – 36, 64, 65].”
- Authors
- Hanna, G. L., Liu, Y., Isaacs, Y. E., Ayoub, A. M., Torres, J. J., O’Hara, N. B., & Gehring, W. J.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Hanna, Gregory L.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2016-10
- Volume
- 55
- Issue
- 10
- Pages
- 906-913.e2
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC5577943
- OpenAlex
- W2479213417
- Cited by
- 30
- References
- 40
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 1 · 2022: 3 · 2021: 5 · 2020: 7 · 2019: 4 · 2018: 3 · 2017: 1
- FWCI
- 3.57
- Type
- journal article
- Language
- en
- Status
- Retracted
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH101493, R01MH085321)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- obsessive-compulsive disorder, error-related negativity, performance monitoring, anterior cingulate cortex, corticostriatal circuits, internalizing disorders, flanker task, response accuracy, pediatric OCD, Child Behavior Checklist
- MeSH terms
- Adolescent, Brain, Child, Depression, Electroencephalography, Evoked Potentials, Female, Humans, Male, Obsessive-Compulsive Disorder, Psychomotor Performance, Reaction Time
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