EEG correlates of attentional control in anxiety disorders: A systematic review of error-related negativity and correct-response negativity findings
Abstract
Background Anxiety disorders are highly prevalent and cause substantial personal, social and economic burden. Altered attentional control has been shown to be present across anxiety disorders and is associated with specific changes in brain activity which can be recorded by electroencephalogram (EEG). These include changes in the EEG markers of error-related negativity (ERN) and correct-response negativity (CRN), both believed to reflect response monitoring and attentional control pathophysiology in anxiety. The aim of this review was to systematically assess the research on ERN and CRN in attentional control in individuals with clinical anxiety and healthy controls, across emotional and non-emotional attentional control. Methods A comprehensive literature search was conducted for studies published prior to October 22 nd , 2020. Details of the protocol for this systematic review were registered on PROSPERO (CRD42019144885). Results 66 studies had their data extracted. All 66 studies measured ERN, with 85% finding significantly increased ERN amplitudes associated with clinical anxiety. Only 44 of the extracted studies analysed CRN and only ~20% of these found significant changes in CRN amplitude associated with individuals with clinical anxiety. Limitations There were several anxiety disorders that had either limited literature (i.e. specific phobia, separation anxiety disorder or agoraphobia) or nil literature (i.e. selective mutism) available. No extracted studies included s…
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The finding of increased ERN amplitude in OCD cases compared to healthy controls is consistent with numerous other reports.
“ERN amplitude was increased in OCD cases compared to HC, which is consistent with numerous other reports (Bellato et al. 2021; Lamothe et al. 2025; Michael et al. 2021; Riesel 2019).”
From Reaction Time Variability and Electrophysiological Indices of Performance Monitoring in Youths With Attention-Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder (2026) · cites this paper as Michael et al. 2021
The finding that OCD cases were less accurate than healthy controls on the flanker task is contrary to studies of adults with OCD.
“However, the OCD cases were less accurate than the HC on the flanker task in our study, which is contrary to studies of adults with OCD (Bellato et al. 2021; Michael et al. 2021; Riesel 2019).”
From Reaction Time Variability and Electrophysiological Indices of Performance Monitoring in Youths With Attention-Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder (2026) · cites this paper as Michael et al. 2021
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Cognitive neuroscience of obsessive-compulsive disorder
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“ERN amplitude was increased in OCD cases compared to HC, which is consistent with numerous other reports (Bellato et al. 2021; Lamothe et al. 2025; Michael et al. 2021; Riesel 2019).”
Influential
- Authors
- Michael, J. A., Wang, M., Kaur, M., Fitzgerald, P. B., Fitzgibbon, B. M., & Hoy, K. E.
- Affiliations
- Epworth Hospital (AU)
- Corresponding author
- Michael, Jessica A.
- ORCID
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2021-08
- Volume
- 291
- Pages
- 140-153
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W3165617290
- Cited by
- 43
- References
- 19
- Citations by year
- 2026: 3 · 2025: 14 · 2024: 9 · 2023: 6 · 2022: 8 · 2021: 3
- FWCI
- 1.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Health and Medical Research Council (1082894, GNT111261)
- Brain and Behavior Research Foundation (26366)
- National Alliance for Research on Schizophrenia and Depression
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › EEG and Brain-Computer Interfaces
- Keywords
- anxiety disorders, attentional control, error-related negativity, correct response negativity, response monitoring, EEG biomarkers, emotional attention, transdiagnostic markers
- MeSH terms
- Aged, Anxiety, Anxiety Disorders, Attention, Electroencephalography, Evoked Potentials, Humans, Reaction Time
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