Diminished error-related negativity and error positivity in children and adults with externalizing problems and disorders: a meta-analysis on error processing

Lutz, Miranda Christine; Kok, Rianne; Verveer, Ilse; Malbec, Marcelo; Koot, Susanne; van Lier, Pol A.C.; Franken, Ingmar H.A.

doi:10.1503/jpn.200031

Cited by 44Neural and Behavioral Psychology StudiesChild and Adolescent Psychosocial and Emotional DevelopmentAttention Deficit Hyperactivity Disorder

Diminished error-related negativity and error positivity in children and adults with externalizing problems and disorders: a meta-analysis on error processing

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Lutz, Miranda Christine, Kok, Rianne, Verveer, Ilse, Malbec, Marcelo, Koot, Susanne, van Lier, Pol A.C., Franken, Ingmar H.A.·2021·Journal of Psychiatry and Neuroscience

DOI 10.1503/jpn.200031PMC PMC8580828

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Abstract

Background: Deficits in error processing are reflected in an inability of people with externalizing problems to adjust their problem behaviour. The present study contains 2 meta-analyses, testing whether error processing — indexed by the event-related potentials error-related negativity (ERN) and error positivity (Pe) — is reduced in children and adults with externalizing problems and disorders compared to healthy controls. Methods: We conducted a systematic search in PubMed (1980 to December 2018), PsycInfo (1980 to December 2018) and Scopus (1970 to December 2018), identifying 328 studies. We included studies that measured error processing using the Eriksen flanker task, the go/no-go task or the stop-signal task in healthy controls and in adults or children with clearly described externalizing behavioural problems (e.g., aggression) or a clinical diagnosis on the externalizing spectrum (e.g., addiction). Results: Random-effect models (ERN: 23 studies, 1739 participants; Pe: 27 studies, 1456 participants) revealed a reduced ERN amplitude (Hedges’ g = 0.44, 95% confidence interval [CI] 0.29 to 0.58) and a reduced Pe amplitude (Hedges’ g = −0.27, 95% CI −0.44 to −0.09) during error processing in people with externalizing problems or disorders compared to healthy controls. Type of diagnosis, age and the presence of performance feedback or comorbidity did not moderate the results. The employed cognitive task was a moderator for Pe but not for ERN. The go/no-go task generated a greater amplitude difference in Pe than the Eriksen flanker task. Small-sample assessment revealed evidence of publication bias for both event-related potentials. However, a p curve analysis for ERN showed that evidential value was present; for Pe, the p curve analysis was inconclusive. Limitations: The moderators did not explain the potential heterogeneity in most of the analysis, suggesting that other disorder- and patient-related factors affect error processing. Conclusion: Our findings indicate the presence of compromised error processing in externalizing psychopathology, suggesting diminished activation of the prefrontal cortex during performance monitoring.

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Meta-analytic evidence supports the ERN as a potential biomarker for psychopathology, with anxiety symptoms associated with larger (more negative) amplitudes and externalizing symptoms associated with smaller (less negative) amplitudes.
“Meta-analytic evidence supports the ERN as a potential biomarker for psychopathology, with anxiety symptoms associated with larger (more negative) amplitudes (Moser et al., 2013) and externalizing symptoms associated with smaller (less negative) amplitudes (Lutz et al., 2021).”
From Foster care intervention protects cognitive control skills in young adults exposed to institutional rearing (2026) · cites this paper as Lutz et al., 2021
A previous meta-analysis found that elevated externalizing problems were associated with smaller ERN amplitudes.
“a previous meta-analysis found that elevated externalizing problems were associated with smaller ERN amplitudes (Lutz et al., 2021)”
From Foster care intervention protects cognitive control skills in young adults exposed to institutional rearing (2026) · cites this paper as Lutz et al., 2021

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Externalizing Proneness and Psychophysiological Responses in a Reinforcement-Learning Task
(2012) · DigiNole (Florida State University)

Authors: Lutz, M. C., Kok, R., Verveer, I., Malbec, M., Koot, S., van Lier, P. A. C., & Franken, I. H. A.
Affiliations: Vrije Universiteit Amsterdam (NL)
the Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, HV Amsterdam, the Netherlands
Corresponding author: Lutz, Miranda Christine
ORCID: Lutz, Miranda Christine
Kok, Rianne
Verveer, Ilse
Malbec, Marcelo
Koot, Susanne
Franken, Ingmar H.A.
Venue: Journal of Psychiatry and Neuroscience
Publisher: Canadian Science Publishing
Published: 2021-12-21
Volume: 46
Issue: 6
Pages: E615-E627
ISSN: 1180-4882 (ISSN-L)
1488-2434
DOI: 10.1503/jpn.200031
PMC: PMC8580828
OpenAlex: W3213334440
Cited by: 44
References: 103
Citations by year: 2026: 8 · 2025: 9 · 2024: 13 · 2023: 7 · 2022: 7
FWCI: 1.00
Type: journal article
Language: en
Open access: diamond
doi.org
Licence: cc-by-nc-nd
www.nrcresearchpress.com/page/about/CorporateTextAndDataMining (tdm)
Locations: Journal of Psychiatry and Neuroscience (publishedVersion, cc-by-nc-nd)
PubMed Central (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, cc-by-nc-nd)
VU Research Portal (publishedVersion, other-oa)
EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, cc-by-nc-nd)
OSF Preprints (OSF Preprints) (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders: Erasmus Universiteit Rotterdam
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Keywords: error processing, error-related negativity, error positivity, externalizing problems, externalizing disorders, event-related potentials, performance monitoring, prefrontal cortex, aggression, addiction, children and adolescents, go/no-go task, flanker task, stop-signal task, publication bias
MeSH terms: Adult, Aggression, Child, Electroencephalography, Evoked Potentials, Humans, Psychomotor Performance, Reaction Time

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Diminished error-related negativity and error positivity in children and adults with externalizing problems and disorders: a meta-analysis on error processing

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