Altered Error Monitoring and Decreased Flanker Task Accuracy in Pediatric Obsessive-Compulsive Disorder
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The error-related negativity (ERN) and error positivity (Pe) are components of the event-related potential following an error that are potential mechanistic biomarkers of obsessive-compulsive disorder (OCD). The study examined the ERN, Pe, flanker task accuracy, and clinical measures in 105 OCD cases and 105 matched healthy controls (HC), ages 8 to 18 years, with 21 cases having a tic disorder history. Higher flanker task accuracy in all participants was associated with an increased ERN amplitude and increased difference between Pe and correct positivity amplitudes (ΔPe). Compared to HC, OCD cases had an increased ERN but decreased flanker task accuracy and ΔPe. Those differences were also significant in tic-related and non-tic-related OCD cases compared to HC. A lower ΔPe was associated in OCD cases with an earlier age at OCD symptom onset. The results support the hypothesis that OCD involves defects in an error monitoring system and suggest a reduced ΔPe may compromise error signaling and cause uncertainty about the correctness of a response.
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Hanna et al. found that the difference between the amplitudes of the Pe and Pc components was significantly smaller in children with OCD than in age-matched controls.
“Recently, Hanna et al. [67] found that the difference between the amplitudes of the Pe and Pc components was significantly smaller in children with OCD than in age‐matched controls.”
From Error-Related Brain Potentials as Biomarkers of Pathology Severity and Treatment Resistance in Patients With Obsessive-Compulsive Disorder (2026) · cites this paper as [67]
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Holbrook, A., Park, B., Baldwin, S. A., Riesel, A., Larson, M. J., & Clayson, P. (2025) · Psychophysiology · doi:10.1111/psyp.70042 · Cited by 6 · see citing works
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“Recently, Hanna et al. [67] found that the difference between the amplitudes of the Pe and Pc components was signi fi cantly smaller in children with OCD than in age-matched controls.”
Dück, K., Overmeyer, R., Dieterich, R., & Endraß, T. (2026) · Scientific Reports · doi:10.1038/s41598-026-58046-4
- Authors
- Hanna, G., Liu, Y., Rentschler, L., Hanna, B., Arnold, P., & Gehring, W.
- Affiliations
- University of Michigan (US)
- University of Calgary (CA)
- Corresponding author
- Hanna, Gregory
- Venue
- Child Psychiatry & Human Development
- Publisher
- Research Square Platform LLC
- Published
- 2024-02-13
- Volume
- 57
- Issue
- 2
- Pages
- 390-403
- ISSN
- 0009-398X (ISSN-L)
- PMC
- PMC10896395
- OpenAlex
- W4399012606
- Cited by
- 4
- References
- 44
- Citations by year
- 2026: 2 · 2025: 2
- FWCI
- 2.00
- Type
- journal article
- Language
- en
- Open access
- green
- dx.doi.org
- Locations
- Child Psychiatry & Human Development (publishedVersion)
- Research Square (acceptedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (submittedVersion, cc-by)
- Funders
- National Institutes of Health
- National Institute of Mental Health (R01MH101493)
- 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
- pediatric obsessive-compulsive disorder, error monitoring, error-related negativity, error positivity, flanker task, event-related potentials, age at symptom onset, biomarkers, response uncertainty
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