Neural responses to error in youth: the impact of social context, anxiety, and worry

Atypical error responses characterize pediatric anxiety disorders. Error responses are considerably influenced by situational factors such as social context, which typically elicits enhanced error responses. This study investigates the impact of social context on the neural correlates of error processing and how individual differences in anxiety symptoms and naturalistically-sampled daily worry influences these associations. Sixty-two youth (32 with an anxiety disorder, 30 healthy controls; M_age =13.9 +/- 2.7, 61% female) underwent functional magnetic resonance imaging while completing a flanker task in both peer and alone context. Anxiety symptoms were measured using Screen for Child Anxiety Related Disorders, and daily worry was measured using ecological momentary assessment. Diagnosis inclusions were only used to ensure enriched sample for symptoms dimensions of anxiety but not used as a grouping criteria. The presence of a simulated peer was associated with decreased activity in the precuneus, mid-orbital gyrus, and parahippocampal gyrus/amygdala during error processing. In youth with higher anxiety symptom severity, the presence of a peer was associated with decreased activity in the superior/middle temporal gyrus and middle frontal gyrus. In contrast, for youth rating higher levels of daily worries, the presence of a peer was associated with increased activity in the inferior frontal gyrus and middle cingulate cortex. Findings highlight the importance of social context in error processing. Results further suggest that anxiety and worry differentially modulate neural responses in the presence of a peer.