Neural mechanisms of uncertain decision-making in anxious adolescents: an EEG study based on the balloon analogue...

Adolescence is marked by heightened vulnerability to anxiety which can impair decision-making under uncertainty. The underlying neural oscillatory network-level mechanisms in anxious adolescents require further elucidation.

We recruited 40 adolescents (20 adolescents with clinically diagnosed anxiety disorders, 20 matched controls). Participants performed a gain/loss version of the Balloon Analogue Risk Task (BART) during EEG recording. Behavioral data, time-frequency EEG power in beta (13-30 Hz) and theta (4-7 Hz) bands, and phase-based functional connectivity were analyzed.

Anxious adolescents exhibited significant behavioral avoidance, reflected in fewer pump attempts and lower BART scores compared to controls. EEG analysis revealed elevated beta-band power during gain decisions and enhanced beta-band occipito-temporal connectivity in the anxious group. In loss contexts, anxious adolescents showed increased theta-band parieto-temporal connectivity.

Adolescent anxiety is associated with a generalized avoidance pattern during uncertain decision-making, characterized by distinct neural dynamics. Beta-band changes in gain contexts may reflect heightened vigilance, while theta-band connectivity in loss contexts may indicate amplified threat monitoring. These neural signatures may represent candidate neurophysiological signatures of anxiety-related alterations in decision-making under uncertainty, warranting further validation in longitudinal and predictive studies.