Enhanced Neural Reactivity to Threatening Faces in Anxious Youth: Evidence from Event-Related Potentials

Anxiety disorders are characterized by enhanced reactivity to threat, and event-related potentials (ERPs) are useful neural measures of the dynamics of threat processing. In particular, the late positive potential (LPP) is an ERP component that reflects sustained attention towards motivationally salient information. Previous studies in adults suggest that the LPP is enhanced to threatening stimuli in anxiety but blunted in depression; however, very little work has evaluated the LPP to threat in anxious youth. We measured the LPP during an emotional face-matching task in youth (age 7-19) with current anxiety disorders (n = 53) and healthy controls with no history of psychopathology (n = 37). We evaluated group differences, as well as the effect of depressive symptoms on the LPP. Youth with anxiety disorders exhibited enhanced LPPs to angry and fearful faces 1000-2000 ms after stimulus onset. Higher depressive symptoms were associated with reduced LPPs to angry faces across both groups. Enhanced LPPs to threatening faces were most apparent for social anxiety disorder, as opposed to generalized anxiety disorder or separation anxiety disorder. Results suggest the LPP may be a useful neural measure of threat reactivity in youth with anxiety disorders and highlight the importance of accounting for symptoms of both depression and anxiety when examining emotional processing.