Gilbert Kirsten, Perino Michael T, Myers Michael J, Sylvester Chad M
Department of Psychiatry, Washington University in St. Louis, 4444 Forest Park, Suite 2100, St. Louis MO, 63108, USA.
Department of Psychiatry, Washington University in St. Louis, 4444 Forest Park, Suite 2100, St. Louis MO, 63108, USA.
J Anxiety Disord. 2020 May;72:102224. doi: 10.1016/j.janxdis.2020.102224. Epub 2020 Apr 6.
Multiple risk factors that may contribute to the development and severity of pediatric anxiety disorders, one of which is dimensional overcontrol. Overcontrol is a constellation of characteristics including heightened performance monitoring, inflexibility, perfectionism and aversion to making mistakes. In this study, we examined overcontrol in children with anxiety disorders and tested whether the underlying dimension of overcontrol specifically explains altered brain response to errors in pediatric anxiety disorders. Parent-reported scores of child overcontrol were collected in a sample of children (ages 8-12 years) with (n = 35) and without (n = 34) anxiety disorders and the relationship of overcontrol and anxiety symptoms to neural responding to errors during functional magnetic resonance imaging (fMRI) was examined. Results indicated childhood overcontrol was elevated in pediatric anxiety disorders and was significantly associated with anxiety severity, even when controlling for comorbid depression and ADHD. Additionally, overcontrol was associated with reduced neural response to errors versus correct responses in the bilateral dorsal anterior cingulate cortex (dACC) and insula, even when controlling for anxiety symptoms. Overcontrol may serve as an underlying mechanism associated with clinical pediatric anxiety that demonstrates significant associations with aberrant neural error responding. Overcontrol may be an underlying mechanism contributing to pediatric anxiety that could be targeted for early intervention.
多种风险因素可能导致儿童焦虑症的发生和严重程度，其中之一是维度过度控制。过度控制是一系列特征的集合，包括增强的表现监控、僵化、完美主义和对犯错的厌恶。在本研究中，我们研究了焦虑症儿童的过度控制情况，并测试了过度控制的潜在维度是否能具体解释儿童焦虑症中大脑对错误的反应改变。在一组患有（n = 35）和未患有（n = 34）焦虑症的儿童（8至12岁）样本中收集了家长报告的儿童过度控制得分，并研究了过度控制和焦虑症状与功能磁共振成像（fMRI）期间对错误的神经反应之间的关系。结果表明，儿童过度控制在儿童焦虑症中有所升高，并且即使在控制了共病的抑郁症和注意力缺陷多动障碍后，仍与焦虑严重程度显著相关。此外，即使在控制了焦虑症状后，过度控制与双侧背侧前扣带回皮质（dACC）和脑岛中对错误与正确反应的神经反应减少有关。过度控制可能是与临床儿童焦虑相关的一种潜在机制，与异常的神经错误反应存在显著关联。过度控制可能是导致儿童焦虑的一种潜在机制，可作为早期干预的目标。
