Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, USA.
Res Child Adolesc Psychopathol. 2022 Dec;50(12):1629-1642. doi: 10.1007/s10802-022-00953-x. Epub 2022 Jul 19.
Anxiety and obsessive-compulsive disorders are common childhood psychiatric disorders. Behavioral inhibition (BI) is a widely studied risk factor for anxiety. Less is known about overcontrol, a related behavioral phenotype characterized by concern for errors, perfectionism, and inflexibility and also associated with anxiety and obsessive-compulsive disorder. Both BI and overcontrol show associations with aberrant cognitive control and neural error responding (via the error-related negativity; ERN) yet it is unknown whether each imparts differential risk. Understanding whether overcontrol demonstrates independent associations from BI with cognitive functioning, neural error monitoring, and childhood anxiety and obsessive-compulsive presentations could aid in identifying a novel mechanistic treatment target. We assessed BI, overcontrol, cognitive functioning and psychopathology in a cross-sectional sample of 5-6 year old children (N = 126). Children completed an electroencephalogram (EEG) to assess the ERN. Overcontrol was associated with worse cognitive shifting, worse inhibitory control and higher anxiety and obsessive-compulsive symptoms, beyond BI. BI was associated with worse cognitive shifting, better inhibitory control and higher anxiety symptoms, beyond overcontrol. When assessed simultaneously, only overcontrol demonstrated a significant relationship with a blunted ERN. Moreover, overcontrol mediated (cross-sectionally) the well-established relationship between ERN and anxiety and obsessive-compulsive symptoms. BI and overcontrol impart differential risk for child cognitive functioning and anxiety while overcontrol demonstrates additional risk for aberrant neural error monitoring, anxiety and obsessive-compulsive presentations. Overcontrol may also be a mechanistic pathway between the ERN and transdiagnostic anxiety and obsessive-compulsive symptoms. Overcontrol may be a target warranted for early-childhood intervention in anxiety and OCD.
焦虑症和强迫症是常见的儿童期精神疾病。行为抑制（BI）是焦虑的一个广泛研究的风险因素。较少被关注的是过度控制，这是一种相关的行为表型，其特征是对错误、完美主义和不灵活的关注，也与焦虑症和强迫症有关。BI 和过度控制都与异常的认知控制和神经错误反应（通过错误相关负波；ERN）有关，但尚不清楚两者是否具有不同的风险。了解过度控制是否与 BI 一起对认知功能、神经错误监测以及儿童期焦虑和强迫症表现具有独立的关联，可能有助于确定新的机制治疗靶点。我们在一个 5 至 6 岁儿童的横断面样本中评估了 BI、过度控制、认知功能和精神病理学（N = 126）。儿童完成了脑电图（EEG）以评估 ERN。过度控制与认知转换、抑制控制较差、焦虑和强迫症症状较高有关，BI 也是如此。BI 与认知转换较差、抑制控制较好和焦虑症状较高有关，过度控制也是如此。当同时评估时，只有过度控制与 ERN 呈显著相关。此外，过度控制（横断面）介导了 ERN 与焦虑和强迫症症状之间已确立的关系。BI 和过度控制对儿童认知功能和焦虑有不同的风险，而过度控制对异常神经错误监测、焦虑和强迫症表现有额外的风险。过度控制也可能是 ERN 与跨诊断焦虑和强迫症症状之间的机制途径。过度控制可能是焦虑症和强迫症儿童早期干预的一个目标。
