Neural Reactivity to Angry Faces Predicts Treatment Response in Pediatric Anxiety

Nora Bunford, Autumn Kujawa, Kate D. Fitzgerald, James E. Swain, Gregory L. Hanna, Elizabeth Koschmann, David Simpson, Sucheta Connolly, Christopher S. Monk, K. Luan Phan

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Although cognitive-behavioral psychotherapy (CBT) and pharmacotherapy are evidence-based treatments for pediatric anxiety, many youth with anxiety disorders fail to respond to these treatments. Given limitations of clinical measures in predicting treatment response, identifying neural predictors is timely. In this study, 35 anxious youth (ages 7–19 years) completed an emotional face-matching task during which the late positive potential (LPP), an event-related potential (ERP) component that indexes sustained attention towards emotional stimuli, was measured. Following the ERP measurement, youth received CBT or selective serotonin reuptake inhibitor (SSRI) treatment, and the LPP was examined as a predictor of treatment response. Findings indicated that, accounting for pre-treatment anxiety severity, neural reactivity to emotional faces predicted anxiety severity post- CBT and SSRI treatment such that enhanced electrocortical response to angry faces was associated with better treatment response. An enhanced LPP to angry faces may predict treatment response insofar as it may reflect greater emotion dysregulation or less avoidance and/or enhanced engagement with environmental stimuli in general, including with treatment.

Original languageEnglish (US)
Pages (from-to)385-395
Number of pages11
JournalJournal of Abnormal Child Psychology
Issue number2
StatePublished - Feb 1 2017

All Science Journal Classification (ASJC) codes

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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