Atypical action updating in a dynamic environment associated with adolescent obsessive-compulsive disorder

Background Computational research had determined that adults with obsessive-compulsive disorder (OCD) display heightened action updating in response to noise in the environment and neglect meta-cognitive information (such as confidence) when making decisions. These features are proposed to underlie patients compulsions despite knowledge they are irrational. Nonetheless, it is unclear whether this extends to adolescents with OCD as research in this population is lacking. Thus, this study aimed to investigate the interplay between action and confidence in adolescents with OCD. Methods Twenty-seven adolescents with OCD and 46 controls completed a predictive-inference task, designed to probe how subjects actions and confidence ratings fluctuate in response to unexpected outcomes. We investigated how subjects update actions in response to prediction errors (indexing mismatches between expectations and outcomes) and used parameters from a Bayesian model to predict how confidence and action evolve over time. Confidence-action association strength was assessed using a regression model. We also investigated the effects of serotonergic medication. Results Adolescents with OCD showed significantly increased learning rates, particularly following small prediction errors. Results were driven primarily by unmedicated patients. Confidence ratings appeared equivalent between groups, although model-based analysis revealed that patients confidence was less affected by prediction errors compared to controls. Patients and controls did not differ in the extent to which they updated actions and confidence in tandem. Conclusions Adolescents with OCD showed enhanced action adjustments, especially in the face of small prediction errors, consistent with previous research establishing just-right compulsions, enhanced error-related negativity, and greater decision-uncertainty in paediatric-OCD. These tendencies were ameliorated in patients receiving serotonergic medication, emphasising the importance of early intervention in preventing disorder-related cognitive deficits. Confidence ratings were equivalent between young patients and controls, mirroring findings in adults OCD research.

Neurocognitive development of novelty and error monitoring in children and adolescents

The abilities to monitor one’s actions and novel information in the environment are crucial for behavioural and cognitive control. This study investigated the development of error and novelty monitoring and their electrophysiological correlates by using a combined flanker with novelty-oddball task in children (7–12 years) and adolescents (14–18 years). Potential moderating influences of prenatal perturbation of steroid hormones on these performance monitoring processes were explored by comparing individuals who were prenatally exposed and who were not prenatally exposed to synthetic glucocorticoids (sGC). Generally, adolescents performed more accurately and faster than children. However, behavioural adaptations to error or novelty, as reflected in post-error or post-novelty slowing, showed different developmental patterns. Whereas post-novelty slowing could be observed in children and adolescents, error-related slowing was absent in children and was marginally significant in adolescents. Furthermore, the amplitude of error-related negativity was larger in adolescents, whereas the amplitude of novelty-related N2 was larger in children. These age differences suggest that processes involving top-down processing of task-relevant information (for instance, error monitoring) mature later than processes implicating bottom-up processing of salient novel stimuli (for instance, novelty monitoring). Prenatal exposure to sGC did not directly affect performance monitoring but initial findings suggest that it might alter brain-behaviour relation, especially for novelty monitoring.

Understanding the Error in Psychopathology: Notable Intraindividual Differences in Neural Variability of Performance Monitoring

Background: Abnormal performance monitoring is a possible transdiagnostic marker common across psychopathology. Most research on neural indices of performance monitoring, including the error-related negativity (ERN), has examined group and interindividual (between-person) differences in mean/average scores. Intraindividual (within-person) variability in neural activity captures the capacity to dynamically adjust from moment to moment, and excessive neural variability appears maladaptive. Intraindividual variability in ERN represents a unique and largely unexplored dimension that might impact functioning. We tested whether psychopathology group differences (major depressive disorder [MDD], generalized anxiety disorder [GAD], obsessive-compulsive disorder [OCD]) or corresponding psychiatric symptoms account for intraindividual variability in single-trial ERN scores. Methods: ERN was recorded in 51 participants with MDD, 44 participants with GAD, 31 participants with OCD, and 56 psychiatrically-healthy control participants. Multilevel location-scale models were used to simultaneously examine interindividual and intraindividual differences in ERN amplitude. Results: Analyses indicated considerable intraindividual variability in ERN that was common across all groups. However, we did not find strong evidence to support clinical differences in ERN when examining traditional diagnostic categories or relationships with transdiagnostic symptoms. Conclusions: These findings point to important methodological implications for studies of performance monitoring in healthy and clinical populations—the common assumption of fixed intraindividual variability (i.e., residual variance) is inappropriate for ERN studies in clinical or healthy populations. Implementation of multilevel location-scale models in future research can leverage between-person differences in intraindividual variability in performance monitoring to gain a rich understanding of the trial-to-trial dynamics of performance monitoring.