When Mistakes Are a Threat to Mental Health

September 23, 2014
by Suzanne Bouffard

Most people don’t like to make mistakes, but some people are more sensitive to errors than others, and that can make them more prone to anxiety, according to Greg Hajcak Proudfit, associate professor of psychology at Stony Brook University. Proudfit’s research on how people’s brains process mistakes is helping to identify who is at risk for anxiety and even to suggest new avenues for treatment of anxiety and related disorders.

In lab studies, Proudfit and his colleagues measure the amount of brain activity while participants are completing a computer task. Immediately after people make a mistake, a region of the brain called the anterior cingulate cortex is activated, and scientists call the increase in activity the error-related negativity (ERN). Proudfit speculates that this change in neural activity is important for humans at an evolutionary level, because making some kinds of errors can threaten our safety or even survival. “Errors are important to detect because they represent missed opportunities and potential harm,” he explains.

Everyone has an ERN after mistakes, but the magnitude of ERN varies among people and across situations, and higher ERN is associated with greater risk for mental health problems. “More anxious people tend to have a higher ERN, and we think it’s because they’re more sensitive to errors and potential threats,” Proudfit says. He has found higher ERNs not only among people with clinical diagnoses of anxiety, but among people who tend to worry or exhibit anxious symptoms.

What makes some people prone to higher ERNs and therefore anxiety? The ERN is somewhat heritable; for instance, healthy individuals who have immediate family members with anxiety and obsessive compulsive disorder tend to have a larger ERN. But situational factors also affect ERN. In lab studies, Proudfit has shown that it’s possible to induce a higher ERN by “punishing” participants for errors, for example by playing a very loud and aggravating sound after the participant makes a mistake.

Importantly, Proudfit has shown that real-world situations outside the lab, like interactions between parents and children, may also increase ERN. He and his colleagues recently found that when parents engage in more hostile and critical interactions with their children at age 3, the children are more likely to have high ERNs at age 6, and in turn, more likely to have anxiety. In the same sample, the researchers have also found that an increased ERN at age 6 predicts new anxiety disorders by age 9.

This study, which involves following children to ages 12 and beyond, adds to other research on how parenting practices can contribute to anxiety, and suggests opportunities for parenting interventions to reduce the risk. It also shows that measuring ERN can be useful for predicting future anxiety. What’s exciting, Proudfit believes, is that such risk can be measured easily, using the electroencephalogram, or EEG. EEG is an inexpensive and direct measure of brain activity; it is quick to interpret and non-invasive; and it can be used even with young children, he points out.

“This means you could theoretically collect data from very large samples of kids and attempt to predict, over and above other factors like mothers’ history of anxiety, the likelihood of later anxiety.” And that provides opportunities for early intervention, even without information about parent-child relationships. Proudfit’s lab studies suggest that ERN tends to remain relatively stable over time, but some of his current studies are evaluating approaches for reducing ERN and finding that modification is possible. This work suggests that helping people cope with mistakes may be an important key to preventing anxiety.

Greg Proudfit was honored with the Federation of Associations in Behavioral & Brain Sciences (FABBS) Foundation Early Career Impact Award during the annual meeting of the Society for Psychophysiological Research in September 2014 in Atlanta, GA.