Associations between GAD symptom severity and error monitoring depend on neural quenching variability

Generalized anxiety disorder (GAD) has been inconsistently associated with exaggerated threat monitoring measured via the error-related negativity (ERN). This suggests the need to consider whether the link between GAD and ERN is influenced by additional processes, such as cognitive inhibition of non-threat. The current study explored this possibility by employing a novel, trait-like measure of cognitive processing inhibition, neural quenching (NQ). Electroencephalography was recorded while 16 adults diagnosed with GAD and 14 age-matched healthy controls viewed angry and neutral faces prior to individual trials of a flanker task. NQ was generated to aversive (angry) and non-aversive (neutral) facial primes, and the ERN was generated to incorrect and correct responses on the flanker task. We tested the hypothesis that higher GAD symptom severity would be associated with larger-magnitude ERN when NQ to non-aversive was enhanced (higher levels of non-aversive processing inhibition), but with blunted ERN when NQ to non-aversive was also blunted (lower levels of non-aversive processing inhibition). Overall, greater NQ to non-aversive faces was associated with larger-magnitude ERNs. As predicted, higher GAD symptom severity was associated with blunted ERN when accompanied by blunted NQ to non-aversive. Findings suggest that exaggerated threat processing is not uniform in GAD and may depend on individual differences in the ability to inhibit processing of non-aversive and other types of information.