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Psychosocial intervention in at-risk adolescents: using event-related potentials to assess changes in decision making and feedback processing

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Abstract

Decision making and feedback processing are two important cognitive processes that are impacted by social context, particularly during adolescence. The current study examined whether a psychosocial intervention could improve psychological wellbeing in at-risk adolescent boys, thereby improving their decision making and feedback processing skills. Two groups of at-risk adolescents were compared: those who were relatively new to a psychosocial intervention, and those who had engaged over a longer time period. Electroencephalography was recorded while the young people participated in a modified version of the Taylor Aggression Paradigm. The late positive potential (LPP) was measured during the decision phase of the task (where participants selected punishments for their opponents). The feedback-related negativity (FRN) and P3 components were measured during the task’s outcome phase (where participants received ‘win’ or ‘lose’ feedback). Adolescents who were new to the intervention (the minimal-intervention group) were harsher in their punishment selections than those who had been engaged in the program for much longer. The minimal-intervention group also showed an enhanced LPP during the decision phase of the task, which may be indicative of immature decision making in that group. Analysis of the FRN and P3 amplitudes revealed that the minimal-intervention group was physiologically hypo-sensitive to feedback, compared with the extended-intervention group. Overall, these findings suggest that long-term community-based psychosocial intervention programs are beneficial for at-risk adolescents, and that event-related potentials can be employed as biomarkers of therapeutic change. However, because participants were not randomly allocated to treatment groups, alternative explanations cannot be excluded until further randomized controlled trials are undertaken.

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Acknowledgements

We would like to thank all of the participants, schools and key workers who took part in this study. We would like to especially thank the following individuals for their assistance with data collection and/or preparing the data for analysis: Charlotte Bargus, Elizabeth Harding, Danae Kokorikou, Jodie Walman and Anna Zonderman. This work was supported by the Waterloo Foundation (Grant code 564/709) and Kids Company, London.

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Authors and Affiliations

  1. Developmental Neuroscience Unit, Anna Freud National Centre for Children and Families, London, UK

    H. L. Pincham, P. Fonagy & R. M. Pasco Fearon

  2. Department of Psychology, University of Tübingen, Tübingen, Germany

    D. Bryce

  3. Research Department of Clinical, Educational and Health Psychology, University College London, London, UK

    P. Fonagy & R. M. Pasco Fearon

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  1. H. L. Pincham
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  2. D. Bryce
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Correspondence to R. M. Pasco Fearon.

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Ethical standards

Ethical approval for the study was provided by the Research Ethics Committee at University College London (ID: 3064/001), and debriefing occurred at the end of the study. This study has been performed in accordance with 1964 Declaration of Helsinki, and its later amendments.

Conflict of interest

This study was supported by the Waterloo Foundation and Kids Company. The Waterloo Foundation had no role in study design, data collection and analysis, the decision to publish, or preparation of the manuscript. Kids Company supported the recruitment of participants from their services, and provided lab space, equipment and top-up funding. Kids Company had no role in study design, data collection and analysis, the decision to publish, or preparation of the manuscript. Professor Peter Fonagy is chief executive of Anna Freud National Centre for Children and Families (a child mental health charity).

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Pincham, H.L., Bryce, D., Fonagy, P. et al. Psychosocial intervention in at-risk adolescents: using event-related potentials to assess changes in decision making and feedback processing. Eur Child Adolesc Psychiatry 28, 223–236 (2019). https://doi.org/10.1007/s00787-018-1167-3

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