Neural Changes Associated with Treatment Outcome in Children with Externalizing Problems

Background: The current study directly investigated whether changes in the neural correlates of self-regulation (SR) are associated with the effectiveness of treatment for the externalizing problems of children. Methods: Seventy-one children 8-12 years of age with clinical levels of externalizing behavior and their families completed a 3-month cognitive behavioral therapy program with a parent management training component. Electroencephalogram correlates of SR were evaluated before and after treatment with a go/no-go task requiring inhibitory control. Results: Results showed that neural markers of SR, such as the N2 and frontal P3 event-related potential magnitudes, differed between the clinical sample and a matched comparison group before treatment: the clinical sample had larger N2 magnitudes and smaller frontal P3 magnitudes. Children who improved with treatment demonstrated a marked decrease in the magnitude of the N2 in comparison with children who did not improve. For improvers only, source analyses during the time period of the N2 estimated activation decreases in medial and ventral prefrontal cortex as well as the anterior medial temporal lobe. Conclusions: A decrease in N2 magnitudes and corresponding source activation in children who improved with treatment might reflect improved efficiency in the neural mechanisms of SR.