Mindfulness-Oriented Recovery Enhancement remediates anhedonia in chronic opioid use by enhancing neurophysiological responses during savoring of natural rewards.

BACKGROUND: Neuropsychopharmacologic effects of long-term opioid therapy (LTOT) in the context of chronic pain may result in subjective anhedonia coupled with decreased attention to natural rewards. Yet, there are no known efficacious treatments for anhedonia and reward deficits associated with chronic opioid use. Mindfulness-Oriented Recovery Enhancement (MORE), a novel behavioral intervention combining training in mindfulness with savoring of natural rewards, may hold promise for treating anhedonia in LTOT. METHODS: Veterans receiving LTOT (N = 63) for chronic pain were randomized to 8 weeks of MORE or a supportive group (SG) psychotherapy control. Before and after the 8-week treatment groups, we assessed the effects of MORE on the late positive potential (LPP) of the electroencephalogram and skin conductance level (SCL) during viewing and up-regulating responses (i.e. savoring) to natural reward cues. We then examined whether these neurophysiological effects were associated with reductions in subjective anhedonia by 4-month follow-up. RESULTS: Patients treated with MORE demonstrated significantly increased LPP and SCL to natural reward cues and greater decreases in subjective anhedonia relative to those in the SG. The effect of MORE on reducing anhedonia was statistically mediated by increases in LPP response during savoring. CONCLUSIONS: MORE enhances motivated attention to natural reward cues among chronic pain patients on LTOT, as evidenced by increased electrocortical and sympathetic nervous system responses. Given neurophysiological evidence of clinical target engagement, MORE may be an efficacious treatment for anhedonia among chronic opioid users, people with chronic pain, and those at risk for opioid use disorder.

Adolescent cognitive control, theta oscillations, and social observation.

Theta oscillations (4-8 Hz) provide an organizing principle of cognitive control, allowing goal-directed behavior. In adults, theta power over medial-frontal cortex (MFC) underlies conflict/error monitoring, whereas theta connectivity between MFC and lateral-frontal regions reflects cognitive control recruitment. However, prior work has not separated theta responses that occur before and immediately after a motor response, nor explained how medial-lateral connectivity drives different kinds of control behaviors. Theta's role during adolescence, a developmental window characterized by a motivation-control mismatch also remains unclear. As social observation is known to influence motivation, this might be a particularly important context for studying adolescent theta dynamics. Here, adolescents performed a flanker task alone or under social observation. Focusing first on the nonsocial context, we parsed cognitive control into dissociable subprocesses, illustrating how theta indexes distinct components of cognitive control working together dynamically to produce goal-directed behavior. We separated theta power immediately before/after motor responses, identifying behavioral links to conflict monitoring and error monitoring, respectively. MFC connectivity was separated before/after responses and behaviorally-linked to reactive and proactive control, respectively. Finally, distinct forms of post-error control were dissociated, based on connectivity with rostral/caudal frontal cortex. Social observation was found to exclusively upregulate theta measures indexing post-response error monitoring and proactive control, as opposed to conflict monitoring and reactive control. Linking adolescent cognitive control to theta oscillations provides a bridge between non-invasive recordings in humans and mechanistic studies of neural oscillations in animal models; links to social observation provide insight into the motivation-control interactions that occur during adolescence.

Neuroimaging measures of error-processing: Extracting reliable signals from event-related potentials and functional magnetic resonance imaging.

Error-related brain activity has become an increasingly important focus of cognitive neuroscience research utilizing both event-related potentials (ERPs) and functional magnetic resonance imaging (fMRI). Given the significant time and resources required to collect these data, it is important for researchers to plan their experiments such that stable estimates of error-related processes can be achieved efficiently. Reliability of error-related brain measures will vary as a function of the number of error trials and the number of participants included in the averages. Unfortunately, systematic investigations of the number of events and participants required to achieve stability in error-related processing are sparse, and none have addressed variability in sample size. Our goal here is to provide data compiled from a large sample of healthy participants (n=180) performing a Go/NoGo task, resampled iteratively to demonstrate the relative stability of measures of error-related brain activity given a range of sample sizes and event numbers included in the averages. We examine ERP measures of error-related negativity (ERN/Ne) and error positivity (Pe), as well as event-related fMRI measures locked to False Alarms. We find that achieving stable estimates of ERP measures required four to six error trials and approximately 30 participants; fMRI measures required six to eight trials and approximately 40 participants. Fewer trials and participants were required for measures where additional data reduction techniques (i.e., principal component analysis and independent component analysis) were implemented. Ranges of reliability statistics for various sample sizes and numbers of trials are provided. We intend this to be a useful resource for those planning or evaluating ERP or fMRI investigations with tasks designed to measure error-processing.

Severe sexual abuse in childhood and altered neurophysiological response to reward in female adults.

BACKGROUND: A relatively understudied but growing body of research indicates that individuals with a history of childhood trauma exhibit altered reward processing in adulthood. Research to date has focused on adversity broadly, with studies typically finding evidence of blunted response to rewards in adults with a history of childhood trauma. OBJECTIVE: Given the role of reward processing in risk for psychopathology and the particularly pathogenic nature of sexual abuse (SA), the present study sought to assess whether adults with a history of severe childhood SA exhibit altered neurophysiological response to rewards. PARTICIPANTS AND SETTING: Female adults (N = 105) were included from two study sites that used the same measures of childhood trauma (Childhood Trauma Questionnaire, CTQ), reward processing (Doors Task), and psychopathology (SCID). METHODS: Based on participants' CTQ and SCID responses, three groups were created: Severe SA (n = 36), Clinical Match (with comparable lifetime psychopathology but no-to-minimal SA history; n = 35), and Healthy Controls (n = 34). Group differences in RewP amplitude were assessed. RESULTS: The Severe SA group exhibited larger reward positivity (RewP) amplitude to monetary rewards than the Clinical Match and Healthy Control groups (partial ƞ2 = 0.06, p = .047). This effect remained after covarying for severity of other forms of childhood trauma. CONCLUSIONS: Our study found that severe SA in childhood was related to a heightened response to reward in adulthood. Furthermore, this was not attributable to the severity of other forms of early trauma or comorbid psychopathology. Future studies are needed to identify how heightened reward processing following severe childhood SA may be implicated in the onset and course of psychopathology.

Are excluding e-cigarettes a loophole in the smokefree public housing rule?

The U.S. Department of Housing and Urban Development (HUD) required all Public Housing Authorities to become smokefree in July 2018, following an 18-month implementation period that began February 2017. The HUD rule included all combustible tobacco products; e-cigarettes were not included. This purpose of this study is to characterize e-cigarette use overall and initiation after the implementation of the smokefree rule among tobacco users living in public housing. Data were collected from 396 adult (18+ years) current tobacco users at the time of rule implementation residing in the District of Columbia Housing Authority between July 2018 and November 2021. Measures include e-cigarette use, age of initiation, reasons for e-cigarette use, e-cigarette use susceptibility (among non-users), and sociodemographic characteristics. Descriptive and crosstab statistics were calculated to characterize e-cigarette use. Nearly-one-quarter of tobacco users reported lifetime use of e-cigarettes (24 %, n = 95) and 4.8 % (n = 19) indicated past 30-day e-cigarette use. Of the lifetime users, twenty-two (23.2 %) initiated their use after the smoke-free rule went into effect, with only two of those residents indicating they did so because of the rule. Of those who never used an e-cigarette, 23.5 % (n = 70) indicated being curious about e-cigarettes and 10.7 % (n = 40) said they may use e-cigarettes in the next year. Results indicate low use of e-cigarette products and low uptake due to the rule. Few tobacco users who never used e-cigarettes indicated intentions to use. Results suggest that omitting e-cigarettes from the HUD rule has not led to significant use of these products in this sample.

Sequential gains and losses during gambling feedback: Differential effects in time-frequency delta and theta measures.

One critical aspect of reward-feedback is the impact of local outcome history-how past experiences with choices and outcomes influences current behavior and neural activity. Yet, prior event-related potential work in this area has been contentious. This study contributes to this field by using time-frequency measures to better isolate constituent processes. Specifically, we identify how theta and delta are differentially sensitive to local outcome history. Participants completed a binary monetary choice task while we collected EEG data. Unbeknownst to them, trial outcomes were manipulated into pre-determined sequences, ranging from one to eight gains or losses in a row. Analyses were arranged by sequence establishment (first 2 trials of a sequence) and continuation (prolonged sequences of 3-8 trials). During the establishment of a sequence, delta activity to gains and losses were virtually identical on the first (change) trial, demonstrating marked divergence only on the second trial. This difference grew throughout the continuation period, as delta activity was sustained with accruing gains but declined with multiple losses. Theta activity, conversely, demonstrated a maximal loss-gain difference on the change trial but was insensitive to the establishment of a new sequence. Differential theta activity between outcomes decreased as sequences continued, with theta activity increasing over accruing gains and remaining stable over losses. Results indicate that delta-gain and theta-loss signals are relatively stable across sequential outcomes. Furthermore, theta is most sensitive to loss-gain differences on the initial change trial, while delta is more sensitive to gain-loss differences with the continuation of a sequence.

Neurophysiological Deficits During Reappraisal of Negative Emotional Stimuli in Opioid Misuse.

BACKGROUND: Opioid misuse is hypothesized to compromise the ability to regulate negative emotions, as manifested through visceral and peripheral physiological signals. However, neurophysiological impairment of top-down cognitive emotion regulation in opioid misuse has not previously been shown. METHODS: Patients with chronic pain who had been taking opioids for 90 days or longer (N = 149; female, n = 98) underwent a negative emotion regulation task with electroencephalography. Participants were instructed to view or reappraise negative images presented for 3 seconds. Using a validated cutoff score on the Current Opioid Misuse Measure, participants were classified as exhibiting aberrant drug-related behavior consistent with opioid misuse (MISUSE+) or as being low risk for opioid misuse (MISUSE-). Participants reported their craving in response to negative emotions over the past week. RESULTS: We observed a group × condition interaction (p = .003) such that the MISUSE- group decreased the late positive potential of the electroencephalography during reappraisal, whereas the MISUSE+ group showed increased late positive potential during reappraisal. This deficit in negative emotion regulation remained significant after controlling for an array of potential confounding variables, including opioid dose, pain, and depression. Heightened late positive potential during reappraisal was associated with more severe opioid craving. CONCLUSIONS: Opioid misuse may occasion top-down deficits in emotional regulation that begin as early as 400 ms after presentation of negative stimuli. It remains unknown whether emotion dysregulation is the cause, correlate, or consequence of opioid misuse. Nonetheless, targeting emotion dysregulation in opioid misuse with reappraisal-focused interventions may represent an important treatment approach.

How Racial Identity and Worry About Discrimination Impact Coping Responses to Racial Discrimination Among Black American Community Members.

Every year, most Black Americans report experiencing racial discrimination, which has been shown to have a variety of negative consequences. Aspects of racial identity, particularly holding a positive perception of one's racial group (private regard), may buffer the impact of negative experiences including racial discrimination through differential coping strategy use. The current study (1) examined whether level of private regard impacted the type of coping strategies used across various forms of perceived experiences of racial discrimination and (2) tested for indirect pathways from perceived experiences of racial discrimination to different coping strategy use. Adults (N = 297) from the community who self-identified as Black American/African American completed several questionnaires on Amazon's Mechanical Turk (MTurk). Four-fifths (80%) of participants reported racial discrimination at least once. Racial identity-particularly private regard-was positively associated with active coping strategy use. Furthermore, results from mediation models demonstrated racial identity was an important predictor of coping strategy use, suggesting high private regard has protective effects against racial discrimination. Worry was an especially robust mediator for pathways from racial discrimination to coping strategies. Altogether, results indicate a need for targeted interventions that promote the development of private regard and address worry about racial discrimination among Black American adults.

Recommendations and publication guidelines for studies using frequency domain and time-frequency domain analyses of neural time series.

Since its beginnings in the early 20th century, the psychophysiological study of human brain function has included research into the spectral properties of electrical and magnetic brain signals. Now, dramatic advances in digital signal processing, biophysics, and computer science have enabled increasingly sophisticated methodology for neural time series analysis. Innovations in hardware and recording techniques have further expanded the range of tools available to researchers interested in measuring, quantifying, modeling, and altering the spectral properties of neural time series. These tools are increasingly used in the field, by a growing number of researchers who vary in their training, background, and research interests. Implementation and reporting standards also vary greatly in the published literature, causing challenges for authors, readers, reviewers, and editors alike. The present report addresses this issue by providing recommendations for the use of these methods, with a focus on foundational aspects of frequency domain and time-frequency analyses. It also provides publication guidelines, which aim to (1) foster replication and scientific rigor, (2) assist new researchers who wish to enter the field of brain oscillations, and (3) facilitate communication among authors, reviewers, and editors.

Evidence of disrupted functional connectivity in the brain after combat-related blast injury.

Non-impact blast-related mild traumatic brain injury (mTBI) appears to be present in soldiers returning from deployments to Afghanistan and Iraq. Although mTBI typically results in cognitive deficits that last less than a month, there is evidence that disrupted coordination of brain activity can persist for at least several months following injury (Thatcher et al., 1989, 2001). In the present study we examined whether neural communication may be affected in soldiers months after blast-related mTBI, and whether coordination of neural function is associated with underlying white matter integrity. The investigation included an application of a new time-frequency based method for measuring electroencephalogram (EEG) phase synchronization (Aviyente et al., 2010) as well as fractional anisotropy measures of axonal tracts derived from diffusion tensor imaging (DTI). Nine soldiers who incurred a blast-related mTBI during deployments to Afghanistan or Iraq were compared with eight demographically similar control subjects. Despite an absence of cognitive deficits, the blast-related mTBI group exhibited diminished EEG phase synchrony of lateral frontal sites with contralateral frontal brain regions suggesting diminished interhemispheric coordination of brain activity as a result of blast injury. For blast injured (i.e., blast-related mTBI) soldiers we found that EEG phase synchrony was associated with the structural integrity of white matter tracts of the frontal lobe (left anterior thalamic radiations and the forceps minor including the anterior corpus callosum). Analyses revealed that diminished EEG phase synchrony was not the consequence of combat-stress symptoms (e.g., post-traumatic stress and depression) and commonly prescribed medications. Results provide evidence for poor coordination of frontal neural function after blast injury that may be the consequence of damaged anterior white matter tracts.

A phase synchrony measure for quantifying dynamic functional integration in the brain.

The temporal coordination of neural activity within structural networks of the brain has been posited as a basis for cognition. Changes in the frequency and similarity of oscillating electrical potentials emitted by neuronal populations may reflect the means by which networks of the brain carry out functions critical for adaptive behavior. A computation of the phase relationship between signals recorded from separable brain regions is a method for characterizing the temporal interactions of neuronal populations. Recently, different phase estimation methods for quantifying the time-varying and frequency-dependent nature of neural synchronization have been proposed. The most common method for measuring the synchronization of signals through phase computations uses complex wavelet transforms of neural signals to estimate their instantaneous phase difference and locking. In this article, we extend this idea by introducing a new time-varying phase synchrony measure based on Cohen's class of time-frequency distributions. This index offers improvements over existing synchrony measures by characterizing the similarity of signals from separable brain regions with uniformly high resolution across time and frequency. The proposed measure is applied to both synthesized signals and electroencephalography data to test its effectiveness in estimating phase changes and quantifying neural synchrony in the brain.

Pretending to Be Better Than They Are? Emotional Manipulation in Imprisoned Fraudsters.

Fraud can cause severe financial losses and affect the physical and mental health of victims. This study aimed to explore the manipulative characteristics of fraudsters and their relationship with other psychological variables. Thirty-four fraudsters were selected from a medium-security prison in China, and thirty-one healthy participants were recruited online. Both groups completed an emotional face-recognition task and self-report measures assaying emotional manipulation, psychopathy, emotion recognition, and empathy. Results showed that imprisoned fraudsters had higher accuracy in identifying fear and surprise faces but lower accuracy in identifying happiness than controls (t = 5.26, p < 0.001; t = 2.38, p < 0.05; t = 3.75, p < 0.001). Significantly lower scores on non-prosocial factors on the Managing the Emotions of Others scale (MEOS) were found for imprisoned fraudsters, relative to controls (t = 3.21, p < 0.01). Imprisoned fraudsters had low scores in the assessment of psychopathy than the control group, especially Factor 1 (t = 2.04, p = 0.05). For empathy, imprisoned fraudsters had significantly higher scores in perspective-taking than controls (t = 2.03, p = 0.05). Correlation analyses revealed that psychopathic traits were positively correlated with non-prosocial factors in both groups. However, the relationships between emotional manipulation and emotional recognition and empathy were not consistent across the groups. The results suggest that fraudsters may pretend to be as prosocial as healthy controls, who had lower antisocial tendencies, normal empathy ability, and would like to manipulate others' emotions positively during social interaction.

Identifying objects impairs knowledge of other objects: a relearning explanation for the neural repetition effect.

Different items in long-term knowledge are stored in the neocortex as partially overlapping representations that can be altered slightly with usage. This encoding scheme affords well-documented benefits, but potential costs have not been well explored. Here we use functional magnetic resonance imaging (fMRI), neurocomputational modeling, and electrophysiological measures to show that strengthening some visual object representations not only enhances the subsequent ability to identify those (repeated) objects-an effect long known as repetition priming-but also impairs the ability to identify other (non-repeated) objects-a new effect labeled antipriming. As a result, the non-repeated objects elicit increased neural activity likely for the purpose of reestablishing their previously weakened representations. These results suggest a novel reevaluation of the ubiquitously observed repetition effect on neural activity, and they indicate that maintenance relearning may be a crucial aspect of preserving overlapping neural representations of visual objects in long-term memory.

P3 amplitude reductions are associated with shared variance between internalizing and externalizing psychopathology.

P3 amplitude reductions, commonly elicited in oddball paradigms, have been associated with both internalizing (e.g., depression and anxiety) and externalizing problems (e.g., substance use, aggression, and impulsivity). Recent factor analytic models have focused on the shared variance between internalizing and externalizing problems as a potentially important separable psychopathology construct (a general psychopathology factor, or p-factor). To assess neurophysiological markers of this shared variance, we examined P3 amplitude to target and novel stimuli in an undergraduate sample with a range of internalizing and externalizing problems. Participants (N = 125) completed a rotated heads visual oddball paradigm, with IAPS pictures serving as infrequent novel stimuli. Results replicated P3 amplitude reduction relative to both target and novel stimuli separately for internalizing and externalizing problems, and found that the shared variance across internalizing and externalizing was significantly related to lower P3 amplitude to novels, targets, and a factor score of target and novel P3 measures. The present results are consistent with the interpretation that a general or shared problem behavior factor accounts for much of the associations between reduced P3 amplitude and internalizing and externalizing problems.

Dynamics of processing invisible faces in the brain: automatic neural encoding of facial expression information.

The fusiform face area (FFA) and the superior temporal sulcus (STS) are suggested to process facial identity and facial expression information respectively. We recently demonstrated a functional dissociation between the FFA and the STS as well as correlated sensitivity of the STS and the amygdala to facial expressions using an interocular suppression paradigm [Jiang, Y., He, S., 2006. Cortical responses to invisible faces: dissociating subsystems for facial-information processing. Curr. Biol. 16, 2023-2029.]. In the current event-related brain potential (ERP) study, we investigated the temporal dynamics of facial information processing. Observers viewed neutral, fearful, and scrambled face stimuli, either visibly or rendered invisible through interocular suppression. Relative to scrambled face stimuli, intact visible faces elicited larger positive P1 (110-130 ms) and larger negative N1 or N170 (160-180 ms) potentials at posterior occipital and bilateral occipito-temporal regions respectively, with the N170 amplitude significantly greater for fearful than neutral faces. Invisible intact faces generated a stronger signal than scrambled faces at 140-200 ms over posterior occipital areas whereas invisible fearful faces (compared to neutral and scrambled faces) elicited a significantly larger negative deflection starting at 220 ms along the STS. These results provide further evidence for cortical processing of facial information without awareness and elucidate the temporal sequence of automatic facial expression information extraction.

Neural Evidence of Superior Memory: How to Capture Brain Activities of Encoding Processes Underlying Superior Memory.

Relatively little attention has been paid to the neural basis of superior memory despite its potential in providing important insight into efforts to improve memory in the general population or to offset age-related cognitive decline. The current study reports a rare opportunity to reproduce and isolate specific neural activities directly associated with exceptional memory. To capture the brain processes responsible for superior memory, we returned to a laboratory task and analytic approach used to explore the nature of exceptional memory, namely, digit-span task combined with verbal protocol analysis. One participant with average memory received approximately 50 h of digit-span training and the participant's digit-span increased from normative (8 digits) to exceptional (30 digits). Event-related potentials were recorded while the participant's digit span increased from 19 to 30 digits. Protocol analysis allowed us to identify direct behavioral indices of idiosyncratic encoding processes underlying the superior memory performance. EEG indices directly corresponding to the behavioral indices of encoding processes were identified. The results suggest that the early attention-related encoding processes were reflected in theta and delta whereas the later attention-independent encoding processes were reflected in time-domain slow-wave. This fine-grained approach offers new insights into studying neural mechanism mediating superior memory and the cognitive effort necessary to develop it.

Gender differences in the relation between the late positive potential in response to anxiety sensitivity images and self-reported anxiety sensitivity.

Anxiety sensitivity (AS), or the fear of anxious arousal, is a transdiagnostic risk factor predictive of a wide variety of affective disorders. Whereas AS is widely studied via self-report, the neurophysiological correlates of AS are poorly understood. One specific issue this may help resolve is well-established gender differences in mean levels of AS. The current study evaluated late positive potential (LPP) for images designed to target AS during an emotional picture viewing paradigm. Structural equation modeling was used to examine convergent and discriminant validity for self-report AS and the LPP for AS images, considering gender as a potential moderator. Analyses were conducted in an at-risk sample of 251 community adults (M age = 35.47, SD = 15.95; 56.2% female; 53.6% meeting for a primary Axis I anxiety or related disorder). Findings indicated that the AS image LPP was significantly, uniquely associated with self-report AS, controlling for the LPP for unpleasant images, in females only. Mean levels of AS self-report as well as the AS image LPP were higher in females than in males. These findings provide initial support for the AS image LPP as a useful neurophysiological correlate of AS self-report in females. These findings also provide support for a biological cause for gender differences in AS. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Independent contributions of theta and delta time-frequency activity to the visual oddball P3b.

A growing body of work suggests that the P300 (P3) event-related potential (ERP) component is better understood as a mixture of task-relevant processes (Polich, 2007). This converges with earlier time-frequency work suggesting that the P3b is primarily composed of centroparietal delta (0.5-3 Hz) and frontocentral theta (3-7 Hz) activity. Within this study (N = 229), we hope to re-affirm these prior ideas and expand upon them in several crucial ways, reassessing how delta and theta contribute to the visual oddball P3b through the lens of several recent decades of additional P3b research. We provide a comprehensive assessment of how theta and delta time-frequency activity contribute to several common variants of the time-domain P3b, specifically measuring the target and non-target P3b, as well as differences between targets and non-targets, target-to-target interval (TTI), and target habituation. Results replicate and extend earlier work indicating that delta and theta account for a majority of variance in both the target and non-target P3b as well as their respective amplitude differences. They also newly indicate that theta and delta activity can have unique contributions to TTI differences and target habituation effects. Results in target habituation particularly demonstrate how time-frequency analyses can disentangle nuanced changes in P3b activity, shedding new light on these complicated phenomena. Findings suggest that delta and theta measures index separable processes occurring during the P3b, and provide additional support for the idea that they index theoretical frontocentral and centroparietal P3 subcomponents.

Effects of reward context on feedback processing as indexed by time-frequency analysis.

The role of reward context has been investigated as an important factor in feedback processing. Previous work has demonstrated that the amplitude of the feedback negativity (FN) depends on the value of the outcome relative to the range of possible outcomes in a given context, not the objective value of the outcome. However, some research has shown that the FN does not scale with loss magnitude in loss-only contexts, suggesting that some contexts do not show a pattern of context dependence. Methodologically, time-frequency decomposition techniques have proven useful for isolating time-domain ERP activity as separable processes indexed in delta (< 3 Hz) and theta (3-7 Hz). Thus, the current study assessed the role of context in a modified gambling feedback task using time-frequency analysis to better isolate the underlying processes. Results revealed that theta was more context dependent and reflected a binary evaluation of bad versus good outcomes in the gain and even contexts. Delta was more context independent: good outcomes scaled linearly with reward magnitude and good-bad differences scaled with context valence. Our findings reveal that theta and delta are differentially sensitive to context and that context valence may play a critical role in determining how the brain processes feedback.

Anxiety and feedback processing in a gambling task: Contributions of time-frequency theta and delta.

The feedback negativity (FN) event-related potential (ERP) is widely studied during gambling feedback tasks. However, research on FN and anxiety is minimal and the findings are mixed. To clarify these discrepancies, the current study (N = 238) used time-frequency analysis to disentangle overlapping contributions of delta (0-3 Hz) and theta (3-7 Hz) to feedback processing in a clinically anxious sample, with severity assessed through general worry and physiological arousal scales. Greater general worry showed enhanced delta- and theta-FN broadly across both gain and loss conditions, with theta-FN stronger for losses. Regressions indicated delta-FN maintained unique effects, accounted for theta, and explained the blunted time domain FN for general worry. Increased delta was also associated with physiological arousal, but the effects were accounted for by general worry. Broadly, anxiety-related alterations in feedback processing can be explained by an overall heightened sensitivity to feedback as represented by enhanced delta-FN in relation to the general worry facet of anxiety.