Auditory event-related potentials and psychosis dimensions

Neuropsychopharmacology. 2026 Jul 4. doi: 10.1038/s41386-026-02487-y. Online ahead of print.

ABSTRACT

The auditory event-related potential (ERP) components N1 and P3 have been identified as potential neural markers of psychotic disorders. However, the literature has largely examined categorical disorders, and the auditory N1 and P3 have also been associated with internalizing disorders. It is unclear whether the auditory N1 and P3 relate to specific features of psychosis, broad psychosis, or general psychopathology. The present study examined the relationship between the auditory N1, P3a, and P3b and dimensional representations of psychosis and comorbid psychopathology. We tested whether auditory ERPs (1) were associated with specific psychosis dimensions (thought disorder, detachment, cognition, functioning) or the psychosis superspectrum, and (2) demonstrated specificity to psychosis compared to comorbid internalizing psychopathology. Participants (M_age = 49.57, 45.2% female) were 202 individuals with a history of hospitalization for a psychotic disorder and 304 demographically matched comparisons. All participants completed an auditory oddball task while we recorded electroencephalography, diagnostic interviews, self-report questionnaires, and a neuropsychological battery. A more blunted auditory N1, P3a, and P3b were associated with greater scores on the psychosis superspectrum. After controlling for the psychosis superspectrum, the N1 and P3a were not independently related to any specific psychosis dimension, but a smaller P3b was associated with poorer cognition. The N1 and P3b, but not P3a, demonstrated specificity to the psychosis superspectrum compared to the internalizing spectrum. A blunted auditory N1 and P3b are uniquely associated with the psychosis superspectrum, while a blunted P3a was common to both the psychosis superspectrum and internalizing spectrum.

PMID:42401756 | DOI:10.1038/s41386-026-02487-y