Relationships between affective states and decision-making

A multinational analysis of how emotions relate to economic decisions regarding time or risk

Emotions have been theorized to be important drivers of economic choices, such as intertemporal or risky decisions. Our systematic review and meta-analysis of the previous literature (378 results and 50,972 participants) indicates that the empirical basis for these claims is mixed and the cross-cultural generalizability of these claims has yet to be systematically tested. We analysed a dataset with representative samples from 74 countries (n = 77,242), providing a multinational test of theoretical claims that individuals' ongoing emotional states predict their economic preferences regarding time or risk. Overall, more positive self-reported emotions generally predicted a willingness to wait for delayed rewards or to take favourable risks, in line with some existing theories. Contrary to the assumption of a universal relationship between emotions and decision-making, we show that these relationships vary substantially and systematically across countries. Emotions were stronger predictors of economic decisions in more economically developed and individualistic countries.

Cardiac sensitivity to rewards in cognitively inflexible nonclinical participants

Background

In psychopathologies characterized by compulsive decision-making, core impairments include cognitive inflexibility and excessive sensitivity to rewards. It has been posited that traits shared by nonclinical individuals and psychiatric patients could help explain the pathogenesis of compulsive decision-making.

Methods

To investigate whether cognitive inflexibility predisposes nonclinical individuals to poor choices and hyper-reactivity to reward, we recruited people with high and low scores for cognitive persistence and used the Iowa Gambling Task to assess decision-making and cardiac reactivity to monetary gains/losses.

Results

As is frequently observed in psychophysiological research, the data indicated discrepancies among self-reports, behavior, and physiology. Cognitive inflexibility was not related to worse performance; however, monetary gains, in line with the literature, prompted marked cardiac accelerations. Consistent with our research goal, only inflexible participants showed large cardiac accelerations during the largest monetary wins.

Discussion

Taken together, the data confirm an association between cognitive persistence and physiological reward sensitivity in a nonclinical population. The findings are in line with recent theories on the development of compulsive behaviors that consider cognitive inflexibility as a transdiagnostic impairment and predisposing factor for excessive reactivity to rewards, and might act both as a preexisting individual trait and drug-induced deficit.

A Temporospatial Study of Sympathetic Skin Response and Electroencephalogram in Oral Mucosa Thermal Perception

Objective

To investigate the temporospatial changes in sympathetic skin response (SSR) and electroencephalogram (EEG) under thermal stimuli and to draw a topographic map of SSR threshold temperature of the oral mucosa.

Materials and Methods

A total of 40 healthy volunteers (24 men, 16 women, mean age of 23 ± 3) were enrolled. Thermal stimuli were applied to the 35 partitions of oral mucosa starting from 36°C at the gradience of 1°C and the lowest temperature evoked SSR was defined as SSR threshold temperature. SSR and EEG signals at 45, 48, 51, and 54°C were then recorded synchronously.

Results

The SSR threshold temperature increased from the anterior areas to the posterior areas. No significant difference between bilateral corresponding areas or between genders was observed. The SSR amplitude value increased from 45 to 54°C in the same area, while the highest value was recorded on the tip of the tongue and decreased backwardly from the anterior area. There were significant differences in latency of SSR between the tip of the tongue and the molar areas of the oral cavity (p < 0.05). Reduction in the alpha frequency band was observed after thermal stimuli, and there were statistical differences between baseline and thermal stimuli in all four degrees of temperatures (p < 0.05).

Conclusion

The result of the experiment revealed that the autonomic and central nervous system (CNS) played important roles in thermal perception of oral mucosa and could be helpful for better understanding of pathological mechanism of burning mouth syndrome (BMS).

Decision making in Parkinson's disease: An analysis of the studies using the Iowa Gambling Task

In Parkinson's disease (PD) impairments in decision making can occur, in particular because of the tendency toward risky and rewarding options. The Iowa Gambling Task has been widely used to investigate decision processes involving these options. The task assesses the ability to manage risk and to learn from feedback. The present paper aims at critically examining those studies in which this task has been administered to PD patients, in order to understand possible anomalies in patients' decision processes and which variables are responsible for that. A meta‐analysis has been conducted as well. Features of the task, sociodemographic and clinical aspects (including daily drugs intake), cognitive conditions and emotional disorders of the patients have been taken into account. Neural correlates of decision‐making competences were considered. It emerged that PD patients show a trend of preference toward risky choices, probably due to an impairment in anticipating the unrewarding consequences or to an insensitiveness to punishment. The possible role played by dopamine medications in decision making under uncertain conditions, affecting basal ganglia and structures involved in the limbic loop, was discussed. Attention has been focused on some aspects that need to be investigated in further research, in order to delve into this issue and promote patients' quality of life.

Physiological synchrony is associated with cooperative success in real-life interactions

Cooperation is pivotal for society to flourish. To foster cooperation, humans express and read intentions via explicit signals and subtle reflections of arousal visible in the face. Evidence is accumulating that humans synchronize these nonverbal expressions and the physiological mechanisms underlying them, potentially influencing cooperation. The current study is designed to verify this putative linkage between synchrony and cooperation. To that end, 152 participants played the Prisoner's Dilemma game in a dyadic interaction setting, sometimes facing each other and sometimes not. Results showed that synchrony in both heart rate and skin conductance level emerged during face-to-face contact. However, only synchrony in skin conductance levels predicted cooperative success of dyads. Crucially, this positive linkage was strengthened when participants could see each other. These findings show the strong relationship between our bodily responses and social behavior, and emphasize the importance of studying social processes between rather than within individuals in real-life interactions.

Sweating the small stuff: A meta-analysis of skin conductance on the Iowa gambling task

To systematically examine the role of anticipatory skin conductance responses (aSCRs) in predicting Iowa Gambling Task (IGT) performance. Secondly, to assess the quality of aSCR evidence for the Somatic Marker Hypothesis (SMH) during the IGT. Finally, to evaluate the reliability of current psychophysiological measurements on the IGT. Electronic databases, journals and reference lists were examined for inclusion. Data were extracted by two reviewers and validated by another reviewer, using a standardised extraction sheet along with a quality assessment. Two meta-analyses of aSCR measures were conducted to test the relationship between overall aSCR and IGT performance, and differences in aSCR between advantageous and disadvantageous decks. Twenty studies were included in this review. Quality assessment revealed that five studies did not measure anticipatory responses, and few stated they followed standard IGT and/or psychophysiological procedures. The first meta-analysis of 15 studies revealed a significant, small-to-medium relationship between aSCR and IGT performance (r= .22). The second meta-analysis of eight studies revealed a significant, small difference in aSCR between the advantageous and disadvantageous decks (r= .10); however, publication bias is likely to be an issue. Meta-analyses revealed aSCR evidence supporting the SMH. However, inconsistencies in the IGT and psychophysiological methods, along with publication bias, cast doubt on these effects. It is recommended that future tests of the SMH use a range of psychophysiological measures, a standardised IGT protocol, and discriminate between advantageous and disadvantageous decks.

Electrophysiological Measurement of Emotion and Somatic State Affecting Ambiguity Decision: Evidences From SCRs, ERPs, and HR

Twenty-three years ago, the Somatic Marker Hypothesis (SMH) proposed by Damasio was introduced to explain the role of emotion in decision-making, and provided a unique neuroanatomical framework for decision-making and its influence by emotion. The core idea of the SMH is that decision-making is a process that is affected by somatic state signals, including those that express themselves in emotion and feeling. In order to verify the SMH, the Iowa Gambling Task (IGT) was originally designed by Bechara et al. and the skin conductance responses (SCRs) was recorded during the IGT. The initial confirmatory results showed that normal subjects would generate anticipatory SCRs when they received reward or punishment, but patients of the VMPFC lesion entirely failed to generate anticipatory SCRs prior to their selection of a card. With the further development of the SMH–related researches, other electrophysiological methods of measuring somatic state was gradually used to test the SMH, including event-related potentials (ERPs), and heart rate (HR). In this mini review article, we summarize the extant electrophysiological research on the SMH and decision-making under ambiguity, propose an integrative perspective for employing different electrophysiological measurement methods, and indicate the application of electrophysiological measurement based on the SMH in daily social decision-making.

Cooperative versus competitive influences of emotion and cognition on decision making: A primer for psychiatry research

Clinical research across the developmental spectrum increasingly reveals the nuanced ways in which emotion and cognition can work to either support or derail rational (i.e., healthy or goal-consistent) decision making. However, psychological theories offer discrepant views on how these processes interact, and on whether emotion is helpful or harmful to rational decision making. In order to translate theoretical predictions from basic psychology to clinical research, an understanding of theoretical perspectives on emotion and cognition, as informed by experimental psychology, is needed. Here, I review the ways in which dual-process theories have incorporated emotion into the process of decision making, discussing how they account for both positive and negative influences. I first describe seven theoretical perspectives that make explicit assumptions and predictions about the interaction between emotion and cognition: affect as information, the affect heuristic, risk as feelings, hot versus cool cognition, the somatic parker hypothesis, prospect theory, and fuzzy-trace theory. I then discuss the conditions under which each theoretical perspective conceptualizes emotion as beneficial or harmful to decision making, providing examples from research on psychiatric disorders.

Child Maltreatment, Delayed Reward Discounting, and Alcohol and Other Drug Use Problems: The Moderating Role of Heart Rate Variability

BACKGROUND

Child maltreatment (CM) is robustly associated with youth risk for addictive behaviors, and recent findings suggest that this may be mediated through impulsive discounting of future rewards. However, research indicates that youth self-regulation (emotional and cognitive), particularly in peer contexts, is critical to consider in the study of decision making. This study aimed to examine the indirect link between CM and alcohol and other drug use problems, through delayed reward discounting (DRD), among a community sample of emerging adults. Further, this investigation aimed to examine whether this indirect link was moderated by heart rate variability (HRV), a physiological proxy for regulation of stress reactivity.

METHODS

A sample of emerging adults (N = 225; Mage  = 21.56; SDage  = 2.24; 52.9% female) was assessed at 2 time points, with 1 year between assessments. The sample was comprised of rural emerging adults from lower socioeconomic backgrounds. DRD was examined using a monetary choice task, and HRV reactivity was derived during a social stress task.

RESULTS

Increased CM experiences were significantly linked to riskier DRD. HRV reactivity amplified the indirect effect between CM and alcohol use problems via riskier DRD.

CONCLUSIONS

The results demonstrate that the connection between CM and alcohol use problems via impulsive decision making is modulated by acute stress response reactivity, as indexed by HRV.

Decision-Making in Adolescents with Profound Hearing Loss

People with profound hearing loss show differences in language-related cognitive functions that may affect decision-making processes, but few studies have examined their decision-making behavior. The current study used the Iowa Gambling Task and the Game of Dice Task to explore the decision-making characteristics of adolescents with profound hearing loss. In the Iowa Gambling Task, deaf adolescents were more inclined to choose from the deck of infrequent losses with large immediate gains and larger future losses. In the Game of Dice Task, the deaf adolescents showed a preference for high-risk choices with high gains and high losses. These results suggest that deaf adolescents show a stronger preference for choices with immediate high gains and underestimate the potential risks, which may be related to differences in executive function or utilization of feedback.

Executive function impairments in fibromyalgia syndrome: Relevance of clinical variables and body mass index

Background

Several investigations suggest the presence of deterioration of executive function in fibromyalgia syndrome (FMS). The study quantified executive functions in patients with FMS. A wide array of functions was assessed, including updating, shifting and inhibition, as well as decision making and mental planning. Moreover, clinical variables were investigated as possible mediators of executive dysfunction, including pain severity, psychiatric comorbidity, medication and body mass index (BMI).

Methods

Fifty-two FMS patients and 32 healthy controls completed a battery of 14 neuropsychological tests. Clinical interviews were conducted and the McGill Pain Questionnaire, Beck Depression Inventory, State-Trait Anxiety Inventory, Fatigue Severity Scale and Oviedo Quality of Sleep Questionnaire were presented.

Results

Patients performed poorer than controls on the Letter Number Sequencing, Arithmetic and Similarities subtests of the Wechsler Adult Intelligence Scale, the Spatial Span subtest of the Wechsler Memory Scale, an N-back task, a verbal fluency task, the Ruff Figural Fluency Test, the Inhibition score of the Stroop Test, the Inhibition and Shifting scores of the Five Digits Test, the Key Search Test and the Zoo Map Task. Moreover, patients exhibited less steep learning curves on the Iowa Gambling Task. Among clinical variables, BMI and pain severity explained the largest proportion of performance variance.

Conclusions

This study demonstrated impairments in executive functions of updating, shifting inhibition, decision making and planning in FMS. While the mediating role of pain in cognitive impairments in FMS had been previously established, the influence of BMI is a novel finding. Overweight and obesity should be considered by FMS researchers, and in the treatment of the condition.

Understanding self-reported difficulties in decision-making by people with autism spectrum disorders

Autobiographical accounts and a limited research literature suggest that adults with autism spectrum disorders can experience difficulties with decision-making. We examined whether some of the difficulties they describe correspond to quantifiable differences in decision-making when compared to adults in the general population. The participants (38 intellectually able adults with autism spectrum disorders and 40 neurotypical adults) were assessed on three tasks of decision-making (Iowa Gambling Task, Cambridge Gamble Task and Information Sampling Task), which quantified, respectively, decision-making performance and relative attention to negative and positive outcomes, speed and flexibility, and information sampling. As a caution, all analyses were repeated with a subset of participants ( n_ASD = 29 and n_neurotypical = 39) who were not taking antidepressant or anxiolytic medication. Compared to the neurotypical participants, participants with autism spectrum disorders demonstrated slower decision-making on the Cambridge Gamble Task, and superior performance on the Iowa Gambling Task. When those taking the medications were excluded, participants with autism spectrum disorders also sampled more information. There were no other differences between the groups. These processing tendencies may contribute to the difficulties self-reported in some contexts; however, the results also highlight strengths in autism spectrum disorders, such as a more logical approach to, and care in, decision-making. The findings lead to recommendations for how adults with autism spectrum disorders may be better supported with decision-making.

Psychophysiological arousal and inter- and intraindividual differences in risk-sensitive decision making

The current study assessed peripheral responses during decision making under explicit risk, and tested whether intraindividual variability in choice behavior can be explained by fluctuations in peripheral arousal. Electrodermal activity (EDA) and heart rate (HR) were monitored in healthy volunteers (N = 68) during the Roulette Betting Task. In this task, participants were presented with risky gambles to bet on, with the chances of winning varying across trials. Hierarchical Bayesian analyses demonstrated that EDA and HR acceleration responses during the decision phase were sensitive to the chances of winning. Interindividual differences in this peripheral reactivity during risky decision making were related to trait sensitivity to punishment and trait sensitivity to reward. Moreover, trial-by-trial variation in EDA and HR acceleration responses predicted a small portion of intraindividual variability in betting choices. Our results show that psychophysiological responses are sensitive to explicit risk and can help explain intraindividual heterogeneity in choice behavior.

Anxiety and Gender Influence Reward-Related Processes in Children and Adolescents

OBJECTIVE

This study examined the effects of pediatric anxiety and its interaction with gender on reward processes. Based on the purported greater sensitivity to risk in females than males and the propensity for risk aversion in anxiety, clinical anxiety and female gender were hypothesized to act synergistically in reducing reward sensitivity and increasing risk aversion in a pediatric population.

METHODS

This hypothesis was tested in two separate experiments using two independent samples. Both experiments compared clinically anxious with typically developing (TD) youth, 8-18 years. Experiment 1 used a decision-making task, the Wheel of Fortune task (WOF), to examine risk taking as a function of varying levels of risk and reward in 36 anxious and 61 TD youths. Experiment 2 used an incentive delay task, the Piñata task, to examine sensitivity to reward and motivation to work for a reward in 38 anxious and 30 TD youth. Percent bet, reaction time, and accuracy were analyzed as a function of gender and diagnostic group.

RESULTS

As hypothesized, anxiety was associated with reduced risk taking and sensitivity to reward. However, contrary to prediction, this effect was seen in males and not in females. These findings are consistent across both experiments. In experiment 1 (WOF), betting rate (i.e., risk taking) was significantly lower in anxious than in TD males (F[1;53] = 7.07, p = 0.01), whereas anxious females did not differ from TD females (F[1,42] = 1.2, p = 0.28). In experiment 2 (Piñata), anxiety impaired performance accuracy in males (F[1;36] = 8.39; p < 0.01) but not females (F[1;28] = 0.6; p = 0.445).

CONCLUSIONS

Anxiety affected reward function differently in males and females. Contrary to hypothesis, anxious females behaved similarly to TD females on both tasks. However, anxious males were significantly more risk averse and less accurate than TD males. These findings suggest that therapeutic interventions for anxiety, which use manipulations of reward processes, should consider gender for optimal outcome.

The Influence of Math Anxiety, Math Performance, Worry, and Test Anxiety on the Iowa Gambling Task and Balloon Analogue Risk Task

Multiple studies have shown that performance on behavioral decision-making tasks, such as the Iowa Gambling Task (IGT) and Balloon Analogue Risk Task (BART), is influenced by external factors, such as mood. However, the research regarding the influence of worry is mixed, and no research has examined the effect of math or test anxiety on these tasks. The present study investigated the effects of anxiety (including math anxiety) and math performance on the IGT and BART in a sample of 137 undergraduate students. Math performance and worry were not correlated with performance on the IGT, and no variables were correlated with BART performance. Linear regressions indicated math anxiety, physiological anxiety, social concerns/stress, and test anxiety significantly predicted disadvantageous selections on the IGT during the transition from decision making under ambiguity to decision making under risk. Implications for clinical evaluation of decision making are discussed.

Trait Anxiety Has Effect on Decision Making under Ambiguity but Not Decision Making under Risk

Previous studies have reported that trait anxiety (TA) affects decision making. However, results remain largely inconsistent across studies. The aim of the current study was to further address the interaction between TA and decision making. 304 subjects without depression from a sample consisting of 642 participants were grouped into high TA (HTA), medium TA (MTA) and low TA (LTA) groups based on their TA scores from State Trait Anxiety Inventory. All subjects were assessed with the Iowa Gambling Task (IGT) that measures decision making under ambiguity and the Game of Dice Task (GDT) that measures decision making under risk. While the HTA and LTA groups performed worse on the IGT compared to the MTA group, performances on the GDT between the three groups did not differ. Furthermore, the LTA and HTA groups showed different individual deck level preferences in the IGT: the former showed a preference for deck B indicating that these subjects focused more on the magnitude of rewards, and the latter showed a preference for deck A indicating significant decision making impairment. Our findings suggest that trait anxiety has effect on decision making under ambiguity but not decision making under risk and different levels of trait anxiety related differently to individual deck level preferences in the IGT.

The impact of stress on financial decision-making varies as a function of depression and anxiety symptoms

Stress can precipitate the onset of mood and anxiety disorders. This may occur, at least in part, via a modulatory effect of stress on decision-making. Some individuals are, however, more resilient to the effects of stress than others. The mechanisms underlying such vulnerability differences are nevertheless unknown. In this study we attempted to begin quantifying individual differences in vulnerability by exploring the effect of experimentally induced stress on decision-making. The threat of unpredictable shock was used to induce stress in healthy volunteers (N = 47) using a within-subjects, within-session design, and its impact on a financial decision-making task (the Iowa Gambling Task) was assessed alongside anxious and depressive symptomatology. As expected, participants learned to select advantageous decks and avoid disadvantageous decks. Importantly, we found that stress provoked a pattern of harm-avoidant behaviour (decreased selection of disadvantageous decks) in individuals with low levels of trait anxiety. By contrast, individuals with high trait anxiety demonstrated the opposite pattern: stress-induced risk-seeking (increased selection of disadvantageous decks). These contrasting influences of stress depending on mood and anxiety symptoms might provide insight into vulnerability to common mental illness. In particular, we speculate that those who adopt a more harm-avoidant strategy may be better able to regulate their exposure to further environmental stress, reducing their susceptibility to mood and anxiety disorders.

Avoidant decision making in social anxiety: the interaction of angry faces and emotional responses

Recent research indicates that angry facial expressions are preferentially processed and may facilitate automatic avoidance response, especially in socially anxious individuals. However, few studies have examined whether this bias also expresses itself in more complex cognitive processes and behavior such as decision making. We recently introduced a variation of the Iowa Gambling Task which allowed us to document the influence of task-irrelevant emotional cues on rational decision making. The present study used a modified gambling task to investigate the impact of angry facial expressions on decision making in 38 individuals with a wide range of social anxiety. Participants were to find out which choices were (dis-) advantageous to maximize overall gain. To create a decision conflict between approach of reward and avoidance of fear-relevant angry faces, advantageous choices were associated with angry facial expressions, whereas disadvantageous choices were associated with happy facial expressions. Results indicated that higher social avoidance predicted less advantageous decisions in the beginning of the task, i.e., when contingencies were still uncertain. Interactions with specific skin conductance responses further clarified that this initial avoidance only occurred in combination with elevated responses before choosing an angry facial expressions. In addition, an interaction between high trait anxiety and elevated responses to early losses predicted faster learning of an advantageous strategy. These effects were independent of intelligence, general risky decision-making, self-reported state anxiety, and depression. Thus, socially avoidant individuals who respond emotionally to angry facial expressions are more likely to show avoidance of these faces under uncertainty. This novel laboratory paradigm may be an appropriate analog for central features of social anxiety.

Patients with chronic pain lack somatic markers during decision-making

Patients with chronic pain have impaired cognitive functions, including decision making, as shown with the Iowa gambling task (IGT). The main aim of this study was to elucidate whether patients’ decision making is associated with a lack of the anticipatory skin conductance response (SCR). An increase in anticipatory SCR before making unfavorable choices is known to guide decisions in healthy controls during the IGT. Since several brain regions involved in decision making are reported to have altered morphology in patients with chronic pain, the second aim was to explore the associations between IGT performance and brain structure volumes. Eighteen patients with chronic pain of mixed etiology and 19 healthy controls matched in terms of age, sex, and education were investigated with a computerized IGT during the recording of SCR, heart rate, and blood pressure. The participants also underwent neuropsychological testing, and three-dimensional T1-weighted cerebral magnetic resonance images were obtained. Contrary to controls, patients did not generate anticipatory SCRs before making unfavorable choices, and they switched between decks of cards during the late phase of the IGT significantly more often, and this was still observed after adjusting for depression scores. None of the other autonomic measures differed during IGT performance in either group or between groups. In patients, IGT scores correlated positively with total cortical grey matter volume. In controls, there was no such association, but their IGT scores correlated with the anticipatory SCR. It may be speculated that the reduction in anticipatory SCRs makes the chronic pain patients rely more on cortical resources during decision making.

Caloric vestibular stimulation as a treatment for conversion disorder: a case report and medical hypothesis

Conversion disorder is a medical condition in which a person has paralysis, blindness, or other neurological symptoms that cannot be clearly explained physiologically. To date, there is neither specific nor conclusive treatment. In this paper, we draw together a number of disparate pieces of knowledge to propose a novel intervention to provide transient alleviation for this condition. As caloric vestibular stimulation has been demonstrated to modulate a variety of cognitive functions associated with brain activations, especially in the temporal-parietal cortex, anterior cingulate cortex, and insular cortex, there is evidence to assume an effect in specific mental disorders. Therefore, we go on to hypothesize that lateralized cold vestibular caloric stimulation will be effective in treating conversion disorder and we present provisional evidence from one patient that supports this conclusion. If our hypothesis is correct, this will be the first time in psychiatry and neurology that a clinically well-known mental disorder, long considered difficult to understand and to treat, is relieved by a simple or common, non-invasive medical procedure.

The influence of worry and avoidance on the Iowa Gambling Task

BACKGROUND

It has been proposed that worry in individuals with Generalized Anxiety Disorder may be reinforced by a positive effect of worry on decision making, as reflected by a steeper learning curve on the Iowa Gambling Task (IGT). We hypothesized that this apparent positive effect of worry is dependent on the IGT parameters, in particular the absence of an opportunity to avoid decisions.

OBJECTIVE

(1) To replicate previous findings on the effect of worry on IGT performance. (2) To examine the influence of avoidance opportunity on IGT performance. We hypothesized that the positive effect of worry on learning would be abolished or reversed by the opportunity to avoid.

METHOD

A standard IGT and a new IGT version that includes a pass (avoidance) option were completed by 78 and 79 participants, respectively.

RESULTS

A beneficial effect of worry on learning in the standard version of the IGT was not observed. In the pass version of the IGT, worry status and avoidance were negatively associated with performance. Worry was not related, however, to pass usage. The hypothesized mediating effect of avoidance was non-significant.

LIMITATIONS

It is unclear to what extent these findings generalize to real-life decision making and how clinical status affects results.

CONCLUSION

The possibility to avoid a decision results in poorer IGT performance in high relative to low trait worriers. Possible explanations for these findings are discussed.

On the interaction of self-regulation, interoception and pain perception

BACKGROUND

Interoceptive processes were found to be associated with better self-regulation capacities in healthy participants. Further empirical research suggests that interoceptive sensitivity is also important for the perception of pain both in healthy participants and in somatoform patients. Nevertheless, little is known about the interaction of interoceptive processes and self-regulation for pain. We therefore conducted a study examining the interaction of interoception and self-regulation in somatoform patients.

METHODS

We investigated interoceptive sensitivity and self-regulatory capacities in 30 somatoform patients and 30 healthy controls when experimentally assessing pain threshold and pain tolerance.

RESULTS

Interoceptive sensitivity was associated with better self-regulation capacities. Somatoform patients exhibited a significantly reduced interoceptive sensitivity and reduced self-regulatory capacities as assessed by self-report. Additionally, pain tolerance was significantly increased in somatoform patients as compared to controls.

CONCLUSIONS

Our findings highlight that interoceptive sensitivity differentially interacts with pain and self-regulation both in healthy participants and somatoform patients. This might provide ideas for novel therapeutic interventions, e.g. a combined training of interoceptive sensitivity with certain aspects of self-regulation.

Seeing the forest through the trees: improving decision making on the Iowa gambling task by shifting focus from short- to long-term outcomes

Introduction: The present study sought to examine two methods by which to improve decision making on the Iowa Gambling Task (IGT): inducing a negative mood and providing additional learning trials.

Method: In the first study, 194 undergraduate students [74 male; M_age = 19.44 (SD = 3.69)] were randomly assigned to view a series of pictures to induce a positive, negative, or neutral mood immediately prior to the IGT. In the second study, 276 undergraduate students [111 male; M_age = 19.18 (SD = 2.58)] completed a delay discounting task and back-to-back administrations of the IGT.

Results: Participants in an induced negative mood selected more from Deck C during the final trials than those in an induced positive mood. Providing additional learning trials resulted in better decision making: participants shifted their focus from the frequency of immediate gains/losses (i.e., a preference for Decks B and D) to long-term outcomes (i.e., a preference for Deck D). In addition, disadvantageous decision making on the additional learning trials was associated with larger delay discounting (i.e., a preference for more immediate but smaller rewards).

Conclusions: The present results indicate that decision making is affected by negative mood state, and that decision making can be improved by increasing the number of learning trials. In addition, the current results provide evidence of a relationship between performance on the IGT and on a separate measure of decision making, the delay discounting task. Moreover, the present results indicate that improved decision making on the IGT can be attributed to shifting focus toward long-term outcomes, as evidenced by increased selections from advantageous decks as well as correlations between the IGT and delay discounting task. Implications for the assessment of decision making using the IGT are discussed.

The cognitive processes underlying affective decision-making predicting adolescent smoking behaviors in a longitudinal study

This study investigates the relationship between three different cognitive processes underlying the Iowa Gambling Task (IGT) and adolescent smoking behaviors in a longitudinal study. We conducted a longitudinal study of 181 Chinese adolescents in Chengdu City, China. The participants were followed from 10th to 11th grade. When they were in the 10th grade (Time 1), we tested these adolescents' decision-making using the IGT and working memory capacity using the Self-ordered Pointing Test (SOPT). Self-report questionnaires were used to assess school academic performance and smoking behaviors. The same questionnaires were completed again at the 1-year follow-up (Time 2). The Expectancy-Valence (EV) Model was applied to distill the IGT performance into three different underlying psychological components: (i) a motivational component which indicates the subjective weight the adolescents assign to gains vs. losses; (ii) a learning-rate component which indicates the sensitivity to recent outcomes vs. past experiences; and (iii) a response component which indicates how consistent the adolescents are between learning and responding. The subjective weight to gains vs. losses at Time 1 significantly predicted current smokers and current smoking levels at Time 2, controlling for demographic variables and baseline smoking behaviors. Therefore, by decomposing the IGT into three different psychological components, we found that the motivational process of weight gain vs. losses may serve as a neuropsychological marker to predict adolescent smoking behaviors in a general youth population.

Affective decision-making is predictive of three-month relapse in polysubstance-dependent alcoholics

BACKGROUND/AIMS

Common and long-lasting deficits in decision-making in polysubstance-dependent alcoholics (PSA) reflect neurobiological alterations that define the chronic nature of addiction. These deficits affect goal-directed behavior and might be critical risk factors predicting relapse in PSA.

METHODS

The Delay Discounting Task (DDT) and the Iowa Gambling Task (IGT) assessed the delay-discounting and decision-making skills among 37 abstinent PSA.

RESULTS

The findings indicated that IGT but not DDT performances were associated with 3-month abstinence, irrespective of the influence of personality traits and coexistent medications.

CONCLUSION

The results show that the IGT, which assesses processes that are important in the latter stages of addiction, is ecologically more valid compared to the DDT, which assesses processes important in the early stages. They underline the importance of using neurocognitive measures to identify high relapse risk patients and emphasize the relevance of promoting new treatments.

Emotion and decision-making: affect-driven belief systems in anxiety and depression

Emotion processing and decision-making are integral aspects of daily life. However, our understanding of the interaction between these constructs is limited. In this review, we summarize theoretical approaches that link emotion and decision-making, and focus on research with anxious or depressed individuals to show how emotions can interfere with decision-making. We integrate the emotional framework based on valence and arousal with a Bayesian approach to decision-making in terms of probability and value processing. We discuss how studies of individuals with emotional dysfunctions provide evidence that alterations of decision-making can be viewed in terms of altered probability and value computation. We argue that the probabilistic representation of belief states in the context of partially observable Markov decision processes provides a useful approach to examine alterations in probability and value representation in individuals with anxiety and depression, and outline the broader implications of this approach.

Is a prostate cancer screening anxiety measure invariant across two different samples of age-appropriate men?

Background

In order to explore the influence of anxiety on decision–making processes, valid anxiety measures are needed. We evaluated a prostate cancer screening (PCS) anxiety scale that measures anxiety related to the prostate–specific antigen (PSA) test, the digital rectal examination (DRE), and the decision to undergo PCS (PCS-D) using two samples in different settings.

Methods

We assessed four psychometric properties of the scale using baseline data from a randomized, controlled decision aid trial (n = 301, private clinic; n = 149, public).

Results

The 3-factor measure had adequate internal consistency reliability, construct validity, and discriminant validity. Confirmatory factor analyses indicated that the 3–factor model did not have adequate fit. When subscales were considered separately, only the 6–item PCS-D anxiety measure had adequate fit and was invariant across clinics.

Conclusions

Our results support the use of a 6–item PCS-D anxiety measure with age-appropriate men in public and private settings. The development of unique anxiety items relating to the PSA test and DRE is still needed.

Personality and Skin Conductance Responses to Reward and Punishment

For several years now, the somatic aspect of emotions has been regarded as a major factor in the decision-making process. A large body of literature has investigated this issue, within the somatic marker hypothesis perspective, using the classical Iowa Gambling Task (IGT). Many studies reported an influence of clinical and differential factors, including personality, on IGT performance. On the other hand, personality appears to modulate the emotional responses as a function of valence (i.e., responses to rewards vs. punishments). The present study investigated whether the influence of personality on the decision-making process might be mediated by differential emotional responsiveness. Skin conductance levels were recorded in 32 subjects while performing the IGT. The results showed that novelty seeking (NS) modulated the skin conductance responses to feedback, and both NS and harm avoidance (HA) influenced anticipative response development. We also found that NS tended to modulate the final score, beyond the influence of beneficial anticipative autonomic responses. The present data partially support the hypothesis that personality-related differential emotional responsiveness may modulate somatic marker development in a decision-making situation. On the other hand, personality influence on the performance was not entirely explained by these emotional differences.

Negative mood induction normalizes decision making in male cocaine dependent individuals

RATIONALE

Decision making is thought to play a key role in psychostimulant relapse, but very few studies have addressed the issue of how to counteract decision-making deficits in addicted individuals. According to the somatic marker framework, pervasive decision-making problems in addicted individuals may relate to abnormalities in the processing of emotional signals that work to anticipate the prospective outcomes of potential decisions.

OBJECTIVE

The present study was conducted to test whether the induction of different emotional states (positive, negative, or drug-related) could either normalize or further impair decision-making performance in male cocaine polysubstance-using individuals (CPSI), as indexed by the Iowa gambling task (IGT).

METHODS

Forty-two CPSI and 65 healthy control individuals (all males) were randomly allocated in four affective conditions using a parallel-group design. Participants in the different conditions performed the IGT during exposure to neutral, positive, negative, or drug-related sets of affective images.

RESULTS

The results showed that the CPSI exposed to the negative affective context showed a preference for the risk-averse safe choices of the IGT and had a net performance indistinguishable from that of controls. On the other hand, CPSI exposed to positive, drug-related, and neutral contexts showed the typical pattern of disadvantageous performance in the IGT and performed significantly poorer than controls. The impact of the negative mood induction could not be explained in terms of baseline differences in decision-making skills, personality traits related to sensitivity to reward/punishment, or trait positive/negative affect.

CONCLUSIONS

We conclude that negative mood induction can normalize decision-making performance in male CPSI, which may have important implications for the treatment of cocaine use-related disorders.

A reverse translational approach to quantify approach-avoidance conflict in humans

Animal approach-avoidance conflict paradigms have been used extensively to characterize effects of anxiolytic agents and probe neural circuitry related to anxiety. However, there are few behavioral approaches to measure conflict in human populations, limiting the translation of findings from animal conflict tasks to human clinical research. We developed a novel approach-avoidance conflict (AAC) paradigm involving situations in which the same decision is associated with "reward" (points) and "punishment" (negative affective stimuli). The AAC task was completed by 95 young adults (56 female) with varying levels of self-reported trait anxiety. As expected, conflict-related approach behavior correlated with self-reported motivation to approach reward and avoid punishment and greater reward level increased approach behavior. Additionally, females exhibited less approach behavior than males. Anxiety Sensitivity Index (Physical subscale) scores related negatively to approach behavior for males, while Behavioral Activation Scale (BAS, Fun Seeking subscale) scores related positively to approach behavior for females. Results support the utility of the AAC task as a behavioral test that has strong reverse translational features. Findings indicate that approach drives and anxiety sensitivity may be important in determining conflict behavior for females and males respectively. The approach-avoidance conflict task offers a novel, translational measure to probe neural systems underlying conflict behavior, motivational processes, and anxiety disorders.

Neural systems underlying approach and avoidance in anxiety disorders

Approach-avoidance conflict is an important psychological concept that has been used extensively to better understand cognition and emotion. This review focuses on neural systems involved in approach, avoidance, and conflict decision making, and how these systems overlap with implicated neural substrates of anxiety disorders. In particular, the role of amygdala, insula, ventral striatal, and prefrontal regions are discussed with respect to approach and avoidance behaviors. Three specific hypotheses underlying the dysfunction in anxiety disorders are proposed, including: (i) over-representation of avoidance valuation related to limbic overactivation; (ii) under- or over-representation of approach valuation related to attenuated or exaggerated striatal activation respectively; and (iii) insufficient integration and arbitration of approach and avoidance valuations related to attenuated orbitofrontal cortex activation. These dysfunctions can be examined experimentally using versions of existing decision-making paradigms, but may also require new translational and innovative approaches to probe approach-avoidance conflict and related neural systems in anxiety disorders.

Future-oriented decision-making in Generalized Anxiety Disorder is evident across different versions of the Iowa Gambling Task

Generalized Anxiety Disorder (GAD) and excessive worrying are characterized by a preoccupation with the future. Thus, enhanced identification of potential future punishments or omissions of reward may be related to the disorder. To test this hypothesis, n=47 students meeting GAD criteria according to the GADQ-IV (GAD analogues) or not (control participants) performed the Iowa Gambling Task, which has been related to sensitivity to future consequences. In order to disentangle sensitivity to future loss and sensitivity to high short-term loss magnitudes, which could also lead to enhanced Iowa Gambling Task performance, participants also performed a modified version of the task with reversed contingencies. In both versions, GAD analogues learned to avoid decisions with high probability of long-term loss significantly faster than control participants. Results, therefore, indicate that GAD is characterized by enhanced processing of potential future losses rather than sensitivity to large short-term loss.