The somatic marker hypothesis: A critical evaluation

Older adults' decision-making following bad advice

There is minimal research investigating the influence of advice on decision-making in older age. The present study investigated the effect of different types of bad advice, relative to no advice, on young and older adults' decision-making in the Iowa Gambling Task (IGT). Fifty-four older adults and 59 young adults completed the IGT after receiving no advice, or advice to select from disadvantageous deck A (small, high-frequency losses), or disadvantageous deck B (larger, low-frequency losses). Corrugator EMG, memory and fluid intelligence were assessed. Averaged across advice conditions, older adults made more disadvantageous selections than young adults. There were no age-related differences in responding to bad advice, nor in corrugator activity in response to losses (i.e. frowning), or in learning to avoid deck A faster than deck B. Selecting from deck B was associated with reduced education among older adults, and reduced fluid intelligence among young adults. The data suggest that older adults make more disadvantageous decisions than young adults, and this is not exacerbated by bad advice. Both young and older adults are slower at learning to avoid choices resulting in low frequency relative to high-frequency losses, and this may be associated with individual differences in cognitive processing.

Normatively irrelevant disgust interferes with decision under uncertainty: Insights from the Iowa gambling task

This study investigates whether a not informative, irrelevant emotional reaction of disgust interferes with decision-making under uncertainty. We manipulate the Iowa Gambling Task (IGT) by associating a disgust-eliciting image with selections from Disadvantageous/Bad decks (Congruent condition) or Advantageous/Good decks (Incongruent condition). A Control condition without manipulations is also included. Results indicate an increased probability of selecting from a Good deck as the task unfolds in all conditions. However, this effect is modulated by the experimental manipulation. Specifically, we detect a detrimental effect (i.e., a significant decrease in the intercept) of the disgust-eliciting image in Incongruent condition (vs. Control), but this effect is limited to the early stages of the task (i.e., first twenty trials). No differences in performance trends are detected between Congruent and Control conditions. Anticipatory Skin Conductance Response, heart rate, and pupil dilation are also assessed as indexes of anticipatory autonomic activation following the Somatic Marker Hypothesis, but no effects are shown for the first two indexes in any of the conditions. Only a decreasing trend is detected for pupil dilation as the task unfolds in Control and Incongruent conditions. Results are discussed in line with the "risk as feelings" framework, the Somatic Marker Hypothesis, and IGT literature.

Modulation of dlPFC function and decision-making capacity by repetitive transcranial magnetic stimulation in methamphetamine use disorder

This study explores the impact of repetitive transcranial magnetic stimulation (rTMS) on decision-making capabilities in individuals with methamphetamine use disorder (MUD), alongside potential underlying psychological mechanisms. Employing the Iowa Gambling Task (IGT) and computational modeling techniques, we assessed the decision-making processes of 50 male MUD participants (24 underwent rTMS treatment, 26 received no treatment) and 39 healthy controls (HC). We compared pre- and post-rTMS treatment alterations in the left dorsolateral prefrontal cortex (dlPFC). Results revealed inferior performance in the IGT among the MUD group, characterized by aberrant model parameters in the Value-Plus-Perseverance (VPP) model, including heightened learning rate, outcome sensitivity, and reinforcement learning weight, alongside diminished response consistency and loss aversion. RTMS treatment demonstrated efficacy in reducing craving scores, enhancing decision-making abilities, and partially restoring normalcy to certain model parameters in the MUD cohort. Nonetheless, no linear relationship between changes in model parameters and craving was observed. These findings lend support to the somatic marker hypothesis, implicating the dlPFC in the decision-making deficits observed in MUD, with rTMS potentially ameliorating these deficits by modulating the function of these brain regions. This study not only offers novel insights and methodologies for MUD rehabilitation but also underscores the necessity for further research to corroborate and refine these findings. Trial Registration www.chictr.org.cn Identifier: No. ChiCTR17013610.

Executive functioning and treatment outcome among adolescents undergoing cognitive-behavioral therapy for binge-eating disorder

BACKGROUND

Cognitive-behavioral therapy (CBT) is an evidence-supported treatment for adolescents with binge-eating disorder (BED). Executive dysfunctions, which are associated with binge eating and elevated body weight in youth, may undermine CBT outcomes by making it difficult for youth to engage with or adhere to treatment, including recalling and/or implementing intervention strategies in real-world contexts.

METHODS

We assessed 73 adolescents [82.2% female; Mage = 15.0 ± 2.5 year; M baseline standardized body mass index (zBMI) = 1.9 ± 1.0 kg/m2] with BED at baseline, posttreatment, 6-, 12-, and 24-month follow-up. Linear mixed models examined the effects of baseline executive functioning (EF) on loss of control (LOC) eating and weight change following CBT. Linear and logistic regressions probed associations between EF, attendance, and attrition.

RESULTS

More impulsive decision-making, as reflected in higher baseline scores on the Iowa Gambling Task, predicted better attendance (β = .07; p = .019) and more frequent LOC eating following treatment (β = .12; p = .017). Lower cognitive flexibility, as reflected in lower baseline T-scores on the Comprehensive Trail Making Test complex sequencing index, predicted higher zBMI following treatment (β = -.03; p = .003). Inhibition, concentration, attention, and parent-reported EF behavior symptoms were not associated with outcome, attendance, or attrition.

CONCLUSIONS

More impulsive decision-making and lower cognitive flexibility were associated with suboptimal response to CBT for BED, although findings should be interpreted with caution in light of the sample size and waitlist control design. Future research should examine whether strengthening EF could improve eating and weight outcomes among adolescents with BED who have lower pre-treatment EF.

Religiosity, Financial Risk Taking, and Reward Processing: An Experimental Study

The present study investigated the extent to which financial risk-taking (FRT) perspectives and religiosity influenced an individual's performance on financial decision-making tasks under risk and/or uncertainty. It further investigated the potential to measure this interaction using electro-encephalogram (EEG) assessments through reward-related event-related potentials (P3 and FRN). EEG data were collected from 37 participants undergoing four decision-making tasks comprising the Balloon Analogue Risk Task (BART), Iowa Gambling Test (IGT), Mixed-Gamble Loss-Aversion Task (MGLAT), and MGLA-Success Task (MGLAST). The present study found that BART performance may be affected by an interaction of FRT perspectives and religiosity. The physiological effects of task feedback were also distinguished between religious and non-religious individuals objectively with EEG data. Overall, while religiosity and FRT may not significantly influence IGT and MGLA performance, and interact with BART in a complex way, physiological reaction towards feedback after BART performance appears to be strongly affected by religiosity and FRT perspectives.

An in vivo Dissection, and Analysis of Socio-Affective Symptoms related to Cerebellum-Midbrain Reward Circuitry in Humans

Emerging research in non-human animals implicates cerebellar projections to the ventral tegmental area (VTA) in appetitive behaviors, but these circuits have not been characterized in humans. Here, we mapped cerebello-VTA white-matter connectivity in humans using probabilistic tractography on diffusion imaging data from the Human Connectome Project. We uncovered the topographical organization of these connections by separately tracking from parcels of cerebellar lobule VI, crus I/II, vermis, paravermis, and cerebrocerebellum. Results revealed that connections from the cerebellum to the VTA predominantly originate in the right hemisphere, interposed nucleus, and paravermal cortex, and terminate mostly ipsilaterally. Paravermal crus I sends the most connections to the VTA compared to other lobules. We discovered a medial-to-lateral gradient of connectivity, such that the medial cerebellum has the highest connectivity with the VTA. Individual differences in microstructure were associated with measures of negative affect and social functioning. By splitting the tracts into quarters, we found that the socio-affective effects were driven by the third quarter of the tract, corresponding to the point at which the fibers leave the deep nuclei. Taken together, we produced detailed maps of cerebello-VTA structural connectivity for the first time in humans and established their relevance for trait differences in socio-affective regulation.

Transcranial direct current stimulation combined with cognitive training improves decision making and executive functions in opioid use disorder: a triple-blind sham-controlled pilot study

Opioid use disorder (OUD) is a chronic disorder with a considerable amount of morbidity and mortality. Despite remarkable improvement achieved by maintenance programs, an array of treatment goals were still unmet. Mounting evidence suggests that transcranial Direct Current Stimulation (tDCS) improves decision making and cognitive functions in addictive disorders. tDCS paired with a decision making task was depicted to diminish impulsivity as well.

The present study aimed to assess the effect of tDCS combined with cognitive training (CT) in OUD for the first time.

In this triple-blind randomized sham-controlled pilot study, 38 individuals with OUD from the Buprenorphine-Naloxone Maintenance Therapy program were administered 20-minutes of 2 mA active/sham tDCS over the dorsolateral prefrontal cortex with concomitant cognitive training. A selected test battery evaluating decision making under risk and ambiguity as well as executive functions, verbal fluency and working memory was utilized before and after the intervention.

Greater improvements were observed in decision making under ambiguity (p = 0.016), set shifting ability and alternating fluency while no improvements were observed in decision making under risk in the active group, compared to sham.

Deficits of decision making and executive functions have a pivotal role in the perpetuation and the relapse of the OUD. Alleviation of these impairments brought tDCS/CT forth as an expedient neuroscientifically-grounded treatment option that merits further exploration in OUD, Trial registration: NCT05568251.

The Iowa Gambling Task: Men and Women Perform Differently. A Meta-analysis

The Iowa Gambling Task (IGT) was designed to assess decision-making under conditions of complexity and uncertainty; it is currently one of the most widely used tests to assess decision-making in both experimental and clinical settings. In the original version of the task, participants are given a loan of play money and four decks of cards and are asked to maximize profits. Although any single card unpredictably yields wins/losses, variations in frequency and size of gains/losses ultimately make two decks more advantageous in the long term. Several studies have previously suggested that there may be a sex-related difference in IGT performance. Thus, the present study aimed to explore and quantify sex differences in IGT performance by pooling the results of 110 studies. The meta-analysis revealed that males tend to perform better than females on the classic 100-trial IGT (UMD = 3.381; p < 0.001). Furthermore, the significant heterogeneity observed suggests high variability in the results obtained by individual studies. Results were not affected by publication bias or other moderators. Factors that may contribute to differences in male and female performance are discussed, such as functional sex-related asymmetries in the ventromedial prefrontal cortex and amygdala, as well as differences in sensitivity to wins/losses.

Differential psychophysiological responses associated with decision-making in children from different socioeconomic backgrounds

This study examined how socioeconomic status (SES) influences on decision-making processing. The roles of anticipatory/outcome-related cardiac activity and awareness of task contingencies were also assessed. One hundred twelve children (Mage  = 5.83, SDage  = 0.32; 52.7% female, 51.8% low-SES; data collected October-December 2018 and April-December 2019) performed the Children's Gambling Task, while heart rate activity was recorded. Awareness of gain/loss contingencies was assessed after completing the task. Distinct decision-making strategies emerged among low and middle/high-SES children. Despite similar awareness levels between SES groups, future-oriented decision-making was linked solely to the middle/high-SES group. Somatic markers did not manifest unequivocally. However, contrasting cardiac patterns were evident concerning feedback processing and the association between anticipatory activity and awareness (low: acceleration vs. middle/high: deceleration). Results are interpreted from an evolutionary-developmental perspective.

Investigating the relationship between self-reported interoceptive experience and risk propensity

Risky behaviour may be associated with visceral experiences, such as increased heart rate. Previous studies examining the relationship between perception of such signals (interoception) and risk-taking typically used behavioural tasks with potential for monetary reward. This approach may be less informative for understanding general risk propensity. In addition, such research does not usually consider the varied ways individuals engage with interoceptive signals. However, examining these different forms of engagement may help us understand how subjective experience of interoception influences risk-taking. As such, we performed two surveys (n = 471, primarily young adults) to examine the relationship between self-reported engagement with interoceptive signals (measured using the Multidimensional Assessment of Interoceptive Awareness) and a generalised measure of risk propensity (the General Risk Propensity Scale). Results indicated that different ways of interpreting or engaging with interoceptive signals were differentially associated with risk propensity. In particular, they provide preliminary evidence that those with the ability to ignore or not worry about visceral signals when they are uncomfortable display greater risk propensity (and these effects may possibly be gender-specific).

Bittersweet memories and somatic marker hypothesis: adaptive control in emotional recall facilitates long-term decision-making in the Iowa Gambling Task

The somatic marker hypothesis states that emotional recall and its somatic influence guide long-term decision-making. However, the mechanism through which decision-making benefits from emotional recall is unclear; whether emotional recall and the induced affect increase the regulatory demand or amplify the affect state that requires inhibition. It is unclear if controlling the automatic flow of emotion in recall improves adaptive decision-making. Two studies examine the hypothesis that affect control in emotional recall facilitates inhibitory control and benefits long-term decision-making. In Experiment 1 (n = 137), affect control was assessed in emotional recall to examine if switching of affect in recall of positive and negative valence (order: positive-negative memory recall vs. negative-positive memory recall) is linked with long-term decision-making. Results for long-term decision-making showed that negative-positive recall sequence was associated with higher long-term decision-making, whereas automatic frequency-based decision-making remained unaffected by the recall sequence. In experiment 2 (n = 71, all male), emotional recall (positive vs. negative), recall specificity (i.e., specific vs. overgeneralized recall), and post-recall mood regulation (post-recall positive mood regulation vs. no regulation) was expected to facilitate long-term decision-making. Results showed that emotional recall and post-recall mood regulation (i.e., negative recall - positive mood and positive recall - negative mood) were associated with higher long-term decision-making (decks C' and D'). Results of frequency decision-making showed that positive emotional recall, and poor recall specificity led to infrequent punishment deck choices (decks B' and D'). Hierarchical regression indicated that emotional recall increased infrequent deck choices and accounted for 10% of choices made, recall specificity increased the explanatory power to 19%, and higher recall specificity was associated with fewer infrequent punishment deck choices. Affect control engaged via negative emotional recall, post-recall mood regulation, and recall specificity might be a potential mechanism through which affect control in emotional recall might facilitate long-term decision-making.

Decision making and its correlates in recurrent depressive disorder

Objective

Decision-making (DM) is simply choosing among alternatives or defining one's course of action. A depressed individual does not perceive himself as a decision-maker as ruminations reinforce dysfunctional metacognitive beliefs and poor executive functioning. The aim was to study and compare the relationship among DM, metacognition, and executive functioning in those with recurrent depressive disorder (RDD) and in healthy controls (HCs).

Methods

A cross-sectional comparative group study design was used with a sample size of 40, with 20 participants in each group. The tools used were Mini International Neuropsychiatric Interview, General Health Questionnaire, Melbourne Decision Making Questionnaire, Metacognitive Questionnaire, Wisconsin Card Sorting Test, and Controlled Oral Word Association Test.

Results

The RDD group had significantly higher scores on buck-passing (BP), procrastination (PR), hypervigilance, and dysfunctional metacognitive beliefs, and poor performance on executive functioning than HC. PR was inversely correlated with executive functioning and dysfunctional metacognitive beliefs in the RDD group, whereas in the HC group, BP was positively correlated with executive functioning and dysfunctional metacognitive beliefs.

Conclusion

DM has a significant relationship with executive functions and dysfunctional metacognitive beliefs; therefore, changes in any one variable contribute to changes in the other two. The altered attentional and executive control due to dysfunctional metacognitive beliefs leads to poor DM, resulting in psychosocial dysfunction. The underlying metacognitive beliefs and executive functioning play a crucial role in DM, the process determining psychosocial functioning.

Economic and social values in the brain: evidence from lesions to the human ventromedial prefrontal cortex

Making good economic and social decisions is essential for individual and social welfare. Decades of research have provided compelling evidence that damage to the ventromedial prefrontal cortex (vmPFC) is associated with dramatic personality changes and impairments in economic and social decision-making. However, whether the vmPFC subserves a unified mechanism in the social and non-social domains remains unclear. When choosing between economic options, the vmPFC is thought to guide decision by encoding value signals that reflect the motivational relevance of the options on a common scale. A recent framework, the "extended common neural currency" hypothesis, suggests that the vmPFC may also assign values to social factors and principles, thereby guiding social decision-making. Although neural value signals have been observed in the vmPFC in both social and non-social studies, it is yet to be determined whether they have a causal influence on behavior or merely correlate with decision-making. In this review, we assess whether lesion studies of patients with vmPFC damage offer evidence for such a causal role of the vmPFC in shaping economic and social behavior.

Disgust Processing and Potential Relationships with Behaviors in Autism

PURPOSE OF REVIEW

While there are reports of differences in emotion processing in autism, it is less understood whether the emotion of disgust, in particular, plays a significant role in these effects. Here, we review literature on potential disgust processing differences in autism and its possible associations with autistic traits.

RECENT FINDINGS

In autism, there is evidence for differences in physical disgust processing, pica behaviors, attention away from other's disgust facial expressions, and differences in neural activity related to disgust processing. In typically developing individuals, disgust processing is related to moral processing, but modulated by individual differences in interoception and alexithymia. Autistic individuals may experience atypical disgust, which may lead to difficulty avoiding contaminants and affect socio-emotional processing. In autism, such outcomes may lead to increased occurrences of illness, contribute to gastrointestinal issues, diminish vicarious learning of disgust expression and behaviors, and potentially contribute to differences in processes related to moral reasoning, though further research is needed.

RISK aversion in Italian forensic and non-forensic patients with schizophrenia spectrum disorders

BACKGROUND

Goal-directed decision-making is a central component of the broader reward and motivation system, and requires the ability to dynamically integrate both positive and negative feedback from the environment in order to maximize rewards and minimize losses over time. Altered decision-making processes, in which individuals fail to consider the negative consequences of their decisions on both themselves and others, may play a role in driving antisocial behaviour.

AIM

The main study aim was to investigate possible differences in loss and risk aversion across matched patients, all with a schizophrenia spectrum disorder (SSD), but who varied according to whether they had a history of serious interpersonal violence or not, and a sample of healthy controls with no history of violence.

RESULTS

The sample included 14 forensic and 21 non-forensic patients with SSD, and 41 healthy controls. Among the three decision-making variables under investigation, risk aversion was the only significant predictor of membership of the three groups, with greater risk aversion among non-forensic patients with SSD compared to healthy controls. No differences were observed across groups in loss aversion and choice consistency.

CONCLUSIONS

This evidence suggests a new potential treatment target for rehabilitative measures aimed at achieving functional improvements in patients with SSD by selectively leveraging the neuro-cognitive processing of reward.

Testing the somatic marker hypothesis in decisions-from-experience with non-stationary outcome probabilities

Introduction

The Somatic Marker Hypothesis (SMH) posits that in experience-based choice, people develop physiological reactions that mark options as either positive or negative. These somatic markers aid decision making because they differentiate between "good" and "bad" options during pre-choice deliberation.

Methods

We examined this proposed role for somatic states in two decision-from-experience tasks (each N = 36) in which participants selected repeatedly with full feedback (i.e., for obtained and forgone outcomes) between two unlabeled options that returned wins or losses, with half receiving an additional summary of past outcomes. The probabilities of good and bad outcomes changed at an unannounced point. Participants completed a 100-trial game with a switch in the optimal option after trial 40 (Study 1) or a 200-trial game with switch points after trial 40 and trial 120 (Study 2). Skin conductance (SC) was measured continuously as an index of emotional intensity, from which we extracted measures of anticipatory SC (pre-choice) and outcome SC (post-choice).

Results

Participants reliably selected the optimal option prior to any switches. They also altered their choices appropriately when the payoffs changed, though optimal play following payoff switches was reduced. Losses resulted in a greater outcome SC than wins, but only in Study 1, as did the finding that the outcome SC was greater when the forgone outcome was positive. Anticipatory SC did not reliably predict optimal play in either study.

Discussion

These results provide little support for the SMH. Our studies point to the importance of using diverse tasks and measures and very large sample sizes when testing the role of somatic states in decision making.

Decision-making under ambiguity after frontal lobe resection for epilepsy

PURPOSE

Decision-making is crucial to daily life and can impact our society as well as economic conditions. Although the frontal lobes have been identified as important for decision-making, this capacity has only been studied to a limited extent in frontal lobe epilepsy and not at all after frontal lobe resection (FLR) for epilepsy. This study aimed to explore decision-making under ambiguity after FLR for epilepsy.

METHODS

Fourteen patients having undergone FLR for epilepsy completed the Iowa Gambling Task (IGT) which is a widely used tool to measure decision-making under ambiguity. Iowa Gambling Task scores included in the analysis were: total net score, separate scores from five blocks across the test, and a change score (last block of IGT minus first block). A group of healthy controls (n = 30) was used as a comparison. Associations between IGT and standardized neuropsychological methods for assessment of executive functions, self-rating questionnaires of mental health, fatigue, and behavior linked to frontal lobe dysfunction were also investigated.

RESULTS

The patient group performed inferior to controls at the final block of the IGT (p =.001).A group difference in IGT change scores was found (p =.005), reflectingthe absence of a positive change in performance over time for the FLR group compared to the control group. Correlations with tests of executive functions as well as self-rating scales were mainly statistically nonsignificant.

CONCLUSIONS

This study shows that patients having undergone FLR for epilepsy have difficulties with decision-making under ambiguity. The performance illustrated a failure to learn throughout the task. Executive as well as emotional deficits may impact decision-making processes in this patient group and need to be considered in further studies. Prospective studies with larger cohorts are needed.

Temporal dynamics of the semantic versus affective representations of valence during reversal learning

Valence, the representation of a stimulus in terms of good or bad, plays a central role in models of affect, value-based learning theories, and value-based decision-making models. Previous work used Unconditioned Stimulus (US) to support a theoretical division between two different types of valence representations for a stimulus: the semantic representation of valence, i.e., stored accumulated knowledge about the value of the stimulus, and the affective representation of valence, i.e., the valence of the affective response to this stimulus. The current work extended past research by using a neutral Conditioned Stimulus (CS) in the context of reversal learning, a type of associative learning. The impact of expected uncertainty (the variability of rewards) and unexpected uncertainty (reversal) on the evolving temporal dynamics of the two types of valence representations of the CS was tested in two experiments. Results show that in an environment presenting the two types of uncertainty, the adaptation process (learning rate) of the choices and of the semantic valence representation is slower than the adaptation of the affective valence representation. In contrast, in environments with only unexpected uncertainty (i.e., fixed rewards), there is no difference in the temporal dynamics of the two types of valence representations. Implications for models of affect, value-based learning theories, and value-based decision-making models are discussed.

Risk Decision Making and Executive Function among Adolescents and Young Adults

The dual theory establishes that the decision-making process relies on two different systems, the affective system and the executive function (EF), developed during adolescence. This study analyzes the relationship between the decision-making and EF processes in a group of early adolescents (mean age = 12.51 years, SD = 0.61), where more affective impulse processes are developed, and in young adults (mean age = 19.38 years, SD = 1.97), where cognitive control processes have already matured. For this purpose, 140 participants in Spain completed the Iowa Gambling Task (IGT) to measure their risky decisions and the Wisconsin Card Sorting Task (WCST) to measure their EF. Performance on the IGT improves over blocks; however, adolescents received lower mean scores than young adults. However, controlling for age, perseverative errors were negatively associated with the mean net score on the risky blocks of IGT; thus, those who committed more perseverative errors in the WCST were more likely to take cards from the disadvantageous decks on the last blocks of the IGT. The current study shows that adolescents and adults solve ambiguous decisions by trial and error; however, adolescents are more likely to make risky decisions without attending to the long-term consequences. Following the dual theory hypothesis, the maturation of EF with age partly accounts for this difference in risky decision-making between adolescents and adults.

Context effects, skin conductance responses and personality traits - Influencing variables on risk-taking within a modified version of the balloon analog risk task

When individuals take risks, they must weigh potential costs and benefits associated with a decision. Differences in risk-taking appear to be influenced by contextual, and inter-individual factors. However, it is still ambiguous to what extent these characteristics jointly influence risk-taking. We investigated how risk-taking varies as function of context effects, incentives, skin conductance responses (SCR), and personality traits such as impulsivity and sensitivity to reward and punishment. Sixty-eight healthy participants conducted a modified version of the Balloon Analogue Risk Task (BART) composed of a gain-framed (G-BART) and loss-framed (L-BART) context with each a low and a high outcome magnitude condition. While the goal in G-BART was to maximize gains, the goal in L-BART was to minimize losses. In both versions, participants can potentially accumulate the same amounts. We conducted trial-by-trial mixed model analyses to account for within- and between-participant effects. Participants showed greater risk-taking when playing L-BART than G-BART; more risk-taking was observed in the high compared to the low outcome magnitude condition. Furthermore, higher SCR were associated with less risk-taking. Lower impulsivity was related to a greater difference in risk-taking in both contexts, with greater risk-taking in L-BART. Likewise, sensitivity to reward was associated with a greater difference in risk-taking in both contexts, with greater risk-taking in G-BART. Finally, greater sensitivity to punishment was related to risk-taking among participants describing themselves as sensitive to rewards. Results support a multidimensional state-trait model of risk-taking suggesting that risk-taking is favored by loss-aversion along with incentives, psychophysiological arousal, and personality traits.

Interoceptive accuracy is associated with benefits in decision making in children

Introduction

Decision making results not only from logical analyses, but seems to be further guided by the ability to perceive somatic information (interoceptive accuracy). Relations between interoceptive accuracy and decision making have been exclusively studied in adults and with regard to complex, uncertain situations (as measured by the Iowa Gambling Task, IGT).

Methods

In the present study, 1454 children (6-11 years) were examined at two time points (approximately 1 year apart) using an IGT as well as a delay-of-gratification task for sweets-items and toy-items. Interoceptive accuracy was measured using a child-adapted version of the Heartbeat Perception Task.

Results

The present results revealed that children with higher, as compared to lower, interoceptive accuracy showed more advantageous choices in the IGT and delayed more sweets-items, but not toy-items, in a delay-of-gratification task at time point 2 but not at time point 1. However, no longitudinal relation between interoceptive accuracy and decision making 1 year later could be shown.

Discussion

Results indicate that interoceptive accuracy relates to decision-making abilities in situations of varying complexity already in middle childhood, and that this link might consolidate across the examined 1-year period. Furthermore, the association of interoceptive accuracy and the delay of sweets-items might have implications for the regulation of body weight at a later age.

The Bangor Gambling Task: Computerized replication and reappraisal of an emotion-based decision task

Emotion-based decision making (EBDM) is the capacity to make decisions based on prior emotional consequences of actions. Several neuropsychological tasks, using different gambling paradigms and with different levels of complexity, have been designed to assess EBDM. The Bangor Gambling Task (BGT) was created as a brief and simple card gambling-task to assess EBDM. BGT contains a single-card deck and requires participants to decide whether to gamble or not, which can result in wins or losses. Unknown to the participant, the winning probabilities decrease throughout the task (from 0.75 in the first block to 0.25 in the fifth block), requiring participants to reduce their gambling probability to avoid long-term losses. A few studies have offered evidence regarding the BGT convergent validity. However, there are no computerized versions of BGT available, thus slowing the process of gathering information to explore the EBDM mechanisms behind the task, its validity, and clinical usefulness. In this article, we present a computerized version of the BGT using the Matlab environment and make all our code available. We explore BGT's replicability and analyze its probabilistic structure, providing trial-level and block-level analyses. Eighty-one participants performed the computerized version, which followed the same structure as the original version. It took participants 8.5 ± 3.3 minutes to complete the task, which is faster than the paper version. Replicating previous studies, participants diminished their gambling probability throughout the task, learning to inhibit the initially rewarded gambling behavior. This change in gambling probability could be considered a proxy for EBDM. Our analyses suggest that the last blocks are especially sensitive to capturing deficits in EBDM, and we propose some modifications to BGT's original version to enhance the initial exploratory and learning phase. Our results show that the BGT constitutes a quick and simple task to evaluate EBDM capacities.

Effects of electronic personal health information technology on American women's cancer screening behaviors mediated through cancer worry: Differences and similarities between 2017 and 2020

Backgrounds

Thanks to their accessibility and low cost, electronic personal health information (ePHI) technologies have been widely used to facilitate patient-physician communication and promote health prevention behaviors (e.g. cancer screening). Despite that empirical evidence has supported the association between ePHI technology use and cancer screening behaviors, the underlying mechanism through which ePHI technology use influences cancer screening behaviors remains a topic of discussion.

Objective

This study investigates the relationship between ePHI technology uses and cancer screening behaviors of American women and examines the mediating role of cancer worry.

Methods

Data for this study were from the Health Information National Trends Survey (HINTS) collected in 2017 (HINTS 5 Cycle 1) and 2020 (HINTS 5 Cycle 4). The final sample included 1914 female respondents in HINTS 5 Cycle 1 and 2204 in HINTS 5 Cycle 4. Mann-Whitney U test, two-sample t-test, and mediation analysis were performed. We also referred to the regression coefficients generated by min-max normalization as percentage coefficients (bp) for the comparison.

Results

This study reports increased usage of ePHI technologies (from 1.41 in 2017 to 2.19 to 2020), increased cancer worry (from 2.60 in 2017 to 2.84 in 2020), and a stable level of cancer screening behaviors (from 1.44 in 2017 to 1.34 in 2020) among American women. Cancer worry was found to mediate the ePHI effect on cancer screening behaviors (bp = 0.005, 95% confidence interval [0.001, 0.010]) in a positive complementary mediation in 2020.

Conclusions

The research findings support a positive association between ePHI technology use and cancer screening behaviors, and cancer worry has been identified as a salient mediator. An understanding of the mechanism that prompts US women's cancer screening practices provides practical implications for health campaign practitioners.

Aging-related changes in reward-based decision-making depend on punishment frequency: An fMRI study

Introduction

Aging is often accompanied by significant cognitive decline and altered decision making. Previous studies have found that older adults have difficulty in processing reward/risk information, leading to suboptimal decision strategy. However, it is still under investigated about the neural substrates of risky decision-making under ambiguity in aging.

Methods

Using the Iowa Gambling Task, the current study investigated inter-individual differences of risk-taking behaviors in healthy older adults with task-related functional magnetic resonance imaging.

Results

It was found that participants were able to improve their decisions in advantageous decks, but failed to avoid disadvantageous decks during task performance. The task-related activations within multiple brain regions were observed significantly different across the four decks, and showed negative correlations with age in disadvantageous decks but not in advantageous decks. Consistently, age-related whole brain analyses confirmed the negative age-effect on brain activations in disadvantageous decks, especially in high punishment frequency. In addition, the relationship between age and task performance in high punishment frequency was mediated by activation in the frontal subregions such as the middle frontal cortex and superior medial frontal cortex.

Discussion

Our findings shed light on the neural substrates of altered risk-taking behaviors in aging, suggesting a greater sensitivity to high punishment frequency in older adults.

Implicit Negativity Bias Leads to Greater Loss Aversion and Learning during Decision-Making

It is widely accepted there is the existence of negativity bias, a greater sensitivity to negative emotional stimuli compared with positive ones, but its effect on decision-making would depend on the context. In risky decisions, negativity bias could lead to non-rational choices by increasing loss aversion; yet in ambiguous decisions, it could favor reinforcement-learning and better decisions by increasing sensitivity to punishments. Nevertheless, these hypotheses have not been tested to date. Our aim was to fill this gap. Sixty-nine participants rated ambiguous emotional faces (from the NimStim set) as positive or negative to assess negativity bias. The implicit level of the bias was also obtained by tracking the mouse's trajectories when rating faces. Then, they performed both a risky and an ambiguous decision-making task. Participants displayed negativity bias, but only at the implicit level. In addition, this bias was associated with loss aversion in risky decisions, and with greater performance through the ambiguous decisional task. These results highlight the need to contextualize biases, rather than draw general conclusions about whether they are inherently good or bad.

The comparison of decision-making in ambiguous situations and galvanic skin responses as somatic markers in patients with posterior cortex epilepsy and mesial temporal lobe epilepsy with hippocampal sclerosis

INTRODUCTION

Decision-making behaviors of patients with mesial temporal lobe epilepsy (MTLE) is a subject that has been studied frequently. However, determining the neuropsychological profiles of patients with different types of epilepsy is also important. Our main purpose was to examine the decision-making behaviors of patients with posterior cortex epilepsy (PCE) through the assumptions of somatic marker hypothesis (SMH) and to compare their performances with those of a MTLE group and a control group.

METHOD

Participants comprised of 13 patients with PCE (mean age 30.92 ± 9.99 years); 14 patients with MTLE with hippocampal sclerosis (MTLE-HS) (mean age 25.53 ± 7.40 years) and 15 controls (mean age 24.60 ± 8.45 years). Decision-making performances were assessed with the Iowa gambling test (IGT) and anticipatory skin responses before each choice were recorded. A comprehensive neuropsychological test battery was also given to all participants in order to examine the relationship of decision-making with other cognitive functions.

RESULTS

Anticipatory responses before choosing from disadvantageous decks were significantly larger than choosing from advantageous decks in the PCE group (p = 0.00). No significant difference was found between the PCE and control group's total net scores. IGT total net scores was significantly correlated with Stroop test interference time (p = 0.03).

CONCLUSION

The study reveals that cognitive impairments of patients with PCE are not limited to brain's posterior areas' functions, and provides evidence for the current paradigm which understands epilepsy as a network disorder.

Exploring decision-making strategies in the Iowa gambling task and rat gambling task

Decision-making requires that individuals perceive the probabilities and risks associated with different options. Experimental human and animal laboratory testing provide complimentary insights on the psychobiological underpinnings of decision-making. The Iowa gambling task (IGT) is a widely used instrument that assesses decision-making under uncertainty and risk. In the task participants are faced with a choice conflict between cards with varying monetary reinforcer/loss contingencies. The rat gambling task (rGT) is a pre-clinical version using palatable reinforcers as wins and timeouts mimicking losses. However, interspecies studies elaborating on human and rat behavior in these tasks are lacking. This study explores decision-making strategies among young adults (N = 270) performing a computerized version of the IGT, and adult outbred male Lister Hooded rats (N = 72) performing the rGT. Both group and individual data were explored by normative scoring approaches and subgroup formations based on individual choices were investigated. Overall results showed that most humans and rats learned to favor the advantageous choices, but to a widely different extent. Human performance was characterized by both exploration and learning as the task progressed, while rats showed relatively consistent pronounced preferences for the advantageous choices throughout the task. Nevertheless, humans and rats showed similar variability in individual choice preferences during end performance. Procedural differences impacting on the performance in both tasks and their potential to study different aspects of decision-making are discussed. This is a first attempt to increase the understanding of similarities and differences regarding decision-making processes in the IGT and rGT from an explorative perspective.

Interoception in Old Age

Emotion regulation in old age was found to be more efficient; seniors seem to focus less on the negative aspects of experiences. Here, we ask, do older individuals regulate their emotions more efficiently or are they numb to the physiological changes that modulate these emotions? Interoception, the perception of physical feelings, influences a person’s mood, emotions, and sense of well-being, and was hardly tested among older adults. We examined the awareness of physiological changes (physiological arousal—blood pressure and heart rate) of 47 older adults, compared to 18 young adults, and their subjective reports of emotional experiences while viewing emotional stimuli. Interoception was decreased in old age. Blood pressure medications had a partial role in this reduction. Moreover, interoception mediated emotional experience, such that low interoception led to lower experiences of changes in physiological arousal. These findings may account for the emotional changes in old age, suggesting a decline in sensitivity with age, which leads to a positive interpretation of information.

Heterogeneity of decision-making strategies for preschoolers on a variant of the IGT

Adaptive decision-making strategies are critical for dealing with the complexity of the social world. The present study investigated the use of decision-making strategies in preschoolers and their association to prosocial behavior and peer problems. Eighty-six preschoolers aged 3- and 4-years completed the preschool decision-making task (PGT), a child variant of the Iowa Gambling task . Win-stay/lose-shift responses along with exploration (consecutive choices from the advantageous deck) and exploitation (shifting between options) were examined. Preschoolers showed a range of strategies, with 4-year-olds adapting their approach as the game progressed and making better use of feedback in comparison to 3-year-olds. Children who differed in terms of choices from the advantageous deck were distinguished by different combinations of exploration and exploitation. Furthermore, unique combinations of decision-making strategies also distinguished children who were rated as high versus low in prosocial behavior as well as children rated as having a high versus low level of peer problems. The findings suggest that consideration of strategies used in decision-making tasks could provide useful insight in a clinical setting, particularly for populations with social difficulties.

Use of the QuickSort with older adults whose lifestyle decision-making capacity is being questioned

OBJECTIVES

Cognitive impairment affects older adults' capacity to live independently and make lifestyle decisions (lifestyle decision-making capacity; LS-DMC). Cognitive screens and clinical interviews are often used to assess people's need for living-supports prior to conducting comprehensive LS-DMC assessments in busy clinical settings. This study investigated whether the QuickSort - a brief new cognitive screen - provides efficient and accurate information regarding patients' LS-DMC when initially interviewed.

METHODS

This is an observational and diagnostic accuracy study of older inpatients (≥60 years) consecutively referred for neuropsychological assessment of LS-DMC (n = 124). The resources required by inpatients with questionable LS-DMC were quantified (length of hospital stay, living-supports). QuickSort scores, patient background information, and two common cognitive screens were used to differentiate between older inpatients (n = 124) who lacked (64%)/did not-lack (36%) LS-DMC.

RESULTS

Hospitalizations averaged 49 days, with 62% of inpatients being readmitted within one year. The QuickSort differentiated between those lacking/not-lacking LS-DMC better than two common cognitive screens and patient information. The likelihood that inpatients lacked LS-DMC increased by a factor of 65.26 for QuickSort scores <2 and reduced by a factor of 0.32 for scores ≥13. Modeling revealed that the post-test likelihood of lacking LS-DMC increased to 99% (scores <2) and reduced to 30% (scores ≥ 13) in settings where many inpatients lack LS-DMC.

CONCLUSIONS

Older adult inpatients with questionable LS-DMC have a high risk of extended hospitalization and readmission. The QuickSort provides time-efficient and sensitive information regarding patients' LS-DMC, making it a viable alternative to longer cognitive screens that are used at the initial interview stage.

Decision-making and risk-taking in forensic and non-forensic patients with schizophrenia spectrum disorders: A multicenter European study

Studies of patients with schizophrenia and offenders with severe mental disorders decision-making performance have produced mixed findings. In addition, most earlier studies have assessed decision-making skills in offenders or people with mental disorders, separately, thus neglecting the possible additional contribution of a mental disorder on choice patterns in people who offend.

This study aimed to fill this gap by comparing risk-taking in patients with schizophrenia spectrum disorders (SSD), with and without a history of serious violent offending assessing whether, and to what extent, risk-taking represents a significant predictor of group membership, controlling for their executive skills, as well as for socio-demographic and clinical characteristics.

Overall, 115 patients with a primary diagnosis of SSD were recruited: 74 were forensic patients with a lifetime history of severe interpersonal violence and 41 were patients with SSD without such a history. No significant group differences were observed on psychopathological symptoms severity. Forensic generally displayed lower scores than non-forensic patients in all cognitive subtests of the Brief Assessment of Cognition in Schizophrenia (except for the “token motor” and the “digit sequencing” tasks) and on all the six dimensions of the Cambridge Gambling Task, except for “Deliberation time”, in which forensic scored higher than non-forensic patients. “Deliberation time” was also positively, although weakly correlated with “poor impulse control”.

Identifying those facets of impaired decision-making mostly predicting offenders' behaviour among individuals with mental disorder might inform risk assessment and be targeted in treatment and rehabilitation protocols.

Capturing daily-life executive impairments in adults: Does the choice of neuropsychological tests matter?

OBJECTIVE

Standardized executive functioning (EF) measures do not reliably capture EF-related difficulties reported in daily life. We aim to determine if an ecologically relevant neuropsychological battery is more strongly associated with self-reported everyday EF impairments than classically used tests.

METHOD

Fifty-nine adults aged 18-49 self-rated their EF abilities using the Barkley Deficits in EF Scale (BDEFS) and were randomly assigned to complete either a test battery composed of EF measures with hypothesized ecological relevance (Six Elements, Zoo Map, Hayling Sentence Completion, Iowa Gambling, and Auditory Startle Tasks) or one composed of traditional EF tasks (Card Sorting, Trail Making, Color-Word Interference, and Verbal Fluency). Associations were examined using linear regression.

RESULTS

There were no strong associations between BDEFS subscales and performance on either test battery. Only the regression model predicting Emotional Regulation from ecological tasks was significant. Iowa Gambling Task performance and corrugator muscle contraction in the Auditory Startle Task individually contributed significantly to the model, with small and moderate effect sizes respectively.

CONCLUSION

Results align with evidence that self-reported EF difficulties are not adequately captured by formal neuropsychological measures, even for performance-based measures which directly tap everyday constructs. Findings are interpreted cautiously in the context of a small, high-functioning sample.

Brain Neural Underpinnings of Interoception and Decision-Making in Alzheimer's Disease: A Narrative Review

This study reviews recent literature on interoception directing decision-making in Alzheimer's disease (AD). According to the somatic marker hypothesis, signals from the internal body direct decision-making and involve the ventromedial prefrontal cortex (vmPFC). After reviewing relevant studies, we summarize the brain areas related to interoception and decision-making (e.g., vmPFC, hippocampus, amygdala, hypothalamus, anterior cingulate cortex, and insular cortex) and their roles in and relationships with AD pathology. Moreover, we outline the relationship among interoception, the autonomic nervous system, endocrine system, and AD pathology. We discuss that impaired interoception leads to decreased decision-making ability in people with AD from the perspective of brain neural underpinning. Additionally, we emphasize that anosognosia or reduced self-awareness and metacognition in AD are remarkably congruent with the malfunction of the autonomic nervous system regulating the interoceptive network. Furthermore, we propose that impaired interoception may contribute to a loss in the decision-making ability of patients with AD. However, there still exist empirical challenges in confirming this proposal. First, there has been no standardization for measuring or improving interoception to enhance decision-making ability in patients with AD. Future studies are required to better understand how AD pathology induces impairments in interoception and decision-making.

Tasks activating the default mode network map multiple functional systems

Recent developments in network neuroscience suggest reconsidering what we thought we knew about the default mode network (DMN). Although this network has always been seen as unitary and associated with the resting state, a new deconstructive line of research is pointing out that the DMN could be divided into multiple subsystems supporting different functions. By now, it is well known that the DMN is not only deactivated by tasks, but also involved in affective, mnestic, and social paradigms, among others. Nonetheless, it is starting to become clear that the array of activities in which it is involved, might also be extended to more extrinsic functions. The present meta-analytic study is meant to push this boundary a bit further. The BrainMap database was searched for all experimental paradigms activating the DMN, and their activation likelihood estimation maps were then computed. An additional map of task-induced deactivations was also created. A multidimensional scaling indicated that such maps could be arranged along an anatomo-psychological gradient, which goes from midline core activations, associated with the most internal functions, to that of lateral cortices, involved in more external tasks. Further multivariate investigations suggested that such extrinsic mode is especially related to reward, semantic, and emotional functions. However, an important finding was that the various activation maps were often different from the canonical representation of the resting-state DMN, sometimes overlapping with it only in some peripheral nodes, and including external regions such as the insula. Altogether, our findings suggest that the intrinsic-extrinsic opposition may be better understood in the form of a continuous scale, rather than a dichotomy.

Decision-making in uncertain contexts: The role of autonomic markers in resolving indecision

Although impulsivity is associated with an increased willingness to make risky decisions, uncertainty intolerance may also contribute to maladaptive decision-making behavior, where individuals neglect to pursue potential rewards even when probabilities for success are in their favor. Several theories have sought to explain the neural systems that guide decision-making in this context, with evidence supporting a role for increased sympathetic activation. However, it remains unclear whether the sympathetic system is associated with greater apprehension in response to uncertain outcomes, or whether it serves to guide behavioral decisions in the context of this uncertainty. Furthermore, although postulated as a within-person process, most research has examined the association between decision behavior and sympathetic activation at the between-person level. We hypothesize that in the context of uncertainty between-person differences in skin conductance will be associated with longer deliberation times; whereas within-person trial-level increases in skin conductance will be associated with a tendency to reject uncertain options. Data were collected from n = 56 children aged 7-11 years, using a computerized card game in which children chose to accept or reject cards of varying point value at varying levels of probability. Skin conductance level (SCL) was recorded throughout the task. No significant between-person associations emerged. However, within-person analyses indicated that momentary deliberation time moderated the association between momentary skin-conductance and decision outcome. This moderation was such that for trials during which the individual deliberated longer (i.e., was more indecisive), a concurrent increase in skin conductance was associated with a significantly higher likelihood of rejecting the card. The within-person nature of these results suggests that skin conductance may help in resolving indecision in the context of uncertainty.

Reanalyzing the Maia and McClelland (2004) Empirical Data: How Do Participants Really Behave in the Iowa Gambling Task?

Background

Since 2007, the Iowa Gambling Task (IGT) has been a standardized clinical assessment tool for assessing decision behavior in 13 psychiatric/neurological conditions. After the publication of Maia and McClelland's (1) article, there were two responses in 2005 from Bechara et al. and Maia and McClelland, respectively, discussing whether implicit emotion or explicit knowledge influences the development of foresighted decision strategies under uncertain circumstances (e.g., as simulated in the IGT).

Methods and Results

We reanalyze and verify the data obtained by Maia and McClelland (1) in their study "What participants really know in the Iowa Gambling Task" and find that decision-makers were lured into shortsighted decisions by the prospect of immediate gains and losses.

Conclusion

Although the findings of this reanalysis cannot support any arguments concerning the effect of either implicit emotion or explicit knowledge, we find evidence that, based on the gain-loss frequency in the IGT, participants behave myopically. This is consistent with most IGT-related articles (58 out of 86) in Lee et al.'s (2) cross-cultural review. Alternatively, under uncertain circumstances, there is probably no such thing as foresighted decision strategy irrespective of the proposed mechanisms of implicit emotion or explicit knowledge.

Affect and Cognition in Managerial Decision Making: A Systematic Literature Review of Neuroscience Evidence

How do affect and cognition interact in managerial decision making? Over the last decades, scholars have investigated how managers make decisions. However, what remains largely unknown is the interplay of affective states and cognition during the decision-making process. We offer a systematization of the contributions produced on the role of affect and cognition in managerial decision making by considering the recent cross-fertilization of management studies with the neuroscience domain. We implement a Systematic Literature Review of 23 selected contributions dealing with the role of affect and cognition in managerial decisions that adopted neuroscience techniques/points of view. Collected papers have been analyzed by considering the so-called reflexive (X-) and reflective (C-) systems in social cognitive neuroscience and the type of decisions investigated in the literature. Results obtained help to support an emerging "unified" mind processing theory for which the two systems of our mind are not in conflict and for which affective states have a driving role toward cognition. A research agenda for future studies is provided to scholars who are interested in advancing the investigation of affect and cognition in managerial decision making, also through neuroscience techniques - with the consideration that these works should be at the service of the behavioral strategy field.

Random Network and Non-rich-club Organization Tendency in Children With Non-syndromic Cleft Lip and Palate After Articulation Rehabilitation: A Diffusion Study

Objective

The neuroimaging pattern in brain networks after articulation rehabilitation can be detected using graph theory and multivariate pattern analysis (MVPA). In this study, we hypothesized that the characteristics of the topology pattern of brain structural network in articulation-rehabilitated children with non-syndromic cleft lip and palate (NSCLP) were similar to that in healthy comparisons.

Methods

A total of 28 children with NSCLP and 28 controls with typical development were scanned for diffusion tensor imaging on a 3T MRI scanner. Structural networks were constructed, and their topological properties were obtained. Besides, the Chinese language clear degree scale (CLCDS) scores were used for correlation analysis with topological features in patients with NSCLP.

Results

The NSCLP group showed a similar rich-club connection pattern, but decreased small-world index, normalized rich-club coefficient, and increased connectivity strength of connections compared to controls. The univariate and multivariate patterns of the structural network in articulation-rehabilitated children were primarily in the feeder and local connections, covering sensorimotor, visual, frontoparietal, default mode, salience, and language networks, and orbitofrontal cortex. In addition, the connections that were significantly correlated with the CLCDS scores, as well as the weighted regions for classification, were chiefly distributed in the dorsal and ventral stream associated with the language networks of the non-dominant hemisphere.

Conclusion

The average level rich-club connection pattern and the compensatory of the feeder and local connections mainly covering language networks may be related to the CLCDS in articulation-rehabilitated children with NSCLP. However, the patterns of small-world and rich-club structural organization in the articulation-rehabilitated children exhibited a random network and non-rich-club organization tendency. These findings enhanced the understanding of neuroimaging patterns in children with NSCLP after articulation rehabilitation.

Do Emotions Benefit Investment Decisions? Anticipatory Emotion and Investment Decisions in Non-professional Investors

Increasing financial trading performance is big business. A lingering question within academia and industry concerns whether emotions improve or degrade trading performance. In this study, 30 participants distributed hypothetical wealth between a share (a risk) and the bank (paying a small, sure, gain) within four trading games. Skin Conductance Response was measured while playing the games to measure anticipatory emotion, a covert emotion signal that impacts decision-making. Anticipatory emotion was significantly associated with trading performance but the direction of the correlation was dependent upon the share’s movement. Thus, anticipatory emotion is neither wholly “good” nor “bad” for trading; instead, the relationship is context-dependent. This is one of the first studies exploring the association between anticipatory emotion and trading behaviour using trading games within an experimentally rigorous environment. Our findings elucidate the relationship between anticipatory emotion and financial decision-making and have applications for improving trading performance in novice and expert traders.

Hypersensitivity to negative feedback during dynamic risky-decision making in major depressive disorder: An event-related potential study

BACKGROUND

Patients with major depressive disorder (MDD) exhibit a diminished ability to think or concentrate, indecisiveness, and altered sensitivity to reward and punishment. These impairments can influence complex risk-related decision-making in dynamic environments. The neurophysiological mechanisms mediating MDD effects on decision-making behavior are not well understood.

METHODS

Patients with MDD (N=50) and healthy controls (HC, N=40) were enrolled. They completed a series of psychometric tests. Event-related potentials (ERPs) were recorded during the performance of a well-validated modified version of Balloon Analogue Risk Task (BART).

RESULTS

BART behavior data were similar across the two groups except the MDD patients showed more stability of risk aversion. Neurophysiologically, BART losses generated larger P3 amplitudes than wins, and MDD patients had larger feedback-related negativity (FRN) components than HCs in response to negative feedback (losses). Greater FRN amplitudes in response to losses correlated with higher levels of depressiveness, psychological pain, and anhedonia. A longer FRN latency in MDD patients was associated with more severe suicidal ideation.

LIMITATIONS

The findings are based on cross-sectional data, which are not powerful enough to make causal inferences.

CONCLUSION

MDD patients exhibit enhanced FRNs in the frontocentral region after receiving negative feedback in a risky decision-making task. FRN magnitude is associated with depressive symptom severity. Punishment hypersensitivity may contribute to the maintenance of depressive symptoms in MDD patients, and FRN may be a useful index of such hypersensitivity.

Reduced sensitivity to delayed time and delayed reward of the post-operative insular glioma patients in delay discounting

Previous studies have shown that the insula is closely related to addiction, and the structure's role in delay discounting can be measured by a specific task, but the specific role of the insula has been less studied. In this study, we first conducted a lesion study in which we recruited healthy controls (n = 30) and patients with unilateral insula injury (n = 16) to complete a behavioral delay discounting task. Then we conducted a functional magnetic resonance imaging (fMRI) study, and a separate group healthy volunteers (n = 51) completed a delay discounting task during the fMRI scan. The lesion study showed a significant difference between the two groups in the delay discounting task, which revealed that insula injury was associated with impaired decision making. The fMRI study revealed choice-sensitive insula activation that was modulated by delayed time and delayed reward, indicating an important role of the insula in delay discounting. Overall, our results provide evidence for a role of the insular lobe in delay discounting and suggests that this structure may be considered an important factor in the future treatment and diagnosis of addiction disorders.

Decision Making: a Theoretical Review

Decision-making is a crucial skill that has a central role in everyday life and is necessary for adaptation to the environment and autonomy. It is the ability to choose between two or more options, and it has been studied through several theoretical approaches and by different disciplines. In this overview article, we contend a theoretical review regarding most theorizing and research on decision-making. Specifically, we focused on different levels of analyses, including different theoretical approaches and neuropsychological aspects. Moreover, common methodological measures adopted to study decision-making were reported. This theoretical review emphasizes multiple levels of analysis and aims to summarize evidence regarding this fundamental human process. Although several aspects of the field are reported, more features of decision-making process remain uncertain and need to be clarified. Further experimental studies are necessary for understanding this process better and for integrating and refining the existing theories.

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.

The Prominent Deck B Phenomenon in Schizophrenia: An Empirical Study on Iowa Gambling Task

Background: The Iowa Gambling Task (IGT) was established to evaluate emotion-based decision-making ability under uncertain circumstances in clinical populations, including schizophrenia (Sz). However, there remains a lack of stable behavioral measures regarding discrimination for decision-making performance in IGT between schizophrenic cases and healthy participants. None of the Sz-IGT studies has specifically verified the prominent deck B (PDB) phenomenon gradually revealed in other populations. Here, we provided a global review and empirical study to verify these Sz-IGT issues. Methods: Seeking reliable and valid behavioral measures, we reviewed 38 studies using IGT to investigate decision-making behavior in Sz groups. The IGT, the Wisconsin Card Sorting Test (WCST), and clinical symptoms evaluations were administered to 61 schizophrenia or schizoaffective cases diagnosed by psychiatrists and 62 demographically matched healthy participants. Results: There were no valid behavioral measures in IGT that could significantly identify the decision-making dysfunction of Sz. However, Sz cases, on average, made more choices from disadvantageous deck B relative to other decks, particularly in the later learning process (block 3-5). Compared to the control group, the Sz group was more impaired on the WCST. The high-gain frequency decks B and D showed significant correlations with WCST but no correlation between clinical symptoms and IGT/WCST. Conclusions: Gain-loss frequency (GLF) has a dominant and stable impact on the decision-making process in both Sz and control groups. PDB phenomenon is essentially challenging to be observed on the ground of the expected value (EV) viewpoint approach on the IGT in both populations. Consequently, caution should be exercised when launching the IGT to assess the decision-making ability of Sz under a clinical scenario.

Neural Representation of Costs and Rewards in Decision Making

Decision making is crucial for animal survival because the choices they make based on their current situation could influence their future rewards and could have potential costs. This review summarises recent developments in decision making, discusses how rewards and costs could be encoded in the brain, and how different options are compared such that the most optimal one is chosen. The reward and cost are mainly encoded by the forebrain structures (e.g., anterior cingulate cortex, orbitofrontal cortex), and their value is updated through learning. The recent development on dopamine and the lateral habenula's role in reporting prediction errors and instructing learning will be emphasised. The importance of dopamine in powering the choice and accounting for the internal state will also be discussed. While the orbitofrontal cortex is the place where the state values are stored, the anterior cingulate cortex is more important when the environment is volatile. All of these structures compare different attributes of the task simultaneously, and the local competition of different neuronal networks allows for the selection of the most appropriate one. Therefore, the total value of the task is not encoded as a scalar quantity in the brain but, instead, as an emergent phenomenon, arising from the computation at different brain regions.

Component Processes of Decision Making in a Community Sample of Precariously Housed Persons: Associations With Learning and Memory, and Health-Risk Behaviors

The Iowa Gambling Task (IGT) is a widely used measure of decision making, but its value in signifying behaviors associated with adverse, "real-world" consequences has not been consistently demonstrated in persons who are precariously housed or homeless. Studies evaluating the ecological validity of the IGT have primarily relied on traditional IGT scores. However, computational modeling derives underlying component processes of the IGT, which capture specific facets of decision making that may be more closely related to engagement in behaviors associated with negative consequences. This study employed the Prospect Valence Learning (PVL) model to decompose IGT performance into component processes in 294 precariously housed community residents with substance use disorders. Results revealed a predominant focus on gains and a lack of sensitivity to losses in these vulnerable community residents. Hypothesized associations were not detected between component processes and self-reported health-risk behaviors. These findings provide insight into the processes underlying decision making in a vulnerable substance-using population and highlight the challenge of linking specific decision making processes to "real-world" behaviors.