Neural loss aversion differences between depression patients and healthy individuals: A functional MRI investigation

Decomposing loss aversion from a single neural signal

People often display stronger aversion to losses than appetite for equivalent gains, a widespread phenomenon known as loss aversion. The prevailing theory attributes loss aversion to a valuation bias that amplifies losses relative to gains. An alternative account attributes loss aversion to a response bias that avoids choices that might result in loss. By modeling the temporal dynamics of scalp electrical activity during decisions to accept or reject gambles within a sequential sampling framework, we decomposed valuation bias and response bias from a single event-related neural signal, the P3. Specifically, we found valuation bias manifested as larger sensitivity of P3 to losses than gains, which was localizable to reward-related brain regions. By contrast, response bias manifested as larger P3 preceding gamble acceptance than rejection and was localizable to motor cortex. Our study reveals the dissociable neural biomarkers of response bias and valuation bias underpinning loss-averse decisions.

Amplification of positivity for depression and anxiety: Neural prediction of treatment response

Psychosocial treatments targeting the positive valence system (PVS) in depression and anxiety demonstrate efficacy in enhancing positive affect (PA), but response to treatment varies. We examined whether individual differences in neural activation to positive and negative valence incentive cues underlies differences in benefitting from a PVS-targeted treatment. Individuals with clinically elevated depression and/or anxiety (N = 88, ages 18 to 55) participated in one of two randomized, waitlist-controlled trials of Amplification of Positivity (AMP; NCT02330627, NCT03196544), a cognitive and behavioral intervention targeting the PVS. Participants completed a monetary incentive delay (MID) task during fMRI acquisition at baseline measuring neural activation to the possibility of gaining or losing money. Change in PA from before to after treatment was assessed using the Positive and Negative Affect Schedule. No significant associations were observed between baseline neural activation during gain anticipation and AMP-related changes in PA in regions of interest (striatum and insula) or whole-brain analyses. However, higher baseline striatal and insula activation during loss anticipation was associated with greater increases in PA post-AMP. This study provides preliminary evidence suggesting neural reactivity to negative valence cues may inform who stands to benefit most from treatments targeting the PVS.

An ecological assessment of decision-making under risk and ambiguity through the virtual serious game Kalliste Decision Task

Traditional methods for evaluating decision-making provide valuable insights yet may fall short in capturing the complexity of this cognitive capacity, often providing insufficient for the multifaceted nature of decisions. The Kalliste Decision Task (KDT) is introduced as a comprehensive, ecologically valid tool aimed at bridging this gap, offering a holistic perspective on decision-making. In our study, 81 participants completed KDT alongside established tasks and questionnaires, including the Mixed Gamble Task (MGT), Iowa Gambling Task (IGT), and Stimulating & Instrumental Risk Questionnaire (S&IRQ). They also completed the User Satisfaction Evaluation Questionnaire (USEQ). The results showed excellent usability, with high USEQ scores, highlighting the user-friendliness of KDT. Importantly, KDT outcomes showed significant correlations with classical decision-making variables, shedding light on participants' risk attitudes (S&IRQ), rule-based decision-making (MGT), and performance in ambiguous contexts (IGT). Moreover, hierarchical clustering analysis of KDT scores categorized participants into three distinct profiles, revealing significant differences between them on classical measures. The findings highlight KDT as a valuable tool for assessing decision-making, addressing limitations of traditional methods, and offering a comprehensive, ecologically valid approach that aligns with the complexity and heterogeneity of real-world decision-making, advancing research and providing insights for understanding and assessing decision-making across multiple domains.

Aberrant reward learning, but not negative reinforcement learning, is related to depressive symptoms: an attentional perspective

BACKGROUND

Aberrant reward functioning is implicated in depression. While attention precedes behavior and guides higher-order cognitive processes, reward learning from an attentional perspective - the effects of prior reward-learning on subsequent attention allocation - has been mainly overlooked.

METHODS

The present study explored the effects of reward-based attentional learning in depression using two separate, yet complimentary, studies. In study 1, participants with high (HD) and low (LD) levels of depression symptoms were trained to divert their gaze toward one type of stimuli over another using a novel gaze-contingent music reward paradigm - music played when fixating the desired stimulus type and stopped when gazing the alternate one. Attention allocation was assessed before, during, and following training. In study 2, using negative reinforcement, the same attention allocation pattern was trained while substituting the appetitive music reward for gazing the desired stimulus type with the removal of an aversive sound (i.e. white noise).

RESULTS

In study 1 both groups showed the intended shift in attention allocation during training (online reward learning), while generalization of learning at post-training was only evident among LD participants. Conversely, in study 2 both groups showed post-training generalization. Results were maintained when introducing anxiety as a covariate, and when using a more powerful sensitivity analysis. Finally, HD participants showed higher learning speed than LD participants during initial online learning, but only when using negative, not positive, reinforcement.

CONCLUSIONS

Deficient generalization of learning characterizes the attentional system of HD individuals, but only when using reward-based positive reinforcement, not negative reinforcement.

Material Hardship Predicts Response Bias in Loss-Averse Decisions: The Roles of Anxiety and Cognitive Control

Income poverty is associated with an enhanced tendency to avoid losses in economic decisions, which can be driven by a response bias (risk avoidance) and a valuation bias (loss aversion). However, the impact of non-income dimensions of poverty on these biases remains unclear. The current study tested the impact of material hardship on these biases, and the mediating effects of anxiety, depression, and cognitive control in these associations. Healthy adults (N = 188) completed questionnaire and behavioral measures of the variables. Results of regression-based analyses showed that participants who reported higher material hardship exhibited greater response bias, but not valuation bias. This effect was mediated by anxiety. Although material hardship predicted lower cognitive control, cognitive control did not mediate the association between material hardship and either type of bias. These findings suggest that material hardship may lead to economic decision-making biases because it impacts emotional states rather than cognitive control.

Uncovering the Neural Correlates of Anhedonia Subtypes in Major Depressive Disorder: Implications for Intervention Strategies

Major depressive disorder (MDD) represents a serious public health concern, negatively affecting individuals' quality of life and making a substantial contribution to the global burden of disease. Anhedonia is a core symptom of MDD and is associated with poor treatment outcomes. Variability in anhedonia components within MDD has been observed, suggesting heterogeneity in psychopathology across subgroups. However, little is known about anhedonia subgroups in MDD and their underlying neural correlates across subgroups. To address this question, we employed a hierarchical cluster analysis based on Temporal Experience of Pleasure Scale subscales in 60 first-episode, drug-naive MDD patients and 32 healthy controls. Then we conducted a connectome-wide association study and whole-brain voxel-wise functional analyses for identified subgroups. There were three main findings: (1) three subgroups with different anhedonia profiles were identified using a data mining approach; (2) several parts of the reward network (especially pallidum and dorsal striatum) were associated with anticipatory and consummatory pleasure; (3) different patterns of within- and between-network connectivity contributed to the disparities of anhedonia profiles across three MDD subgroups. Here, we show that anhedonia in MDD is not uniform and can be categorized into distinct subgroups, and our research contributes to the understanding of neural underpinnings, offering potential treatment directions. This work emphasizes the need for tailored approaches in the complex landscape of MDD. The identification of homogeneous, stable, and neurobiologically valid MDD subtypes could significantly enhance our comprehension and management of this multifaceted condition.

Logical decisions after a psychosocial stressor: The late phase of acute stress reduces loss aversion

Loss aversion, the principle that losses have a greater impact on decision-making than gains, can be modulated by stress. Most findings reported that stress reduces loss aversion, in line with the alignment hypothesis. Yet, decision-making was always assessed at the early stages of the stress response. Instead, the latter phase of the stress response enhances the salience-network and then, it could amplify the salience of losses, thereby increasing loss aversion. To our knowledge, it has never been studied how the latter stress response influences loss aversion and our aim is to fill this gap. 92 participants were divided into experimental and control group. The first one was exposed to the Trier Social Stress Test, and controls viewed a match-length distractor video. Both groups performed a mixed gamble task to measure loss aversion through a Bayesian-computational model. During and after the stressor, experimental group exhibited signs of both physiological and psychological stress which indicated that stress induction was effective. However, rather than increasing, loss aversion of stressed participants was lower. These results constitute a new evidence of stress influencing loss aversion and are discussed within the alignment hypothesis, according to which stress aligns sensitivity to gains and losses.

The modulation of attentional deployment on emotional sensitivity to missed opportunity in depressive individuals: An event-related potential study

BACKGROUND

Depression affects individuals' physical and mental health seriously. It's important to explore the pathological mechanisms underlying depression. However, the emotional sensitivity to missed opportunity in depressive individuals and whether attentional deployment influences it remain unclear. The exploration of these questions could help to find novel approaches for the treatment of depression.

METHODS

Experiment 1 investigated the emotional sensitivity to missed opportunity in depressive participants during a sequential risk-taking task relative to healthy participants. Experiment 2 added attentional deployment manipulation to the task, i.e., inducing participants to focus on the positive or negative part of decision outcome, and investigated the modulation of attentional deployment on depressive participants' emotional sensitivity to missed opportunity and the neural mechanisms underlying this process by using EEG.

RESULTS

Depressive participants showed stronger emotional sensitivity to missed opportunity and LPP was a biomarker of this sensitivity. Moreover, focusing on the positive part of outcome reduced depressive participants' emotional sensitivity to missed opportunity effectively, and alpha power in the parietal area played a key role in this process.

CONCLUSIONS

The current study primarily revealed that depressive individuals were more sensitive to missed opportunity and attentional deployment was an effective way to modulate this sensitivity.

The Effects of Citalopram and Thalamic Dopamine D2/3 Receptor Availability on Decision-Making and Loss Aversion in Alcohol Dependence

Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for patients who misuse alcohol, especially in the context of comorbid depressive symptoms. Deficits in impulse control and decision-making are linked to routine alcohol consumption and alcohol dependence. The goal of this study was to determine the effects of a single dose of citalopram on measures of impulsivity, decision-making, and/or brain dopamine receptor availability in alcohol-dependent individuals. A double-blind, placebo-controlled, within-subject, outpatient study was conducted with active alcohol-dependent (DSM-IV-TR criteria) participants (n = 12) and matched healthy controls (n = 13). Serial doses of both citalopram (40 mg) and saline were administered intravenously before laboratory tests of decision-making (Balloon Analogue Risk Task, delay discounting task, and Loss Aversion Gambling Task) and positron emission tomography with [¹⁸F]-fallypride to measure dopamine D_2/3 receptor availability, separated by at least one week. Alcohol-dependent participants demonstrated greater loss aversion than healthy controls, but there were no group differences in risk taking on the Balloon Analogue Risk Task. Citalopram increased delay discounting across groups, with no group difference in the effect. There were no effects of citalopram on risk taking on the Balloon Analogue Risk Task. PET showed a negative correlation between thalamic dopamine D_2/3 receptor availability and loss aversion across groups. The effect of citalopram to decrease the valuation of monetary reward as a function of delay raises the possibility that SSRIs can influence risky decision-making in clinical populations. In addition, these results suggest that altered thalamic dopamine signaling may play an important role in disproportionately valuing losses in patients with Alcohol Use Disorder. This trial is registered under ClinicalTrials.gov registration NCT01657760.

Emotional stress & decision-making: an emotional stressor significantly reduces loss aversion

Stress influences loss aversion, the principle that losses loom larger than gains, although the nature of this relationship is unclear. Studies show that stress reduces loss aversion; however, stress response has been only studied by means of physiological measures, but the stressor emotional impact remained unclear. Since emotions can modify stress response and increase the activity of the loss aversion neural substrates, it could be expected that an emotional stressor may produce the opposite effect, i.e. loss aversion increase. 69 participants were divided into experimental and control group. The first one was exposed to emotional stress through a 5-minutes video, and control group viewed a match-length distractor video. Physiological stress response was assessed by means of electrodermal activity (EDA), and both perceived stress, and negative affect (i.e. psychological stress response) were registered through questionnaires. Both groups performed a mixed gamble task, which allowed the extraction of loss aversion through a Bayesian-computational model. During and after video, experimental group had higher electrodermal activity, perceived stress, and negative affect than controls, suggesting that emotional stress induction was effective. However, rather than increasing, loss aversion of stressed participants was lower. These results constitute a new evidence of emotional stress influencing loss aversion and highlight that stress, regardless of its emotional impact, can reduce this phenomenon. These results should be considered when predicting risky decisions.

Economic Decisions with Ambiguous Outcome Magnitudes Vary with Low and High Stakes but Not Trait Anxiety or Depression

Most of life's decisions involve risk and uncertainty regarding whether reward or loss will follow. Decision makers often face uncertainty not only about the likelihood of outcomes (what are the chances that I will get a raise if I ask my supervisor? What are the chances that my supervisor will be upset with me for asking?) but also the magnitude of outcomes (if I do get a raise, how large will it be? If my supervisor gets upset, how bad will the consequences be for me?). Only a few studies have investigated economic decision making with ambiguous likelihoods, and even fewer have investigated ambiguous outcome magnitudes. In the present report, we investigated the effects of ambiguous outcome magnitude, risk, and gains/losses in an economic decision-making task with low stakes (Study 1; $3.60-$5.70; N = 367) and high stakes (Study 2; $6-$48; N = 210) using a within-subjects design. We conducted computational modeling to determine individuals' preferences/aversions for ambiguous outcome magnitudes, risk, and gains/losses. We additionally investigated the association between trait anxiety and trait depression and decision-making parameters. Our results show that increasing stakes increased ambiguous gain aversion and unambiguous risk aversion but increased ambiguous sure loss preference; participants also became more averse to ambiguous sure gains relative to unambiguous risky gains. There were no significant effects of trait anxiety or trait depression on economic decision making. Our results suggest that as stakes increase, people tend to avoid uncertainty in the gain domain (especially ambiguous gains) but prefer ambiguous vs unambiguous sure losses.

The effects of minocycline in improving of methamphetamine withdrawal syndrome in male mice

Methamphetamine (METH) is a potent psychostimulant drug with an increasing rate of abuse over recent years. Depressive-like behaviors are one of the major symptoms patients in the METH withdrawal period experience. There is limited evidence regarding the METH withdrawal treatment, and conventional managements are not completely effective. Furthermore, extensive promising literature supports minocycline, a well-known antibiotic with anti-oxidant, anti-inflammatory properties, to treat depressive-like behaviors. Therefore, we hypothesized that administration of minocycline might mitigate the methamphetamine (METH) induced depression in male mice. Administration of METH (2 mg/kg) to mice two times a day for 14 constitutive days was done to induce the METH-induced withdrawal syndrome model. Animals were divided into 10 groups (n = 10 in each group), and three doses of minocycline (2.5, 5 and 10 mg/kg) were daily administered to male albino mice for 10 days. Following the behavioral test, the animals were scarified, their hippocampus were dissected to measure oxidative stress parameters. Our data revealed that chronic administration of minocycline provoked antidepressant effects in behavioral tests, such as forced swim test (FST), tail suspension test (TST) and splash test. Additionally, minocycline was able to improve oxidative stresses and neuronal damage in the hippocampus and restore the body's antioxidant system by increasing glutathione (GSH) and the cellular energy (ATP) and reducing the malondialdehyde (MDA) level. According to our promising results of minocycline on targeting mitochondria and its performance, we suggest minocycline as a new therapeutic option in clinical trials of depression treatment.

The Negative Association Between Positive Psychological Wellbeing and Loss Aversion

When making decisions, people tend to overweigh the impact of losses compared to gains, a phenomenon known as loss aversion (LA). A moderate amount of LA may be adaptive as it is necessary for protecting oneself from danger. However, excessive LA may leave people few opportunities and ultimately lead to suboptimal outcomes. Despite frequent reports of elevated LA in specific populations such as patients with depression, little is known about what psychological characteristics are associated with the tendency of LA. Based on the neurobiological studies of LA, we hypothesized that positive psychological wellbeing may be negatively associated with people's tendency of LA. In the present study, we set out to test this hypothesis in a sample of young adults. We evaluated LA using a decision-making task in which subjects were asked to decide whether to accept or reject a series of coin-toss gambles. Our results revealed that individuals with more advanced personal growth as assessed by the Ryff's Psychological Well-being Inventory showed reduced LA. To our knowledge, this is the first report demonstrating an association between positive psychological wellbeing and LA. These findings suggest that personal growth might be employed as interventional targets for correcting excessive LA in vulnerable populations.

The effects of social comparison and depressive mood on adolescent social decision-making

BACKGROUND

Based on social comparison theory, two experiments were conducted to explore the effects of depression and social comparison on adolescents, using the ultimatum game (UG).

METHODS

Before the formal experiment began, a preliminary experiment tested the effectiveness of social comparison settings. This study used the UG paradigm to explore adolescents' social decision-making in the context of gain and loss through two experiments. These experiments were designed as a 2 (group: depressive mood group, normal mood group) × 2 (social comparison: upward, downward) × 3 (fairness level: fair 5:5, unfair 3:7, extremely unfair 1:9) three-factor hybrid study.

RESULTS

(1) The fairer the proposal was, the higher the sense of fairness participants felt, and the higher their acceptance rate. (2) The acceptance rate of the participants for downward social comparison was significantly higher than that for upward social comparison, but there was no difference in fairness perception between the two social comparisons. (3) Under the context of gain, the acceptance rate of the depressive mood group was higher than that of the normal mood group, but there was no difference in the acceptance rate between the depressive mood group and the normal mood group under the loss context. Depressive mood participants had more feelings of unfairness in the contexts of both gain and loss. (4) The effects of depressive mood, social comparison and the fairness level of distribution on social decision-making interact.

CONCLUSIONS

The interaction of social comparison, depressive mood and proposal type demonstrates that besides one's emotion, cognitive biases and social factors can also have an effect on social decision-making. These findings indicate that behavioral decision boosting may provide an avenue for appropriate interventions in helping to guide adolescents to make social decisions.

Heart rate variability after vigorous physical exercise is positively related to loss aversion

BACKGROUND AND OBJECTIVES OF THE ARTICLE

Loss aversion bias, whereby losses loom larger than gains, can be reduced by stress. At the same time, vigorous physical exercise is a powerful neuroendocrine stressor and heart rate variability (HRV) provides an objective measure of the actual exercise impact, relative to each individual physical condition. Our aim was to study whether vigorous exercise can influence loss aversion, considering HRV in this relation. We hypothesized that the lower HRV derived from vigorous exercise (i.e., when stressor produced the most impact) would predict a lower loss aversion.

METHODS

Two groups (Experimental, N = 37; Control, N = 39) completed a loss aversion task, but the experimental group was exposed to an acute physical stressor before.

RESULTS

Results revealed a significant group x HRV interaction. In the control group, HRV was not associated with loss aversion. Conversely, as hypothesized, the lower HRV levels derived from exercise were associated with a lesser loss aversion in the experimental group.

CONCLUSIONS

Results suggest that physiological changes from physical exercise could affect decision-making by reducing loss aversion.

Association of Loss Aversion, Personality Traits, Depressive, Anxious, and Suicidal Symptoms: Systematic Review

OBJECTIVE

Loss aversion is defined as the individual perception of losses with a more significant impact than the gains of the same proportion, where people would be more sensitive to the possibility of losing objects or money than to the possibility of winning, even the same quantities. However, studies relating to loss aversion and psychological factors are still incipient. The aim of the present literature review was to identify and analyze the results of studies that investigated loss aversion regarding personality traits and symptoms of depression, anxiety, and suicidal tendencies.

METHOD

A systematic review was done through PUBMED and Scopus databases. Descriptors were defined according to each database specificities.

RESULTS

At first, 103 articles were encountered. After evaluation of the inclusion and exclusion criteria, there were a total of 14 remaining articles that were group together into six categories related to loss aversion, depression, anxiety, suicidal tendencies, and personality.

CONCLUSIONS

The present study contributes to the literature mapping in the Behavioural Economics field. However, discrepancies were found among the studies, which made it difficult to acquire more conclusive findings.

Repetitive negative thinking following exposure to a natural stressor prospectively predicts altered stress responding and decision-making in the laboratory

Repetitive negative thinking (RNT) represents a transdiagnostic risk factor for affective disorders, and stress is theorized to exacerbate this vulnerability. One mechanism by which stress may influence individual differences in psychiatric symptoms is through altered decision-making, and loss aversion in particular. The present study uses multiple methods to investigate the relationships between RNT, stress, and decision-making. We measured RNT in young adults (N = 90) recently exposed to a natural stressor, Hurricane Irma, and tested the influence of RNT on changes in affect, cortisol, and decision-making during a laboratory stress induction two months later. Post-hurricane RNT predicted greater increases in loss averse decision-making (β = 0.30 [0.14, 0.47], p < .001; rp² = 0.079) and negative affect (β = 0.59 [0.37, 0.81], p < .001; rp² = 0.319) during the early-phase response to the laboratory stressor, as well as poorer cortisol recovery (β = 0.32, [0.10, 0.54], p = .005; rp² = 0.095) in the late-phase stress response. Results highlight the role of loss aversion and stress in understanding RNT as an affective vulnerability factor.

Approach-Avoidance Conflict in Major Depressive Disorder: Congruent Neural Findings in Humans and Nonhuman Primates

BACKGROUND

Maladaptive approach-avoidance behavior has been implicated in the pathophysiology of major depressive disorder (MDD), but the neural basis of these abnormalities in decision making remains unclear. Capitalizing on recent preclinical findings, we adapted an approach-avoidance conflict task from nonhuman primate research for use in human functional magnetic resonance imaging (fMRI).

METHODS

Forty-two female participants, including 18 unmedicated individuals with current MDD (mean age 25.2 ± 5.1 years) and 24 psychiatrically healthy control subjects (mean age 26.3 ± 7.6 years) completed the adapted approach-avoidance task during fMRI. To probe potential mechanistic factors underlying the observed behavioral and fMRI findings and to inform interpretation of putative group differences, we examined electrophysiological data from 2 female Macaca mulatta monkeys performing the approach-avoidance conflict task mimicked in the fMRI study.

RESULTS

Findings demonstrated congruent neural correlates of approach-avoidance conflict and aversive responsiveness in the anterior cingulate cortex, including the pregenual cortex, of human subjects and macaques (humans: p < .05 whole-brain corrected; macaques: p < .05). The MDD group exhibited aberrant task-related activations in the anterior cingulate cortex, prefrontal cortex, and striatum (all ps < .05). Neural effects in the MDD group were cross-sectionally associated with stress and depressive symptoms. Importantly, they also prospectively predicted stress at 6-month follow-up (all ps < .05).

CONCLUSIONS

Findings indicate that there is conservation of anterior cingulate activation across species and that frontal and striatal regions, in unmedicated humans with MDD, are abnormally responsive during cost-benefit decision making. We suggest that these disruptions could be valuable candidates for translational biomarkers.

A multi factorial model of self-harm behaviors in Anorexia-nervosa and Bulimia-nervosa

BACKGROUND

Co-existence of eating disorders and NSSI, suicide attempts and ideations is well established yet much is not known about the personality traits and behavioral tendencies that maintain this relationship. To this date no empirical work has been produced that offers a multifactorial view on the contributing variables to the occurrence of self-harm behaviors in EDs.

METHOD

Binge eating, depression, impulsivity, ruminations and loss aversion were assessed in a sample of 93 patients diagnosed with Anorexia-Nervosa and Bulimia-Nervosa and other EDs with a history of NSSI and suicide attempts.

RESULTS

Binge eating was found to be a predictor of depression, which in turn was found to be related to NSSI frequency, suicide attempts and suicide ideations. Ruminations were found to mediate a relationship between depression and suicide ideations. Trait impulsivity predicted suicide attempts, while the attentional construct of impulsivity was associated to suicide ideations as well as attempts. Higher loss aversion was positively associated with NSSI frequency and suicide ideations.

CONCLUSION

Our findings suggest that trait and state aspects of impulsivity are related to different self-harm behaviors in EDs. Exploring these differences is potentially of great value in understanding the process of transition from suicidal ideation to suicide attempt and the process of NSSI and may assist clinicians formulate better interventions for patients with EDs at risk. Ways in which individual findings in our model correspond with previous research and future implications are discussed.

Dissociable Neural Responses to Monetary and Social Gain and Loss in Women With Major Depressive Disorder

Neuroimaging studies have revealed aberrant reward and loss processing in patients with major depressive disorder (MDD). While most studies use monetary stimuli to study these processes, it is important to consider social stimuli given that the social environment plays a significant role in the development and maintenance of MDD. In the present study, we examined whether monetary gain/loss and social acceptance/rejection would elicit dissociable salience-related neural responses in women diagnosed with MDD compared to healthy control (HC) women. Twenty women diagnosed with MDD and 20 matched HC women performed the monetary incentive delay task (MID) and the social feedback task (SFT) during functional magnetic resonance imaging (fMRI). This study focused on women since women have a higher rate of MDD, higher frequency of relapse, and are more likely to develop MDD as a consequence of negative interpersonal relationships compared to men. We found that during the MID, HCs but not MDD patients demonstrated strong overlapping activations in the right anterior insula (AI) in response to both monetary gain and loss. During the SFT, MDD patients but not HCs showed overlapping activations in the AI in response to social acceptance and rejection. Our results may suggest a dissociation such that MDD patients show decreased sensitivity to monetary stimuli whether gain or loss, and increased sensitivity to social stimuli whether acceptance or rejection, although this will need to be verified in larger samples with direct comparisons between groups and stimuli. These data demonstrate distinct abnormalities in reward and loss processing that converge within the AI. Our findings also highlight the critical need to assess across both non-social and social domains when examining reward and loss systems in MDD to broaden our understanding of the disorder and identify novel targets for treatment.

Affect and Decision Making: Insights and Predictions from Computational Models

In recent years interest in integrating the affective and decision sciences has skyrocketed. Immense progress has been made, but the complexities of each field, which can multiply when combined, present a significant obstacle. A carefully defined framework for integration is needed. The shift towards computational modeling in decision science provides a powerful basis and a path forward, but one whose synergistic potential will only be fully realized by drawing on the theoretical richness of the affective sciences. Reviewing research using a popular computational model of choice (the drift diffusion model), we discuss how mapping concepts to parameters reduces conceptual ambiguity and reveals novel hypotheses.

Risk-taking, peer-influence and child maltreatment: a neurocognitive investigation

Maltreatment is associated with increased risk of a range of psychiatric disorders, many of which are characterized by altered risk-taking propensity. Currently, little is known about the neural correlates of risk-taking in children exposed to maltreatment, nor whether their risk-taking is atypically modulated by peer influence. Seventy-five 10- to 14-year-old children [maltreated (MT) group: N = 41; non-maltreated Group (NMT): N = 34] performed a Balloon Analogue Risk Task (BART), under three different peer influence conditions: while alone, while being observed by a peer and while being encouraged by a peer to take risks. The MT group engaged in less risk-taking irrespective of peer influence. There was no differential effect of peer influence on risk-taking behaviour across groups. At the neural level, the right anterior insula (rAI) exhibited altered risk sensitivity across conditions in the MT group. Across groups and conditions, rAI risk sensitivity was negatively associated with risk-taking and within the MT group greater rAI risk sensitivity was related to more anxiety symptoms. These findings suggest that children with a history of maltreatment show reduced risk-taking but typical responses to peer influence. Abnormal rAI functioning contributes to the pattern of reduced risk-taking and may predispose children exposed to maltreatment to develop future psychopathology.

Reward Processing in Depression: A Conceptual and Meta-Analytic Review Across fMRI and EEG Studies

OBJECTIVE

A role for aberrant reward processing in the pathogenesis of depression has long been proposed. However, no review has yet examined its role in depression by integrating conceptual and quantitative findings across functional MRI (fMRI) and EEG methodologies. The authors quantified these effects, with an emphasis on development.

METHOD

A total of 38 fMRI and 12 EEG studies were entered into fMRI and EEG meta-analyses. fMRI studies primarily examined reward anticipation and reward feedback. These were analyzed using the activation likelihood estimation method. EEG studies involved mainly the feedback-related negativity (FRN) event-related potential, and these studies were analyzed using random-effects meta-analysis of the association between FRN and depression.

RESULTS

Analysis of fMRI studies revealed significantly reduced striatal activation in depressed compared with healthy individuals during reward feedback. When region-of-interest analyses were included, reduced activation was also observed in reward anticipation, an effect that was stronger in individuals under age 18. FRN was also significantly reduced in depression, with pronounced effects in individuals under age 18. In longitudinal studies, reduced striatal activation in fMRI and blunted FRN in EEG were found to precede the onset of depression in adolescents.

CONCLUSIONS

Taken together, the findings show consistent neural aberrations during reward processing in depression, namely, reduced striatal signal during feedback and blunted FRN. These aberrations may underlie the pathogenesis of depression and have important implications for development of new treatments.

Is the encoding of Reward Prediction Error reliable during development?

Reward Prediction Errors (RPEs), defined as the difference between the expected and received outcomes, are integral to reinforcement learning models and play an important role in development and psychopathology. In humans, RPE encoding can be estimated using fMRI recordings, however, a basic measurement property of RPE signals, their test-retest reliability across different time scales, remains an open question. In this paper, we examine the 3-month and 3-year reliability of RPE encoding in youth (mean age at baseline = 10.6 ± 0.3 years), a period of developmental transitions in reward processing. We show that RPE encoding is differentially distributed between the positive values being encoded predominantly in the striatum and negative RPEs primarily encoded in the insula. The encoding of negative RPE values is highly reliable in the right insula, across both the long and the short time intervals. Insula reliability for RPE encoding is the most robust finding, while other regions, such as the striatum, are less consistent. Striatal reliability appeared significant as well once covarying for factors, which were possibly confounding the signal to noise ratio. By contrast, task activation during feedback in the striatum is highly reliable across both time intervals. These results demonstrate the valence-dependent differential encoding of RPE signals between the insula and striatum, and the consistency of RPE signals or lack thereof, during childhood and into adolescence. Characterizing the regions where the RPE signal in BOLD fMRI is a reliable marker is key for estimating reward-processing alterations in longitudinal designs, such as developmental or treatment studies.

Hyper-responsivity to losses in the anterior insula during economic choice scales with depression severity

BACKGROUND

Commonly observed distortions in decision-making among patients with major depressive disorder (MDD) may emerge from impaired reward processing and cognitive biases toward negative events. There is substantial theoretical support for the hypothesis that MDD patients overweight potential losses compared with gains, though the neurobiological underpinnings of this bias are uncertain.

METHODS

Twenty-one unmedicated patients with MDD were compared with 25 healthy controls (HC) using functional magnetic resonance imaging (fMRI) together with an economic decision-making task over mixed lotteries involving probabilistic gains and losses. Region-of-interest analyses evaluated neural signatures of gain and loss coding within a core network of brain areas known to be involved in valuation (anterior insula, caudate nucleus, ventromedial prefrontal cortex).

RESULTS

Usable fMRI data were available for 19 MDD and 23 HC subjects. Anterior insula signal showed negative coding of losses (gain > loss) in HC subjects consistent with previous findings, whereas MDD subjects demonstrated significant reversals in these associations (loss > gain). Moreover, depression severity further enhanced the positive coding of losses in anterior insula, ventromedial prefrontal cortex, and caudate nucleus. The hyper-responsivity to losses displayed by the anterior insula of MDD patients was paralleled by a reduced influence of gain, but not loss, stake size on choice latencies.

CONCLUSIONS

Patients with MDD demonstrate a significant shift from negative to positive coding of losses in the anterior insula, revealing the importance of this structure in value-based decision-making in the context of emotional disturbances.

Reported maladaptive decision-making in unipolar and bipolar depression and its change with treatment

Mood disorder patients frequently experience difficulty making decisions and may make sub-optimal decisions with adverse life consequences. However, patients' styles for decision-making when ill and after treatment have received little study to date. We assessed healthy controls (HC, n = 69) and patients with major depressive disorder (MDD, n = 61) or bipolar disorder (BP, n = 26) in a current major depressive episode using the Melbourne Decision-making Questionnaire. A subset of participants was re-evaluated after completing six weeks of pharmacotherapy. HC demonstrated significantly greater use of the healthy vigilance style, and significantly lower use of maladaptive decision-making styles, than the MDD and depressed BP patients. After six weeks of treatment, neither the MDD nor BP patients reported meaningful improvements in the vigilance style of decision-making, but scores on most maladaptive decision-making styles declined. BP patients who remitted reported significantly lower buckpassing and procrastination scores than healthy controls. Among MDD patients, however, the maladaptive passive buckpassing style of decision-making did not significantly diminish. For MDD patients, reported decision-making styles may remain impaired even after achieving remission. Among BP patients, low levels of adaptive vigilance decision-making may be a trait component of the illness, whereas for MDD patients, reported maladaptive passive decision-making styles are persistent.

Heightened aversion to risk and loss in depressed patients with a suicide attempt history

Suicide attempters have been found to be impaired in decision-making; however, their specific biases in evaluating uncertain outcomes remain unclear. Here we tested the hypothesis that suicidal behavior is associated with heightened aversion to risk and loss, which might produce negative predictions about uncertain future events. Forty-five depressed patients with a suicide attempt history, 47 nonsuicidal depressed patients, and 75 healthy controls participated in monetary decision-making tasks assessing risk and loss aversion. Suicide attempters compared with the other groups exhibited greater aversion to both risk and loss during gambles involving potential loss. Risk and loss aversion correlated with each other in the depressed patients, suggesting that a common pathophysiological mechanism underlies these biases. In addition, emotion regulation via suppression, a detrimental emotional control strategy, was positively correlated with loss aversion in the depressed patients, also implicating impairment in regulatory processes. A preliminary fMRI study also found disrupted neural responses to potential gains and losses in the subgenual anterior cingulate cortex, insula cortex, and left amygdala, brain regions involved in valuation, emotion reactivity, and emotion regulation. The findings thus implicate heightened negative valuation in decision-making under risk, and impaired emotion regulation in depressed patients with a history of suicide attempts.

The Effect of Wealth Shocks on Loss Aversion: Behavior and Neural Correlates

Kahneman and Tversky (1979) first demonstrated that when individuals decide whether or not to accept a gamble, potential losses receive more weight than possible gains in the decision. This phenomenon is referred to as loss aversion. We investigated how loss aversion in risky financial decisions is influenced by sudden changes to wealth, employing both behavioral and neurobiological measures. We implemented an fMRI experimental paradigm, based on that employed by Tom et al. (2007). There are two treatments, called RANDOM and CONTINGENT. In RANDOM, the baseline setting, the changes to wealth, referred to as wealth shocks in economics, are independent of the actual choices participants make. Under CONTINGENT, we induce the belief that the changes in income are a consequence of subjects' own decisions. The magnitudes and sequence of the shocks to wealth are identical between the CONTINGENT and RANDOM treatments. We investigated whether more loss aversion existed in one treatment than another. The behavioral results showed significantly greater loss aversion in CONTINGENT compared to RANDOM after a negative wealth shock. No differences were observed in the response to positive shocks. The fMRI results revealed a neural loss aversion network, comprising the bilateral striatum, amygdala and dorsal anterior cingulate cortex that was common to the CONTINGENT and RANDOM tasks. However, the ventral prefrontal cortex, primary somatosensory cortex and superior occipital cortex, showed greater activation in response to a negative change in wealth due to individual's own decisions than when the change was exogenous. These results indicate that striatum activation correlates with loss aversion independently of the source of the shock, and that the ventral prefrontal cortex (vPFC) codes the experimental manipulation of agency in one's actions influencing loss aversion.

Schizophrenia illness severity is associated with reduced loss aversion

Loss aversion, whereby losses weigh more heavily than equal-sized gains, has been demonstrated in many decision-making settings. Previous research has suggested reduced loss aversion in schizophrenia, but with little evidence of a link between loss aversion and schizophrenia illness severity. In this study, 20 individuals with schizophrenia and 16 control participants, matched by age and sex, played two versions of the Iterated Prisoners' Dilemma, one version with only positive payoffs and another version in which negative payoffs were possible, with the second version being derived from the first by subtracting a constant value from all payoffs. The control group demonstrated significantly lower cooperation rates under negative payoffs, compared with the version with only positive payoffs, indicative of loss aversion. The patient group on average showed no loss aversion response. Moreover, the extent of loss aversion in patients was found to be negatively correlated with schizophrenia illness severity, with less ill patients showing loss aversion more similar to controls. Results were found to be robust to the inclusion of potential confounding factors as covariates within rigorous probit regression analyses. Reduced loss aversion is a feature of schizophrenia and related to illness severity.

Activation of the DLPFC Reveals an Asymmetric Effect in Risky Decision Making: Evidence from a tDCS Study

The phenomenon of loss aversion (the tendency for losses to have a greater impact than comparable gains) has long been observed in daily life. Neurocognitive studies and brain imaging studies have shed light on the correlation between the phenomenon of loss aversion and the brain region of the prefrontal cortex. Recent brain stimulation studies using bilateral transcranial magnetic stimulation or transcranial direct current stimulation (tDCS) have obtained various results showing the causal relationship between brain regions and decision making. With the goal of studying whether unilateral stimulation can change participants’ risky decision making in the frames of gains and losses, we applied different polarities of tDCS over the regions of the right or left prefrontal cortex. We also designed a risk measurement table (Multiple Price List) to reflect the participants’ attitudes toward risky decision making via the crossover point including the frames of gains and losses. The results of our experiment indicated that the participants tended to be more risk averse in the gain frame after receiving left anodal tDCS and more risk seeking in the loss frame after receiving right cathodal tDCS, which was consistent with the hypothesis that the process of risky decision making was correlated with the interaction of multiple systems in the brain. Our conclusion revealed an asymmetric effect of right/left DLPFC when the participants faced gains and losses, which partially provided the neural evidence and a feasible paradigm to help better understand risky decision making and loss aversion. The current study can not only expand the traditional understanding of the behavioral preferences of humans in economics but also accommodate empirical observations of behavioral economists on the preferences of humans.

Individual Differences in Subjective Utility and Risk Preferences: The Influence of Hedonic Capacity and Trait Anxiety

Individual differences in decision-making are important in both normal populations and psychiatric conditions. Variability in decision-making could be mediated by different subjective utilities or by other processes. For example, while traditional economic accounts attribute risk aversion to a concave subjective utility curve, in practice other factors could affect risk behavior. This distinction may have important implications for understanding the biological basis of variability in decision-making and for developing interventions to improve decision-making. Another aspect of decision-making that may vary between individuals is the sensitivity of subjective utility to counterfactual outcomes (outcomes that could have occurred, but did not). We investigated decision-making in relation to hedonic capacity and trait anxiety, two traits that relate to psychiatric conditions but also vary in the general population. Subjects performed a decision-making task, in which they chose between low- and high-risk gambles to win 0, 20, or 40 points on each trial. Subjects then rated satisfaction after each outcome on a visual analog scale, indicating subjective utility. Hedonic capacity was positively associated with the subjective utility of winning 20 points but was not associated with the concavity of the subjective utility curve (constructed using the mean subjective utility of winning 0, 20, or 40 points). Consistent with economic theory, concavity of the subjective utility curve was associated with risk aversion. Hedonic capacity was independently associated with risk seeking (i.e., not mediated by the shape of the subjective utility curve), while trait anxiety was unrelated to risk preferences. Contrary to our expectations, counterfactual sensitivity was unrelated to hedonic capacity and trait anxiety. Nevertheless, trait anxiety was associated with a self-report measure of regret-proneness, suggesting that counterfactual influences may occur via a pathway that is separate from immediate counterfactual processing biases. Taken together, our results show that hedonic capacity but not trait anxiety affects risk-taking through a mechanism that appears independent of the shape of the subjective utility curve, while hedonic capacity and trait anxiety do not affect the influence of counterfactual outcomes on subjective utility. The results have implications for understanding the underlying mechanisms of variable decision-making and for developing interventions to improve decision-making.

Increased Loss Aversion in Unmedicated Patients with Obsessive-Compulsive Disorder

INTRODUCTION

Obsessive-compulsive disorder (OCD) patients show abnormalities in decision-making and, clinically, appear to show heightened sensitivity to potential negative outcomes. Despite the importance of these cognitive processes in OCD, few studies have examined the disorder within an economic decision-making framework. Here, we investigated loss aversion, a key construct in the prospect theory that describes the tendency for individuals to be more sensitive to potential losses than gains when making decisions.

METHODS

Across two study sites, groups of unmedicated OCD patients (n = 14), medicated OCD patients (n = 29), and healthy controls (n = 34) accepted or rejected a series of 50/50 gambles containing varying loss/gain values. Loss aversion was calculated as the ratio of the likelihood of rejecting a gamble with increasing potential losses to the likelihood of accepting a gamble with increasing potential gains. Decision times to accept or reject were also examined and correlated with loss aversion.

RESULTS

Unmedicated OCD patients exhibited significantly more loss aversion compared to medicated OCD or controls, an effect that was replicated across both sites and remained significant even after controlling for OCD symptom severity, trait anxiety, and sex. Post hoc analyses further indicated that unmedicated patients' increased likelihood to reject a gamble as its loss value increased could not be explained solely by greater risk aversion among patients. Unmedicated patients were also slower to accept than reject gambles, effects that were not found in the other two groups. Loss aversion was correlated with decision times in unmedicated patients but not in the other two groups.

DISCUSSION

These data identify abnormalities of decision-making in a subgroup of OCD patients not taking psychotropic medication. The findings help elucidate the cognitive mechanisms of the disorder and suggest that future treatments could aim to target abnormalities of loss/gain processing during decision-making in this population.