Dynamic integration of forward planning and heuristic preferences during multiple goal pursuit

Forward planning driven by context-dependant conflict processing in anterior cingulate cortex

Cognitive control and forward planning in particular is costly, and therefore must be regulated such that the amount of cognitive resources invested is adequate to the current situation. However, knowing in advance how beneficial forward planning will be in a given situation is hard. A way to know the exact value of planning would be to actually do it, which would ab initio defeat the purpose of regulating planning, i.e. the reduction of computational and time costs. One possible solution to this dilemma is that planning is regulated by learned associations between stimuli and the expected demand for planning. Such learning might be based on generalisation processes that cluster together stimulus states with similar control relevant properties into more general control contexts. In this way, the brain could infer the demand for planning, based on previous experience with situations that share some structural properties with the current situation. Here, we used a novel sequential task to test the hypothesis that people use control contexts to efficiently regulate their forward planning, using behavioural and functional magnetic resonance imaging data. Consistent with our hypothesis, reaction times increased with trial-by-trial conflict, where this increase was more pronounced in a context with a learned high demand for planning. Similarly, we found that fMRI activity in the dorsal anterior cingulate cortex (dACC) increased with conflict, and this increase was more pronounced in a context with generally high demand for planning. Taken together, the results indicate that the dACC integrates representations of planning demand at different levels of abstraction to regulate planning in an efficient and situation-appropriate way.

Reward Value Enhances Sequence Monitoring Ramping Dynamics as Ending Rewards Approach in the Rostrolateral Prefrontal Cortex

Many fundamental human behaviors contain multiple sequences performed to reach a desired outcome, such as cooking. Reward is inherently associated with sequence completion and has been shown to generally enhance cognitive control. However, the impact of reward on cognitive sequence processing remains unexplored. To address this key question, we focused on the rostrolateral prefrontal cortex (RLPFC). This area is necessary and exhibits increasing (“ramping”) activation during sequences, a dynamic that may be related to reward processing in other brain regions. To separate these dynamics, we designed a task where reward was only provided after multiple four-item sequences (“iterations”), rather than each individual sequence. Using fMRI in humans, we investigated three possible interactions of reward and sequential control signals in RLPFC: (1) with the visibility of sequential cues, i.e., memory; (2) equally across individual sequence iterations; and (3) differently across individual sequence iterations (e.g., increasing as reward approaches). Evidence from previous, nonsequential cognitive control experiments suggested that reward would uniformly change RLPFC activity across iterations and may depend on the visibility of cues. However, we found the influence of reward on RLPFC ramping increased across sequence iterations and did not interact with memory. These results suggest an active, predictive, and distinctive role for RLPFC in sequence monitoring and integration of reward information, consistent with extant literature demonstrating similar accelerating reward-related dopamine dynamics in regions connected to RLPFC. These results have implications for understanding sequential behavior in daily life, and when they go awry in disorders such as addiction.

Feeling and thinking: can theories of human motivation explain how EHR design impacts clinician burnout?

The psychology of motivation can help us understand the impact of electronic health records (EHRs) on clinician burnout both directly and indirectly. Informatics approaches to EHR usability tend to focus on the extrinsic motivation associated with successful completion of clearly defined tasks in clinical workflows. Intrinsic motivation, which includes the need for autonomy, sense-making, creativity, connectedness, and mastery is not well supported by current designs and workflows. This piece examines existing research on the importance of 3 psychological drives in relation to healthcare technology: goal-based decision-making, sense-making, and agency/autonomy. Because these motives are ubiquitous, foundational to human functioning, automatic, and unconscious, they may be overlooked in technological interventions. The results are increased cognitive load, emotional distress, and unfulfilling workplace environments. Ultimately, we hope to stimulate new research on EHR design focused on expanding functionality to support intrinsic motivation, which, in turn, would decrease burnout and improve care.