Chronic and Acute Stress Promote Overexploitation in Serial Decision Making

Major depression symptom severity associations with willingness to exert effort and patch foraging strategy

Individuals with major depressive disorder (MDD) can experience reduced motivation and cognitive function, leading to challenges with goal-directed behavior. When selecting goals, people maximize 'expected value' by selecting actions that maximize potential reward while minimizing associated costs, including effort 'costs' and the opportunity cost of time. In MDD, differential weighing of costs and benefits are theorized mechanisms underlying changes in goal-directed cognition and may contribute to symptom heterogeneity. We used the Effort Foraging Task to quantify cognitive and physical effort costs, and patch leaving thresholds in low effort conditions (hypothesized to reflect perceived opportunity cost of time) and investigated their shared versus distinct relationships to clinical features in participants with MDD (N=52, 43 in-episode) and comparisons (N=27). Contrary to our predictions, none of the decision-making measures differed with MDD diagnosis. However, each of the measures were related to symptom severity, over and above effects of ability (i.e., performance). Greater anxiety symptoms were selectively associated with lower cognitive effort cost (i.e. greater willingness to exert effort). Anhedonia symptoms were associated with increased physical effort costs. Finally, greater physical anergia was related to decreased patch leaving thresholds. Markers of effort-based decision-making may inform understanding of MDD heterogeneity. Increased willingness to exert cognitive effort may contribute to anxiety symptoms such as rumination and worry. The association of decreased leaving thresholds with symptom severity is consistent with reward rate-based accounts of reduced vigor in MDD. Future research should address subtypes of depression with or without anxiety, which may relate differentially to cognitive effort decisions.

Directed exploration is elevated in affective disorders but reduced by an aversive interoceptive state induction

Elevated anxiety and uncertainty avoidance are known to exacerbate maladaptive choice in individuals with affective disorders. However, the differential roles of state vs. trait anxiety remain unclear, and underlying computational mechanisms have not been thoroughly characterized. In the present study, we investigated how a somatic (interoceptive) state anxiety induction influences learning and decision-making under uncertainty in individuals with clinically significant levels of trait anxiety. A sample of 58 healthy comparisons (HCs) and 61 individuals with affective disorders (iADs; i.e., depression and/or anxiety) completed a previously validated explore-exploit decision task, with and without an added breathing resistance manipulation designed to induce state anxiety. Computational modeling revealed a pattern in which iADs showed greater information-seeking (i.e., directed exploration; Cohen's d=.39, p=.039) in resting conditions, but that this was reduced by the anxiety induction. The affective disorders group also showed slower learning rates across conditions (Cohen's d=.52, p=.003), suggesting more persistent uncertainty. These findings highlight a complex interplay between trait anxiety and state anxiety. Specifically, while elevated trait anxiety is associated with persistent uncertainty, acute somatic anxiety can paradoxically curtail exploratory behaviors, potentially reinforcing maladaptive decision-making patterns in affective disorders.

Hierarchical control over foraging behavior by anterior cingulate cortex

Foraging is a natural behavior that involves making sequential decisions to maximize rewards while minimizing the costs incurred when doing so. The prevalence of foraging across species suggests that a common brain computation underlies its implementation. Although anterior cingulate cortex is believed to contribute to foraging behavior, its specific role has been contentious, with predominant theories arguing either that it encodes environmental value or choice difficulty. Additionally, recent attempts to characterize foraging have taken place within the reinforcement learning framework, with increasingly complex models scaling with task complexity. Here we review reinforcement learning foraging models, highlighting the hierarchical structure of many foraging problems. We extend this literature by proposing that ACC guides foraging according to principles of model-based hierarchical reinforcement learning. This idea holds that ACC function is organized hierarchically along a rostral-caudal gradient, with rostral structures monitoring the status and completion of high-level task goals (like finding food), and midcingulate structures overseeing the execution of task options (subgoals, like harvesting fruit) and lower-level actions (such as grabbing an apple).

The structure and development of explore-exploit decision making

A critical component of human learning reflects the balance people must achieve between focusing on the utility of what they know versus openness to what they have yet to experience. How individuals decide whether to explore new options versus exploit known options has garnered growing interest in recent years. Yet, the component processes underlying decisions to explore and whether these processes change across development remain poorly understood. By contrasting a variety of tasks that measure exploration in slightly different ways, we found that decisions about whether to explore reflect (a) random exploration that is not explicitly goal-directed and (b) directed exploration to purposefully reduce uncertainty. While these components similarly characterized the decision-making of both youth and adults, younger participants made decisions that were less strategic, but more exploratory and flexible, than those of adults. These findings are discussed in terms of how people adapt to and learn from changing environments over time.Data has been made available in the Open Science Foundation platform (osf.io).

In your CORT: Corticosterone and its receptors in the brain underlie mate choosiness in female Cope's gray treefrogs (Hyla chrysoscelis)

Selecting an attractive mate can involve trade-offs related to investment in sampling effort. Glucocorticoids like corticosterone (CORT) are involved in resolving energetic trade-offs. However, CORT is rarely studied in the context of mate choice, despite its elevated levels during reproductive readiness and the energetic transitions that characterize reproduction. Few systems are as well suited as anuran amphibians to evaluate how females resolve energetic trade-offs during mate choice. Phonotaxis tests provide a robust bioassay of mate choice that permit the precise measurement of inter-individual variation in traits such as choosiness-the willingness to pursue the most attractive mate despite costs. In Cope's gray treefrogs (Hyla chrysoscelis), females exhibit remarkable variation in circulating CORT as well as choosiness during mate choice, and a moderate dose of exogenous CORT rapidly (<1 h) and reliably induce large increases in choosiness. Here we measured the expression of glucocorticoid (GR) and mineralocorticoid (MR) receptors in the brains of females previously treated with exogenous CORT and tested for mate choosiness. We report a large decrease in GR expression in the hindbrain and midbrain of females that were treated with the moderate dosage of CORT-the same treatment group that exhibited a dramatic increase in choosiness following CORT treatment. This association, however, does not appear to be causal, as only forebrain GR levels, which are not affected by CORT injection, are positively associated with variation in choosiness. No strong effects were found for MR. We discuss these findings and suggest future studies to test the influence of glucocorticoids on mate choice.

Meta-Analysis Reveals That Explore-Exploit Decisions are Dissociable by Activation in the Dorsal Lateral Prefrontal Cortex and the Anterior Cingulate Cortex

Explore-exploit research has challenges in generalizability due to a limited theoretical basis of exploration and exploitation. Neuroimaging can help identify whether explore-exploit decisions use an opponent processing system to address this issue. Thus, we conducted a coordinate-based meta-analysis (N=23 studies) where we found activation in the dorsal lateral prefrontal cortex and anterior cingulate cortex during exploration versus exploitation, providing some evidence for opponent processing. However, the conjunction of explore-exploit decisions was associated with activation in the dorsal anterior cingulate cortex, dorsal medial prefrontal cortex, and anterior insula, suggesting that these brain regions do not engage in opponent processing. Further, exploratory analyses revealed heterogeneity in brain responses between task types during exploration and exploitation respectively. Coupled with results suggesting that activation in exploration and exploitation decisions is generally more similar than it is different suggests there remain significant challenges toward characterizing explore-exploit decision making. Nonetheless, dlPFC and ACC activation differentiate explore and exploit decisions and identifying these responses can help in targeted interventions aimed at manipulating these decisions.

Latent-state and model-based learning in PTSD

Post-traumatic stress disorder (PTSD) is characterized by altered emotional and behavioral responding following a traumatic event. In this article, we review the concepts of latent-state and model-based learning (i.e., learning and inferring abstract task representations) and discuss their relevance for clinical and neuroscience models of PTSD. Recent data demonstrate evidence for brain and behavioral biases in these learning processes in PTSD. These new data potentially recast excessive fear towards trauma cues as a problem in learning and updating abstract task representations, as opposed to traditional conceptualizations focused on stimulus-specific learning. Biases in latent-state and model-based learning may also be a common mechanism targeted in common therapies for PTSD. We highlight key knowledge gaps that need to be addressed to further elaborate how latent-state learning and its associated neurocircuitry mechanisms function in PTSD and how to optimize treatments to target these processes.

Effort Foraging Task reveals positive correlation between individual differences in the cost of cognitive and physical effort in humans

Effort-based decisions, in which people weigh potential future rewards against effort costs required to achieve those rewards involve both cognitive and physical effort, though the mechanistic relationship between them is not yet understood. Here, we use an individual differences approach to isolate and measure the computational processes underlying effort-based decisions and test the association between cognitive and physical domains. Patch foraging is an ecologically valid reward rate maximization problem with well-developed theoretical tools. We developed the Effort Foraging Task, which embedded cognitive or physical effort into patch foraging, to quantify the cost of both cognitive and physical effort indirectly, by their effects on foraging choices. Participants chose between harvesting a depleting patch, or traveling to a new patch that was costly in time and effort. Participants' exit thresholds (reflecting the reward they expected to receive by harvesting when they chose to travel to a new patch) were sensitive to cognitive and physical effort demands, allowing us to quantify the perceived effort cost in monetary terms. The indirect sequential choice style revealed effort-seeking behavior in a minority of participants (preferring high over low effort) that has apparently been missed by many previous approaches. Individual differences in cognitive and physical effort costs were positively correlated, suggesting that these are perceived and processed in common. We used canonical correlation analysis to probe the relationship of task measures to self-reported affect and motivation, and found correlations of cognitive effort with anxiety, cognitive function, behavioral activation, and self-efficacy, but no similar correlations with physical effort.

Childhood unpredictability and the development of exploration

Early in development, the process of exploration helps children gather new information that fosters learning about the world. Yet, it is unclear how childhood experiences may influence the way humans approach new learning. What influences decisions to exploit known, familiar options versus trying a novel alternative? We found that childhood unpredictability, characterized by unpredictable caregiving and unstable living environments, was associated with reduced exploratory behavior. This effect holds while controlling for individual differences, including anxiety and stress. Individuals who perceived their childhoods as unpredictable explored less and were instead more likely to repeat previous choices (habitual responding). They were also more sensitive to uncertainty than to potential rewards, even when the familiar options yielded lower rewards. We examined these effects across multiple task contexts and via both in-person (N = 78) and online replication (N = 84) studies among 10- to 13-y-olds. Results are discussed in terms of the potential cascading effects of unpredictable environments on the development of decision-making and the effects of early experience on subsequent learning.

Acetylcholine and noradrenaline enhance foraging optimality in humans

Foraging theory prescribes when optimal foragers should leave the current option for more rewarding alternatives. Actual foragers often exploit options longer than prescribed by the theory, but it is unclear how this foraging suboptimality arises. We investigated whether the upregulation of cholinergic, noradrenergic, and dopaminergic systems increases foraging optimality. In a double-blind, between-subject design, participants (N = 160) received placebo, the nicotinic acetylcholine receptor agonist nicotine, a noradrenaline reuptake inhibitor reboxetine, or a preferential dopamine reuptake inhibitor methylphenidate, and played the role of a farmer who collected milk from patches with different yield. Across all groups, participants on average overharvested. While methylphenidate had no effects on this bias, nicotine, and to some extent also reboxetine, significantly reduced deviation from foraging optimality, which resulted in better performance compared to placebo. Concurring with amplified goal-directedness and excluding heuristic explanations, nicotine independently also improved trial initiation and time perception. Our findings elucidate the neurochemical basis of behavioral flexibility and decision optimality and open unique perspectives on psychiatric disorders affecting these functions.

Prolonged Physiological Stress Is Associated With a Lower Rate of Exploratory Learning That Is Compounded by Depression

BACKGROUND

Stress is a major risk factor for depression, and both are associated with important changes in decision-making patterns. However, decades of research have only weakly connected physiological measurements of stress to the subjective experience of depression. Here, we examined the relationship between prolonged physiological stress, mood, and explore-exploit decision making in a population navigating a dynamic environment under stress: health care workers during the COVID-19 pandemic.

METHODS

We measured hair cortisol levels in health care workers who completed symptom surveys and performed an explore-exploit restless-bandit decision-making task; 32 participants were included in the final analysis. Hidden Markov and reinforcement learning models assessed task behavior.

RESULTS

Participants with higher hair cortisol exhibited less exploration (r = -0.36, p = .046). Higher cortisol levels predicted less learning during exploration (β = -0.42, false discovery rate [FDR]-corrected p [pFDR] = .022). Importantly, mood did not independently correlate with cortisol concentration, but rather explained additional variance (β = 0.46, pFDR = .022) and strengthened the relationship between higher cortisol and lower levels of exploratory learning (β = -0.47, pFDR = .022) in a joint model. These results were corroborated by a reinforcement learning model, which revealed less learning with higher hair cortisol and low mood (β = -0.67, pFDR = .002).

CONCLUSIONS

These results imply that prolonged physiological stress may limit learning from new information and lead to cognitive rigidity, potentially contributing to burnout. Decision-making measures link subjective mood states to measured physiological stress, suggesting that they should be incorporated into future biomarker studies of mood and stress conditions.

Decision-Making and Risk-Propensity Changes during and after the COVID-19 Pandemic Lockdown

The imposition of lockdowns during the COVID-19 pandemic placed individuals under conditions of environmental stress, threatening individual and collective wellbeing. This study aimed to investigate the temporal effects of isolation and confinement during and after the Italian lockdown on decision-making, risk propensity, and cognitive control processes. The present study covered almost the entire Italian lockdown period (each week from the end of March to mid-May 2020), plus a follow-up measure (September 2020). At each time-point, respondents completed online behavioral tasks, which involved measuring risk-propensity (Balloon Analogue Risk Task), decision-making (Iowa Gambling Task), and cognitive flexibility (Category Switch Task). They also filled in questionnaires regarding subjective stress and anxiety. The main findings showed that the decision-making abilities of the respondents were affected as the confinement progressed. Furthermore, individuals who were more subjectively impacted by the lockdown/isolation experience exhibited impaired decision-making, especially during the lockdown. The results of the study highlight that prolonged confinement may affect human decision making, and help understand individuals' misbehaviors during emergencies and develop effective countermeasures aimed at reducing the burden of the healthcare system.

Statistical information about reward timing is insufficient for promoting optimal persistence decisions

When deciding how long to keep waiting for delayed rewards that will arrive at an uncertain time, different distributions of possible reward times dictate different optimal strategies for maximizing reward. When reward timing distributions are heavy-tailed (e.g., waiting on hold) there is a point at which waiting is no longer advantageous because the opportunity cost of waiting is too high. Alternatively, when reward timing distributions have more predictable timing (e.g., uniform), it is advantageous to wait as long as necessary for the reward. Although people learn to approximate optimal strategies, little is known about how this learning occurs. One possibility is that people learn a general cognitive representation of the probability distribution that governs reward timing and then infer a strategy from that model of the environment. Another possibility is that they learn an action policy in a way that depends more narrowly on direct task experience, such that general knowledge of the reward timing distribution is insufficient for expressing the optimal strategy. Here, in a series of studies in which participants decided how long to persist for delayed rewards before quitting, we provided participants with information about the reward timing distribution in several ways. Whether the information was provided through counterfactual feedback (Study 1), previous exposure (Studies 2a and 2b), or description (Studies 3a and 3b), it did not obviate the need for direct, feedback-driven learning in a decision context. Therefore, learning when to quit waiting for delayed rewards might depend on task-specific experience, not solely on probabilistic reasoning.

Early adversity and the development of explore-exploit tradeoffs

Childhood adversity can have wide-ranging and long-lasting effects on later life. But what are the mechanisms that are responsible for these effects? This article brings together the cognitive science literature on explore-exploit tradeoffs, the empirical literature on early adversity, and the literature in evolutionary biology on 'life history' to explain how early experience influences later life. We propose one potential mechanism: early experiences influence 'hyperparameters' that determine the balance between exploration and exploitation. Adversity might accelerate a shift from exploration to exploitation, with broad and enduring effects on the adult brain and mind. These effects may be produced by life-history adaptations that use early experience to tailor development and learning to the likely future states of an organism and its environment.

Overharvesting in human patch foraging reflects rational structure learning and adaptive planning

Patch foraging presents a sequential decision-making problem widely studied across organisms-stay with a current option or leave it in search of a better alternative? Behavioral ecology has identified an optimal strategy for these decisions, but, across species, foragers systematically deviate from it, staying too long with an option or "overharvesting" relative to this optimum. Despite the ubiquity of this behavior, the mechanism underlying it remains unclear and an object of extensive investigation. Here, we address this gap by approaching foraging as both a decision-making and learning problem. Specifically, we propose a model in which foragers 1) rationally infer the structure of their environment and 2) use their uncertainty over the inferred structure representation to adaptively discount future rewards. We find that overharvesting can emerge from this rational statistical inference and uncertainty adaptation process. In a patch-leaving task, we show that human participants adapt their foraging to the richness and dynamics of the environment in ways consistent with our model. These findings suggest that definitions of optimal foraging could be extended by considering how foragers reduce and adapt to uncertainty over representations of their environment.

Diminished prospective mental representations of reward mediate reward learning strategies among youth with internalizing symptoms

BACKGROUND

Adolescent internalizing symptoms and trauma exposure have been linked with altered reward learning processes and decreased ventral striatal responses to rewarding cues. Recent computational work on decision-making highlights an important role for prospective representations of the imagined outcomes of different choices. This study tested whether internalizing symptoms and trauma exposure among youth impact the generation of prospective reward representations during decision-making and potentially mediate altered behavioral strategies during reward learning.

METHODS

Sixty-one adolescent females with varying exposure to interpersonal violence exposure (n = 31 with histories of physical or sexual assault) and severity of internalizing symptoms completed a social reward learning task during fMRI. Multivariate pattern analyses (MVPA) were used to decode neural reward representations at the time of choice.

RESULTS

MVPA demonstrated that rewarding outcomes could accurately be decoded within several large-scale distributed networks (e.g. frontoparietal and striatum networks), that these reward representations were reactivated prospectively at the time of choice in proportion to the expected probability of receiving reward, and that youth with behavioral strategies that favored exploiting high reward options demonstrated greater prospective generation of reward representations. Youth internalizing symptoms, but not trauma exposure characteristics, were negatively associated with both the behavioral strategy of exploiting high reward options as well as the prospective generation of reward representations in the striatum.

CONCLUSIONS

These data suggest diminished prospective mental simulation of reward as a mechanism of altered reward learning strategies among youth with internalizing symptoms.

Trait somatic anxiety is associated with reduced directed exploration and underestimation of uncertainty

Anxiety has been related to decreased physical exploration, but past findings on the interaction between anxiety and exploration during decision making were inconclusive. Here we examined how latent factors of trait anxiety relate to different exploration strategies when facing volatility-induced uncertainty. Across two studies (total N = 985), we demonstrated that people used a hybrid of directed, random and undirected exploration strategies, which were respectively sensitive to relative uncertainty, total uncertainty and value difference. Trait somatic anxiety, that is, the propensity to experience physical symptoms of anxiety, was inversely correlated with directed exploration and undirected exploration, manifesting as a lesser likelihood for choosing the uncertain option and reducing choice stochasticity regardless of uncertainty. Somatic anxiety is also associated with underestimation of relative uncertainty. Together, these results reveal the selective role of trait somatic anxiety in modulating both uncertainty-driven and value-driven exploration strategies.

Disentangling the roles of dopamine and noradrenaline in the exploration-exploitation tradeoff during human decision-making

Balancing the exploration of new options and the exploitation of known options is a fundamental challenge in decision-making, yet the mechanisms involved in this balance are not fully understood. Here, we aimed to elucidate the distinct roles of dopamine and noradrenaline in the exploration-exploitation tradeoff during human choice. To this end, we used a double-blind, placebo-controlled design in which participants received either a placebo, 400 mg of the D2/D3 receptor antagonist amisulpride, or 40 mg of the β-adrenergic receptor antagonist propranolol before they completed a virtual patch-foraging task probing exploration and exploitation. We systematically varied the rewards associated with choice options, the rate by which rewards decreased over time, and the opportunity costs it took to switch to the next option to disentangle the contributions of dopamine and noradrenaline to specific choice aspects. Our data show that amisulpride increased the sensitivity to all of these three critical choice features, whereas propranolol was associated with a reduced tendency to use value information. Our findings provide novel insights into the specific roles of dopamine and noradrenaline in the regulation of human choice behavior, suggesting a critical involvement of dopamine in directed exploration and a role of noradrenaline in more random exploration.

Neither Threat of Shock nor Acute Psychosocial Stress Affects Ambiguity Attitudes

Decisions under uncertainty can be differentiated into two classes: risky, which has known probabilistic outcomes, and ambiguous, which has unknown probabilistic outcomes. Across a variety of types of decisions, people find ambiguity extremely aversive, subjectively more aversive than risk. It has been shown that the transient sympathetic arousal response to a choice predicts decisions under ambiguity but not risk, and that lifetime stress uniquely predicts attitudes toward ambiguity. Building on these findings, this study explored whether we could bias ambiguity and risk preferences with an arousal or acute stress manipulation that is incidental to the choice in two independent experiments. One experiment induced sympathetic arousal with an anticipatory threat paradigm, and the other manipulated incidental acute stress via a psychosocial stressor. The efficacy of the manipulations was confirmed via pupil dilation and salivary cortisol, respectively. Participants made choices between a guaranteed $5 option and a lottery with either a known (risky) or unknown (ambiguous) probabilistic outcome. Consistent with previous findings, participants were more averse to a given level of ambiguity than to a numerically equal level of risk. However, in contrast to our hypothesis, we found no evidence that transient arousal or acute stress that is incidental to the choice biases ambiguity preferences.

Ongoing pain facilitates emotional decision-making behaviors

Emotion toward anticipated and actual outcomes acts as a vital signal on emotional decision-making, and the Iowa Gambling Task (IGT) can mimic this decision-making process. Pain can impair emotional decision-making behaviors because it captures attention and distracts from the task at hand. Alternatively, pain may facilitate emotional decision-making behaviors by prompting alertness and mobilizing cognitive resources to maximize rewards. The present study investigated the influence of ongoing pain on emotional decision-making behaviors using the IGT. Our study recruited two groups of participants and applied capsaicin (pain group) or control cream (control group) to their forearms. We then compared performances and selections between the pain and control groups. The results revealed that participants successfully learned the required adaptive selection strategy as the task progressed. The study observed a tendency toward optimal choices for both groups under the condition of frequent–small losses. However, we observed a disadvantageous preference for the control group, but not the pain group, when faced with choices with infrequent but large losses. The study implies that a distressing pain experience motivates individuals to adjust goal-directed behaviors to maximize their rewards in a task. Thus, the finding suggests that ongoing pain facilitates emotional decision-making behaviors.

Effects of psychological stress and cortisol on decision making and modulating factors: a systematic review

Evidence suggests that psychological stress has effects on decision making, but the results are inconsistent, and the influence of cortisol and other modulating factors remains unclear. Based on the PRISMA criteria, 18 studies carried out between 2015 and 2020 that examined the effects of psychological stress on decision making and measured cortisol levels were selected. Eight studies employed uncertainty-based economic tasks, five studies used decision-making tasks in hypothetical situations that can be encountered in real life or in a specific setting, and five studies employed prosocial decision tasks. Seventeen studies assessed acute stress, and two assessed chronic stress; eight evaluated the influence of sex. Most of the studies that explored the association between stress and decision making using uncertainty-based economic tasks found statistically significant differences as a function of stress exposure and the cortisol response to stress, whereas most of the studies that employed non-economic decision-making tasks in hypothetical situations did not find statistically significant differences. When prosocial decision making was evaluated, more altruistic decisions were found after acute stress, and these decisions were positively associated with cortisol. Half of the studies that assessed the role of sex observed a greater impact on decision making after stress in women. Results suggest that it is important to consider modulating factors - the type of decision-making task, the cortisol response to stress, the characteristics of the psychological stressor, or the subject's sex - when trying to understand psychosocial stress phenomena.

Decision neuroscience and neuroeconomics: Recent progress and ongoing challenges

In the past decade, decision neuroscience and neuroeconomics have developed many new insights in the study of decision making. This review provides an overarching update on how the field has advanced in this time period. Although our initial review a decade ago outlined several theoretical, conceptual, methodological, empirical, and practical challenges, there has only been limited progress in resolving these challenges. We summarize significant trends in decision neuroscience through the lens of the challenges outlined for the field and review examples where the field has had significant, direct, and applicable impacts across economics and psychology. First, we review progress on topics including reward learning, explore-exploit decisions, risk and ambiguity, intertemporal choice, and valuation. Next, we assess the impacts of emotion, social rewards, and social context on decision making. Then, we follow up with how individual differences impact choices and new exciting developments in the prediction and neuroforecasting of future decisions. Finally, we consider how trends in decision-neuroscience research reflect progress toward resolving past challenges, discuss new and exciting applications of recent research, and identify new challenges for the field. This article is categorized under: Psychology > Reasoning and Decision Making Psychology > Emotion and Motivation.

Piloting the Update: The Use of Therapeutic Relationship for Change - A Free Energy Account

We apply the Free Energy Principle (FEP) to cognitive behavioral therapy (CBT). FEP describes the basic functioning of the brain as a predictive organ and states that any self-organizing system that is in equilibrium with its environment must minimize its free energy. Based on an internal model of the world and the self, predictions-so-called priors-are created, which are matched with the information input. The sum of prediction errors corresponds to the Free Energy, which must be minimized. Internal models can be identified with the cognitive-affective schemas of the individual that has become dysfunctional in patients. The role of CBT in this picture is to help the patient update her/his priors. They have evolved in learning history and no longer provide adaptive predictions. We discuss the process of updating in terms of the exploration-exploitation dilemma. This consists of the extent to which one relies on what one already has, i.e., whether one continues to maintain and "exploit" one's previous priors ("better safe than sorry") or whether one does explore new data that lead to an update of priors. Questioning previous priors triggers stress, which is associated with increases in Free Energy in short term. The role of therapeutic relationship is to buffer this increase in Free Energy, thereby increasing the level of perceived safety. The therapeutic relationship is represented in a dual model of affective alliance and goal attainment alliance and is aligned with FEP. Both forms of alliance support exploration and updating of priors. All aspects are illustrated with the help of a clinical case example.

Mechanisms of memory under stress

It is well established that stress has a major impact on memory, driven by the concerted action of various stress mediators on the brain. Recent years, however, have seen considerable advances in our understanding of the cellular, neural network, and cognitive mechanisms through which stress alters memory. These novel insights highlight the intricate interplay of multiple stress mediators, including-beyond corticosteroids, catecholamines, and peptides-for instance, endocannabinoids, which results in time-dependent shifts in large-scale neural networks. Such stress-induced network shifts enable highly specific memories of the stressful experience in the long run at the cost of transient impairments in mnemonic flexibility during and shortly after a stressful event. Based on these recent discoveries, we provide a new integrative framework that links the cellular, systems, and cognitive mechanisms underlying acute stress effects on memory processes and points to potential targets for treating aberrant memory in stress-related mental disorders.

Individuals with adverse childhood experiences explore less and underweight reward feedback

Adverse childhood experiences (ACEs) are extreme stressors that lead to negative psychosocial outcomes in adulthood. Nonhuman animals explore less after exposure to early stress. Therefore, in this preregistered study, we hypothesized that reduced exploration following ACEs would also be evident in human adults. Further, we predicted that adults with ACEs, in a foraging task, would adopt a decision-making policy that relies on the most-recent reward feedback, a rational strategy for unstable environments. We analyzed data from 145 adult participants, 47 with four or more ACEs and 98 with fewer than four ACEs. In the foraging task, participants evaluated the trade-off between exploiting a known patch with diminishing rewards and exploring a novel one with a fresh distribution of rewards. Using computational modeling, we quantified the degree to which participants' decisions weighted recent feedback. As predicted, participants with ACEs explored less. However, contrary to our hypothesis, they underweighted recent feedback. These unexpected findings indicate that early adversity may dampen reward sensitivity. Our results may help to identify cognitive mechanisms that link childhood trauma to the onset of psychopathology.

Control over patch encounters changes foraging behavior

Foraging is a common decision problem in natural environments. When new exploitable sites are always available, a simple optimal strategy is to leave a current site when its return falls below a single average reward rate. Here, we examined foraging in a more structured environment, with a limited number of sites that replenished at different rates and had to be revisited. When participants could choose sites, they visited fast-replenishing sites more often, left sites at higher levels of reward, and achieved a higher net reward rate. Decisions to exploit-or-leave a site were best explained with a computational model that included both the average reward rate for the environment and reward information about the unattended sites. This suggests that unattended sites influence leave decisions, in foraging environments where sites can be revisited.

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Being able to select sites during foraging increased visits to high value sites

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This visitation pattern was efficient, producing higher average reward rates

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Decisions to leave a site were influenced by information about alternative sites

Chronic Stress Weakens Connectivity in the Prefrontal Cortex: Architectural and Molecular Changes

Chronic exposure to uncontrollable stress causes loss of spines and dendrites in the prefrontal cortex (PFC), a recently evolved brain region that provides top-down regulation of thought, action, and emotion. PFC neurons generate top-down goals through recurrent excitatory connections on spines. This persistent firing is the foundation for higher cognition, including working memory, and abstract thought. However, exposure to acute uncontrollable stress drives high levels of catecholamine release in the PFC, which activates feedforward calcium-cAMP signaling pathways to open nearby potassium channels, rapidly weakening synaptic connectivity to reduce persistent firing. Chronic stress exposures can further exacerbate these signaling events leading to loss of spines and resulting in marked cognitive impairment. In this review, we discuss how stress signaling mechanisms can lead to spine loss, including changes to BDNF-mTORC1 signaling, calcium homeostasis, actin dynamics, and mitochondrial actions that engage glial removal of spines through inflammatory signaling. Stress signaling events may be amplified in PFC spines due to cAMP magnification of internal calcium release. As PFC dendritic spine loss is a feature of many cognitive disorders, understanding how stress affects the structure and function of the PFC will help to inform strategies for treatment and prevention.

Chronic unpredictable stress shifts rat behavior from exploration to exploitation

Chronic stress evokes wide-ranging behavioral alterations, including risk avoidance, increased motoric output, and reduced consummatory behaviors. These are often interpreted as dysfunctions, but they may subserve adaptations for coping with existential threats. We tested this in a cohort of rats previously exposed to mild unpredictable stress for 5 weeks. Previously stressed rats exhibited the typically increased avoidance of open field and altered responses to predator odor, suggesting enhanced sensitivity to threatening contexts and cues. Interestingly, these animals collected rewards at a higher rate than controls, because they locomoted faster, spent less time in off-task (exploratory) behavior, and committed fewer licks at feeders. Further, they were not impaired in flexibly shifting choice as reward probabilities changed among feeders, suggesting that behavioral adaptations are not simply of transference to behavioral control to neural systems insensitive to reward (e.g. habits). These data add to a small but growing body of evidence indicating that stress shifts responses away from exploration and toward exploitation of resources, possibly to reduce threat exposure.HighlightsRats with a history of stress collected reward at a higher rate than controls on an operant task, owing to increase locomotion speed, reduced off-task behavior, and reduced time licking at feeders.Previously stressed rats exhibited increased win-stay responses than controls, suggesting the involvement of neural circuits related to goal-directed responding.Previously stressed rats performed equally to controls on a task requiring a shift of preferences based on reward probability, suggesting that they are not simply relying more on habit-based neural systems.

Acute Psychosocial Stress Increases Cognitive-Effort Avoidance

Adverse effects following acute stress are traditionally thought to reflect functional impairments of central executive-dependent cognitive-control processes. However, recent evidence demonstrates that cognitive-control application is perceived as effortful and aversive, indicating that stress-related decrements in cognitive performance could denote decreased motivation to expend effort instead. To investigate this hypothesis, we tested 40 young, healthy individuals (20 female, 20 male) under both stress and control conditions in a 2-day study that had a within-subjects design. Cognitive-effort avoidance was assessed using the demand-selection task, in which participants chose between performing low-demand and high-demand variants of a task-switching paradigm. We found that acute stress indeed increased participants' preference for less demanding behavior, whereas task-switching performance remained intact. Additional Bayesian and multiverse analyses confirmed the robustness of this effect. Our findings provide novel insights into how stressful experiences shape behavior by modulating our motivation to employ cognitive control.

Sympathetic involvement in time-constrained sequential foraging

Appraising sequential offers relative to an unknown future opportunity and a time cost requires an optimization policy that draws on a learned estimate of an environment’s richness. Converging evidence points to a learning asymmetry, whereby estimates of this richness update with a bias toward integrating positive information. We replicate this bias in a sequential foraging (prey selection) task and probe associated activation within the sympathetic branch of the autonomic system, using trial-by-trial measures of simultaneously recorded cardiac autonomic physiology. We reveal a unique adaptive role for the sympathetic branch in learning. It was specifically associated with adaptation to a deteriorating environment: it correlated with both the rate of negative information integration in belief estimates and downward changes in moment-to-moment environmental richness, and was predictive of optimal performance on the task. The findings are consistent with a framework whereby autonomic function supports the learning demands of prey selection.

The exploration-exploitation trade-off in a foraging task is affected by mood-related arousal and valence

The exploration-exploitation trade-off shows conceptual, functional, and neural analogies with the persistence-flexibility trade-off. We investigated whether mood, which is known to modulate the persistence-flexibility balance, would similarly affect the exploration-exploitation trade-off in a foraging task. More specifically, we tested whether interindividual differences in foraging behavior can be predicted by mood-related arousal and valence. In 119 participants, we assessed mood-related interindividual differences in exploration-exploitation using a foraging task that included minimal task constraints to reduce paradigm-induced biases of individual control tendencies. We adopted the marginal value theorem as a model-based analysis approach, which approximates optimal foraging behavior by tackling the patch-leaving problem. To assess influences of mood on foraging, participants underwent either a positive or negative mood induction. Throughout the experiment, we assessed arousal and valence levels as predictors for explorative/exploitative behavior. Our mood manipulation affected participants' arousal and valence ratings as expected. Moreover, mood-related arousal was found to predict exploration while valence predicted exploitation, which only partly matched our expectations and thereby the proposed conceptual overlap with flexibility and persistence, respectively. The current study provides a first insight into how processes related to arousal and valence differentially modulate foraging behavior. Our results imply that the relationship between exploration-exploitation and flexibility-persistence is more complicated than the semantic overlap between these terms might suggest, thereby calling for further research on the functional, neural, and neurochemical underpinnings of both trade-offs.

Moderately elevated glucocorticoids increase mate choosiness but do not affect sexual proceptivity or preferences in female gray treefrogs

Glucocorticoids (GCs) are rarely studied in the context of female mate choice, despite the expression of receptors for these products in sexual, sensory and decision-making brain areas. Here we investigated the effects of GC concentrations on three aspects of female sexual behavior in breeding Cope's gray treefrogs (Hyla chrysoscelis): proceptivity-a measure of sexual motivation, intraspecific mate preferences, and mate choosiness. To our knowledge this is the first experimental study on the endocrine basis of mate choosiness. We predicted that mate choosiness-forfeiting an initial mate preference to pursue a suddenly more attractive mate-would be particularly impacted by elevated GCs with moderate GC levels associated with greater choosiness. We found support for this predicted inverted-U relationship. Females in the control group (no injection) showed no change in choosiness across timepoints. In contrast, females in the vehicle, Low (20 ng g^-1) and High (180 ng g^-1) corticosterone groups exhibited a nominal decline in choosiness after injection, suggesting that the experience of injection has little or perhaps slightly suppressive effects on female choosiness. Females in the moderate dose group (60 ng g^-1), however, exhibited a significant increase (>100%) in choosiness. Further, we found no effect of elevated GCs on sexual proceptivity or the species-typical preference for longer calls. These findings may reflect a buffering of primary sensory areas in the brain against elevated GCs. The recruitment of other cognitive processes during active decision-making, however, may facilitate GC modulation of mate choosiness, thereby promoting tactical plasticity at this critical life history juncture.

Foraging behavior in visual search: A review of theoretical and mathematical models in humans and animals

Visual search (VS) is a fundamental task in daily life widely studied for over half a century. A variant of the classic paradigm-searching one target among distractors-requires the observer to look for several (undetermined) instances of a target (so-called foraging) or several targets that may appear an undefined number of times (recently named as hybrid foraging). In these searches, besides looking for targets, the observer must decide how much time is needed to exploit the area, and when to quit the search to eventually explore new search options. In fact, visual foraging is a very common search task in the real world, probably involving additional cognitive functions than typical VS. It has been widely studied in natural animal environments, for which several mathematical models have been proposed, and just recently applied to humans: Lévy processes, composite and area-restricted search models, marginal value theorem, and Bayesian learning (among others). We conducted a systematic search in the literature to understand those mathematical models and study its applicability in human visual foraging. The review suggests that these models might be the first step, but they seem to be limited to fully comprehend foraging in visual search. There are essential variables involving human visual foraging still to be established and understood. Indeed, a jointly theoretical interpretation based on the different models reviewed could better account for its understanding. In addition, some other relevant variables, such as certain individual differences or time perception might be crucial to understanding visual foraging in humans.

Pandemic buying: Testing a psychological model of over-purchasing and panic buying using data from the United Kingdom and the Republic of Ireland during the early phase of the COVID-19 pandemic

The over-purchasing and hoarding of necessities is a common response to crises, especially in developed economies where there is normally an expectation of plentiful supply. This behaviour was observed internationally during the early stages of the Covid-19 pandemic. In the absence of actual scarcity, this behaviour can be described as 'panic buying' and can lead to temporary shortages. However, there have been few psychological studies of this phenomenon. Here we propose a psychological model of over-purchasing informed by animal foraging theory and make predictions about variables that predict over-purchasing by either exacerbating or mitigating the anticipation of future scarcity. These variables include additional scarcity cues (e.g. loss of income), distress (e.g. depression), psychological factors that draw attention to these cues (e.g. neuroticism) or to reassuring messages (eg. analytical reasoning) or which facilitate over-purchasing (e.g. income). We tested our model in parallel nationally representative internet surveys of the adult general population conducted in the United Kingdom (UK: N = 2025) and the Republic of Ireland (RoI: N = 1041) 52 and 31 days after the first confirmed cases of COVID-19 were detected in the UK and RoI, respectively. About three quarters of participants reported minimal over-purchasing. There was more over-purchasing in RoI vs UK and in urban vs rural areas. When over-purchasing occurred, in both countries it was observed across a wide range of product categories and was accounted for by a single latent factor. It was positively predicted by household income, the presence of children at home, psychological distress (depression, death anxiety), threat sensitivity (right wing authoritarianism) and mistrust of others (paranoia). Analytic reasoning ability had an inhibitory effect. Predictor variables accounted for 36% and 34% of the variance in over-purchasing in the UK and RoI respectively. With some caveats, the data supported our model and points to strategies to mitigate over-purchasing in future crises.

Stress reduces both model-based and model-free neural computations during flexible learning

Stressful events are thought to impair the flexible adaptation to changing environments, yet the underlying mechanisms are largely unknown. Here, we combined computational modeling and functional magnetic resonance imaging (fMRI) to elucidate the neurocomputational mechanisms underlying stress-induced deficits in flexible learning. Healthy participants underwent a stress or control manipulation before they completed, in the MRI scanner, a Markov decision task, frequently used to dissociate model-based and model-free contributions to choice, with repeated reversals of reward contingencies. Our results showed that stress attenuated the behavioral sensitivity to reversals in reward contingencies. Computational modeling further indicated that stress specifically affected the use of value computations for subsequent action selection. This reduced application of learned information on subsequent behavior was paralleled by a stress-induced reduction in inferolateral prefrontal cortex activity during model-free computations. For model-based learning, stress decreased specifically posterior, but not anterior, hippocampal activity, pointing to a functional segregation of model-based processing and its modulation by stress along the hippocampal longitudinal axis. Our findings shed light on the mechanisms underlying deficits in flexible learning under stress and indicate that, in highly dynamic environments, stress may hamper both model-based and model-free contributions to adaptive behavior.

Are adolescents more optimal decision-makers in novel environments? Examining the benefits of heightened exploration in a patch foraging paradigm

Adolescence is a period of heightened exploration relative to adulthood and childhood. This predisposition has been linked with negative behaviours related to risk-taking, including dangerous driving, substance misuse and risky sexual practices. However, recent models have argued that adolescents' heightened exploration serves a functional purpose within the lifespan, allowing adolescents to develop experiential knowledge of their surroundings. Yet, there is limited evidence that heightened exploration in adolescence is associated with positive outcomes. To address this, the present pre-registered study utilised a foraging paradigm with a sample of adolescents aged 16-17 (N = 68) and of adults aged 21 and above (N = 69). Participants completed a patch foraging task, which required them to choose between exploiting a known resource which gradually yields fewer rewards, and exploring a novel, unknown resource with a fresh distribution of rewards. Findings demonstrated that adolescents explored more than adults, which - in the context of the current task-represented more optimal patch foraging behaviour. These findings indicate that adolescents' heightened exploration can be beneficial, as they were able to effectively navigate unknown environments and accrue rewards more successfully than adults. This provides evidence that heightened exploration in adolescence, relative to adulthood, can lead to positive outcomes and contributes to our understanding of the role increased novelty-seeking plays at this point in the lifespan.

Acute stress enhances tolerance of uncertainty during decision-making

Acute stress has been shown to influence reward sensitivity, feedback learning, and risk-taking during decision-making, primarily through activation of the hypothalamic pituitary axis (HPA). However, it is unclear how acute stress affects decision-making among choices that vary in their degree of uncertainty. To address this question, we conducted two experiments in which participants repeatedly chose between two options-a high-uncertainty option that offered highly variable rewards but was advantageous in the long-term, and a low-uncertainty option that offered smaller yet more consistent rewards. The Socially Evaluated Cold Pressor Task (SECPT) was utilized to induce acute stress. Participants in Experiment 1 (N = 114) were exposed to either the SECPT or a warm-water control condition and then completed the decision-making under uncertainty task. Compared to the control condition, those exposed to the acute stress manipulation chose the high-uncertainty option that provided highly variable but larger rewards over the option that provided stable, smaller rewards. Experiment 2 (N = 95) incorporated a salivary cortisol measure. Results replicated the behavioral findings in Experiment 1 and demonstrated that the acute stress manipulation increased salivary cortisol. This work suggests that moderate acute stress is associated with tolerance of outcome variability in contexts that depend on learning to maximize rewards.

Decision Making, Stress Assessed by Physiological Response and Virtual Reality Stimuli

Many decisions must be made under stress; therefore, stress and decision-making are intrinsically related not only at the behavioral level but also at the neural level. Additionally, virtual reality tools have been proposed as a method to induce stress in the laboratory. This review focuses on answering the following research question: Does stress assessed by physiological variables of a subject under virtual reality stimuli increase the chances of error in decision-making? The reviewed studies were consulted in the following databases: PubMed, IEEE Xplore, and Science Direct. The analysis of the consulted literature indicates that the stress induced in the laboratory using virtual reality tools and the physiological response of the central and autonomous nervous system are complementary subjects and allow the design of training and support systems for the decision-making process

Biased belief updating and suboptimal choice in foraging decisions

Deciding which options to engage, and which to forego, requires developing accurate beliefs about the overall distribution of prospects. Here we adapt a classic prey selection task from foraging theory to examine how individuals keep track of an environment’s reward rate and adjust choices in response to its fluctuations. Preference shifts were most pronounced when the environment improved compared to when it deteriorated. This is best explained by a trial-by-trial learning model in which participants estimate the reward rate with upward vs. downward changes controlled by separate learning rates. A failure to adjust expectations sufficiently when an environment becomes worse leads to suboptimal choices: options that are valuable given the environmental conditions are rejected in the false expectation that better options will materialize. These findings offer a previously unappreciated parallel in the serial choice setting of observations of asymmetric updating and resulting biased (often overoptimistic) estimates in other domains.

In some types of decision-making, people must accept or forego an option without knowing what prospects might later be available. Here, the authors reveal how a key bias– asymmetric learning from negative versus positive outcomes – emerges in this type of decision.

Feedback processing is enhanced following exploration in continuous environments

Decision-making is typically studied by presenting participants with a small set of options. However, real-world behaviour, like foraging, often occurs in continuous environments. The degree to which human decision-making in discrete tasks generalizes to continuous tasks is questionable. For example, successful foraging comprises both exploration (learning about the environment) and exploitation (taking advantage of what is known). Although progress has been made in understanding the neural processes related to this trade-off in discrete tasks, it is currently unclear how, or whether, the same processes are involved in continuous tasks. To address this, we recorded electroencephalographic data while participants "dug for gold" by selecting locations on a map. Participants were cued beforehand that the map contained either a single patch of gold, or many patches of gold. We then used a computational model to classify participant responses as either exploitations, which were driven by previous reward locations and amounts, or explorations. Our participants were able to adjust their strategy based on reward distribution, exploring more in multi-patch environments and less in single-patch environments. We observed an enhancement of the feedback-locked P300, a neural signal previously linked to exploration in discrete tasks, which suggests the presence of a general neural system for managing the explore-exploit trade-off. Furthermore, the P300 was accompanied by an exploration-related enhancement of the late positive potential that was greatest in the multi-patch environment, suggesting a role for motivational processes during exploration.

Trait impulsivity and acute stress interact to influence choice and decision speed during multi-stage decision-making

Impulsivity and stress exposure are two factors that are associated with changes in reward-related behavior in ways that are relevant to both healthy and maladaptive decision-making. Nonetheless, little empirical work has examined the possible independent and joint effects of these factors upon reward learning. Here, we sought to examine how trait impulsivity and acute stress exposure affect participants' choice behavior and decision speed in a two-stage sequential reinforcement-learning task. We found that more impulsive participants were more likely to repeat second-stage choices after previous reward, irrespective of stress condition. Exposure to stress, on the other hand, was associated with an increased tendency to repeat second-stage choices independent of whether these choices previously led to a reward, and this tendency was exacerbated in more impulsive individuals. Such interaction effects between stress and impulsivity were also found on decision speed. Stress and impulsivity levels interacted to drive faster choices overall (again irrespective of reward) at both task stages, while reward received on the previous trial slowed subsequent first-stage choices, particularly among impulsive individuals under stress. Collectively, our results reveal novel, largely interactive effects of trait impulsivity and stress exposure and suggest that stress may reveal individual differences in decision-making tied to impulsivity that are not readily apparent in the absence of stress.

Glucocorticoids, male sexual signals, and mate choice by females: Implications for sexual selection

We review work relating glucocorticoids (GCs), male sexual signals, and mate choice by females to understand the potential for GCs to modulate the expression of sexually selected traits and how sexual selection potentially feeds back on GC regulation. Our review reveals that the relationship between GC concentrations and the quality of male sexual traits is mixed, regardless of whether studies focused on structural traits (e.g., coloration) or behavioral traits (e.g., vocalizations) or were examined in developmental or activational frameworks. In contrast, the few mate choice experiments that have been done consistently show that females prefer males with low GCs, suggesting that mate choice by females favors males that maintain low levels of GCs. We point out, however, that just as sexual selection can drive the evolution of diverse reproductive strategies, it may also promote diversity in GC regulation. We then shift the focus to females where we highlight evidence indicating that stressors or high GCs can dampen female sexual proceptivity and the strength of preferences for male courtship signals. Hence, even in cases where GCs are tightly coupled with male sexual signals, the strength of sexual selection on aspects of GC physiology can vary depending on the endocrine status of females. Studies examining how GCs relate to sexual selection may shed light on how variation in stress physiology, sexual signals, and mate choice are maintained in natural populations and may be important in understanding context-dependent relationships between GC regulation and fitness.

Placebo and nocebo effects and operant pain-related avoidance learning

INTRODUCTION

Research on learning in placebo and nocebo has relied predominantly on Pavlovian conditioning procedures. Operant learning procedures may more accurately model learning in real-life situations in which placebo and nocebo effects occur.

OBJECTIVES

To investigate the development and persistence of placebo and nocebo effects using an operant avoidance learning task.

METHODS

Pain-free participants (n = 58) could learn to avoid pain by performing movements that differed in difficulty and intensity of painful stimulation. Participants performed movements in 2 contexts. In the high cost of avoidance context, pain stimulus intensity reduced with increasing movement difficulty. In the low cost of avoidance context, contingencies were reversed. Participants rated pain expectations and pain intensity. During test, movement difficulties were unchanged, but participants always received a medium-intensity pain stimulus. Placebo and nocebo effects were defined as lower/higher pain intensity ratings for trajectories that previously resulted in low/high-intensity compared with medium-intensity stimulation.

RESULTS

As expected, participants acquired differential movement-pain expectations and differential movement choices. Testing with a medium-intensity pain stimulus quickly erased differences in movement choice across contexts, but differences in pain expectations were maintained. Pain modulation across context was in line with movement-pain expectations. However, we only observed placebo effects within the low cost of avoidance context and found no evidence of nocebo effects.

CONCLUSION

Operant learning can change pain expectations, pain modulation, and pain-related avoidance behavior. Persisting pain expectations suggest that acquired pain beliefs may be resistant to disconfirmation, despite self-initiated experience with novel pain-movement contingencies.

"We Won't Retire Without Skeletons in the Closet": Healthcare-Related Regrets Among Physicians and Nurses in German-Speaking Swiss Hospitals

Physicians and nurses are expected to systematically provide high-quality healthcare in a context marked by complexity, time pressure, heavy workload, and the influence of nonclinical factors on clinical decisions. Therefore, healthcare professionals must eventually deal with unfortunate events to which regret is a typical emotional reaction. Using semistructured interviews, 11 physicians and 13 nurses working in two different hospitals in the German-speaking part of Switzerland reported a total of 48 healthcare-related regret experiences. Intense feelings of healthcare-related regrets had far-reaching repercussions on participants' health, work-life balance, and medical practice. Besides active compensation strategies, social capital was the most important coping resource. Receiving superiors' support was crucial for reaffirming professional identity and helped prevent healthcare professionals from quitting their job. Findings suggest that training targeting emotional coping could be beneficial for quality of life and may ultimately lead to lower job turnover among healthcare professionals.

Updating Beliefs under Perceived Threat

Humans are better at integrating desirable information into their beliefs than undesirable information. This asymmetry poses an evolutionary puzzle, as it can lead to an underestimation of risk and thus failure to take precautionary action. Here, we suggest a mechanism that can speak to this conundrum. In particular, we show that the bias vanishes in response to perceived threat in the environment. We report that an improvement in participants' tendency to incorporate bad news into their beliefs is associated with physiological arousal in response to threat indexed by galvanic skin response and self-reported anxiety. This pattern of results was observed in a controlled laboratory setting (Experiment I), where perceived threat was manipulated, and in firefighters on duty (Experiment II), where it naturally varied. Such flexibility in how individuals integrate information may enhance the likelihood of responding to warnings with caution in environments rife with threat, while maintaining a positivity bias otherwise, a strategy that can increase well-being.SIGNIFICANCE STATEMENT The human tendency to be overly optimistic has mystified scholars and lay people for decades: How could biased beliefs have been selected over unbiased beliefs? Scholars have suggested that although the optimism bias can lead to negative outcomes, including financial collapse and war, it can also facilitate health and productivity. Here, we demonstrate that a mechanism generating the optimism bias, namely asymmetric information integration, evaporates under threat. Such flexibility could result in enhanced caution in dangerous environments while supporting an optimism bias otherwise, potentially increasing well-being.

The effects of acute stress on the calibration of persistence

People frequently fail to wait for delayed rewards after choosing them. These preference reversals are sometimes thought to reflect self-control failure. Other times, however, continuing to wait for a delayed reward may be counterproductive (e.g., when reward timing uncertainty is high). Research has demonstrated that people can calibrate how long to wait for rewards in a given environment. Thus, the role of self-control might be to integrate information about the environment to flexibly adapt behavior, not merely to promote waiting. Here we tested effects of acute stress, which has been shown to tax control processes, on persistence, and the calibration of persistence, in young adult human participants. Half the participants (n = 60) performed a task in which persistence was optimal, and the other half (n = 60) performed a task in which it was optimal to quit waiting for reward soon after each trial began. Each participant completed the task either after cold pressor stress or no stress. Stress did not influence persistence or optimal calibration of persistence. Nevertheless, an exploratory analysis revealed an "inverted-U" relationship between cortisol increase and performance in the stress groups, suggesting that choosing the adaptive waiting policy may be facilitated with some stress and impaired with severe stress.