Losses Motivate Cognitive Effort More Than Gains in Effort-Based Decision Making and Performance

Evaluating the Effectiveness of the Nudge Theory in Improving the Oral Self-Care of Schoolchildren with Refugee and Immigrant Backgrounds in Mashhad, Iran

Nudge theory proposes using subtle interventions to encourage individuals to make better decisions. The aim of this study was to evaluate the effectiveness of the Nudge theory in plaque control and assess caries experience among third-grade primary schoolchildren with refugee and immigrant backgrounds in Mashhad, Iran. Moreover, Afghan and Iranian schoolchildren were compared to assess differences in oral health outcomes. A quasi-experimental field trial was conducted in three public primary schools, comprising 309 participants approximately 9 years old. Interventions were randomly assigned to three schools: School I Messages based on Social Norms (MSN), School II Messages based on Fear of Negative Outcome (MFNO), and School III control group (C). MSN and MFNO received customized motivational video clips at baseline, while C only received Oral hygiene instruction (OHI). All participants received OHI, a brush, and toothpaste. Baseline plaque index (PI) and caries experience in primary and permanent dentition (dmft/DMFT) were recorded. PI was reassessed at two weeks, two months, and six months post-intervention. All data were subjected to statistical analysis. The mean PI decreased significantly in all three groups at the two-week follow-up (p < 0.01). The PI improvements declined over a six-month follow-up period in all groups, and the mean PI difference after six months compared to the pre-intervention was significant only in MSN and MFNO (p < 0.01), while C reverted almost to the pre-study level. Schoolchildren with at least one filled tooth or Iranian nationality showed a greater PI reduction (p < 0.01, p = 0.05). The overall mean ± SD dmft and DMFT were 4.24 ± 2.11 and 1.70 ± 1.24, respectively. Among all the examined participants, 32 (10.40%) individuals were caries-free. The mean dmft was statistically significantly higher in Afghan children than in Iranians (p = 0.01). MSN was more effective on PI reduction in the short term, while MFNO was more long-lasting. Using the Nudge theory via visual aids was more effective in motivating children to perform better oral self-care than solely traditional OHI.

The Neurobiology of Cognitive Fatigue and Its Influence on Effort-Based Choice

Feelings of cognitive fatigue emerge through repeated mental exertion and are ubiquitous in our daily lives. However, there is a limited understanding of the neurobiological mechanisms underlying the influence of cognitive fatigue on decisions to exert. We use functional magnetic resonance imaging to examine brain activity while participants make choices to exert effort for reward, before and after bouts of fatiguing cognitive exertion. We found that when participants became cognitively fatigued, they were more likely to choose to forgo higher levels of reward that required more effort. We describe a mechanism by which signals related to cognitive exertion in dlPFC influence effort value computations, instantiated by the insula, thereby influencing an individual's decisions to exert while fatigued. Our results suggest that cognitive fatigue plays a critical role in decisions to exert effort and provides a mechanistic link through which information about cognitive state shapes effort-based choice.

Acute stress promotes effort mobilization for safety-related goals

Although the acute stress response is a highly adaptive survival mechanism, much remains unknown about how its activation impacts our decisions and actions. Based on its resource-mobilizing function, here we hypothesize that this intricate psychophysiological process may increase the willingness (motivation) to engage in effortful, energy-consuming, actions. Across two experiments (n = 80, n = 84), participants exposed to a validated stress-induction protocol, compared to a no-stress control condition, exhibited an increased willingness to exert physical effort (grip force) in the service of avoiding the possibility of experiencing aversive electrical stimulation (threat-of-shock), but not for the acquisition of rewards (money). Use of computational cognitive models linked this observation to subjective value computations that prioritize safety over the minimization of effort expenditure; especially when facing unlikely threats that can only be neutralized via high levels of grip force. Taken together, these results suggest that activation of the acute stress response can selectively alter the willingness to exert effort for safety-related goals. These findings are relevant for understanding how, under stress, we become motivated to engage in effortful actions aimed at avoiding aversive outcomes.

Cognitive Effort-Based Decision-Making Across Experimental and Daily Life Indices in Younger and Older Adults

OBJECTIVES

The study investigated whether cognitive effort decision-making measured via a neuroeconomic paradigm that manipulated framing (gain vs. loss outcomes), could predict daily life engagement in mentally demanding activities in both younger and older adults.

METHOD

Younger and older adult participants (N = 310) completed the Cognitive Effort Discounting paradigm (Cog-ED), under both gain and loss conditions, to provide an experimental index of cognitive effort costs for each participant in each framing condition. A subset of participants (N = 230) also completed a 7-day Ecological Momentary Assessment (EMA) protocol measuring engagement in mentally demanding daily life activities.

RESULTS

In a large, online sample, we replicated a robust increase in cognitive effort costs among older, relative to younger, adults. Additionally, costs were found to be reduced in the loss relative to gain frame, although these effects were only reliable at high levels of task difficulty and were not moderated by age. Critically, participants who had lower effort costs in the gain frame tended to report engaging in more mentally demanding daily life activities, but the opposite pattern was observed in the loss frame. Further analyses demonstrated the specificity of reward-related cognitive motivation in predicting daily life mentally demanding activities.

DISCUSSION

Together, these results suggest that cognitive effort costs, as measured through behavioral choice patterns in a neuroeconomic decision-making task, can be used to predict and explain engagement in mentally demanding activities during daily life among both older and younger adults.

Disordered Decision Making: A Cognitive Framework for Apathy and Impulsivity in Huntington's Disease

A caregiver's all‐too‐familiar narrative ‐ “He doesn't think through what he does, but mostly he does nothing.” Apathy and impulsivity, debilitating and poorly understood, commonly co‐occur in Huntington's disease (HD). HD is a neurodegenerative disease with manifestations bridging clinical neurology and psychiatry. In addition to movement and cognitive symptoms, neurobehavioral disturbances, particularly apathy and impulsivity, are prevalent features of HD, occurring early in the disease course, often worsening with disease progression, and substantially reducing quality of life. Treatments remain limited, in part because of limited mechanistic understanding of these behavioral disturbances. However, emerging work within the field of decision‐making neuroscience and beyond points to common neurobiological mechanisms underpinning these seemingly disparate problems. These insights bridge the gap between underlying disease pathology and clinical phenotype, offering new treatment strategies, novel behavioral and physiological biomarkers of HD, and deeper understanding of human behavior. In this review, we apply the neurobiological framework of cost‐benefit decision making to the problems of apathy and impulsivity in HD. Through this decision‐making lens, we develop a mechanistic model that elucidates the occurrence of these behavioral disturbances and points to potential treatment strategies and crucial research priorities. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson Movement Disorder Society.

The Cost of Imagined Actions in a Reward-Valuation Task

Growing evidence suggests that humans and other animals assign value to a stimulus based not only on its inherent rewarding properties, but also on the costs of the action required to obtain it, such as the cost of time. Here, we examined whether such cost also occurs for mentally simulated actions. Healthy volunteers indicated their subjective value for snack foods while the time to imagine performing the action to obtain the different stimuli was manipulated. In each trial, the picture of one food item and a home position connected through a path were displayed on a computer screen. The path could be either large or thin. Participants first rated the stimulus, and then imagined moving the mouse cursor along the path from the starting position to the food location. They reported the onset and offset of the imagined movements with a button press. Two main results emerged. First, imagery times were significantly longer for the thin than the large path. Second, participants liked significantly less the snack foods associated with the thin path (i.e., with longer imagery time), possibly because the passage of time strictly associated with action imagery discounts the value of the reward. Importantly, such effects were absent in a control group of participants who performed an identical valuation task, except that no action imagery was required. Our findings hint at the idea that imagined actions, like real actions, carry a cost that affects deeply how people assign value to the stimuli in their environment.

Cognitive Control as a Multivariate Optimization Problem

A hallmark of adaptation in humans and other animals is our ability to control how we think and behave across different settings. Research has characterized the various forms cognitive control can take-including enhancement of goal-relevant information, suppression of goal-irrelevant information, and overall inhibition of potential responses-and has identified computations and neural circuits that underpin this multitude of control types. Studies have also identified a wide range of situations that elicit adjustments in control allocation (e.g., those eliciting signals indicating an error or increased processing conflict), but the rules governing when a given situation will give rise to a given control adjustment remain poorly understood. Significant progress has recently been made on this front by casting the allocation of control as a decision-making problem. This approach has developed unifying and normative models that prescribe when and how a change in incentives and task demands will result in changes in a given form of control. Despite their successes, these models, and the experiments that have been developed to test them, have yet to face their greatest challenge: deciding how to select among the multiplicity of configurations that control can take at any given time. Here, we will lay out the complexities of the inverse problem inherent to cognitive control allocation, and their close parallels to inverse problems within motor control (e.g., choosing between redundant limb movements). We discuss existing solutions to motor control's inverse problems drawn from optimal control theory, which have proposed that effort costs act to regularize actions and transform motor planning into a well-posed problem. These same principles may help shed light on how our brains optimize over complex control configuration, while providing a new normative perspective on the origins of mental effort.

Cognitive Effort Exertion Enhances Electrophysiological Responses to Rewarding Outcomes

Recent work has highlighted neural mechanisms underlying cognitive effort-related discounting of anticipated rewards. However, findings on whether effort exertion alters the subjective value of obtained rewards are inconsistent. Here, we provide a more nuanced account of how cognitive effort affects subsequent reward processing in a novel task designed to assess effort-induced modulations of the Reward Positivity, an event-related potential indexing reward-related neural activity. We found that neural responses to both gains and losses were significantly elevated in trials requiring more versus less cognitive effort. Moreover, time-frequency analysis revealed that these effects were mirrored in gain-related delta, but not in loss-related theta band activity, suggesting that people ascribed more value to high-effort outcomes. In addition, we also explored whether individual differences in behavioral effort discounting rates and reward sensitivity in the absence of effort may affect the relationship between effort exertion and subsequent reward processing. Together, our findings provide evidence that cognitive effort exertion can increase the subjective value of subsequent outcomes and that this effect may primarily rely on modulations of delta band activity.

Aversive motivation and cognitive control

Aversive motivation plays a prominent role in driving individuals to exert cognitive control. However, the complexity of behavioral responses attributed to aversive incentives creates significant challenges for developing a clear understanding of the neural mechanisms of this motivation-control interaction. We review the animal learning, systems neuroscience, and computational literatures to highlight the importance of experimental paradigms that incorporate both motivational context manipulations and mixed motivational components (e.g., bundling of appetitive and aversive incentives). Specifically, we postulate that to understand aversive incentive effects on cognitive control allocation, a critical contextual factor is whether such incentives are associated with negative reinforcement or punishment. We further illustrate how the inclusion of mixed motivational components in experimental paradigms enables increased precision in the measurement of aversive influences on cognitive control. A sharpened experimental and theoretical focus regarding the manipulation and assessment of distinct motivational dimensions promises to advance understanding of the neural, monoaminergic, and computational mechanisms that underlie the interaction of motivation and cognitive control.

Gain-loss asymmetry in delay and effort discounting of different amounts

Loss aversion entails that people attribute greater weight to losses than to equivalent gains. In terms of discounting, it is reflected in a higher discounting rate for gains than for losses. Research on delay discounting indicates that such gain-loss asymmetry may depend on the amount of the outcome being considered. Consequently, here we address the question of how gains and losses are discounted in delay or effort conditions (physical or cognitive) across four outcome amounts. Our results replicate previous findings for intertemporal choices by showing that losses are discounted more slowly than gains, but only for smaller amounts-with no evidence of an asymmetrical evaluation for larger amounts. In physical effort discounting, we found an inverse asymmetry for the smallest amount tested (gains are discounted less steeply than losses). However, this effect was absent for larger amounts. We found no evidence to support a gain-loss asymmetry in the evaluation of gains or losses in cognitive effort. Overall, our findings indicate that loss aversion may not be as pervasive as previously expected, at least when decisions are effort-based.

The role of the vestibular system in value attribution to positive and negative reinforcers

Somatic inputs originating from bioregulatory processes can guide cognition and behavior. One such bodily signal, mostly overlooked so far, is represented by visuo-vestibular coupling and its alteration, which in extreme cases may result in motion sickness. We argued that the inherently perturbed interoceptive state that follows can be a powerful determinant of human motivated behavior, resulting in a blunted response to appetitive stimuli and an exaggerated response to noxious ones. We sought to assess such differential impact of visuo-vestibular mismatches on value through a task involving conflict monitoring. We therefore administered to 42 healthy participants a modified version of the Flankers task, in which distractors (arrows, pointing in either a congruent or incongruent direction) signaled the availability of monetary incentives (gains, losses, or neutral trials). While performing the task, participants received either galvanic vestibular stimulation (GVS), or sham stimulation. We have found impaired behavioral performances when value, which was attached to task-irrelevant information, was at stake. Gains and losses, interestingly, dissociated, and only the latter caused enhanced interference costs in the task, suggesting that negative incentives may be more effective in capturing human attention than positive ones. Finally, we have found some weak evidence for GVS to further increase the processing of losses, as suggested by even larger interference costs in this condition. Results were, however, overall ambiguous, and suggest that much more research is needed to better understand the link between the vestibular system and motivation.