A neuropsychological approach to understanding risk-taking for potential gains and losses

Value-based decision-making deficits in non-suicidal self-injury: A systematic review and meta-analysis

Non-suicidal self-injury (NSSI) is a significant global mental health issue. However, whether the deficit in value-based decision-making processing is the consistently key mechanisms of NSSI across studies with heterogeneous decision-making tasks remains uncertain. Hence, we reviewed literature on value-based decision-making and its moderating factors in NSSI, and then conducted a meta-analysis on studies in NSSI, specifically with Iowa Gambling Task. In total, 31 studies with 8417 participants aged from 8 to 50 were included in the systematic review of and 8 studies with 657 participants aged from 10 to 37 included in the meta-analysis. We found consistent impairments in value-based decision-making processing among individuals who engage in NSSI. Importantly, age is a significant moderator, with adolescents with NSSI performance worse, exhibiting increased reward sensitivity and preference for immediate rewards compared to other age groups. These results suggest the important role of value-based decision making in NSSI behaviors, especially during the development of adolescents. Our work provides new insights and integrative evidence for decision-making based prevention and intervention of NSSI.

Context Modulates Perceived Fairness in Altruistic Punishment: Neural Signatures from ERPs and EEG Oscillations

Social norms and altruistic punitive behaviours are both based on the integration of information from multiple contexts. Individual behavioural performance can be altered by loss and gain contexts, which produce different mental states and subjective perceptions. In this study, we used event-related potential and time-frequency techniques to examine performance on a third-party punishment task and to explore the neural mechanisms underlying context-dependent differences in punishment decisions. The results indicated that individuals were more likely to reject unfairness in the context of loss (vs. gain) and to increase punishment as unfairness increased. In contrast, fairness appeared to cause an early increase in cognitive control signal enhancement, as indicated by the P2 amplitude and theta oscillations, and a later increase in emotional and motivational salience during decision-making in gain vs. loss contexts, as indicated by the medial frontal negativity and beta oscillations. In summary, individuals were more willing to sanction violations of social norms in the loss context than in the gain context and rejecting unfair losses induced more equity-related cognitive conflict than accepting unfair gains, highlighting the importance of context (i.e., gain vs. loss) in equity-related social decision-making processes.

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

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

Insular and Striatal Correlates of Uncertain Risky Reward Pursuit in Schizophrenia

BACKGROUND AND HYPOTHESIS

Risk-taking in specific contexts can be beneficial, leading to rewarding outcomes. Schizophrenia is associated with disadvantageous decision-making, as subjects pursue uncertain risky rewards less than controls. However, it is unclear whether this behavior is associated with more risk sensitivity or less reward incentivization. Matching on demographics and intelligence quotient (IQ), we determined whether risk-taking was more associated with brain activation in regions affiliated with risk evaluation or reward processing.

STUDY DESIGN

Subjects (30 schizophrenia/schizoaffective disorder, 30 controls) completed a modified, fMRI Balloon Analogue Risk Task. Brain activation was modeled during decisions to pursue risky rewards and parametrically modeled according to risk level.

STUDY RESULTS

The schizophrenia group exhibited less risky-reward pursuit despite previous adverse outcomes (Average Explosions; F(1,59) = 4.06, P = .048) but the comparable point at which risk-taking was volitionally discontinued (Adjusted Pumps; F(1,59) = 2.65, P = .11). Less activation was found in schizophrenia via whole brain and region of interest (ROI) analyses in the right (F(1,59) = 14.91, P < 0.001) and left (F(1,59) = 16.34, P < 0.001) nucleus accumbens (NAcc) during decisions to pursue rewards relative to riskiness. Risk-taking correlated with IQ in schizophrenia, but not controls. Path analyses of average ROI activation revealed less statistically determined influence of anterior insula upon dorsal anterior cingulate bilaterally (left: χ2 = 12.73, P < .001; right: χ2 = 9.54, P = .002) during risky reward pursuit in schizophrenia.

CONCLUSIONS

NAcc activation in schizophrenia varied less according to the relative riskiness of uncertain rewards compared to controls, suggesting aberrations in reward processing. The lack of activation differences in other regions suggests similar risk evaluation. Less insular influence on the anterior cingulate may relate to attenuated salience attribution or inability for risk-related brain region collaboration to sufficiently perceive situational risk.

Theory of brain complexity and marital behaviors: The application of complexity science and neuroscience to explain the complexities of marital behaviors

The extant theories on the quality and stability of marital relationships have some difficulties in explaining some of the complexities of marital behaviors. The present article is an initial attempt to explain the complexities of marital behaviors based on the science of complexity and neuroscience. This article proposes a new theoretical framework relying on this simple argument that marital behaviors, as one of the most complex human behaviors, are the product of one's brain's complex adaptive system (CAS). Hence, to understand the complexities of marital behaviors, a movement toward familiarity with the brain's CAS involved in marital behaviors needs to be started. The article presents the theory of brain complexity and marital behaviors (BCM) and outlines its assumptions, concepts, and propositions. Then, BCM is compared with the extant theories on happy and stable marriage, and finally, it was concluded by discussing the testability and the potential application of the theory. This article might inspire interdisciplinary studies of marital relationships, complex systems, and neuroscience and may have considerable practical implications.

Is loss avoidance differentially rewarding in adolescents versus adults? Differences in ventral striatum and anterior insula activation during the anticipation of potential monetary losses

Avoiding loss is a crucial, adaptive guide to human behavior. While previous developmental research has primarily focused on gaining rewards, less attention has been paid to loss processing and its avoidance. In daily life, it is often unknown how likely an action will result in a loss, making the role of uncertainty in loss processing particularly important. By using functional magnetic resonance imaging, we investigated the influence of varying outcome probabilities (12%, 34%, and 67%) on brain regions implicated in loss processing (ventral striatum (VS), anterior insula (AI)) by comparing 28 adolescents (10-18 years) and 24 adults (22-32 years) during the anticipation of potential monetary loss.Overall, results revealed slower RTs in adolescents compared to adults with both groups being faster in the experimental (monetary condition) vs. control trials (verbal condition). Fastest RTs were observed for the 67% outcome probability in both age groups. An age group × outcome probability interaction effect revealed the greatest differences between the groups for the 12% vs. the 67% outcome probability. Neurally, both age groups demonstrated a higher percent signal change in the VS and AI during the anticipation of potential monetary loss versus the verbal condition. However, adults demonstrated an even greater activation of VS and AI than adolescents during the anticipation of potential monetary loss, but not during the verbal condition. This may indicate that adolescents differ from adults regarding their experience of avoiding losing monetary rewards.

Microsurgical anatomy and insular connectivity of the cerebral opercula

OBJECTIVE

Radiological, anatomical, and electrophysiological studies have shown the insula and cerebral opercula to have extremely high functionality. Because of this complexity, interventions in this region cause higher morbidity compared to those in other areas of the brain. In most early studies of the insula and white matter pathways, insular dissection was begun after the opercula were removed. In this study, the authors examined the insula and deep white matter pathways to evaluate the insula as a whole with the surrounding opercula.

METHODS

Twenty formalin-fixed adult cerebral hemispheres were studied using fiber microdissection techniques and examination of sectional anatomy. Dissections were performed from lateral to medial, medial to lateral, inferior to superior, and superior to inferior. A silicone brain model was used to show the normal gyral anatomy. Sections and fibers found at every stage of dissection were photographed with a professional camera. MRI tractography studies were used to aid understanding of the dissections.

RESULTS

The relationships between the insula and cerebral opercula were investigated in detail through multiple dissections and sections. The relationship of the extreme and external capsules with the surrounding opercula and the fronto-occipital fasciculus with the fronto-orbital operculum was demonstrated. These findings were correlated with the tractography studies. Fibers of the extreme capsule connect the medial aspect of the opercula with the insula through the peri-insular sulcus. Medial to lateral dissections were followed with the removal of the central core structures, and in the last step, the medial surface of the cerebral opercula was evaluated in detail.

CONCLUSIONS

This anatomical study clarifies our understanding of the insula and cerebral opercula, which have complex anatomical and functional networks. This study also brings a new perspective to the connection of the insula and cerebral opercula via the extreme and external capsules.

Self‐affirmation reduces uncertainty aversion for potential gains

Decisions about one's health are often accompanied by uncertain outcomes, which may be either positively or negatively valenced. The presence of this uncertainty, which can range along a continuum from risk to ambiguity (i.e., decisions in which the outcome probabilities are known or unknown), can be perceived as threatening, and individuals tend to be averse to uncertain outcomes, and will attempt to avoid uncertainty when possible. We proposed that one way to reduce uncertainty aversion could be to provide opportunities to affirm one's core values, or "self-affirmation." Prior research has suggested that self-affirmation promotes health behaviour by providing a buffer against potential threats to the self. However, the degree to which self-affirmation affects decision-making is still unclear. Across two studies, we tested the effects of a self-affirmation manipulation on risk (Study 1) and ambiguity (Study 2) preferences for both potential gains and losses. In both studies, we found that, compared to the non-affirmed group, affirmed individuals were more accepting of uncertainty when the decision involved potential gains, but not for potential losses. Further, for risky decisions, the increased acceptance of uncertainty came at the expense of making choices consistent with expected value, such that self-affirmed individuals made more disadvantageous choices than non-affirmed individuals. Our results suggest both benefits and costs of self-affirmation in the context of risky choice, an important finding given the many applications of self-affirmation in behavioral decision making contexts.

“Sound” Decisions: The Combined Role of Ambient Noise and Cognitive Regulation on the Neurophysiology of Food Cravings

Our ability to evaluate long-term goals over immediate rewards is manifested in the brain’s decision circuit. Simplistically, it can be divided into a fast, impulsive, reward “system 1” and a slow, deliberate, control “system 2.” In a noisy eating environment, our cognitive resources may get depleted, potentially leading to cognitive overload, emotional arousal, and consequently more rash decisions, such as unhealthy food choices. Here, we investigated the combined impact of cognitive regulation and ambient noise on food cravings through neurophysiological activity. Thirty-seven participants were recruited for an adapted version of the Regulation of Craving (ROC) task. All participants underwent two sessions of the ROC task; once with soft ambient restaurant noise (∼50 dB) and once with loud ambient restaurant noise (∼70 dB), while data from electroencephalography (EEG), electrodermal activity (EDA), and self-reported craving were collected for all palatable food images presented in the task. The results indicated that thinking about future (“later”) consequences vs. immediate (“now”) sensations associated with the food decreased cravings, which were mediated by frontal EEG alpha power. Likewise, “later” trials also increased frontal alpha asymmetry (FAA) —an index for emotional motivation. Furthermore, loud (vs. soft) noise increased alpha, beta, and theta activity, but for theta activity, this was solely occurring during “later” trials. Similarly, EDA signal peak probability was also higher during loud noise. Collectively, our findings suggest that the presence of loud ambient noise in conjunction with prospective thinking can lead to the highest emotional arousal and cognitive load as measured by EDA and EEG, respectively, both of which are important in regulating cravings and decisions. Thus, exploring the combined effects of interoceptive regulation and exteroceptive cues on food-related decision-making could be methodologically advantageous in consumer neuroscience and entail theoretical, commercial, and managerial implications.

Investigating the Neural Correlates of the Affect Heuristic Using Functional Magnetic Resonance Imaging

This study investigated the neural correlates of the so-called "affect heuristic," which refers to the phenomenon whereby individuals tend to rely on affective states rather than rational deliberation of utility and probabilities during judgments of risk and utility of a given event or scenario. The study sought to explore whether there are shared regional activations during both judgments of relative risk and relative benefit of various scenarios, thus being a potential candidate of the affect heuristic. Using functional magnetic resonance imaging, we developed a novel risk perception task, based on a preexisting behavioral task assessing the affect heuristic. A whole-brain voxel-wise analysis of a sample of participants (n = 42) during the risk and benefit conditions revealed overlapping clusters in the left insula, left inferior frontal gyrus, and left medial frontal gyrus across conditions. Extraction of parameter estimates of these clusters revealed that activity of these regions during both tasks was inversely correlated with a behavioral measure assessing the inclination to use the affect heuristic. More activity in these areas during risk judgments reflect individuals' ability to disregard momentary affective impulses. The insula may be involved in integrating viscero-somatosensory information and forming a representation of the current emotional state of the body, whereas activity in the left inferior frontal gyrus and medial frontal gyrus indicates that executive processes may be involved in inhibiting the impulse of making judgments in favor of deliberate risk evaluations.

The role of cognition and reinforcement sensitivity in older adult decision-making under explicit risk conditions

Introduction: Previous research has suggested that individual differences in executive functions, memory and reinforcement sensitivity are associated with performance on behavioral decision-making tasks. Decision-making performance may also decline with age, however there is a lack of research on the interplay of cognitive and affective processes, and their impact on older adult decision-making. This study examined associations between executive functions, memory and reinforcement sensitivity on the Game of Dice Task (a measure of decision-making under explicit risk) among older adults.Method: One thousand and two older adults without cognitive impairment (aged 72-78 years) participated as part of an Australian longitudinal cohort study (the Personality and Total Health Through Life study). Decision-making sub-types were identified through cluster analysis and multinomial logistic regression was used to assess associations with measures of cognition and reinforcement sensitivity.Results: Cluster analysis identified three decision-making sub-types, which we label "advantageous," "disadvantageous" and "switching." Multivariate analyses found that relative to the mid-performing "switching" sub-type, advantageous decision-makers were more likely to be younger, male and have higher scores on a test of verbal learning. Disadvantageous decision-makers were more likely to have poorer scores on some components of executive function (set shifting, but not working memory or inhibitory control), although this effect was partly attenuated by a measure of reinforcement sensitivity (reward responsiveness).Conclusion: These results indicate that specific components of learning and executive functions are influential in decision-making under explicit risk among a sample of older adults.

Expected value and sensitivity to punishment modulate insular cortex activity during risky decision making

The exact contribution of the insula to risky decision making remains unclear, as are the specific outcome parameters and inter-individual characteristics that modulate insular activity prior to a risky choice. This fMRI study examines the contributions of outcome valence, magnitude, probability, and expected value (EV) to insular activity during risky decision making, and explores the influence of sensitivity to reward and to punishment, and anxiety, to insular activity. Participants (N = 31) performed a gambling task requiring choice between two roulettes with different outcome magnitude, probability and EV, under gain and loss conditions separately, and filled questionnaires assessing sensitivity to punishment/reward, and state/trait anxiety. Parametric analyses were conducted to examine the modulation of brain activity during decision making in relation to each task parameter. Correlations were examined between insular activity and psychometric questionnaires. EV of the selected roulette was associated with right posterior insula activation during decision making. Higher sensitivity to punishment was associated with lower bilateral insular activation. These findings suggest that the right posterior insula is involved in tracking the EV of a risky option during decision making. The involvement of the insula when making risky decisions also appears to be influenced by inter-individual differences in sensitivity to punishment.

Effects of Total and Partial Sleep Deprivation on Reflection Impulsivity and Risk-Taking in Deliberative Decision-Making

STUDY OBJECTIVES

To evaluate the effects of total and partial sleep deprivation on reflection impulsivity and risk-taking in tasks requiring deliberative decision-making processes.

PARTICIPANTS AND METHODS

Seventy-four healthy young adults were selected to participate in two independent experiments, each consisting of a crossover design. In Experiment 1, 32 participants were tested after one night of regular sleep (RS), and after one night of total sleep deprivation (TSD). In Experiment 2, 42 participants were tested following five nights of RS and after five nights of partial sleep deprivation (PSD), implying five hours of sleep per night. In both the experiments, two deliberative decision-making tasks were administered, involving different decision-making constructs. The Mosaic Task (MT) assessed reflection impulsivity, the tendency to gather information before making a decision. The Columbia Card Task cold version (CCTc) evaluated risk-taking propensity in a dynamic environment.

RESULTS

Unlike TSD, PSD led to an increment of reflection impulsivity and risk-taking. Nevertheless, analyses taking into account the individuals' baseline (RS) performance showed consistent results between the two experimental sleep manipulations. Participants who gathered more information to make decisions in the MT when well-rested, then relied on less evidence under sleep loss, and more cautious participants in the CCTc tended to make riskier decisions.

CONCLUSION

Results pointed to differential consequences of sleep deprivation depending on the habitual way to respond during decision-making involving deliberative reasoning processes. Results were interpreted according to a putative interaction between sleep loss effect and individual difference factors.

Dopaminergic influences on risk preferences of Parkinson's disease patients

Clinicians are increasingly recognizing impulse control disorders (ICDs) as a complication of dopaminergic treatment in Parkinson's disease (PD). Considering the pivotal role of dopamine in reward information processing, ICDs may originate from dysregulation of reward-oriented behavior, and the behavioral changes may be reflected in shifts of psychological risk preference during decision-making. We used a behavioral economics paradigm to evaluate quantitatively the risk preferences of PD patients in levodopa on and off states. We also examined age-matched healthy controls. We found that levodopa increased the subjective value and prolonged the decision time in PD patients. These effects are apparently not explained by kinematic improvements but are attributed to psychological shifts of risk preferences and increased attention during risky decision-making. The risk preferences of healthy controls were similar to those of PD on levodopa treatment. The risk preferences of PD patients were not correlated with the scores of routine cognitive batteries, suggesting that dopamine-sensitive risk preferences are independent of cognitive capacities as measured by conventional batteries, including general intelligence, memory, and frontal functioning. By contrast, apathy and ICD partially predicted the risk attitude in PD patients, suggesting a common background of limbic origin behind these properties. The present results demonstrated that dopamine deficiency in off-state PD leads to risk-avoiding behavior and levodopa treatment increases the risk preferences. Behavioral economics framework is useful to evaluate short-term psychological changes in response to levodopa in PD patients.

Anticipatory feelings: Neural correlates and linguistic markers

This review introduces anticipatory feelings (AF) as a new construct related to the process of anticipation and prediction of future events. AF, defined as the state of awareness of physiological and neurocognitive changes that occur within an oganism in the form of a process of adapting to future events, are an important component of anticipation and expectancy. They encompass bodily-related interoceptive and affective components and are influenced by intrapersonal and dispositional factors, such as optimism, hope, pessimism, or worry. In the present review, we consider evidence from animal and human research, including neuroimaging studies, to characterize the brain structures and brain networks involved in AF. The majority of studies reviewed revealed three brain regions involved in future oriented feelings: 1) the insula; 2) the ventromedial prefrontal cortex (vmPFC); and 3) the amygdala. Moreover, these brain regions were confirmed by a meta-analysis, using a platform for large-scale, automated synthesis of fMRI data. Finally, by adopting a neurolinguistic and a big data approach, we illustrate how AF are expressed in language.

Gain-loss situation modulates neural responses to self-other decision making under risk

Although self-other behavioral differences in decision making under risk have been observed in some contexts, little is known about the neural mechanisms underlying such differences. Using functional magnetic resonance imaging (fMRI) and the cups task, in which participants choose between risky and sure options for themselves and others in gain and loss situations, we found that people were more risk-taking when making decisions for themselves than for others in loss situations but were equally risk-averse in gain situations. Significantly stronger activations were observed in the dorsomedial prefrontal cortex (dmPFC) and anterior insula (AI) when making decisions for the self than for others in loss situations but not in gain situations. Furthermore, the activation in the dmPFC was stronger when people made sure choices for others than for themselves in gain situations but not when they made risky choices, and was both stronger when people made sure and risky choices for themselves than for others in loss situations. These findings suggest that gain-loss situation modulates self-other differences in decision making under risk, and people are highly likely to differentiate the self from others when making decisions in loss situations.

Learning Process During Risk Detection in Adolescents With ADHD

OBJECTIVE

To evaluate and describe the performance during the learning process of risk-detection versus risk-benefit processing in adolescents diagnosed with ADHD.

METHOD

Thirty-five adolescents with ADHD and 26 paired controls participated. The tests applied are Iowa-type children version paradigm and Stroop test.

RESULTS

Adolescents with ADHD exhibited lower risk-benefit processing capacity and lower ability to detect risk selections; main findings also indicate that adolescents with ADHD were slower to learn to avoid risk choices. In addition, they also presented a deficient inhibitory control.

CONCLUSION

Results confirm the presence of a deficit in advantageous choice in adolescents with ADHD. By providing a measure of risk choice-and not only a net score-we show that adolescents with ADHD also fail to avoid risk choices. This deficit is mainly because they are slower in learning how to avoid risk choices, and not simply deficient. Literature is scarce concerning studies with Iowa-type paradigms in samples intregated exclusively by adolescents. More research is needed to clarify the nature of these deficiencies.

Reinforcement learning models of risky choice and the promotion of risk-taking by losses disguised as wins in rats

Risky decisions are inherently characterized by the potential to receive gains or incur losses, and these outcomes have distinct effects on subsequent decision-making. One important factor is that individuals engage in loss-chasing, in which the reception of a loss is followed by relatively increased risk-taking. Unfortunately, the mechanisms of loss-chasing are poorly understood, despite the potential importance for understanding pathological choice behavior. The goal of the present experiment was to illuminate the mechanisms governing individual differences in loss-chasing and risky-choice behaviors. Rats chose between a low-uncertainty outcome that always delivered a variable amount of reward and a high-uncertainty outcome that probabilistically delivered reward. Loss-processing and loss-chasing were assessed in the context of losses disguised as wins (LDWs), which are loss outcomes that are presented along with gain-related stimuli. LDWs have been suggested to interfere with adaptive decision-making in humans and thus potentially increase loss-making. Here, the rats presented with LDWs were riskier, in that they made more choices for the high-uncertainty outcome. A series of nonlinear models were fit to individual rats' data to elucidate the possible psychological mechanisms that best account for individual differences in high-uncertainty choices and loss-chasing behaviors. The models suggested that the rats presented with LDWs were more prone to showing a stay bias following high-uncertainty outcomes compared to rats not presented with LDWs. These results collectively suggest that LDWs acquire conditioned reinforcement properties that encourage continued risk-taking and increase loss-chasing following previous high-risk decisions. (PsycINFO Database Record

Decision-making impairments following insular and medial temporal lobe resection for drug-resistant epilepsy

Besides the prefrontal cortex, the insula and medial structures of the temporal lobe are thought to be involved in risky decision-making. However, their respective contributions to decision processes remain unclear due to the lack of studies involving patients with isolated insular damage. We assessed adult patients who underwent resection of the insula (n = 13) or of the anterior temporal lobe (including medial structures) (n = 13) as part of their epilepsy surgery, and a group of healthy volunteers (n = 20), on the Iowa Gambling Task (IGT) and on the Cups Task. Groups were matched on sociodemographic, estimated-IQ and surgery-related factors. On the IGT, patients with temporal lobe resection performed significantly worse than both the insular and healthy control groups, as they failed to learn which decks were advantageous on the long-term. On the Cups Task, the insular and temporal groups both showed impaired sensitivity to expected value in the loss domain, when compared with healthy controls. These findings provide clinical evidence that the insula and mesiotemporal structures are specifically involved in risky decision-making when facing a potential loss, and that temporal structures are also involved in learning the association between behavior and consequences in the long-term.

Structure and Function of the Human Insula

The insular cortex, or "Island of Reil," is hidden deep within the lateral sulcus of the brain. Subdivisions within the insula have been identified on the basis of cytoarchitectonics, sulcal landmarks, and connectivity. Depending on the parcellation technique used, the insula can be divided into anywhere between 2 and 13 distinct subdivisions. The insula subserves a wide variety of functions in humans ranging from sensory and affective processing to high-level cognition. Here, we provide a concise summary of known structural and functional features of the human insular cortex with a focus on lesion case studies and recent neuroimaging evidence for considerable functional heterogeneity of this brain region.

Resting-State Functional Connectivity Within Medial Prefrontal Cortex Mediates Age Differences in Risk Taking

To investigate the association between age-related changes in risk taking and resting-state functional activity, we recorded resting-state scans from both young (n = 26) and older adults (n = 27). In addition, all participants completed two decision-making tasks: the Cambridge Gambling Task and the Balloon Analogue Risk Task. We found that older adults showed decreased functional connectivity within the medial prefrontal cortex, particularly between the ventromedial prefrontal cortex and the dorsal medial prefrontal cortex. Moreover, these changes in resting-state functional connectivity were associated with the individuals' risk-taking behavior, and mediated the influence of age on risk taking.

Dissociable neural processes during risky decision-making in individuals with Internet-gaming disorder

Risk-taking is purported to be central to addictive behaviors. However, for Internet gaming disorder (IGD), a condition conceptualized as a behavioral addiction, the neural processes underlying impaired decision-making (risk evaluation and outcome processing) related to gains and losses have not been systematically investigated. Forty-one males with IGD and 27 healthy comparison (HC) male participants were recruited, and the cups task was used to identify neural processes associated with gain- and loss-related risk- and outcome-processing in IGD. During risk evaluation, the IGD group, compared to the HC participants, showed weaker modulation for experienced risk within the bilateral dorsolateral prefrontal cortex (DLPFC) (t = - 4.07; t = - 3.94; PFWE  < 0.05) and inferior parietal lobule (IPL) (t = - 4.08; t = - 4.08; PFWE  < 0.05) for potential losses. The modulation of the left DLPFC and bilateral IPL activation were negatively related to addiction severity within the IGD group (r = - 0.55; r = - 0.61; r = - 0.51; PFWE  < 0.05). During outcome processing, the IGD group presented greater responses for the experienced reward within the ventral striatum, ventromedial prefrontal cortex, and orbitofrontal cortex (OFC) (t = 5.04, PFWE  < 0.05) for potential gains, as compared to HC participants. Within the IGD group, the increased reward-related activity in the right OFC was positively associated with severity of IGD (r = 0.51, PFWE  < 0.05). These results provide a neurobiological foundation for decision-making deficits in individuals with IGD and suggest an imbalance between hypersensitivity for reward and weaker risk experience and self-control for loss. The findings suggest a biological mechanism for why individuals with IGD may persist in game-seeking behavior despite negative consequences, and treatment development strategies may focus on targeting these neural pathways in this population.

Functional and Structural Signatures of the Anterior Insula are associated with Risk-taking Tendency of Analgesic Decision-making

In a medical context, decision-making is associated with complicated assessment of gains, losses and uncertainty of outcomes. We here provide novel evidence about the brain mechanisms underlying decision-making of analgesic treatment. Thirty-six healthy participants were recruited and completed the Analgesic Decision-making Task (ADT), which quantified individual tendency of risk-taking (RPI), as the frequency of choosing a riskier option to relieve pain. All the participants received resting-state (rs) functional magnetic resonance imaging (MRI) and structural MRI. On rs-functional connectome, degree centrality (DC) of the bilateral anterior insula (aINS) was positively correlated with the RPI. The functional connectivity between the aINS, the nucleus accumbens and multiple brain regions, predominantly the medial frontal cortex, was positively correlated with the RPI. On structural signatures, the RPI was positively correlated with grey matter volume at the right aINS, and such an association was mediated by DC of the left aINS. Regression analyses revealed that both DC of the left aINS and participants’ imagined pain relief, as the utility of pain reduction, could predict the individual RPI. The findings suggest that the functional and structural brain signature of the aINS is associated with the individual differences of risk-taking tendency in the context of analgesic decision-making.

Anodal Stimulation of the Left DLPFC Increases IGT Scores and Decreases Delay Discounting Rate in Healthy Males

Previous correlational imaging studies have implicated the dorsolateral prefrontal cortex (DLPFC) in decision making. Using High-Definition Transcranial Direct Current Stimulation (HD-tDCS), the present study directly investigated the causal role of the DLPFC in performing the Iowa Gambling Task (IGT) and the Inter-Temporal Choice (ITC) task. Three experiments were conducted: Experiment 1 (N = 41) to study the left DLPFC, Experiment 2 (N = 49) to study the right DLPFC, and Experiment 3 (N = 20, a subset of those in Experiment 1) to switch the experimental and control conditions. All participants were healthy male college students. For Experiments 1 and 2, participants were randomly assigned to either the HD-tDCS or the sham stimulation condition. For Experiment 3, participants were assigned to the condition they were not in during Experiment 1. Results showed that HD-tDCS over the left DLPFC increased IGT score, decreased the recency parameter in IGT, and lowered delay discounting rate (k) in the ITC task. We discussed the potential roles of impulse control and time perception in mediating the effect of tDCS stimulation of left DLPFC on decision making. Our results have clinical implications for the treatment of disorders involving poor decision-making, such as addictions.

Altered Value Coding in the Ventromedial Prefrontal Cortex in Healthy Older Adults

Previous work suggests that aging is associated with changes in risk taking but less is known about their underlying neural basis, such as the potential age differences in the neural processing of value and risk. The goal of the present study was to investigate adult age differences in functional neural responses in a naturalistic risk-taking task. Twenty-six young adults and 27 healthy older adults completed the Balloon Analogue Risk Task while undergoing functional magnetic resonance imaging. Young and older adults showed similar overt risk-taking behavior. Group comparison of neural activity in response to risky vs. control stimuli revealed similar patterns of activation in the bilateral striatum, anterior insula (AI) and ventromedial prefrontal cortex (vmPFC). Group comparison of parametrically modulated activity in response to continued pumping similarly revealed comparable results for both age groups in the AI and, potentially, the striatum, yet differences emerged for regional activity in the vmPFC. At whole brain level, insular, striatal and vmPFC activation was predictive of behavioral risk taking for young but not older adults. The current results are interpreted and discussed as preserved neural tracking of risk and reward in the AI and striatum, respectively, but altered value coding in the vmPFC in the two age groups. The latter finding points toward older adults exhibiting differential vmPFC-related integration and value coding. Furthermore, neural activation holds differential predictive validity for behavioral risk taking in young and older adults.

Plasticity of risky decision making among maltreated adolescents: Evidence from a randomized controlled trial

Childhood maltreatment has lasting negative effects throughout the life span. Early intervention research has demonstrated that these effects can be remediated through skill-based, family-centered interventions. However, less is known about plasticity during adolescence, and whether interventions are effective many years after children experience maltreatment. This study investigated this question by examining adolescent girls' ability to make advantageous decisions in the face of risk using a validated decision-making task; performance on this task has been associated with key neural regions involved in affective processing and executive functioning. Maltreated foster girls (n = 92), randomly assigned at age 11 to either an intervention designed to prevent risk-taking behaviors or services as usual (SAU), and nonmaltreated age and socioeconomic status matched girls living with their biological parent(s) (n = 80) completed a decision-making task (at age 15-17) that assessed risk taking and sensitivity to expected value, an index of advantageous decision making. Girls in the SAU condition demonstrated the greatest decision-making difficulties, primarily for risks to avoid losses. In the SAU group, frequency of neglect was related to greater difficulties in this area. Girls in the intervention condition with less neglect performed similarly to nonmaltreated peers. This research suggests that early maltreatment may impact decision-making abilities into adolescence and that enriched environments during early adolescence provide a window of plasticity that may ameliorate these negative effects.

Divergence and Convergence of Risky Decision Making Across Prospective Gains and Losses: Preferences and Strategies

People choose differently when facing potential gains than when facing potential losses. Clear gross differences in decision making between gains and losses have been empirically demonstrated in numerous studies (e.g., framing effect, risk preference, loss aversion). However, theories maintain that there are strong underlying connections (e.g., reflection effect). We investigated the relationship between gains and losses decision making, examining risk preferences, and choice strategies (the reliance on option information) using a monetary gamble task with interleaved trials. For risk preferences, participants were on average risk averse in the gains domain and risk neutral/seeking in the losses domain. We specifically tested for a theoretically hypothesized correlation between individual risk preferences across the gains and losses domains (the reflection effect), but found no significant relationship in the predicted direction. Interestingly, despite the lack of reflected risk preferences, cross-domain risk preferences were still informative of individual choice behavior. For choice strategies, in both domains participants relied more heavily on the maximizing strategy than the satisficing strategy, with increased reliance on the maximizing strategy in the losses domain. Additionally, while there is no mathematical reliance between the risk preference and strategy metrics, within both domains there were significant relationships between risk preferences and strategies-the more participants relied upon the maximizing strategy the more risk neutral they were (equating value and utility maximization). These results demonstrate the complexity of gains and losses decision making, indicating the apparent contradiction that their underlying cognitive/neural processes are both dissociable and overlapping.

Roles of the Different Sub-Regions of the Insular Cortex in Various Phases of the Decision-Making Process

This paper presents a coherent account of the role of the insular cortex (IC) in decision-making. We follow a conceptualization of decision-making that is very close to one previously proposed by Ernst and Paulus (2005): that the decision process is a progression of four phases: (1) re-focusing attention; (2) evaluation; (3) action; and (4) outcome processing, and we present evidence for the insula’s role in all these phases. We review the existing work on insula’s functional anatomy that subdivides the IC into posterior, dorsal anterior and ventral anterior regions. We re-map the results provided by the existing literature into these subdivisions wherever possible, to identify the components’ role in each decision making phase. In addition, we identify a self-regulating quality of the IC focused on harm avoidance.

Diurnal cortisol rhythm is associated with increased risky decision-making in older adults

Although past research has suggested a link between chronic stress and both physical and mental well-being in older adults, less is known about the degree to which neuroendocrine markers of stress are associated with higher-order cognitive processes such as decision-making. In a sample of healthy older adults (55-85 years), we tested the degree to which variation in the diurnal cortisol rhythm, an index of hypothalamic-adrenal-pituitary axis dynamics, was related to differences in risky decision-making. We found that diurnal cortisol fall predicted performance on the Cups Task, a risky decision-making task that independently tests risk-taking to achieve gains and risk-taking to avoid losses. For potential gains, we found that greater risk-taking was associated with lower diurnal cortisol fall, independent of age or sex of the participant. For risks to avoid potential losses, we found that lower diurnal fall was associated with suboptimal decision-making for men only. Compared with males with more typical diurnal fall, those who displayed lower diurnal fall made more risky choices and demonstrated lower sensitivity to the expected value of the risky choice. We integrate these results with the extant literature on the effects of stress on decision-making and cognitive aging.

Relative gains, losses, and reference points in probabilistic choice in rats

Theoretical reference points have been proposed to differentiate probabilistic gains from probabilistic losses in humans, but such a phenomenon in non-human animals has yet to be thoroughly elucidated. Three experiments evaluated the effect of reward magnitude on probabilistic choice in rats, seeking to determine reference point use by examining the effect of previous outcome magnitude(s) on subsequent choice behavior. Rats were trained to choose between an outcome that always delivered reward (low-uncertainty choice) and one that probabilistically delivered reward (high-uncertainty). The probability of high-uncertainty outcome receipt and the magnitudes of low-uncertainty and high-uncertainty outcomes were manipulated within and between experiments. Both the low- and high-uncertainty outcomes involved variable reward magnitudes, so that either a smaller or larger magnitude was probabilistically delivered, as well as reward omission following high-uncertainty choices. In Experiments 1 and 2, the between groups factor was the magnitude of the high-uncertainty-smaller (H-S) and high-uncertainty-larger (H-L) outcome, respectively. The H-S magnitude manipulation differentiated the groups, while the H-L magnitude manipulation did not. Experiment 3 showed that manipulating the probability of differential losses as well as the expected value of the low-uncertainty choice produced systematic effects on choice behavior. The results suggest that the reference point for probabilistic gains and losses was the expected value of the low-uncertainty choice. Current theories of probabilistic choice behavior have difficulty accounting for the present results, so an integrated theoretical framework is proposed. Overall, the present results have implications for understanding individual differences and corresponding underlying mechanisms of probabilistic choice behavior.

Decision-making for risky gains and losses among college students with Internet gaming disorder

Individuals with Internet gaming disorder (IGD) tend to exhibit disadvantageous risky decision-making not only in their real life but also in laboratory tasks. Decision-making is a complex multifaceted function and different cognitive processes are involved in decision-making for gains and losses. However, the relationship between impaired decision-making and gain versus loss processing in the context of IGD is poorly understood. The main aim of the present study was to separately evaluate decision-making for risky gains and losses among college students with IGD using the Cups task. Additionally, we further examined the effects of outcome magnitude and probability level on decision-making related to risky gains and losses respectively. Sixty college students with IGD and 42 matched healthy controls (HCs) participated. Results indicated that IGD subjects exhibited generally greater risk taking tendencies than HCs. In comparison to HCs, IGD subjects made more disadvantageous risky choices in the loss domain (but not in the gain domain). Follow-up analyses indicated that the impairment was associated to insensitivity to changes in outcome magnitude and probability level for risky losses among IGD subjects. In addition, higher Internet addiction severity scores were associated with percentage of disadvantageous risky options in the loss domain. These findings emphasize the effect of insensitivity to losses on disadvantageous decisions under risk in the context of IGD, which has implications for future intervention studies.

Mechanisms of Individual Differences in Impulsive and Risky Choice in Rats

Individual differences in impulsive and risky choice are key risk factors for a variety of maladaptive behaviors such as drug abuse, gambling, and obesity. In our rat model, ordered individual differences are stable across choice parameters, months of testing, and span a broad spectrum, suggesting that rats, like humans, exhibit trait-level impulsive and risky choice behaviors. In addition, impulsive and risky choices are highly correlated, suggesting a degree of correlation between these two traits. An examination of the underlying cognitive mechanisms has suggested an important role for timing processes in impulsive choice. In addition, in an examination of genetic factors in impulsive choice, the Lewis rat strain emerged as a possible animal model for studying disordered impulsive choice, with this strain demonstrating deficient delay processing. Early rearing environment also affected impulsive behaviors, with rearing in an enriched environment promoting adaptable and more self-controlled choices. The combined results with impulsive choice suggest an important role for timing and reward sensitivity in moderating impulsive behaviors. Relative reward valuation also affects risky choice, with manipulation of objective reward value (relative to an alternative reference point) resulting in loss chasing behaviors that predicted overall risky choice behaviors. The combined results are discussed in relation to domain-specific versus domain-general subjective reward valuation processes and the potential neural substrates of impulsive and risky choice.

Effects of incentives, age, and behavior on brain activation during inhibitory control: a longitudinal fMRI study

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Reward-modulated cognitive control is supported by amygdalar incentive processing.

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NAcc activation supports inhibitory control in youths.

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NAcc activation hinders inhibitory control in adults.

We investigated changes in brain function supporting inhibitory control under age-controlled incentivized conditions, separating age- and performance-related activation in an accelerated longitudinal design including 10- to 22-year-olds. Better inhibitory control correlated with striatal activation during neutral trials, while Age X Behavior interactions in the striatum indicated that in the absence of extrinsic incentives, younger subjects with greater reward circuitry activation successfully engage in greater inhibitory control. Age was negatively correlated with ventral amygdala activation during Loss trials, suggesting that amygdala function more strongly mediates bottom-up processing earlier in development when controlling the negative aspects of incentives to support inhibitory control. Together, these results indicate that with development, reward-modulated cognitive control may be supported by incentive processing transitions in the amygdala, and from facilitative to obstructive striatal function during inhibitory control.

Risk-based learning games improve long-term retention of information among school pupils

Risk heightens motivation and, if used appropriately, may have the potential to improve engagement in the classroom. We have developed a risk-based learning game for school pupils in order to test whether such learning games can improve later recall of information. The study was performed during a series of public engagement workshops delivered by undergraduate students. Undergraduate neuroscience students delivered 90-minute science workshops to 9–10 year old school pupils (n = 448) that were divided into ‘Risk’, ‘No risk’ and ‘Control’ classes. ‘Risk’ classes received periodic multiple-choice questions (MCQs) during the workshops which required small teams of pupils to assign tokens to the answer(s) they believed to be correct. Tokens assigned to the correct answer were returned to the group and an equal number given back as a prize; tokens assigned to incorrect answers were lost. Participation was incentivised by the promise of a brain-related prize to the team with the most tokens at the end of the workshop. ‘No risk’ classes received MCQs without the risk component whilst the ‘Control’ classes received no MCQs. When presented with a neuroscience quiz based on workshop content at the end of the workshop, pupils in the ‘Risk’ classes exhibited significantly greater recall of information one week later. Quiz scores were higher than scores from the day of the workshop which suggested pupils may have discussed the workshop content outside of the classroom, thereby increasing knowledge over and above what was learned during the workshop. This is supported by feedback from pupils in ‘Risk’ classes which indicated that ‘Risk’ workshops were more interesting than ‘No risk’ and ‘Control’ workshops. These data suggest that there is a role for risk in the classroom but further investigations are required to elucidate the causal mechanisms of improved retention of information.

Dual conception of risk in the Iowa Gambling Task: effects of sleep deprivation and test-retest gap

Risk in the Iowa Gambling Task (IGT) is often understood in terms of intertemporal choices, i.e., preference for immediate outcomes in favor of delayed outcomes is considered risky decision making. According to behavioral economics, healthy decision makers are expected to refrain from choosing the short-sighted immediate gain because, over time (10 trials of the IGT), the immediate gains result in a long term loss (net loss). Instead decision makers are expected to maximize their gains by choosing options that, over time (10 trials), result in delayed or long term gains (net gain). However, task choices are sometimes made on the basis of the frequency of reward and punishment such that frequent rewards/infrequent punishments are favored over infrequent rewards/frequent punishments. The presence of these two attributes (intertemporality and frequency of reward) in IGT decision making may correspond to the emotion-cognition dichotomy and reflect a dual conception of risk. Decision making on the basis of the two attributes was tested under two conditions: delay in retest and sleep deprivation. An interaction between sleep deprivation and time delay was expected to attenuate the difference between the two attributes. Participants were 40 male university students. Analysis of the effects of IGT attribute type (intertemporal vs. frequency of reinforcement), sleep deprivation (sleep deprivation vs. no sleep deprivation), and test-retest gap (short vs. long delay) showed a significant within-subjects effect of IGT attribute type thus confirming the difference between the two attributes. Sleep deprivation had no effect on the attributes, but test-retest gap and the three-way interaction between attribute type, test-retest gap, and sleep deprivation were significantly different. Post-hoc tests revealed that sleep deprivation and short test-retest gap attenuated the difference between the two attributes. Furthermore, the results showed an expected trend of increase in intertemporal decision making at retest suggesting that intertemporal decision making benefited from repeated task exposure. The present findings add to understanding of the emotion-cognition dichotomy. Further, they show an important time-dependent effect of a universally experienced constraint (sleep deprivation) on decision making. It is concluded that risky decision making in the IGT is contingent on the attribute under consideration and is affected by factors such as time elapsed and constraint experienced before the retest.

Decision-making deficits among maltreated children

Although maltreated children involved with child welfare services are known to exhibit elevated levels of health-risking behaviors, little is known about their decision-making processes leading to such tendencies. Research findings suggest that maltreated children exhibit developmental delays in neurocognitive and emotional regulation systems that could adversely impact their abilities to make decisions under conditions of risk. Whereas prior researchers have examined risky decision making as a global construct, maltreated children's decision making was examined in two contexts in the present study: potential gains and potential losses. Comparing maltreated children (n = 25) and a nonmaltreated community group (n = 112), it was found that the maltreated children showed decision-making impairments for both domains: This impairment was especially prominent in the loss domain. The maltreated children took excessive risks and were insensitive to changes in expected value. Follow-up analyses revealed that these differences were primarily associated with insensitivity to changes in outcome magnitude for the risky option. Finally, response latency analyses indicated that the maltreated children were slower to make choices, reinforcing underlying differences in decision processes between groups. These results have implications for basic and translational science.