The uncertain brain: A co-ordinate based meta-analysis of the neural signatures supporting uncertainty during different contexts

Psychological mechanisms underpinning change in intolerance of uncertainty across anxiety-related disorders: New insights for translational research

Intolerance of uncertainty (IU), the tendency to find uncertainty negative, is a fundamental transdiagnostic dimension across anxiety-related disorders. Over the past two decades, there has been an increase in both clinical and experimental research on the role of IU in the maintenance and treatment of anxiety-related disorders. However, there has been a lack of integration of research findings from a mechanistic perspective, which has slowed progress in translational research. This review seeks to fill this gap by synthesising the clinical (e.g. randomised controlled trials) and experimental (e.g. lab-based) literature on the psychological mechanisms that drive change in IU across anxiety-related disorders. The review highlighted that: (1) cognitive restructuring, supported by mechanisms such as cognitive appraisal, modify IU-related cognitions, (2) behavioural exposures, supported by mechanisms such as inhibitory learning, alter IU-related cognitions and physiological arousal, and (3) mindfulness techniques underpinned by mechanisms such as attentional monitoring, decentering, and acceptance, change IU-related cognitions. Across the different therapeutic techniques reviewed, there was a lack of evidence for how different mechanisms change IU-related emotions and behaviours. Directions for further research include directly comparing the effectiveness of different mechanisms that produce change in IU across anxiety disorders and other mental health disorders, and examining the specificity of change in IU over other anxious traits. Overall, the findings provide a foundation for future translational research efforts to build upon maximising existing treatment interventions and/or to develop novel treatment interventions to target dispositional IU and situational uncertainty-related distress in anxiety-related disorders and beyond.

Active information sampling in health and disease

Active information gathering is a fundamental cognitive process that enables organisms to navigate uncertainty and make adaptive decisions. Here we synthesise current knowledge on the behavioural, neural, and computational mechanisms underlying information sampling in healthy people and across several brain disorders. The role of cortical and subcortical regions spanning limbic, insular, fronto-parietal, and striatal systems is considered, along with the contributions of key neurotransmitters involving norepinephrine, dopamine, and serotonin. We also examine how various clinical conditions, including schizophrenia, obsessive-compulsive disorder, and Parkinson's disease have an impact on information gathering behaviours. To account for the findings, we outline a neuroeconomic perspective on how the brain may evaluate the costs and benefits of acquiring information to resolve uncertainty. This work highlights how active information gathering is a crucial brain process for adaptive behaviour in healthy individuals and how its breakdown is relevant to several psychiatric and neurological conditions. The findings have important implications for developing novel computational assays as well as targeted interventions in brain disorders.

Individual differences in intolerance of uncertainty is primarily linked to the structure of inferior frontal regions

Increased intolerance of uncertainty (IU), or distress felt when encountering situations with unknown outcomes, occurs transdiagnostically across various forms of psychopathology and is targeted in therapeutic intervention. Increased intolerance of uncertainty shows overlap with symptoms of internalizing disorders, such as depression and anxiety, including negative affect and anxious apprehension (worry). While neuroanatomical correlates of IU have been reported, previous investigations have not disentangled the specific neural substrates of IU above and beyond any overlapping relationships with aspects of internalizing psychopathology. The current study did so in a sample of 42 adults and 79 adolescents, who completed questionnaires assessing IU and internalizing symptoms, and underwent structural MRI. When controlling for internalizing symptoms, across adults and adolescents, specific associations of IU were found with the structure of the inferior frontal cortex and orbitofrontal cortex, regions implicated in cognitive control and emotional valuation/regulation. In addition, in adolescents, associations were observed with rostral middle frontal cortex and portions of the cingulate cortex. No associations were observed with threat-related regions, such as the amygdala. Potential cognitive/emotional mechanisms that might explain the association between individual differences in intolerance of uncertainty and morphology of the inferior frontal cortex are discussed.

Thalamocortical dysrhythmia and reward deficiency syndrome as uncertainty disorders

A common anatomical core has been described for psychiatric disorders, consisting of the dorsal anterior cingulate cortex (dACC) and anterior insula, processing uncertainty. A common neurophysiological core has been described for other brain related disorders, called thalamocortical dysrhythmia (TCD), consisting of persistent cross-frequency coupling between low and high frequencies. And a common genetic core has been described for yet another set of hypodopaminergic pathologies called reward deficiency syndromes (RDS). Considering that some RDS have the neurophysiological features of TCD, it can be hypothesized that TCD and RDS have a common anatomical core, yet a differentiating associated neurophysiological mechanism. The EEGs of 683 subjects are analysed in source space for both differences and conjunction between TCD and healthy controls, RDS and healthy controls, and between TCD and RDS. A balance between current densities of the pregenual anterior cingulate cortex (pgACC) extending into the ventromedial prefrontal cortex (vmPFC) and dACC is calculated as well. TCD and RDS share a common anatomical and neurophysiological core, consisting of beta activity in the dACC and theta activity in dACC extending into precuneus and dorsolateral prefrontal cortex. TCD and RDS differ in pgACC/vmPFC activity and demonstrate an opposite balance between pgACC/vmPFC and dACC. Based on the Bayesian brain model TCD and RDS can be defined as uncertainty disorders in which the pgACC/vmPFC and dACC have an opposite balance, possibly explained by an inverted-U curve profile of both pgACC/vmPFC and dACC.

The influence of contextual uncertainty on facial expression processing: Evidence from behavior and ERPs

The brain helps individuals build expectations based on emotional prediction, facilitating the processing of faces in social interactions. Due to the intricacy of the environment, accurately predicting emotions remains a formidable task. Contextual uncertainty represents a state characterized by the inability to predict when, how, and why events occur. It leads to intensified sentiments and triggers adverse emotions like anxiety. Therefore, comprehending the influences of contextual uncertainty carries importance. The present study utilized event-related potentials (ERPs) technology to investigate contextual uncertainty's influence on facial expression processing. We employed a novel S1-S2 paradigm, using scene images as S1 and faces as S2. From the learning phase into the testing phase, the certain to uncertain group (CER to UNC) experienced more unpredictability (increased uncertainty), whereas the uncertain to certain group (UNC to CER) experienced more predictability (decreased uncertainty). This allowed for manipulating dynamic alterations in predictive relationships. The behavioral results showed that the valence ratings of neutral facial expressions were more negative in the CER to UNC group with increased contextual uncertainty. The ERP results showed that the more negative SPN (stimulus preceding negativity) amplitudes and positive LPP (late positive potential) amplitudes were observed in the UNC to CER group with decreased contextual uncertainty, compared to the CER to UNC group with increased contextual uncertainty. These findings have indicated that contextual uncertainty affects facial expression processing. In summary, these results contributed to comprehending the contextual uncertainty.

Monitoring pilot trainees' cognitive control under a simulator-based training process with EEG microstate analysis

The objective of pilot training is to equip trainees with the knowledge, judgment, and skills to maintain control of an aircraft and respond to critical flight tasks. The present research aims to investigate changes in trainees' cognitive control levels during a pilot training process while they underwent basic flight maneuvers. EEG microstate analysis was applied together with spectral power features to quantitatively monitor trainees' cognitive control under varied flight tasks during different training sessions on a flight simulator. Not only could EEG data provide an objective measure of cognitive control to complement the current subjective assessments, but the application of EEG microstate analysis is particularly well-suited for capturing rapid dynamic changes in cognitive states that may happen under complex human activities in conducting flight maneuvers. Comparisons were conducted between two types of tasks and across different training stages to monitor how pilot trainees' cognitive control responds to varied flight task types and training stages. The present research provides insights into the changes in trainees' cognitive control during a pilot training process and highlights the potential of EEG microstate analysis for monitoring cognitive control.

Asymmetric Adaption in Social Learning: Understanding the Dilemma of Competition and Cooperation

The constant challenge in social interactions involves making informed decisions in the face of competitive and cooperative dilemmas. The decision-making process can be influenced by various factors present in the social context. According to the behavior-pattern-categorization framework of information acquisition, potential biases may develop at all stages of decision-making as information about social context is progressively entered and integrated. In this study, employing the Chicken Game, we investigated the influence of varying information levels within the behavior-pattern-categorization framework (i.e., competitiveness of behavior choice, uncertainty of behavior pattern, and sociality of category) on decision-making in the dilemma of competition and cooperation. Combined with reinforcement learning models, our findings from three experiments showed that participants exhibited basic complementary behavior, becoming less competitive against highly competitive opponents and vice versa. Notably, individuals exhibited varying adaptation rates to different levels of opponent competitiveness and fluctuations. Specifically, participants adapted slower to highly competitive opponents and faster to cooperative opponents. This asymmetric adaptation in social learning is related to the rate at which various levels of information are updated. The current study disentangles the different levels of information acquisition and highlights the asymmetric processing that can occur during the updating of information within each level.

Neural correlates of static and dynamic social decision-making in real-time sibling interactions

In traditional game theory tasks, social decision-making is centered on the prediction of the intentions (i.e., mentalizing) of strangers or manipulated responses. In contrast, real-life scenarios often involve familiar individuals in dynamic environments. Further research is needed to explore neural correlates of social decision-making with changes in the available information and environmental settings. This study collected fMRI hyperscanning data (N = 100, 46 same-sex pairs were analyzed) to investigate sibling pairs engaging in an iterated Chicken Game task within a competitive context, including two decision-making phases. In the static phase, participants chose between turning (cooperate) and continuing (defect) in a fixed time window. Participants could estimate the probability of different events based on their priors (previous outcomes and representation of other's intentions) and report their decision plan. The dynamic phase mirrored real-world interactions in which information is continuously changing (replicated within a virtual environment). Individuals had to simultaneously update their beliefs, monitor the actions of the other, and adjust their decisions. Our findings revealed substantial choice consistency between the two phases and evidence for shared neural correlates in mentalizing-related brain regions, including the prefrontal cortex, temporoparietal junction (TPJ), and precuneus. Specific neural correlates were associated with each phase; increased activation of areas associated with action planning and outcome evaluation were found in the static compared with the dynamic phase. Using the opposite contrast, dynamic decision-making showed higher activation in regions related to predicting and monitoring other's actions, including the anterior cingulate cortex and insula. Cooperation (turning), compared with defection (continuing), showed increased activation in mentalizing-related regions only in the static phase, while defection, relative to cooperation, exhibited higher activation in areas associated with conflict monitoring and risk processing in the dynamic phase. Men were less cooperative and had greater TPJ activation. Sibling competitive relationship did not predict competitive behavior but showed a tendency to predict brain activity during dynamic decision-making. Only individual brain activation results are included here, and no interbrain analyses are reported. These neural correlates emphasize the significance of considering varying levels of information available and environmental settings when delving into the intricacies of mentalizing during social decision-making among familiar individuals.

Differentiating neural sensitivity and bias during face-emotion processing in youth: a computational approach

The ability to interpret face-emotion displays is critical for the development of adaptive social interactions. Using a novel variant of a computational model and fMRI data, we examined behavioral and neural associations between two metrics of face-emotion labeling (sensitivity and bias) and age in youth. Youth and adults (n = 44, M age = 20.02, s.d. = 7.44, range = 8-36) completed an explicit face-emotion labeling fMRI task including happy to angry morphed face emotions. A drift-diffusion model was applied to choice and reaction time distributions to examine sensitivity and bias in interpreting face emotions. Model fit and reliability of parameters were assessed on adult data (n = 42). Linear and quadratic slopes modeled brain activity associated with dimensions of face-emotion valence and ambiguity during interpretation. Behaviorally, age was associated with sensitivity. The bilateral anterior insula exhibited a more pronounced neural response to ambiguity with older age. Associations between sensitivity and bias metrics and activation patterns indicated that systems encoding face-emotion valence and ambiguity both contribute to the ability to discriminate face emotions. The current study provides evidence for age-related improvement in perceptual sensitivity to facial affect across adolescence and young adulthood.

A neural signature for the subjective experience of threat anticipation under uncertainty

Uncertainty about potential future threats and the associated anxious anticipation represents a key feature of anxiety. However, the neural systems that underlie the subjective experience of threat anticipation under uncertainty remain unclear. Combining an uncertainty-variation threat anticipation paradigm that allows precise modulation of the level of momentary anxious arousal during functional magnetic resonance imaging (fMRI) with multivariate predictive modeling, we train a brain model that accurately predicts subjective anxious arousal intensity during anticipation and test it across 9 samples (total n = 572, both gender). Using publicly available datasets, we demonstrate that the whole-brain signature specifically predicts anxious anticipation and is not sensitive in predicting pain, general anticipation or unspecific emotional and autonomic arousal. The signature is also functionally and spatially distinguishable from representations of subjective fear or negative affect. We develop a sensitive, generalizable, and specific neuroimaging marker for the subjective experience of uncertain threat anticipation that can facilitate model development.

Understanding anxiety through uncertainty quantification

Uncertainty has been a central concept in psychological theories of anxiety. However, this concept has been plagued by divergent connotations and operationalizations. The lack of consensus hinders the current search for cognitive and biological mechanisms of anxiety, jeopardizes theory creation and comparison, and restrains translation of basic research into improved diagnoses and interventions. Drawing upon uncertainty decomposition in Bayesian Decision Theory, we propose a well-defined conceptual structure of uncertainty in cognitive and clinical sciences, with a focus on anxiety. We discuss how this conceptual structure provides clarity and can be naturally applied to existing frameworks of psychopathology research. Furthermore, it allows formal quantification of various types of uncertainty that can benefit both research and clinical practice in the era of computational psychiatry.

Neural underpinnings of preferential pain learning and the modulatory role of fear

Due to its unique biological relevance, pain-related learning might differ from learning from other aversive experiences. This functional magnetic resonance imaging study compared neural mechanisms underlying the acquisition and extinction of different threats in healthy humans. We investigated whether cue-pain associations are acquired faster and extinguished slower than cue associations with an equally unpleasant tone. Additionally, we studied the modulatory role of stimulus-related fear. Therefore, we used a differential conditioning paradigm, in which somatic heat pain stimuli and unpleasantness-matched auditory stimuli served as US. Our results show stronger acquisition learning for pain- than tone-predicting cues, which was augmented in participants with relatively higher levels of fear of pain. These behavioral findings were paralleled by activation of brain regions implicated in threat processing (insula, amygdala) and personal significance (ventromedial prefrontal cortex). By contrast, extinction learning seemed to be less dependent on the threat value of the US, both on the behavioral and neural levels. Amygdala activity, however, scaled with pain-related fear during extinction learning. Our findings on faster and stronger (i.e. "preferential") pain learning and the role of fear of pain are consistent with the biological relevance of pain and may be relevant to the development or maintenance of chronic pain.

Behavioral and brain reactivity to uncertain stress prospectively predicts binge drinking in youth

Prior studies show that individuals with alcohol use disorder exhibit exaggerated behavioral and brain reactivity to uncertain threats (U-threat). It is posited this brain-based factor emerges early in life and contributes to the onset and escalation of alcohol problems. However, no study to date has tested this theory using a longitudinal within-subjects design. Ninety-five young adults, ages 17-19, with minimal alcohol exposure and established risk factors for alcohol use disorder participated in this multi-session study with a 1-year tracking period. Startle eyeblink potentiation and brain activation were collected at separate baseline sessions during the well-validated No-Predictable-Unpredictable (NPU) threat-of-shock task designed to probe reactivity to U-threat and predictable threat (P-threat). Participants self-reported their drinking behavior over the past 90 days at baseline and one-year later. We fit a series of multilevel hurdle models to model the binary outcome of whether binge drinking occurred and the continuous outcome of number of binge drinking episodes. Zero-inflated binary submodels revealed that greater baseline startle reactivity, bilateral anterior insula (AIC) reactivity, and dorsal anterior cingulate cortex (dACC) reactivity to U-threat were associated with increased probability of binge drinking. There were no other associations between reactivity to U- and P-threat and probability of binge drinking and number of binging episodes. These results demonstrate that exaggerated reactivity to U-threat is a brain-based individual difference factor that connotes risk for problem drinking. These findings also add to a growing literature implicating AIC and dACC dysfunction in the pathophysiology of alcohol use disorder.

A Role for Uncertainty in the Neural Distinction Between Social and Nonsocial Thought

Neuroimaging research has identified a network of brain regions that is consistently more engaged when people think about the minds of other people than when they engage in nonsocial tasks. Activations in this "mentalizing network" are sometimes interpreted as evidence for the domain-specificity of cognitive processes supporting social thought. Here, we examine the alternative possibility that at least some activations in the mentalizing network may be explained by uncertainty. A reconsideration of findings from existing functional MRI studies in light of new data from independent raters suggests that (a) social tasks used in past studies have higher levels of uncertainty than their nonsocial comparison tasks and (b) activation in a key brain region associated with social cognition, the dorsomedial prefrontal cortex (DMPFC), may track with the degree of uncertainty surrounding both social and nonsocial inferences. These observations suggest that the preferential DMPFC response observed consistently in social scenarios may reflect the engagement of domain-general processes of uncertainty reduction, which points to avenues for future research into the core cognitive mechanisms supporting typical and atypical social thought.

Intolerance of uncertainty and functional connectivity of the anterior insula during anticipation of unpredictable reward

Individuals with high intolerance of uncertainty (IU) tend to display maladaptive cognitive, behavioral, physiological, and/or neural responses during anticipation of uncertain or ambiguous outcomes, both positive and negative in valence. Importantly, high IU has been proposed as a key transdiagnostic phenotypic risk factor for the onset and maintenance of several psychiatric disorders. Within the context of reward processing, high IU has been related to dysfunctional reward anticipation, which may be mediated by hyperactive anterior insula (AIC) response to uncertainty. The present study further investigated the relationship between the AIC and IU by examining the association between individual differences in IU and task-based functional connectivity of the right AIC using functional magnetic resonance imaging (fMRI). Participants (N = 171) completed a self-report measure of IU and a reward anticipation task during fMRI. Generalized psychophysiological interaction (gPPI) analyses were performed with a seed in the right AIC. In the U-threat model, we found that greater self-reported levels of IU were correlated with increased functional connectivity between the right AIC and the dorsal anterior cingulate cortex (dACC) and the right dorsolateral prefrontal cortex (dlPFC). In the P-threat model, we did not find these associations, perhaps indicating that they may be more robust during uncertainty. These preliminary findings suggest that parts of salience and central executive control networks may be impacted by and underlie the expression of IU. Future studies should examine the generalizability of these findings to clinical populations and investigate how disruption of these functional networks may contribute to psychopathology.

Neural responding during uncertain threat anticipation in pediatric anxiety

Excessive fear responses to uncertain threat are a key feature of anxiety disorders (ADs), though most mechanistic work considers adults. As ADs onset in childhood and confer risk for later psychopathology, we sought to identify conditions of uncertain threat that distinguish 8-17-year-old youth with AD (n = 19) from those without AD (n = 33), and assess test-retest reliability of such responses in a companion sample of healthy adults across three sites (n = 19). In an adapted uncertainty of threat paradigm, visual cues parametrically signaled threat of aversive stimuli (fear faces) in 25 % increments (0 %, 25 %, 50 %, 100 %), while participants underwent functional magnetic resonance imaging (fMRI). We compared neural response elicited by cues signaling different degrees of probability regarding the subsequent delivery of fear faces. Overall, youth displayed greater engagement of bilateral inferior parietal cortex, fusiform gyrus, and lingual gyrus during uncertain threat anticipation in general. Relative to healthy youth, AD youth exhibited greater activation in ventrolateral prefrontal cortex (vlPFC)/BA47 during uncertain threat anticipation in general. Further, AD differed from healthy youth in scaling of ventral striatum/sgACC activation with threat probability and attenuated flexibility of responding during parametric uncertain threat. Complementing these results, significant, albeit modest, cross-site test-retest reliability in these regions was observed in an independent sample of healthy adults. While preliminary due to a small sample size, these findings suggest that during uncertainty of threat, AD youth engage vlPFC regions known to be involved in fear regulation, response inhibition, and cognitive control. Findings highlight the potential of isolating neural correlates of threat anticipation to guide treatment development and translational work in youth.

Intolerance of uncertainty heightens negative emotional states and dampens positive emotional states

Individuals high in self-reported Intolerance of Uncertainty (IU) tend to view uncertainty as unbearable and stressful. Notably, IU is transdiagnostic, and high levels of IU are observed across many different emotional disorders (e.g., anxiety, depression). Research has primarily focused on how IU evokes and modulates emotional states such as fear and anxiety. However, recent research suggests that IU may have relevance for a broader range of emotional states. Here, an online survey was conducted to examine whether IU evokes and modulates a range of negative (e.g., fear/anxiety, sadness/upset, anger/frustration, disgust) and positive (e.g., happiness/joy, excitement/enthusiasm, surprise/interest) emotional states. Findings within a community sample (n = 231) revealed that individuals with higher levels of IU report: (1) that uncertainty in general and uncertainty under ambiguity are more likely to evoke negative emotional states and less likely to evoke positive emotional states, (2) that uncertainty under risk is less likely to evoke positive emotional states, and (3) that uncertainty heightens existing negative emotional states and dampens existing positive emotional states. Importantly, these IU-related findings remained when controlling for current experiences of general distress, anxious arousal, and anhedonic depression. Taken together, these findings suggest that IU is involved in evoking and modulating a wide array of emotional phenomena, which likely has relevance for transdiagnostic models and treatment plans for emotional disorders.

Brain networks under uncertainty: A coordinate-based meta-analysis of brain imaging studies

In recent years, uncertainty has been extensively studied as a core factor in anxiety models. However, it remains unclear whether there is a stable brain circuitry to cope with uncertainty. Addressing this yet open question, we first distinguish uncertainty into three different states: risky, ambiguity, and threat anticipation. Then, we performed three meta-analyses of fMRI studies to identify those regions that are commonly activated by the three domains using activation likelihood estimation (ALE). The overlapping analyses of the three ALE maps revealed major conjunctions of the risk decision making, ambiguity decision making, and the threat anticipation in specifically the right insula. Contrast analysis further confirmed this finding. In addition, different uncertainty states also have different brain networks involved. Specifically, a large number of brain regions in the frontal-parietal cortex were recruited under ambiguity state, while subcortical gray matter regions were recruited under risk decision making, and the bilateral insula were closely associated with threat anticipation. Additionally, we assessed the co-activation pattern of identified regions using meta-analytic connectivity modeling (MACM) to investigate the potential network underlying the relationship of three domains. The MACM analysis further confirmed that different uncertain states have specific brain network basis. We concluded that the right insula serves as a convergent brain region for brain regions recruited for different uncertain states, and its co-activation pattern also corresponds to the brain network of the three uncertain states. This study is a preliminary attempt to further uncover the brain circuitry of anxiety models with uncertainty at their core.

Sometimes I feel the fear of uncertainty: How intolerance of uncertainty and trait anxiety impact fear acquisition, extinction and the return of fear

It is hypothesized that the ability to discriminate between threat and safety is impaired in individuals with high dispositional negativity, resulting in maladaptive behavior. A large body of research investigated differential learning during fear conditioning and extinction protocols depending on individual differences in intolerance of uncertainty (IU) and trait anxiety (TA), two closely-related dimensions of dispositional negativity, with heterogenous results. These might be due to varying degrees of induced threat/safety uncertainty. Here, we compared two groups with high vs. low IU/TA during periods of low (instructed fear acquisition) and high levels of uncertainty (delayed non-instructed extinction training and reinstatement). Dependent variables comprised subjective (US expectancy, valence, arousal), psychophysiological (skin conductance response, SCR, and startle blink), and neural (fMRI BOLD) measures of threat responding. During fear acquisition, we found strong threat/safety discrimination for both groups. During early extinction (high uncertainty), the low IU/TA group showed an increased physiological response to the safety signal, resulting in a lack of CS discrimination. In contrast, the high IU/TA group showed strong initial threat/safety discrimination in physiology, lacking discriminative learning on startle, and reduced neural activation in regions linked to threat/safety processing throughout extinction training indicating sustained but non-adaptive and rigid responding. Similar neural patterns were found after the reinstatement test. Taken together, we provide evidence that high dispositional negativity, as indicated here by IU and TA, is associated with greater responding to threat cues during the beginning of delayed extinction, and, thus, demonstrates altered learning patterns under changing environments.

Cross-paradigm integration shows a common neural basis for aversive and appetitive conditioning

Sharing imaging data and comparing them across different psychological tasks is becoming increasingly possible as the open science movement advances. Such cross-paradigm integration has the potential to identify commonalities in findings that neighboring areas of study thought to be paradigm-specific. However, even the integration of research from closely related paradigms, such as aversive and appetitive classical conditioning is rare - even though qualitative comparisons already hint at how similar the 'fear network' and 'reward network' may be. We aimed to validate these theories by taking a multivariate approach to assess commonalities across paradigms empirically. Specifically, we quantified the similarity of an aversive conditioning pattern derived from meta-analysis to appetitive conditioning fMRI data. We tested pattern expression in three independent appetitive conditioning studies with 29, 76 and 38 participants each. During fMRI scanning, participants in each cohorts performed an appetitive conditioning task in which a CS+ was repeatedly rewarded with money and a CS- was never rewarded. The aversive pattern was highly similar to appetitive CS+ > CS- contrast maps across samples and variations of the appetitive conditioning paradigms. Moreover, the pattern distinguished the CS+ from the CS- with above-chance accuracy in every sample. These findings provide robust empirical evidence for an underlying neural system common to appetitive and aversive learning. We believe that this approach provides a way to empirically integrate the steadily growing body of fMRI findings across paradigms.

The role of intolerance of uncertainty when solving the exploration-exploitation dilemma

When making behavioral decisions, individuals need to balance between exploiting known options or exploring new ones. How individuals solve this exploration-exploitation dilemma (EED) is a key research question across psychology, leading to attempting to disentangle the cognitive mechanisms behind it. A potential predictive factor of performance in an EED is intolerance of uncertainty (IU), an individual difference factor referring to the extent to which uncertain situations are reported to be aversive. Here, we present the results of a series of exploratory analyses in which we tested the relationship between IU and performance in an EED task. For this, we compiled data from 3 experiments, in which participants received the opportunity to exploit different movements in order to avoid a painful stimulus and approach rewards. For decomposing performance in this task, we used different computational models previously employed in studies on the EED. Then, the parameters of the winning model were correlated with the scores of participants in the IU scale. Correlational and cluster analyses, within both frequentists and Bayesian frameworks, did not provide strong evidence for a relation between EED and IU, apart from the decay rate and the subscale "tendency to become paralyzed in the face of uncertainty". Given the theoretical relation between EED and IU, we propose research with different experimental paradigms.

Neighborhood Socioeconomic Disadvantage and the Neurobiology of Uncertainty in Traumatically Injured Adults

BACKGROUND

Individuals residing in more socioeconomically disadvantaged neighborhoods experience greater uncertainty through insecurity of basic needs such as food, employment, and housing, compared with more advantaged neighborhoods. Although the neurobiology of uncertainty has been less frequently examined in relation to neighborhood disadvantage, there is evidence that neighborhood disadvantage is associated with widespread neural alterations.

METHODS

Recently traumatically injured participants (n = 90) completed a picture anticipation task in the magnetic resonance imaging scanner, in which they viewed images presented in a temporally predictable or unpredictable manner. We investigated how neighborhood disadvantage (via area deprivation index [ADI]) was related to neural activation during anticipation and presentation of negative and neutral images after accounting for individual factors (i.e., age, gender, income, acute posttraumatic stress symptoms).

RESULTS

There was a significant interaction during the anticipation period such that higher ADI rankings were related to greater activation of the right anterior cingulate cortex to predictable versus unpredictable neutral stimuli. Although no other robust interactions emerged related to ADI, we note several novel simple effects of ADI during anticipation and presentation periods in the hippocampus and prefrontal, cingulate, and occipital cortices.

CONCLUSIONS

Together, these results may represent an adaptive response to predictable and/or negative stimuli, stemming from chronic exposure to socioeconomic-based uncertainties. Although effects were modest, future work should continue to examine pretrauma context on posttrauma outcomes. To better understand trauma outcomes, it is imperative that researchers consider the broader context in which trauma survivors reside.

Unbalanced functional connectivity at rest affects the ERP correlates of affective prediction in high intolerance of uncertainty individuals: A high density EEG investigation

In a recent study we outlined the link between Intolerance of Uncertainty (IU) and the neural correlates of affective predictions, as constructed by the brain (generation stage) to prepare to relevant stimuli (implementation stage), and update predictive models according to incoming stimuli (updating stage). In this study we further explored whether the brain's functional organization at rest can modulate neural activity elicited within an emotional S1-S2 paradigm as a function of IU and uncertainty of S1-S2 contingencies. We computed resting state functional connectivity (RS-FC) from a 3-min resting period recorded with high density EEG, and we tested whether RS graph theory nodal measures (i.e., strength, clustering coefficient, betweenness centrality) predicted in-task ERP modulation as a function of IU. We found that RS-FC differently predicted in-task ERPs within the generation and updating stages. Higher IU levels were associated to altered RS-FC patterns within both domain-specific (i.e., right superior temporal sulcus) and domain-general regions (i.e., right orbitofrontal cortex), predictive of a reduced modulation of in-task ERPs in the generation and updating stages. This is presumably ascribable to an unbalancing between synchronization and integration within these regions, which may disrupt the exchange of information between top-down and bottom-up pathways. This altered RS-FC pattern may in turn result in the construction of less efficient affective predictions and a reduced ability to deal with contextual uncertainty in individuals high in IU.

Association between startle reactivity to uncertain threats and structural brain volume

Sensitivity to uncertain threat (U-threat) is a clinically important individual difference factor in multiple psychopathologies. Recent studies have implicated a specific frontolimbic circuit as a key network involved in the anticipation of aversive stimuli. In particular, the insula, thalamus, and dorsal anterior cingulate cortex (dACC) have recently been found to be robustly activated by anticipation of U-threat. However, no study to date has examined the association between U-threat reactivity and structural brain volume. In the present study, we utilized a pooled sample of 186 young adult volunteers who completed a structural MRI scan and the well-validated No-Predictable-Unpredictable (NPU) threat of electric shock task. Startle eyeblink potentiation was collected during the NPU task as an objective index of aversive reactivity. ROI-based analyses revealed that increased startle reactivity to U-threat was associated with reduced gray matter volume in the right insula and bilateral thalamus, but not the dACC. These results add to a growing literature implicating the insula and thalamus as core nodes involved in individual differences in U-threat reactivity.

Hyperreactivity to uncertainty is a key feature of subjective cognitive impairment

With an increasingly ageing global population, more people are presenting with concerns about their cognitive function, but not all have an underlying neurodegenerative diagnosis. Subjective cognitive impairment (SCI) is a common condition describing self-reported deficits in cognition without objective evidence of cognitive impairment. Many individuals with SCI suffer from depression and anxiety, which have been hypothesised to account for their cognitive complaints. Despite this association between SCI and affective features, the cognitive and brain mechanisms underlying SCI are poorly understood. Here, we show that people with SCI are hyperreactive to uncertainty and that this might be a key mechanism accounting for their affective burden. Twenty-seven individuals with SCI performed an information sampling task, where they could actively gather information prior to decisions. Across different conditions, SCI participants sampled faster and obtained more information than matched controls to resolve uncertainty. Remarkably, despite their ‘urgent’ sampling behaviour, SCI participants were able to maintain their efficiency. Hyperreactivity to uncertainty indexed by this sampling behaviour correlated with the severity of affective burden including depression and anxiety. Analysis of MRI resting functional connectivity revealed that SCI participants had stronger insular-hippocampal connectivity compared to controls, which also correlated with faster sampling. These results suggest that altered uncertainty processing is a key mechanism underlying the psycho-cognitive manifestations in SCI and implicate a specific brain network target for future treatment.

Uncertainty Makes Me Emotional: Uncertainty as an Elicitor and Modulator of Emotional States

Uncertainty and emotion are an inevitable part of everyday life and play a vital role in mental health. Yet, our understanding of how uncertainty and emotion interact is limited. Here, an online survey was conducted (n = 231) to examine whether uncertainty evokes and modulates a range of negative and positive emotions. The data show that uncertainty is predominantly associated with negative emotional states such as fear/anxiety. However, uncertainty was also found to modulate a variety of other negative (i.e., sadness/upset, anger/frustration, and confusion) and positive (i.e., surprise/interest and excited/enthusiastic) emotional states, depending on the valence of an anticipated outcome (i.e., negative and positive) and the sub parameter of uncertainty (i.e., risk and ambiguity). Uncertainty increased the intensity of negative emotional states and decreased the intensity of positive emotional states. These findings support prior research suggesting that uncertainty is aversive and associated with negative emotional states such as fear and anxiety. However, the findings also revealed that uncertainty is involved in eliciting and modulating a wide array of emotional phenomena beyond fear and anxiety. This study highlights an opportunity for further study of how uncertainty and emotion interactions are conceptualised generally and in relation to mental health.

Mental imagery can generate and regulate acquired differential fear conditioned reactivity

Mental imagery is an important tool in the cognitive control of emotion. The present study tests the prediction that visual imagery can generate and regulate differential fear conditioning via the activation and prioritization of stimulus representations in early visual cortices. We combined differential fear conditioning with manipulations of viewing and imagining basic visual stimuli in humans. We discovered that mental imagery of a fear-conditioned stimulus compared to imagery of a safe conditioned stimulus generated a significantly greater conditioned response as measured by self-reported fear, the skin conductance response, and right anterior insula activity (experiment 1). Moreover, mental imagery effectively down- and up-regulated the fear conditioned responses (experiment 2). Multivariate classification using the functional magnetic resonance imaging data from retinotopically defined early visual regions revealed significant decoding of the imagined stimuli in V2 and V3 (experiment 1) but significantly reduced decoding in these regions during imagery-based regulation (experiment 2). Together, the present findings indicate that mental imagery can generate and regulate a differential fear conditioned response via mechanisms of the depictive theory of imagery and the biased-competition theory of attention. These findings also highlight the potential importance of mental imagery in the manifestation and treatment of psychological illnesses.

Network oscillations imply the highest cognitive workload and lowest cognitive control during idea generation in open-ended creation tasks

Design is a ubiquitous, complex, and open-ended creation behaviour that triggers creativity. The brain dynamics underlying design is unclear, since a design process consists of many basic cognitive behaviours, such as problem understanding, idea generation, idea analysis, idea evaluation, and idea evolution. In this present study, we simulated the design process in a loosely controlled setting, aiming to quantify the design-related cognitive workload and control, identify EEG-defined large-scale brain networks, and uncover their temporal dynamics. The effectiveness of this loosely controlled setting was tested through comparing the results with validated findings available in the literature. Task-related power (TRP) analysis of delta, theta, alpha and beta frequency bands revealed that idea generation was associated with the highest cognitive workload and lowest cognitive control, compared to other design activities in the experiment, including problem understanding, idea evaluation, and self-rating. EEG microstate analysis supported this finding as microstate class C, being negatively associated with the cognitive control network, was the most prevalent in idea generation. Furthermore, EEG microstate sequence analysis demonstrated that idea generation was consistently associated with the shortest temporal correlation times concerning finite entropy rate, autoinformation function, and Hurst exponent. This finding suggests that during idea generation the interplay of functional brain networks is less restricted and the brain has more degrees of freedom in choosing the next network configuration than during other design activities. Taken together, the TRP and EEG microstate results lead to the conclusion that idea generation is associated with the highest cognitive workload and lowest cognitive control during open-ended creation task.

Intolerance of uncertainty is associated with heightened responding in the prefrontal cortex during cue-signalled uncertainty of threat

Heightened responding to uncertain threat is considered a hallmark of anxiety disorder pathology. We sought to determine whether individual differences in self-reported intolerance of uncertainty (IU), a key transdiagnostic dimension in anxiety-related pathology, underlies differential recruitment of neural circuitry during cue-signalled uncertainty of threat (n = 42). In an instructed threat of shock task, cues signalled uncertain threat of shock (50%) or certain safety from shock. Ratings of arousal and valence, skin conductance response (SCR), and functional magnetic resonance imaging were acquired. Overall, participants displayed greater ratings of arousal and negative valence, SCR, and amygdala activation to uncertain threat versus safe cues. IU was not associated with greater arousal ratings, SCR, or amygdala activation to uncertain threat versus safe cues. However, we found that high IU was associated with greater ratings of negative valence and greater activity in the medial prefrontal cortex and dorsomedial rostral prefrontal cortex to uncertain threat versus safe cues. These findings suggest that during cue-signalled uncertainty of threat, individuals high in IU rate uncertain threat as aversive and engage prefrontal cortical regions known to be involved in safety-signalling and conscious threat appraisal. Taken together, these findings highlight the potential of IU in modulating safety-signalling and conscious appraisal mechanisms in situations with cue-signalled uncertainty of threat, which may be relevant to models of anxiety-related pathology.

The role of intolerance of uncertainty in classical threat conditioning: Recent developments and directions for future research

Intolerance of uncertainty (IU), the tendency to find uncertainty aversive, is an important transdiagnostic dimension in mental health disorders. Over the last decade, there has been a surge of research on the role of IU in classical threat conditioning procedures, which serve as analogues to the development, treatment, and relapse of anxiety, obsessive-compulsive, and trauma- and stressor-related disorders. This review provides an overview of the existing literature on IU in classical threat conditioning procedures. The review integrates findings based on the shared or discrete parameters of uncertainty embedded within classical threat conditioning procedures. Under periods of unexpected uncertainty, where threat and safety contingencies change, high IU, over other self-reported measures of anxiety, is specifically associated with poorer threat extinction learning and retention, as well as overgeneralisation. Under periods of estimation and expected uncertainty, where the parameters of uncertainty are being learned or have been learned, such as threat acquisition training and avoidance learning, the findings are mixed for IU. These findings provide evidence that individual differences in IU play a significant role in maintaining learned fear and anxiety, particularly under volatile environments. Recommendations for future research are outlined, with discussion focusing on how parameters of uncertainty can be better defined to capture how IU is involved in the maintenance of learned fear and anxiety. Such work will be crucial for understanding the role of IU in neurobiological models of uncertainty-based maintenance of fear and anxiety and inform translational work aiming to improve the diagnosis and treatment of relevant psychopathology.

Dissociating the effect of reward uncertainty and timing uncertainty on neural indices of reward prediction errors: A reward positivity (RewP) event-related potential (ERP) study

Accurate reward predictions include forecasting both what a reward will be and when a reward will occur. We tested how variations in the certainty of reward outcome and certainty in timing of feedback presentation modulate neural indices of reward prediction errors using the reward positivity (RewP) component of the scalp-recorded brain event-related potential (ERP). In a within-subjects design, seventy-three healthy individuals completed two versions of a cued doors task; one cued the probability of a reward outcome while the other cued the probability of a delay before feedback. Replicating previous results, RewP amplitude was larger for uncertain feedback compared to certain feedback. Additionally, RewP amplitude was differentially associated with uncertainty of presence/absence of reward, but not uncertainty of feedback timing. Findings suggest a dissociation in that RewP amplitude is modulated by reward prediction certainty but is less affected by certainty surrounding timing of feedback.

A Decision Architecture for Safety Computations

Accurately estimating safety is critical to pursuing nondefensive survival behaviors. However, little attention has been paid to how the human brain computes safety. We conceptualize a model that consists of two components: (i) threat-oriented evaluations that focus on threat value, imminence, and predictability; and (ii) self-oriented evaluations that focus on the agent's experience, strategies, and ability to control the situation. Our model points to the dynamic interaction between these two components as a mechanism of safety estimation. Based on a growing body of human literature, we hypothesize that distinct regions of the ventromedial prefrontal cortex (vmPFC) respond to threat and safety to facilitate survival decisions. We suggest safety is not an inverse of danger, but reflects independent computations that mediate defensive circuits and behaviors.

Complete the triangulation: Quantifying differential fear conditioning with a noninterfering and sensitive behavioral measure along with self-report and physiological measures

According to the multicomponent view, emotion is expressed through subjective feelings and thoughts, physiological activation, and behavioral responses. In human fear conditioning research, the former two are much more popular than the third category. One concern is that concurrent behavioral probes may interfere with the conditioning process. To allow triangulation of emotion research through simultaneous employment of subjective, physiological, and behavioral measurement, it is necessary to find behavioral measures that meet the criteria of causing no interference while being sensitive to conditioning. In this study, a basic visual attention task was examined in terms of its impact on differential fear conditioning as measured by both subjective (i.e., self-reported fear and shock estimation) and physiological (i.e., skin conductance response/SCR) expression; and its ability to detect fear conditioning indicated by a reaction time (RT) or accuracy difference between the two conditioned stimuli (CS+ vs. CS-). While participants in the probe group (n = 86) completed differential fear conditioning with the behavioral task, those in the no-probe group (n = 76) underwent conditioning by itself. Based on self-reported fear, shock estimation, and SCR, both groups successfully acquired differential fear with no apparent between-group difference in the degree of conditioning. In the probe group, RT but not accuracy exhibited a difference between CS+ and CS-. These findings suggest that the selected visual attention task does not interfere with differential fear conditioning measured via SCR and self-report and is a sensitive measure of differential conditioning. Exploratory individual analyses also revealed significant relationships between the above measures.

A change of mind: Globus pallidus activity and effective connectivity during changes in choice selections

The basal ganglia are a group of interconnected subcortical nuclei that plays a key role in multiple motor and cognitive processes, in a close interplay with several cortical regions. Two conflicting theories postulate that the basal ganglia pathways can either foster or suppress the cortico-striatal output or, alternatively, they can stabilize or destabilize the cortico-striatal circuit dynamics. These different approaches significantly impact the understanding of observable behaviours and cognitive processes in healthy, as well as clinical populations. We investigated the predictions of these models in healthy participants (N = 28), using dynamic causal modeling of fMRI BOLD activity to estimate time- and context-dependent changes in the indirect pathway effective connectivity, in association with repetitions or changes of choice selections. We used two multi-option tasks that required the participants to adapt to uncontrollable environmental changes, by performing sequential choice selections, with and without value-based feedbacks. We found that, irrespective of the task, the trials that were characterized by changes in choice selections (switch trials) were associated with a neural response that mostly overlapped with a network commonly described for the encoding of uncertainty. More interestingly, dynamic causal modeling and family-wise model comparison identified with high likelihood a directed causal relation from the external to the internal part of the globus pallidus (i.e., the short indirect pathway in the basal ganglia), in association with the switch trials. This finding supports the hypothesis that the short indirect pathway in the basal ganglia drives instability in the network dynamics, resulting in changes in choice selection.

Uncertainty Potentiates Neural and Cardiac Responses to Visual Stimuli in Anxiety Disorders

BACKGROUND

Intolerance of uncertainty and worry about future events are cardinal features of anxiety. However, the neurobiological and physiological mechanisms underlying these characteristics of anxiety remain to be fully elucidated.

METHODS

Individuals with diagnosed anxiety disorders (n = 29, 22 female) and age-matched comparison subjects (n = 28, 17 female) completed a task in which pictures (aversive or neutral content) were preceded by cues indicating certainty or uncertainty about the emotional valence of the subsequent pictures. We assessed functional magnetic resonance imaging and heart rate activity with respect to the 1) cue period, 2) emotional valence of the pictures, and 3) modulatory effect of uncertainty on responses to subsequent pictures.

RESULTS

Individuals with anxiety disorders and comparison subjects exhibited similar functional magnetic resonance imaging and cardiac activity during the cue period and for the aversive versus neutral picture contrast. However, individuals with anxiety disorders exhibited greater modulatory effects of uncertainty on their responses to subsequent pictures. Specifically, they displayed greater functional magnetic resonance imaging activity in a number of cortical regions (visual cortex, anterior cingulate cortex, superior temporal gyrus, and anterior insula), as well as significantly reduced cardiac deceleration to pictures preceded by the uncertainty cue.

CONCLUSIONS

These findings suggest that heightened neural and autonomic reactivity to stimuli during conditions of uncertainty may be a key psychobiological mechanism of anxiety.

Interoceptive active inference and self-representation in social anxiety disorder (SAD): exploring the neurocognitive traits of the SAD self

This article provides an interoceptive active inference (IAI) account of social anxiety disorder (SAD). Through a neurocognitive framework, we argue that the cognitive and behavioural profile of SAD is best conceived of as a form of maladaptive IAI produced by a negatively biased self-model that cannot reconcile inconsistent tendencies to approach and avoid social interaction. Anticipated future social interactions produce interoceptive prediction error (bodily states of arousal). These interoceptive states are transcribed and experienced as states of distress due to the influence of inconsistent and unstable self-models across a hierarchy of interrelated systems involved in emotional, interoceptive and affective processing. We highlight the role of the insula cortex, in concert with the striatum, amygdala and dorsal anterior cingulate in the generation and reduction of interoceptive prediction errors as well as the resolution of social approach-avoidance conflict. The novelty of our account is a shift in explanatory priority from the representation of the social world in SAD to the representation of the SAD self. In particular, we show how a high-level conceptual self-model of social vulnerability and inadequacy fails to minimize prediction errors produced by a basic drive for social affiliation combined with strong avoidant tendencies. The result is a cascade of interoceptive prediction errors whose attempted minimization through action (i.e. active inference) yields the symptom profile of SAD. We conclude this article by proposing testable hypotheses to further investigate the neurocognitive traits of the SAD self with respect to IAI.

Computational imaging during video game playing shows dynamic synchronization of cortical and subcortical networks of emotions

Emotions are multifaceted phenomena affecting mind, body, and behavior. Previous studies sought to link particular emotion categories (e.g., fear) or dimensions (e.g., valence) to specific brain substrates but generally found distributed and overlapping activation patterns across various emotions. In contrast, distributed patterns accord with multi-componential theories whereby emotions emerge from appraisal processes triggered by current events, combined with motivational, expressive, and physiological mechanisms orchestrating behavioral responses. According to this framework, components are recruited in parallel and dynamically synchronized during emotion episodes. Here, we use functional MRI (fMRI) to investigate brain-wide systems engaged by theoretically defined components and measure their synchronization during an interactive emotion-eliciting video game. We show that each emotion component recruits large-scale cortico-subcortical networks, and that moments of dynamic synchronization between components selectively engage basal ganglia, sensory-motor structures, and midline brain areas. These neural results support theoretical accounts grounding emotions onto embodied and action-oriented functions triggered by synchronized component processes.

The Reflection Effect in Memory-Based Decisions

Previous research has indicated a bias in memory-based decision-making, with people preferring options that they remember better. However, the cognitive mechanisms underlying this memory bias remain elusive. Here, we propose that choosing poorly remembered options is conceptually similar to choosing options with uncertain outcomes. We predicted that the memory bias would be reduced when options had negative subjective value, analogous to the reflection effect, according to which uncertainty aversion is stronger in gains than in losses. In two preregistered experiments ( N = 36 each), participants made memory-based decisions between appetitive and aversive stimuli. People preferred better-remembered options in the gain domain, but this behavioral pattern reversed in the loss domain. This effect was not related to participants’ ambiguity or risk attitudes, as measured in a separate task. Our results increase the understanding of memory-based decision-making and connect this emerging field to well-established research on decisions under uncertainty.

An insula-driven network computes decision uncertainty and promotes abstinence in chronic cocaine users

The anterior insular cortex (AIC) and its interconnected brain regions have been associated with both addiction and decision-making under uncertainty. However, the causal interactions in this uncertainty-encoding neurocircuitry and how these neural dynamics impact relapse remain elusive. Here, we used model-based fMRI to measure choice uncertainty in a motor decision task in 61 individuals with cocaine use disorder (CUD) and 25 healthy controls. CUD participants were assessed before discharge from a residential treatment program and followed for up to 24 weeks. We found that choice uncertainty was tracked by the AIC, dorsal anterior cingulate cortex (dACC) and ventral striatum (VS), across participants. Stronger activations in these regions measured pre-discharge predicted longer abstinence after discharge in individuals with CUD. Dynamic causal modeling revealed an AIC-to-dACC-directed connectivity modulated by uncertainty in controls, but a dACC-to-AIC connectivity in CUD participants. This reversal was mostly driven by early relapsers (<30 days). Furthermore, CUD individuals who displayed a stronger AIC-to-dACC excitatory connection during uncertainty encoding remained abstinent for longer periods. These findings reveal a critical role of an AIC-driven, uncertainty-encoding neurocircuitry in protecting against relapse and promoting abstinence.

Pictures of preterm infants elicit increased affective responses and reduced reward-motivation or perspective taking in the maternal brain

Preterm-birth increases the risk of several physical, cognitive, neuromotor, and psychosocial problems in children, and is also related to difficulties in the parent-child relationship. Research suggests that the development of early parent-child interactions in general is affected by deviations from typical infant facial characteristics, which may also be important in the case of small, preterm born infants. Therefore, we examined mothers' (N = 22, of whom 17 had no direct experience with preterm birth) neural responses to pictures of preterm and full-term infants using functional magnetic resonance imaging (fMRI). We also explored whether neural responses to preterm and full-term infants correlated with mothers' self-reported tendencies to be nurturing and protective with children, and with mothers' ratings of affection or aversion toward pictures of preterm infants. Results revealed that, compared to pictures of full-term infants, those of preterm infants elicited more activity in specific areas of the brain (dmPFC, right insula, left caudate, hippocampi, parahippocampi, and PAG), that have previously been associated with processing of negative emotions and with empathy. In addition, less activity was seen in one area of the brain (vmPFC) known to be associated with reward-motivation or mental state understanding and perspective-taking. Higher self-reported maternal nurturance was associated with increased activity to pictures of preterm infants vs full-term infants in the caudate, which might reflect approach- or reward-related processing. To conclude, neural responses to preterm infants are related to reward-motivation, mentalizing, negative emotions, and empathy. Future studies should examine whether such neural processing of preterm infant stimuli might underlie difficulties in the parent-child relationship of parents with a preterm child.

Towards a model of uncertainty distress in the context of Coronavirus (COVID-19)

The paper forms part of a series of papers outlining the theoretical framework for a new model of uncertainty distress (this paper), treatment implications arising from the model, and empirical tests of the model. We define uncertainty distress as the subjective negative emotions experienced in response to the as yet unknown aspects of a given situation. In the first paper we draw on a robust body of research on distinct areas including: threat models of anxiety, perceived illness uncertainty and intolerance of uncertainty. We explore how threat and uncertainty are separable in anxiety and how we can understand behaviours in response to uncertainty. Finally, we propose a clinically, theoretically and empirically informed model for uncertainty distress, and outline how this model can be tested. Caveats, clinical applications and practitioner key points are briefly included, although these are more fully outlined in the treatment implications article. While we outline this model in the context of novel coronavirus (COVID-19), the model has broader applications to both mental and physical health care settings.

KEY LEARNING AIMS

(1)To define the concept of uncertainty distress.(2)To understand the role of threat, over-estimation of threat, perceived uncertainty, actual uncertainty, and intolerance of uncertainty in distress maintenance.(3)To understand how people may behave in response to uncertainty distress.(4)To describe a model of uncertainty distress.

Level of uncertainty about the affective nature of a pictorial stimulus influences anticipatory neural processes: An event-related potential (ERP) study

Uncertainty about the emotional impact of future events is a common part of everyday life. However, relatively little is known about whether the level of uncertainty about the affective nature of an upcoming visual image influences anticipatory neurocognitive processes. To investigate this, participants viewed a series of negative and neutral pictures, which were preceded by abstract anticipatory cues. Neural activity was measured using event-related potentials (ERPs). In the 'uncertain' cue condition, the cue could be followed by either a negative or a neutral picture with equal probability; in the 'fairly uncertain' condition the cue was followed by a negative picture on 70% of trials, and by a neutral picture on 30% of trials. In the 'certain' condition, the cue was always followed by a negative picture. For the P200 component, reflecting early stages of selective attention, there was no amplitude difference between cue conditions. At later stages of processing, the early posterior negativity (EPN) amplitude was enhanced for cues indicating a greater level of certainty, and the late positive potential (LPP) amplitude was greater for certain, compared to fairly uncertain and uncertain cues. The stimulus preceding negativity (SPN), an index of anticipatory processing, was more negative for certain cues compared to fairly uncertain and uncertain cues. For the SPN there was no difference between fairly uncertain and uncertain cues. These results provide evidence that the level of uncertainty regarding the affective nature of an upcoming picture influenced several stages of processing during the anticipation of the stimulus.

Affective evaluation of others' altruistic decisions under risk and ambiguity

Gratitude arises when one is the target of an altruistic decision, particularly when this decision incurs cost to the agent. Here we examined how individuals evaluate others' altruistic decisions under risky (uncertainty with known probabilities) and ambiguous (uncertainty with unknown probabilities) costs and respond with gratitude and reciprocity. Participants played an interactive game in an fMRI scanner in which they would receive painful electric shocks. An anonymous co-player either intentionally (Human conditions) or unintentionally (Computer conditions) decided whether to help the participant reduce half of the pain by undertaking an amount of pain (i.e., cost) with varying level of uncertainty (Certain vs. Risky vs. Ambiguous). Participants could then transfer monetary points to the co-player knowing that the co-player was unaware of this transfer. Behaviorally, monetary allocation and gratitude rating increased as the uncertainty level of cost increased in Human conditions; these effects were reduced in Computer conditions. The effect of cost uncertainty on gratitude was mediated by the perceived kind intention behind the help. FMRI revealed both shared and differential neurocognitive substrates for evaluating the benefactor's altruistic decisions under risk and ambiguity: both were associated with fear- and anxiety-related processes, involving right lateral orbitofrontal cortex and anterior insula; ambiguity additionally recruited mentalizing- and conflict monitoring-related processes, involving dorsal medial prefrontal cortex and dorsal anterior cingulate cortex. These findings underscore the crucial role of social uncertainty perception in the generation of gratitude.

Decision making under uncertainty in a quasi realistic binary decision task - An fMRI study

Approaching real life decision making through Quasi Realistic Decision Making may increase the ecological validity of decision making experiments. This could help narrow the gap between laboratory settings and observations in real world contexts and thus allow for generalization of laboratory results to everyday life. A binary decision task with quasi realistic context and stimuli was created to investigate neural processing of certain and uncertain decision making, using functional Magnetic Resonance Imaging. On the basis of behavioral data (consistency of decisions in identical contexts), trials with uncertain and certain decision making were identified. This allowed for comparing uncertain and certain conditions, and contrasting each condition with a low level baseline (i.e., between trial fixation dot). A Conjunction analysis between contrasts of uncertainty versus baseline and certainty versus baseline indicated a large overlap of neural network recruitment distributed in bilateral middle frontal, medial frontal, inferior parietal, occipito-temporal, and medio-temporal areas, and the cingulate cortex. While basic neural processing principles in uncertain and certain contexts were comparable, the direct contrast revealed activation foci in middle cingulate and in frontal and parietal areas. The quasi realistic approach revealed a common network for decision making which is modulated by uncertainty.