The Neural Basis of Approach-Avoidance Conflict: A Model Based Analysis

Belief inference for hierarchical hidden states in spatial navigation

Uncertainty abounds in the real world, and in environments with multiple layers of unobservable hidden states, decision-making requires resolving uncertainties based on mutual inference. Focusing on a spatial navigation problem, we develop a Tiger maze task that involved simultaneously inferring the local hidden state and the global hidden state from probabilistically uncertain observation. We adopt a Bayesian computational approach by proposing a hierarchical inference model. Applying this to human task behaviour, alongside functional magnetic resonance brain imaging, allows us to separate the neural correlates associated with reinforcement and reassessment of belief in hidden states. The imaging results also suggest that different layers of uncertainty differentially involve the basal ganglia and dorsomedial prefrontal cortex, and that the regions responsible are organised along the rostral axis of these areas according to the type of inference and the level of abstraction of the hidden state, i.e. higher-order state inference involves more anterior parts.

The neurocomputational link between defensive cardiac states and approach-avoidance arbitration under threat

Avoidance, a hallmark of anxiety-related psychopathology, often comes at a cost; avoiding threat may forgo the possibility of a reward. Theories predict that optimal approach-avoidance arbitration depends on threat-induced psychophysiological states, like freezing-related bradycardia. Here we used model-based fMRI analyses to investigate whether and how bradycardia states are linked to the neurocomputational underpinnings of approach-avoidance arbitration under varying reward and threat magnitudes. We show that bradycardia states are associated with increased threat-induced avoidance and more pronounced reward-threat value comparison (i.e., a stronger tendency to approach vs. avoid when expected reward outweighs threat). An amygdala-striatal-prefrontal circuit supports approach-avoidance arbitration under threat, with specific involvement of the amygdala and dorsal anterior cingulate (dACC) in integrating reward-threat value and bradycardia states. These findings highlight the role of human freezing states in value-based decision making, relevant for optimal threat coping. They point to a specific role for amygdala/dACC in state-value integration under threat.

Temporal dynamics of costly avoidance in naturalistic fears: Evidence for sequential-sampling of fear and reward information

Excessive avoidance is characteristic for anxiety disorders, even when approach would lead to positive outcomes. The process of how such approach-avoidance conflicts are resolved is not sufficiently understood. We examined the temporal dynamics of approach-avoidance in intense fear of spiders. Highly fearful and non-fearful participants chose repeatedly between a fixed no spider/low reward and a spider/high reward option with varying fear (probability of spider presentation) and reward information (reward magnitude). By sequentially presenting fear and reward information, we distinguished whether decisions are dynamically driven by both information (sequential-sampling) or whether the impact of fear information is inhibited (cognitive control). Mouse movements were recorded to assess temporal decision dynamics (i.e., how strongly which information impacts decision preference at which timepoint). Highly fearful participants showed stronger avoidance despite lower gains (i.e., costly avoidance). Time-continuous multiple regression of their mouse movements yielded a stronger impact of fear compared to reward information. Importantly, presenting either information first (fear or reward) enhanced its impact during the early decision process. These findings support sequential sampling of fear and reward information, but not inhibitory control. Hence, pathological avoidance may be characterized by biased evidence accumulation rather than altered cognitive control.

Anxiety may alter the role of fronto-striatal circuitry in adolescent risky decision-making

BACKGROUND

Anxiety disorders often emerge in adolescence and are associated with risk aversion. Risk aversion conflicts with the typical adolescent approach-motivated phenotype and can interfere with learning and contribute to symptom maintenance.

METHODS

We investigated the neural and behavioral correlates of risk avoidance in a diverse sample of adolescents (N = 137; MAge = 11.3; 34.3 % white, 22.1 % Latino, 20 % Asian, 14.3 % Black, 9.3 % Mixed Race) as they completed a task involving risky decision-making and response inhibition during fMRI. Voluntary cautious choice was compared to successful response inhibition to isolate the neural systems underlying the decision to avoid a risk and identify their relation to risk-taking and anxiety in adolescents.

RESULTS

Anxious adolescents self-reported more avoidance but demonstrated normative risk-taking on the laboratory task. Interestingly, they responded quickly during response inhibition but took longer to decide in the face of risk. All youth showed widespread recruitment of decision-making and salience network regions when deciding to avoid risk. The neural mechanisms driving avoidance differed based on anxiety such that left inferior frontal gyrus (IFG) activation was linked to risk avoidance in adolescents with low anxiety and risk-taking in anxious adolescents, while striatal connectivity was linked to risk avoidance in anxious adolescents and risk-taking in those with low anxiety.

LIMITATIONS

This work is cross-sectional and therefore cannot speak to causality or directionality of effects.

CONCLUSIONS

These results suggest that the neural mechanisms contributing to adolescent risk-taking may function to promote avoidance in anxious youth, increasing vulnerability to maladaptive avoidance and further anxiety development.

The empirical status of predictive coding and active inference

Research on predictive processing models has focused largely on two specific algorithmic theories: Predictive Coding for perception and Active Inference for decision-making. While these interconnected theories possess broad explanatory potential, they have only recently begun to receive direct empirical evaluation. Here, we review recent studies of Predictive Coding and Active Inference with a focus on evaluating the degree to which they are empirically supported. For Predictive Coding, we find that existing empirical evidence offers modest support. However, some positive results can also be explained by alternative feedforward (e.g., feature detection-based) models. For Active Inference, most empirical studies have focused on fitting these models to behavior as a means of identifying and explaining individual or group differences. While Active Inference models tend to explain behavioral data reasonably well, there has not been a focus on testing empirical validity of active inference theory per se, which would require formal comparison to other models (e.g., non-Bayesian or model-free reinforcement learning models). This review suggests that, while promising, a number of specific research directions are still necessary to evaluate the empirical adequacy and explanatory power of these algorithms.

Placing Approach-Avoidance Conflict Within the Framework of Multi-objective Reinforcement Learning

Many psychiatric disorders are marked by impaired decision-making during an approach-avoidance conflict. Current experiments elicit approach-avoidance conflicts in bandit tasks by pairing an individual's actions with consequences that are simultaneously desirable (reward) and undesirable (harm). We frame approach-avoidance conflict tasks as a multi-objective multi-armed bandit. By defining a general decision-maker as a limiting sequence of actions, we disentangle the decision process from learning. Each decision maker can then be identified as a multi-dimensional point representing its long-term average expected outcomes, while different decision making models can be associated by the geometry of their 'feasible region', the set of all possible long term performances on a fixed task. We introduce three example decision-makers based on popular reinforcement learning models and characterize their feasible regions, including whether they can be Pareto optimal. From this perspective, we find that existing tasks are unable to distinguish between the three examples of decision-makers. We show how to design new tasks whose geometric structure can be used to better distinguish between decision-makers. These findings are expected to guide the design of approach-avoidance conflict tasks and the modeling of resulting decision-making behavior.

Neural correlates of learning accommodation and consolidation in generalised anxiety disorder

OBJECTIVE.

Anxiety can interfere with attention and working memory, which are components that affect learning. Statistical models have been designed to study learning, such as the Bayesian Learning Model, which takes into account prior possibilities and behaviours to determine how much of a new behaviour is determined by learning instead of chance. However, the neurobiological basis underlying how anxiety interferes with learning is not yet known. Accordingly, we aimed to use neuroimaging techniques and apply a Bayesian Learning Model to study learning in individuals with generalised anxiety disorder (GAD).

METHODS.

Participants were 25 controls and 14 individuals with GAD and comorbid disorders. During fMRI, participants completed a shape-button association learning and reversal task. Using a flexible factorial analysis in SPM, activation in the dorsolateral prefrontal cortex, basal ganglia, and hippocampus was compared between groups during first reversal. Beta values from the peak of these regions were extracted for all learning conditions and submitted to repeated measures analyses in SPSS.

RESULTS.

Individuals with GAD showed less activation in the basal ganglia and the hippocampus only in the first reversal compared with controls. This difference was not present in the initial learning and second reversal.

CONCLUSION.

Given that the basal ganglia is associated with initial learning, and the hippocampus with transfer of knowledge from short- to long-term memory, our results suggest that GAD may engage these regions to a lesser extent during early accommodation or consolidation of learning, but have no longer term effects in brain activation patterns during subsequent learning.

Elucidating medial temporal and frontal lobe contributions to approach-avoidance conflict decision-making using functional MRI and the hierarchical drift diffusion model

The prefrontal cortex (PFC) has long been associated with arbitrating between approach and avoidance in the face of conflicting and uncertain motivational information, but recent work has also highlighted medial temporal lobe (MTL) involvement. It remains unclear, however, how the contributions of these regions differ in their resolution of conflict information and uncertainty. We designed an fMRI paradigm in which participants approached or avoided object pairs that differed by motivational conflict and outcome uncertainty (complete certainty vs. complete uncertainty). Behavioral data and decision-making parameters estimated using the hierarchical drift diffusion model revealed that participants' responding was driven by conflict rather than uncertainty. Our neural data suggest that PFC areas contribute to cognitive control during approach-avoidance conflict by potentially adjusting response caution and the strength of evidence generated towards either choice, with differential involvement of anterior cingulate cortex and dorsolateral prefrontal cortex. The MTL, on the other hand, appears to contribute to evidence generation, with the hippocampus linked to evidence accumulation for stimuli. Although findings within perirhinal cortex were comparatively equivocal, some evidence suggests contributions to perceptual representations, particularly under conditions of threat. Our findings provide evidence that MTL and PFC regions may contribute uniquely to arbitrating approach-avoidance conflict.

Quantifying aberrant approach-avoidance conflict in psychopathology: A review of computational approaches

Making effective decisions during approach-avoidance conflict is critical in daily life. Aberrant decision-making during approach-avoidance conflict is evident in a range of psychological disorders, including anxiety, depression, trauma-related disorders, substance use disorders, and alcohol use disorders. To help clarify etiological pathways and reveal novel intervention targets, clinical research into decision-making is increasingly adopting a computational psychopathology approach. This approach uses mathematical models that can identify specific decision-making related processes that are altered in mental health disorders. In our review, we highlight foundational approach-avoidance conflict research, followed by more in-depth discussion of computational approaches that have been used to model behavior in these tasks. Specifically, we describe the computational models that have been applied to approach-avoidance conflict (e.g., drift-diffusion, active inference, and reinforcement learning models), and provide resources to guide clinical researchers who may be interested in applying computational modeling. Finally, we identify notable gaps in the current literature and potential future directions for computational approaches aimed at identifying mechanisms of approach-avoidance conflict in psychopathology.

Social avoidance behavior modulates motivational responses to social reward-threat conflict signals: A preliminary fMRI study

Social avoidance behavior (SAB) produces impairment in multiple domains and contributes to the development and maintenance of several psychiatric disorders. Social behaviors such as SAB are influenced by approach-avoidance (AA) motivational responses to affective facial expressions. Notably, affective facial expressions communicate varying degrees of social reward signals (happiness), social threat signals (anger), or social reward-threat conflict signals (co-occurring happiness and anger). SAB is associated with dysregulated modulation of automatic approach-avoidance (AA) motivational responses exclusively to social reward-threat conflict signals. However, no neuroimaging research has characterized SAB-related modulation of automatic and subjective AA motivational responses to social reward-threat conflict signals. We recruited 30 adults reporting clinical, moderate, or minimal SAB based on questionnaire cutoff scores. SAB groups were matched on age range and gender. During fMRI scanning, participants completed implicit and subjective approach-avoidance tasks (AATs), which involved more incidental or more explicit evaluation of facial expressions that parametrically varied in social reward signals (e.g., 50%_Happy), social threat signals (e.g., 50%_Angry), or social reward-threat conflict signals (e.g., 50%_Happy + 50%_Angry). In the implicit AAT, SAB was associated with slower automatic avoidance actions and weaker amygdala-pgACC connectivity exclusively as a function of social reward-threat conflict signals. In the subjective AAT, SAB was associated with smaller increases in approach ratings, smaller decreases in avoidance ratings, and weaker dlPFC-pgACC connectivity exclusively in response to social reward-threat conflict signals. Thus, SAB is associated with dysregulated modulation of automatic and subjective AA motivational sensitivity to social reward-threat conflict signals, which may be facilitated by overlapping neural systems.

Large-scale neural network computations and multivariate representations during approach-avoidance conflict decision-making

Many real-world situations require navigating decisions for both reward and threat. While there has been significant progress in understanding mechanisms of decision-making and mediating neurocircuitry separately for reward and threat, there is limited understanding of situations where reward and threat contingencies compete to create approach-avoidance conflict (AAC). Here, we leverage computational learning models, independent component analysis (ICA), and multivariate pattern analysis (MVPA) approaches to understand decision-making during a novel task that embeds concurrent reward and threat learning and manipulates congruency between reward and threat probabilities. Computational modeling supported a modified reinforcement learning model where participants integrated reward and threat value into a combined total value according to an individually varying policy parameter, which was highly predictive of decisions to approach reward vs avoid threat during trials where the highest reward option was also the highest threat option (i.e., approach-avoidance conflict). ICA analyses demonstrated unique roles for salience, frontoparietal, medial prefrontal, and inferior frontal networks in differential encoding of reward vs threat prediction error and value signals. The left frontoparietal network uniquely encoded degree of conflict between reward and threat value at the time of choice. MVPA demonstrated that delivery of reward and threat could accurately be decoded within salience and inferior frontal networks, respectively, and that decisions to approach reward vs avoid threat were predicted by the relative degree to which these reward vs threat representations were active at the time of choice. This latter result suggests that navigating AAC decisions involves generating mental representations for possible decision outcomes, and relative activation of these representations may bias subsequent decision-making towards approaching reward or avoiding threat accordingly.

Striatal reactivity during emotion and reward relates to approach-avoidance conflict behaviour and is altered in adults with anxiety or depression

BACKGROUND

We have previously reported activation in reward, salience and executive control regions during functional MRI (fMRI) using an approach-avoidance conflict (AAC) decision-making task with healthy adults. Further investigations into how anxiety and depressive disorders relate to differences in neural responses during AAC can inform their understanding and treatment. We tested the hypothesis that people with anxiety or depression have altered neural activation during AAC.

METHODS

We compared 118 treatment-seeking adults with anxiety or depression and 58 healthy adults using linear mixed-effects models to examine group-level differences in neural activation (fMRI) during AAC decision-making. Correlational analyses examined relationships between behavioural and neural measures.

RESULTS

Adults with anxiety or depression had greater striatal engagement when reacting to affective stimuli (p = 0.008, d = 0.31) regardless of valence, and weaker striatal engagement during reward feedback (p = 0.046, d = -0.27) regardless of the presence of monetary reward. They also had blunted amygdala activity during decision-making (p = 0.023, d = -0.32) regardless of the presence of conflict. Across groups, approach behaviour during conflict decision-making was inversely correlated with striatal activation during affective stimuli (p < 0.001, r = -0.28) and positively related to striatal activation during reward feedback (p < 0.001, r = 0.27).

LIMITATIONS

Our transdiagnostic approach did not allow for comparisons between specific anxiety disorders, and our cross-sectional approach did not allow for causal inference.

CONCLUSION

Anxiety and depression were associated with altered neural responses to AAC. Findings were consistent with the role of the striatum in action selection and reward responsivity, and they point toward striatal reactivity as a future treatment target. Blunting of amygdala activity in anxiety or depression may indicate a compensatory response to inhibit affective salience and maintain approach.

Active and avoidant coping profiles in children and their relationship with anxiety and depression during the COVID-19 pandemic

Active and avoidant coping styles are important dispositional factors in the development of anxiety and depression symptoms. Children use both active and avoidant coping strategies together in daily life. No studies have investigated the relationship between active–avoidant coping profiles and internalizing symptoms in children. The present study aimed to investigate children’s active–avoidant coping profiles and assess the relationship that active–avoidant coping profiles have with anxiety and depression symptoms. A two-wave longitudinal study was conducted among 322 Chinese children in the People’s Republic of China during the COVID-19 pandemic. Participants completed the Children’s Coping Strategies Checklist-Revised 1 at Time 1 and the Revised Child Anxiety and Depression Scale at Time 1 and 6 months later (Time 2). Four active–avoidant coping profiles were revealed: low active copers, high active copers, balanced copers, and avoidant copers. Low and high active copers had lower levels of anxiety and depression symptoms than balanced copers and avoidant copers. Avoidant copers showed a larger decrease in depression symptoms than balanced copers and high active copers during the COVID-19 pandemic. It is important to improve children’s active–avoidant coping profiles to relieve anxiety and depression symptoms.

The neural signature of the decision value of future pain

SignificanceWe often willingly experience pain to reach a goal. However, potential pain can also prevent reckless action. How do we consider future pain when deciding on the best course of action? To date, the precise neural mechanisms underlying the valuation of future pain remain unknown. Using functional MRI, we derive a whole-brain signature of the value of future pain capable of predicting participants' choices to accept pain in exchange for a reward. We show that this signature is characterized by a distributed pattern of activity with clear contributions from structures encoding reward and salience, notably the ventral and dorsal striatum. These findings highlight how the brain assigns value to future pain when choosing the best course of action.

Costly avoidance of Pavlovian fear stimuli and the temporal dynamics of its decision process

Conflicts between avoiding feared stimuli versus approaching them for competing rewards are essential for functional behavior and anxious psychopathology. Yet, little is known about the underlying decision process. We examined approach-avoidance decisions and their temporal dynamics when avoiding Pavlovian fear stimuli conflicted with gaining rewards. First, a formerly neutral stimulus (CS+) was repeatedly paired with an aversive stimulus (US) to establish Pavlovian fear. Another stimulus (CS−) was never paired with the US. A control group received neutral tones instead of aversive USs. Next, in each of 324 trials, participants chose between a CS−/low reward and a CS+/high reward option. For the latter, probability of CS+ presentation (Pavlovian fear information) and reward magnitude (reward information) varied. Computer mouse movements were tracked to capture the decision dynamics. Although no more USs occurred, pronounced and persistent costly avoidance of the Pavlovian fear CS+ was found. Time-continuous multiple regression of movement trajectories revealed a stronger and faster impact of Pavlovian fear compared to reward information during decision-making. The impact of fear information, but not reward information, modestly decreased across trials. These findings suggest a persistently stronger weighting of fear compared to reward information during approach-avoidance decisions, which may facilitate the development of pathological avoidance.

Value priorities and value conflicts in patients with mental disorders compared to a general population sample

Personal values are considered as guiding principles for humans’ attitudes and behavior, what makes them an essential component of mental health. Although these notions are widely recognized, investigations in clinical samples examining the link between values and mental health are lacking. We assessed n = 209 patients with affective disorders, neurotic disorders, reaction to severe stress, and adjustment disorders and personality disorders and compared them to a stratified random sample (n = 209) drawn from the European Social Survey. Personal values were assessed using the Portraits Value Questionnaire. Severity of psychopathology was assessed using the Beck Depression Inventory and the Brief Symptom Inventory. Clinical participants showed a higher preference for the values power, achievement and tradition/conformity and a lower preference for hedonism compared to controls. Patients exhibited more incompatible value patterns than controls. Across diagnostic groups, patients with neurotic disorders reported incompatible values most frequently. Value priorities and value conflicts may have the potential to contribute to a better understanding of current and future actions and experiences in patients with mental disorders.

Frontal Asymmetry as a Neural Correlate of Motivational Conflict

Motivational systems of approach, avoidance, and inhibition are fundamental to human behavior. While past research has linked approach motivation with greater relative left frontal asymmetry, many attempts to link avoidance motivation with greater relative right frontal asymmetry have been mixed. These mixed effects could be due to coactivation of the avoidance and behavioral inhibition system (BIS). Much recent evidence indicates that the behavioral inhibition system may be associated with greater relative right frontal activation. The current review examines evidence linking traits associated with the behavioral inhibition system with resting right frontal asymmetry. Other research links individual differences associated with the behavioral inhibition system with state changes in relative right frontal asymmetry. Moreover, activation of the behavioral inhibition system, but not activation of withdrawal motivation, increases greater relative right frontal asymmetry. Together, this work highlights the role of relative frontal asymmetry as a neural correlate in motivational conflict and helps to disentangle behavioral inhibition from avoidance motivation.

The Role of the Dorsal-Lateral Prefrontal Cortex in Reward Sensitivity During Approach-Avoidance Conflict

Approach-Avoidance conflict (AAC) arises from decisions with embedded positive and negative outcomes, such that approaching leads to reward and punishment and avoiding to neither. Despite its importance, the field lacks a mechanistic understanding of which regions are driving avoidance behavior during conflict. In the current task, we utilized transcranial magnetic stimulation (TMS) and drift-diffusion modeling to investigate the role of one of the most prominent regions relevant to AAC-the dorsolateral prefrontal cortex (dlPFC). The first experiment uses in-task disruption to examine the right dlPFC's (r-dlPFC) causal role in avoidance behavior. The second uses single TMS pulses to probe the excitability of the r-dlPFC, and downstream cortical activations, during avoidance behavior. Disrupting r-dlPFC during conflict decision-making reduced reward sensitivity. Further, r-dlPFC was engaged with a network of regions within the lateral and medial prefrontal, cingulate, and temporal cortices that associate with behavior during conflict. Together, these studies use TMS to demonstrate a role for the dlPFC in reward sensitivity during conflict and elucidate the r-dlPFC's network of cortical regions associated with avoidance behavior. By identifying r-dlPFC's mechanistic role in AAC behavior, contextualized within its conflict-specific downstream neural connectivity, we advance dlPFC as a potential neural target for psychiatric therapeutics.

Motivational system modulates brain responses during exploratory decision-making

Managers face risk in explorative decision-making and those who are better at such decisions can achieve future viability. To understand what makes a manager effective at explorative decision-making requires an analysis of the manager’s motivational characteristics. The behavioral activation/inhibition system (BAS/BIS), fitting the motivational orientation of “approach” or “avoidance,” can affect individual decision-making. However, very little is known about the neural correlates of BAS/BIS orientation and their interrelationship with the mental activity during explorative decision-making. We conducted an fMRI study on 111 potential managers to investigate how the brain responses of explorative decision-making interact with BAS/BIS. Participants were separated into high- and low-performance groups based on the median exploration-score. The low-performance group showed significantly higher BAS than that of the high-performance group, and its BAS had significant negative association with neural networks related to reward-seeking during explorative decision-making. Moreover, the BIS of the low-performance group was negatively correlated with the activation of cerebral regions responding to risk-choice during explorative decision-making. Our finding showed that BAS/BIS was associated with the brain activation during explorative decision-making only in the low-performance group. This study contributed to the understanding of the micro-foundations of strategically relevant decision-making and has an implication for management development.

Test-retest reliability of approach-avoidance conflict decision-making during functional magnetic resonance imaging in healthy adults

Neural and behavioral mechanisms during approach-avoidance conflict decision-making are relevant across various psychiatric disorders, particularly anxiety disorders. Studies using approach-avoidance conflict paradigms in healthy adults have identified preliminary neural mechanisms, but findings must be replicated and demonstrated as reliable before further application. This study sought to replicate previous findings and examine test-retest reliability of behavioral (approach behavior, reaction time) and neural (regions of interest [ROIs]) responses during an approach-avoidance conflict task conducted during functional magnetic resonance imaging (fMRI). Thirty healthy adults completed an approach-avoidance conflict task during fMRI on two occasions (mean interval: 17 days; range: 11-32). Effects of task condition during three task phases (decision-making, affective outcome and monetary reward) and intraclass correlation coefficients (ICCs) were calculated across time points. Results replicated that approach behavior was modulated by conflict during decision-making. ROI activations were replicated such that dorsal anterior cingulate cortex (dACC) was modulated by conflict during decision-making, and dACC, striatum, and anterior insula were modulated by valence during affective outcomes (p's <.0083). Approach behavior during conflict demonstrated excellent reliability (ICCs ≥.77). Activation of dACC during conflict decision-making and anterior insula during negative outcomes demonstrated fair reliability (ICCs = .51 and .54), and dACC and striatum activation demonstrated good reliability during negative outcomes (ICCs = .63 and .69). Two additional ROIs (amygdala, left dorsolateral prefrontal cortex) showed good reliability during negative outcomes (ICCs ≥.60). These results characterize several specific behavioral and neuroimaging responses that are replicable and sufficiently reliable during approach-avoidance conflict decision-making to support future utility.

Using mobile brain/body imaging to advance research in arts, health, and related therapeutics

The uses of mobile brain/body imaging (MoBI) are expanding and allow for more direct study of the neurophysiological signals associated with behavior in psychotherapeutic encounters. Neuroaesthetics is concerned with the cognitive and neural basis of art appreciation, and scientific correlations are being made in the field that might help to clarify theories claimed in the creative arts therapies. Yet, most neuroaesthetics studies are confined to the laboratory and do not propose a translation for research methods and clinical applications. The creative arts therapies have a long history of clinical success with various patient populations and will benefit from increased scientific explanation to support intervention strategies. Examining the brain dynamics and motor behaviors that are associated with the higher complex processes involved in artistic expression offers MoBI as a promising instrumentation to move forward in linking ideas from neuroaesthetics to the creative arts therapies. Tracking brain dynamics in association with behavioral change allows for more objective and quantitative physiological monitors to evaluate, and together with subjective patient reports provides insight into the psychological mechanisms of change in treatment. We outline a framework that shows how MoBI can be used to study the effectiveness of creative arts therapy interventions motivated by the 4E approach to cognition with a focus on visual art therapy. The article illuminates how a new partnership among the fields of art therapy, neuroscience, and neuroaesthetics might work together within the 4E/MoBI framework in efforts to advance transdisciplinary research for clinical health populations.

Deep brain stimulation for psychiatric disorders: From focal brain targets to cognitive networks

Deep brain stimulation (DBS) is a promising intervention for treatment-resistant psychiatric disorders, particularly major depressive disorder (MDD) and obsessive-compulsive disorder (OCD). Up to 90% of patients who have not recovered with therapy or medication have reported benefit from DBS in open-label studies. Response rates in randomized controlled trials (RCTs), however, have been much lower. This has been argued to arise from surgical variability between sites, and recent psychiatric DBS research has focused on refining targeting through personalized imaging. Much less attention has been given to the fact that psychiatric disorders arise from dysfunction in distributed brain networks, and that DBS likely acts by altering communication within those networks. This is in part because psychiatric DBS research relies on subjective rating scales that make it difficult to identify network biomarkers. Here, we overview recent DBS RCT results in OCD and MDD, as well as the follow-on imaging studies. We present evidence for a new approach to studying DBS' mechanisms of action, focused on measuring objective cognitive/emotional deficits that underpin these and many other mental disorders. Further, we suggest that a focus on cognition could lead to reliable network biomarkers at an electrophysiologic level, especially those related to inter-regional synchrony of the local field potential (LFP). Developing the network neuroscience of DBS has the potential to finally unlock the potential of this highly specific therapy.

Human social defeat and approach-avoidance: Escalating social-evaluative threat and threat of aggression increases social avoidance

Basic research on avoidance by Murray Sidman laid the foundation for advances in the classification, conceptualization and treatment of avoidance in psychological disorders. Contemporary avoidance research is explicitly translational and increasingly focused on how competing appetitive and aversive contingencies influence avoidance. In this laboratory investigation, we examined the effects of escalating social-evaluative threat and threat of social aggression on avoidance of social interactions. During social-defeat learning, 38 adults learned to associate 9 virtual peers with an increasing probability of receiving negative evaluations. Additionally, 1 virtual peer was associated with positive evaluations. Next, in an approach-avoidance task with social-evaluative threat, 1 peer associated with negative evaluations was presented alongside the peer associated with positive evaluations. Approaching peers produced a positive or a probabilistic negative evaluation, while avoiding peers prevented a negative evaluation (and forfeited a positive evaluation). In an approach-avoidance task with social aggression, virtual peers gave and took money away from participants. Escalating social-evaluative threat and aggression increased avoidance, ratings of feeling threatened and threat expectancy and decreased ratings of peer favorableness. These findings underscore the potential of coupling social defeat and approach-avoidance paradigms for translational research on the neurobehavioral mechanisms of social approach-avoidance decision-making and anxiety.