Reciprocal associations between affective decision-making and mental health in adolescence

Poor affective decision-making has been shown to associate cross-sectionally with poor mental health in clinical populations. However, evidence from general population samples is scarce. Moreover, whether decision-making is prospectively linked to mental health in youth in the general population and whether such associations are reciprocal have yet to be examined. The present study examined bidirectional associations between various aspects of affective decision-making and emotional and behavioural problems at ages 11 and 14 years in 13,366 members of the Millennium Cohort Study. Decision-making (delay aversion, deliberation time, quality of decision-making, risk adjustment, risk-taking) and emotional (emotional symptoms, peer problems) and behavioural (conduct problems, hyperactivity/inattention) problems were measured using the Cambridge Gambling Task and the Strengths and Difficulties Questionnaire, respectively. Results of cross-lagged panel models adjusted for confounding revealed a negative reciprocal association between hyperactivity and quality of decision-making but also positive reciprocal associations between conduct problems and delay aversion, and between peer problems and deliberation time. Emotional problems and peer problems predicted a decrease in risk-taking, conduct problems predicted an increase in risk-taking, and hyperactivity predicted an increase in delay aversion and deliberation time. Furthermore, hyperactivity and conduct problems predicted less risk adjustment, and risk adjustment predicted fewer peer problems. The results suggest that behavioural problems are prospectively linked to greater risk-taking and lower risk adjustment in adolescence. Moreover, adolescents with behavioural problems tend to make poorer decisions and be more delay-averse, but also poorer quality of decision-making and increased delay aversion are associated with more behavioural problems over time.

A systematic review and meta-analysis of risky decision-making in specific domains of problematic use of the internet: Evidence across different decision-making tasks

This systematic review summarizes empirical evidence on risky decision-making (objective risk and ambiguity) in specific domains of problematic use of the internet (PUI) focusing on online addictive behaviors. We conducted a pre-registered (PROSPERO: CRD42020188452) PubMed search for PUI domains: gaming, social-network use, online buying-shopping, online pornography use, and unspecified PUI. We used the Newcastle-Ottawa Scale for quality assessment. Relevant studies were identified only for gaming (n = 19), social-network use (n = 8), unspecified PUI (n = 7), and online gambling (n = 1). The meta-analyses included 25 studies (2498 participants) comparing PUI and control groups regarding decision-making performance under objective risk and ambiguity. Across PUI domains, individuals with PUI compared to control participants showed more disadvantageous decision-making in measures of objective risk (g = -0.42 [-0.69, -0.16], p = .002) but not ambiguity (g = -0.22 [-0.47, -0.04], p = .096). PUI domain and gender were significant moderators. In the risk domain, effects were particularly present in gaming disorder, especially in exclusively male samples. Overall, the paucity of empirical studies in the considered area necessitates further research to identify probable gender- and disorder-specific cognitive relationships.

The Role of Decision-Making in Psychological Wellbeing and Risky Behaviours in Autistic Adolescents Without ADHD: Longitudinal Evidence from the UK Millennium Cohort Study

This study examined the development of decision-making and its association with psychological wellbeing and risky behaviours in adolescents with and without autism. Participants included 270 autistic and 9,713 typically developing adolescents. In both samples, those with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) were excluded. Data came from the Millennium Cohort Study, a nationally representative population-based birth cohort. Decision-making was assessed using the Cambridge Gambling Task at ages 11 and 14. Psychological wellbeing (happiness, self-esteem, depressive symptoms and self-harm) and risky/antisocial behaviours were self-reported at age 14. After adjusting for sex, cognitive ability, spatial working memory, socioeconomic status and pubertal status, autistic adolescents showed comparable quality of decision-making to that of their peers at both ages but also a more deliberative decision-making style as they aged. Only in autistic adolescents was this decision-making style associated with positive outcomes.

Contrasting effects of d-amphetamine and atomoxetine on measures of impulsive action and choice

Amphetamine (AMP) and atomoxetine (ATX) represent two of the most widely studied drug treatments used in the investigation of impulsive behaviour. While both drugs have relatively well defined effects in tests designed to investigate impulsive action (e.g. 5-choice task; 5-CSRTT), the effects of both drugs in tests of impulsive choice (e.g. delay discounting) are less consistent. In the present study both AMP and ATX were tested in a rodent gambling task (rGT) and delay discounting in rats separately trained to either an ascending or descending delay schedule. Effects of both drugs were compared to measures of impulsive action (premature (PREM) responses) and perseverative (PSV) responses measured in the 5-choice and rGT tasks. Consistent with previous studies, AMP (0.1-1 mg/kg) increased both PREM and PSV responses, and ATX (0.5-2 mg/kg) reduced both measures in the 5-choice and rGT tasks. At equivalent doses ATX had no reliable effect on choice behaviour in either the rGT or delay discounting suggesting a null effect of this drug on impulsive choice and risky decision making. The effects of AMP were more complex, with a subtle shift in preference to a low risk (P1) choice in the rGT, and an effect on discounting that was unrelated to reinforcer value, but instead dependent on delay sequence and baseline choice preference. One aspect to these outcomes is to highlight the importance of multiple methodological factors when assessing drug effects on complex behaviours such as impulsive choice, and question what are the most appropriate test conditions under which to examine these drugs on discounting.

Interpersonal relationships modulate outcome evaluation in a social comparison context: The pain and pleasure of intimacy

Previous research has revealed that interpersonal relationships and social comparisons play important roles in evaluating outcomes. To our knowledge, how interpersonal relationships influence the process of outcome evaluations in a social comparison context remains largely unclear. In the current study, participants engaged in a simple gambling task with an acquaintance or a stranger and received outcome feedback. Behavioral results showed that participants' satisfaction level was sensitive to the outcome of their fellow players when participants won. In this condition, the satisfaction level was greater when their fellow players won rather than lost. Moreover, the satisfaction level was greater when their friends won compared with when a stranger won. Event-related potential (ERP) results showed that when participants won, the feedback-related negativity (FRN) was more negative going for other's losses than for other's gains. Moreover, the FRN was also more negative going for a stranger's gains than a friend's gains. In contrast, in the self-loss condition, the FRN was more negative going for other's gains than for other's losses regardless of the type of interpersonal relationship. These FRN findings indicate that the experience of other's outcomes is sensitive to participants' own outcomes. Importantly, the interpersonal relationship only showed its influence when both the self and others received monetary gains. Finally, the P300 registered participants' attention resource allocation toward monetary gains for themselves and for others, which was unaffected by the interpersonal relationship. This work reveals that outcome evaluation in various social comparison contexts is sensitive to the difference in interpersonal relationship in its early stage, labeled by the FRN.

Chronic exposure to glucocorticoids induces suboptimal decision-making in mice

Anxio-depressive symptoms as well as severe cognitive dysfunction including aberrant decision-making (DM) are documented in neuropsychiatric patients with hypercortisolaemia. Yet, the influence of the hypothalamo-pituitary-adrenal (HPA) axis on DM processes remains poorly understood. As a tractable mean to approach this human condition, adult male C57BL/6JRj mice were chronically treated with corticosterone (CORT) prior to behavioural, physiological and neurobiological evaluation. The behavioural data indicate that chronic CORT delays the acquisition of contingencies required to orient responding towards optimal DM performance in a mouse Gambling Task (mGT). Specifically, CORT-treated animals show a longer exploration and a delayed onset of the optimal DM performance. Remarkably, the proportion of individuals performing suboptimally in the mGT is increased in the CORT condition. This variability seems to be better accounted for by variations in sensitivity to negative rather than to positive outcome. Besides, CORT-treated animals perform worse than control animals in a spatial working memory (WM) paradigm and in a motor learning task. Finally, Western blotting neurobiological analyses show that chronic CORT downregulates glucocorticoid receptor expression in the medial Prefrontal Cortex (mPFC). Besides, corticotropin-releasing factor signalling in the mPFC of CORT individuals negatively correlates with their DM performance. Collectively, this study describes how chronic exposure to glucocorticoids induces suboptimal DM under uncertainty in a mGT, hampers WM and motor learning processes, thus affecting specific emotional, motor, cognitive and neurobiological endophenotypic dimensions relevant for precision medicine in biological psychiatry.

A generic brain connectome map linked to different types of everyday decision-making in old age

Making reasonable decisions related to financial and health scenarios is a crucial capacity that can be difficult for older adults to maintain as they age, yet few studies examine neurocognitive factors that are generalizable to different types of everyday decision-making capacity. Here we propose an innovative approach, based on individual risk-taking preference, to identify neural profiles that may help predict older adults' everyday decision-making capacity. Using performance and cognitive arousal information from two gambling tasks, we identified three decision-making preference groups: ambiguity problem-solvers (A), risk-seekers (R), and a control group without strong risk-taking preferences (C). Comparisons of the number of connections within white matter tracts between A vs. C and R vs. C groups resulted in features consistent with the theory of dual neural functional systems involved in decision-making. Unique tracts from the A vs. C contrast were primarily centered in dorsal frontal regions/reflective system; unique tracts from the R vs. C contrast were centered in the ventral frontal regions/impulsive system; and shared tracts from both contrasts were centered in the basal ganglia, coordinating the switch between the two types of decision-making preference. Number of connections from the tracts differentiating A vs. C significantly predicted financial and health/safety decision-making capacity, and the association remained significant after controlling for multiple socioeconomic and cognitive factors. The connectome identified may provide insight into a generic white matter mechanism related to everyday decision-making capacity in older age.

Risky economic choices and frontal EEG asymmetry in the context of Reinforcer-Sensitivity-Theory-5

This study investigated individual risky choice behavior in a gambling task and its relation with traits proposed by the Reinforcer-Sensitivity-Theory-5 (RST-5; Corr & McNaughton in Neuroscience and Biobehavioral Reviews, 36(10), 2339-2354, 2012) as well as with frontal EEG asymmetry. As assumed by the RST-5, the results showed independent influences of approach/avoidance and gain/loss sensitivities on participants' behavior in risky choices. Individual approach/avoidance sensitivity was predicted by trait measures of the behavioral approach system (BAS) and the behavioral inhibition system (BIS), while no such correlation was present for gain/loss sensitivity. EEG recordings revealed relatively stronger left-frontal cortical activity for trials with approach motivation compared to conflict and avoidance motivation. On the individual level, relatively stronger left-frontal cortical activity was associated with trait BAS. In addition, activity changes in frontal EEG asymmetry were associated relatively higher behavioral approach sensitivity. We conclude that frontal EEG asymmetry is an especially useful neuronal marker of BAS sensitivity and that the traits proposed by the RST-5 (measured by frontal EEG asymmetry and self-report) can be used to explain individual differences in risky choice behavior.

Effects of the NMDA receptor antagonists dizocilpine and Ro 63-1908 on delay-discounting and risky decision-making in a gambling task

Previous studies demonstrated that NMDA receptor antagonists such as dizocilpine (MK801) and the GluN2B NMDA antagonist Ro 63-1908 promote impulsive action (motor impulsivity). The effects of these treatments on impulsive choice and decision-making is less well characterized. Two experiments were undertaken. In the first experiment, given evidence for delay order as a factor in choice selection, the effect of dizocilpine was examined in a delay discounting task with separate groups of male Long-Evans rats trained to a schedule of either ascending (i.e. 0-40 s), or descending delays (i.e. 40-0 s). Under the ascending-delay schedule, dizocilpine (0.03-0.06 mg/kg SC) reduced discounting, yet on the descending-delay schedule discounting was increased. Subgrouping rats according to discounting rate under vehicle pretreatment were consistent with a treatment-induced choice perseveration. In a second experiment, male Long-Evans rats were trained to a gambling task (rGT). Neither dizocilpine (0.01-0.06 mg/kg SC) nor Ro 63-1908 (0.1-1 mg/kg SC) shifted choice from the advantageous to the disadvantageous options. However dizocilpine, and marginally Ro 63-1908, increased choice of the least risky, but suboptimal option. This effect was most evident in rats that initially preferred the disadvantageous options. Consistent with previous studies, both treatments increased measures of motor impulsivity. These results demonstrate that dizocilpine has effects on discounting dependent on delay order and likely reflective of perseveration. On the rGT task, neither dizocilpine nor Ro 63-1908 promoted risky choice, yet both NMDA receptor antagonists increased impulsive action.

Disadvantageous decision-making in borderline personality disorder: Partial support from a meta-analytic review

To achieve long-term goals, organisms evaluate outcomes and expected consequences of their behaviors. Unfavorable decisions maintain many symptoms of borderline personality disorder (BPD); therefore, a better understanding of the mechanisms underlying decision-making in BPD is needed. In this review, the current literature comparing decision-making in patients with BPD versus healthy controls is analyzed. Twenty-eight empirical studies were identified through a structured literature search. The effect sizes from studies applying comparable experimental tasks were analyzed. It was found that (1) BPD patients discounted delayed rewards more strongly; (2) reversal learning was not significantly altered in BPD; and (3) BPD patients achieved lower net gains in the Iowa Gambling Task (IGT). Current psychotropic medication, sex and differences in age between the patient and control group moderated the IGT outcome. Altered decision-making in a variety of other tasks was supported by a qualitative review. In summary, current evidence supports the altered valuation of outcomes in BPD. A multifaceted influence on decision-making and adaptive learning is reflected in this literature.

Influence of negative affect on decision making in women with restrictive and binge-purge type anorexia nervosa

The present study aims to examine the influence of negative affect on decision making in women with anorexia nervosa (AN) compared to healthy control women and, secondly, to assess differences between the restrictive (ANR) and binge-purge (ANBP) subtypes. One hundred four women (32 with ANR, 32 with ANBP, and 40 healthy controls) participated. All women were asked to watch either a negative or a control film fragment, both followed by the Bechara Gambling Task (BGT). Before and after the fragments negative affect was measured. Additionally, relevant characteristics (e.g., overall depressive symptoms) were assessed. Differences in negative affect did not influence decision making performance. Independent of affective state, decision making was found to be impaired in women with ANBP (no learning effect on the BGT), but not in women with ANR. These findings highlight the importance of considering different AN subtypes when examining decision making processes. However, the role of negative affect on decision making remains uncertain. Since other affect related factors such as affect dysregulation may also play a role, future studies on decision making in AN should take the role of affect into account.

Risky decision making in Attention-Deficit/Hyperactivity Disorder: A meta-regression analysis

ADHD has been associated with various forms of risky real life decision making, for example risky driving, unsafe sex and substance abuse. However, results from laboratory studies on decision making deficits in ADHD have been inconsistent, probably because of between study differences. We therefore performed a meta-regression analysis in which 37 studies (n ADHD=1175; n Control=1222) were included, containing 52 effect sizes. The overall analysis yielded a small to medium effect size (standardized mean difference=.36, p<.001, 95% CI [.22, .51]), indicating that groups with ADHD showed more risky decision making than control groups. There was a trend for a moderating influence of co-morbid Disruptive Behavior Disorders (DBD): studies including more participants with co-morbid DBD had larger effect sizes. No moderating influence of co-morbid internalizing disorders, age or task explicitness was found. These results indicate that ADHD is related to increased risky decision making in laboratory settings, which tended to be more pronounced if ADHD is accompanied by DBD. We therefore argue that risky decision making should have a more prominent role in research on the neuropsychological and -biological mechanisms of ADHD, which can be useful in ADHD assessment and intervention.

Temporal dynamics and potential neural sources of goal conduciveness, control, and power appraisal

A major emotion theory, the Component Process Model, predicts that emotion-antecedent appraisal proceeds sequentially (e.g., goal conduciveness>control>power appraisal). In a gambling task, feedback manipulated information about goal conduciveness (outcome: win, loss), control (perceived high and low control), and power appraisals (choice options to change the outcome). Using mean amplitudes of event-related potentials, we examine the sequential prediction of these appraisal criteria. Additionally, we apply source localization analysis to estimate the neural sources of the evoked components of interest. Early ERPs (230-300 ms) show main effects of goal conduciveness and power but no interaction effects suggesting goal obstructiveness assessment of task-relevant feedback information. Late ERPs (350-600 ms) reveal main effects of all appraisals and interaction effects representing the integration of all appraisal information. Source localization analysis suggests distinct neural sources for these appraisal criteria.

Reduced impact of emotion on choice behavior in presymptomatic BACHD rats, a transgenic rodent model for Huntington Disease

Executive dysfunction and psychiatric symptoms are hallmarks of Huntington disease (HD), a neurodegenerative disorder genetically characterized by expanded CAG repeats in the HTT gene. Using the BACHD rat model of HD (97 CAG-CAA repeats), the present research seeks to characterize the progressive emergence of decision-making impairments in a rat version of the Iowa Gambling Task (RGT) and the impact of emotional modulation, whether positive or negative, on choice behavior. The choice efficiency shown both by WT rats (independent of their age) and the youngest BACHD rats (2 and 8months old) evidenced that they are able to integrate outcomes of past decisions to determine expected reward values for each option. However, 18months old BACHD rats made fewer choices during the RGT session and were less efficient in choosing advantageous options than younger animals. Presenting either chocolate pellets or electrical footshocks half-way through a second RGT session reduced exploratory activity (inefficient nose-poking) and choices with a weaker effect on BACHD animals than on WT. Choice efficiency was left intact in transgenic rats. Our results bring new knowledge on executive impairments and impact of emotional state on decision-making at different stages of the disease, increasing the face-validity of the BACHD rat model.

Prefronto-subcortical imbalance characterizes poor decision-making: neurochemical and neural functional evidences in rats

A major challenge of decision-making research in recent years has been to develop models of poor decision-making to identify its neural bases. Toward this goal, we developed a Rat Gambling Task that discerns good and poor decision-makers in a complex and conflicting situation such as the human Iowa Gambling Task. Nothing is known about the role of the monoaminergic modulatory systems in shaping these phenotypes. Moreover, functional and temporal contributions of brain areas during poor compared to good decision-making remains elusive. Good and poor decision-makers were identified in the Rat Gambling Task. We investigated neurobiological correlates of decision-making capacities in (1) dopamine and serotonin turnovers using post-mortem tissue measurements, (2) the neural circuits differentially recruited during decision-making within the prefronto-subcortical network using cellular Fos immunodetection. Imbalance in monoamine metabolism was revealed in poor decision-makers, i.e. a higher infralimbic vs. lower amygdala serotonergic metabolism. Moreover, good decision-making recruited a wide prefronto-subcortical network but once good choices had been made, a disengagement of key prefrontal areas (insular and infralimbic cortices notably) and the amygdala was observed. By contrast, poor decision-making was associated with a strikingly low recruitment of the prefronto-subcortical network, together with sustained amygdala activity. Our results identify two complementary neurobiological substrates characterizing poor decision-makers: imbalanced monoaminergic systems at rest, congruent with their previously identified complex behavioral phenotype, and an aberrant low recruitment of key brain areas for executive functions and affective valence during the process of decision-making. These biomarkers could sustain vulnerability to developing poor decision-making related disorders.

Deficit in decision-making in chronic, stable schizophrenia: from a reward and punishment perspective

OBJECTIVE

We compared patients with chronic schizophrenia and normal controls with respect to decision-making ability. Measures were implemented to control for the participants' intelligence levels as well as to ensure to use of a moderate sample size. The goal of this study was to confirm inconsistent results from previous studies which had stemmed from too small of a sample size, highly variable performance of normal controls, and not controlling for intelligence as a confounding factor.

METHODS

Fifty-two chronic stable schizophrenic inpatients and 55 healthy controls participated in the study. We controlled for intelligence by including subjects with intelligence quotient's (IQ) between 80 and 120, examining any differences in decision-making performance between groups on the Iowa Gambling Task (IGT). We also addressed several issues relating to performance on the IGT, such as working memory and clinical symptoms.

RESULTS

Schizophrenic patients were found to perform poorly on the IGT relative to normal controls (F(1,105)=17.73, p<0.001); however, more importantly, they also displayed the slow yet profitable shift from disadvantageous decks to advantageous decks over time. We also found that when compared with healthy controls, schizophrenic patients showed a poorer performance on the Wisconsin Card Sorting Test (WCST)(t=-5.48, p<0.001 for perseverative error) which was not related to their performance on the IGT.

CONCLUSION

Based on previous literature and the results of this study, impaired sensitivity to both reward and punishment might be a more plausible explanation for the poor performance on the IGT in the schizophrenic group. We speculated that this impairment seemed related more to the different responsiveness to the magnitude than to the frequency of punishment, and to the different interpretation of less informative verbal cues in the context of the reinforcing schedule.