Understanding suicidal pathways through the lens of a Dual-System Model of Suicidality in real-time: The potential of ecological momentary assessments

Within the ideation-to-action framework, existing theories of suicidal thoughts and behaviors (STBs) primarily focus on the linear progression of suicide risk. This, however, neglects growing evidence that many suicidal individuals do not experience their suicide attempt as a planned action, and in some instances deny even having experienced any suicidal thoughts. Furthermore, recent research has found that risk factors differ substantially between persons and that this is reflected in the variety of suicidal pathways. Considering the strong variability of STBs, new innovative theoretical concepts and assessment methods are needed to advance our understanding of multiple suicidal pathways. In this review, we apply a dual-system framework to suicidality, the Dual-System Model of Suicidality (DSMS), which accounts for two different systems of information processing and behavior. The first of these described is the reflective system, whereby STBs are viewed from a self-regulation perspective and thusly considered as maladaptive coping behavior to perceived discrepancies regarding important goals. Applying a feedback-based view such as this to STBs provides a deeper understanding into underlying psychological processes involved in the development of STBs. The second system described by the DSMS is the impulsive system. Here, STBs are seen as a maladaptive self-organizing pattern that gets activated in high-risk situations of acute stress, negative affect, and when resources of the reflective system are depleted. In this context, the DSMS is informed by a strength model of self-regulation, which assumes that self-regulation resources are limited, an aspect with important theoretical and clinical implications for the development of STBs. In order to demonstrate the theoretical and practical utility of the DSMS, this review draws mainly on studies using ecological momentary assessment (EMA), a technology that allows to investigate moment-to-moment changes in STBs, and is therefore well suited for capturing the complex interplay of self-regulatory and impulsive processes proposed by the DSMS. The application of a dual-system framework to suicide research represents an innovative and integrative approach for expanding our knowledge about fundamental processes and how their dynamics lead to STBs. The usefulness of the DSMS, implications for future suicide research with EMA, and clinical implications are discussed.

Decision Making Deficits in Relation to Food Cues Influence Obesity: A Triadic Neural Model of Problematic Eating

In this review article we propose a model of the brain systems, the deficiency of which may underlie problematic eating. This integrative model is based on studies that have focused on discrete brain components involved in problematic eating, combined with insights from studies on the neurocognitive basis of other addictive and problematic behaviors. The model includes: (a) a hyper-functioning reward anticipation and processing system (amygdala-striatum dependent) in response to food-related cues; (b) a hypo-functioning reflective and inhibitory control system (prefrontal cortex dependent), that fails to anticipate and properly weigh future outcomes; and (c) an altered interoceptive awareness system (insular cortex dependent) that translates homeostatic violation signals into a strong consumption desire that hijacks the inhibitory system and excites the reward system. We posit that when the abovementioned systems are imbalanced in such a way that the dopamine axis is hyperactive in relation to food cues and the inhibitory system is weak, and this is further aggravated by an altered interoceptive awareness system, people may experience loss of control or inability to resist tempting/rewarding foods. This loss of control over food consumption can explain, at least in part, the development of excess weight and contribute to the obesity epidemic.

Performance Pressure Enhances Speech Learning

Real-world speech learning often occurs in high pressure situations such as trying to communicate in a foreign country. However, the impact of pressure on speech learning success is largely unexplored. In this study, adult, native speakers of English learned non-native speech categories under pressure or no-pressure conditions. In the pressure conditions, participants were informed that they were paired with a (fictitious) partner, and that each had to independently exceed a performance criterion for both to receive a monetary bonus. They were then informed that their partner had exceeded the bonus and the fate of both bonuses depended upon the participant's performance. Our results demonstrate that pressure significantly enhanced speech learning success. In addition, neurobiologically-inspired computational modeling revealed that the performance advantage was due to faster and more frequent use of procedural learning strategies. These results integrate two well-studied research domains and suggest a facilitatory role of motivational factors in speech learning performance that may not be captured in traditional training paradigms.

Dual systems of speech category learning across the lifespan

Although categorization is fundamental to speech processing, little is known about the learning systems that mediate auditory categorization and even less is known about changes across the life span. Vision research supports dual-learning systems that are grounded in neuroscience and are partially dissociable. The reflective, rule-based system is prefrontally mediated and uses working memory and executive attention to develop and test rules for classifying in an explicit fashion. The reflexive, information-integration system is striatally mediated and operates by implicitly associating perception with actions that lead to reinforcement. We examine the extent to which dual-learning systems mediate auditory and speech learning in younger and older adults. We examined auditory category learning when a rule-based strategy (Experiment 1) or information-integration strategy (Experiment 2) was optimal, and found an age-related rule-based deficit, but intact information-integration learning. Experiment 3 examined natural auditory category learning, and found an age-related performance deficit. Computational modeling suggested that this was attributable to older adults' persistent reliance on suboptimal, unidimensional strategies when 2-dimensional strategies were optimal. Working memory capacity was also found to be associated with improved rule-based and natural auditory category learning, but not information-integration category learning. These results suggest that dual-learning systems are operative in speech category learning across the life span, and that performance deficits, when present, are attributable to deficiencies in frontally mediated, rule-based processes.

Pathological gambling and the loss of willpower: a neurocognitive perspective

The purpose of this review is to gain more insight on the neurocognitive processes involved in the maintenance of pathological gambling. Firstly, we describe structural factors of gambling games that could promote the repetition of gambling experiences to such an extent that some individuals may become unable to control their gambling habits. Secondly, we review findings of neurocognitive studies on pathological gambling. As a whole, poor ability to resist gambling is a product of an imbalance between any one or a combination of three key neural systems: (1) an hyperactive 'impulsive' system, which is fast, automatic, and unconscious and promotes automatic and habitual actions; (2) a hypoactive 'reflective' system, which is slow and deliberative, forecasting the future consequences of a behavior, inhibitory control, and self-awareness; and (3) the interoceptive system, translating bottom-up somatic signals into a subjective state of craving, which in turn potentiates the activity of the impulsive system, and/or weakens or hijacks the goal-driven cognitive resources needed for the normal operation of the reflective system. Based on this theoretical background, we focus on certain clinical interventions that could reduce the risks of both gambling addiction and relapse.