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Scientific Reports Jun 2022Affective experience has an important role in decision-making with recent theories suggesting a modulatory role of affect in ongoing subjective value computations....
Affective experience has an important role in decision-making with recent theories suggesting a modulatory role of affect in ongoing subjective value computations. However, it is unclear how varying expectations and uncertainty dynamically influence affective experience and how dynamic representation of affect modulates risky choices. Using hierarchical Bayesian modeling on data from a risky choice task (N = 101), we find that the temporal integration of recently encountered choice parameters (expected value, uncertainty, and prediction errors) shapes affective experience and impacts subsequent choice behavior. Specifically, self-reported arousal prior to choice was associated with increased loss aversion, risk aversion, and choice consistency. Taken together, these findings provide clear behavioral evidence for continuous affective modulation of subjective value computations during risky decision-making.
Topics: Affect; Arousal; Bayes Theorem; Choice Behavior; Decision Making; Humans; Risk-Taking
PubMed: 35739234
DOI: 10.1038/s41598-022-14810-w -
Neuron Oct 2019To understand decision-making behavior in simple, controlled environments, Bayesian models are often useful. First, optimal behavior is always Bayesian. Second, even... (Review)
Review
To understand decision-making behavior in simple, controlled environments, Bayesian models are often useful. First, optimal behavior is always Bayesian. Second, even when behavior deviates from optimality, the Bayesian approach offers candidate models to account for suboptimalities. Third, a realist interpretation of Bayesian models opens the door to studying the neural representation of uncertainty. In this tutorial, we review the principles of Bayesian models of decision making and then focus on five case studies with exercises. We conclude with reflections and future directions.
Topics: Bayes Theorem; Decision Making; Humans; Models, Psychological; Uncertainty
PubMed: 31600512
DOI: 10.1016/j.neuron.2019.09.037 -
The British Journal of General Practice... Aug 2022Shared decision making (SDM), utilising the expertise of both patient and clinician, is a key feature of good-quality patient care. Multimorbidity can complicate SDM,...
BACKGROUND
Shared decision making (SDM), utilising the expertise of both patient and clinician, is a key feature of good-quality patient care. Multimorbidity can complicate SDM, yet few studies have explored this dynamic for older patients with multimorbidity in general practice.
AIM
To explore factors influencing SDM from the perspectives of older patients with multimorbidity and GPs, to inform improvements in personalised care.
DESIGN AND SETTING
Qualitative study. General practices (rural and urban) in Devon, England.
METHOD
Four focus groups: two with patients (aged ≥65 years with multimorbidity) and two with GPs. Data were coded inductively by applying thematic analysis.
RESULTS
Patient acknowledgement of clinician medicolegal vulnerability in the context of multimorbidity, and their recognition of this as a barrier to SDM, is a new finding. Medicolegal vulnerability was a unifying theme for other reported barriers to SDM. These included expectations for GPs to follow clinical guidelines, challenges encountered in applying guidelines and in communicating clinical uncertainty, and limited clinician self-efficacy for SDM. Increasing consultation duration and improving continuity were viewed as facilitators.
CONCLUSION
Clinician perceptions of medicolegal vulnerability are recognised by both patients and GPs as a barrier to SDM and should be addressed to optimise delivery of personalised care. Greater awareness of multimorbidity guidelines is needed. Educating clinicians in the communication of uncertainty should be a core component of SDM training. The incorrect perception that most clinicians already effectively facilitate SDM should be addressed to improve the uptake of personalised care interventions.
Topics: Aged; Clinical Decision-Making; Decision Making; Decision Making, Shared; Humans; Multimorbidity; Patient Participation; Qualitative Research; Uncertainty
PubMed: 35379603
DOI: 10.3399/BJGP.2021.0529 -
Annals of Palliative Medicine Feb 2020Patients, and their families, with Parkinson's disease (PD) and related disorders face many issues, including physical, psychological, social and spiritual. Palliative... (Review)
Review
Patients, and their families, with Parkinson's disease (PD) and related disorders face many issues, including physical, psychological, social and spiritual. Palliative care is an essential part of care from the time of diagnosis, and should be provided by all services involved with the patient and family. Specialist palliative care is able to support the overall care particularly for complex issues-whether symptoms or psychosocial and spiritual problems, ethical and decisions making issues, and at the end of life. This should be in collaboration with other teams, working together to improve the quality of life (QOL) of patients and families, supporting the professional teams and enabling patients to be as fully involved in the decisions about their care and at the end of life.
Topics: Decision Making; Humans; Palliative Care; Parkinson Disease
PubMed: 32008340
DOI: 10.21037/apm.2019.12.01 -
Trends in Neurosciences Oct 2020Animals and humans evolved sophisticated nervous systems that endowed them with the ability to form internal-models or beliefs and make predictions about the future to... (Review)
Review
Animals and humans evolved sophisticated nervous systems that endowed them with the ability to form internal-models or beliefs and make predictions about the future to survive and flourish in a world in which future outcomes are often uncertain. Crucial to this capacity is the ability to adjust behavioral and learning policies in response to the level of uncertainty. Until recently, the neuronal mechanisms that could underlie such uncertainty-guided control have been largely unknown. In this review, I discuss newly discovered neuronal circuits in primates that represent uncertainty about future rewards and propose how they guide information-seeking, attention, decision-making, and learning to help us survive in an uncertain world. Lastly, I discuss the possible relevance of these findings to learning in artificial systems.
Topics: Animals; Attention; Choice Behavior; Decision Making; Learning; Reward; Uncertainty
PubMed: 32736849
DOI: 10.1016/j.tins.2020.06.009 -
Behavioral Neuroscience Apr 2021One of the most important factors in decision-making is estimating the value of available options. Subregions of the prefrontal cortex, including the orbitofrontal... (Review)
Review
One of the most important factors in decision-making is estimating the value of available options. Subregions of the prefrontal cortex, including the orbitofrontal cortex (OFC), have been deemed essential for this process. Value computations require a complex integration across numerous dimensions, including, reward magnitude, effort, internal state, and time. The importance of the temporal dimension is well illustrated by temporal discounting tasks, in which subjects select between smaller-sooner versus larger-later rewards. The specific role of OFC in telling time and integrating temporal information into decision-making remains unclear. Based on the current literature, in this review we reevaluate current theories of OFC function, accounting for the influence of time. Incorporating temporal information into value estimation and decision-making requires distinct, yet interrelated, forms of temporal information including the ability to tell time, represent time, create temporal expectations, and the ability to use this information for optimal decision-making in a wide range of tasks, including temporal discounting and wagering. We use the term "temporal cognition" to refer to the integrated use of these different aspects of temporal information. We suggest that the OFC may be a critical site for the integration of reward magnitude and delay, and thus important for temporal cognition. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Topics: Cognition; Decision Making; Delay Discounting; Humans; Prefrontal Cortex; Reward
PubMed: 34060872
DOI: 10.1037/bne0000430 -
Current Opinion in Neurobiology Dec 2012In this review, I briefly summarize current neurobiological studies of decision-making that bear on two general themes. The first focuses on the nature of neural... (Review)
Review
In this review, I briefly summarize current neurobiological studies of decision-making that bear on two general themes. The first focuses on the nature of neural representation and dynamics in a decision circuit. Experimental and computational results suggest that ramping-to-threshold in the temporal domain and trajectory of population activity in the state space represent a duality of perspectives on a decision process. Moreover, a decision circuit can display several different dynamical regimes, such as the ramping mode and the jumping mode with distinct defining properties. The second is concerned with the relationship between biologically-based mechanistic models and normative-type models. A fruitful interplay between experiments and these models at different levels of abstraction have enabled investigators to pose increasingly refined questions and gain new insights into the neural basis of decision-making. In particular, recent work on multi-alternative decisions suggests that deviations from rational models of choice behavior can be explained by established neural mechanisms.
Topics: Animals; Brain; Choice Behavior; Decision Making; Humans; Models, Neurological; Nerve Net; Primates
PubMed: 23026743
DOI: 10.1016/j.conb.2012.08.006 -
Community Mental Health Journal Apr 2022There is increased interest over the last decade in the use of Shared Decision Making with individuals with serious mental illness to improve engagement in treatment and...
There is increased interest over the last decade in the use of Shared Decision Making with individuals with serious mental illness to improve engagement in treatment and clinical outcomes. We conducted semi-structured qualitative interviews with 15 individuals with serious mental illness treated in an outpatient transitional care clinic serving people immediately after discharge from a psychiatric hospitalization. Parallel interviews were conducted with a variety of clinical providers (n = 9). Using latent thematic analysis, six themes were identified including: (1) Differences in the Use of SDM, (2) Consideration of Past Experiences, (3) Decisional Power Preferences, (4) Use of SDM in Psychiatry Versus Other Areas of Medicine, (5) Dignity and Disengagement, and (6) External Forces Impacting SDM. Implications for clinical practice and research using a shared decision-making approach within this treatment setting are further discussed.
Topics: Ambulatory Care Facilities; Decision Making; Decision Making, Shared; Humans; Patient Participation; Psychiatry
PubMed: 34176054
DOI: 10.1007/s10597-021-00856-z -
Journal of Neuroscience Research Jun 2020Goal-directed and habitual decision-making are fundamental processes that support the ongoing adaptive behavior. There is a growing interest in examining their... (Review)
Review
Goal-directed and habitual decision-making are fundamental processes that support the ongoing adaptive behavior. There is a growing interest in examining their disruption in psychiatric disease, often with a focus on a disease shifting control from one process to the other, usually a shift from goal-directed to habitual control. However, several different experimental procedures can be used to probe whether decision-making is under goal-directed or habitual control, including outcome devaluation and contingency degradation. These different experimental procedures may recruit diverse behavioral and neural processes. Thus, there are potentially many opportunities for these disease phenotypes to manifest as alterations to both goal-directed and habitual controls. In this review, we highlight the examples of behavioral and neural circuit divergence and similarity, and suggest that interpretation based on behavioral processes recruited during testing may leave more room for goal-directed and habitual decision-making to coexist. Furthermore, this may improve our understanding of precisely what the involved neural mechanisms underlying aspects of goal-directed and habitual behavior are, as well as how disease affects behavior and these circuits.
Topics: Animals; Brain; Decision Making; Goals; Habits
PubMed: 31642551
DOI: 10.1002/jnr.24545 -
Scientific Reports Oct 2023During insightful problem solving, the solution appears unexpectedly and is accompanied by the feeling of an AHA!. Research suggests that this affective component of...
During insightful problem solving, the solution appears unexpectedly and is accompanied by the feeling of an AHA!. Research suggests that this affective component of insight can have consequences beyond the solution itself by motivating future behavior, such as risky (high reward and high uncertainty) decision making. Here, we investigate the behavioral and neural support for the motivational role of AHA in decision making involving monetary choices. The positive affect of the AHA! experience has been linked to internal reward. Reward in turn has been linked to dopaminergic signal transmission in the Nucleus Accumbens (NAcc) and risky decision making. Therefore, we hypothesized that insight activates reward-related brain areas, modulating risky decision making. We tested this hypothesis in two studies. First, in a pre-registered online study (Study 1), we demonstrated the behavioral effect of insight-related increase in risky decision making using a visual Mooney identification paradigm. Participants were more likely to choose the riskier monetary payout when they had previously solved the Mooney image with high compared to low accompanied AHA!. Second, in an fMRI study (Study 2), we measured the effects of insight on NAcc activity using a similar Mooney identification paradigm to the one of Study 1. Greater NAcc activity was found when participants solved the Mooney image with high vs low AHA!. Taken together, our results link insight to enhanced NAcc activity and a preference for high but uncertain rewards, suggesting that insight enhances reward-related brain areas possibly via dopaminergic signal transmission, promoting risky decision making.
Topics: Humans; Nucleus Accumbens; Decision Making; Brain; Uncertainty; Problem Solving; Dopamine; Reward; Risk-Taking
PubMed: 37821507
DOI: 10.1038/s41598-023-44293-2