Model-free decision making is prioritized when learning to avoid harming others.

Moral behavior requires learning how our actions help or harm others. Theoretical accounts of learning propose a key division between "model-free" algorithms that cache outcome values in actions and "model-based" algorithms that map actions to outcomes. Here, we tested the engagement of these mechanisms and their neural basis as participants learned to avoid painful electric shocks for themselves and a stranger. We found that model-free decision making was prioritized when learning to avoid harming others compared to oneself. Model-free prediction errors for others relative to self were tracked in the thalamus/caudate. At the time of choice, neural activity consistent with model-free moral learning was observed in subgenual anterior cingulate cortex (sgACC), and switching after harming others was associated with stronger connectivity between sgACC and dorsolateral prefrontal cortex. Finally, model-free moral learning varied with individual differences in moral judgment. Our findings suggest moral learning favors efficiency over flexibility and is underpinned by specific neural mechanisms.

Transformative experience and social connectedness mediate the mood-enhancing effects of psychedelic use in naturalistic settings.

Past research suggests that use of psychedelic substances such as LSD or psilocybin may have positive effects on mood and feelings of social connectedness. These psychological effects are thought to be highly sensitive to context, but robust and direct evidence for them in a naturalistic setting is scarce. In a series of field studies involving over 1,200 participants across six multiday mass gatherings in the United States and the United Kingdom, we investigated the effects of psychedelic substance use on transformative experience, social connectedness, and positive mood. This approach allowed us to test preregistered hypotheses with high ecological validity and statistical precision. Controlling for a host of demographic variables and the use of other psychoactive substances, we found that psychedelic substance use was significantly associated with positive mood-an effect sequentially mediated by self-reported transformative experience and increased social connectedness. These effects were particularly pronounced for those who had taken psychedelic substances within the last 24 h (compared to the last week). Overall, this research provides robust evidence for positive affective and social consequences of psychedelic substance use in naturalistic settings.

Neural and Cognitive Signatures of Guilt Predict Hypocritical Blame.

A common form of moral hypocrisy occurs when people blame others for moral violations that they themselves commit. It is assumed that hypocritical blamers act in this manner to falsely signal that they hold moral standards that they do not really accept. We tested this assumption by investigating the neurocognitive processes of hypocritical blamers during moral decision-making. Participants (62 adult UK residents; 27 males) underwent functional MRI scanning while deciding whether to profit by inflicting pain on others and then judged the blameworthiness of others' identical decisions. Observers (188 adult U.S. residents; 125 males) judged participants who blamed others for making the same harmful choice to be hypocritical, immoral, and untrustworthy. However, analyzing hypocritical blamers' behaviors and neural responses shows that hypocritical blame was positively correlated with conflicted feelings, neural responses to moral standards, and guilt-related neural responses. These findings demonstrate that hypocritical blamers may hold the moral standards that they apply to others.

Serotonin depletion impairs both Pavlovian and instrumental reversal learning in healthy humans.

Serotonin is involved in updating responses to changing environmental circumstances. Optimising behaviour to maximise reward and minimise punishment may require shifting strategies upon encountering new situations. Likewise, autonomic responses to threats are critical for survival yet must be modified as danger shifts from one source to another. Whilst numerous psychiatric disorders are characterised by behavioural and autonomic inflexibility, few studies have examined the contribution of serotonin in humans. We modelled both processes, respectively, in two independent experiments (N = 97). Experiment 1 assessed instrumental (stimulus-response-outcome) reversal learning whereby individuals learned through trial and error which action was most optimal for obtaining reward or avoiding punishment initially, and the contingencies subsequently reversed serially. Experiment 2 examined Pavlovian (stimulus-outcome) reversal learning assessed by the skin conductance response: one innately threatening stimulus predicted receipt of an uncomfortable electric shock and another did not; these contingencies swapped in a reversal phase. Upon depleting the serotonin precursor tryptophan-in a double-blind randomised placebo-controlled design-healthy volunteers showed impairments in updating both actions and autonomic responses to reflect changing contingencies. Reversal deficits in each domain, furthermore, were correlated with the extent of tryptophan depletion. Initial Pavlovian conditioning, moreover, which involved innately threatening stimuli, was potentiated by depletion. These results translate findings in experimental animals to humans and have implications for the neurochemical basis of cognitive inflexibility.

COVID-19 Incidence and Death Rates Among Unvaccinated and Fully Vaccinated Adults with and Without Booster Doses During Periods of Delta and Omicron Variant Emergence - 25 U.S. Jurisdictions, April 4-December 25, 2021.

Previous reports of COVID-19 case, hospitalization, and death rates by vaccination status† indicate that vaccine protection against infection, as well as serious COVID-19 illness for some groups, declined with the emergence of the B.1.617.2 (Delta) variant of SARS-CoV-2, the virus that causes COVID-19, and waning of vaccine-induced immunity (1-4). During August-November 2021, CDC recommended§ additional primary COVID-19 vaccine doses among immunocompromised persons and booster doses among persons aged ≥18 years (5). The SARS-CoV-2 B.1.1.529 (Omicron) variant emerged in the United States during December 2021 (6) and by December 25 accounted for 72% of sequenced lineages (7). To assess the impact of full vaccination with additional and booster doses (booster doses),¶ case and death rates and incidence rate ratios (IRRs) were estimated among unvaccinated and fully vaccinated adults by receipt of booster doses during pre-Delta (April-May 2021), Delta emergence (June 2021), Delta predominance (July-November 2021), and Omicron emergence (December 2021) periods in the United States. During 2021, averaged weekly, age-standardized case IRRs among unvaccinated persons compared with fully vaccinated persons decreased from 13.9 pre-Delta to 8.7 as Delta emerged, and to 5.1 during the period of Delta predominance. During October-November, unvaccinated persons had 13.9 and 53.2 times the risks for infection and COVID-19-associated death, respectively, compared with fully vaccinated persons who received booster doses, and 4.0 and 12.7 times the risks compared with fully vaccinated persons without booster doses. When the Omicron variant emerged during December 2021, case IRRs decreased to 4.9 for fully vaccinated persons with booster doses and 2.8 for those without booster doses, relative to October-November 2021. The highest impact of booster doses against infection and death compared with full vaccination without booster doses was recorded among persons aged 50-64 and ≥65 years. Eligible persons should stay up to date with COVID-19 vaccinations.

When Helping Is Risky: The Behavioral and Neurobiological Trade-off of Social and Risk Preferences.

Helping other people can entail risks for the helper. For example, when treating infectious patients, medical volunteers risk their own health. In such situations, decisions to help should depend on the individual's valuation of others' well-being (social preferences) and the degree of personal risk the individual finds acceptable (risk preferences). We investigated how these distinct preferences are psychologically and neurobiologically integrated when helping is risky. We used incentivized decision-making tasks (Study 1; N = 292 adults) and manipulated dopamine and norepinephrine levels in the brain by administering methylphenidate, atomoxetine, or a placebo (Study 2; N = 154 adults). We found that social and risk preferences are independent drivers of risky helping. Methylphenidate increased risky helping by selectively altering risk preferences rather than social preferences. Atomoxetine influenced neither risk preferences nor social preferences and did not affect risky helping. This suggests that methylphenidate-altered dopamine concentrations affect helping decisions that entail a risk to the helper.

Who are "we" and why are we cooperating? Insights from social psychology.

Tomasello argues in the target article that a sense of moral obligation emerges from the creation of a collaborative "we" motivating us to fulfill our cooperative duties. We suggest that "we" takes many forms, entailing different obligations, depending on the type (and underlying functions) of the relationship(s) in question. We sketch a framework of such types, functions, and obligations to guide future research in our commentary.

Concern for Others Leads to Vicarious Optimism.

An optimistic learning bias leads people to update their beliefs in response to better-than-expected good news but neglect worse-than-expected bad news. Because evidence suggests that this bias arises from self-concern, we hypothesized that a similar bias may affect beliefs about other people's futures, to the extent that people care about others. Here, we demonstrated the phenomenon of vicarious optimism and showed that it arises from concern for others. Participants predicted the likelihood of unpleasant future events that could happen to either themselves or others. In addition to showing an optimistic learning bias for events affecting themselves, people showed vicarious optimism when learning about events affecting friends and strangers. Vicarious optimism for strangers correlated with generosity toward strangers, and experimentally increasing concern for strangers amplified vicarious optimism for them. These findings suggest that concern for others can bias beliefs about their future welfare and that optimism in learning is not restricted to oneself.

Serotonin enhances the impact of health information on food choice.

Serotonin has been implicated in promoting self-control, regulation of hunger and physiological homeostasis, and regulation of caloric intake. However, it remains unclear whether the effects of serotonin on caloric intake reflect purely homeostatic mechanisms, or whether serotonin also modulates cognitive processes involved in dietary decision making. We investigated the effects of an acute dose of the serotonin reuptake inhibitor citalopram on choices between food items that differed along taste and health attributes, compared with placebo and the noradrenaline reuptake inhibitor atomoxetine. Twenty-seven participants attended three sessions and received single doses of atomoxetine, citalopram, and placebo in a double-blind randomised cross-over design. Relative to placebo, citalopram increased choices of more healthy foods over less healthy foods. Citalopram also increased the emphasis on health considerations in decisions. Atomoxetine did not affect decision making relative to placebo. The results support the hypothesis that serotonin may influence food choice by enhancing a focus on long-term goals. The findings are relevant for understanding decisions about food consumption and also for treating health conditions such as eating disorders and obesity.

Harm to others outweighs harm to self in moral decision making.

Concern for the suffering of others is central to moral decision making. How humans evaluate others' suffering, relative to their own suffering, is unknown. We investigated this question by inviting subjects to trade off profits for themselves against pain experienced either by themselves or an anonymous other person. Subjects made choices between different amounts of money and different numbers of painful electric shocks. We independently varied the recipient of the shocks (self vs. other) and whether the choice involved paying to decrease pain or profiting by increasing pain. We built computational models to quantify the relative values subjects ascribed to pain for themselves and others in this setting. In two studies we show that most people valued others' pain more than their own pain. This was evident in a willingness to pay more to reduce others' pain than their own and a requirement for more compensation to increase others' pain relative to their own. This "hyperaltruistic" valuation of others' pain was linked to slower responding when making decisions that affected others, consistent with an engagement of deliberative processes in moral decision making. Subclinical psychopathic traits correlated negatively with aversion to pain for both self and others, in line with reports of aversive processing deficits in psychopathy. Our results provide evidence for a circumstance in which people care more for others than themselves. Determining the precise boundaries of this surprisingly prosocial disposition has implications for understanding human moral decision making and its disturbance in antisocial behavior.

Postpartum Laboratory Follow-up in Women With Hepatitis B in Massachusetts From 2007 to 2012.

GOALS: To determine postpartum hepatitis B virus (HBV) laboratory testing rates and identify factors associated with a lack of follow-up testing in Massachusetts. BACKGROUND: Screening for HBV infection in pregnant women is standard of care. Guidelines recommend that patients with chronic HBV have ongoing care and laboratory testing, but little is known about postpartum maternal HBV care outcomes. STUDY: We conducted a retrospective cohort study using Massachusetts Virtual Epidemiologic Network, an electronic public health surveillance system maintained by the Massachusetts Department of Public Health. We identified women who tested hepatitis B surface antigen positive during their first reported (index) pregnancy in Massachusetts from 2007 to 2012 and measured HBV-related laboratory tests reported to Massachusetts Department of Public Health during and after pregnancy. RESULTS: We identified 983 hepatitis B surface antigen positive pregnant women. Half (492/983) did not have evidence of additional postpartum HBV laboratory testing following their index pregnancy. Women who had postpartum laboratory tests reported were younger [mean age (SD): 29 (5.3) vs. 31 (5.5) y, P=0.0001] and more likely to have >1 pregnancy during the study period (41% vs. 1%, P<0.0001). There were no differences in race, ethnicity, and US born status. On multivariable logistic regression, older age predicted a lower likelihood of having postpartum laboratory testing (odds ratio, 0.77; 95% confidence interval, 0.70-0.90). CONCLUSIONS: Postpartum maternal HBV follow-up laboratory testing occurred in only half of Massachusetts women and did not vary by race, ethnicity, or US born status. Our results were limited to a single state surveillance database, which likely underestimates the number of tests ordered.

Serotonin modulates striatal responses to fairness and retaliation in humans.

Humans are willing to incur personal costs to punish others who violate social norms. Such "costly punishment" is an important force for sustaining human cooperation, but the causal neurobiological determinants of punishment decisions remain unclear. Using a combination of behavioral, pharmacological, and neuroimaging techniques, we show that manipulating the serotonin system in humans alters costly punishment decisions by modulating responses to fairness and retaliation in the striatum. Following dietary depletion of the serotonin precursor tryptophan, participants were more likely to punish those who treated them unfairly, and were slower to accept fair exchanges. Neuroimaging data revealed activations in the ventral and dorsal striatum that were associated with fairness and punishment, respectively. Depletion simultaneously reduced ventral striatal responses to fairness and increased dorsal striatal responses during punishment, an effect that predicted its influence on punishment behavior. Finally, we provide behavioral evidence that serotonin modulates specific retaliation, rather than general norm enforcement: depleted participants were more likely to punish unfair behavior directed toward themselves, but not unfair behavior directed toward others. Our findings demonstrate that serotonin modulates social value processing in the striatum, producing context-dependent effects on social behavior.

Serotonin selectively influences moral judgment and behavior through effects on harm aversion.

Aversive emotional reactions to real or imagined social harms infuse moral judgment and motivate prosocial behavior. Here, we show that the neurotransmitter serotonin directly alters both moral judgment and behavior through increasing subjects' aversion to personally harming others. We enhanced serotonin in healthy volunteers with citalopram (a selective serotonin reuptake inhibitor) and contrasted its effects with both a pharmacological control treatment and a placebo on tests of moral judgment and behavior. We measured the drugs' effects on moral judgment in a set of moral 'dilemmas' pitting utilitarian outcomes (e.g., saving five lives) against highly aversive harmful actions (e.g., killing an innocent person). Enhancing serotonin made subjects more likely to judge harmful actions as forbidden, but only in cases where harms were emotionally salient. This harm-avoidant bias after citalopram was also evident in behavior during the ultimatum game, in which subjects decide to accept or reject fair or unfair monetary offers from another player. Rejecting unfair offers enforces a fairness norm but also harms the other player financially. Enhancing serotonin made subjects less likely to reject unfair offers. Furthermore, the prosocial effects of citalopram varied as a function of trait empathy. Individuals high in trait empathy showed stronger effects of citalopram on moral judgment and behavior than individuals low in trait empathy. Together, these findings provide unique evidence that serotonin could promote prosocial behavior by enhancing harm aversion, a prosocial sentiment that directly affects both moral judgment and moral behavior.

The prefrontal cortex and (uniquely) human cooperation: a comparative perspective.

Humans have an exceptional ability to cooperate relative to many other species. We review the neural mechanisms supporting human cooperation, focusing on the prefrontal cortex. One key feature of human social life is the prevalence of cooperative norms that guide social behavior and prescribe punishment for noncompliance. Taking a comparative approach, we consider shared and unique aspects of cooperative behaviors in humans relative to nonhuman primates, as well as divergences in brain structure that might support uniquely human aspects of cooperation. We highlight a medial prefrontal network common to nonhuman primates and humans supporting a foundational process in cooperative decision-making: valuing outcomes for oneself and others. This medial prefrontal network interacts with lateral prefrontal areas that are thought to represent cooperative norms and modulate value representations to guide behavior appropriate to the local social context. Finally, we propose that more recently evolved anterior regions of prefrontal cortex play a role in arbitrating between cooperative norms across social contexts, and suggest how future research might fruitfully examine the neural basis of norm arbitration.

Prosocial behavior is associated with transdiagnostic markers of affective sensitivity in multiple domains.

Prosocial behaviors-actions that benefit others-fundamentally shape our interpersonal interactions. Psychiatric disorders have been suggested to be related to prosocial disturbances, which may underlie many of their social impairments. However, broader affective traits, present to different degrees in both psychiatric and healthy populations, also have been linked to variability in prosociality. Therefore, it is unclear to what extent prosocial variability is explained by specific psychiatric disorders relative to broad affective traits. Using a computational, transdiagnostic approach in two online studies, we found that participants who reported being more affectively reactive across a broad cluster of traits manifested greater frequencies of prosocial actions in two different contexts: They reported being more averse to harming others for profit, and they were more willing to exert effort to benefit others. These findings help illuminate the profile of prosociality across psychiatric conditions as well as the architecture of prosocial behavior in healthy individuals. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Children punish third parties to satisfy both consequentialist and retributive motives.

Adults punish moral transgressions to satisfy both retributive motives (such as wanting antisocial others to receive their 'just deserts') and consequentialist motives (such as teaching transgressors that their behaviour is inappropriate). Here, we investigated whether retributive and consequentialist motives for punishment are present in children approximately between the ages of five and seven. In two preregistered studies (N = 251), children were given the opportunity to punish a transgressor at a cost to themselves. Punishment either exclusively satisfied retributive motives by only inflicting harm on the transgressor, or additionally satisfied consequentialist motives by teaching the transgressor a lesson. We found that children punished when doing so satisfied only retributive motives, and punished considerably more when doing so also satisfied consequentialist motives. Together, these findings provide evidence for the presence of both retributive and consequentialist motives in young children.

How peer influence shapes value computation in moral decision-making.

Moral behavior is susceptible to peer influence. How does information from peers influence moral preferences? We used drift-diffusion modeling to show that peer influence changes the value of moral behavior by prioritizing the choice attributes that align with peers' goals. Study 1 (N = 100; preregistered) showed that participants accurately inferred the goals of prosocial and antisocial peers when observing their moral decisions. In Study 2 (N = 68), participants made moral decisions before and after observing the decisions of a prosocial or antisocial peer. Peer observation caused participants' own preferences to resemble those of their peers. This peer influence effect on value computation manifested as an increased weight on choice attributes promoting the peers' goals that occurred independently from peer influence on initial choice bias. Participants' self-reported awareness of influence tracked more closely with computational measures of prosocial than antisocial influence. Our findings have implications for bolstering and blocking the effects of prosocial and antisocial influence on moral behavior.

How social learning amplifies moral outrage expression in online social networks.

Moral outrage shapes fundamental aspects of social life and is now widespread in online social networks. Here, we show how social learning processes amplify online moral outrage expressions over time. In two preregistered observational studies on Twitter (7331 users and 12.7 million total tweets) and two preregistered behavioral experiments (N = 240), we find that positive social feedback for outrage expressions increases the likelihood of future outrage expressions, consistent with principles of reinforcement learning. In addition, users conform their outrage expressions to the expressive norms of their social networks, suggesting norm learning also guides online outrage expressions. Norm learning overshadows reinforcement learning when normative information is readily observable: in ideologically extreme networks, where outrage expression is more common, users are less sensitive to social feedback when deciding whether to express outrage. Our findings highlight how platform design interacts with human learning mechanisms to affect moral discourse in digital public spaces.

How social relationships shape moral wrongness judgments.

Judgments of whether an action is morally wrong depend on who is involved and the nature of their relationship. But how, when, and why social relationships shape moral judgments is not well understood. We provide evidence to address these questions, measuring cooperative expectations and moral wrongness judgments in the context of common social relationships such as romantic partners, housemates, and siblings. In a pre-registered study of 423 U.S. participants nationally representative for age, race, and gender, we show that people normatively expect different relationships to serve cooperative functions of care, hierarchy, reciprocity, and mating to varying degrees. In a second pre-registered study of 1,320 U.S. participants, these relationship-specific cooperative expectations (i.e., relational norms) enable highly precise out-of-sample predictions about the perceived moral wrongness of actions in the context of particular relationships. In this work, we show that this 'relational norms' model better predicts patterns of moral wrongness judgments across relationships than alternative models based on genetic relatedness, social closeness, or interdependence, demonstrating how the perceived morality of actions depends not only on the actions themselves, but also on the relational context in which those actions occur.

Dreading the pain of others? Altruistic responses to others' pain underestimate dread.

A dislike of waiting for pain, aptly termed 'dread', is so great that people will increase pain to avoid delaying it. However, despite many accounts of altruistic responses to pain in others, no previous studies have tested whether people take delay into account when attempting to ameliorate others' pain. We examined the impact of delay in 2 experiments where participants (total N = 130) specified the intensity and delay of pain either for themselves or another person. Participants were willing to increase the experimental pain of another participant to avoid delaying it, indicative of dread, though did so to a lesser extent than was the case for their own pain. We observed a similar attenuation in dread when participants chose the timing of a hypothetical painful medical treatment for a close friend or relative, but no such attenuation when participants chose for a more distant acquaintance. A model in which altruism is biased to privilege pain intensity over the dread of pain parsimoniously accounts for these findings. We refer to this underestimation of others' dread as a 'Dread Empathy Gap'.