A synthesis of evidence for policy from behavioural science during COVID-19.

Scientific evidence regularly guides policy decisions1, with behavioural science increasingly part of this process2. In April 2020, an influential paper3 proposed 19 policy recommendations ('claims') detailing how evidence from behavioural science could contribute to efforts to reduce impacts and end the COVID-19 pandemic. Here we assess 747 pandemic-related research articles that empirically investigated those claims. We report the scale of evidence and whether evidence supports them to indicate applicability for policymaking. Two independent teams, involving 72 reviewers, found evidence for 18 of 19 claims, with both teams finding evidence supporting 16 (89%) of those 18 claims. The strongest evidence supported claims that anticipated culture, polarization and misinformation would be associated with policy effectiveness. Claims suggesting trusted leaders and positive social norms increased adherence to behavioural interventions also had strong empirical support, as did appealing to social consensus or bipartisan agreement. Targeted language in messaging yielded mixed effects and there were no effects for highlighting individual benefits or protecting others. No available evidence existed to assess any distinct differences in effects between using the terms 'physical distancing' and 'social distancing'. Analysis of 463 papers containing data showed generally large samples; 418 involved human participants with a mean of 16,848 (median of 1,699). That statistical power underscored improved suitability of behavioural science research for informing policy decisions. Furthermore, by implementing a standardized approach to evidence selection and synthesis, we amplify broader implications for advancing scientific evidence in policy formulation and prioritization.

Modulation of facial muscle responses by another person's presence and affiliative touch during affective image viewing.

Stimulating CT-afferents by forearm caresses produces the subjective experience of pleasantness in the receiver and modulates subjective evaluations of viewed affective images. Receiving touch from another person includes the social element of another person's presence, which has been found to influence affective image evaluations without involving touch. The current study investigated whether these modulations translate to facial muscle responses associated with positive and negative affect across touch-involving and mere presence conditions. Female participants (N = 40, M(age) = 22.4, SD = 5.3) watched affective images (neutral, positive, negative) while facial electromyography was recorded (sites: zygomaticus, corrugator). Results from ANOVAs showed that providing touch to another person or oneself modulated zygomaticus site responses when viewing positive images. Providing CT-afferent stimulating touch (i.e., forearm caresses) to another person or oneself dampened the positive affective facial muscle response to positive affective images. Providing touch to another person generally increased corrugator facial muscle activity related to negative affect. Receiving touch did not modulate affective facial muscle responses during the viewing of affective images but may have effects on later cognitive processes. Together, previously reported social and touch modulations of subjective evaluations of affective images do not translate to facial muscle responses during affective image viewing, which were differentially modulated.

Does it matter who harmed whom? A cross-cultural study of moral judgments about harm by and to insiders and outsiders.

This cross-cultural study compared judgments of moral wrongness for physical and emotional harm with varying combinations of in-group vs. out-group agents and victims across six countries: the United States of America (N = 937), the United Kingdom (N = 995), Romania (N = 782), Brazil (N = 856), South Korea (N = 1776), and China (N = 1008). Consistent with our hypothesis we found evidence of an insider agent effect, where moral violations committed by outsider agents are generally considered more morally wrong than the same violations done by insider agents. We also found support for an insider victim effect where moral violations that were committed against an insider victim generally were seen as more morally wrong than when the same violations were committed against an outsider, and this effect held across all countries. These findings provide evidence that the insider versus outsider status of agents and victims does affect moral judgments. However, the interactions of these identities with collectivism, psychological closeness, and type of harm (emotional or physical) are more complex than what is suggested by previous literature. Supplementary information: The online version contains supplementary material available at 10.1007/s12144-023-04986-3.

The electrophysiology of audiovisual processing in visual narratives in adolescents with autism spectrum disorder.

We investigated the semantic processing of the multimodal audiovisual combination of visual narratives with auditory descriptive words and auditory sounds in individuals with ASD. To this aim, we recorded ERPs to critical auditory words and sounds associated with events in visual narrative that were either semantically congruent or incongruent with the climactic visual event. A similar N400 effect was found both in adolescents with ASD and neurotypical adolescents (ages 9-16) when accessing different types of auditory information (i.e. words and sounds) into a visual narrative. This result might suggest that verbal information processing in ASD adolescents could be facilitated by direct association with meaningful visual information. In addition, we observed differences in scalp distribution of later brain responses between ASD and neurotypical adolescents. This finding might suggest ASD adolescents differ from neurotypical adolescents during the processing of the multimodal combination of visual narratives with auditory information at later stages of the process. In conclusion, the semantic processing of verbal information, typically impaired in individuals with ASD, can be facilitated when embedded into a meaningful visual information.

Associations between hypomania proneness and attentional bias to happy, but not angry or fearful, faces in emerging adults.

Mania, the core feature of bipolar disorder, is associated with heightened and positive emotion responding. Yet, little is known about the underlying cognitive processes that may contribute to heightened positive emotionality observed. Additionally, while previous research has investigated positive emotion biases in non-clinical samples, few if any, account for subthreshold clinical symptoms or traits, which have reliably assessed psychopathological risk. The present study compared continuous scores on a widely used self-report measure of hypomania proneness (HPS-48) with a dot-probe task to investigate attentional biases for happy, angry, fearful, and neutral faces among 66 college student participants. Results suggested that hypomania proneness was positively associated with attentional bias towards happy, but not angry or fearful faces. Results remained robust when controlling for positive affect and did not appear to be affected by negative affect or current symptoms of depression, anxiety, and stress. Findings provide insight into potential behavioural markers that co-occur with heightened positive emotional responding and hypomania in emerging adults.

Electrophysiological indexes of ToM and non-ToM humor in healthy adults.

The cognitive processes involved in humor comprehension were analyzed by directly comparing the time course of brain activity associated with the perception of slapstick humor and that associated with the comprehension of humor requiring theory of mind (ToM). Four different comic strips (strips containing humorous scenes that required ToM, non-ToM humorous strips, non-humorous semantically coherent strips and non-humorous semantically incoherent strips) were presented to participants, while their EEG response was recorded. Results showed that both of the humorous comic strips and the semantically incongruent strip elicited an N400 effect, suggesting similar cognitive mechanisms underlying the processing of incongruent and humorous comic strips. The results also showed that the humorous ToM strips elicited a frontal late positive (LP) response, possibly reflecting the active deployment of ToM abilities such as perspective-taking and empathy that allow for the resolution and interpretation of apparently incongruent situations. In addition, the LP response was positively correlated with ratings of perceived amusement as well as individual empathy scores, suggesting that the increased LP response to ToM humorous strips reflects the combined activation of neural mechanisms involved in the experience of amusement and ToM abilities. Overall, humor comprehension appears to demand distinct cognitive steps such as the detection of incongruent semantic components, the construction of semantic coherence, and the appreciation of humoristic elements such as maladaptive emotional reactions. Our results show that the deployment of these distinct cognitive steps is at least partially dependent on individual empathic abilities.

Anodal transcranial direct current stimulation over the posterior parietal cortex reduces the onset time to the rubber hand illusion and increases the body ownership.

The body ownership induced by the rubber hand illusion (RHI) has been related to a neural network involving a frontal-parietal circuit. Previous functional neuroimaging studies have demonstrated neural activation in the parietal area relative to the multisensory integration processing and to the recalibration of the felt position of body while a ventral premotor cortex activation has been linked to bodily self-attribution during the RHI. Our study aimed to investigate the effects of transcranial direct current stimulation (tDCS) on the posterior parietal cortex (PPC) or on the premotor cortex (PMv) during RHI to address the specific roles of these two brain areas in the illusion. 156 young adult participants (21.2 ± 3.13 years old; all right-handed) were enrolled for this between-subjects design experiment. Participants received anodal, cathodal and sham tDCS in three different sessions on the right PPC or right PMv and experienced visual-tactile stimulation from the brushes touching the rubber hand and their own left hand in synchronous or asynchronous manner. The RHI was quantified by the (1) onset time for the feeling of body ownership of the rubber hand, (2) proprioceptive drift, and (3) questionnaire about the intensity of the illusion as reported by the participant. All subjects felt the RHI during the synchronous condition. However, we found that the illusion onset time can be modulated by the anodal tDCS condition on the PPC: anodal tDCS decreased the illusion onset time and the subjective experience of body ownership. These findings suggest that the parietal area plays a crucial role in the speed of visual and tactile multisensory integration in the RHI and introduce tDCS as technique that can accelerate the time to integrate an artificial body part and increased the perception of body ownership.

Neuromodulating Attention and Mind-Wandering Processes with a Single Session Real Time EEG.

Our minds are continuously alternating between external attention (EA) and mind wandering (MW). An appropriate balance between EA and MW is important for promoting efficient perceptual processing, executive functioning, decision-making, auto-biographical memory, and creativity. There is evidence that EA processes are associated with increased activity in high-frequency EEG bands (e.g., SMR), contrasting with the dominance of low-frequency bands during MW (e.g., Theta). The aim of the present study was to test the effects of two distinct single session real-time EEG (rtEEG) protocols (SMR up-training/Theta down-training-SMR⇑Theta⇓; Theta up-training/SMR down-training-Theta⇑SMR⇓) on EA and MW processes. Thirty healthy volunteers were randomly assigned to one of two rtEEG training protocols (SMR⇑Theta⇓; Theta⇑SMR⇓). Before and after the rtEEG training, participants completed the attention network task (ANT) along with several MW measures. Both training protocols were effective in increasing SMR (SMR⇑Theta⇓) and theta (Theta⇑SMR⇓) amplitudes but not in decreasing the amplitude of down-trained bands. There were no significant effects of the rtEEG training in either EA or MW measures. However, there was a significant positive correlation between post-training SMR increases and the use of deliberate MW (rather than spontaneous) strategies. Additionally, for the Theta⇑SMR⇓ protocol, increase in post-training Theta amplitude was significantly associated with a decreased efficiency in the orientation network.

tDCS in Addiction and Impulse Control Disorders.

The study of addiction and impulsion control disorders has shown that behaviors of seeking and consumption of addictive substances are subserved by neurobiological alterations specifically related to brain networks for reward, stress, and executive control, representing the brain's adaptation to the continued use of an addictive substance. In parallel, studies using neuromodulation techniques such as transcranial direct current stimulation (tDCS) have demonstrated promising effects in modulating cognitive and motor functions. This review aims to describe the neurobiology of addiction and some of the most relevant cognitive models of addictive behavior and to clarify how tDCS application modulates the intake and craving for several addictive substances, such as food, alcohol, nicotine, cocaine, crack, methamphetamine, and cannabis. We also discuss the positive and null outcomes of the use of this neuromodulatory technique in the treatment of addiction disorders resulting from the use of these substances. The reviewed findings lead us to conclude that tDCS interventions hold several promising clinical avenues in addiction and impulsive control. However, methodological investigations are necessary for undercover optimal parameters before implementing its clinical application.

tDCS application over the STG improves the ability to recognize and appreciate elements involved in humor processing.

The superior temporal gyrus (STG) has been found to play a crucial role in the recognition of actions and facial expressions and may, therefore, be critical for the processing of humorous information. Here we investigated whether tDCS application to the STG would modulate the ability to recognize and appreciate the comic element in serious and comedic situations of misfortune. To this aim, the effects of different types of tDCS stimulation on the STG were analyzed during a task in which the participants were instructed to categorize various misfortunate situations as "comic" or "not comic". Participants underwent three different tDCS conditions: Anodal-right/Cathodal-left; Cathodal-right/Anodal-left; Sham. Images depicting people involved in accidents were grouped into three categories based on the facial expression of the victim: angry or painful (Affective); bewildered and funny (Comic); and images that did not contain the victim's face (No Face). An improvement in mean reaction times in response to both the Comic and No Face stimuli was observed following Anodal-left/Cathodal-right stimulation when compared to sham stimulation. This suggests that this stimulation type reduced the reaction times to socio-emotional complex scenes, regardless of facial expression. The Anodal-right/Cathodal-left stimulation reduced the mean reaction times for Comic stimuli only, suggesting that specifically the right STG may be involved in facial expression recognition and in the appreciation of the comic element in misfortunate situations. These results suggest a functional hemispheric asymmetry in STG response to social stimuli: the left STG might have a role in a general comprehension of social complex situations, while the right STG may be involved in the ability to recognize and integrate specific emotional aspects in a complex scene.

Human biological and nonbiological point-light movements: Creation and validation of the dataset.

Human action perception is so powerful that people can identify movement efficiently in the absence of pictorial information, such as in point-light displays. Interest is growing in this type of stimulus for research in neuroscience. This interest stems from the advantage of separating the component of pure human action kinematics from other pictorial information, such as facial expression and muscle contraction. Although several groups have previously developed datasets of human point-light actions, due to the lack of datasets composed of daily actions with short durations, we developed 20 biological and 40 control (scrambled) point-light movements by using the technique of recording people wearing reflector patches. The videos are about 1 s long. Subsequently, we performed a judgment task in which 100 participants (50 male and 50 female) evaluated each video according to three categories: human action resemblance, performed action, and gender of actor. We present the mean scores of each evaluation for each video, and further propose a selection of the most suitable videos to be used as human point-light action displays and scrambled point-light displays for control. Finally, we discuss our findings on the gender attributions of the point-light displays.

Contrasting effects of transcranial direct current stimulation on central and peripheral visual fields.

Recent research suggested that transcranial direct current stimulation (tDCS) can affect visual processing and that it can be useful in visual rehabilitation. Nevertheless, there are still few investigations on the subject. tDCS selectivity and the extent of its outcomes on visual perception are still to be assessed. Here, we investigate whether central and peripheral visual fields are equally affected by tDCS. We also tried to reproduce a previous work that has evaluated tDCS effects on the central visual field only (Kraft et al. 207:283-290, 2010). Fifteen healthy subjects participated in this randomized repeated-measure design study and received 1.5-mA anodal, cathodal and sham stimulation in different sessions, while performing 10-2 and 60-4 protocols in an automated perimeter. Anodal tDCS significantly decreased thresholds, but was limited to the most eccentric regions of the visual field measured (60°). This suggests that tDCS might be used for rehabilitation of peripheral visual field losses. We did not replicate the excitatory tDCS effect in the central visual field as previously reported by another group. Instead, we observed a trend toward an inhibitory (yet not statistically significant) effect of anodal tDCS on the central field. This might be explained by methodological differences. These results highlight that although tDCS is a technique with a low focality in the spatial domain, its effects might be highly focal in a functional domain. When taken together with previous findings, this also suggests that tDCS may have a differential effect on different retinotopic areas in the brain.

Transcranial direct current stimulation can selectively affect different processing channels in human visual cortex.

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that can modulate cortical activity. Nonetheless, information regarding its functional specificity and the extent by which visual performance can be modulated is still lacking. Here, we used vision as model to address if it differentially affects different cell groups in the stimulated area. We applied tDCS to the occiput and performed a series of visual tests in a sham-controlled repeated-measures design. Achromatic contrast sensitivity was assessed psychophysically during tDCS, with tasks designed to target specific spatial frequency (SF) channels, inferred ON, OFF channels and inferred magnocellular and parvocellular pathways of the visual system. Sweep visual evoked potential (sVEP) for contrast sensitivity and Vernier acuity was recorded before and after tDCS. Anodal tDCS significantly increased thresholds for luminance decrements (OFF) only for the inferred magnocellular thresholds. Although tDCS had no significant effects on Vernier or contrast sVEP thresholds, it modulated suprathreshold amplitudes for both tasks. Cathodal tDCS increased sVEP amplitudes at a low SF, decreased it at a medium, and had no effect at a high SF. Cathodal tDCS increased sVEP phase lags for low and decreased it for high SF (maximum change corresponding to change in apparent latency >6 ms). Cathodal and anodal stimulation decreased amplitudes of sVEP Vernier responses. Exclusive tDCS effects on magnocellular thresholds agree with reports of pathway-specific tDCS effects. The dependence of tDCS effects on SF and contrast levels further suggests that tDCS differentially affects different cell groups in the visual cortex.

Reducing transcranial direct current stimulation-induced erythema with skin pretreatment: considerations for sham-controlled clinical trials.

OBJECTIVES: Transcranial direct current stimulation (tDCS)-induced erythema (skin reddening) has been described as an adverse effect that can harm blinding integrity in sham-controlled designs. To tackle this issue, we investigated whether the use of topical pretreatments could decrease erythema and other adverse effects associated with tDCS. MATERIALS AND METHODS: Thirty healthy volunteers were recruited, and four interventions were applied 30 min prior to tDCS in a Latin square design: placebo, ketoprofen 2%, hydroxyzine 1%, and lidocaine 5%. TDCS was applied for 30 min (2 mA, anode and cathode over F3 and F4, respectively) in two active sessions with a minimum 1-week interval. The Draize erythema scoring system scale was used to assess erythema intensity; a tDCS questionnaire was used to assess other adverse effects (e.g., tingling, itching, burning sensation, and pain). RESULTS: We found that ketoprofen (but not hydroxyzine or lidocaine) significantly attenuated tDCS-induced erythema regarding intensity and duration, with a medium effect compared with placebo. Erythema was overall mild, short-lived (lasting 18-24 min after tDCS ending), and more intense under the anode. Subjects with darker skin color also tended to present less intense tDCS-induced erythema. The prevalence of other adverse effects was low and did not differ between dermatological groups. CONCLUSIONS: Ketoprofen 2% topical pretreatment might be an interesting strategy to reduce tDCS-induced erythema and might be useful for blinding improvement in further sham-controlled tDCS trials.

Transcranial direct current stimulation modulates ERP-indexed inhibitory control and reduces food consumption.

Food craving can be defined as the "urge to eat a specific food". Previous findings suggest impairment of inhibitory control, specifically a regulatory deficit in the lateral prefrontal circuitry that is associated with a compulsion for food. As demonstrated by three previous studies, bilateral transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) (anode right/cathode left) reduces food craving and caloric intake. We designed the present study to evaluate the neural mechanisms that underlie these effects. We replicated the design of one of these previous studies but included electroencephalographic assessments to register evoked potentials in a Go/No-go task that contained pictures of food and furniture (a control visual stimulus). We collected data from nine women (mean age = 23.4 ± 2 years) in a crossover experiment. We observed that active DLPFC tDCS (anode right/cathode left), compared with sham stimulation, reduced the frontal N2 component and enhanced the P3a component of responses to No-go stimuli, regardless of the stimulus condition (food or furniture). Active tDCS was also associated with a reduction in caloric intake. We discuss our findings in the context of cortico-subcortical processing of craving and tDCS effects on inhibitory control neural circuitry.

Enhancement of affective processing induced by bifrontal transcranial direct current stimulation in patients with major depression.

OBJECTIVE: Our aim was to evaluate whether one single section of transcranial direct current stimulation (tDCS), a neuromodulatory technique that noninvasively modifies cortical excitability, could induce acute changes in the negative attentional bias in patients with major depression. SUBJECTS AND METHODS: Randomized, double-blind, sham-controlled, parallel design enrolling 24 age-, gender-matched, drug-free, depressed subjects. Anode and cathode were placed over the left and right dorsolateral prefrontal cortex. We performed a word Emotional Stroop Task collecting the response times (RTs) for positive-, negative-, and neutral-related words. The emotional Stroop effect for negative vs. neutral and vs. positive words was used as the measure of attentional bias. RESULTS: At baseline, RTs were significantly slower for negative vs. positive words. We found that active but not sham tDCS significantly modified the negative attentional bias, abolishing slower RT for negative words. CONCLUSION: Active but not sham tDCS significantly modified the negative attentional bias. These findings add evidence that a single tDCS session transiently induces potent changes in affective processing, which might be one of the mechanisms of tDCS underlying mood changes.

Addressing climate change with behavioral science: A global intervention tournament in 63 countries.

Effectively reducing climate change requires marked, global behavior change. However, it is unclear which strategies are most likely to motivate people to change their climate beliefs and behaviors. Here, we tested 11 expert-crowdsourced interventions on four climate mitigation outcomes: beliefs, policy support, information sharing intention, and an effortful tree-planting behavioral task. Across 59,440 participants from 63 countries, the interventions' effectiveness was small, largely limited to nonclimate skeptics, and differed across outcomes: Beliefs were strengthened mostly by decreasing psychological distance (by 2.3%), policy support by writing a letter to a future-generation member (2.6%), information sharing by negative emotion induction (12.1%), and no intervention increased the more effortful behavior-several interventions even reduced tree planting. Last, the effects of each intervention differed depending on people's initial climate beliefs. These findings suggest that the impact of behavioral climate interventions varies across audiences and target behaviors.

Heart rate variability is a trait marker of major depressive disorder: evidence from the sertraline vs. electric current therapy to treat depression clinical study.

Decreased heart rate variability (HRV) is a cardiovascular predictor of mortality. Recent debate has focused on whether reductions in HRV in major depressive disorder (MDD) are a consequence of the disorder or a consequence of pharmacotherapy. Here we report on the impact of transcranial direct current stimulation (tDCS), a non-pharmacological intervention, vs. sertraline to further investigate this issue. The employed design was a double-blind, randomized, factorial, placebo-controlled trial. One hundred and eighteen moderate-to-severe, medication-free, low-cardiovascular risk depressed patients were recruited for this study and allocated to either active/sham tDCS (10 consecutive sessions plus two extra sessions every other week) or placebo/sertraline (50 mg/d) for 6 wk. Patients were age and gender-matched to healthy controls from a concurrent cohort study [the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)]. The impact of disorder, treatment and clinical response on HRV (root mean square of successive differences and high frequency) was examined. Our findings confirmed that patients displayed decreased HRV relative to controls. Furthermore, HRV scores did not change following treatment with either a non-pharmacological (tDCS) or pharmacological (sertraline) intervention, nor did HRV increase with clinical response to treatment. Based on these findings, we discuss whether reduced HRV is a trait-marker for MDD, which may predispose patients to a host of conditions and disease even after response to treatment. Our findings have important implications for our understanding of depression pathophysiology and the relationship between MDD, cardiovascular disorders and mortality.

The sertraline versus electrical current therapy for treating depression clinical study (select-TDCS): results of the crossover and follow-up phases.

BACKGROUND: Transcranial direct current stimulation (tDCS) is a promising nonpharmacological therapy for major depression. In the Sertraline versus Electrical Current Therapy for Treating Depression Clinical Trial (SELECT-TDCS) trial, phase-I (Brunoni et al., JAMA Psychiatry, 2013) we found that tDCS is effective for the acute episode. Here, we describe tDCS effects during phases II (crossover) and III (follow-up) of this trial (NCTs: 01149889 and 01149213). METHODS: Phase II (n = 25) was the open-label, crossover phase in which phase-I nonresponders who had received sham-tDCS received a 10-day course of active-tDCS. In phase-III (n = 42), all active-tDCS responders (>50% Montgomery-Asberg Depression Rating Scale (MADRS) improvement or MADRS ≤ 12) were enrolled to a 24-week, follow-up phase in which a maximum of nine tDCS sessions were performed-every other week for 3 months and, thereafter, once a month for the subsequent 3 months-sessions would be interrupted earlier whether the subject relapsed. TDCS was applied at 2 mA/30 min, with the anode over the left and the cathode over the right dorsolateral prefrontal cortex. Relapse was the outcome measure. RESULTS: In phase-II, 52% of completers responded to tDCS. In phase-III, the mean response duration was 11.7 weeks. The survival rate per Kaplan-Meier analysis was 47%. Patients with treatment-resistant depression presented a much lower 24-week survival rate as compared to nonrefractory patients (10% vs. 77%, OR = 5.52; P < .01). Antidepressant use (sertraline 50 mg/day, eight patients) was not a predictor of relapse. TDCS was well tolerated and with few side effects. CONCLUSION: Continuation tDCS protocols should be optimized as to prevent relapse among tDCS responders, particularly for patients with baseline treatment-resistant depression.

Effects of co-players' identity and reputation in the public goods game.

Players' identity and their reputation are known to influence cooperation in economic games, but little is known about how they interact. Our study aimed to understand how presenting pre-programmed co-players' identities (face photos; names) along with their previous cooperation history (reputation) could influence participants' cooperative decisions in a public goods game. Participants (N = 759) were allocated to one of six experimental groups: (i) control (no information); (ii) only reputation (neutral, free-rider, or cooperative); (iii) only face; (iv) face with reputation; (v) only name; (vi) name with reputation. In the reputation group, cooperation significantly decreased when free-riders were playing and significantly increased when they were cooperators. Person's identity affected cooperativeness only when combined with reputation: face photo mitigated the negative effect of the free-rider reputation, while name identity mitigated any significant effect expected for reputation. Our study suggests a hierarchy: reputation changes cooperation, but a person's identity can modulate reputation.