A cognitive pathway to punishment insensitivity.

Individuals differ in their sensitivity to the adverse consequences of their actions, leading some to persist in maladaptive behaviors. Two pathways have been identified for this insensitivity: a motivational pathway based on excessive reward valuation and a behavioral pathway based on autonomous stimulus-response mechanisms. Here, we identify a third, cognitive pathway based on differences in punishment knowledge and use of that knowledge to suppress behavior. We show that distinct phenotypes of punishment sensitivity emerge from differences in what people learn about their actions. Exposed to identical punishment contingencies, some people (sensitive phenotype) form correct causal beliefs that they use to guide their behavior, successfully obtaining rewards and avoiding punishment, whereas others form incorrect but internally coherent causal beliefs that lead them to earn punishment they do not like. Incorrect causal beliefs were not inherently problematic because we show that many individuals benefit from information about why they are being punished, revaluing their actions and changing their behavior to avoid further punishment (unaware phenotype). However, one condition where incorrect causal beliefs were problematic was when punishment is infrequent. Under this condition, more individuals show punishment insensitivity and detrimental patterns of behavior that resist experience and information-driven updating, even when punishment is severe (compulsive phenotype). For these individuals, rare punishment acted as a "trap," inoculating maladaptive behavioral preferences against cognitive and behavioral updating.

Category-specific general Pavlovian-instrumental transfer.

Modern living is characterized by easy access to highly palatable energy-dense foods. Environmental cues associated with palatable foods increase seeking of those foods (specific transfer) and other palatable foods (general transfer). We conducted a series of studies testing the boundaries of food cue-reactivity by evaluating the impact of broader flavor associations (i.e. saltiness, sweetness) in eliciting general transfer effects. Experiment 1 was an online experiment with fictive rewards that tested if two actions associated with different food rewards (chip and chocolate points) could be provoked by images of other foods that were either similar or distinct in flavor from the foods associated with these instrumental actions. We observed that response excitation was only elicited by similarly flavored food cues, whereas distinctly flavored food cues inhibited response rates relative to control cues. Experiment 2 confirmed this observation in a classroom setting where real food rewards were contingent on task performance. Experiment 3 was an online study that further confirmed the reliability of the effects with a well powered sample. There were moderate-to-strong associations between specific and general transfer effects across all studies, suggesting overlapping cognitive processes are responsible for both transfer effects. These data improve the mechanistic understanding of how broad category associations can moderate the impact of food cues on food choices. This knowledge could be helpful for improving the precision of psychological interventions that seek to mitigate the impact of food cue-reactivity.

Validating the interpersonal theory of suicide among older adultspre- and peri-COVID-19 pandemic.

OBJECTIVES: Global suicide rates are highest among older adults, and especially older men, yet proximal predictors of suicidal ideation in older age remain poorly understood. This study tested the Interpersonal Theory of Suicide in older men and women by investigating whether perceived burdensomeness and thwarted belongingness and/or their interaction are proximal predictors of suicidal ideation before versus during the global COVID-19 pandemic. METHODS: The sample (N = 208) included healthy community-dwelling older Australian persons surveyed face-to-face pre-pandemic (n = 102), or online peri-pandemic (n = 106). Depression, social interaction, social satisfaction, thwarted belongingness, and perceived burdensomeness were assessed as predictors of suicidal ideation. RESULTS: Perceived burdensomeness was a more proximal predictor of suicidal ideation among older adults than depression or thwarted belongingness. Suicidal ideation and perceived burdensomeness were higher in men than women, but sex did not moderate the influence of perceived burdensomeness, thwarted belongingness or social satisfaction on suicidal desire. The interaction between perceived burdensomeness and thwarted belongingness predicted more additional variance in suicidal ideation in the older persons surveyed during the COVID-19 pandemic relative to those surveyed before the pandemic. CONCLUSION: Suicidal ideation among older persons peri-pandemic is discussed, and recommendations are made for age-specific suicide prevention strategies.

Human appetitive Pavlovian-to-instrumental transfer: a goal-directed account.

Pavlovian-to-instrumental transfer (PIT) tasks assess the impact of environmental stimuli on instrumental actions. Since their initial translation from animal to human experiments, PIT tasks have provided insight into the mechanisms that underlie reward-based behaviour. This review first examines the main types of PIT tasks used in humans. We then seek to contribute to the current debate as to whether human PIT effects reflect a controlled, goal-directed process, or a more automatic, non-goal-directed mechanism. We argue that the data favour a goal-directed process. The extent to which the major theories of PIT can account for these data is then explored. We discuss a number of associative accounts of PIT as well as dual-process versions of these theories. Ultimately, however, we favour a propositional account, in which human PIT effects are suggested to be driven by both perceived outcome availability and outcome value. In the final section of the review, we present the potential objections to the propositional approach that we anticipate from advocates of associative link theories and our response to them. We also identify areas for future research.

A cluster randomised controlled feasibility study of nurse-initiated behavioural strategies to manage interruptions during medication administration.

OBJECTIVES: To examine the feasibility of a behavioural e-learning intervention to support nurses to manage interruptions during medication administration. DESIGN: A cluster randomised feasibility trial. SETTING: The cluster trial included four intervention and four control wards randomly selected across four metropolitan hospitals in Sydney, Australia. PARTICIPANTS: We observed 806 (402 pre-intervention and 404 post-intervention) medication events, where nurses prepared and administered medications to patients within the cluster wards. MAIN OUTCOME MEASURES: The primary outcome measured was the observed number of interruptions occurring during administration, with secondary outcomes being the number of clinical errors and procedural failures. Changes in the use of behavioural strategies to manage interruptions, targeted by the e-learning intervention, were also assessed. RESULTS: No significant differences were found in the number of interruptions (P = 0.82), procedural failures (P = 0.19) or clinical errors per 100 medications (P = 0.32), between the intervention and control wards. Differences in the use of specific behavioural strategies (engagement and multitasking) were found in the intervention wards. CONCLUSION: This behavioural e-learning intervention has not been found to significantly reduce interruptions, however, changes in the use of strategies did occur. Careful selection of clinical settings where there is a high number of predictable interruptions is recommended for further research into the impact of the behavioural e-learning intervention. An increase in the intensity of this intervention is recommended with training undertaken away from the clinical setting. Further research on additional consumer-sensitive interventions is urgently needed.

Negative emotional appraisal selectively disrupts retrieval of expected outcome values required for goal-directed instrumental choice.

Stress induction reduces people's ability to modify their instrumental choices following changes in the value of outcomes, but the mechanisms underpinning this effect have not been specified because previous studies have lacked crucial control conditions. To address this, the current study had participants learn two instrumental responses for food and water, respectively, before water was devalued by specific satiety. Choice between these two responses was then measured in extinction, reacquisition and Pavlovian to instrumental transfer (PIT) tests. Concurrently during these tests, a negative emotional appraisal group evaluated aversive images (stress induction), whereas a control group evaluated neutral images, at the same time as choosing between the two instrumental responses. Negative emotional appraisal abolished the impact of water devaluation on instrumental choice in the extinction test, but did not affect instrumental choice in the reacquisition or PIT tests. These findings suggest that negative emotional appraisal selectively impaired participants' ability to retrieve the expected value of outcomes required to make goal-directed instrumental choices in the extinction test, and that this effect was not due to task disengagement, nullification of the devaluation treatment or impaired knowledge of response-outcome relationships.

Predictability of Interruptions During Medication Administration With Related Behavioral Management Strategies.

The aim of this qualitative study was to examine the nature of interruptions during medication administration. Focus groups were conducted with medical/surgical nurses (n = 15), critical care nurses (n = 13), and nurse managers/educators/specialists (n = 6). Most interruptions (78%) were predictable. Nurse-adopted strategies included blocking, engaging, mediating, multitasking, and preventing. Educational content was developed that relates behavioral strategies to respond to predictable and unpredictable interruptions.

Reward and punishment-based compound cue learning and generalization in opiate dependency.

Substance dependence is thought to be mediated by abnormalities in cognitive abilities, but how this impacts decision-making remains unclear. This study aimed to test whether people who are opiate dependent differed from never-dependent controls in learning from reward and punishment or in the generalization of learning to novel conditions. Participants with opiate dependency consisted of 21 people who were outpatients in a methadone maintenance program; the control group consisted of 21 healthy participants with no histories of substance abuse. Subjects completed a computer-based task that involved two phases: the training phase involved participants being presented with compound stimulus (a shape and color) in each trial, with the goal of learning which compounds to 'pick' for rewards or 'skip' to avoid punishment. The test phase involved a transfer test, where stimuli from the first phase were combined together to form novel compounds without feedback. The control group demonstrated fewer errors compared to opiate-dependent individuals during the training phase. In the test phase, controls used prior knowledge of both shapes and colors in responding; however, opiate-dependent individuals used shapes but did not use their knowledge of color to modulate responding. When performance during training was equated in the groups using a learning threshold, this difference between groups on the generalization test remained. A deficit in learning generalization might be indicative of group differences in learning strategies in operation during training; however, future work is necessary to uncover the specific neural substrates in action during transfer tasks, and to determine the effects of acute methadone dosage on decision-making.

I like it by mere association: Conditioning preferences in infants.

Preferences have a profound impact on our behavior; however, relatively little is known about how preference formation works early in life. Evaluative conditioning occurs when the valence of an initially neutral object changes when it is paired with a positively or negatively valenced stimulus. It is possible that evaluative conditioning may account for early preference learning; however, the extent to which this kind of learning operates during infancy has not been empirically tested. The aim of the current studies was to assess whether infants' preferences for neutral objects is influenced by pairing them with affective stimuli (Experiment 1: happy vs. angry faces, N=20; Experiment 2: mother vs. stranger faces, N=22). Infants' preferences were tested using both looking time and behavioral choice measures. The results showed that infants tended to choose the object that had been paired with the positive stimulus (Experiment 1: 13/20; Experiment 2: 14/22). Gaze behavior at test did not differentiate between the two objects; however, gaze behavior during conditioning predicted infants' behavioral preference. Only infants who looked longer at the affective stimulus than at the object during learning chose the object that had been paired with positive valence more often than chance. These results suggest that infants' preferences may be influenced by learned associations between objects and affective stimuli, a process akin to evaluative conditioning in adults.

The impact of interruptions on medication errors in hospitals: an observational study of nurses.

AIM: To explore interruptions during medication preparation and administration and their consequences. BACKGROUND: Although not all interruptions in nursing have a negative impact, interruptions during medication rounds have been associated with medication errors. METHOD: A non-participant observational study was undertaken of nurses conducting medication rounds. RESULTS: Fifty-six medication events (including 101 interruptions) were observed. Most medication events (99%) were interrupted, resulting in nurses stopping medication preparation or administration to address the interruption (mean 2.5 minutes). The mean number of interruptions was 1.79 (SD 1.04). Thirty-four percent of medication events had at least one procedural failure, while 3.6% resulted in a clinical error. CONCLUSIONS: Our study confirmed that interruptions occur frequently during medication preparation and administration, and these interruptions were associated with procedural failures and clinical errors. Nurses were the primary source of interruptions with interruptions often being unrelated to patient care. IMPLICATIONS FOR NURSING MANAGEMENT: This study has confirmed that interruptions are frequent and result in clinical errors and procedural failures, compromising patient safety. These interruptions contribute a substantial additional workload to medication tasks. Various interventions should be implemented to reduce non-patient-related interruptions. Medication systems and procedures are advocated, that reduce the need for joint double-checking of medications, indirectly avoiding interruptions.

I Think, Therefore Eyeblink: The Importance of Contingency Awareness in Conditioning.

Can conditioning occur without conscious awareness of the contingency between the stimuli? We trained participants on two separate reaction time tasks that ensured attention to the experimental stimuli. The tasks were then interleaved to create a differential Pavlovian contingency between visual stimuli from one task and an airpuff stimulus from the other. Many participants were unaware of the contingency and failed to show differential eyeblink conditioning, despite attending to a salient stimulus that was contingently and contiguously related to the airpuff stimulus over many trials. Manipulation of awareness by verbal instruction dramatically increased awareness and differential eyeblink responding. These findings cast doubt on dual-system theories, which propose an automatic associative system independent of cognition, and provide strong evidence that cognitive processes associated with awareness play a causal role in learning.

Limits of Executive Control: Sequential Effects in Predictable Environments.

Cognitive-control theories attribute action control to executive processes that modulate behavior on the basis of expectancy or task rules. In the current study, we examined corticospinal excitability and behavioral performance in a go/no-go task. Go and no-go trials were presented in runs of five, and go and no-go runs alternated predictably. At the beginning of each trial, subjects indicated whether they expected a go trial or a no-go trial. Analyses revealed that subjects immediately adjusted their expectancy ratings when a new run started. However, motor excitability was primarily associated with the properties of the previous trial, rather than the predicted properties of the current trial. We also observed a large latency cost at the beginning of a go run (i.e., reaction times were longer for the first trial in a go run than for the second trial). These findings indicate that actions in predictable environments are substantially influenced by previous events, even if this influence conflicts with conscious expectancies about upcoming events.

The role of contingency awareness in single-cue human eyeblink conditioning.

Single-cue delay eyeblink conditioning is presented as a prototypical example of automatic, nonsymbolic learning that is carried out by subcortical circuits. However, it has been difficult to assess the role of cognition in single-cue conditioning because participants become aware of the simple stimulus contingency so quickly. In this experiment (n = 166), we masked the contingency to reduce awareness. We observed a strong relationship between contingency awareness and conditioned responding, with both trace and delay procedures. This finding suggests that explicit associative knowledge and anticipatory behavior are regulated by a coordinated system rather than by functionally and neurally distinct systems.

Older adults' decision-making following bad advice.

There is minimal research investigating the influence of advice on decision-making in older age. The present study investigated the effect of different types of bad advice, relative to no advice, on young and older adults' decision-making in the Iowa Gambling Task (IGT). Fifty-four older adults and 59 young adults completed the IGT after receiving no advice, or advice to select from disadvantageous deck A (small, high-frequency losses), or disadvantageous deck B (larger, low-frequency losses). Corrugator EMG, memory and fluid intelligence were assessed. Averaged across advice conditions, older adults made more disadvantageous selections than young adults. There were no age-related differences in responding to bad advice, nor in corrugator activity in response to losses (i.e. frowning), or in learning to avoid deck A faster than deck B. Selecting from deck B was associated with reduced education among older adults, and reduced fluid intelligence among young adults. The data suggest that older adults make more disadvantageous decisions than young adults, and this is not exacerbated by bad advice. Both young and older adults are slower at learning to avoid choices resulting in low frequency relative to high-frequency losses, and this may be associated with individual differences in cognitive processing.

Cognitive and Emotional Factors Influencing the Incorporation of Advice Into Decision Making Across the Adult Lifespan.

OBJECTIVES: The present study sought to investigate the influence of advice on decision making in older age, as well as the potential influence of depressive symptoms and age-related differences in the cognitively demanding emotion regulation on advice-taking. METHOD: A nonclinical sample (N = 156; 50% female; 47 young: M age = 29.87, standard deviation [SD] = 5.58; 54 middle-aged: M age = 50.91, SD = 7.13; 55 older: M age = 72.51, SD = 5.33) completed a judge-advisor task to measure degree of advice-taking, as well as measures of fluid intelligence, depressive symptoms, confidence, perceived advice accuracy, and emotion regulation. RESULTS: Age did not influence degree of advice-taking. Greater depressive symptoms were associated with more reliance on advice, but only among individuals who identified as emotion regulators. Interestingly, older age was associated with perceiving advice to be less accurate. DISCUSSION: The study contributes to the sparse literature on advice-taking in older age. Cognitive and emotional factors influence the degree to which advice is incorporated into decision making in consistent ways across the adult lifespan. A key difference is that older adults take as much advice as younger adults despite perceiving the advice to be less accurate.

Translational research in punishment learning.

Punishment learning is learning of the causal relationship between responses and their adverse or undesirable consequences. Here, we review our translational approach for understanding whether, when, and how individuals differ in what they learn during punishment, and how these differences in learning may drive persistent poor or maladaptive decisions. We show that individual differences in punishment insensitivity can emerge from differences between individuals in what they learn about punishment (instrumental contingency knowledge), rather than differences in aversive valuation, reward valuation, general (impulsivity), or specific (habit) behavioral control. These differences in instrumental contingency knowledge are shared with and can be studied in other animals. Our approach has strong construct and predictive validity, providing a robust translational platform for studying how punishment learning and decision making may contribute to neuropsychiatric disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Parallel acquisition of awareness and differential delay eyeblink conditioning.

There is considerable debate about whether differential delay eyeblink conditioning can be acquired without awareness of the stimulus contingencies. Previous investigations of the relationship between differential-delay eyeblink conditioning and awareness of the stimulus contingencies have assessed awareness after the conditioning session was finished using a post-experimental questionnaire. In two experiments, the point at which contingency awareness developed during the conditioning session was estimated from a button-press measure of expectancy of the unconditioned stimulus (US). In both experiments, knowledge of the stimulus contingencies and acquisition of differential delay eyeblink conditioning developed approximately in parallel. In Experiment 1 it was shown that predicting the US facilitated eyeblink conditioning compared with predicting the eyeblink response. In Experiment 2, a masking task was used that slowed down the emergence of awareness, and it was shown that differential conditioning only occurred in participants who were able to predict the US. The current findings challenge the hypothesis that differential delay eyeblink conditioning is entirely mediated by a functionally and neurally distinct nondeclarative learning system.

A neural network model of mathematics anxiety: The role of attention.

Anxiety about performing numerical calculations is becoming an increasingly important issue. Termed mathematics anxiety, this condition negatively impacts performance in numerical tasks which can affect education outcomes and future employment. The disruption account proposes poor performance is due to anxiety disrupting limited attentional and inhibitory resources leaving fewer cognitive resources for the current task. This study provides the first neural network model of math anxiety. The model simulates performance in two commonly-used tasks related to math anxiety: the numerical Stroop and symbolic number comparison. Different model modifications were used to simulate high and low math-anxious conditions by modifying attentional processes and learning; these model modifications address different theories of math anxiety. The model simulations suggest that math anxiety is associated with reduced attention to numerical stimuli. These results are consistent with the disruption account and the attentional control theory where anxiety decreases goal-directed attention and increases stimulus-driven attention.

Infants are sensitive to cultural differences in emotions at 11 months.

A myriad of emotion perception studies has shown infants' ability to discriminate different emotional categories, yet there has been little investigation of infants' perception of cultural differences in emotions. Hence little is known about the extent to which culture-specific emotion information is recognised in the beginning of life. Caucasian Australian infants of 10-12 months participated in a visual-paired comparison task where their preferential looking patterns to three types of infant-directed emotions (anger, happiness, surprise) from two different cultures (Australian, Japanese) were examined. Differences in racial appearances were controlled. Infants exhibited preferential looking to Japanese over Caucasian Australian mothers' angry and surprised expressions, whereas no difference was observed in trials involving East-Asian Australian mothers. In addition, infants preferred Caucasian Australian mothers' happy expressions. These findings suggest that 11-month-olds are sensitive to cultural differences in spontaneous infant-directed emotional expressions when they are combined with a difference in racial appearance.

Punishment insensitivity in humans is due to failures in instrumental contingency learning.

Punishment maximises the probability of our individual survival by reducing behaviours that cause us harm, and also sustains trust and fairness in groups essential for social cohesion. However, some individuals are more sensitive to punishment than others and these differences in punishment sensitivity have been linked to a variety of decision-making deficits and psychopathologies. The mechanisms for why individuals differ in punishment sensitivity are poorly understood, although recent studies of conditioned punishment in rodents highlight a key role for punishment contingency detection (Jean-Richard-Dit-Bressel et al., 2019). Here, we applied a novel 'Planets and Pirates' conditioned punishment task in humans, allowing us to identify the mechanisms for why individuals differ in their sensitivity to punishment. We show that punishment sensitivity is bimodally distributed in a large sample of normal participants. Sensitive and insensitive individuals equally liked reward and showed similar rates of reward-seeking. They also equally disliked punishment and did not differ in their valuation of cues that signalled punishment. However, sensitive and insensitive individuals differed profoundly in their capacity to detect and learn volitional control over aversive outcomes. Punishment insensitive individuals did not learn the instrumental contingencies, so they could not withhold behaviour that caused punishment and could not generate appropriately selective behaviours to prevent impending punishment. These differences in punishment sensitivity could not be explained by individual differences in behavioural inhibition, impulsivity, or anxiety. This bimodal punishment sensitivity and these deficits in instrumental contingency learning are identical to those dictating punishment sensitivity in non-human animals, suggesting that they are general properties of aversive learning and decision-making.