Risk-sensitive neurons in macaque posterior cingulate cortex

People and animals often demonstrate strong attraction or aversion to options with uncertain or risky rewards, yet the neural substrate of subjective risk preferences has rarely been investigated. Here we show that monkeys systematically preferred the risky target in a visual gambling task in which they chose between two targets offering the same mean reward but differing in reward uncertainty. Neuronal activity in posterior cingulate cortex (CGp), a brain area linked to visual orienting and reward processing, increased when monkeys made risky choices and scaled with the degree of risk. CGp activation was better predicted by the subjective salience of a chosen target than by its actual value. These data suggest that CGp signals the subjective preferences that guide visual orienting.     

Decision‐ and feedback‐related brain potentials reveal risk processing mechanisms in patients with alcohol use disorder

Individuals with alcohol use disorder (AUD) are aware of the risks of alcohol abuse yet continue risky drinking. Research indicates that dysfunctional decision processes and trait variables such as impulsivity contribute to this awareness‐behavior discrepancy. The present study focused on decision‐related versus feedback‐related processes as potential contributors to decision making in AUD by examining the relationship between decision choices and decision‐ and feedback‐related ERP phenomena in the balloon analogue risk task (BART). N = 39 AUD and n = 35 healthy comparison participants (HC) performed the BART modified for EEG assessment. In each of 100 runs, participants made a series of choices about whether to pump up a virtual balloon, which popped pseudorandomly, ending the run. Alternatively, participants ended the run by pressing a “cash‐out” button. Each pump not producing a pop provided .05 €; popping resulted in loss of the run’s accumulated gain. Groups made similar choices, though AUD responded more slowly. The decision P3 200?400 ms after decision prompt (balloon) was larger in AUD than in HC, and decision P3 enhancement on high‐risk trials predicted choices to pump. Feedback‐related negativity (FRN) after loss (relative to cash out) feedback was smaller in AUD than in HC, suggesting indifference to negative feedback. In AUD, high impulsivity was associated with risk‐modulated decision P3 but not FRN. Results indicate atypical decision‐ and feedback‐related processes that could contribute to difficulties in engaging with daily challenges effectively.     

Contextual valence modulates the neural dynamics of risk processing

A well‐known bias in risky decision making is that most people tend to be risk averse when gains are salient but risk seeking when losses are salient. The present study addressed the neural dynamics of this process by recording ERPs during a gambling task in a gain and a loss context. Behaviorally, participants were found to be risk averse in the gain context but risk neutral in the loss context. During the anticipation stage, an increased stimulus‐preceding negativity was elicited by high‐ versus low‐risk choices in the gain but not the loss context. During the outcome‐appraisal stage, the feedback‐related negativity was larger after high‐ versus low‐risk choices in the gain instead of the loss context. For the P300, an outcome valence effect (a larger P300 for gain vs. loss outcomes) emerged following the high‐ versus low‐risk decisions in the gain but not the loss context. Our findings suggest that risk processing can be modulated by the context of valence during the anticipation stage and by both the contextual valence and the outcome valence during the outcome‐appraisal stage, which may be driven by the motivational salience imposed by the context of valence.     

Developmental changes and individual differences in risk and perspective taking in adolescence

Despite the assumed prevalence of risk-taking behavior in adolescence, the laboratory evidence of risk taking remains scarce, and the individual variation poorly understood. Drawing from neuroscience studies, we tested whether risk and reward orientation are influenced by the perspective that adolescents take when making risky decisions. Perspective taking was manipulated by cuing participants prior to each choice whether the decision was made for "self," or from the perspective of an "other" (the experimenter in Experiment 1; a hypothetical peer in Experiment 2). In Experiment 1, we show a developmental decrease in risk-taking behavior across different stages of adolescence. In addition, all age groups made fewer risky choices for the experimenter, but the difference between self and other was larger in early adolescence. In Experiment 2, we show that high sensation-seeking (SS) adolescents make more risky choices than low SS adolescents, but both groups make a similar differentiation for other individuals (low risk-taking or high risk-taking peers). Together, the results show that younger adolescents and high SS adolescents make more risky choices for themselves, but can appreciate that others may make fewer risky choices. The developmental change toward more rational decisions versus emotional, impulsive decisions may reflect, in part, more efficient integration of others' perspectives into one's decision making. These developmental results are discussed regarding brain systems important for risk taking and perspective taking.     

Protecting the sacred and expressions of rituality: Examining the relationship between extrinsic dimensions of religiosity and unhealthy guilt

The aim of the present study was to examine the relationship between extrinsic religiosity and unhealthy guilt by testing two specific hypotheses. Using multidimensional measures of religious orientation and guilt, among 344 (169 male and 175 female) adults, and consistent with predictions; extrinsic‐personal religiosity was found to be related to trait and state guilt, and extrinsic‐social religiosity was found to be related to moral standards guilt. The present findings suggest evidence for a present conceptualization of the relationship between extrinsic religiosity and unhealthy guilt as the result of internal and external conflicts. The findings suggest that, when looking at maladaptive guilt among religious clients in clinical, therapeutic or counselling settings, it may be crucial to distinguish between dimensions of extrinsic religiosity and unhealthy guilt.     

Parenting style and obsessive‐compulsive symptoms and personality traits in a student sample

There is widespread acceptance of the idea that aspects of parenting such as overprotectiveness and perfectionism contribute to the pathogenesis of obsessive‐compulsive disorder (OCD). Less resolved is whether the important dimensions of parenting are overprotectiveness, lack of acceptance, authoritarian style, discouragement of risk‐taking, and/or induction of guilt. It is also unclear whether different parenting characteristics are associated with the development of symptoms of OCD, compared to the traits of obsessive‐compulsive personality disorder (OCPD). OCD symptoms and OC personality traits were measured in a non‐clinical, student sample and correlated with students' report of parents' acceptance, disciplinary firmness, and psychological control (a construct which included psychological manipulation and guilt‐induction). Following the literature on both clinical and subclinical OCD and OCPD, we predicted that all three scales would correlate with OCD symptoms and OCPD traits. Stepwise regression analysis revealed that psychological control was the unique predictor, controlling for depressive symptoms. Unexpectedly, a controlling parenting style was not selectively associated with classical OC symptoms or OC personality traits. Rather, psychological control was associated with a broad‐spectrum of anxiety and depressive symptoms which cut across diagnostic boundaries. Findings are generally compatible with a single underlying vulnerability to both OCD and OCPD, as well as generalized/social anxiety and depressive symptoms, which can be shaped by cultural and familial factors to a specific clinical presentation. Copyright © 2002 John Wiley & Sons, Ltd.     

Helping the soul: the relationship between connectivity and well‐being within a church community

Although previous research attests to the importance of psychological sense of community (PSOC) to individuals' well‐being, little research has examined this relationship for the four proposed dimensions of PSOC: membership, influence, integration and fulfillment of needs, and shared emotional connection (McMillan & Chavis, 1986). Further, little research has explored multiple aspects of community connectivity in the one study. The current research investigated the relationship between participants' (N=127) religiosity, PSOC, social support, and identification within a church community context and their well‐being. Results indicated that the PSOC dimensions of shared emotional connection and influence were particularly important in the prediction of well‐being in this context. Further, individuals' perception of social support mediated the relationship between PSOC and well‐being and the strength of individuals' identification as a church member enhanced the relationships of both PSOC and religiosity with well‐being. © 2009 Wiley Periodicals, Inc.     

Psychological processing of transplantation in lung recipients: A quantitative study of organ integration and the relationship to the donor

Objectives Lung recipients undergo a complex psychological process, including organ integration and processing of attitudes towards the organ donor. Design Seventy‐six lung recipients were asked to participate in a cross‐sectional questionnaire study on the psychological processing of lung transplants. Methods The questionnaire consisted of statements describing aspects of organ integration and the patient's relationship with the donor. Furthermore, chronic stress/psychological distress (Screening Scale of the Trier Inventory; Symptom Checklist SCL‐K‐9) and the emotional effects of transplantation/immunosuppression (Transplant Effects Questionnaire; Medication Experience Scale for Immunosuppressants) were assessed. Results In general, lung recipients perceive the transplant as part of themselves (97.4%) and not as a foreign object (90%). One‐third of patients still have frequent thoughts about the donor, whilst the majority (80.3%) do not believe that they have adopted the donor's characteristic traits. Factor analysis reveals the two‐dimensional structure of the questionnaire items ‘organ integration’ (factor 1) and ‘relationship to the donor’ (factor 2). Poor organ integration predicts low adherence, low disclosure and high feelings of guilt, whilst a close donor relationship predicts chronic stress and psychological distress. Conclusions Poor organ integration and a close relationship to the donor should be borne in mind in psychosocial treatment regarding the patient's adherence behaviour and psychological distress.     

Distinct neuropsychological processes may mediate decision-making under uncertainty with known and unknown probability in gain and loss frames

Decision-making under uncertainty has been studied in psychiatry, economic psychology, and neuroeconomics. Psychiatric patients (e.g., drug addicts) often show low degrees of aversion to potential danger. Investigation into neuropsychological processing underlying decision under uncertainty is important for medical treatments of neuropsychiatric disorders. In economic decision theory, choices under uncertainty with and without known probabilities of outcomes have been discriminated. Regarding decision-making under uncertainty with known probabilities (risk), Kahnemann-Tversky's prospect theory revealed that people tend to avoid uncertainty in potential gains (i.e., risk-aversion in a gain-frame); on the contrary, prefer uncertainty in potential losses (i.e., risk-seeking in a loss-frame). Regarding choices between possible gains with known and unknown probabilities, Ellsberg demonstrated that, in a gain-frame, people tend to avoid uncertainty with unknown probabilities, more dramatically than uncertainty with known probabilities. This can be explained by risk/uncertainty aversion in the gain-frame, suggesting that uncertainty with known and unknown probabilities (i.e., risk and Knightian uncertainty, respectively) may possibly be processed by similar neuropsychological processing in the gain-frame. However, in spite of accumulating evidence in neuroimaging and neuroeconomic studies, it is still unknown whether probability and Knightian uncertainty in the loss-frame are mediated by similar neuropsychological processes as well. We propose that distinct neuropsychological processes may mediate potential losses with known and unknown probabilities, based on recent findings in neuroeconomics and our experiment. Importance of examining subjects' degree of Knightian uncertainty aversion for the prediction/treatment of drug addicts' risky behavior (e.g., needle-sharing) is also discussed.     

The Mother,The Psychoanalyst,The Poet and The Artist: Containment and Growth of The Mind

This paper considers the difficulties which humans have in using and developing their capacity for thought. Growth of the human mind, through attunement of the mother's unconscious experience with the infant's, is explored along with the distortions which arise because of aversion to uncertainty and suffering. It then looks at psychoanalysis and the verbal and visual arts in the light of the maternal function, and the way in which they also promote the growth of the mind. Four products of the human mind – an excerpt from an infant observation published in 1998, some post‐Kleinian psychoanalytic clinical case material from the 1980s, John Keats's 19th century Ode to a Nightingale and Lucas Cranach's 1526 painting, Adam and Eve – are used to illustrate some of the similarities and differences among them in giving conscious form to the unconscious.     

Victims of Fukushima Daiichi nuclear power plant accident in long‐lasting disillusionment phase

This study describes the existence of the long‐lasting disillusionment phase for the victims after the accident at the Fukushima Daiichi Nuclear Power Plant following the Great East Japan Earthquake in March 2011. Through analyzing the mental situation of the victims, the situations were categorized into 2 groups for forced evacuees: “in the disillusionment phase” and “in the reconstruction phase,” Other 2 groups are for host Iwaki residents: “with negative feelings against evacuees” and “leading their life constructively.” The negative feeling enhances the vicious psychological cycle for the evacuees in the long‐lasting disillusionment phase and repeating emotion of survivor's guilt in the reconstruction phase. We propose that people who were getting back to a normal life while leading their life constructively should raise their voices in favor of living together with evacuees.     

How does the mode of inheritance of a genetic condition influence families? A study of guilt,blame, stigma,and understanding of inheritance and reproductive risks in families with X-linked and autosomal recessive diseases

PURPOSE: While the mode of inheritance of a genetic condition has long been considered to have not only medical, but also psychosocial consequences for families, this supposition has never been tested. METHODS: We surveyed 112 members of 51 families (59% response) with chronic granulomatous disease to determine the influence of mode of inheritance on parents', siblings', and patients' (1) knowledge of inheritance and reproductive risk; (2) concern about risk to future family-members; (3) feelings of guilt and blame; and (4) feelings of stigmatization. Ninety-six members of 51 families (49% response) with Duchenne/Becker muscular dystrophy and spinal muscular atrophy types II/III were also studied. RESULTS: X-linked families had better understanding of inheritance (P < 0.001) and reproductive risks (P < 0.01). X-linked mothers worried more about risks to future generations; other autosomal-recessive family members were as worried. X-linked mothers were more likely to feel guilty (P < 0.01) and blame themselves (P < 0.001). X-linked fathers blamed their child's mother (P < 0.05) and X-linked mothers felt more blamed by the father (P < 0.01). X-linked family-members were more likely to consider being a carrier stigmatizing (P < 0.05). CONCLUSION: When providing genetic counseling, attention should be given to guilt and blame in X-linked families and understanding reproductive risks in autosomal recessive families.     

Individual measurement of exposure to everyday violence among elementary schoolchildren across various settings

One hundred and thirty‐four second‐ and fourth‐grade students from two schools in Israel were measured individually using a Hebrew adaptation of the Violence Exposure Scale—Revised (VEX‐R), a self‐report scale measuring children's exposure to everyday violence. Children reported exposure as a function of situation (witness or victim) and setting (home, school, or neighborhood). They also reported on their own distress symptoms. The children's mothers also completed the VEX‐R, indicating how they expected their child would report, and the Child Behavior Checklist. Children reported more exposure to violence at school compared to either the home or neighborhood, and more as witnesses than victims. Most of the violence reported was mild (e.g., pushing, chasing), while severe violence (e.g., shooting, stabbing) was rare in all settings. Children who reported themselves as frequent victims of violence were rated by their mothers as exhibiting more behavior problems than those reporting less victimization. The results support the validity of the VEX‐R as a measure of exposure to violence for young children. © 2001 John Wiley & Sons, Inc.     

Definition and measurement of guilt: Implications for clinical research and practice

Research on the relation of guilt to psychopathology is highly inconsistent. Some studies suggest that guilt contributes to psychopathology; others suggest that guilt serves a protective role. This review of 23 theory-based definitions of guilt and 25 measures of guilt suggests that a lack of conceptual clarity may be to blame. Measures of guilt do not correspond well to the definitions from which they derive. Many definitions and measures reflect the intrusion of extraneous constructs that could confound guilt research. Furthermore, definitions and measures of guilt change with developmental level. Nevertheless, two broad conceptualizations of guilt emerge. Central to both is a focus on one's action or inactions involving real or imagined moral transgressions. Distinguishing the two conceptualizations is whether or not guilt is inherently adaptive construct, generating remorse, augmenting a sense of responsibility, and motivating reparation. Recommendations for the definition and measurement of guilt are discussed.     

Psychophysiological arousal and inter‐ and intraindividual differences in risk‐sensitive decision making

The current study assessed peripheral responses during decision making under explicit risk, and tested whether intraindividual variability in choice behavior can be explained by fluctuations in peripheral arousal. Electrodermal activity (EDA) and heart rate (HR) were monitored in healthy volunteers (N = 68) during the Roulette Betting Task. In this task, participants were presented with risky gambles to bet on, with the chances of winning varying across trials. Hierarchical Bayesian analyses demonstrated that EDA and HR acceleration responses during the decision phase were sensitive to the chances of winning. Interindividual differences in this peripheral reactivity during risky decision making were related to trait sensitivity to punishment and trait sensitivity to reward. Moreover, trial‐by‐trial variation in EDA and HR acceleration responses predicted a small portion of intraindividual variability in betting choices. Our results show that psychophysiological responses are sensitive to explicit risk and can help explain intraindividual heterogeneity in choice behavior.     

Help‐seeking among male victims of partner abuse: men's hard times

Sixty‐eight agency representatives in the United States completed a survey to identify issues of male victims in partner abuse: half referenced responses from male clients and the other half responses from male victims who were their family members, friends, colleagues, or themselves. Almost 25% revealed that male victims did not utilize social services. For those men who used services, individual counseling and legal advice were most popular; group counseling and sharing through the Internet were least used. Qualitative data found five themes that triggered men's hard times: service target perception, shame and embarrassment, denial, stigmatization, and fear. The study resulted in three recommendations: (a) increase public awareness and education; (b) provide gender‐inclusive practice and services, and (c) strengthen training for service providers working with domestic violence male victims. © 2010 Wiley Periodicals, Inc.     

Pregnant couples at increased risk for common aneuploidies choose maximal information from invasive genetic testing

Genomic array detects more pathogenic chromosome aberrations than conventional karyotyping (CK), including genetic variants associated with a susceptibility for neurodevelopmental disorders; susceptibility loci (SL). Consensus regarding the scope of invasive prenatal diagnosis (PND) pregnant couples should be offered is lacking. This study examined pregnant couples' preferences, doubts and satisfaction regarding the scope of invasive PND. Eighty‐two couples choosing prenatal screening (PNS) and 59 couples choosing invasive PND were offered a choice between 5 (comparable to CK) and 0.5 Mb resolution array analysis outcomes, the latter with or without reporting SL. A pre‐test self‐report questionnaire and post‐test telephone interview assessed their choices in‐depth. Actual (PND) and hypothetical (PNS) choices differed significantly (p < 0.001). Ninety‐five percent of the couples in the PND group chose 0.5 Mb array, vs 69% in the PNS group. Seven percent of the PND group wished not to be informed of SL. Ninety percent was satisfied with their choice and wished to decide about the scope themselves. Pregnant couples wish to make their own choices regarding the scope of invasive PND. It therefore seems justified to offer them a choice in both the resolution of array and disclosure of SL.     

Male views on help‐seeking for depression: A Q methodology study

Objectives

To identify viewpoints among men with depression about depression and its treatment, consider how these might influence help‐seeking behaviour, and generate ideas for interventions and future research.

Design

Q methodology.

Methods

Twenty‐nine men with depression completed a Q sort by ranking a set of statements about depression and help‐seeking according to their relative agreement with each statement. Factor analysis was used to identify viewpoints relating to male understandings of depression and help‐seeking, which were interpreted in the context of participant characteristics and additional information from post‐sorting interviews.

Results

A two‐factor solution accounting for 45% of the total variance was considered the best fit for the data. The 2 factors were: (1) Help is available if you can get to the point of asking for it (34% of the variance) and (2) depression should be dealt with in private; help‐seeking makes you vulnerable (11% of the variance). Participants who were significantly associated with both factors described a sense of shame, relating to their own or others' views that being depressed and help‐seeking are in conflict with socially constructed ‘masculine' values, such as strength and self‐sufficiency. In the viewpoint represented by Factor 1, however, the benefits of help‐seeking outweigh the negatives. In contrast, the viewpoint represented in Factor 2 holds that depression should remain a private struggle and that help‐seeking is too risky a move to make.

Conclusions

In order to access treatment, men must first recognize depression, then overcome considerable perceived and internalized stigma to ask for help. Improving public knowledge about the nature of depression; positive messages about the act of help‐seeking, types of treatment available, and effectiveness of treatments; and work to overcome the challenges posed by long waiting times and other service constraints may increase rates of help‐seeking, and represent areas for future research.

Practitioner points

• Interventions to improve recognition of depression symptoms, particularly in the absence of recent negative life events or suicidal ideation, might help to improve help‐seeking rates among men.
• Media campaigns should consider focusing on the positive elements of help‐seeking and potential for recovery, and the impact of such campaigns should be evaluated.
• Improving public knowledge of the types of non‐medical intervention that are available for depression may help to increase help‐seeking rates.
• Clinical services and commissioners should be aware of the impact of long waiting times and strict discharge policies on service users, especially those who have difficulty asking for help.