From avoidance to approach: The influence of threat-of-shock on reward-based decision making
Introduction
Individuals often need to choose between behavioral options which are linked to either positive or negative outcomes. If one's choice, however, can result in rewards and aversive events at the same time, an approach-avoidance conflict emerges (Cacioppo and Berntson, 1994, Corr, 2013, Miller, 1959). Adaptive action selection then requires balanced decisions between approaching rewards and avoiding harm (Lejuez et al., 2002). In this approach-avoidance framework, the anticipation of consequences is important to organize goal-directed behavior and a priori information about potential threat versus safety is crucial to decide which behavior is most functional. Decisions may therefore be guided by emotional stimuli that convey information about potential threat. Fundamental motivational neural circuits are assumed to organize this influence of emotional information on approach and avoidance behavior (Lang & Bradley, 2010). This model received much support from studies measuring physiological response parameters (e.g., reflex-based motor and autonomic nervous system activity; Bradley, Codispoti, Cuthbert, & Lang, 2001); as well as neuroimaging studies (e.g., Lang & Davis, 2006). However, surprisingly little is known about potential avoidance biases on more complex behavioral decision-making.
In behavioral decision-making tasks there is often either one positive or one negative outcome. In reward-based decisions, for example, individuals typically show increased selections of profitable options, which are associated with higher or more frequent rewards (e.g., Balleine and Dickinson, 1998, Richards et al., 2013). In contrast, individuals will consistently avoid options associated with a single aversive outcome (e.g., an aversive electrical stimulation; Dymond et al., 2012, Glotzbach et al., 2012, Lovibond et al., 2009, Ly and Roelofs, 2009).
In approach-avoidance conflicts, however, rewards and aversive consequences directly compete. There is growing interest in how competing reward- and threat-related consequences are integrate to guide behavioral decision making (Aupperle et al., 2015, Botvinick and Braver, 2015, Hayes et al., 2014, Pittig et al., 2014a, Pittig et al., 2014c, Schlund et al., 2016, Sierra-Mercado et al., 2015, Talmi and Pine, 2012). For example, whereas healthy individuals will avoid aversive stimuli when competing rewards are absent, too small, or uncertain, they may tolerate the same aversive stimuli and switch towards approach behavior when sufficiently rewarded (Aupperle et al., 2011, Sierra-Mercado et al., 2015, Talmi et al., 2009). A reversed switch or “tipping point” towards consistent avoidance has been found for decisions associated with stable rewards, but increasing threat. Healthy individuals switch from approaching the reward to threat avoidance when the increasing threat exceeds the reward value (e.g., Schlund et al., 2016).
Similar decision making has been observed in anxious individuals when more profitable options were linked to individually fear-relevant stimuli. Spider fearful individuals, for example, initially avoided options associated with the presentation of spider pictures, but tolerated such confrontations when gaining higher rewards with these choices (similar with socially anxious individuals in response to angry facial expressions; see Pittig et al., 2015, Pittig et al., 2014a, Pittig et al., 2014b). Thus, considering both competing rewards and aversive outcomes is crucial for adaptive goal-directed behavior and imbalances may be associated with psychopathology.
Decision making crucially depends on the anticipation of consequences, which in turn requires that individuals effectively learn about environmental contingencies. This is particularly true for the learning and anticipation of aversive events, as these may harm the organism's physical integrity (Johnson, Blumstein, Fowler, & Haselton, 2013). As a model of such learning processes, much research has employed Pavlovian fear conditioning paradigms, in which formerly neutral stimuli acquire emotional properties through pairing with aversive events such as electric stimulations, heat pain, or monetary loss (Craske et al., 2006, Duits et al., 2015). Importantly, a recent study provided first evidence that fear conditioning experiences may guide subsequent decisions and result in the development of pathological avoidant decisions. Specifically, a former neutral stimulus was paired with an aversive outcome during fear conditioning. In a subsequent decision task, participants avoided options that were linked to this fear conditioned stimulus, even if these decisions resulted in monetary costs and were not anymore linked to the aversive consequences (Pittig, Schulz, et al., 2014; Experiment 1). In addition, this costly avoidance was elevated in individuals with high trait anxiety (Pittig, Schulz, et al., 2014; Experiment 2). These findings demonstrate how behavioral decisions are biased towards costly avoidance by direct fear learning experience.
However, human fear learning may also occur without direct experience of an aversive event. The mere verbal instruction about potential aversive outcomes has been shown to establish a fear-relevant association that reliably provokes defensive responding (i.e., elevated skin conductance responses, heart rate deceleration, and potentiated startle reflexes; e.g., Bradley et al., 2005, Bublatzky et al., 2013, Grillon et al., 1991) and facilitates sensory processing of environmental information (e.g., Baas et al., 2006, Bublatzky and Schupp, 2012, Bublatzky et al., 2010, Cornwell et al., 2007). Importantly, the acquisition of human avoidance behavior may be similarly triggered by stimuli that acquired threat associations either by direct experience or mere verbal instructions (Cameron et al., 2016, Dymond et al., 2012). Despite increasing evidence showing the relevance of instructed threat learning for anxiety and stress-related disorders (e.g., Muris and Field, 2010, Robinson et al., 2013), surprisingly little is known about its impact on the individuals' behavior and decisions in approach-avoidance conflicts.
The present study therefore combined verbal threat instructions and a reward-based decision-making task to test the impact of anticipated threat on reward-directed decisions. Participants had to choose between two decks of cards, which were differently reinforced by monetary incentives and contingent with instructed threat-of-shock or safety cues. Building upon previous research, differential positive reinforcement should favor more frequent choices of the high reward options (e.g., monetary gains; Bechara et al., 1997, Pittig et al., 2014c). On the other hand, instructed threat of aversive events may lead to behavioral avoidance (Dymond et al., 2012) and enhanced defense activation when confronted with a threat cue (i.e., enhanced SCR and heart rate deceleration; Bradley et al., 2005, Olsson and Phelps, 2004). Regarding the interaction of decision making and threat-of-shock, we hypothesized that choices associated with potential threat would be avoided initially (Pittig, Schulz, et al., 2014). However, behavioral avoidance should gradually diminish with increasing experience of reward contingencies and the omission of the aversive consequence. The actual absence of the instructed aversive consequences should further help to overcome behavioral avoidance (see Pittig et al., 2014a, Pittig et al., 2014c), and may support extinction learning (see Bublatzky, Gerdes, & Alpers, 2014).
Section snippets
Participants
Sample size was based on power analyses conducted with G-Power (Faul, Erdfelder, Lang, & Buchner, 2007), which indicated that 62 participants were required to detect all relevant behavioral effects at a medium effect size (power = 0.80, α error = 0.05, medium effect sizes; assumed correlation of repeated measures in repeated measures ANOVA = 0.40). Because of randomized assignment to two groups, group sizes varied slightly (n = 31 and 34). Sixty-five healthy participants (39 females; 60.0%)
Self-report data
Overall, participants rated the threat/safety instruction as credible (n = 59; 90.8%) and effective (n = 52; 80%) in provoking a state of aversive apprehension. The successful verbal threat manipulation was also evident in valence and arousal ratings. Self-reported valence and arousal varied as a function of Cue by Instruction Phase, Fs(1,62) > 8.41, ps < 0.006, ηp2 > 0.118. Whereas ratings for both stimuli did not differ on both dimensions after the non-threat instruction phase, all ts < 1.50,
Discussion
The present study showed that instructed threat – although there were actually no aversive consequences– can trigger avoidance of profitable decisions. Implementing an approach-avoidance conflict, participants could choose a more profitable option which was at the same time contingent with instructed threat of aversive electrical stimulations. Another option was associated with less rewards but always followed by an instructed safety signal (indicating the absence of aversive consequences).
Acknowledgements
We are grateful to M. Borger, L. Laubisch, and E. Smolenskaya for their assistance in data collection. This work was supported, in part, by the “Struktur-und Innovationsfonds (SI-BW)” of the state of Baden-Wuerttemberg, Germany, and by the German Research Foundation (BU 3255/1-1) to FB.
References (72)
- et al.
A reverse translational approach to quantify approach-avoidance conflict in humans
Behavioural Brain Research
(2011) - et al.
Brainstem correlates of defensive states in humans
Biological Psychiatry
(2006) - et al.
Goal-directed instrumental action: Contingency and incentive learning and their cortical substrates
Neuropharmacology
(1998) - et al.
Measuring emotion: The self-assessment manikin and the semantic differential
Journal of Behavior Therapy and Experimental Psychiatry
(1994) - et al.
Learned, instructed and observed pathways to fear and avoidance
Journal of Behavior Therapy and Experimental Psychiatry
(2016) - et al.
Neural responses to auditory stimulus deviance under threat of electric shock revealed by spatially-filtered magnetoencephalography
NeuroImage
(2007) - et al.
Maximizing exposure therapy: An inhibitory learning approach
Behaviour Research and Therapy
(2014) - et al.
Fear generalization in humans: Systematic review and implications for anxiety disorder research
Behavior Therapy
(2015) - et al.
Enhanced avoidance habits in obsessive-compulsive disorder
Biological Psychiatry
(2014) - et al.
Context conditioning and behavioral avoidance in a virtual reality environment: Effect of predictability
Biological Psychiatry
(2006)
Stressor controllability modulates fear extinction in humans
Neurobiology of Learning and Memory
A comparison of neural responses to appetitive and aversive stimuli in humans and other mammals
Neuroscience and Biobehavioral Reviews
Psychophysiological and subjective indicators of aversive pavlovian conditioning in generalized social phobia
Biological Psychiatry
The evolution of error: Error management, cognitive constraints, and adaptive decision-making biases
Trends in Ecology and Evolution
Emotion and the motivational brain
Biological Psychology
Emotion, motivation, and the brain: Reflex foundations in animal and human research
Progress in Brain Research
Response rates for CBT for anxiety disorders: Need for standardized criteria
Clinical Psychology Review
Safety behaviours preserve threat beliefs: Protection from extinction of human fear conditioning by an avoidance response
Behaviour Research and Therapy
Social anxiety and cognitive expectancy of aversive outcome in avoidance conditioning
Behaviour Research and Therapy
Avoidant decision-making in social anxiety disorder: A laboratory task linked to in vivo anxiety and treatment outcome
Behaviour Research and Therapy
The cost of fear: Avoidant decision making in a spider gambling task
Journal of Anxiety Disorders
A systematic review of fMRI reward paradigms used in studies of adolescents vs. adults: The impact of task design and implications for understanding neurodevelopment
Neuroscience & Biobehavioral Reviews
Dynamics of defensive reactivity in patients with panic disorder and agoraphobia: Implications for the etiology of panic disorder
Biological Psychiatry
Defensive activation during the rubber hand illusion: Ownership versus proprioceptive drift
Biological Psychology
The tipping Point: Value differences and parallel dorsal-ventral frontal circuits gating human approach-avoidance behavior
NeuroImage
Is cognitive-behavioral therapy more effective than other therapies?. A meta-analytic review
Clinical Psychology Review
Avoiding treatment failures in specific phobias
Neural substrates of approach-avoidance conflict decision-making
Human Brain Mapping
Deciding advantageously before knowing the advantageous strategy
Science
Comparison of Beck depression inventories-IA and-II in psychiatric outpatients
Journal of Personality Assessment
Motivation and cognitive Control: From behavior to neural mechanism
Annual Review of Psychology
Emotion and motivation I: Defensive and appetitive reactions in picture processing
Emotion
When good things go bad: The reflex physiology of defense
Psychological Science
The interaction of anticipatory anxiety and emotional picture processing: An event-related brain potential study
Psychophysiology
The persistence of socially instructed threat: Two threat-of-shock studies
Psychophysiology
Additive effects of threat-of-shock and picture valence on startle reflex modulation
PLoS One
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Contributed equally.