Posttraumatic Stress Disorder Increases Sensitivity to Long Term Losses among Patients with Major Depressive Disorder

Background

Decisions under risk and with outcomes that are delayed in time are ubiquitous in real life and can have a significant impact on the health and wealth of the decision-maker. Despite its potential relevance for real-world choices, the degree of aberrant risky and intertemporal decision-making in patients suffering from major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) has received little attention to date.

Method

We used a case-control design to compare decision-making in healthy control subjects (N=16) versus untreated depressed subjects in a current major depressive episode (N=20). In order to examine how major depressive disorder (MDD) may impact decision-making, subjects made decisions over (1) risky outcomes and (2) delayed outcomes in the domain of gains and losses using choice paradigms from neuroeconomics. In a pre-planned analysis, depressed subjects were subdivided into those with primary PTSD along with comorbid MDD (MDD+PTSD) versus those with primary MDD without PTSD (MDD-only). Choice behavior was modeled via a standard econometric model of intertemporal choice, a quasi-hyperbolic temporal discounting function, which was estimated for each subject group separately.

Results

Under conditions of potential gain, depressed subjects demonstrated greater discounting for gains across all time frames compared to controls. In the realm of losses, both subgroups of depressed subjects discounted more steeply than controls for short time frames. However, for delayed losses ranging from >1-10 years, MDD+PTSD subjects showed shallower discounting rates relative to MDD-only subjects, who continued to discount future losses steeply. Risk attitudes did not contribute to differences in intertemporal choice.

Conclusions

Depressed patients make choices that minimize current pain and maximize current reward, despite severe later consequences or lost opportunities. Anxiety associated with PTSD may serve as a partially protective factor in decision-making about long-term potential losses compared to MDD patients without PTSD.     

Time discounting,present biases,and health-related behaviors: Evidence from Japan

Human health is considered the outcome of intertemporal choices under tradeoffs between a small immediate reward and a larger delayed reward. Health-related behaviors are thus affected by personal time preferences. Based on an Internet-based survey conducted on Japanese adults, we contribute to the literature by incorporating the multifaceted nature of time discounting in an analysis of the associations between time preference and health-related behaviors. We find that, first, less patient respondents tend to exhibit worse health-related attributes. Second, present bias, which is measured by the degree of declining impatience, is positively associated with unhealthy behaviors for naïve respondents, who are unaware of their self-control problem. Third, such associations cannot be found in sophisticates, who are aware of that. As a policy implication, direct intervention policies, including “nudging,” are more effective than a commitment device provision in correcting the unhealthy behaviors due to present bias. Fourth, the sign effect, wherein future losses are discounted at a lower rate than future gains, is negatively associated with unhealthy outcomes, although at weak statistical significance levels.     

What Do I Want and When Do I Want It: Brain Correlates of Decisions Made for Self and Other

A number of recent functional Magnetic Resonance Imaging (fMRI) studies on intertemporal choice behavior have demonstrated that so-called emotion- and reward-related brain areas are preferentially activated by decisions involving immediately available (but smaller) rewards as compared to (larger) delayed rewards. This pattern of activation was not seen, however, when intertemporal choices were made for another (unknown) individual, which speaks to that activation having been triggered by self-relatedness. In the present fMRI study, we investigated the brain correlates of individuals who passively observed intertemporal choices being made either for themselves or for an unknown person. We found higher activation within the ventral striatum, medial prefrontal and orbitofrontal cortex, pregenual anterior cingulate cortex, and posterior cingulate cortex when an immediate reward was possible for the observer herself, which is in line with findings from studies in which individuals actively chose immediately available rewards. Additionally, activation in the dorsal anterior cingulate cortex, posterior cingulate cortex, and precuneus was higher for choices that included immediate options than for choices that offered only delayed options, irrespective of who was to be the beneficiary. These results indicate that (1) the activations found in active intertemporal decision making are also present when the same decisions are merely observed, thus supporting the assumption that a robust brain network is engaged in immediate gratification; and (2) with immediate rewards, certain brain areas are activated irrespective of whether the observer or another person is the beneficiary of a decision, suggesting that immediacy plays a more general role for neural activation. An explorative analysis of participants’ brain activation corresponding to chosen rewards, further indicates that activation in the aforementioned brain areas depends on the mere presence, availability, or actual reception of immediate rewards.     

Gender-Specific Differences in the Relationship between Autobiographical Memory and Intertemporal Choice in Older Adults

As the population of older adults grows, their economic choices will have increasing impact on society. Research on the effects of aging on intertemporal decisions shows inconsistent, often opposing results, indicating that yet unexplored factors might play an essential role in guiding one''s choices. Recent studies suggest that episodic future thinking, which is based on the same neural network involved in episodic memory functions, leads to reductions in discounting of future rewards. As episodic memory functioning declines with normal aging, but to greatly variable degrees, individual differences in delay discounting might be due to individual differences in the vitality of this memory system in older adults. We investigated this hypothesis, using a sample of healthy older adults who completed an intertemporal choice task as well as two episodic memory tasks. We found no clear evidence for a relationship between episodic memory performance and delay discounting in older adults. However, when additionally considering gender differences, we found an interaction effect of gender and autobiographical memory on delay discounting: while men with higher memory scores showed less delay discounting, women with higher memory scores tended to discount the future more. We speculate that this gender effect might stem from the gender-specific use of different modal representation formats (i.e. temporal or visual) during assessment of intertemporal choice options.     

An effect of inter-trial duration on the gambler's fallacy choice bias

The gambler's fallacy is defined as the avoidance of a winning outcome in a stochastic environment with a constant probability. We tested the possibility that the gambler's fallacy in humans is responsive to the amount of time between choice allocations. Two groups of subjects were placed in a six-choice betting game in which the choices were clustered into two “patches.” Groups were defined by the length of time - 2 s or 6 s - between trials. On any given trial subjects allocated six points among the alternatives, and retained any points that were bet on the winning alternative. Both groups showed evidence of the gambler's fallacy bias. However, the bias was stronger in the 6-s ITI group than in the 2-s ITI group. This difference was found primarily to be due to differences in the number of subjects showing an opposing bias to the gambler's fallacy, namely a preference for the most recent winning alternative. This choice bias is termed the hot hand fallacy. Our findings contradict predictions derived from a foraging heuristic and from traditional accounts of the gambler's fallacy.     

Evolutionary pressures on primate intertemporal choice

From finding food to choosing mates, animals must make intertemporal choices that involve fitness benefits available at different times. Species vary dramatically in their willingness to wait for delayed rewards. Why does this variation across species exist? An adaptive approach to intertemporal choice suggests that time preferences should reflect the temporal problems faced in a species''s environment. Here, I use phylogenetic regression to test whether allometric factors relating to body size, relative brain size and social group size predict how long 13 primate species will wait in laboratory intertemporal choice tasks. Controlling for phylogeny, a composite allometric factor that includes body mass, absolute brain size, lifespan and home range size predicted waiting times, but relative brain size and social group size did not. These findings support the notion that selective pressures have sculpted intertemporal choices to solve adaptive problems faced by animals. Collecting these types of data across a large number of species can provide key insights into the evolution of decision making and cognition.     

Interindividual Variability in Functional Connectivity as Long-Term Correlate of Temporal Discounting

During intertemporal choice (IT) future outcomes are usually devaluated as a function of the delay, a phenomenon known as temporal discounting (TD). Based on task-evoked activity, previous neuroimaging studies have described several networks associated with TD. However, given its relevance for several disorders, a critical challenge is to define a specific neural marker able to predict TD independently of task execution. To this aim, we used resting-state functional connectivity MRI (fcMRI) and measured TD during economic choices several months apart in 25 human subjects. We further explored the relationship between TD, impulsivity and decision uncertainty by collecting standard questionnaires on individual trait/state differences. Our findings indicate that fcMRI within and between critical nodes of task-evoked neural networks associated with TD correlates with discounting behavior measured a long time afterwards, independently of impulsivity. Importantly, the nodes form an intrinsic circuit that might support all the mechanisms underlying TD, from the representation of subjective value to choice selection through modulatory effects of cognitive control and episodic prospection.     

Monkeys Are More Patient in a Foraging Task than in a Standard Intertemporal Choice Task

Studies of animal impulsivity generally find steep subjective devaluation, or discounting, of delayed rewards – often on the order of a 50% reduction in value in a few seconds. Because such steep discounting is highly disfavored in evolutionary models of time preference, we hypothesize that discounting tasks provide a poor measure of animals’ true time preferences. One prediction of this hypothesis is that estimates of time preferences based on these tasks will lack external validity, i.e. fail to predict time preferences in other contexts. We examined choices made by four rhesus monkeys in a computerized patch-leaving foraging task interleaved with a standard intertemporal choice task. Monkeys were significantly more patient in the foraging task than in the intertemporal choice task. Patch-leaving behavior was well fit by parameter-free optimal foraging equations but poorly fit by the hyperbolic discount parameter obtained from the intertemporal choice task. Day-to-day variation in time preferences across the two tasks was uncorrelated with each other. These data are consistent with the conjecture that seemingly impulsive behavior in animals is an artifact of their difficulty understanding the structure of intertemporal choice tasks, and support the idea that animals are more efficient rate maximizers in the multi-second range than intertemporal choice tasks would suggest.     

Intertemporal choice in lemurs

Different species vary in their ability to wait for delayed rewards in intertemporal choice tasks. Models of rate maximization account for part of this variation, but other factors such as social structure and feeding ecology seem to underly some species differences. Though studies have evaluated intertemporal choice in several primate species, including Old World monkeys, New World monkeys, and apes, prosimians have not been tested. This study investigated intertemporal choices in three species of lemur (black-and-white ruffed lemurs, Varecia variegata, red ruffed lemurs, Varecia rubra, and black lemurs, Eulemur macaco) to assess how they compare to other primate species and whether their choices are consistent with rate maximization. We offered lemurs a choice between two food items available immediately and six food items available after a delay. We found that by adjusting the delay to the larger reward, the lemurs were indifferent between the two options at a mean delay of 17 s, ranging from 9 to 25 s. These data are comparable to data collected from common marmosets (Callithrix jacchus). The lemur data were not consistent with models of rate maximization. The addition of lemurs to the list of species tested in these tasks will help uncover the role of life history and socio-ecological factors influencing intertemporal choices.     

Anticipation and Choice Heuristics in the Dynamic Consumption of Pain Relief

Humans frequently need to allocate resources across multiple time-steps. Economic theory proposes that subjects do so according to a stable set of intertemporal preferences, but the computational demands of such decisions encourage the use of formally less competent heuristics. Few empirical studies have examined dynamic resource allocation decisions systematically. Here we conducted an experiment involving the dynamic consumption over approximately 15 minutes of a limited budget of relief from moderately painful stimuli. We had previously elicited the participants’ time preferences for the same painful stimuli in one-off choices, allowing us to assess self-consistency. Participants exhibited three characteristic behaviors: saving relief until the end, spreading relief across time, and early spending, of which the last was markedly less prominent. The likelihood that behavior was heuristic rather than normative is suggested by the weak correspondence between one-off and dynamic choices. We show that the consumption choices are consistent with a combination of simple heuristics involving early-spending, spreading or saving of relief until the end, with subjects predominantly exhibiting the last two.     

Do pretty women inspire men to discount the future?

Organisms 'discount the future' when they value imminent goods over future goods. Optimal discounting varies: selection should favour allocations of effort that effectively discount the future relatively steeply in response to cues promising relatively good returns on present efforts. However, research on human discounting has hitherto focused on stable individual differences rather than situational effects. In two experiments, discounting was assessed on the basis of choices between a smaller sum of money tomorrow and a larger sum at a later date, both before and after subjects rated the 'appeal' of 12 photographs. In experiment 1, men and women saw either attractive or unattractive opposite-sex faces; in experiment 2, participants saw more or less appealing cars. As predicted, discounting increased significantly in men who viewed attractive women, but not in men who viewed unattractive women or women who viewed men; viewing cars produced a different pattern of results.     

Influence of an Interpersonal Laboratory Stressor on Youths’ Choice to Be Physically Active

Objective: To determine whether interpersonal stress reduces youths’ motivation to exercise in a laboratory setting. Research Methods and Procedures: Physical activity and sedentary behavior were measured in boys and girls across a control day, after reading children's magazines, and on a stress day, after giving a videotaped speech. For one analysis, children were divided into low (n = 12) and high (n = 13) heart‐rate reactivity groups based on changes in heart rate to stress. In a second analysis, children were divided into low and high perceived level of stress based on changes in perceived stress. To determine differences in choice of exercise or sedentary behavior across the control and stress conditions, subjects chose either to exercise for progressively longer periods to earn a monetary reinforcer or to engage in a high‐rated sedentary behavior. Results: The choice to exercise was influenced by stress reactivity differently in the stress and control conditions. Low heart‐rate reactive children participated in similar (p > 0.50) amounts of exercise on the stress and control days, but high heart‐rate reactive children participated in less (p < 0.01) exercise (22.0 ± 2.5 vs. 26.3 ± 2.2 minutes) on the stress than control days. When grouped by change in perceived stress, there were no group differences, but subjects exercised longer (p < 0.01) on the control day than the stress day. Discussion: Interpersonal stress decreased exercise in children susceptible to interpersonal stress. Stress‐induced alterations in health behaviors may lead to weight gain in children.     

Adapting to the destitute situations: poverty cues lead to short-term choice

Background

Why do some people live for the present, whereas others save for the future? The evolutionary framework of life history theory predicts that preference for delay of gratification should be influenced by social economic status (SES). However, here we propose that the decision to choose alternatives in immediate and delayed gratification in poverty environments may have a psychological dimension. Specifically, the perception of environmental poverty cues may induce people alike to favor choices with short-term, likely smaller benefit than choices with long-term, greater benefit.

Methodology/Principal Findings

The present study was conducted to explore how poverty and affluence cues affected individuals'' intertemporal choices. In our first two experiments, individuals exposed explicitly (Experiment 1) and implicitly (Experiment 2) to poverty pictures (the poverty cue) were induced to prefer immediate gratification compared with those exposed to affluence pictures (the affluence cue). Furthermore, by the manipulation of temporary perceptions of poverty and affluence status using a lucky draw game; individuals in the poverty state were more impulsive in a manner, which made them pursue immediate gratification in intertemporal choices (Experiment 3). Thus, poverty cues can lead to short-term choices.

Conclusions/Significance

Decision makers chose more frequently the sooner-smaller reward over the later-larger reward as they were exposed to the poverty cue. This indicates that it is that just the feeling of poverty influences intertemporal choice – the actual reality of poverty (restricted resources, etc.) is not necessary to get the effect. Furthermore, our findings emphasize that it is a change of the poverty-affluence status, not a trait change, can influence individual preference in intertemporal choice.     

Intangibility in intertemporal choice

Since the advent of the discounted utility (DU) model, economists have thought about intertemporal choice in very specific terms. DU assumes that people make explicit trade-offs between costs and benefits occurring at different points in time. While this explicit trade-off perspective is simple and tractable, and has stimulated productive research, it does not provide a very realistic representation of a wide range of the most important intertemporal trade-offs that people face in daily life. If one considers the most important and commonly discussed examples of intertemporal choices, a striking pattern emerges: in almost all cases, early outcomes tend to be concrete (e.g. purchasing this latte), but later outcomes tend to be much less tangible (e.g. the unknown item that could have been purchased later with the money spent on this latte). We propose that people rely on anticipatory emotions as a proxy for intangible outcomes when trade-offs are implicit. This paper reviews neuroeconomic evidence that has begun to elucidate the role of anticipatory emotions in decisions involving intangible outcomes. Although most progress has been made in the domain of spending and saving, we discuss how the existing neuroeconomic research could be extended to other domains where trade-offs are ill defined.     

Time preference and nutrition label use: Evidence from China

The assumption that label use behavior is, to some extent, intertemporal decision behavior because the benefit of label use cannot be realized instantly, is insufficiently considered. This paper is the first to examine directly if food nutrition label use is associated with behavioral inclinations in time preference. Using a theoretical analysis, this paper illustrates that individuals with lower present bias and higher long-run patience tend to use nutrition labels more frequently. In an empirical investigation, an analysis of a nationwide survey of 1220 Chinese adults confirmed that time preference relates to label use behavior, not only via impatience but also via hyperbolic discounting. Results of this study can help to better understand label-use behavior. They also provide important policy implications for the design of proper strategies for improving food nutrition label use, as well as help consumers in China and other developing countries choose healthier diets.     

The Value of Emotion: How Does Episodic Prospection Modulate Delay Discounting?

Background

Humans often show impatience when making intertemporal choice for monetary rewards, preferring small rewards delivered immediately to larger rewards delivered after a delay, which reflects a fundamental psychological principle: delay discounting. However, we propose that episodic prospection humans can vividly envisage exerts a strong and broad influence on individuals'' delay discounting. Specifically, episodic prospection may affect individuals'' intertemporal choice by the negative or positive emotion of prospection.

Methodology/Principal Findings

The present study explored how episodic prospection modulated delay discounting by emotion. Study 1 showed that participants were more inclined to choose the delayed but larger rewards when they imaged positive future events than when they did not image events; Study 2 showed that participants were more inclined to choose the immediate but smaller rewards when they imaged negative future events than when they did not image events; In contrast, study 3 showed that choice preferences of participants when they imaged neutral future events were the same as when they did not image events.

Conclusions/Significance

By manipulating the emotion valence of episodic prospection, our findings suggested that positive emotion made individuals tend to choose delayed rewards, while negative emotion made individuals tend to choose immediate rewards. Only imaging events with neutral emotion did not affect individuals'' choice preference. Thus, the valence of imaged future events'' emotion might play an important role in individuals'' intertemporal choice. It is possible that the valence of emotion may affect the changed direction (promote or inhibit) of individuals'' delay discounting, while the ability to image future events affects the changed degree of individuals'' delay discounting.     

Attentional Bias towards Positive Emotion Predicts Stress Resilience

There is extensive evidence for an association between an attentional bias towards emotionally negative stimuli and vulnerability to stress-related psychopathology. Less is known about whether selective attention towards emotionally positive stimuli relates to mental health and stress resilience. The current study used a modified Dot Probe task to investigate if individual differences in attentional biases towards either happy or angry emotional stimuli, or an interaction between these biases, are related to self-reported trait stress resilience. In a nonclinical sample (N = 43), we indexed attentional biases as individual differences in reaction time for stimuli preceded by either happy or angry (compared to neutral) face stimuli. Participants with greater attentional bias towards happy faces (but not angry faces) reported higher trait resilience. However, an attentional bias towards angry stimuli moderated this effect: The attentional bias towards happy faces was only predictive for resilience in those individuals who also endorsed an attentional bias towards angry stimuli. An attentional bias towards positive emotional stimuli may thus be a protective factor contributing to stress resilience, specifically in those individuals who also endorse an attentional bias towards negative emotional stimuli. Our findings therefore suggest a novel target for prevention and treatment interventions addressing stress-related psychopathology.     

Feedback in pulse rate change and divergent affective reactions for high and low sensation-seekers

The present investigation examined the relationship between affect and pulse rate (PR) change for individuals with different sensation-seeking preferences. Based on their scores on the Sensation-Seeking Scale (Zuckerman, Kolin, Price, & Zoob, 1964), high (HSS) and low (LSS) sensation-seekers were assigned randomly to either 40 minutes of feedback or nofeedback in PR. Subjects were instructed either to decrease or to increase PR. Measures of affect were administered after the 40-minute period. The results indicated that while feedback caused subjects to change PR in either direction, HSS subjects were more successful at increasing, while LSS subjects were more successful at decreasing. Moreover, negative affect resulted only when HSS subjects decreased and LSS subjects increased PR. The results are discussed in terms of the importance of considering individual differences in preference for activation in order to clarify the relationship between physiological and affective responses.     

A neuroeconomic theory of rational addiction and nonlinear time-perception

Neuroeconomic conditions for "rational addiction" (Becker & Murphy 1988) have been unknown. This paper derived the conditions for "rational addiction" by utilizing a nonlinear time-perception theory of "hyperbolic" discounting, which is mathematically equivalent to the q-exponential intertemporal choice model based on Tsallis' statistics. It is shown that (i) Arrow-Pratt measure for temporal cognition corresponds to the degree of irrationality (i.e., Prelec's "decreasing impatience" parameter of temporal discounting) and (ii) rationality in addicts is controlled by a nondimensionalization parameter of the logarithmic time-perception function. Furthermore, the present theory illustrates the possibility that addictive drugs increase impulsivity via dopaminergic neuroadaptation without increasing irrationality. Future directions in the application of the model to studies in neuroeconomics are discussed.