Value-based Decision-making Processes Research Articles

Modeling the value-based decision to consume alcohol in response to emotional experiences.

Evidence for negative reinforcement of alcohol use is mixed; one possible explanation for this is that people make value-based decisions whether to regulate their emotions via alcohol or an alternative, and only drink-to-cope when alcohol's reinforcing value is larger than that of available alternatives. If this is the case, immediately following a negative emotional event, the value for alcohol should increase primarily in heavy drinkers, whereas in light drinkers, alternative ways of coping should be valued. We conducted a preregistered online experiment (N = 200) with a mixed design (between: heavy vs. light drinker; within: negative/neutral/positive mood induction). In each of three experimental sessions, participants first provided value ratings for a set of alcohol and food stimuli. Second, they were subjected to a mood induction. Third, they made forced choices between either two alcohol or food stimuli. We then applied a drift-diffusion model to these data and tested whether alcohol- and food-related decision-making parameters are differentially affected following the mood inductions in heavy and light drinkers. In preregistered analyses, we found that heavy drinkers did not value alcohol more but valued food less after the negative mood induction. Exploratory analyses uncovered that both heavy- and light-drinking participants valued alcohol more following the negative mood induction if they reported high alcohol craving at the start of the session. Collectively, these results provide some evidence for the idea that drinking-to-cope might be a value-based decision-making process. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Single-trial visually evoked potentials predict both individual choice and market outcomes

A central assumption in the behavioral sciences is that choice behavior generalizes enough across individuals that measurements from a sampled group can predict the behavior of the population. Following from this assumption, the unit of behavioral sampling or measurement for most neuroimaging studies is the individual; however, cognitive neuroscience is increasingly acknowledging a dissociation between neural activity that predicts individual behavior and that which predicts the average or aggregate behavior of the population suggesting a greater importance of individual differences than is typically acknowledged. For instance, past work has demonstrated that some, but not all, of the neural activity observed during value-based decision-making is able to predict not just individual subjects’ choices but also the success of products on large, online marketplaces—even when those two behavioral outcomes deviate from one another—suggesting that some neural component processes of decision-making generalize to aggregate market responses more readily across individuals than others do. While the bulk of such research has highlighted affect-related neural responses (i.e. in the nucleus accumbens) as a better predictor of group-level behavior than frontal cortical activity associated with the integration of more idiosyncratic choice components, more recent evidence has implicated responses in visual cortical regions as strong predictors of group preference. Taken together, these findings suggest a role of neural responses during early perception in reinforcing choice consistency across individuals and raise fundamental scientific questions about the role sensory systems in value-based decision-making processes. We use a multivariate pattern analysis approach to show that single-trial visually evoked electroencephalographic (EEG) activity can predict individual choice throughout the post-stimulus epoch; however, a nominally sparser set of activity predicts the aggregate behavior of the population. These findings support an account in which a subset of the neural activity underlying individual choice processes can scale to predict behavioral consistency across people, even when the choice behavior of the sample does not match the aggregate behavior of the population.

Prelimbic neuron assemblies with delayed activation encode the economic decision-making process in a bandit game

The medial prefrontal cortex (mPFC) is critical to an animal’s value-based decision-making process. However, due to heterogeneity of local mPFC neurons, which neuron group and how it contributes to the alteration of the animal’s decision is yet to be explored. And the effect of empty reward in this process is often neglected. Here, we adopted a two-port bandit game paradigm for mice and applied synchronized calcium imaging to the prelimbic area of the mPFC. The results showed that neurons recruited in the bandit game exhibit three distinct firing patterns. Specially, neurons with delayed activation (deA neurons11deA neurons: neurons with delayed activation) carried exclusive information on reward type and changes of choice value. We demonstrated that these deA neurons were essential for the construction of choice-outcome correlation and the trial-to-trial modification of decision. Additionally, we found that in a long-term gambling game, members of the deA neuron assembly were dynamically shifting while maintaining the function, and the importance of empty reward feedbacks were gradually elevated to the same level as reward. Together, these results revealed a vital role for prelimbic deA neurons in the gambling tasks and a new perspective on the encoding of economic decision-making.

Social value at a distance: Higher identification with all of humanity is associated with reduced social discounting

How much we value the welfare of others has critical implications for the collective good. Yet, it is unclear what leads people to make more or less equal decisions about the welfare of those from whom they are socially distant. The current research sought to explore the psychological mechanisms that might underlie welfare judgements across social distance. Here, a social discounting paradigm was used to measure the tendency for the value of a reward to be discounted as the social distance of its recipient increased. Across two cohorts (one discovery, one replication), we found that a more expansive identity with all of humanity was associated with reduced social discounting. Additionally, we investigated the specificity of this association by examining whether this relationship extended to delay discounting, the tendency for the value of a reward to be discounted as the temporal distance to its receipt increases. Our findings suggest that the observed association with identity was unique to social discounting, thus underscoring a distinction in value-based decision-making processes across distances in time and across social networks. As data were collected during the COVID-19 pandemic, we also considered how stress associated with this global threat might influence welfare judgements across social distances. We found that, even after controlling for COVID-19 related stress, correlations between identity and social discounting held. Together, these findings elucidate the psychological processes that are associated with a more equal distribution of generosity.

Medicines regulation, pricing and reimbursement in Brazil

Brazil is an upper-middle-income country with a high human development index (HDI) of 0.765 (2019). The Unique Health System (SUS) is a universal, decentralised system, free at point-of-care, although 27% of Brazilians have voluntary supplementary health insurance. Medicines are provided free-of-charge through the SUS, though there are a few exceptions where co-payment is required. Around 87% of the country’s expenditure with medicines and medical devices corresponds to out-of-pocket, highlighting the importance of price regulation. Marketing authorisation and maximum price approval are mandatory market entry requirements for medicines. Pricing policies include maximum price approval, regulation of mark-ups, tax exemption, annual price adjustment and a mandatory discount for government procurement and enforcement mechanisms. The pricing of new drugs considers the patent status and added therapeutic benefit. It is a combination of health technology assessment and external or internal reference pricing, while drugs with active ingredients in the market follow internal reference pricing. The maximum price of generics must be up to 65% of the reference’s price. The maximum approved prices and public procurement prices are publicly available. Brazil has a value-based decision-making process for incorporating medicines and other technologies at the SUS. Current areas of work include horizon scanning, participation of patients in decision-making and re-assessment of technologies. As a decentralised system, medicines are procured by the Ministry of Health, states and municipalities, according to their level of responsibility. Pricing and reimbursement policies, including a consolidated generics policy, have been important in promoting transparency, predictability, and price stability, in turn contributing to cost-containment and access. Ongoing challenges include high rates of judicialisation, medicines with excessive prices not commensurate with their clinical benefits, no provision for pricing review, problems related to governance and politics. To address these challenges, the authors have three main recommendations. First: improving regulatory governance, second: incentivising the development and promoting access to medicines with stronger evidence, added clinical benefit and fair prices, and third: increasing awareness among stakeholders, avoiding judicialisation and minimising its impact; contributing to closing the gap between innovation and access to medicines.

A Neuroeconomic Framework for Creative Cognition

Neuroeconomics is the study of the neurobiological bases of subjective preferences and choices. We present a novel framework that synthesizes findings from the literatures on neuroeconomics and creativity to provide a neurobiological description of creative cognition. We propose that value-based decision-making processes and activity in the locus ceruleus-norepinephrine (LC-NE) neuromodulatory system underlie creative cognition, as well as the large-scale brain network dynamics shown to be associated with creativity. This reconceptualization leads to several falsifiable hypotheses that can further understanding of creativity, decision making, and brain network dynamics.

Flexible decision-making in grooming partner choice in sooty mangabeys and chimpanzees.

Living in permanent social groups forces animals to make decisions about when, how and with whom to interact, requiring decisions to be made that integrate multiple sources of information. Changing social environments can influence this decision-making process by constraining choice or altering the likelihood of a positive outcome. Here, we conceptualized grooming as a choice situation where an individual chooses one of a number of potential partners. Studying two wild populations of sympatric primate species, sooty mangabeys (Cercocebus atys atys) and western chimpanzees (Pan troglodytes verus), we tested what properties of potential partners influenced grooming decisions, including their relative value based on available alternatives and the social relationships of potential partners with bystanders who could observe the outcome of the decision. Across 1529 decision events, multiple partner attributes (e.g. dominance ranks, social relationship quality, reproductive state, partner sex) influenced choice. Individuals preferred to initiate grooming with partners of similar global rank, but this effect was driven by a bias towards partners with a high rank compared to other locally available options. Individuals also avoided grooming partners who had strong social relationships with at least one bystander. Results indicated flexible decision-making in grooming interactions in both species, based on a partner's value given the local social environment. Viewing partner choice as a value-based decision-making process allows researchers to compare how different species solve similar social problems.

The Development of Self and Identity in Adolescence: Neural Evidence and Implications for a Value-Based Choice Perspective on Motivated Behavior.

Following a key developmental task of childhood-building a foundation of self-knowledge in the form of domain-specific self-concepts-adolescents begin to explore their emerging identities in ways that foster autonomy and connectedness. Neuroimaging studies of self-related processes demonstrate enhanced engagement of the ventromedial prefrontal cortex in adolescence, which may facilitate and reflect the development of identity by integrating the value of potential actions and choices. Drawing from neuroeconomic and social cognitive accounts, we propose that motivated behavior during adolescence can be modeled by a general value-based decision-making process centered around value accumulation in the ventromedial prefrontal cortex. This approach advances models of adolescent neurodevelopment that focus on reward sensitivity and cognitive control by considering more diverse value inputs, including contributions of developing self- and identity-related processes. It also considers adolescent decision making and behavior from adolescents' point of view rather than adults' perspectives on what adolescents should value or how they should behave.

A comparative study of drug listing recommendations and the decision-making process in Australia, the Netherlands, Sweden, and the UK

Drug listing recommendations from health technology assessment (HTA) agencies often fail to coincide with one another. We conducted a comparative analysis of listing recommendations in Australia (PBAC), the Netherlands (CVZ), Sweden (TLV) and the UK (NICE) over time, examined interagency agreement, and explored how process-related factors—including time delay between HTA evaluations, therapeutic indication and orphan drug status, measure of health economic value, and comparator—impacted decision-making in drug coverage. Agreement was poor to moderate across HTA agency listing recommendations, yet it increased as the delay between HTA agency appraisals decreased, when orphan drugs were assessed, and when medicines deemed to provide low value (immunosuppressants, antineoplastics) were removed from the sample. International differences in drug listing recommendations seem to occur in part due to inconsistencies in how the supporting evidence informs assessment, but also to differences in how domestic priorities shape the value-based decision-making process.

Value-based cancer care. From traditional evidence-based decision making to balanced decision making within frameworks of shared values

Clinical decision making in oncology is based so far on the evidence of efficacy from high-quality clinical research. Data collection and analysis from experimental studies provide valuable insight into response rates and progression-free or overall survival. Data processing generates valuable information for medical professionals involved in cancer patient care, enabling them to make objective and unbiased choices. The increased attention of many scientific associations toward a more rational resource consumption in clinical decision making is mirrored in the Choosing Wisely campaign against the overuse or misuse of exams and procedures of little or no benefit for the patient. This cultural movement has been actively promoting care solutions based on the concept of "value". As a result, the value-based decision-making process for cancer care should not be dissociated from economic sustainability and from ethics of the affordability, also given the growing average cost of the most recent cancer drugs. In support of this orientation, the National Comprehensive Cancer Network (NCCN) has developed innovative and "complex" guidelines based on values, defined as "evidence blocks", with the aim of assisting the medical community in making overall sustainable choices.

Differential activation of the ventromedial prefrontal cortex between male and female givers of social reputation

Accumulating evidence has shown the profound influence of social reputation on human behavior and has implicated the ventromedial prefrontal cortex (vmPFC) in representing subjective values induced by social interaction. However, little is known regarding how the vmPFC encodes subjective pleasantness induced by social reputation received from others. We used functional magnetic resonance imaging (fMRI) to investigate how the vmPFC in males and females encodes the subjective pleasantness of social reputation received from the same gender and from the opposite gender. Behavioral data showed that positive reputation was perceived to be more pleasant than negative reputation. Intriguingly, both male and female subjects showed greater differences in the pleasantness scores between the positive reputation condition and the negative reputation condition from females than between positive and negative reputations from males. Imaging data revealed that the left vmPFC specifically contributed to the processing of positive reputation. The activity patterns of the vmPFC corresponded to the gender differences in behavior during the processing of social reputation. These results indicate that the vmPFC plays a role in representing the subjective value of positive social reputation and that this region might be a final computational site in a stream of value-based decision-making processes.

The Reconstruction of Choice Value in the Brain: A Look into the Size of Consideration Sets and Their Affective Consequences

It has been proposed that choice utility exhibits an inverted U-shape as a function of the number of options in the choice set. However, most researchers have so far only focused on the "physically extant" number of options in the set while disregarding the more important psychological factor, the "subjective" number of options worth considering to choose-that is, the size of the consideration set. To explore this previously ignored aspect, we examined how variations in the size of a consideration set can produce different affective consequences after making choices and investigated the underlying neural mechanism using fMRI. After rating their preferences for art posters, participants made a choice from a presented set and then reported on their level of satisfaction with their choice and the level of difficulty experienced in choosing it. Our behavioral results demonstrated that enlarged assortment set can lead to greater choice satisfaction only when increases in both consideration set size and preference contrast are involved. Moreover, choice difficulty is determined based on the size of an individual's consideration set rather than on the size of the assortment set, and it decreases linearly as a function of the level of contrast among alternatives. The neuroimaging analysis of choice-making revealed that subjective consideration set size was encoded in the striatum, the dACC, and the insula. In addition, the striatum also represented variations in choice satisfaction resulting from alterations in the size of consideration sets, whereas a common neural specificity for choice difficulty and consideration set size was shown in the dACC. These results have theoretical and practical importance in that it is one of the first studies investigating the influence of the psychological attributes of choice sets on the value-based decision-making process.