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Deception is an essentially social act, yet little is known about how social consequences affect the decision to deceive. In this study, participants played a computerized game of deception without constraints on whether or when to attempt to deceive their opponent. Participants were questioned by an opponent outside the scanner about their knowledge of the content of a display. Importantly, questions were posed so that, in some conditions, it was possible to be deceptive, while in other conditions it was not. To simulate a realistic interaction, participants could be confronted about their claims by the opponent. This design, therefore, creates a context in which a deceptive participant runs the risk of being punished if their deception is detected. Our results show that participants were slower to give honest than to give deceptive responses when they knew more about the display and could use this knowledge for their own benefit. The condition in which confrontation was not possible was associated with increased activity in subgenual anterior cingulate cortex. The processing of a question which allows a deceptive response was associated with activation in right caudate and inferior frontal gyrus. Our findings suggest the decision to deceive is affected by the potential risk of social confrontation rather than the claim itself.

Punishing violators of social norms when there is personal cost is known as altruistic punishment. We tested patients with Parkinson's disease (PD) with and without impulsive-compulsive behaviours (ICBs) and matched control subjects, on and off their regular dopamine replacement therapy on a task, in which the patients decided whether or not to invest a sum of money with a trustee. The sum was then quadrupled and the trustee could decide whether or not to return a portion of the investment. Participants could punish the trustee after they were informed of the trustee's decision. We found that PD patients without ICBs on or off medication punished more often than controls, whereas PD patients with ICBs punished more than controls on medication, but similar to controls off medication. These results suggest a role for dopamine in altruistic punishment decisions in PD patients with impulsive compulsive behaviour.

We show that individual investors over-extrapolate from their personal experience when making savings decisions. Investors who experience particularly rewarding outcomes from saving in their 401(k)—a high average and/or low variance return—increase their 401(k) savings rate more than investors who have less rewarding experiences with saving. This finding is not driven by aggregate time-series shocks, income effects, rational learning about investing skill, investor fixed effects, or time-varying investor-level heterogeneity that is correlated with portfolio allocations to stock, bond, and cash asset classes. We discuss implications for the equity premium puzzle and interventions aimed at improving household financial outcomes.

Recent work in the field of neuroeconomics has examined how people make decisions in interactive settings. However, less is currently known about how these social decisions influence subsequent memory for these interactions. We investigated this question by using functional magnetic resonance imaging to scan participants as they viewed photographs of people they had either recently played an Ultimatum Game with in the role of Responder, or that they had never seen before. Based on previous work that has investigated “cheater detection”, we were interested in whether participants demonstrated a relative enhanced memory for partners that made either fair or unfair proposals. We found no evidence, either behaviorally or neurally, supporting enhanced memory based on the amount of money offered by the Proposer. However, we did find that participants’ initial expectations about the offers they would experience in the game influenced their memory. Participants demonstrated relatively enhanced subjective memory for partners that made proposals that were contradictory to their initial expectations. In addition, we observed two distinct brain systems that were associated with partners that either offered more or less than the participants’ expectations. Viewing pictures of partners that exceeded initial expectations was associated with the bilateral anterior insula, anterior cingulate cortex/premotor area, striatum, and bilateral posterior hippocampi, while viewing partners that offered less than initial expectations was associated with bilateral temporal-parietal junction, right STS, bilateral posterior insula, and precuneus. These results suggest that memory for social interaction may not be guided by a specific cheater detection system, but rather a more general expectation violation system.

Background

Reduced responsiveness to positive incentives is a central feature of Major Depressive Disorder (MDD). In the present study, we compared neural correlates of monetary incentive processing in unmedicated depressed participants and never-depressed controls.

Methods

Fourteen currently depressed and twelve never-depressed participants underwent fMRI while participating in a monetary incentive delay task. During the task, participants were cued to anticipate and respond to a rapidly presented target in order to gain or avoid losing varying amounts of money.

Results

Depressed and never-depressed participants did not differ in nucleus accumbens (NAcc) activation or in affective or behavioral responses during gain anticipation. Depressed participants did, however, exhibit increasing anterior cingulate activation during anticipation of increasing gains, whereas never-depressed participants showed increasing anterior cingulate activation during anticipation of increasing loss. Depressed subjects also showed reduced discrimination of gain versus nongain outcomes.

Conclusions

The present findings indicate that while unmedicated depressed individuals have the capacity to experience positive arousal and recruit NAcc activation during gain anticipation, they also exhibit increased ACC activation, suggestive of increased conflict during anticipation of gains, in addition to showing reduced discrimination of gain versus nongain outcomes.

Objectives: To explore how British American Tobacco (BAT), having established cigarette imports, responded to the opportunities for investment in cigarette manufacturing in the former Soviet Union (FSU).

Design: Analysis of documents held at the BAT archive in Guildford, UK.

Results: Considerable priority was attached to investing in the FSU. This led BAT to undertake a major organisational change and to intense competition to acquire assets. BAT used flawed economic arguments to persuade cash starved governments that its investment would reap economic rewards. It offered excise advice that disadvantaged governments while benefiting BAT, confused issues over pricing, and avoided competitive tendering. BAT targeted agriculture ministries, using its expertise in leaf production to differentiate itself from other potential investors. It subverted the principles of corporate social responsibility to promote itself as a business partner. BAT's task was made easier by the naivety of post-Soviet governments and by the international financial organisations' support for rapid economic reform. The latter permitted tobacco transnationals to penetrate markets before effective competitive tendering processes had been established, giving them the opportunity to minimise prices and establish monopolies.

Conclusions: Many of the arguments employed when penetrating post-Soviet markets were highly misleading but governments lacked expertise to realise this. There is a need to build tobacco control capacity in transition economies, within and outside government, to ensure that governments are better informed of the true economic and health impacts of tobacco. Rapid transition from socialist to market economies without establishing regulatory institutional structures may be dangerous when investing companies use business practices that fall short of international standards.

Depression is associated with behavioral avoidance of potentially rewarding environmental contexts. The present study examined the performance of depressive individuals and controls on a neuropsychological measure of decision-making that favors risk avoidance. Depressive (n = 41) and control (n = 44) participants were administered the Iowa Gambling Task, which measures the ability of participants to maximize earnings by choosing low-risk, low-reward responses over high-risk, high-reward responses. Results provided partial support for the hypothesis that depressive participants would learn to avoid risky responses faster than control participants. Depressive participants demonstrated better performance than controls, scoring higher than controls overall and showing a trend towards earning more money overall. However, the lack of an interaction between depressive status and time does not support the specific hypothesis of more rapid learning. Findings suggested enhanced feedback-based decision making and risk aversion among depressive individuals.

Speculative expression has been given to the idea that physicians should prove their continuing education by periodic examinations. With this thought in mind, it was decided that the Denver Medical Society Library should be continued and supported for at least ten years and, that at the end of this time, the entire situation would be re-evaluated in connection with the changing trends in medicine.

Although adequate emotion regulation is considered to be essential in every day life, it is especially important in social interactions. However, the question as to what extent two different regulation strategies are effective in changing decision-making in a consequential socially interactive context remains unanswered. We investigated the effect of expressive suppression and emotional reappraisal on strategic decision-making in a social interactive task, i.e. the Ultimatum Game. As hypothesized, participants in the emotional reappraisal condition accepted unfair offers more often than participants in the suppression and no-regulation condition. Additionally, the effect of emotional reappraisal influenced the amount of money participants proposed during a second interaction with partners that had treated them unfairly in a previous interaction. These results support and extend previous findings that emotional reappraisal as compared to expressive suppression, is a powerful regulation strategy that influences and changes how we interact with others even in the face of inequity.

This paper examines the link between affective experience and decision-making performance. In a stock investment simulation, 101 stock investors rated their feelings on an Internet Web site while making investment decisions each day for 20 consecutive business days. Contrary to the popular belief that feelings are generally bad for decision making, we found that individuals who experienced more intense feelings achieved higher decision-making performance. Moreover, individuals who were better able to identify and distinguish among their current feelings achieved higher decision-making performance via their enhanced ability to control the possible biases induced by those feelings.

To investigate the neural processes of decision-makings between attractive females and money, we recorded 18 male participants' brain event-related potentials (ERPs) when they performed a novel task of deciding between viewing an attractive female's fuzzy picture in clear and gaining a certain amount of money. Two types of attractive females were included: sexy females and beautiful females. Several new electrophysiological discoveries were obtained as following. First, the beautiful females vs. money task (task B) elicited a larger positive ERP deflection (P2) than the sexy females vs. money task (task S) between 290 and 340 ms, and this probably related to the perception matching process between a visual input and an internal representation or expectation. Second, task S evoked greater negative ERP waves (N2) than task B during the time window of 340–390 ms, and this might relate to response conflict and cognitive monitoring for impulsive tendency. Third, the ERP positivity in task S was larger than task B in the time interval of 550–1000 ms, reflecting that sexy female images may have higher decision value for males than beautiful female images. Fourth, compared with choosing to gain money, choosing to view an attractive female evoked a larger late positive component (LPC) during the same time window, possibly because attractive females are more direct and evolutionarily earlier rewards for males than money amounts.

Background

Although reward processing is considered an important part of affective functioning, few studies have investigated reward-related decisions or responses in young people with affective disorders. Depression is postulated to involve decreased activity in reward-related affective systems.

Methods

Using functional MRI, we examined behavioral and neural responses to reward in young people with depressive disorders using a reward decision-making task. The task involved choices about possible rewards involving varying magnitude and probability of reward. The study design allowed the separation of decision/anticipation and outcome phases of reward processing. Participants were 9–17 years old and had diagnoses of Major Depressive Disorder (MDD), anxiety disorders, or no history of psychiatric disorder.

Results

Participants with MDD exhibited less neural response than control participants in reward-related brain areas during both phases of the task. Group differences did not appear to be a function of anxiety. Depressive and anxiety symptoms were associated with activation in reward-related brain areas.

Conclusions

Results suggest that depression involves altered reward processing and underscore the need for further investigation of relations among development, affective disorders, and reward processing.

Introduction

Although medical educational debt continues to escalate, residents receive little guidance in financial planning.

Aim

To educate interns about long-term investment strategies.

Setting

University-based medicine internship program.

Program Description

An unselected cohort of interns (n = 52; 84% of all interns) underwent a 90-minute interactive seminar on personal finance, focusing on retirement savings. Participants completed a preseminar investor literacy test to assess baseline financial knowledge. Afterward, interns rated the seminar and expressed their intention to make changes to their long-term retirement accounts. After 37 interns had attended the seminar, a survey was administered to all interns to compare actual changes to these accounts between seminar attendees and nonattendees.

Measurements and Main Results

Interns’ average score on the investor literacy test was 40%, equal to the general population. Interns strongly agreed that the seminar was valuable (average 5.0 on 5-point Likert scale). Of the 46 respondents to the account allocation survey, interns who had already attended the seminar (n = 25) were more likely than interns who had not yet attended (n = 21) to have switched their investments from low to high-yield accounts at the university hospital (64 vs 19%, P = 0.003) and to enroll in the county hospital retirement plan (64 vs 33%, P = 0.07).

Conclusions

One 90-minute seminar on personal finances leads to significant changes in allocation of tax-deferred retirement savings. We calculate that these changes can lead to substantial long-term financial benefits and suggest that programs consider automatically enrolling trainees into higher yield retirement plans.

Introduction

Although medical educational debt continues to escalate, residents receive little guidance in financial planning.

Aim

To educate interns about long-term investment strategies.

Setting

University-based medicine internship program.

Program Description

An unselected cohort of interns (n = 52; 84% of all interns) underwent a 90-minute interactive seminar on personal finance, focusing on retirement savings. Participants completed a preseminar investor literacy test to assess baseline financial knowledge. Afterward, interns rated the seminar and expressed their intention to make changes to their long-term retirement accounts. After 37 interns had attended the seminar, a survey was administered to all interns to compare actual changes to these accounts between seminar attendees and nonattendees.

Measurements and Main Results

Interns’ average score on the investor literacy test was 40%, equal to the general population. Interns strongly agreed that the seminar was valuable (average 5.0 on 5-point Likert scale). Of the 46 respondents to the account allocation survey, interns who had already attended the seminar (n = 25) were more likely than interns who had not yet attended (n = 21) to have switched their investments from low to high-yield accounts at the university hospital (64 vs 19%, P = 0.003) and to enroll in the county hospital retirement plan (64 vs 33%, P = 0.07).

Conclusions

One 90-minute seminar on personal finances leads to significant changes in allocation of tax-deferred retirement savings. We calculate that these changes can lead to substantial long-term financial benefits and suggest that programs consider automatically enrolling trainees into higher yield retirement plans.

A human social discount function measures the value to a person of a reward to another person at a given social distance. Just as delay discounting is a hyperbolic function of delay, and probability discounting is a hyperbolic function of odds-against, social discounting is a hyperbolic function of social distance. Experiment 1 obtained individual social, delay, and probability discount functions for a hypothetical $75 reward; participants also indicated how much of an initial $100 endowment they would contribute to a common investment in a public good. Steepness of discounting correlated, across participants, among all three discount dimensions. However, only social and probability discounting were correlated with the public-good contribution; high public-good contributors were more altruistic and also less risk averse than low contributors. Experiment 2 obtained social discount functions with hypothetical $75 rewards and delay discount functions with hypothetical $1,000 rewards, as well as public-good contributions. The results replicated those of Experiment 1; steepness of the two forms of discounting correlated with each other across participants but only social discounting correlated with the public-good contribution. Most participants in Experiment 2 predicted that the average contribution would be lower than their own contribution.

In 18 months the Canadian Medical Discoveries Fund (CMDF) has attracted investments worth $180 million to spend on biotechnology and medical research. Although eight initial investments totalled only $9.7 million, Dr. Cal Stiller, chair and CEO of the fund's management corporation, says there are many good Canadian-based technology firms and research projects that merit investment. Examples include a London, Ont., firm that is bringing a 3-D ultrasound-imaging system to market, and world-class genetics research at the University of Ottawa. However, the federal government recently changed tax rules for venture-capital funds, making them less attractive to investors. How will this affect the effort to build a health-research industry in Canada?

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Background

Economic games observe social decision making in the laboratory that involves real money payoffs. Previously we have shown that allocation of funds in the Dictator Game (DG), a paradigm that illustrates costly altruistic behavior, is partially determined by promoter-region repeat region variants in the arginine vasopressin 1a receptor gene (AVPR1a). In the current investigation, the gene encoding the related oxytocin receptor (OXTR) was tested for association with the DG and a related paradigm, the Social Values Orientation (SVO) task.

Methodology/Principal Findings

Association (101 male and 102 female students) using a robust-family based test between 15 single tagging SNPs (htSNPs) across the OXTR was demonstrated with both the DG and SVO. Three htSNPs across the gene region showed significant association with both of the two games. The most significant association was observed with rs1042778 (p = 0.001). Haplotype analysis also showed significant associations for both DG and SVO. Following permutation test adjustment, significance was observed for 2–5 locus haplotypes (p<0.05). A second sample of 98 female subjects was subsequently and independently recruited to play the dictator game and was genotyped for the three significant SNPs found in the first sample. The rs1042778 SNP was shown to be significant for the second sample as well (p = 0.004, Fisher's exact test).

Conclusions

The demonstration that genetic polymorphisms for the OXTR are associated with human prosocial decision making converges with a large body of animal research showing that oxytocin is an important social hormone across vertebrates including Homo sapiens. Individual differences in prosocial behavior have been shown by twin studies to have a substantial genetic basis and the current investigation demonstrates that common variants in the oxytocin receptor gene, an important element of mammalian social circuitry, underlie such individual differences.

Background

Despite advances in neurobiological research on Major Depressive Disorder and Social Anxiety Disorder, little is known about the neural functioning of individuals with comorbid depression/social anxiety. We examined the timing of neural responses to social stress in individuals with major depression and/or social anxiety. We hypothesized that having social anxiety would be associated with earlier responses to stress, having major depression would be associated with sustained responses to stress, and that comorbid participants would exhibit both of these response patterns.

Methods

Participants were females diagnosed with pure depression (n = 12), pure social anxiety (n = 16), comorbid depression/social anxiety (n = 17), or as never having had any Axis-I disorder (control; n = 17). Blood oxygenation-level dependent activity (BOLD) was assessed with functional magnetic resonance imaging (fMRI). To induce social stress, participants prepared a speech that was ostensibly to be evaluated by a third party.

Results

Whereas being diagnosed with depression was associated with a resurgence of activation in the medial frontal cortex late in the stressor, having social anxiety was associated with a vigilance-avoidance activation pattern in the occipital cortex and insula. Comorbid participants exhibited activation patterns that generally overlapped with the non-comorbid groups, with the exception of an intermediate level of activation, between the level of activation of the pure depression and social anxiety groups, in the middle and posterior cingulate cortex.

Conclusions

These findings advance our understanding of the neural underpinnings of major depression and social anxiety, and of their comorbidity. Future research should elucidate more precisely the behavioral correlates of these patterns of brain activation.

During the past several years, we have achieved a deeper understanding of the etiology/pathophysiology of major depressive disorder (MDD). However, this improved understanding has not translated to improved treatment outcome. Treatment often results in symptomatic improvement, but not full recovery. Clinical approaches are largely trial-and-error, and when the first treatment does not result in recovery for the patient, there is little proven scientific basis for choosing the next. One approach to enhancing treatment outcomes in MDD has been the use of standardized sequential treatment algorithms and measurement-based care. Such treatment algorithms stand in contrast to the personalized medicine approach, in which biomarkers would guide decision making. Incorporation of biomarker measurements into treatment algorithms could speed recovery from MDD by shortening or eliminating lengthy and ineffective trials. Recent research results suggest several classes of physiologic biomarkers may be useful for predicting response. These include brain structural or functional findings, as well as genomic, proteomic, and metabolomic measures. Recent data indicate that such measures, at baseline or early in the course of treatment, may constitute useful predictors of treatment outcome. Once such biomarkers are validated, they could form the basis of new paradigms for antidepressant treatment selection.

Even a single night of total sleep deprivation (SD) can have dramatic effects on economic decision making. Here we tested the novel hypothesis that SD influences economic decisions by altering the valuation process. Using functional magnetic resonance imaging we identified value signals related to the anticipation and the experience of monetary and social rewards (attractive female faces). We then derived decision value signals that were predictive of each participant’s willingness to exchange money for brief views of attractive faces in an independent market task. Strikingly, SD altered decision value signals in ventromedial prefrontal cortex (VMPFC) in proportion to the corresponding change in economic preferences. These changes in preference were independent of the effects of SD on attention and vigilance. Our results provide novel evidence that signals in VMPFC track the current state of the individual, and thus reflect not static but constructed preferences.

Background

The National Institutes of Health (NIH) is among the world’s largest investors in biomedical research, with a mandate to: “…lengthen life, and reduce the burdens of illness and disability.” Its funding decisions have been criticized as insufficiently focused on disease burden. We hypothesize that modern portfolio theory can create a closer link between basic research and outcome, and offer insight into basic-science related improvements in public health. We propose portfolio theory as a systematic framework for making biomedical funding allocation decisions–one that is directly tied to the risk/reward trade-off of burden-of-disease outcomes.

Methods and Findings

Using data from 1965 to 2007, we provide estimates of the NIH “efficient frontier”, the set of funding allocations across 7 groups of disease-oriented NIH institutes that yield the greatest expected return on investment for a given level of risk, where return on investment is measured by subsequent impact on U.S. years of life lost (YLL). The results suggest that NIH may be actively managing its research risk, given that the volatility of its current allocation is 17% less than that of an equal-allocation portfolio with similar expected returns. The estimated efficient frontier suggests that further improvements in expected return (89% to 119% vs. current) or reduction in risk (22% to 35% vs. current) are available holding risk or expected return, respectively, constant, and that 28% to 89% greater decrease in average years-of-life-lost per unit risk may be achievable. However, these results also reflect the imprecision of YLL as a measure of disease burden, the noisy statistical link between basic research and YLL, and other known limitations of portfolio theory itself.

Conclusions

Our analysis is intended to serve as a proof-of-concept and starting point for applying quantitative methods to allocating biomedical research funding that are objective, systematic, transparent, repeatable, and expressly designed to reduce the burden of disease. By approaching funding decisions in a more analytical fashion, it may be possible to improve their ultimate outcomes while reducing unintended consequences.

Financial planning decisionss are fundamentally affective in nature; they are decisions related to money, longevity and quality of life. Over the next several decades people will be increasingly responsible for managing their own assets and investments, and they will be subject to the affective influences on active, personal decision-making. Many of these crucial decisions are made and revised across the lifespan, including when to buy or sell a home, how to save for childrens’ education, how to manage healthcare costs, when to retire, how much to save for retirement and how to allocate retirement funds. As average life expectancy increases, many retirees will be faced with inadequate savings to live comfortably until the end of their lives. In the current article, we examine the problems of and potential solutions to inadequate financial planning through the lens of affective science, with an emphasis on how brain-based changes in affective processing with age might contribute to the challenge of financial planning.

Context

Direct-to-consumer (DTC) advertising of prescription drugs in the United States is both ubiquitous and controversial. Critics charge that DTC advertising leads to over-prescribing, while proponents counter that it helps avert under-use of effective treatments, especially for conditions such as depression that are poorly recognized or stigmatized.

Objective

To ascertain the effects of patients’ DTC-related requests on physicians’ initial treatment decisions (prescribing, referral, and follow-up) in patients with depressive symptoms.

Design

Randomized trial using Standardized Patients (SPs). Six SP roles (experimental cells) were created by crossing two conditions (major depression or adjustment disorder) with three request types (brand-specific, general, or none).

Setting

Offices of primary care physicians in Sacramento, CA; San Francisco, CA; and Rochester, NY.

Participants

152 family physicians and general internists recruited from solo and group practices and health maintenance organizations; cooperation rates ranged from 53% to 61%.

Interventions

SPs were randomly assigned to make 298 unannounced visits, with assignments constrained so physicians saw 1 SP with major depression and 1 with adjustment disorder (approximately 50 visits per experimental cell).

Main Outcome Measures

Data on prescribing, mental health referral, and primary care follow-up were obtained from SP written reports, visit audio-recordings, chart review, and analysis of written prescriptions and drug samples. The effects of request type on prescribing were evaluated using contingency tables and confirmed in generalized linear mixed models that accounted for clustering and adjusted for site, physician, and visit characteristics.

Results

SP role fidelity was excellent, and the detection rate was 12%. In major depression, rates of antidepressant prescribing were 53%, 76%, and 31% for SPs making brand-specific requests, general requests, and no requests, respectively (p<.0001). In adjustment disorder, antidepressant prescribing was 55%, 39%, and 10%, respectively (p<.0001). The results were confirmed in multivariate models. “Minimally acceptable initial care” (any combination of an antidepressant, mental health referral, or follow-up within two weeks) in the major depression role was offered to 98% of SPs making a general request, 90% of those making a brand-specific request, and 56% of those making no request (p<0.001).

Conclusions

Patients’ requests have a profound effect on physician prescribing in major depression and adjustment disorder. DTC advertising may have competing effects on quality, potentially both averting under-use and promoting over-use.

Genetic variation at the serotonin transporter-linked polymorphic region (5-HTTLPR) is associated with altered amygdala reactivity and lack of prefrontal regulatory control. Similar regions mediate decision-making biases driven by contextual cues and ambiguity, for example the “framing effect.” We hypothesized that individuals hemozygous for the short (s) allele at the 5-HTTLPR would be more susceptible to framing. Participants, selected as homozygous for either the long (la) or s allele, performed a decision-making task where they made choices between receiving an amount of money for certain and taking a gamble. A strong bias was evident toward choosing the certain option when the option was phrased in terms of gains and toward gambling when the decision was phrased in terms of losses (the frame effect). Critically, this bias was significantly greater in the ss group compared with the lala group. In simultaneously acquired functional magnetic resonance imaging data, the ss group showed greater amygdala during choices made in accord, compared with those made counter to the frame, an effect not seen in the lala group. These differences were also mirrored by differences in anterior cingulate–amygdala coupling between the genotype groups during decision making. Specifically, lala participants showed increased coupling during choices made counter to, relative to those made in accord with, the frame, with no such effect evident in ss participants. These data suggest that genetically mediated differences in prefrontal-amygdala interactions underpin interindividual differences in economic decision making.

Dr Baumgarten analyses three possible justifications for doctors to decide that a patient is 'incompetent' to make or participate in medical decisions affecting him, and points out the difficulties of each. He argues that the degree to which a patient relinquishes control over decision-making which affects him will vary in different circumstances and should be explicitly agreed in the initial doctor-patient contract, rather as it often is when a client employs a professional to invest money on his behalf.