Altered interaction of physiological activity and behavior affects risky decision-making in ADHD.

Background: Adult attention-deficit/hyperactivity disorder (ADHD) is often associated with risky decision-making behavior. However, current research studies are often limited by the ability to adequately reflect daily behavior in a laboratory setting. Over the lifespan impairments in cognitive functions appear to improve, whereas affective functions become more severe. We assume that risk behavior in ADHD arises predominantly from deficits in affective processes. This study will therefore aim to investigate whether a dysfunction in affective pathways causes an abnormal risky decision-making (DM) behavior in adult ADHD. Methods: Twenty-eight participants with ADHD and twenty-eight healthy controls completed a battery of questionnaires regarding clinical symptoms, self-assessment of behavior and emotional competence. Furthermore, skin conductance responses were measured during the performance in a modified version of the Balloon Analogue Risk Task. A linear mixed-effects model analysis was used to analyze emotional arousal prior to a decision and after feedback display. Results: Results showed higher emotional arousal in ADHD participants before decision-making (ß = -0.12, SE = 0.05, t = -2.63, p < 0.001) and after feedback display (ß = -0.14, SE = 0.05, t = -2.66, p = 0.008). Although risky behavior was greater in HC than in ADHD, we found a significant interaction effect of group and anticipatory skin conductance responses regarding the response behavior (ß = 107.17, SE = 41.91, t = 2.56, p = 0.011). Post hoc analyses revealed a positive correlation between anticipatory skin conductance responses and reaction time in HC, whereas this correlation was negative in ADHD. Self-assessment results were in line with the objective measurements. Conclusion: We found altered changes in physiological activity during a risky decision-making task. The results confirm the assumption of an aberrant relationship between bodily response and risky behavior in adult ADHD. However, further research is needed with respect to age and gender when considering physiological activities.

Impulsivity Classification Using EEG Power and Explainable Machine Learning.

Impulsivity is a multidimensional construct often associated with unfavorable outcomes. Previous studies have implicated several electroencephalography (EEG) indices to impulsiveness, but results are heterogeneous and inconsistent. Using a data-driven approach, we identified EEG power features for the prediction of self-reported impulsiveness. To this end, EEG signals of 56 individuals (18 low impulsive, 20 intermediate impulsive, 18 high impulsive) were recorded during a risk-taking task. Extracted EEG power features from 62 electrodes were fed into various machine learning classifiers to identify the most relevant band. Robustness of the classifier was varied by stratified [Formula: see text]-fold cross validation. Alpha and beta band power showed best performance in the classification of impulsiveness (accuracy = 95.18% and 95.11%, respectively) using a random forest classifier. Subsequently, a sequential bidirectional feature selection algorithm was used to estimate the most relevant electrode sites. Results show that as little as 10 electrodes are sufficient to reliably classify impulsiveness using alpha band power ([Formula: see text]-measure = 94.50%). Finally, the Shapley Additive exPlanations (SHAP) analysis approach was employed to reveal the individual EEG features that contributed most to the model's output. Results indicate that frontal as well as posterior midline alpha power seems to be of most importance for the classification of impulsiveness.

Context effects, skin conductance responses and personality traits - Influencing variables on risk-taking within a modified version of the balloon analog risk task.

When individuals take risks, they must weigh potential costs and benefits associated with a decision. Differences in risk-taking appear to be influenced by contextual, and inter-individual factors. However, it is still ambiguous to what extent these characteristics jointly influence risk-taking. We investigated how risk-taking varies as function of context effects, incentives, skin conductance responses (SCR), and personality traits such as impulsivity and sensitivity to reward and punishment. Sixty-eight healthy participants conducted a modified version of the Balloon Analogue Risk Task (BART) composed of a gain-framed (G-BART) and loss-framed (L-BART) context with each a low and a high outcome magnitude condition. While the goal in G-BART was to maximize gains, the goal in L-BART was to minimize losses. In both versions, participants can potentially accumulate the same amounts. We conducted trial-by-trial mixed model analyses to account for within- and between-participant effects. Participants showed greater risk-taking when playing L-BART than G-BART; more risk-taking was observed in the high compared to the low outcome magnitude condition. Furthermore, higher SCR were associated with less risk-taking. Lower impulsivity was related to a greater difference in risk-taking in both contexts, with greater risk-taking in L-BART. Likewise, sensitivity to reward was associated with a greater difference in risk-taking in both contexts, with greater risk-taking in G-BART. Finally, greater sensitivity to punishment was related to risk-taking among participants describing themselves as sensitive to rewards. Results support a multidimensional state-trait model of risk-taking suggesting that risk-taking is favored by loss-aversion along with incentives, psychophysiological arousal, and personality traits.

A Systematic Review on Common and Distinct Neural Correlates of Risk-taking in Substance-related and Non-substance Related Addictions.

Both substance-related as well as non-substance-related addictions may include recurrent engagement in risky actions despite adverse outcomes. We here apply a unified approach and review task-based neuroimaging studies on substance-related (SRAs) and non-substance related addictions (NSRAs) to examine commonalities and differences in neural correlates of risk-taking in these two addiction types. To this end, we conducted a systematic review adhering to the PRISMA guidelines. Two databases were searched with predefined search terms to identify neuroimaging studies on risk-taking tasks in individuals with addiction disorders. In total, 19 studies on SRAs (comprising a total of 648 individuals with SRAs) and 10 studies on NSRAs (comprising a total of 187 individuals with NSRAs) were included. Risk-related brain activation in SRAs and NSRAs was summarized individually and subsequently compared to each other. Results suggest convergent altered risk-related neural processes, including hyperactivity in the OFC and the striatum. As characteristic for both addiction types, these brain regions may represent an underlying mechanism of suboptimal decision-making. In contrast, decreased DLPFC activity may be specific to SRAs and decreased IFG activity could only be identified for NSRAs. The precuneus and posterior cingulate show elevated activity in SRAs, while findings regarding these areas were mixed in NSRAs. Additional scarce evidence suggests decreased ventral ACC activity and increased dorsal ACC activity in both addiction types. Associations between identified activation patterns with drug use severity underpin the clinical relevance of these findings. However, this exploratory evidence should be interpreted with caution and should be regarded as preliminary. Future research is needed to evaluate the findings gathered by this review.

Lifetime Prevalence of Victimization and Perpetration as Related to Men's Health: Clinical Insights.

Violence is a known risk factor for health problems. In this epidemiological study across 5,385 male patients, we investigate the prevalence of perpetrated violence, exposure to violence, their overlap and the relationship between violence, mental, and psychosomatic health, as well as adverse health behaviors, such as self-harming behavior and the consumption of drugs. Participants completed an anonymous questionnaire addressing violence experience (i.e., both expose and perpetration), age of victimization/perpetration, frequency, and perceived severity of violence exposure. We considered physical, psychological as well as sexual violence. Information on health status and adverse health behaviors complemented the data. Results showed that 48.4% of the sample reported having experienced violence (perpetration, victimization, or both). The victim-perpetrator overlap formed the largest group, in which the incidence of having experienced multiple types of violence was significantly higher compared to victims and perpetrators. The age-crime curve flattened more slowly with increasing age in this group. Although the perceived severity of exposure to violence is lower in the overlap group, its health status and adverse health behaviors were worse. Interventions should focus on this group since they constitute a burden for the healthcare system.

Adaptation and validation of a German version of the Dickman impulsivity inventory for the assessment of functional and dysfunctional impulsivity.

Impulsive behavior tends to have a negative connotation in the sense that it is usually associated with detrimental or dysfunctional outcomes. However, under certain circumstances, impulsive behaviors may also have beneficial or functional outcomes. Dickman's Impulsivity Inventory (DII) measures these two distinct aspects of impulsivity, namely, dysfunctional impulsivity (the tendency to act with less forethought than do most people which leads to difficulties) and functional impulsivity (the tendency to act with little forethought when the situation is optimal). In the present study, we translated the DII into German and validated the German version in a sample of 543 adults. The original 23-item model was considered unsuitable for the German version as suggested by fit indices of a confirmatory factor analysis. Exploratory factor analyses rather supported a 16-item version. Further psychometric analyses and inferential statistical analyses on the final German DII indicated its appropriateness for use in German-speaking populations and support a two-factor solution of the DII. Finally, exploratory analyses on the German DII suggest differential relationships between dysfunctional and functional impulsivity and self-reported lifestyle-related variables (smoking, alcohol usage, and sports behavior).

Proactive vs. Reactive Aggression Within Two Modified Versions of the Taylor Aggression Paradigm.

The Taylor Aggression Paradigm (TAP) has been widely used to measure reactive aggression following provocation during competitive interactions. Besides being reactive, aggression can be goal-directed (proactive aggression). Our study presents a novel paradigm to investigate proactive aggression during competitive interactions. Sixty-seven healthy participants competed in two modified versions of the TAP against an ostensible opponent while skin conductance responses (SCRs) were recorded. During the proactive TAP (pTAP), only the participant could interfere with the ostensible opponent's performance by blurring the screen. In the reactive TAP (rTAP), the opponent repeatedly provoked the participant by blurring the screen of the participant, impeding their chance to win. In both versions, the blurriness levels chosen by the participant served as a measure of aggression (unprovoked in the pTAP and provoked in the rTAP). In the pTAP, trial-by-trial mixed model analyses revealed higher aggression with higher self-reported selfishness. SCRs decreased with increasing proactive aggression. An interaction effect between gender and proactive aggression for the SCRs revealed increased SCRs at higher aggression levels in females, but lower SCRs at higher aggression levels in males. In the rTAP, SCRs were not associated with reactive aggression but aggression increased with increasing provocation and especially after losing against the opponent when provoked. While males showed higher aggression levels than females when unprovoked, reactive aggression increased more strongly in females with higher provocation. Mean levels of aggression in both tasks showed a high positive correlation. Our results highlight that, despite being intercorrelated and both motivated by selfishness, proactive and reactive aggression are differentially influenced by gender and physiological arousal. Proactive aggression is related to lower physiological arousal, especially in males, with females showing the opposite association. Reactive aggressive behavior is a result of individual responses to provocation, to which females seem to be more sensitive.

Male or Female? - Influence of Gender Role and Sexual Attraction on Sex Categorization of Faces.

The categorization of dominant facial features, such as sex, is a highly relevant function for social interaction. It has been found that attributes of the perceiver, such as their biological sex, influence the perception of sexually dimorphic facial features with women showing higher recognition performance for female faces than men. However, evidence on how aspects closely related to biological sex influence face sex categorization are scarce. Using a previously validated set of sex-morphed facial images (morphed from male to female and vice versa), we aimed to investigate the influence of the participant's gender role identification and sexual orientation on face sex categorization, besides their biological sex. Image ratings, questionnaire data on gender role identification and sexual orientation were collected from 67 adults (34 females). Contrary to previous literature, biological sex per se was not significantly associated with image ratings. However, an influence of participant sexual attraction and gender role identity became apparent: participants identifying with male gender attributes and showing attraction toward females perceived masculinized female faces as more male and femininized male faces as more female when compared to participants identifying with female gender attributes and attraction toward males. Considering that we found these effects in a predominantly cisgender and heterosexual sample, investigation of face sex perception in individuals identifying with a gender different from their assigned sex (i.e., transgender people) might provide further insights into how assigned sex and gender identity are related.

Replication of Previous Findings? Comparing Gray Matter Volumes in Transgender Individuals with Gender Incongruence and Cisgender Individuals.

The brain structural changes related to gender incongruence (GI) are still poorly understood. Previous studies comparing gray matter volumes (GMV) between cisgender and transgender individuals with GI revealed conflicting results. Leveraging a comprehensive sample of transmen (n = 33), transwomen (n = 33), cismen (n = 24), and ciswomen (n = 25), we employ a region-of-interest (ROI) approach to examine the most frequently reported brain regions showing GMV differences between trans- and cisgender individuals. The primary aim is to replicate previous findings and identify anatomical regions which differ between transgender individuals with GI and cisgender individuals. On the basis of a comprehensive literature search, we selected a set of ROIs (thalamus, putamen, cerebellum, angular gyrus, precentral gyrus) for which differences between cis- and transgender groups have been previously observed. The putamen was the only region showing significant GMV differences between cis- and transgender, across previous studies and the present study. We observed increased GMV in the putamen for transwomen compared to both transmen and ciswomen and for all transgender participants compared to all cisgender participants. Such a pattern of neuroanatomical differences corroborates the large majority of previous studies. This potential replication of previous findings and the known involvement of the putamen in cognitive processes related to body representations and the creation of the own body image indicate the relevance of this region for GI and its potential as a structural biomarker for GI.

Single-Dose of Testosterone and the MAOA VNTR Polymorphism Influence Emotional and Behavioral Responses in Men During a Non-social Frustration Task.

Previous studies suggest that testosterone and several neurotransmitters might interactively influence human aggression. The current study aimed to test potential interactions of a genetic variation linked to the catabolism of serotonin, dopamine, and norepinephrine and exogenous testosterone on the reaction towards non-social provocation. In total, 146 male participants were genotyped for a prominent polymorphism of the monoamine oxidase A (MAOA) gene resulting in a short and long variant. Participants completed a non-social frustration task after receiving either testosterone or a placebo gel in a double-blind set-up. Participants performed a non-social frustration task, where they had to direct a virtually moving ball into a barrel by pulling a joystick (neutral block). During a frustration block, the joystick repeatedly did not respond to participants' reactions thereby causing failed trials to which participants reacted with increased anger and stronger pulling of the joystick. We analyzed the effect of testosterone administration on emotion and behavior in individuals who either carried a low (L) or high (H) activity MAOA variant. Testosterone administration increased provocation-related self-reported anger and abolished the association between trait aggression and joystick deflection in the frustration block. In MAOA-H carriers endogenous testosterone levels at baseline were associated with increased joystick deflection in both blocks. There was, however, no interaction of testosterone administration and genotype. Although preliminary, the results rather indicate independent influences of exogenous testosterone administration and MAOA, but support an interaction of endogenous testosterone levels and MAOA genetics in a frustration task. The administration of testosterone seems to act on the subjective emotional experience in a provoking situation, while endogenous testosterone levels increased pulling impulses only in carriers of the MAOA-H variant.

Altered psychophysiological correlates of risk-taking in borderline personality disorder.

Elevated levels of risk-taking behavior as well as affective instability are both cardinal features of Borderline Personality Disorder (BPD). To our knowledge, there are no studies which directly investigate underlying affective processes of risk-taking behavior in BPD, despite the centrality of affect in BPD symptomatology, and indications of affective dysregulation contributing to increased risk-taking behavior in BPD. Here, we examined risk-taking behavior in BPD and its underlying affective processes, using skin conductance responses (SCRs) as a proxy. Twenty-three individuals with BPD and 24 healthy controls performed a modified version of the Balloon Analogue Risk Task, where decisions take place over a time scale of several seconds, enabling us to investigate a continuous integral of SCRs in anticipation of decisions. We used trial-by-trial mixed model analyses to account for within- and between-participant effects, as well as large variability that are often observed in SCRs. In contrast to healthy controls, who showed elevated SCRs in response to high risk, individuals with BPD did not show differential physiological sensitivity towards different risk levels. In addition, increased SCRs--under low risk--were related to more cautious risk-taking behavior in HCs. However, increased SCRs under low risk in BPD were related to greater risk-taking behavior. Alterations in the processing of affective signals, such as SCRs in the context of risk, may impair adaptation to environmental demands and may lead to increased risk-taking behavior in BPD.

On the Complexity of Aggressive Behavior: Contextual and Individual Factors in the Taylor Aggression Paradigm.

As many paths lead to aggression, understanding which situations and which person-specific traits facilitate or impede aggressive behavior is crucial. Provocation is among one of the most frequently reported predictors of aggressive behavior. However, it remains unclear whether the reaction to provocation is universal across different forms of aggression and whether individuals differ in their reactivity to such signals. Using the Taylor Aggression Paradigm (TAP), we investigated the influence of individual and contextual factors on physical and non-physical aggression in healthy men and women. The impact of trait aggression, sex, provocation, and the success of a competition against a fictitious opponent on aggressive behavior was examined in three different versions of the TAP. While equal provocation and punishment modalities were used in the first two versions, monetary deductions in the first and heat stimulus in the second study, the third experiment used non-physical provocation to trigger physical punishment. Trial-by-trial analyses revealed that provocation, independent of its specific nature, is a strong predictor for aggressive behavior, especially in highly aggressive participants. Although women initially showed less aggression than men, sex differences were diminished under prolonged, increasing provocation when provocation and punishment modality were identical. Only when modalities diverged, women, compared with men, were more hesitant to punish their opponent. These results, thus, extend evidence that women show lower levels of aggression under low provocation. However, high levels of provocation have similar effects on males' and females' reactive aggressive behavior across different forms of aggression. When competing for money, losing against the fictitious opponent was functioning as an additional provocative signal stimulating aggressive responses. Differences in aggressive responding have to be interpreted in the context of the specific type of provocation and aggression that is investigated since these modalities are shown to interact with individual characteristics.

Impulsivity Moderates Skin Conductance Activity During Decision Making in a Modified Version of the Balloon Analog Risk Task.

Individual differences in traits such as impulsivity and processing of risk and reward have been linked to decision making and may underlie divergent decision making strategies. It is, however, unclear whether and how far individual differences in these characteristics jointly influence decision making. Here, we aimed to investigate the roles of skin conductance responses, a psychophysiological marker of risk processing and impulsivity, as assessed by the Barratt Impulsiveness Scale 11 on decision making. Forty-six healthy participants performed a modified version of the Balloon Analog Risk Task (BART), where reward and explosion risk are manipulated separately. Participants are informed about whether they play a high versus low reward and high versus low explosion risk condition. The exact risk and reward contingencies are, however, unknown to participants. Participants were less risk-taking under high, compared to low explosion risk and under high reward, compared to low reward on the modified BART, which served as a validation of the paradigm. Risk-taking was negatively related to skin conductance responses under high explosion risk. This relationship was primarily driven by individuals with relatively high levels of impulsivity. However, impulsivity alone was not found to be related to decision making on the modified BART. These results extend evidence that skin conductance responses may guide decision making in situations, where participants are informed about risk level (high vs. low), which might be differentially moderated by different levels of impulsivity.

Perception in attention deficit hyperactivity disorder.

A large body of research demonstrated that individuals with attention deficit hyperactivity disorder (ADHD) suffer from various neuropsychological deficits. In contrast, less is known and only divergent evidence exists on perceptual functions of individuals with ADHD. This is problematic as neuropsychological and perceptual functions are closely interrelated and are often difficult to disentangle in behavioral assessments. This study presents the conduct and results of a systematic literature review on perceptual functions in children and adults with ADHD. This review considers studies using psychophysical methods (objective measurements) and self- and informant reports (subjective measurements). Results indicate that individuals with ADHD have altered perceptual functions in various domains as compared to typically developing individuals. Increased perceptual functions in individuals with ADHD were found with regard to olfactory detection thresholds, whereas reduced perceptual functions were evident for aspects of visual and speech perception. Moreover, individuals with ADHD were found to experience discomfort to sensory stimuli at a lower level than typically developing individuals. Alterations of perceptual functions in individuals with ADHD were shown to be moderated by various factors, such as pharmacological treatment, cognitive functions, and symptom severity. We conclude by giving implications for daily life functioning and clinical practice.

Performance monitoring in autism spectrum disorders: A systematic literature review of event-related potential studies.

Autism spectrum disorder (ASD) is marked by impairments in social-emotional situations, executive functioning, and behavioral regulation. These symptoms may be related to deficits in performance monitoring, i.e., the ability to observe and evaluate one's own behavior and performance which is necessary for the regulation of future behavior. The present literature review investigated electroencephalic correlates of performance monitoring in ASD. Event-related potentials (ERPs) considered in this review included internal performance monitoring components (error-related negativity, error positivity), external performance monitoring components (feedback-related negativity, feedback-P3), and observational performance monitoring components (observer error-related negativity, observer feedback-related negativity). The majority of studies point to reduced internal performance monitoring in ASD. External performance monitoring in reward-processing paradigms, where rewards are independent of performance, seems to be intact in ASD. So far, no studies have investigated the observer error-related negativity in ASD. Available data on the observer feedback-related negativity are inconclusive, since only two studies with differential study results investigated this construct in ASD. In general, results suggest that individuals with ASD have problems with internal performance monitoring and with learning from external, abstract feedback. In contrast, the processing of external, concrete feedback seems to be largely intact in ASD.