Interplay of Affect and Cognition in Decision Making: Comparing Emotionally Impaired Patients and Controls

我们将研究一组患者的基本决策过程，这些患者在考虑他们的决定的长期后果时无法将思想和感情整合起来。这种功能障碍与大脑中特定神经回路的损伤有关。因此，这一患者群体是研究认知和情感在决策中的运作和整合的理想人群。逻辑是这样的：如果我们可以通过这些患者无法整合思想和情感来描述他们的特征，如果我们可以证明这些患者对风险水平等选定变量的敏感度低于对照组，那么我们就可以更好地理解在整合思想和情感以做出明智决策方面发挥关键作用的因素。对照组将包括一组非患者和一组大脑其他部位有病变的患者。我们的跨学科研究团队具有与目标患者群体合作的背景和经验，以确定其决策缺陷的神经学基础，并创建受控任务，以隔离变量和反应系统，区分“知情”和“不知情”决策。例如，如果我们的新研究表明，目标患者对变化的风险水平的反应不如对照组，那么我们可以断言，对风险水平的扭曲认知是不知情决策的关键标志。我们认为，这项工作的更广泛的影响将包括：(1)向未来的研究人员展示将传统的行为决策理论方法与大脑神经回路分析相结合的有用性；(2)对区分“正常”和“异常”决策的因素进行更完整的描述；(3)找到方法来理解和建议那些在做出符合其最大利益的决策方面表现出缺陷的群体。

We will study basic decision processes in a patient group known to suffer from the inability to integrate thoughts and feelings when considering the long-term consequences of their decisions. This dysfunction has been tied to lesions in a specific neural circuitry within the brain. This patient population is thus ideal for studying the operation and integration of cognition and emotion in decision making. The logic is as follows: if we can characterize these patients by their inability to integrate thoughts and feelings, and if we can show that these patients are less sensitive than controls to selected variables such as risk level, then we will better understand the factors that play a key role in integrating thoughts and feelings for informed decision making. Controls will include a group of non-patients and a group of patients with lesions in other parts of the brain.Our interdisciplinary research team has the background and experience to work with the target patient group to determine the neurological underpinnings of their decision making deficits and to create controlled tasks for isolating variables and response systems that differentiate between "informed" and "uninformed" decision making. For example, if our new studies show that the target patients are less responsive to changing risk levels than are controls, then we can assert that distorted perceptions of risk level are a key marker of uninformed decision making. We believe that the broader impact of this work will include: (1) demonstrating to future researchers the usefulness of combining traditional behavioral decision theory approaches with analyses of neural circuitries in the brain; (2) developing a more complete description of factors that differentiate "normal" and "abnormal" decision making; and (3) finding ways to understand and counsel groups with demonstrated deficits in making decisions that serve their best interests.