Choosing spouses and houses: Impaired congruence between preference and choice following damage to the ventromedial prefrontal cortex.

Abstract

Objective A well-documented effect of focal ventromedial prefrontal cortex (vmPFC) damage is a deficit in real-world decision-making. An important aspect of this deficit may be a deficiency in “internal consistency” during social decision-making – that is, impaired congruence between expressed preferences versus actual behavioral choices. An example of low internal consistency would be if one expressed the desire to marry someone with impeccable moral character,” yet proceeded to marry someone convicted of multiple felonies. Here, we used a neuropsychological approach to investigate neural correlates of internal consistency in complex decision-making. Method Sixteen individuals with focal vmPFC lesions, 16 brain-damage comparison individuals, and 16 normal comparison individuals completed a three-option forced-choice preference task in which choices were made using attribute sets. Participants also completed visual-analogue preference ratings to indicate how much they liked each option, and rated the influence of each attribute on their decision-making. Options were either social (potential spouses) or non-social (potential houses). Internal consistency for a trial was defined as agreement between the choice and the most positively rated option. Results A mixed design ANOVA revealed that internal consistency between choices and preferences derived from summed attribute ratings was significantly lower for the vmPFC group relative to comparison participants, but only in the social condition (pη2 = .09), 95% CI [.002, .163]. Conclusions Internal consistency during social decisions may be deficient in patients with vmPFC damage, leading to a discrepancy between preferences and choices. The vmPFC may provide an important neural mechanism for aligning behavioral choices with expressed preferences.

A Critical Role for Human Ventromedial Frontal Lobe in Value Comparison of Complex Objects Based on Attribute Configuration

“…Puzzlingly, however, these VMF-damaged patients seemed to systematically neglect specific attributes, rather than showing a generic reduction in the attributes that were considered. Other recent work found that VMF damage impaired value-based decisions about spouses, but not houses, and that the number of attributes per option did not affect choice consistency in either condition (Bowren et al, 2018). Together, this argues against a general role for the VMF in combining attributes to assess value, calling instead for a more specific account.…”

“…The present observations raise the possibility that such information may be neglected because it relies more heavily on configural processing. This might also explain the recent observation that VMF damage impairs value-based multiattribute decisions between social "objects" (spouses), but not between nonsocial objects (houses; Bowren et al, 2018), given the evidence that processing of social stimuli, such as faces, is fundamentally configural (Farah, 1996).…”

Economic and social values in the brain: evidence from lesions to the human ventromedial prefrontal cortex

“…Interestingly, recent findings on valuation about multidimensional options could shed light on the specific role of the vmPFC in decision-making. When value has to be inferred from the multiple attributes of a stimulus, vmPFC patients differ from prefrontal lesioned and healthy control individuals in how they weight the different attributes in certain choices, for example when choosing artworks based on their perceptual, conceptual and affective characteristics ( 69 ), but not in other, for example when choosing potential houses based on their features ( 70 ). Recent work suggested that vmPFC damage might specifically affect decision-making when value must be inferred from the unique combination of attributes, in other words their interaction, and not when value can be inferred from the sum of independent attributes ( 71 ).…”

Viewing orbitofrontal cortex contributions to decision-making through the lens of object recognition.

“…A recent lesion study from another research group again questions the generality of the role of OFC/vmPFC in decision-making. Participants made decisions between hypothetical life partners (spouses) and houses in a task in which decisions options were characterized by multiple attributes (Bowren et al, 2018). In this case, the attributes were explicitly identified (i.e., provided as text) and the number of attributes per option was also varied across trials.…”