Test–retest reliability of approach‐avoidance conflict decision‐making during functional magnetic resonance imaging in healthy adults

Abstract

Neural and behavioral mechanisms during approach-avoidance conflict decisionmaking are relevant across various psychiatric disorders, particularly anxiety disorders.Studies using approach-avoidance conflict paradigms in healthy adults have identified preliminary neural mechanisms, but findings must be replicated and demonstrated as reliable before further application. This study sought to replicate previous findings and examine test-retest reliability of behavioral (approach behavior, reaction time) and neural (regions of interest [ROIs]) responses during an approach-avoidance conflict task conducted during functional magnetic resonance imaging (fMRI). Thirty healthy adults completed an approach-avoidance conflict task during fMRI on two occasions (mean interval: 17 days; range: 11-32). Effects of task condition during three task phases (decision-making, affective outcome and monetary reward) and intraclass correlation coefficients (ICCs) were calculated across time points. Results replicated that approach behavior was modulated by conflict during decision-making. ROI activations were replicated such that dorsal anterior cingulate cortex (dACC) was modulated by conflict during decision-making, and dACC, striatum, and anterior insula were modulated by valence during affective outcomes (p's <.0083). Approach behavior during conflict demonstrated excellent reliability (ICCs ≥.77). Activation of dACC during conflict decision-making and anterior insula during negative outcomes demonstrated fair reliability (ICCs = .51 and .54), and dACC and striatum activation demonstrated good reliability during negative outcomes (ICCs = .63 and .69). Two additional ROIs (amygdala, left dorsolateral prefrontal cortex) showed good reliability during negative outcomes (ICCs ≥.60). These results characterize several specific behavioral and neuroimaging responses that are replicable and sufficiently reliable during approach-avoidance conflict decision-making to support future utility.

Striatal reactivity during emotion and reward relates to approach–avoidance conflict behaviour and is altered in adults with anxiety or depression

“…Our AAC task paradigm 19,20 has good test-retest reliability for behavioural responses 36 and fMRI-measured neural activation, 37 supporting its utility for studying individual differences. This task allows for the separate manipulation of decision-making (varying conflict level), affective outcomes (using negative or positive stimuli) and reward feedback (varying reward values).…”

“…This task allows for the separate manipulation of decision-making (varying conflict level), affective outcomes (using negative or positive stimuli) and reward feedback (varying reward values). In 2 previous fMRI studies with samples of 15 and 30 healthy adults, 20,37 participants showed distinct regional activations across the following dimensions: for decision-making, greater conflict trials elicited less activity in the amygdala and more in the dorsal anterior cingulate cortex (dACC), dorsal and ventral striatum, and right dorsolateral prefrontal cortex (dlPFC); for affective outcomes, the amygdala, dACC, dorsal and ventral striatum, and anterior insula were more activated by negatively valenced stimuli than by positively valenced stimuli; and for reward feedback, the dorsal and ventral striatum was significantly activated relative to baseline, but its activity did not differ by reward value. However, the neural activations elicited during this task have been examined only in healthy adult samples.…”

“…However, the neural activations elicited during this task have been examined only in healthy adult samples. 20,37 In the present study, we compared a large sample of treatment-seeking adults with anxiety or depression to a group of healthy adults; we used our AAC decision-making task during fMRI to examine behavioural and neural differences. 19,20 We also examined the functional relationships between behavioural and neural measures and assessed whether these relationships differed across diagnostic groups.…”

“…Our primary analyses focused on activation during each task phase (decision-making, affective outcomes, reward feedback) in the same a priori regions of interest (ROIs) used in our previous test-retest reliability study. 37 We hypothesized that adults with anxiety or depression would demonstrate reduced approach behaviour during AAC and lower activation of the dlPFC and dorsal and ventral striatum during decisionmaking; greater activation of the amygdala and anterior insula during affective outcomes; and less activation of the dorsal and ventral striatum during reward. We also hypothesized that increased activity in the dlPFC and striatum during decision-making would predict greater approach behaviour, that activity in the amygdala and anterior insula during affective outcomes would predict less approach, and that activity in the striatum during reward feedback would predict greater approach.…”

Measuring maladaptive avoidance: from animal models to clinical anxiety

“…This goal would require reliable and valid measurement of avoidance behavior at the level of an individual, with known population norms and/or clinical cut points. While some studies have begun to examine construct validity [34,51], psychometric properties of avoidance paradigms have largely not been established (for a notable exception, see [101]). Psychometrically sound tasks will be essential for translation from research to clinical application [102], with test-retest reliability of particular importance for paradigms assessing constructs that should be stable over time, such as trait avoidance tendency.…”