title: Psychopathic individuals exhibit but do not avoid regret during counterfactual decision making.
abstract: Psychopathy is associated with persistent antisocial behavior and a striking lack of regret for the consequences of that behavior. Although explanatory models for psychopathy have largely focused on deficits in affective responsiveness, recent work indicates that aberrant value-based decision making may also play a role. On that basis, some have suggested that psychopathic individuals may be unable to effectively use prospective simulations to update action value estimates during cost-benefit decision making. However, the specific mechanisms linking valuation, affective deficits, and maladaptive decision making in psychopathy remain unclear. Using a counterfactual decision-making paradigm, we found that individuals who scored high on a measure of psychopathy were as or more likely than individuals low on psychopathy to report negative affect in response to regret-inducing counterfactual outcomes. However, despite exhibiting intact affective regret sensitivity, they did not use prospective regret signals to guide choice behavior. In turn, diminished behavioral regret sensitivity predicted a higher number of prior incarcerations, and moderated the relationship between psychopathy and incarceration history. These findings raise the possibility that maladaptive decision making in psychopathic individuals is not a consequence of their inability to generate or experience negative emotions. Rather, antisocial behavior in psychopathy may be driven by a deficit in the generation of forward models that integrate information about rules, costs, and goals with stimulus value representations to promote adaptive behavior.
authors.affiliation: Department of Psychology, Yale University, New Haven, CT 06511; arielle.baskin-sommers@yale.edu joshuabuckholtz@fas.harvard.edu.
authors.forename: Arielle
authors.initials: A
authors.lastname: Baskin-Sommers
authors.affiliation: Department of Psychology, Yale University, New Haven, CT 06511.
authors.forename: Allison M
authors.initials: AM
authors.lastname: Stuppy-Sullivan
authors.affiliation: Department of Psychology, Harvard University, Cambridge, MA 02138; arielle.baskin-sommers@yale.edu joshuabuckholtz@fas.harvard.edu.|Center for Brain Science, Harvard University, Cambridge, MA 02138.|Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114.
authors.forename: Joshua W
authors.initials: JW
authors.lastname: Buckholtz
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D000987:Antisocial Personality Disorder / Q000523:psychology*; D002755:Choice Behavior; D000066479:Criminal Behavior; D003657:Decision Making; D004644:Emotions; D005715:Gambling / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D011446:Prospective Studies; D012201:Reward; D055815:Young Adult
keywords: affect; counterfactual reasoning; decision making; psychopathy; reward