Neuroscience of behavioual change: goals and habitual actions · serotonin reuptake inhibitor...
Transcript of Neuroscience of behavioual change: goals and habitual actions · serotonin reuptake inhibitor...
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Екатерина Винник, M.D., Ph.D. Москва 2018
Neuroscience of
behavioual
change: goals and
habitual actions
Ekaterina Vinnik, MD, PhD HBT, Lisbon, Portugal
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Today
(1) Mechanisms of goal-directed and habitual actions
(2) How stress affects these mechanisms
Tomorrow
(1) Neurobiology of depression in light of psychotherapeutic approach
(2) How do antidepressants work?
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
• Внутренняя реальность – это необходимый этап вычислений. Чтобы превратить информацию об окружающем мире в полезное, адаптивное действие, нужно эту информацию преобразовать
• MИР – внутренняя репрезентация – МИР
• Все что можно, превращается в хардваре, или в автоматические действия External world Action
Goal-directed
Habitual
?
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Value of the outcome!
Goal-directed actions
Habitual actions
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Goal-directed actions
• Based on outcome • sensitive to changes in the expected outcome • Voluntary control
Habits
• To a smaller degree based on outcome • Less sensitive to changes in the expected value of the outcome • Towards compulsive behaviour
★ Extended training,
★ different schedules
Hilario and Costa, 2008
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Frontal cortex
Striatum
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
The brain
Rat Human
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Striatum
Rat Human
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
How do scientists study goal-directed behaviour in the lab?
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019 Schwabe and Wolf, 2009 0-2° C 2-3 minutes
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Social stress
Control group
Task with outcome devaluation
Schwabe and Wolf, 2009
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
The instrumental
learning task
(modified from
Valentin et al.,
2007). Participants
completed three trial
types (chocolate,
orange, and neutral).
On each trial, they
were asked to
choose between two
actions represented
by unique symbols.
In each trial type,
there was one action
that led with a high
probability to a food
outcome and one
action that led with a
low probability to a
food outcome.
Depending on the
trial type, the high
probability action
delivered chocolate
milk and orange
juice, respectively,
with a probability of p
= 0.50, a common
liquid (peppermint
tea) with a probability
of p = 0.20, or
nothing. The low
probability action
yielded the common
outcome with a
probability of p =
0.20. When an action
was chosen, the
related symbol was
highlighted for 3 s
before the outcome
was delivered.
50% 20% 20%
Options
Choice
Reinforce-ment
Schwabe and Wolf, 2009
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
The instrumental learning task
(modified from Valentin et al., 2007).
Participants completed three trial types
(chocolate, orange, and neutral). On
each trial, they were asked to choose
between two actions represented by
unique symbols. In each trial type,
there was one action that led with a
high probability to a food outcome and
one action that led with a low
probability to a food outcome.
Depending on the trial type, the high
probability action delivered chocolate
milk and orange juice, respectively,
with a probability of p = 0.50, a
common liquid (peppermint tea) with a
probability of p = 0.20, or nothing. The
low probability action yielded the
common outcome with a probability of
p = 0.20. When an action was chosen,
the related symbol was highlighted for
3 s before the outcome was delivered.
50% 20% 20%
Options
Choice
Reinforce-ment
Schwabe and Wolf, 2009
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019 Schwabe and Wolf, 2009
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019 Schwabe and Wolf, 2009
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58% vs. 28% awareness of the action–outcome associations
Schwabe and Wolf, 2009
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Hilario and Costa, 2008
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? How to test whether the rat’s actions are goal-directed or habitual?
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Devaluation!
? How to test whether the rat’s actions are goal-directed or habitual?
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Devaluation test
Hilario and Costa, 2008
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019 Hilario and Costa, 2008
Devaluation test
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019 Hilario and Costa, 2008
Devaluation test
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Behaviour remains more sensitive to devaluation is reinforcement is random (+- every 20 presses)
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Where we are so far
• Neuroscience uses simple models to study complicated things • Rats have goal-directed and habitual behaviours • Sensitivity to the value of the outcome is critical
Next: the brain
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019 Yin et al., 2005
Sensorimotor cortex
Associative areas
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019 Yin et al., 2005
“Stimulus-response”
(Habits)
Goal directed
actions
Sensorimotor cortex
Associative areas
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Muscimol- GABA agonist
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
“Stimulus-response”
(Habits)
Goal directed
actions
Yin et al., 2005
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
“Stimulus-response”
(Habits)
Goal directed
actions
Yin et al., 2004, 2005
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Frontal cortex
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Frontal cortex
• stimulus-outcome learning • goal-directed decision-making • dependent on the expected action value
value!
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019 Cremel and Costa, 2013, Ostlund and Balleine, 2007, Rolls et al., 1996, Stalnaker et al., 2015)
Orbitofrontal
cortex
(value!)
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
VALUE!
How does orbitofrontal cortex impact habitual behaviour?
Orbitofrontal
cortex
Cremel and Costa, 2013, Ostlund and Balleine, 2007, Rolls et al., 1996, Stalnaker et al., 2015)
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019 Cremel and Costa, 2013, Ostlund and Balleine, 2007, Rolls et al., 1996, Stalnaker et al., 2015)
↓↑
Orbitofrontal
cortex
value!
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Elaborating on the desired outcome helps clients to switch from habitual to goal-directed mode
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Interim conclusions
• Both cortical and subcortical areas participate in goal directed actions
• Same for habitual actions! • A frontal area that encodes value shifts behaviour towards
goal directed
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Why is it more difficult to get rid of habits during stress?
?
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
• Внутренняя реальность – это необходимый этап вычислений. Чтобы превратить информацию об окружающем мире в полезное, адаптивное действие, нужно эту информацию преобразовать
• MИР – внутренняя репрезентация – МИР
• Все что можно, превращается в хардваре, или в автоматические действия
Stress
External world Action
Goal directed
Habitual actions
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Stress
Valued ≈ devalued
Packard and Wingard,2004; Kim et al., 2001; Schwabe et al., 2007, Dias-ferreira et al, 2012 Schwabe and, Wolf, 2009
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How does stress affect those parts of the brain?
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019 Dias-ferreira et al, 2012
Control Stress
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019 Dias-ferreira et al, 2012
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019 Dias-ferreira et al, 2012
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
• Внутренняя реальность – это необходимый этап вычислений. Чтобы превратить информацию об окружающем мире в полезное, адаптивное действие, нужно эту информацию преобразовать
• MИР – внутренняя репрезентация – МИР
• Все что можно, превращается в хардваре, или в автоматические действия
Stress
External world Action
Goal directed
Habitual actions
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
• Both cortical and subcortical areas participate in goal directed actions • Same for habitual actions! • Stress alters behaviour: towards more habitual actions
• And neuronal circuits
Interim conclusions (2)
• Both cortical and subcortical areas participate in goal directed actions
• Same for habitual actions! • Stress changes neuronal circuits • Thus alters behaviour: bias towards habitual actions
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Stress management as a part of behavioural change efforts
E.g. depression
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019 Jakubovski et al., 2014
Baseline clinical characteristics most informative in predicting
treatment outcome:
○ employment status
○ income level
→ a low likelihood of response of 18%
● income < $10,000, comorbid generalized anxiety disorder,
● < 16 years of education
→ high likelihood of response of 68%
● income ≥ $40,000,
● no comorbid posttraumatic stress disorder
J Clin Psychiatry. 2014 Jul;75(7):738-47. doi: 10.4088/JCP.13m08727. Prognostic subgroups for citalopram response in the STAR*D trial. Jakubovski E1, Bloch MH. Author information Abstract OBJECTIVE: Few data exist to help clinicians predict likelihood of treatment response in individual patients with major depressive disorder (MDD). Our aim was to identify subgroups of MDD patients with differential treatment outcomes based on presenting clinical characteristics. We also sought to quantify the likelihood of treatment success based on the degree of improvement and side effects after 2 and 4 weeks of selective serotonin reuptake inhibitor (SSRI) pharmacotherapy. METHOD: We analyzed data from the first treatment phase of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial, in which subjects with a DSM-IV diagnosis of MDD were treated for 8-14 weeks with open-label citalopram. A receiver operating characteristic (ROC) analysis was conducted to determine homogenous subgroups with different rates of response and remission in depressive symptoms. Included predictor variables were initial clinical characteristics, initial improvement, and side effects after 2 and 4 weeks of SSRI treatment. The primary outcome measures were treatment response (defined as a greater than 50% reduction in 17-item Hamilton Depression Rating Scale [HDRS-17] score from baseline) and remission (defined as an HDRS-17 score ≤ 17). RESULTS: Baseline clinical characteristics were able to identify subgroups from a low likelihood of response of 18% (income < $10,000, comorbid generalized anxiety disorder, < 16 years of education; P < .01) to a high likelihood of response of 68% (income ≥ $40,000, no comorbid posttraumatic stress disorder; P < .01). Among baseline clinical characteristics, employment status (N = 2,477; χ²₁ = 78.1; P < .001) and income level (N = 2,512; χ²₁ = 77.7; P < .001) were the most informative in predicting treatment outcome. For the models at weeks 2 and 4, treatment success was best predicted by early symptom improvement. CONCLUSIONS: Socioeconomic data such as low income, education, and unemployment were most discriminative in predicting a poor response to citalopram, even with disparities in access to care accounted for. This finding implies that socioeconomic factors may be more useful predictors of medication response than traditional psychiatric diagnoses or past treatment history. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00021528. © Copyright 2014 Physicians Postgraduate Press, Inc.
Predictors of responses to depression treatment
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Conclusions
• Habits and Goal-directed actions: • Both cortical and subcortical areas participate in goal
directed actions and habitual actions • Stress alters structure and function of prefrontal-
subcortical neuronal circuits, creates bias towards habitual actions
• SMART goals!
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● Myths and truths about the brain ● Decision making: where does confidence
come from? ● Resilience: neurobiological mechanisms ● Social intelligence
● Rescripting, EMDR and exposition therapy:
brain mechanisms ● Anxiety: what’s known about mechanisms of
psychotherapy? ● Peculiar brain: mechanisms of OCD
Neurobiology & cognitive technologies
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Екатерина Винник, M.D., Ph.D. Рига 2018
? ? ? ? ? ? ? ? ? ? ? ? ?? ? ? ? ? ? ? ?
? ? ? ? ?? ? ? ? ? ? ? ? ? ? ? ? ?? ?
? ? ? ? ? ? ? ? ? ? ?
? ? ? ? ? ? ? ? ? ? ? ? ?? ? ? ? ? ? ? ?
? ? ? ? ?? ? ? ? ? ? ? ? ? ? ? ? ?? ?
? ? ? ? ? ? ? ? ? ? ?
+351918951392
vinnikekaterina
ekaterina-vinnik
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Привычное
поведение
Привычная
ситуация?
да
нет
да
нет no
Психотерапия,
коучинг
Существующее
решение?
Целенаправленное поведение
Решение
проблемы
Аналитически,
эмпирически
[…]
Инсайт
Психотерапия,
коучинг
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Slide title here
INSIGHT
Insight denotes a mental restructuring that leads to a sudden gain of explicit knowledge allowing qualitatively changed behaviour (Köhler, 1947, Sternberg, 1995).
Ekaterina Vinnik., MD, PhD !! Neuroscience of behavioural change
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INSIGHT - A TYPE OF CREATIVE THINKING
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INSIGHT
Left or right hemisphere?
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“the simplistic argument that the essential aspect of creativity resides in the right hemisphere” “the claim that creativity is located ‘in’ the right hemisphere should be dispelled with at once.”
Katz 1997,
Dietrich and Kanso, 2010 Image source: Gizmondo
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The left brain is dominant for language and speech. The right excels at visual-motor tasks.
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Both left and right!
REFERENCE
Ogawa et al., 2018
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What do we know?
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Subramaniam et al., 2008
More insights in good mood
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More insights in good mood
Ekaterina Vinnik., MD, PhD Neuroscience of behavioural change
Rowe, Hirsch & Anderson, 2007;
Amabile, Barsade, Mueller, & Staw, 2005; Isen, 1999a, 1999b;
Estrada, Young, & Isen, 1994;
Isen, Daubman, & Nowicki, 1987
Good mood specifically facilitates insight compared to analytical solutions
Positive mood - assessed or induced (sic!) How does it work?
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ANTERIOR CINGULATE CORTEX
Positive mood is one factors that enhances activity in the dACC, and this mediates the shift toward insight solutions
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Conclusions
• Habits and Goal-directed actions: • Both cortical and subcortical areas participate in goal directed
actions and habitual actions • Stress alters structure and function of prefrontal-subcortical
neuronal circuits, creates bias towards habitual actions • Insights:
• Creative solutions involve right & left hemisphere! • Good mood facilitates insight
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
THANK YOU FOR YOUR ATTENTION!
+351918951392
vinnikekaterina
ekaterina-vinnik
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
THANK YOU FOR YOUR ATTENTION!
+351918951392
vinnikekaterina
ekaterina-vinnik
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Slide title here
A-ha!
According to legend, Archimedes shouted “Eureka!” (“I have found it!”) when he
suddenly discovered that water displacement could be used to calculate density. Since
then, “Eureka!,” or “Aha!,” has often been used to express the feeling one gets when
solving a problem with insight. Insight is pervasive in human (and possibly animal
[Epstein et al. 1984]) cognition, occurring in perception, memory retrieval, language
comprehension, problem solving, and various forms of practical, artistic, and scientific
creativity (Sternberg and Davidson 1995). The Archimedes legend has persisted over
two millennia in part because it illustrates some of the key ways in which insight
solutions differ from solutions achieved through more straightforward problem solving
Ekaterina Vinnik., MD, PhD !! Neuroscience of behavioural change
a mental restructuring that leads to a sudden gain
of explicit knowledge allowing qualitatively changed
behaviour
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NIGHT
WRIST WATCH
FIND a solution word that can form a compound word or phrase with each problem word. The solution word can precede or follow each problem word.
Compound remote assotiative task
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STOP!
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Habitual
behaviour
Very familiar
task &
circumstances
yes
no
yes
no no
COACHING!
Existing
solution?
Goal-oriented behaviour
Problem
solving
COACHING
Analytical,
Empirical,
[…]
Insight
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Frontal lobe
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
ORBITOFRONTAL CORTEX
• stimulus-outcome learning • goal-directed decision-making • dependent on the expected action value
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Habitual
behaviour
Very familiar
task &
circumstances
yes
no
yes
no no
Existing
solution?
Goal-oriented behaviour
Problem
solving
Analytical,
Empirical,
[…]
Insight
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Neurons change!
Dias-ferreira et al, 2012
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Prefrontal cortex
Some areas - shrink, some areas increase
Dias-ferreira et al, 2012
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
The connection between NAcc, hippocampus, and medial prefrontal cortex (see below), has the potential to explain the effects of positive mood on insight (Isen, Daubman, & Nowicki, 1987; Subramaniam et al., 2009).
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Positive affect enhances cognitive flexibility in various settings, such as in classifying material (Isen & Daubman, 1984), in negotiation tasks (Carnevale & Isen, 1986), in medical diagnoses (Estrada et al., 1994), and in creative problem-solving tasks (Isen, Mitzi, Johnson, Mertz, & Robinson, 1985; Isen &
Daubman, 1984).
One possible mechanism by which PA could facilitate
insight is through cognitive restructuring processes. PA
is likely to facilitate insight by increasing a person’s
ability to switch and select alternative cognitive perspectives
(Baumann & Kuhl, 2005; Dreisbach & Goschke,
2004; Isen, 1999b), reducing perseveration on one particular
solution candidate or solving approach, thus
increasing the probability of engaging in various cognitive
restructuring processes.
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HOW?
one hypothesis is that PA promotes a
more global scope of attention (Bolte, Goschke, & Kuhl,
2003; Gasper & Clore, 2002), enhancing access to distant or unusual associations (Friedman, Fishbein, Fo¨rster, & Werth, 2003; Federmeier, Kirson, Moreno, & Kutas, 2001; Isen et al., 1985), which facilitates creative solutions to classic insight problems such as Duncker’s (1945) candle task (Isen et al., 1987) and improves performance (Rowe et al., 2007; Isen et al., 1987) on the Remote Associates Test (Mednick, 1962). Another hypothesis is that PA enhances switching between global and local attentional modes (Baumann & Kuhl, 2005) or between strategies (Dreisbach & Goschke, 2004), or, similarly, that it enhances selection of different perspectives (Ashby et al., 1999).
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In contrast, negative affect (NA) states such as anxiety and depression have been associated with deficits in attentional and cognitive control mechanisms (Bishop, Duncan, Brett, & Lawrence, 2004; Mayberg et al., 1999), often inducing a narrow scope of attention (Easterbrook, 1959). Therefore, anxiety in particular should impede cognitive flexibility, problem restructuring, and insight solving.
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Compared with solving problems without insight, solving with
insight involves stronger activity in right temporal regions thought to be important for integrating distant
semantic associations ( Jung-Beeman et al., 2004). Additional
brain regions showed similar but weaker ‘‘insight
effects’’ in the earlier study but manifested strong effects
in the current study; these include anterior cingulate,
posterior cingulate cortex (PCC), parahippocampal cortex
(PHC), right superior frontal gyrus (SFG), and right
inferior parietal lobe (IPL).
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Slide title here
ANTERIOR CINGULATE CORTEX
Stronger ACC activity
occurs prior to trials solved with insight than those
solved more analytically (Kounios et al., 2006).
insights would involve greater
cognitive control and restructuring processes, and that
the dACC would be involved in the shift and the selection
of a new solution path.
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ACC Interaction between cognitive and affective networks
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Thus, we have strongly demonstrated that positive mood is reliably associated with preparatory states that increase responsivity in the rostral dACC, and that this modulation is associated with processing that leads to insight solutions. We are not arguing that the activation in ACC represents a neural correlate of positive mood or that positive mood states induce insight. We are concluding that positive mood is one factor that enhances activity in the rostral dACC, and that this mediates the shift toward insight solutions
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TOOTH HEART
POTATO
Compound remote assotiative task
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SWEET TOOTH HEART
POTATO
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Slide title here
Amygdala activation predicts whether perceptual insight
will be remembered
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
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Thank you very much for your attention!
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Slide title here
SLEEP ENHANCES INSIGHT
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Based on continuous monitoring of subjects’
behavioural responses, the task allows the exact determination of
the time point when insight occurs, that is, when explicit knowledge
of a hidden abstract rule is gained, leading to an abrupt, qualitative
shift in responding
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Wagner et al., 2004
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● Solutions of camouflage images can remain in long-term memory after one-shot viewing
● Many solutions are lost within a week, but those remembered are retained long after
● Observers retain different subsets of camouflage solutions in long-term memory
● Amygdala activity during one-shot viewing predicts which solutions will be remembered
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Slide title here
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Illustration credit: Dias-ferreira, 2011
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Ekaterina Vinnik, M.D., Ph.D. // Riga 2019
Prefrontal cortex
Striatum