Computations and Connectivity Underlying Aversive Counterfactuals.

Background: Mentally simulating counterfactuals (scenarios that have not actually occurred) is a sophisticated human cognitive function underlying creativity, planning, and daydreaming. One example is the "would you rather" game, in which forced choices are made between outlandish negative counterfactuals. Materials and Methods: We measured behavioral and neural correlates while participants made "would you rather" choices framed as approaching or avoiding aversive counterfactual scenarios (e.g., illnesses, car accidents). Results: We found in two independent cohorts that participants were highly susceptible to framing effects when making these decisions, taking significantly longer to respond to approach frames compared with avoidance. Brain imaging showed that choices to approach and avoid resulted in a pattern of activation consistent with a network associated with responding to aversive stimuli, identified via a coordinate-based meta-analysis of 238 studies. Bayesian graph connectivity analysis showed that network connectivity differed by choice frame, with significantly stronger connectivity for approach choices compared with avoidance choices among primarily limbic nodes (putamen, insula, caudate, and amygdala). Computational modeling of behavior revealed that approach frames led to significantly longer nondecision times, increased evidence required to make decisions, and faster evidence accumulation than avoidance frames. Stronger network connectivity between corticostriatal and limbic regions was associated with rate of evidence accumulation and length of nondecision time during approach choices. For avoidance choices, prefrontal connectivity was related to nondecision time. Conclusions: These results suggest that "would you rather" decisions about aversive counterfactuals differentially recruit limbic circuit connectivity based on choice frame. Impact statement We measured brain connectivity and latent cognitive variables underlying aversive counterfactual choices. We found a replicable reaction time effect whereby approach decisions were slower than avoidance decisions. Computational modeling identified that the latent cognitive variable of evidence accumulation was related to strength of connectivity between corticostriatal and limbic nodes during approach decisions. Multidimensional scaling (MDS) and clustering revealed a three-dimensional choice structure that differed between individuals, and between approach and avoidance choices within individuals. Our results suggest that cognitive evaluations of aversive counterfactuals involve flexible representations that can be altered by choice framing. These findings have broad implications for prospective decision making.