Negative Emotions Impact on Decision-Making

Overseen By Silvia Lopez Guzman, M.D.

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: National Institute of Mental Health (NIMH)

Must not be taking: Psychoactive, Corticosteroids, Pain, Antidepressants

Disqualifiers: Unstable medical, Psychiatric, Substance-related, Pregnancy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

900 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how negative emotions, such as stress or hunger, alter decision-making. Participants will encounter various stressors, like watching a video or immersing their hand in ice water (known as the Cold Pressor Test), to observe how these experiences might influence their thinking and choices. Researchers aim to understand these effects in healthy individuals, potentially aiding future mental disorder treatments. The trial seeks healthy individuals aged 18 to 55 willing to participate in several stress tests and decision-making tasks. As an unphased trial, this study allows participants to contribute to foundational research that could lead to breakthroughs in mental health treatment.

Will I have to stop taking my current medications?

The trial requires that participants do not regularly use psychoactive medications or substances, corticosteroids, or certain pain medications. If you are taking any of these, you may need to stop before participating.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that the treatments in the "Negative Emotions Impact on Decision-Making" study are safe. In the cold pressor test, participants place a hand or forearm in cold water, causing mild to moderate pain. This pain is typically manageable, temporary, and not harmful.

The study's sections on economic loss, frustration, and negative emotions do not involve physical treatments. They focus on emotional experiences and decision-making tasks, which are non-invasive and safe.

For the pain and thermal pain tests, controlled heat creates temporary discomfort. Research supports these methods as safe, with no lasting effects reported after the test.

Stress induction in research often involves mental tasks or mild challenges, which are safe and temporary. Participants might feel stressed during the test, but these feelings usually dissipate quickly after the session.

Overall, the methods used in this study are standard in research and designed to be safe for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it aims to understand how negative emotions impact decision-making, which could provide valuable insights into human behavior under stress. Unlike typical studies that focus on treatments like medication or therapy for managing emotions, this study uses unique interventions such as the cold pressor test and thermal pain to induce negative emotions and observe their effects. By exploring how various negative states like frustration, stress, and economic loss influence decisions, the study could pave the way for developing new strategies to improve decision-making under adverse conditions. This research stands out because it combines psychological and physiological approaches to capture a more comprehensive picture of emotional impact on decision-making.

What evidence suggests that this trial's treatments could be effective?

Studies have shown that negative emotions can greatly affect decision-making and thought processes. Research on stress indicates that it can either help or hinder decision-making, depending on the situation. Some studies even suggest that stress doesn't always lead to worse choices. In this trial, participants will undergo different negative state inductions, such as the cold pressor test, which involves exposure to cold stress. This test is known to impair memory and reduce flexible thinking, affecting decision-making. Economic stress, like financial strain, has been found to lower thinking ability and increase the likelihood of mistakes. Feelings of frustration and negative emotions can slow reaction times, increase errors, and disrupt thinking tasks. These findings reveal the complex ways negative emotions influence decision-making, suggesting that understanding these effects could be important for addressing mental health issues. ^{6 7 8 9 10}

Who Is on the Research Team?

Silvia Lopez Guzman, M.D.

Principal Investigator

National Institute of Mental Health (NIMH)

Are You a Good Fit for This Trial?

Healthy adults aged 18 to 55 who can understand and sign consent, read and write English. Excluded are those using psychoactive drugs or corticosteroids, pregnant women, NIMH staff/family, people with chronic pain or metal in the body that affects MRI scans, left-handed individuals for certain tests, and anyone with medical conditions affecting the study.

Inclusion Criteria

Ability of subject to understand and the willingness to sign a written informed consent document.

I understand my participation will help ensure diversity in the study.

Able to read and write in English to guarantee understanding of all written and spoken instructions, which are in English.

Exclusion Criteria

I have scars, burns, or a recent tattoo that could affect skin sensitivity in the test area.

Has any serious or unstable medical condition or history that in a clinician's assessment implies a cardiovascular, neurological, or physical risk from the study procedures performed to induce negative valence states. This may include chronic systemic disorders that could worsen due to stress (e.g. uncontrolled hypertension, coronary artery disease for example a history of myocardial infarction or stable or unstable angina, or diabetes)

Has any current psychiatric diagnosis (based on SCID) or no diagnosis but scores >=29 on Beck Depression Inventory II or >=26 on Beck Anxiety Inventory

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Experimental Intervention

Participants undergo experimental manipulations of state, including exposure to negative valence states such as stress, pain, and craving, followed by decision-making tasks.

3 weeks

3 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after intervention, including assessment of decision-making behavior and brain activity.

2-4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Cold pressor test
• Craving
• Economic loss
• Frustration
• Negative valence emotion
• Pain
• Stress
• Thermal pain

Trial Overview The trial studies how negative emotions like stress, pain, and craving influence decision-making. Participants undergo emotional stressors (videos, math problems, heat/cold exposure), fill out questionnaires about their state of mind and personality traits while some also perform tasks during an fMRI brain scan.

How Is the Trial Designed?

Group I: 5 Experimental Treatment 1 Intervention

within-subjects experimental study, where each subject will receive a neutral state and a negative state induction intervention in a cross-over design (counterbalanced order across participants).

Group II: 4 Experimental Treatment 1 Intervention

within-subjects experimental study, where each subject will receive a neutral state and a negative state induction intervention in a cross-over design (counterbalanced order across participants).

Group III: 3 Experimental Treatment 1 Intervention

within-subjects experimental study, where each subject will receive a neutral state and a negative state induction intervention in a cross-over design (counterbalanced order across participants).

Group IV: 2 Experimental Treatment 1 Intervention

within-subjects experimental study, where each subject will receive a neutral state and a negative state induction intervention in a cross-over design (counterbalanced order across participants).

Group V: 1 Experimental Treatment 1 Intervention

within-subjects experimental study, where each subject will receive a neutral state and a negative state induction intervention in a cross-over design (counterbalanced order across participants).

Who Is Running the Clinical Trial?

National Institute of Mental Health (NIMH)

Lead Sponsor

Trials

3,007

Recruited

2,852,000+

Published Research Related to This Trial

In two studies with 24 participants each, it was found that both positive and negative emotions reduce the brain's processing resources for tasks, as indicated by a smaller P3 component in emotional conditions compared to neutral ones.

The results suggest that negative emotions take priority in processing, potentially draining resources needed for task performance, while positive emotions also have a similar but less pronounced effect.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Attentional resource allocation to emotional events: An ERP study. Meinhardt, J., Pekrun, R.[2022]

The cold pressor arm wrap (CPAW) is a practical and effective alternative to the traditional cold pressor test (CPT) for inducing stress, using MRI-safe gel packs instead of water, making it suitable for various research environments.

CPAW successfully activates the sympatho-adrenomedullary (SAM) and hypothalamic-pituitary-adrenal (HPA) axes at levels comparable to CPT, ensuring similar physiological responses while being safer and more convenient for studies involving sensitive equipment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An alternative to the traditional cold pressor test: the cold pressor arm wrap. Porcelli, AJ.[2021]

Colder water temperatures in the cold pressor test significantly reduced behavioral pain tolerance (BPT) and increased sensory (SR) and affective ratings (AR) of pain in college women, indicating that physical factors strongly influence pain perception.

Labeling the pain experience with more severe terms decreased pain tolerance and increased affective ratings, suggesting that psychological factors also play a crucial role in how pain is experienced, although sensory ratings remained unchanged.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The physical and psychological experience of pain: the effects of labeling and cold pressor temperature on three pain measures in college women. Hirsch, MS., Liebert, RM.[2021]

Positive emotions can increase pain tolerance and threshold in individuals, including those with substance dependence, indicating that emotional state plays a significant role in pain perception.

The study found that changes in arm temperature did not mediate the relationship between affect and pain modulation, suggesting that non-drug approaches to managing pain could be effective even in people with alcohol or cocaine dependence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Affective modulation of pain in substance-dependent veterans. Rhudy, JL., Dubbert, PM., Parker, JD., et al.[2014]

The Trier Social Stress Test (TSST) produced significantly higher levels of ACTH and cortisol compared to the Cold Pressor Test (CPT) in a study of 31 subjects, indicating a stronger activation of the HPA axis during social stress.

While the TSST led to lower mood ratings than the CPT, the CPT may still be useful for assessing stress responses in patients with diverse diagnoses, such as PTSD and alcohol dependence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Stress reactivity: biological and subjective responses to the cold pressor and Trier Social stressors. McRae, AL., Saladin, ME., Brady, KT., et al.[2022]

The newly developed automated bilateral feet Cold Pressor Test (CPT) effectively eliminates biases associated with traditional hand immersion methods, such as laterality bias and motor response effects, making it a more reliable tool for stress research.

In a study with 28 healthy male students, the bilateral feet CPT produced significant physiological and subjective stress responses, indicating its validity and feasibility as a stress test that can be used in psychobiological research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Validation of an automated bilateral feet cold pressor test. Bachmann, P., Zhang, X., Larra, MF., et al.[2019]

In two experiments involving working memory tasks, it was found that while pain can impair concurrent working memory performance, it did not affect performance on tasks completed after the pain, indicating that the timing of cognitive tasks relative to pain matters.

Despite previous findings suggesting optimism could protect against pain-induced cognitive decline, this study found no evidence that optimism mitigated the negative effects of heat pain on working memory performance during the task.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of experimental pain and induced optimism on working memory task performance. Boselie, JJLM., Vancleef, LMG., Peters, ML.[2018]

Both the cold pressor test (CPT) and mental arithmetic stress (PASAT) significantly reduced pain induced by hypertonic saline in the masseter muscle, with reductions of 35.8% and 30.8% respectively, compared to a control session.

CPT decreased vagal activity, indicating a shift in autonomic function, while PASAT increased heart rate without affecting heart rate variability, suggesting different underlying mechanisms for pain modulation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Experimental stressors alter hypertonic saline-evoked masseter muscle pain and autonomic response. Bendixen, KH., Terkelsen, AJ., Baad-Hansen, L., et al.[2012]

In a study involving 90 students (45 women and 45 men), physiological stress (from the Cold Pressor Test) and combined physiological and psychosocial stress did not significantly change risk-taking behavior compared to a no-stress condition, suggesting that the type of stressor may not always influence decision-making under risk.

However, the study found that men generally made riskier decisions than women, and the type of stressor affected this behavior differently for each sex, indicating that both sex and stress type play important roles in decision-making under risk.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Decision making in response to physiological and combined physiological and psychosocial stress. Nowacki, J., Heekeren, HR., Deuter, CE., et al.[2019]

Acute stress significantly increases cortisol levels and amplifies negative emotions related to decision-making, particularly when comparing actual outcomes to potential alternatives (counterfactuals).

Under stress, individuals are more likely to make decisions that avoid regret, indicating that stress shifts decision-making towards more emotional and intuitive processes rather than rational analysis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acute stress amplifies experienced and anticipated regret in counterfactual decision-making. Wu, Y., van Dijk, E., Li, H.[2021]

In a study with 50 college students, positive affect combined with external mental imagery significantly increased pain tolerance during a cold-pressor test, suggesting that mental imagery can effectively reduce pain perception.

The results indicated that the combination of positive affect and external imagery led to the lowest reported pain levels, highlighting the cognitive influence on pain management rather than physiological responses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Interactive effects of the affect quality and directional focus of mental imagery on pain analgesia. Alden, AL., Dale, JA., DeGood, DE.[2022]

In a study with 56 participants, exposure to cold (via the cold pressor test) primarily drove cortisol responses and pain perception, while the cognitive task (Paced Auditory Serial Addition Task) enhanced cardiovascular reactions without affecting pain ratings.

The simultaneous administration of cognitive and physical stressors showed additive effects on cardiovascular reactivity, indicating that performing cognitive tasks during physical stress does not significantly interfere with stress responses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Combining mental and physical stress: Synergy or interference? Finke, JB., Zhang, X., Plein, D., et al.[2021]

The review outlines various methods to induce stress in humans, such as the Trier Social Stress Test and cold pressor test, which are crucial for studying how the body reacts to stress and for developing new treatments.

It also highlights the importance of assessing stress through biochemical markers like cortisol and physiological changes like heart rate and galvanic skin response, providing a comprehensive approach to understanding stress responses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical experimental stress studies: methods and assessment. Bali, A., Jaggi, AS.[2015]

In a study involving 219 police officers, virtual reality (VR) training was found to induce higher levels of perceived stress compared to a 2D simulator (VirTra V-300) when no pain stimulus was applied.

Adding a pain stimulus during training increased perceived stress in the VirTra simulator but did not enhance the sense of presence or training responses in the VR system, suggesting that VR training is realistic enough on its own.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

No pain, no gain? The effects of adding a pain stimulus in virtual training for police officers. Kleygrewe, L., Hutter, RIV., Oudejans, RRD.[2023]

Citations

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Effect of the cold pressor test on memory and cognitive flexibility The cold pressor test is a known adrenergic stressor that impairs memory, but the effect on cognitive flexibility is unknown.

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Combining mental and physical stress: Synergy or ... At the same time, exposure to cold may reduce cognitive performance [16] and resultant stress effects in turn. Finally, interactions at the ...

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Effect of the Cold Pressor Test on Memory and Cognitive ... The cold pressor test is a known adrenergic stressor that impairs memory, but the effect on cognitive flexibility is unknown. Sixteen subjects ...

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Acute Exposure to the Cold Pressor Stress Impairs Working ... The present study explored the effects of acute stress on human WM processing using event-related potential (ERP) techniques.

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Temperature and the cold pressor test Small variations in water temperature when using the cold pressor test result in significant differences in both pain intensity levels and tolerance times.

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The Effects of Water Temperature on the Cold Pressor Test The cold pressor test is a procedure used for examining pain threshold and tolerance by subjects placing their forearm in an ice bath. Each participant will ...

8. jpain.org jpain.org/article/S1526-5900(05)00366-4/fulltext

Guidelines for the cold pressor task as an experimental ... The cold pressor task (CPT) involves placing a hand or forearm in cold water, a stimulus that produces a slowly mounting pain of mild to moderate intensity.

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The expanding role of the cold pressor test: a brief history The cold-pressor test, which involves immersing a hand in ice-cold water, is a well-established method for inducing acute stress and activating the sympathetic ...

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Water temperature and biological sex influence cold pressor ... Males demonstrated higher pain tolerance in 1°C and 3°C conditions, with 50% reaching the 3-min cutoff, compared to 39% at 6°C, 23% at 3°C, and ...