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Correction to "Cognitive Triad and Depression: A Meta-Analysis of Cross-Sectional and Longitudinal Studies".

Authors:
Journal: Clinical psychology & psychotherapy
mental health psychology open access

Abstract

Animals routinely face situations in which approaching a reward requires entering a potentially harmful context. Such approach‐avoidance conflicts constitute a distinct form of decision making in which appetitive and defensive motivational systems, supported by partially distinct neural circuits for threat processing (LeDoux ; Maren ; Tovote et al. ) and reward seeking (Berridge and Robinson ; Everitt and Robbins ; Floresco ), must be integrated to select a single course of action. Classical behavioral theory formalized this dilemma as competing approach and avoidance gradients (Miller ). Subsequent conflict paradigms operationalized it by placing reward seeking under the threat of punishment, such as punished responding and punished drinking procedures (Paterson and Hanania ; Vogel et al. ). Across species and behavioral tasks, conflict is expressed not simply as suppression of approach, but as a structured sequence of behaviors that includes hesitation, risk assessment, and action commitment. Sensitivity to anxiolytic manipulations highlights the translational relevance of these behaviors (McNaughton and Corr ). Importantly, approach‐avoidance conflict is not reducible to threat or reward alone but emerges when competing motivational values must be resolved under uncertainty (Calhoon and Tye ; Tye ). Despite extensive research on the neural circuits underlying threat and reward, it remains unclear how specific cortical and subcortical nodes contribute to the internal organization of behavior during conflict. Medial prefrontal regions, including the prelimbic and infralimbic cortices, regulate defensive expression and its suppression across threat‐learning and avoidance paradigms (Bravo‐Rivera et al. ; Sotres‐Bayon and Quirk ; Vidal‐Gonzalez et al. ), whereas the orbitofrontal cortex supports value‐based action selection when outcomes involve competing costs and benefits (Orsini et al. ). The insular cortex links the interoceptive state to aversive valuation and motivational drive (Gehrlach et al. ), and subcortical structures, such as the basolateral amygdala and nucleus accumbens, play central roles in assigning motivational significance and guiding goal‐directed behavior (Stuber et al. ). In addition, the lateral habenula has been implicated in negative value signaling and aversive bias during decision making under uncertainty (Shabel et al. ). However, much of this literature derives from tasks that isolate threat or reward, leaving unresolved which of these regions are causally required to organize the sequence and coupling of avoidance, risk assessment, and approach that define motivated conflict. Establishing node‐specific necessity, including both positive and negative contributions, is therefore critical for constraining circuit‐level models of conflict behavior (Choi et al. ; Friedman et al. ). To address this issue, we used the step‐down avoidance–mediated conflict (SDAmC) task, a paradigm that dissociates avoidance, risk assessment, and approach within a single behavioral episode and has been previously validated pharmacologically (Illescas‐Huerta et al. ). In SDAmC, rats must decide whether to descend from a safe platform onto a shock‐associated grid to obtain a palatable reward, allowing a direct comparison between conflict and non‐conflict conditions by manipulating motivational state (thirsty or not). This design isolates behavioral components that are genuinely conflict‐dependent rather than reflecting reward seeking or threat memory alone. To establish causal necessity at the regional level, we used pharmacological inactivation, examining its contribution across multiple cortical and subcortical regions implicated in threat, valuation, interoception, and motivation, including the prelimbic and infralimbic cortices, lateral orbitofrontal cortex, anterior and posterior insular cortex, lateral habenula, basolateral amygdala, and nucleus accumbens (Bravo‐Rivera et al. ; Floresco ; Gremel and Costa ; Moorman and Aston‐Jones ; Parkes et al. ; Ramirez‐Lugo et al. ; Stopper and Floresco ; Velazquez‐Hernandez and Sotres‐Bayon ; Wassum and Izquierdo ). By quantifying both the magnitude and the internal organization of behavioral components, we identify a selective subset of regions that exert dissociable control over risk assessment and action selection during conflict. These findings define a constrained functional architecture in which a selective subset of cortico‐limbic hubs organizes behavior when reward seeking occurs under threat.