Klaassen, F. H.; de Voogd, L. D.; Hulsman, A. M.; O'Reilly, J. X.; Klumpers, F.; Figner, B.; Roelofs, K.

Fearful avoidance is a hallmark of anxiety disorders and often comes at a cost. It reduces the probability of threat and of obtaining rewards. Theoretical models predict that threat-induced psychophysiological states, such as freezing-related bradycardia, facilitate arbitration of approach-avoidance decisions. We indeed show that bradycardia states are linked to the neurocomputational underpinnings of approach-avoidance arbitration when facing varying reward and threat magnitudes. Bradycardia was not only linked to aversive value-related avoidance decisions but also to value comparison (a stronger tendency to approach vs. avoid when expected reward outweighs potential threat). An amygdala-striatal-prefrontal neural circuit supported approach-avoidance arbitration under threat, with specific involvement of the amygdala and dorsal anterior cingulate (dACC) in integrating subjective outcome values and bradycardia states. These findings highlight the role of human freezing states in value-based decision-making, relevant for optimal threat coping. They point to a specific role for amygdala/dACC in state-value integration under threat.