Behavioral and neurobiological mechanisms of punishment: implications for psychiatric disorders [2018]

Punishment involves learning about the relationship between behavior and its adverse consequences. Punishment is fundamental to reinforcement learning, decision-making and choice, and is disrupted in psychiatric disorders such as addiction, depression, and psychopathy. However, little is known about the brain mechanisms of punishment and much of what is known is derived from study of superficially similar, but fundamentally distinct, forms of aversive learning such as fear conditioning and avoidance learning. Here we outline the unique conditions that support punishment, the contents of its learning, and its behavioral consequences. We consider evidence implicating GABA and monoamine neurotransmitter systems, as well as corticostriatal, amygdala, and dopamine circuits in punishment. We show how maladaptive punishment processes are implicated in addictions, impulse control disorders, psychopathy, anxiety, and depression and argue that a better understanding of the cellular, circuit, and cognitive mechanisms of punishment will make important contributions to next generation therapeutic approaches.

Punishment involves learning about the relationship between behavior and its adverse consequences. It is used in different ways in the contemporary literature. In addiction neuroscience, punishment serves as a tool for assessing persistent drug-seeking in the face of adverse consequences and as a qualitative marker of a compulsive behavioral phenotype underlying individual differences in development of compulsive seeking. In the decision neurosciences, punishment serves as a tool for assessing the influences of risk on decision-making and as a tool for identifying the brain mechanisms of value and choice. In the clinical literature, sensitivity to punishment is assessed across a variety of disorders, including addiction, depression, psychopathy as well as eating disorders, enabling insights into the etiology, maintenance, and treatment of these conditions. It is unsurprising, then, that there is considerable diversity in how punishment experiments are conducted and interpreted. In this article, we consider key theoretical and methodological complexities of punishment, the design choices available, and the implications of these choices for interpretation. We then review some of the brain bases of punishment and psychiatric disorders with perturbations in punishment processing.

Philip Jean-Richard-Dit-Bressel, Simon Killcross & Gavan P. McNally
Neuropsychopharmacology, Volume 43, 2018