LAUSR

Significance Insensitivity to the adverse consequences of our actions drives problematic behaviors such as those observed in substance use disorders, conduct disorder, and antisocial personality disorder. Two pathways have been proposed for this insensitivity: a motivational pathway based on differences in reward valuation and a behavioral pathway based on autonomous stimulus–response mechanisms. Here, we identify a third, cognitive pathway based on differences in awareness of the adverse consequences of one’s actions. We show that when the costs of actions are rare, learning via experience and information does not always yield veridical causal knowledge or optimum decision-making, causing some individuals to continually incur punishments that they neither like nor want.