A multimodal approach to understand and improve cognitive decision-making during firefighting

Day-to-day we have to make choices. Even simple decisions involve complex cognitive processes that are still not clearly understood. When it comes to critical decisions which may lead to impactful and irreversible consequences, the understanding of the decision-making process is highly relevant. Dysfunctional coping responses may lead to stress and ultimately to trauma. In the present project, we aim to understand decision-making in the context of firefighting and to study how neurocognitive control and stress management strategies affect decision-making. We present here a functional brain imaging paradigm coupled with biosensors while firefighters play a decision-making task. In this computerized task, the firefighter faces the dilemma of entering or not in a burning house, with variable risk of house collapsing, variable number of victims in danger and variable probability of the victims saving themselves. We present here the preliminary results from a cohort of 13 firefighters, of which none presented clinically significant symptoms of post-traumatic stress disorder. We found brain regions, including the ventromedial and dorsolateral prefrontal cortices and angular gyrus, showing a parametric pattern of activation during the decision phase, i.e. the lower the risk of collapsing, the higher the neural activity in these areas. This suggests that these regions are processing that risk information and signalling the chances of being successful in the rescue phase. We also found that the power in high frequencies of the pulse rate variability of this cohort of firefighters is higher when they decide to enter for the rescue. It is suggestive that deciding not to enter for rescue causes an increase in arousal, which may be related to the expectation about the victims’ outcome (whether they survived or not). Concerning coping strategies, we found that active coping used in personal context was significantly correlated with the age and the years of experience in our sample of firefighters. We aim to understand if this pattern of brain activity reflects the coping strategies and if, in turn, it is reflected in the physiological signals we measure. Concurrently, we are recruiting firefighters with post-traumatic stress disorder and non-firefighters to perform the same task. We will investigate whether the decision processes in firefighters are different from non-firefighters, and we will address if post-traumatic stress disorder impairs decision-making in this context. Biosignals will also be used in a second phase of the project to inform training systems about the physiological state of the firefighter during virtual reality simulation. This may help developing optimal neurocognitive control and better coping strategies to deal with stress.