Proceedings of the Annual Meeting of the Cognitive Science Society

Approach–avoidance conflict arises when the same option entails both reward and aversive consequences. It is a key mechanism in internalising disorders. However, human paradigms capturing this construct remain limited. We developed a Social Approach–avoidance Conflict task grounded in fear of negative evaluation (SAAC–FNE) and combined it with fMRI in 135 participants. On each trial, participants decided whether to accept a monetary reward at the cost of increasing exposure to more or less exigent judges in a future public speaking evaluation, or to avoid and receive a minimal reward. Higher rewards increased approach, whereas higher judge ranks increased negative affect and avoidance. Higher depression–social anxiety (D–SA) symptoms predicted stronger avoidance of high-rank judges and more negative emotional responses. Neurally, increasing judge rank during approach recruited dmPFC/dACC activity, amplified with higher D–SA. These findings show that internalising symptoms bias decision-making during conflict and its neural substrates.