Recent findings show that preferences for food items can be modified without external reinforcements using the cue-approach task. In the task, the mere association of food item images with a neutral auditory cue and a speeded button press, resulted in enhanced preferences for the associated stimuli. In a series of 10 independent samples with a total of 255 participants, we show for the first time that using this non-reinforced method we can enhance preferences for faces, fractals and affective images, as well as snack foods, using auditory, visual and even aversive cues. This change was highly durable in follow-up sessions performed one to six months after training. Preferences were successfully enhanced for all conditions, except for negative valence items. These findings promote our understanding of nonreinforced change, suggest a boundary condition for the effect and lay the foundation for development of novel applications.Behavioral change is an essential tool to improve health and quality of life, from treating addictions to eating and mood disorders [1][2][3] . Scientific research on behavioral change mainly focused on the effects of external reinforcements 2,4-7 or altering the presentation of the decision problem [8][9][10] . Recently, the cue-approach training (CAT) 11 paradigm was introduced as a successful method for enhancing preferences for food items, without external reinforcement, context change or self-control. Here, we test multiple hypotheses that are aimed to shed light on this mechanism by studying its generalizability to multiple stimuli and cues, as well as the long-term durability of the effect. In the cue-approach task, participants initially indicated their preferences for a set of snack-food items by specifying their willingness to pay for each item in an auction procedure. Then, in the CAT, some of the items were consistently associated with a neutral auditory cue and a speeded button press response (these stimuli were termed 'Go items'), whereas other stimuli were presented without a cue ('No-Go items'). In the following probe phase, participants were asked to choose a snack they would like to eat at the end of the experiment. Each probe-choice comprised of a pair of items with similar initial values, in which only one of the two snacks was a Go item. Results showed that the mere association of snack-food images with a neutral auditory cue and a speeded button press, resulted in enhanced preferences for Go items over No-Go items. This preference change effect varied across different value categories -resulting in enhanced preferences for snack-food items of initial high-value, yet significantly less prominent change in preferences for low-value items. The effect was maintained two-months following training 11 . Additional studies with the cue-approach task 12 found that for the behavioral change to take place, CAT required the presence of both a speeded button press response and a cue; i.e. CAT had no effect when training was conducted with an early cue onset which was followed with ...

Behavioral change studies and interventions focus on self-control and external reinforcements to influence preferences. Cue-approach training (CAT) has been shown to induce preference changes lasting months by merely associating items with neutral cues and speeded responses. We utilized this paradigm to study neural representation of preferences and their modification without external reinforcements. We scanned 36 participants with fMRI during a novel passive viewing task before, after and 30 days following CAT. We preregistered the predictions that activity in memory, top-down attention, and value-processing regions will underlie preference modification. While most theories associate preferences with prefrontal regions, we found that “bottom-up” perceptual mechanisms were associated with immediate change, whereas reduced “top-down” parietal activity was related to long-term change. Activity in value-related prefrontal regions was enhanced immediately after CAT for trained items and 1 month after for all items. Our findings suggest a novel neural mechanism of preference representation and modification. We suggest that nonreinforced change of preferences occurs initially in perceptual representation of items, putatively leading to long-term changes in “top-down” processes. These findings offer implementation of bottom-up instead of top-down targeted interventions for long-lasting behavioral change.

Developing effective preference modification paradigms is crucial to improve the quality of life in a wide range of behaviors. The cue-approach training (CAT) paradigm has been introduced as an effective tool to modify preferences lasting months, without external reinforcements, using the mere association of images with a cue and a speeded button response. In the current work for the first time, we used fMRI with faces as stimuli in the CAT paradigm, focusing on face-selective brain regions. We found a behavioral change effect of CAT with faces immediately and 1-month after training, however face-selective regions were not indicative of behavioral change and thus preference change is less likely to rely on face processing brain regions.Nevertheless, we found that during training, fMRI activations in the ventral striatum were correlated with individual preference change. We also found a correlation between preference change and activations in the ventromedial prefrontal cortex during the binary choice phase. Functional connectivity among striatum, prefrontal regions, and high-level visual regions was also related to individual preference change. Our work sheds new light on the involvement of neural mechanisms in the process of valuation. This could lead to development of novel real-world interventions.

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It is commonly assumed that memories contribute to value-based decisions. Nevertheless, most theories of value-based decision-making do not account for memory influences on choice. Recently, new interest has emerged in the interactions between these two fundamental processes, mainly using reinforcement-based paradigms. Here, we aimed to study the role memory processes play in preference change following the nonreinforced cue-approach training (CAT) paradigm. In CAT, the mere association of cued items with a speeded motor response influences choices. Previous studies with this paradigm showed that a single training session induces a long-lasting effect of enhanced preferences for high-value trained stimuli, that is maintained for several months. We hypothesized that CAT increases memory of trained items, leading to enhanced accessibility of their positive associative memories and in turn to preference changes. In two preregistered experiments, we found evidence that memory is enhanced for trained items and that better memory is correlated with enhanced preferences at the individual item level, both immediately and 1 mo following CAT. Our findings suggest that memory plays a central role in value-based decision-making following CAT, even in the absence of external reinforcements. These findings contribute to new theories relating memory and value-based decision-making and set the groundwork for the implementation of novel nonreinforced behavioral interventions that lead to long-lasting behavioral change.