融合强化学习与反应时模型，揭示抑郁症患者决策参与度下降的神经机制

Major depressive disorder (MDD), a leading cause of disability and mortality, is associated with reward-processing abnormalities and concentration issues. Motivated by the probabilistic reward task from the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study, we propose a novel framework that integrates the reinforcement learning (RL) model and drift-diffusion model (DDM) to jointly analyze reward-based decision-making with response times. To account for emerging evidence suggesting that decision-making may alternate between multiple interleaved strategies, we model latent state switching using a hidden Markov model (HMM). In the ''engaged'' state, decisions follow an RL-DDM, simultaneously capturing reward processing, decision dynamics, and temporal structure. In contrast, in the ''lapsed'' state, decision-making is modeled using a simplified DDM, where specific parameters are fixed to approximate random guessing with equal probability. The proposed method is implemented using a computationally efficient generalized expectation-maximization (EM) algorithm with forward-backward procedures. Through extensive numerical studies, we demonstrate that our proposed method outperforms competing approaches across various reward-generating distributions, under both strategy-switching and non-switching scenarios, as well as in the presence of input perturbations. When applied to the EMBARC study, our framework reveals that MDD patients exhibit lower overall engagement than healthy controls and experience longer decision times when they do engage. Additionally, we show that neuroimaging measures of brain activities are associated with decision-making characteristics in the ''engaged'' state but not in the ''lapsed'' state, providing evidence of brain-behavior association specific to the ''engaged'' state.