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Imbalances in approach-avoidance conflict (AAC) decision-making (e.g., sacrificing rewards to avoid negative outcomes) are considered central to multiple psychiatric disorders. We used computational modelling to examine 2 factors that are often not distinguished in descriptive analyses of AAC decision uncertainty and sensitivity to negative outcomes versus rewards (emotional conflict). A previously validated AAC task was completed by 478 participants, including healthy controls ( = 59), people with substance use disorders ( = 159) and p