[Research](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379460/): ([PDF](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379460/pdf/fnins-13-00065.pdf)) "*A reward-based framework of perceived control*" (2019) *\[Stuttering has been associated with a sensation of loss of* ***perceived control*** *i.e., an anticipated error viewed as a problem to be avoided.\]* **Perceived control**, defined as the belief in one's ability to exert control over situations or events, is intricately linked to dopamine neurotransmission within corticostriatal pathways in a reward-based framework. Choice opportunity, intrinsic to perceived control, activates corticostriatal regions in response to anticipation, suggesting inherent appetitive motivation value mediated by dopamine projections to the striatum, particularly the nucleus accumbens. This activation is associated with the preference for choice over no-choice situations, regardless of the effort required. Choice opportunity may bias instrumental action-selection via input from the striatum, which is the main candidate to integrate motivational and affective value with instrumental actions. Actual control relates to instrumental contingency, emphasizing learned relationships between actions and outcomes. The intricate interplay between corticostriatal circuits, dopaminergic prediction error signals, and instrumental actions contributes to context-specific perceived control and decision-making. Generalization processes stemming from past experiences of controllability can shape abstract beliefs about control, influencing behavior in new situations. Effort-based decision-making: Computational accounts have explained these effects by relating the role of tonic dopamine levels to vigor versus sloth behavior and cost-benefit analyses (Niv et al., 2007; Phillips et al., 2007). Although it has often been suggested that tonic and phasic dopamine are mediated by distinct mechanisms (Floresco et al., 2003; Bromberg-Martin et al., 2010), recent data demonstrated that phasic dopamine could trigger secondary events that increase tonic activation of dopamine levels (Lohani et al., 2018). Phasic dopamine signaling associated with higher reward expectancies or action values in context-specific perceived control could influence general perceived control reflected by changes in tonic dopamine levels. Transient changes in tonic dopamine levels could contribute to learning given its association with alertness and motivational drive (Schultz et al., 1997; Niv et al., 2007). Regardless of whether average reward rate or reward prevalence might be a better account for perceived control, outcome-based aspects could constitute an important element contributing to perceived control. One potential caveat of outcome-related processes in perceived control is revealed via contingency judgment tasks where the probabilities of an outcome and the probability of responding may create an ‘illusion of control.’ An illusion of control reflects the subjective judgment that an action-outcome causal relation exists when in fact there is no contingency. When probabilities of reward and action are high, the probability that both coincide is also high, hence affecting estimations of action-outcome causal relationships, which could contribute to the false belief that one has control. Deficits related to affect and motivation could play an important role in this loss of control. *\[Stuttering has been associated with an approach-avoidance "motivational" system.\]* This symptom has been linked to reduced reward sensitivity, reduced dopamine transmission, and structural and functional abnormalities including reduced gray matter volume and diminished reward signals in the striatum. Cognitive distortions have been associated with the recruitment of the reward circuitry. Reductions in reward processing could result from prolonged stress and behavioral dysfunctions leading to reductions in perceived control. Increased striatal activation and volume in relation to anxiety could be associated with increased vigilance for threat or an intolerance for uncertainty. This might explain a fear of losing control as well as subsequent maladaptive forms of control-seeking behavior, such as avoidance and compulsive behavior \[and compensatory behavior\].