Site-Dependent Patterns of Affective Interference Control and Inhibitory Braking Following Auricular Stimulation

Auricular neuromodulation specificity remains debated, particularly for electrical approaches in which current spread may obscure site‐specific effects. We tested whether focal mechanical auricular acupressure produces site‐by‐pathway differences across Hot affective interference control and Cold inhibitory braking. In a single‐blind, randomized, active‐controlled study, 55 young adults with elevated affective symptoms received 48‐h auricular acupressure at Shenmen, Subcortex, Combined (Shenmen + Subcortex), or an active Shoulder control site. Participants completed an Emotional Flanker task indexing Hot control and an Emotional Go/No‐Go task indexing Cold control. Standardized change scores were analyzed using linear mixed‐effects models, with hierarchical drift diffusion modeling and signal detection theory analyses used to constrain mechanistic interpretation. A significant Group × Pathway interaction was observed (p = 0.002). In the Cold pathway, Subcortex and Combined stimulation showed greater improvement than Shenmen stimulation. In the Hot pathway, Shenmen stimulation showed greater improvement than Subcortex stimulation, whereas Hot‐pathway contrasts against the active control were non‐significant. Focal auricular acupressure produced pathway‐selective, site‐dependent profiles across Hot and Cold executive‐control tasks. These findings suggest relative site‐by‐pathway specificity, although further studies with larger samples and optimized control conditions are needed to confirm the robustness and mechanisms of this effect.