Doc, what would you do if you were me? On self-other discrepancies in medical decision making

Doctors often make decisions for their patients and predict their patients' preferences and decisions to customize advice to their particular situation. We investigated how doctors make decisions about medical treatments for their patients and themselves and how they predict their patients' decisions. We also studied whether these decisions and predictions coincide with the decisions that the patients make for themselves. We document 3 important findings. First, doctors made more conservative decisions for their patients than for themselves (i.e., they more often selected a safer medical treatment). Second, doctors did so even if they accurately predicted that their patients would want a riskier treatment than the one they selected. Doctors, therefore, showed substantial self-other discrepancies in medical decision making and did not make decisions that accurately reflected their patients' preferences. Finally, patients were not aware of these discrepancies and thought that the decisions their doctors made for themselves would be similar to the decisions they made for their patients. We explain these results in light of 2 current theories of self-other discrepancies in judgment and decision making: the risk-as-feelings hypothesis and the cognitive hypothesis. Our results have important implications for research on expert decision making and for medical practice, and shed some light on the process underlying self-other discrepancies in decision making.     

Affective biasing of choices in gambling task decision making

The proponents of the somatic marker hypothesis presume that rational decision making is guided by emotional reactions that are developed from prior experience. Supporting evidence for the hypothesis comes almost exclusively from the short-term affective reactions that are learned during the course of a hypothetical decision-making task—the gambling task (GT). We examined GT performance and affective reactions to choices when those choices were biased by words that had preexisting affective value. In one experiment, affectively valued words directly signaled good and bad choices. A congruent relation between affective value of word and choice outcome improved GT performance, whereas an incongruent relation greatly interfered with performance. In another experiment, affectively valued words were maintained as a working memory (WM) load between GT choices. A WM load with affectively positive words somewhat improved GT performance, whereas affectively negative words interfered with performance. Somatic markers—indicated by differential anticipatory skin conductance response (SCR ) amplitude for good and bad choices—appeared at a point in the GT session when choice performance was superior. However, differential SCR developed during the session after good choice performance was already established. These results indicate that preexisting affective biases can influence GT decision making. In addition, the somatic markers that are regular accompaniments of GT decision making appeared to be temporally lagging indicators of choice performance. 2006 Psychonomic Society, Inc.     

Emotions within reason: Resolving conflicts in risk preference

This research focused on differential effects of emotional and rational preferences in decision making and how people resolve conflicting risk preferences caused by inconsistency between their emotional reactions to and rational assessment of a risk problem. In addition, effects of the framing of choice outcomes on emotional, rational, and overall risk preferences were examined. Adopting a within-subjects design, Study 1 showed that the emotional choice preference was often the opposite of the rational choice preference and was more risk-seeking than the rational preference. The overall favourability rating for a chosen option was significantly higher when the emotional choice and rational choice were the same than when they were opposed. Emotional preferences were significantly more susceptible than rational preferences to the hedonic tone of risky choice framing. The overall preference was a compromise of the conflicting emotional and rational preferences in some risk domains, and resembled either the emotional preference or the rational preference in other risk domains. Study 2, using a between-subjects manipulation, further confirmed that emotional preference and rational preference had differential effects on risky choice.     

Affiliation and self disclosure in a specific ego threat situation

This study presents findings about affiliative reactions to a specific ego threat in a real life situation. Subjects exposed to a personal and cognitive evaluation were asked about their preference for sharing this experience with others or experiencing it individually. They were compared with subjects offered the same choice in a neutral non-evaluative situation. The actual self disclosure of the subjects was also evaluated. As hypothesized, the subjects in the evaluative condition reacted with higher levels of emotional arousal and preferred isolation rather than affiliation. The hypothesis that emotional arousal due to a specific ego threat would restrict self disclosing behavior was only partly confirmed.     

Probabilistic Inferences Under Emotional Stress: How Arousal Affects Decision Processes

Many models of decision making neglect emotional states that could affect individuals' cognitive processes. The present work explores the effect of emotional stress on people's cognitive processes when making probabilistic inferences. Two contrasting hypotheses are tested against one another: the uncertainty‐reduction and attention‐narrowing hypotheses of how emotional stress affects decision making. In the experimental study, emotional stress was induced through the use of highly aversive pictures immediately before each decision. Emotional state was assessed by both subjective (state anxiety, arousal, and pleasantness ratings) and objective (skin conductance) measures. The results show that emotional stress impacts decision making; in particular, emotionally aroused participants seem to have focused on the most important information and selected simpler decision strategies relative to participants in a control condition. The results are in line with the attention‐narrowing hypothesis and suggest that emotional stress can impact decision making through limited predecisional information search and the selection of simpler decision strategies. Copyright © 2015 John Wiley & Sons, Ltd.     

Emotional processes in risky and multiattribute health decisions

Objective: Here, we develop an integrative account of the roles of emotion in decision-making. In Part I, we illustrate how emotional inputs into decisions may rely on physiological signals from emotions experienced while making the decision, and we review evidence suggesting that the failure to represent the emotional meaning of options can often reduce decision quality. We propose that health-related decrements in the ability to generate emotional reactions lead people to inaccurately represent emotional responses and compromise decisions, particularly about risk. Part II explores complex decisions in which choice options involve trade-offs between positive and negative attributes. We first review evidence showing that difficult trade-off decisions generate negative affect and physiological arousal. Next, we propose that medical decision-making will be linked to short- and long-term stress and health outcomes.

Conclusion: In sum, this article proposes and reviews initial evidence supporting the effective use and management of emotional inputs as important to both clinical and non-clinical populations. Our approach will contribute to the understanding of patient-centred emotional decision-making and will inform medical decision aids.     

The effects of dispositional empathy on emotional reactions and helping: A multidimensional approach

Recent research indicates that an affective state termed empathic emotion, and characterized by feelings of sympathy and compassion for another, is associated with altruistic responding. That is, persons experiencing high levels of empathic emotion offer help to another even when escape from the situation is easy. Persons experiencing high levels of another emotional state—personal distress—help much less when escape from the situation is easy. A study was conducted to test two related hypotheses. The first was that individual differences in empathy can influence empathic emotion and personal distress, above and beyond the influence of situational factors. The second hypothesis was that this effect of individual differences is due to variation in emotional and not cognitive empathy. The results provide support for both hypotheses. Regarding hypothesis 1, a significantly greater proportion of the variance in emotional reactions was accounted for when individual difference factors were included as predictors. Hypothesis 2 was also supported: It was found that a dispositional measure of emotional empathy was clearly related, and a dispositional measure of cognitive empathy was clearly unrelated, to these emotional reactions. The results provide support for a multidimensional view of empathy.     

Limitations to the deficit attenuation hypothesis: Aging and decision making

The deficit attenuation hypothesis is the proposal that age related declines in basic cognitive functions often result in compensatory changes in decision making strategies. However, the patterns of cognitive changes across the adult life span are complex: Many cognitive abilities change across the adult life span while others do not. Some of the cognitive changes will be detrimental to decision making, others will have no impact and still others may actually improve decision making. We illustrate the complexity of the impact of cognition on aging and decision making with examples from working and long-term memory and use these to suggest boundary conditions for the deficit attenuation hypothesis.     

决策中的延迟选择行为

延迟选择(choice deferral)指个体在应该作出选择的时候却决定不作选择,包括推迟选择(如选择延迟选项)或拒绝在可选项中选择一个选项。本文首先探讨了影响延迟选择行为的认知因素和情绪因素;随后讨论了当在决策情景中引入延迟选项时,延迟选项对决策者随后情绪体验和决策行为的影响;最后对未来研究进行了展望。     

Structure Compatibility and Restructuring in Judgment and Choice

The use of different response modes has been found to influence how subjects evaluate pairs of alternatives described by two attributes. It has been suggested that judgments and choices evoke different kinds of cognitive processes, leading to an overweighing of the prominent attribute in choice (Tversky, Sattath, & Slovic, 1988; Fischer & Hawkins, 1993). Four experiments were conducted to compare alternative cognitive explanations of this so-called prominence effect in judgment and choice. The explanations investigated were the structure compatibility hypothesis and the restructuring hypothesis. According to the structure compatibility hypothesis, it was assumed that the prominence effect is due to a lack of compatibility between the required output from subjects and the structure of information in input. The restructuring hypothesis stated that the decision maker uses mental restructuring operations on a representation of decision options to make the options more clearly differentiated. In Experiment 1, a matching procedure was used to provide pairs of equally attractive options (medical treatments) for the following experiments. In Experiments 2, 3, and 4, preferences were elicited with two different response modes, choice and preference rating. Value ranges on the prominent and nonprominent attributes were manipulated to test the structure compatibility hypothesis. Accountability was also subject to manipulation as it was assumed to stimulate restructuring. Since the prominence effect was not restricted to choices, and effects of value ranges were obtained but not of accountability, the results were interpreted in line with the structure compatibility hypothesis.     

When good decisions have bad outcomes: The impact of affect on switching behavior

Four experiments test the hypothesis that an unfavorable outcome of a good decision leads individuals to switch away from that decision due to negative emotional responses to the outcome. Negative emotional reactions led many participants to abandon the option that they recalled as having been more successful overall in the past (Study 1) and which they expected to perform better in the future (Study 2). A prompt to consider the future success rates of the two alternatives did not eliminate switching (Study 2). An experimental manipulation in Study 3 indicated that individuals switch when they focus on their affective reactions rather than beliefs about the earlier disappointing outcome. In Study 4, individuals with a general tendency to focus on cognitions (i.e., those high in need for cognition) were less likely to switch away from the better option following a disappointing outcome. These results suggest that an emotional reaction to a negative outcome can lead people to switch away from the options that they believe are most likely to be successful on the next occasion.     

Affective forecasting and the Big Five

Recent studies on affective forecasting clarify that the emotional reactions people anticipate often differ markedly from those they actually experience in response to affective stimuli and events. However, core personality differences in affective forecasting have received limited attention, despite their potential relevance to choice behavior. In the present study, 226 college undergraduates rated their anticipated and experienced reactions to the emotionally-evocative event of Valentine's Day and completed a measure of the Big Five personality traits - neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness - and their facet scales. Neuroticism and extraversion were associated with baseline mood, experienced emotional reactions, and anticipated emotional reactions. The present findings hold implications for the study of individual differences in affective forecasting, personality theory, and interventions research.     

The dynamics of deferred decision

Decision makers are often unable to choose between the options that they are offered. In these settings they typically defer their decision, that is, delay the decision to a later point in time or avoid the decision altogether. In this paper, we outline eight behavioral findings regarding the causes and consequences of choice deferral that cognitive theories of decision making should be able to capture. We show that these findings can be accounted for by a deferral-based time limit applied to existing sequential sampling models of preferential choice. Our approach to modeling deferral as a time limit in a sequential sampling model also makes a number of novel predictions regarding the interactions between choice probabilities, deferral probabilities, and decision times, and we confirm these predictions in an experiment. Choice deferral is a key feature of everyday decision making, and our paper illustrates how established theoretical approaches can be used to understand the cognitive underpinnings of this important behavioral phenomenon.     

Sensitivity to Affective Information and Investors' Evaluation of Past Performance: An Eye‐tracking Study

In the present work, we used the eye‐tracking methodology to investigate how affective reactions influence investment decision making. In addition, we looked at individual differences in terms of people's sensitivity to affective information and how efficiently they regulate it, that is, trait emotional intelligence. We demonstrated that people who are more sensitive to affective information have larger pupil dilation when looking at the past performance of a stock fund. In addition, we also found that participants' larger pupil dilation had an impact on their investment decisions (whether people were more likely to sell their shares, hold on to the investment, or buy more shares). A larger pupil dilation led people to be more consistent and willing to invest more money on a fund regardless from its past performance (positive or negative). We also tested the hypothesis that individuals with a larger pupil dilation should be more influenced by a fund's past performance (e.g., selling their shares more often when the past performance of the fund was negative and buying additional shares more often when the past performance was positive). However, results did not support this explanation. Finally, our data revealed that the effect of individual differences in trait emotional intelligence on investment decisions was significantly mediated by pupil dilation. In the discussion, we explored the relationship between our results and previous evidence on the role of pupil dilation in processing information under uncertainty and the role of affect in decision making. Copyright © 2015 John Wiley & Sons, Ltd.     

Simultaneous motor demands affect decision making under objective risk

Previous studies on factors influencing decision making focused on the effects of additional cognitive load, stress, psychological disorders, and the process of aging. The potential effects of simultaneously performing motor demands have been neglected, so far. However, previous motor / cognitive dual-task studies provide evidence for both negative as well as facilitating effects of simultaneously performing cognitive and motor tasks. The study at hand, aimed to investigate the effects of decision making under objective risk while performing additional motor demands. Seventy-two participants ranging from 18 to 30 years performed the Game of Dice Task either while sitting or while standing on one leg. Participants were asked to put similar effort on the decision task and the motor demand. The results revealed a significant main effect for “choice”, as well as a significant interaction of “choice”?×?“group”. Participants standing on one leg more frequently selected the most disadvantageous choice (one single number), whereas the “sitting group” most often selected the advantageous combination of four numbers. The findings are discussed under the aspects of executive functions, working memory, stress, somatic markers and the dual-process theory.     

Mate choice decisions: the role of facial beauty

For most people, facial beauty appears to play a prominent role in choosing a mate. Evidence from research on facial attractiveness indicates that physical beauty is a sexually selected trait mediated, in part, by pubertal facial hormone markers that signal important biological information about the displayer. Such signals would be ineffective if they did not elicit appropriate cognitive and/or emotional responses in members of the opposite sex. In this article, I argue that the effectiveness of these hormonal displays varies with perceivers' brains, which have been organized by the degree of steroid hormone exposure in the uterus, and activated by varying levels of circulating steroids following puberty. I further propose that the methodology used for examining mate choice decisions has general applicability for determining how cognitive and emotional evaluations enter into decision processes.     

前瞻性情绪作为社会风险的信息源假说：公共场景下风险决策的情绪及文化机制探讨

本研究从梳理决策的情绪理论入手, 在综合几种主要理论的基础上提出了“前瞻性情绪作为社会风险信息源”的假说。前瞻性情绪是在决策过程中产生的, 由于对决策选择的预期而感受到的, 进而影响决策行为的情绪。社会环境下的风险事件具有突发和稍纵即逝的特征, 如果一个公民对这类风险事件做出反应, 其结果的概率难于量化。在这种情况下, 前瞻性情绪能够为决策者快速提供有关信息, 并形成对决策预期结果严重性和可能性的综合表征, 从而成为公众场景下风险决策的有效线索。不同前瞻性情绪的组合在面对社会性风险事件时具有针对性的作用。近年来在文化比较中对于面子、荣誉和尊严文化的划分, 也为我们研究文化的情绪特征和行为效应提供了理论框架。本研究拟通过四项研究和多个实验探讨前瞻性情绪如何影响公众场景下人们的风险应对行为, 并对三种文化的情绪特征进行比较, 探索情绪性决策中个人因素、群体因素、及文化因素如何共同决定公共场景下风险决策(如亲社会行为或反社会行为)的发生与发展, 同时也期望为公共政策的制定及风险管理提供科学依据。     

Alexithymia tendencies and mere exposure alter social approachability judgments

ABSTRACT People have a fundamental motivation for social connection and social engagement, but how do they decide whom to approach in ambiguous social situations? Subjective feelings often influence such decisions, but people vary in awareness of their feelings. We evaluated two opposing hypotheses based on visual familiarity effects and emotional awareness on social approachability judgments. These hypotheses differ in their interpretation of the familiarity or mere exposure effect with either an affective or cognitive interpretation. The responses of our 128‐student sample supported the cognitive interpretation. Lower emotional awareness or higher alexithymia was associated with higher approachability judgments to familiarized faces and lower approachability judgments to novel faces. These findings were independent of the Big Five personality factors. The results indicate that individual differences in emotional awareness should be integrated into social decision‐making models. The results also suggest that cognitive‐perceptual alterations may underlie the poorer social outcomes associated with alexithymia.     

Structural Model of Coping,Appraisals, and Emotions After Relationship Breakup

The relationship of coping resources and cognitive appraisals to emotions produced by the end of a romantic relationship at 2 separate times was investigated. Participants were 231 graduate students who completed inventories measuring their coping resources, cognitive appraisals, and emotional reactions. The results of the structural model suggested that preventive coping resources affected the appraised desirability of the event as well as initial emotional reactions and that combative coping resources affected subsequent emotional response. The implications of these findings for stress models of emotions and clinical interventions are discussed.     

Relative visual saliency differences induce sizable bias in consumer choice

Consumers often need to make very rapid choices among multiple brands (e.g., at a supermarket shelf) that differ both in their reward value (e.g., taste) and in their visual properties (e.g., color and brightness of the packaging). Since the visual properties of stimuli are known to influence visual attention, and attention is known to influence choices, this gives rise to a potential visual saliency bias in choices. We utilize experimental design from visual neuroscience in three real food choice experiments to measure the size of the visual saliency bias and how it changes with decision speed and cognitive load. Our results show that at rapid decision speeds visual saliency influences choices more than preferences do, that the bias increases with cognitive load, and that it is particularly strong when individuals do not have strong preferences among the options.