Relationship of depression and anxiety to cancer patients' medical decision-making

The purpose of this study was to examine the relation of depression and anxiety to cancer patients' medical decision-making. Participants were 79 rural and urban cancer patients undergoing chemotherapy. The four decisional styles of the Decisional Processing Model were the independent variables. Dependent variables were anxiety and depression, measured by Spielberger's State-Trait Anxiety and the Center for Disease Control Depression Scale, respectively. Consistent with the Decisional Processing Model, analysis suggested that patients make medical decisions by information seeking, information processing, advice following, or ruminating. Decisional style did not vary according to type or stage of cancer, prognosis, time elapsed since initial diagnosis, or whether cancer was initial or recurrent. Decisional style did not systematically vary with depression and anxiety suggesting how a person makes decisions is a stable personality trait. Thus, decision-making may follow a cognitive schema. It is likely that patients' decisional styles help to manage anxiety and depression when confronted with life-threatening illness. Implications for informed consent and patients' involvement in decision-making are discussed.     

Word‐of‐mouth information processing routes: The mediating role of message and source characteristics

This study investigates word‐of‐mouth (WOM) information processing routes from active WOM seeking behaviour. Employing the elaboration likelihood model (ELM), the direct and indirect effects of factors within information processing routes are examined in a credence service context. A deeper exploration of the causal chains of each route was conducted using serial mediation models of message quality and source characteristics. Data were collected in the higher education context from a survey of 509 high school students applying for tertiary study. Findings indicate that active WOM seeking and the serial mediation effects elicit two routes of information processing: central and peripheral. This study is amongst the first to intensively reveal the underlying causal chains of WOM processing and supports the application of ELM theory in WOM research.     

Hybrid route choice model incorporating latent cognitive effects of real-time travel information using physiological data

The proliferation of information systems is enabling drivers to receive en route real-time travel information, often from multiple sources, for making informed routing decisions. A robust understanding of route choice behavior under information provision can be leveraged by traffic operators to design information and its delivery systems for managing network-wide traffic. However, most existing route choice models lack the ability to consider the latent cognitive effects of information on drivers and their implications on route choice decisions. This paper presents a hybrid route choice modeling framework that incorporates the latent cognitive effects of real-time information and the effects of several explanatory variables that can be measured directly (i.e., route characteristics, information characteristics, driver attributes, and situational factors). The latent cognitive effects are estimated by analyzing drivers’ physiological data (i.e., brain electrical activity patterns) measured using an electroencephalogram (EEG). Data was collected for 95 participants in driving simulator experiments designed to elicit realistic route choices using a network-level setup featuring routes with different characteristics (in terms of travel time and driving environment complexity) and dynamic ambient traffic. Averaged EEG band powers in multiple brain regions were used to extract two latent cognitive variables that capture driver’s cognitive effort during and immediately after the information provision, and cognitive inattention before implementing the route choice decision. A Multiple Indicators Multiple Causes model was used to test the effects of several explanatory factors on the latent cognitive variables, and their combined impacts on route choice decisions. The study results highlight the significant effects of driver attributes and information characteristics on latent cognitive effort and of route characteristics on latent cognitive inattention. They also indicate that drivers who are more attentive and exert more cognitive effort are more likely to switch from their current route by complying with the information provided. The study insights can aid traffic operators and information service providers to incorporate human factors and cognitive aspects while devising strategies for designing and disseminating real-time travel information to influence drivers’ route choices.     

Applying the social cognitive model of career self-management to career exploration and decision-making

We present two studies applying the social cognitive model of career self-management (Lent & Brown, 2013) to career exploration and decision-making outcomes in college students. In the first study (N = 180 college students), we developed a new, brief measure of career exploration and decision-making self-efficacy for use in subsequent model testing. The measure yielded two factors, decisional self-efficacy and coping efficacy, with adequate internal consistency reliability estimates. The decisional self-efficacy factor related strongly to an established measure of career decision self-efficacy and produced theory consistent relations with measures of outcome expectations, social support, conscientiousness, exploration goals, prior engagement in career exploration, decisional anxiety, and level of career decidedness. In the second study (N = 215 college students), we re-examined the factor structure of the new self-efficacy measure and used it to assess the tenability of the self-management model in a path analysis predicting exploration goals, decisional anxiety, and career decidedness. The model fit the data well overall, though certain predictors were linked to the criterion variables only indirectly via mediated pathways. Implications of the findings for the social cognitive model as well as for future research and practice are considered.     

The relative importance of patients’ decisional control preferences and experiences

Objective: Patients’ role in treatment decision-making can influence psychosocial and health-related outcomes (i.e. satisfaction, felt respect, adherence). We examined decisional control in a surgical context, identifying correlates of patients’ preferences and experiences.

Design: 380 patients and 7 surgeons were surveyed during initial surgical consultation visits in a low-income outpatient clinic.

Measures: Patients reported preferences for (pre-consultation) and experiences of (post-consultation) decisional control, demographics, satisfaction with care, and adherence to treatment recommendations. Surgeons rated patients’ health status.

Results: Preferences for and experiences of decisional control were unrelated, suggesting significant preference–experience misalignment. However, this misalignment did not appear to be consequential for patient outcomes. Rather, more decisional control, regardless of patients’ preferences, predicted greater satisfaction with care and greater self-reported adherence as assessed at a post-surgical appointment.

Conclusions: Decisional control predicts better outcomes for patients, regardless of their preferences for control over treatment decisions. These findings suggest that interventions should aim to increase patients’ degree of decisional control when feasible and appropriate.     

Ought we to require emotional capacity as part of decisional competence?

The preceding commentary by Louis Charland suggests that traditional cognitive views of decision-making competence err in not taking into account patients' emotional capacities. Examined closely, however, Charland's argument fails to escape the cognitive bias that he condemns. However, there may be stronger arguments for broadening the focus of competence assessment to include emotional capacities, centering on the ways in which emotions aid humans in processing information. Before emotional capacities are added to the list of functions essential for decisional competence, though, the feasibility and utility of such a reorientation must be demonstrated.     

认知风格对大学生不确定条件下判断和决策的影响

通过3个实验,研究了认知风格对大学生不确定条件下判断和决策的影响。结果表明:(1)认知风格影响大学生在不确定条件下的判断和决策,表现在概率推理中,场依存型比场独立型更容易受“代表性启发”影响。在赌徒推理中,场独立型更少受“赌徒谬误”影响。在风险决策中,场独立型倾向选择受益大、风险也大的决策,场依存型倾向选择稳妥、风险较小的决策。(2)大学生在概率推理、赌徒推理和风险决策时存在显著的性别差异。(3)概率知识学习有助于克服“代表性启发”,但对“赌徒谬误”影响不大。     

Information elaboration and team performance: Examining the psychological origins and environmental contingencies

Information elaboration enables functionally diverse teams to transform their breadth of knowledge resources into actionable solutions to complex problems. The current study advances information elaboration theory and research in two ways. First, we identify how team ability and social motivation composition characteristics provide the psychological origins of complex information processing efforts. Second, we identify environmental turbulence as an important boundary condition, clarifying when information elaboration benefits team performance and when it does not. These ideas were tested in a sample of 4-person self-managed teams (N = 68) which were functionally diverse and performed a cooperative strategic decision-making task. Results indicate that cognitive ability equips teams with the “can do” ability for complex elaboration efforts through emergent team mental models, whereas low preferences for self-reliance provide the “will do” motivation for in-depth information exchange through collective leadership. In turn, teams benefited from information elaboration in turbulent but not stable environments.     

Intersection as key locations for bearded capuchin monkeys (<Emphasis Type="Italic">Sapajus libidinosus</Emphasis>) traveling within a route network

There is evidence that wild animals are able to recall key locations and associate them with navigational routes. Studies in primate navigation suggest most species navigate through the route network system, using intersections among routes as locations of decision-making. Recent approaches presume that points of directional change may be key locations where animals decide where to go next. Over four consecutive years, we observed how a wild group of bearded capuchin monkeys used a route network system and Change Point locations (CPs) in the Brazilian ecotone of Cerrado–Caatinga. We built 200 daily routes of one wild bearded capuchin group. We used ArcGIS, the Change Point Test, Spatial Analysis in Macroecology (SAM), and statistical models to test the hypothesis that wild bearded capuchins use CPs located along routes in a different fashion than they use the CPs located at intersections of routes. A logistic regression model was used to determine the landscape variables affecting capuchins’ directional changes at intersections or along routes. CPs at intersections were important points of travel path changes, whereas CPs along routes represented a zig-zag movement along the routes following the landscape features. CPs at intersections were associated with steeper terrains and shorter distances from important resources, along with better visibility of the home range. Our results support the hypothesis that intersections among routes in the route network system are located at points where monkeys have the best visibility available to make decisions on where to visit next.     

认知风格影响框架效应的ERP研究

采用ERP方法,考察了不同认知风格被试在决策过程中的框架效应。分析的脑电成分为N200和P300成分。结果发现：场依存者的反应时显著高于场独立者;场依存者诱发的N200和P300平均波幅均显著低于场独立者;大脑右半球的N200和P300平均波幅均显著高于左半球。这些结果表明,场独立者在决策过程中更具有理性,基本不受决策问题表述方式的影响,且该决策过程主要发生在大脑的右半球。     

Information giving and involvement in treatment decisions: Is more really better? Psychological effects and relation with adherence

Objectives : The aim of this study is to improve our understanding of the ways in which a medical consultation style relates to satisfaction and adherence.

Design : Participants completed questionnaires about preferred and perceived consultation styles; psychological variables such as satisfaction, anxiety and depression; and questions about taking medication. Questionnaires were completed prior to the consultation, immediately after, three months later and one year later. Doctors also completed a scale on completion of the consultation. The decisions in question related to women seeking advice about Hormone Replacement Therapy (HRT) and decisions about pain management.

Results : Patients expressed preferences for information about the treatment options and for active involvement in the decision process. The extent to which patients perceived themselves as having received information about the treatment options was a particularly consistent predictor of satisfaction. The extent to which patients perceived themselves as having been prepared for the side effects of HRT was a consistent predictor of anxiety.

Conclusions : Perceptions of the amount of information received about medical options, including information preparing individuals for potential side effects of medication, appears to be more important to satisfaction and anxiety, than actual involvement in the decision.     

Development of clinical vignettes to assess healthcare decision-making capacity in elderly with mild cognitive impairment and Alzheimer's disease

IntroductionCognitive impairment can constrict healthcare decision-making capacity, as it affects the ability to understand, appreciate, and reason with information, as well as communication abilities. Therefore, decision-making capacity of elders with mild cognitive impairment or Alzheimer's disease should be carefully assessed when patients are asked to make decisions regarding their health. Vignettes are particularly relevant to assess healthcare decision capacity, since they can come close to real life situations and improve statistical reliability of capacity assessment instruments.ObjectiveThis paper describes the construction and development process of three hypothetical vignettes, to be included in a new Portuguese assessment tool of healthcare decision-making capacity (CAI-Health).MethodFor vignettes’ development, examples from other assessment tools were first reviewed to summarize their text length, language complexity and health information contained. Most prevalent causes of mortality and morbidity in Portuguese elders were then identified, in order to select the health issues to include in CAI-Health’ vignettes. Seven vignettes were developed, and three were selected to be included in CAI-Health. After vignette's selection, these were reviewed by three experienced medical experts, during a focus group.ConclusionVignettes final version include cases of increased complexity, presenting situations of mild cognitive impairment, lung tumor and knee arthrosis.     

Group Communication and Decision-Making Performance A Continued Test of the Functional Perspective

The purpose of this investigation was to demonstrate that group decision-making performance is contingent on the effective or ineffective satisfaction of important decisional functions. The investigation involved three related studies. In the first study, an attempt was made to confirm the existence of systematic relationships between the quality of group decisions and the satisfaction of four functional requirements. The results supported the existence of significant positive relationships between group decision-making performance and the satisfaction of these decisional functions. In the second study, an attempt was made to establish the independent main effects of each of those four functions. Using a three-dimensional interaction coding scheme, it was found that variations in group decision quality can be independently accounted for by the quality of interaction in regards to three functions—problem analysis, evaluation of positive qualities, and evaluation of negative qualities. In the third study, an attempt was made to demonstrate that the quality of group decisions can be traced to the effective or ineffective satisfaction of decisional functions. The results provide conclusive evidence (at least at the level of primary reasoning), that the quality of a group's decision is a direct result of the group's ability (or inability) to perform important decisional functions. Taken as a whole, the studies thus offer continued support for the functional perspective.     

广告传播途径与人们对产品确信度的影响

通过三个实验考察了广告传播途径与人们对产品确信度之间的关系。实验一发现,中心传播途径能够增加被试对科技品的确信度,而边缘途径能够增加被试对日用品的确信度;中心途径能够增加场独立被试对产品的确信度,边缘途径能够增加场依存被试对产品的确信度。实验二发现,反自身利益的广告传播更能够增加被试对产品的确信度;实验三发现,间接传播能够增加被试对产品的确信度,产品类型与传播途径及传播途径与被试认知风格之间都存在着交互作用。     

Specific effect of a cognitive-motor dual-task training on sport performance and brain processing associated with decision-making in semi-elite basketball players

ObjectivesIn this study, we aimed at evaluating the effects of cognitive-motor dual-task training (CMDT) on sport-specific athletic performance and cognitive functions of semi-elite basketball players. Further, we investigated the CMDT effects on reactive brain processing by employing event-related potential (ERP) analysis. Design: A randomized controlled trial was conducted including 52 young semi-elite basketball players (28 females mean age 16.3 ± 1.1 years) who were randomly assigned into an experimental (Exp) group executing the CMDT and a control (Con) group performing standard motor training. Method: Athletes’ sport-specific performance was evaluated with dribbling tests before and after a five-week training. Cognitive performance was assessed by measuring speed and accuracy in a discrimination response task. Brain activity associated with sensory processing, selective attention, and decision-making was measured through the P1, N1, and P3 components. The CMDT consisted of simultaneous execution of dribbling exercises and cognitive tasks which were realized using interactive devices located around the athlete on the basket court. Data were submitted to a mixed analysis of variance. Results: Both groups showed some improvements from pre-to post-tests, but the Exp group improved basket-specific performance by 13% more than the Con group; in addition, the cognitive performance also improved more in the Exp group (25.8% in accuracy and 5.4% response speed). According to the EEG results, training did not affect sensory processing and attentional processing which were equally increased after both kinds of training; however, decision-making processes were specifically affected by the experimental training. Conclusions: This study confirmed the effectiveness of the proposed CMDT protocol on both sport-specific and cognitive performance of basketball players and showed that the neural basis of these benefits may be mediated by more intense decisional processing allowing faster connection between sensory encoding and response execution.     

The role of emotion in decision-making: evidence from neurological patients with orbitofrontal damage

Most theories of choice assume that decisions derive from an assessment of the future outcomes of various options and alternatives through some type of cost-benefit analyses. The influence of emotions on decision-making is largely ignored. The studies of decision-making in neurological patients who can no longer process emotional information normally suggest that people make judgments not only by evaluating the consequences and their probability of occurring, but also and even sometimes primarily at a gut or emotional level. Lesions of the ventromedial (which includes the orbitofrontal) sector of the prefrontal cortex interfere with the normal processing of "somatic" or emotional signals, while sparing most basic cognitive functions. Such damage leads to impairments in the decision-making process, which seriously compromise the quality of decisions in daily life. The aim of this paper is to review evidence in support of "The Somatic Marker Hypothesis," which provides a systems-level neuroanatomical and cognitive framework for decision-making and suggests that the process of decision-making depends in many important ways on neural substrates that regulate homeostasis, emotion, and feeling. The implications of this theoretical framework for the normal and abnormal development of the orbitofrontal cortex are also discussed.     

行为决策中诱饵效应的认知加工机制

在原选项集中加入一个诱饵选项能够使人们的选择发生改变, 这就是诱饵效应。研究者发现可以通过设置相似诱饵、妥协诱饵、吸引诱饵以及幽灵诱饵等达到诱导决策者选择目标选项的目的。当前, 很多研究探索了诱饵效应的认知加工机制, 有研究者基于启发式加工和分析式加工的视角开展研究, 也有研究者从维度加工和选项加工的视角对此进行探索。诱饵效应的认知加工过程受到年龄、后悔情绪、决策形式以及时间压力等因素的影响。未来的研究需要构建适用于各类诱饵效应的统一的认知加工机制模型, 探索知觉在诱饵效应形成过程中的基础性作用, 探索个体的决策风格对不同类型诱饵效应的影响, 并通过合理利用诱饵效应助推社会发展。     

Organizational Decision-making in the Appropriation of Technological Innovation: Cognitive and Political Dimensions

Abstract

Outcomes of innovation may depend upon the user's decision processes in its appropriation. The context for the user's decision-making comprises three interdependent elements: (1) the innovation pool; (2) the user; and (3) the supplier of the innovation. User decisions are seen as a series of four interlocking decision episodes. During the first two episodes (agenda formation and selection) the problem is defined and a solution chosen. In the latter two episodes (implementation and usage) the innovation is adopted and used. Appropriation may depend on dual modification of the innovation and organizational practices until the innovation meets the unique requirements of the user. Cognitive and political variables relevant to technological innovation are suggested and explored by drawing upon qualitative comparisons across seven cases of technological innovation in British manufacturing firms. Particular problems occur when users have inadequate knowledge bases, overuse heuristics and analogies, and have conflicting beliefs about the chosen innovation. The extent to which cognitive variables impose on success with the innovation may be mediated by political processes, and may also interact with national culture. Focus is on the processes during the early episodes of agenda formation and selection on the grounds that problems engendered here carry over to implementation.     

Do we make decisions for other people based on our predictions of their preferences? evidence from financial and medical scenarios involving risk

Abstract

The ways in which the decisions we make for others differ from the ones we make for ourselves has received much attention in the literature, although less is known about their relationship to our predictions of the recipient’s preferences. The latter question is of particular importance given real-world occurrences of surrogate decision-making which require surrogates to consider the recipient’s preferences. We conducted three experiments which explore this relationship in the medical and financial domains. Although there were mean discrepancies between surrogate predictions and choices, we identified a predictive relationship between the two. Moreover, when participants took high risks for themselves, it seems that they were not willing to do so for others, even when they believed that the recipient’s preferences were similar to their own. We discuss these findings relative to current theories and real-world instances of surrogate decision-making.     

Group information elaboration and group decision making: The role of shared task representations

Decision making groups often exchange and integrate distributed information to a lesser extent than is desirable for high-quality decisions. We propose that group members’ shared task representations play an important role in this respect, because groups are often insufficiently attuned to the task’s information elaboration requirements. Task representations emphasizing elaboration of decision-relevant information should therefore enhance decision-making performance. This should hold especially when group members realize that they share these task representations, because this realization removes psychological barriers to introducing new insights. Testing these hypotheses, we compared information elaboration and decision-making performance of control groups and groups receiving instructions emphasizing information elaboration in two experiments. Half of the experimental groups were also made to realize that they shared the elaboration instructions. As predicted, groups with task representations emphasizing information elaboration and the realization they shared these representations outperformed groups in the other conditions. This effect was mediated by information elaboration.