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.     

Scrutinizing the Emotional Nature of Intuitive Coherence Judgments

Dual‐system models propose that cognitive processing can occur either intuitively or deliberately. Unlike deliberate decision strategies, intuitive ones are assumed to have an emotional component attached to the decision process. We tested if intuitive decisions are indeed accompanied by an emotional response while deliberate decisions are not. Specifically, we conducted a psychophysiological study in which participants were instructed to decide either intuitively or deliberately if three simultaneously presented words were semantically coherent or incoherent (triad task). The degree of emotionality of these two decision strategies (intuitive vs. deliberate) was compared using changes in electrodermal activity (EDA) and the reaction time (RT) effect of an affective priming paradigm as primary measurements. Based on a valence‐arousal model, our results revealed that intuitive and deliberate judgments do not differ as to their emotional valence but that they do differ in emotional arousal. Most notably, sympathetic activation during intuitive judgments was significantly lower compared to sympathetic activation during deliberate judgments. Our results reflect that a relaxed state of mind—manifested in low sympathetic activity—could underlie the holistic processing that is assumed to facilitate the proliferation of semantic associations during coherence judgments. This suggests that coherence judgments made under an (instructed) intuitive decision mode have a specific psychophysiological signature and that arousal is the differentiating component between intuitive and deliberate decision strategies. © 2016 The Authors Journal of Behavioral Decision Making Published by John Wiley & Sons Ltd.     

‘If something doesn’t look right,go find out why’: how intuitive decision making is accomplished in police first-response

ABSTRACT

Intuition is an important mechanism by which organizational actors make significant decisions; however, precisely how intuitive decisions are taken is not well understood and hence is worthy of closer scrutiny. First-response decisions, because of the conditions under which they are executed, offer researchers an interesting and relevant context for the study of intuitive decision making in organizations. We used qualitative methods to explore how “peak performing” police officers used intuition in first-response decisions. Our findings show that intuition’s role in first-response occurs in two differing but complementary ways: “recognition-based intuition” and “intuition-based inquiry”. This finding builds on previous intuition research and informs current debates in behavioural sciences regarding “default-intervention” versus “parallel-competitive” variants of dual-process theory; it also reveals how a complex and situated mix of intuition and analysis can guide effective decision making and support peak performance in uncertain, dynamic and complex environments that typify many organizational decision processes. Our findings contribute to intuition research by extending the current theory of “intuition-as-expertise” in going beyond a simple “recognize-and-respond” model. We propose a “Perceiving-Knowing-Enacting-Closing” framework which captures the complex role that intuition in combination with analysis plays in police first-response decisions, and discuss implications for decision-making policies and practices in organizations.     

Should I Drive Today? Development of a daily driving decisions model for older adults

BackgroundOlder adults in communities make daily decisions about how to meet their transportation needs so they can access services and stay socially connected. With the aging of populations in developed countries, the travel decisions of older adults will have increasing impacts. Research studies have identified different sets of factors that contribute to certain travel decisions, but little research has been directed towards understanding how individuals select information from all available factors, what information they include in their decisions under different circumstances, and the processes they use in making their transportation decisions.MethodsThis exploratory study involved 20 men and 17 women, mean age 78.6 years (range 70–96), who drove weekly. All participants were involved in each phase of the 3-phase study. In Phase 1, a review of the literature and interviews with the participants was used to collect information, and inductive thematic analysis was employed to construct a draft conceptual model of older driver decision-making. In Phase 2, participants completed a stated preference task of written scenarios to demonstrate their decision-making strategies. Results were tabulated and used to refine a final Daily Driving Decisions model. In Phase 3, a card sorting decision task was used to test the model with participants.ResultsThe final dynamic Daily Driving Decisions Model was confirmed to describe decision processes used by the participants in making decisions about how they would meet their transportation needs. The model describes three categories of factors used in decisions, labelled Motivators, Constraint/Enablers and Context, each containing four attribute themes. A significant finding was the variable use of the same item to either constrain or enable the decision to drive depending on the variation of other factors in the scenario. Participants demonstrated use of compensatory and noncompensatory (heuristic, habitual) decision processes that were accommodated by the model.ConclusionThe proposed Daily Driving Decisions Model addresses a gap in our understanding of how older drivers make their decisions about meeting their transportation needs. The model presents a template for classifying the types of information used, ignored or discarded by older adults, and the pathways that they take to arrive at their decisions. The model provides opportunities for further research in testing the influence of other factors such as urban/rural residence, income, health status and culture on driving decisions. Further, the model can be used by practitioners to gain insight into the decision-making behaviours of individuals and to develop interventions to enhance their decision-making skills.     

Acceptance,well-being and goals in adolescents with chronic illness: a daily process analysis

Objective: The main aim of this study was to investigate the relationship between acceptance and well-being in adolescents with chronic illness from a daily process perspective. Furthermore, we explored the role of daily experienced interference and facilitation of life goals by treatment goals as mediating mechanisms.

Methods: Thirty-eight adolescents with cystic fibrosis (CF) or diabetes completed questionnaires assessing acceptance, negative life events and goal-related self-efficacy. Furthermore, an online diary assessing daily mood, daily experienced interference and facilitation of life goals by treatment goals was completed during three consecutive weeks.

Results: Acceptance of illness was positively related to daily well-being, but unrelated to daily goal interference and facilitation. Furthermore, daily goal interference and facilitation were unrelated to same-day and next-day well-being.

Conclusion: This study suggests that acceptance of illness plays an important role in the daily mood of adolescents with CF and diabetes. This relationship, however, was not mediated by daily experienced interference and facilitation of life goals by treatment goals. Further research is needed to determine whether interventions promoting acceptance are beneficial for adolescents with CF and diabetes.     

Distinguishing between level and impact of rumination as predictors of depressive symptoms: An experience sampling study

Rumination—repetitively thinking about one's emotional state, its causes and consequences—exacerbates negative mood and plays an important role in the aetiology and maintenance of depression. Yet, it is unclear whether increased vulnerability to depression is associated with simply how much a person ruminates, or the short-term impact rumination has on a person's negative mood. In the current study, we distinguish between the level versus the impact of rumination, and we examine how each uniquely predicts changes in depressive symptoms over time in an undergraduate sample. Using experience sampling, we assessed students’ (N = 101) subjective experiences of positive and negative affect and their use of rumination and distraction in daily life for seven days. Participants also reported their depressive symptoms before and after the experience sampling. Increases in depressive symptoms over the week were predicted by how much people ruminated, but not by its impact on negative mood.     

Intuitive physics and cognitive algebra: A review

IntroductionIntuitive physics explores how people without a formal instruction in physics intuitively understand physical phenomena. After a general overview of the topics of current research in intuitive physics and a discussion of current debates, this paper provides an introduction to Information Integration Theory (IIT).ObjectiveBy means of examples, it is shown how IIT can be used to directly compare the algebraic structure of physical laws and the algebraic structure of cognitive representations of these laws.MethodThe review considers about 40 years of research on the application of IIT in the field of intuitive physics. Occasionally, reference is also made to intuitive physics studies outside this theoretical framework.ResultsThe reviewed studies highlight four main factors that affect the degree of consistency between physical laws and cognitive algebraic laws: the participants’ age, their familiarity with the event under study, the type of task, and possible learning processes.ConclusionThe last part of the article discusses the implications of the results of the reviewed studies for the two main current hypotheses on the nature of intuitive physics, namely, that intuitive physics may be based on sub-optimal heuristics or may be based on the internalization of physical laws.     

Mustering motivation to enact decisions: how decision process characteristics influence goal realization

Decision scientists tend to focus mainly on decision antecedents, studying how people make decisions. Action psychologists, in contrast, study post‐decision issues, investigating how decisions, once formed, are maintained, protected, and enacted. Through the research presented here, we seek to bridge these two disciplines, proposing that the process by which decisions are reached motivates subsequent pursuit and benefits eventual realization. We identify three characteristics of the decision process (DP) as having motivation‐mustering potential: DP effort investment, DP importance, and DP confidence. Through two field studies tracking participants' decision processes, pursuit and realization, we find that after controlling for the influence of the motivational mechanisms of goal intention and implementation intention, the three decision process characteristics significantly influence the successful enactment of the chosen decision directly. The the oretical and practical implications of these findings are considered and future research opportunities are identified. Copyright © 2002 John Wiley & Sons, Ltd.     

Relationship tensions and mood: Adult children's daily experience of aging parents' stubbornness

This study examined middle‐aged individuals' reports of parents' behaviors commonly attributed to stubbornness. Middle‐aged adults (N = 192) completed a 7‐day diary reporting their mood and how often they felt their parents (N = 254) engaged in behaviors often described as “stubbornness” (insistent or risky). Thirty‐one percent of middle‐aged children reported insistent behaviors, and 17% reported risky behaviors by their parent(s). Daily reports of parent behaviors attributed to stubbornness were positively associated with parent–child relationship quality, parent functional limitations, and child neuroticism. Reports of perceived parent insistent behaviors were also associated with greater daily negative mood among adult children. Findings highlight the impact of adult children's daily perceptions of parent behaviors commonly attributed to stubbornness on the individual and relationship.     

Much ado about nothing: The zero effect in life‐saving decisions

Zero is a special value in our daily lives, and previous research on how zero values affect decision making leaves many questions to be explored. The present research examined the zero effect in life‐saving decisions and found that people expressed strong preferences for options offering a possibility that no one will die, even when the expected loss was relatively high. The prominence effect (the notion that the option with possibly zero deaths is easy to defend and justify) was proposed as one possible explanation. Furthermore, we also found that the zero effect in these life‐saving decisions occurs only in loss framing rather than gain framing. We discuss the relationships between the zero effect, framing, and evaluation mode in life saving and other domains.     

Do the right thing: The assumption of optimality in lay decision theory and causal judgment

Human decision-making is often characterized as irrational and suboptimal. Here we ask whether people nonetheless assume optimal choices from other decision-makers: Are people intuitive classical economists? In seven experiments, we show that an agent’s perceived optimality in choice affects attributions of responsibility and causation for the outcomes of their actions. We use this paradigm to examine several issues in lay decision theory, including how responsibility judgments depend on the efficacy of the agent’s actual and counterfactual choices (Experiments 1–3), individual differences in responsibility assignment strategies (Experiment 4), and how people conceptualize decisions involving trade-offs among multiple goals (Experiments 5–6). We also find similar results using everyday decision problems (Experiment 7). Taken together, these experiments show that attributions of responsibility depend not only on what decision-makers do, but also on the quality of the options they choose not to take.     

Processes of patient decision making: Theoretical and methodological issues

Abstract

There is a paucity of research studying patients' decision making processes. Traditional normative approaches investigating human decision have presented rational, analytic processing as a ‘gold standard’ for decision making with decision aids developed to facilitate such thinking. This paradigm has been challenged by the recent emergence of naturalistic decision making. Naturalistic approaches argue for techniques modelled closer to how decisions are actually made in ‘real life’. Early work in this evolving field suggests the importance of more automatic, intuitive processing such as the use of heuristic short-cuts. This paper discusses the contribution of naturalistic decision theory and assesses its usefulness as an alternative to classical decision approaches in investigating patient decision making. Approaches for measuring underlying cognitive processes are also critically discussed.     

The effect of rebranding generic medicines on drug efficacy and side effects

Objectives: Subjective age is an important correlate of health, well-being, and longevity. So far, little is known about short-term variability in subjective age and the circumstances under which individuals feel younger/older in daily life. This study examined whether (a) older adults’ felt age fluctuates on a day-to-day basis, (b) daily changes in health, stressors, and affect explain fluctuations in felt age, and (c) the daily associations between felt age and health, stressors, or affect are time-ordered.

Method: Using an eight-day daily diary approach, N = 43 adults (60–96 years, M = 74.65, SD = 8.19) filled out daily questionnaires assessing subjective age, health, daily stressors, and affect. Data were analysed using multilevel modelling.

Main outcome measures: Subjective age, health, daily stressors, affect.

Results: Intra-individual variability in felt age was not explained by time but by short-term variability in other variables. Specifically, on days when participants experienced more than average health problems, stress, or negative affect they felt older than on days with average health, stress, or negative affect. No time-ordered effects were found.

Conclusion: Bad health, many stressors, and negative affective experiences constitute circumstances under which older adults feel older than they typically do. Thus, daily measures of subjective age could be markers of health and well-being.     

Variations in decision-making profiles by age and gender: A cluster-analytic approach

Using cluster-analysis, we investigated whether rational, intuitive, spontaneous, dependent, and avoidant styles of decision making (Scott & Bruce, 1995) combined to form distinct decision-making profiles that differed by age and gender. Self-report survey data were collected from 1075 members of RAND’s American Life Panel (56.2% female, 18–93 years, M_age = 53.49). Three decision-making profiles were identified: affective/experiential, independent/self-controlled, and an interpersonally-oriented dependent profile. Older people were less likely to be in the affective/experiential profile and more likely to be in the independent/self-controlled profile. Women were less likely to be in the affective/experiential profile and more likely to be in the interpersonally-oriented dependent profile. Interpersonally-oriented profiles are discussed as an overlooked but important dimension of how people make important decisions.     

Postsurgical physical activity and fatigue-related daily interference in women with non-metastatic breast cancer

Purpose: Women undergoing surgery for breast cancer experience side effects, such as fatigue, reduced quality of life (QOL) and depression. Physical activity (PA) is associated with improved psychological adjustment during treatment and survivorship, yet little is known about how PA relates to fatigue, depression and QOL in the period following surgery for breast cancer. The purpose of the study was to examine the relationships between these constructs in women who recently underwent surgery for breast cancer.

Methods: At 2–10 weeks post-surgery, 240 women with non-metastatic breast cancer reported intensity and duration of moderate and vigorous PA (MVPA), fatigue (intensity and interference), depressed mood, clinician-rated depression and functional QOL.

Results: In the path analysis models tested, women that reported greater weekly MVPA reported less fatigue interference, greater functional QOL, less depressed mood, and lower clinician-rated depression. Tests of indirect effects suggested that fatigue interference may be an intermediate pathway by which MVPA relates to functional QOL, clinician-rated depression and depressed mood.

Conclusion: Women who are more physically active in the months after breast cancer surgery show greater psychological adaptation in the initial phases of their treatment.     

The Effect of Intuitive Advice Justification on Advice Taking

How do you respond when receiving advice from somebody with the argumentation “my gut tells me so” or “this is what my intuition says”? Most likely, you would find this justification insufficient and disregard the advice. Are there also situations where people do appreciate such intuitive advice and change their opinion accordingly? A growing number of authors write about the power of intuition in solving problems, showing that intuitively made decisions can be of higher quality than decisions based on analytical reasoning. We want to know if decision makers, when receiving advice based on an intuitive cognitive process, also recognize the value of such advice. Is advice justified by intuition necessarily followed to a lesser extent than an advice justified by analysis? Furthermore, what are the important factors influencing the effect of intuitive justification on advice taking? Participants across three studies show that utilization of intuitive advice varies depending on advisor seniority and type of task for which the advice is given. Summarizing, the results suggest that decision makers a priori doubt the value of intuitive advice and only assess it as accurate if other cues in the advice setting corroborate this. Intuitively justified advice is utilized more if it comes from a senior advisor. In decision tasks with experiential products, intuitively justified advice can even have more impact than analytically justified advice. Copyright © 2013 John Wiley & Sons, Ltd.     

Teaching a rational approach to career decision making: Who benefits most?

Who benefits most from rational decision-making training? Rational, intuitive, fatalistic, and dependent decision makers were compared on how much they learned from a rational decision-making training intervention. A Decision-Making Questionnaire was administered to 255 community college students to determine which style each used predominantly in three past career-related decisions. Subjects were randomly assigned to instruction in rational decision making or to a placebo intervention and later completed the Career Decision-Making Skills Assessment Exercise, a paper and pencil test on the application of rational decision-making principles. Individuals who had been highly impulsive, dependent, or fatalistic in prior course selections and those who exhibited dependency in prior job choices appeared to learn most from the rational training curriculum. Implications for when rational decision-making training should be prescribed are discussed.     

Fitting decisions: Mood and intuitive versus deliberative decision strategies

We investigated the influence of the compatibility between mood and decision strategies on the subjective value of a decision outcome. Several studies have provided evidence for the idea that a sad mood induces people to analyse information carefully, probably fitting well with a deliberative decision strategy. In a happy mood, people tend to act more strongly on their feelings, probably fitting well with an intuitive decision strategy. However, sometimes the situation demands the use of decision strategies that seem incompatible with mood states. We expected that decision makers would value a decision outcome higher in the case of a fit between mood and decision strategy than in the case of a non-fit. After a mood manipulation, participants were instructed to decide either based on their first affective reaction or after deliberation. Results confirmed our expectations: fitting decisions enhanced the subjective value of a decision outcome.