Watching diagnoses develop: Eye movements reveal symptom processing during diagnostic reasoning

Finding a probable explanation for observed symptoms is a highly complex task that draws on information retrieval from memory. Recent research suggests that observed symptoms are interpreted in a way that maximizes coherence for a single likely explanation. This becomes particularly clear if symptom sequences support more than one explanation. However, there are no existing process data available that allow coherence maximization to be traced in ambiguous diagnostic situations, where critical information has to be retrieved from memory. In this experiment, we applied memory indexing, an eye-tracking method that affords rich time-course information concerning memory-based cognitive processing during higher order thinking, to reveal symptom processing and the preferred interpretation of symptom sequences. Participants first learned information about causes and symptoms presented in spatial frames. Gaze allocation to emptied spatial frames during symptom processing and during the diagnostic response reflected the subjective status of hypotheses held in memory and the preferred interpretation of ambiguous symptoms. Memory indexing traced how the diagnostic decision developed and revealed instances of hypothesis change and biases in symptom processing. Memory indexing thus provided direct online evidence for coherence maximization in processing ambiguous information.     

Memory indexing of sequential symptom processing in diagnostic reasoning

In diagnostic reasoning, knowledge about symptoms and their likely causes is retrieved to generate and update diagnostic hypotheses in memory. By letting participants learn about causes and symptoms in a spatial array, we could apply eye tracking during diagnostic reasoning to trace the activation level of hypotheses across a sequence of symptoms and to evaluate process models of diagnostic reasoning directly. Gaze allocation on former locations of symptom classes and possible causes reflected the diagnostic value of initial symptoms, the set of contending hypotheses, consistency checking, biased symptom processing in favor of the leading hypothesis, symptom rehearsal, and hypothesis change. Gaze behavior mapped the reasoning process and was not dominated by auditorily presented symptoms. Thus, memory indexing proved applicable for studying reasoning tasks involving linguistic input. Looking at nothing revealed memory activation because of a close link between conceptual and motor representations and was stable even after one week.     

Lexical ambiguity, semantic context, and visual word recognition.

Some alternative hypotheses about the recognition of ambiguous words are considered. According to the selective-access hypothesis, prior semantic context biases people to access one meaning of an ambiguous word rather than another in lexical memory during recognition. In contrast, the nonselectiveaccess hypothesis states that all meanings of the word are accessed regardless of the context. We tested certain versions of these hypotheses by having students decide whether selected strings of letters were English words. The stimuli included test sequnces of three words in which the second word had two distinct possible meanings, whereas the first and third words were related to these meanings in various ways. When the first and third words were related to the same meaning of the ambiguous second word (e.g., SAVE-BANK-MONEY), the reaction time to recognize the third word decreased. But when the first and third words were related to different meanings of the second word (e.g., RIVER-BANK-MONEY), the reaction time for the third word was not reliably different from a control sequence with unrelated words. These and other data favor the selective-access hypothesis. Selective access to lexical memory is discussed in relation to models of word recognition.     

Secondary-task effects on sequence learning

With a repeated sequence of stimuli, performance in a serial reaction-time task improves more than with a random sequence. The difference has been taken as a measure of implicit sequence learning. Implicit sequence learning is impaired when a secondary task is added to the serial RT task. In the first experiment, secondary-task effects on different types of sequences were studied to test the hypothesis that the learning of unique sequences (where each sequence element has a unique relation to the following one) is not impaired by the secondary task, while the learning of ambiguous sequences is. The sequences were random up to a certain order of sequential dependencies, where they became deterministic. Contrary to the hypothesis, secondary-task effects on the learning of unique sequences were as strong or stronger than such effects on the learning of ambiguous sequences. In the second experiment a hybrid sequence (with unique as well as ambiguous transitions) was used with different secondary tasks. A visuo-spatial and a verbal memory task did not interfere with the learning of the sequence, but interference was observed with an auditory go/no-go task in which high- and low-pitched tones were presented after each manual response and a foot pedal had to be pressed in response to high-pitched tones. Thus, interference seems to be specific to certain secondary tasks and may be related to memory processes (but most likely not to visuo-spatial and verbal memory) or to the organization of sequences, consistent with previous suggestions.     

Selective attention to threat in the dot probe paradigm: differentiating vigilance and difficulty to disengage

The dot probe task [J Abnorm Psychol 95 (1986) 15] is an often-used paradigm to investigate selective attention to threat. A facilitated response to probes that appear at the same location of threat information in comparison with responses to probes at the opposite location of threat information is interpreted as vigilance for threat. We argue that the findings in the dot probe paradigm are ambiguous evidence for the vigilance to threat hypothesis. Results can also be interpreted as a difficulty to disengage from threat. In this study, 44 undergraduates performed a pictorial version of the probe detection task. Taking into account the reaction times on neutral trials, we found no evidence for a facilitated detection of threatening information. It was found that the dot probe effects are at least partially due to disengagement effects. The implications of these results for the understanding of attentional bias in normal and anxious individuals are discussed.     

Concurrent guidance of attention by multiple working memory items: Behavioral and computational evidence

During visual search, task-relevant representations in visual working memory (VWM), known as attentional templates, are assumed to guide attention. A current debate concerns whether only one (Single-Item-Template hypothesis; SIT) or multiple (Multiple-Item-Template hypothesis; MIT) items can serve as attentional templates simultaneously. The current study was designed to test these two hypotheses. Participants memorized two colors, prior to a visual-search task in which the target and the distractor could match or not match the colors held in VWM. Robust attentional guidance was observed when one of the memory colors was presented as the target (reduced response times (RTs) on target-match trials) or the distractor (increased RTs on distractor-match trials). We constructed two drift-diffusion models that implemented the MIT and SIT hypotheses, which are similar in their predictions about overall RTs, but differ in their predictions about RTs on individual trials. Critically, simulated RT distributions and error rates revealed a better match of the MIT hypothesis to the observed data than the SIT hypothesis. Taken together, our findings provide behavioral and computational evidence for the concurrent guidance of attention by multiple items in VWM.

     

Modeling the effects of payoff on response bias in a perceptual discrimination task: bound-change, drift-rate-change, or two-stage-processing hypothesis

Three hypotheses--the bound-change hypothesis, drift-rate-change hypothesis, and two-stage-processing hypothesis--are proposed to account for data from a perceptual discrimination task in which three different response deadlines were involved and three different payoffs were presented prior to each individual trial. The aim of the present research was to show (1) how the three different hypotheses incorporate response biases into a sequential sampling decision process, (2) how payoffs and deadlines affect choice probabilities, and (3) the hypotheses' predictions of response times and choice probabilities. The two-stage-processing hypothesis gave the best account, especially for the choice probabilities, whereas the drift-rate-change hypothesis had problems predicting choice probabilities as a function of deadlines.     

Short-term episodic memory for visual textures: a roving probe gathers some memory

Cognition is shaped by the way that past experiences are represented in memory. To examine the representation of recent visual experiences, we devised a novel procedure that measures episodic recognition memory for synthetic textures. On each trial, two brief study stimuli were followed by a probe, which either replicated one of the study stimuli or differed in spatial frequency from both. The probe's spatial frequency roved from trial to trial, testing recognition with a range of differences between probe and study items. Repeated testing of recognition generated mnemometric functions, snapshots of memory strength's distribution. The distributional characteristics of the mnemometric functions rule out several hypotheses about memory representation, including the hypothesis that representations are prototypes constructed from previously seen stimuli; instead, stimuli are represented in memory as noisy exemplars.     

The nature of memory processes underlying recognition judgments in the process dissociation procedure

The hypothesis is tested that the memory processes involved in recognition judgments in the process dissociation procedure are the same as those involved in standard source-monitoring tasks. It is shown how source-monitoring response categories can be mapped onto process dissociation response categories. On the basis of this observation, an experiment was conducted in which it was possible to compare, using a multinomial modeling approach, the parameters representing memory processes in the process dissociation procedure with those involved in source monitoring. For the two different encoding conditions realized, the results are compatible with the hypothesis that the same processes are involved in source monitoring and in recognition judgments in the process dissociation procedure. Implications for the interpretation of the model’s parameters are discussed.     

Cognitive demands of error processing associated with preparation and execution of a motor skill

Maxwell et al. [Maxwell, J. P., Masters, R. S. W., Kerr, E., & Weedon, E. (2001). The implicit benefit of learning without errors. The Quarterly Journal of Experimental Psychology, 54A, 1049–1068. The implicit benefit of learning without errors. The Quarterly Journal of Experimental Psychology, 54A, 1049–1068] suggested that, following unsuccessful movements, the learner forms hypotheses about the probable causes of the error and the required movement adjustments necessary for its elimination. Hypothesis testing is an explicit process that places demands on cognitive resources. Demands on cognitive resources can be identified by measuring probe reaction times (PRT) and movement times. Lengthened PRT and movement times reflects increased cognitive demands. Thus, PRT and movement times should be longer following errors, relative to successful, movements. This hypothesis was tested using a motor skill (golf putting). Furthermore, the association between error processing and the preparation and execution phases of movement was examined. The data confirmed that cognitive demand is greater for trials following an error, relative to trials without an error. This effect was apparent throughout learning and in both the preparatory and execution phases of the movement. Cognitive effort also appeared to be higher during movement preparation, relative to movement execution.     

Extended Cognition and Propositional Memory

The philosophical case for extended cognition is often made with reference to ‘extended‐memory cases’ (e.g. Clark & Chalmers 1998); though, unfortunately, proponents of the hypothesis of extended cognition (HEC) as well as their adversaries have failed to appreciate the kinds of epistemological problems extended‐memory cases pose for mainstream thinking in the epistemology of memory. It is time to give these problems a closer look. Our plan is as follows: in §1, we argue that an epistemological theory remains compatible with HEC only if its epistemic assessments do not violate what we call ‘the epistemic parity principle’. In §2, we show how the constraint of respecting the epistemic parity principle stands in what appears to be a prima facie intractable tension with mainstream thinking about cases of propositional memory. We then outline and evaluate in §3 several lines of response.     

Effects of perceptual quality and visual field of probe stimulus presentation on memory search for letters

Observers indicated whether a single probe letter presented to the left visual field/right hemisphere (LVF-RH) or to the right visual field/left hemisphere (RVF-LH) was contained in a memory set of 2, 3, 4, or 5 letters. For positive trials, the increase in reaction time caused by perceptually degrading the probe letter became progressively larger as memory set size became larger when the probe was presented to the LVF-RH but not when the probe was presented to the RVF-LH. These results were obtained regardless of whether the case of the probe letter varied randomly (Experiment 1) or only capital letters were used (Experiment 2). The results on LVF-RH trials suggest a relatively visuospatial memory comparison process, whereas the results on RVF-LH trials suggest a more abstract memory comparison process. In addition to these effects, the intercept of the memory set size function was lower on LVF-RH trials than on RVF-LH trials when the probe letter was perceptually degraded, consistent with the hypothesis that the right hemisphere is more efficient than the left at early visuospatial processes. Perhaps it is this efficiency at early visuospatial processes that produces the bias toward visuospatial memory comparison on LVF-RH trials.     

Repetition effects in associative false recognition: Theme-based criterion shifts are the exception, not the rule

Previous reports have demonstrated that false memory for the critical items of associative lists decreases when lists are studied multiple times (Benjamin, 2001). In three experiments, we explored two hypotheses that might account for false memory reductions with repetition. Under an identification hypothesis, repetition decreases false memory because participants realise that critical items are absent from the list at encoding and thus reject them at test. Under a criterion shift hypothesis, repetition decreases false memory because it increases the discriminability of studied words from lures, causing participants to set a higher response criterion for positive recognition responses. Results uniquely supported the criterion shift hypothesis. Furthermore, results showed that participants only changed their criterion on separate recognition tests, not on an item-by-item basis within a single recognition test. The failure to establish separate criteria within a test increased false memory for repeated lists.     

Implications of two local consistency strategy selection models

This paper examines some mathematical implications of two process models of concept identification, the 1-element strategy selection model with a local consistency assumption and Chumbley's hypothesis manipulation (HM) model. Under slightly restrictive assumptions, each process model (Level 1) is shown to imply a stochastic model (Level 3), making predictions of behavior in experimental situations in which the stimulus presented to a subject on any trial is randomly selected and independent of that presented on any other trial. In addition, each model is shown to make predictions at an intermediate level (Level 2) about performance on successive trials with specific stimulus sequences presented.At Level 2, each model is shown to falsely predict zero probabilities for particular response patterns when stated stimulus sequences are used. Fewer such problems arise with the HM model than with the 1-element model. Minimum squared error fits of one set of experimental data show relatively good correspondence of predictions and observations when a Chumbley model with different saliences for different hypotheses is employed.     

Phonemic effects in reading comprehension and text memory

Two experiments investigated the role of phonemic information in adult reading comprehension and replicated the visual tongue-twister effect in a new paradigm–a modified probe memory task. College students took longer to read sentences that repeated word initial consonants (tongue-twisters) than matched control sentences. Equally important, subjects also took longer to respond to probe words from tongue-twisters. Slower response times in both the sentence reading task and the probe memory task indicate that the tongue-twister effect is indeed phonemic in nature and that phonemic information is used in memory during comprehension.     

Response-specific slowing in older age revealed through differential stimulus and response effects on P300 latency and reaction time

Older age produces numerous changes in cognitive processes, including slowing in the rate of mental processing speed. There has been controversy over the past three decades about whether this slowing is generalized or process-specific. A growing literature indicates that it is process-specific and suggests it is most dramatic at the interface where a stimulus input is translated into a response output. We tested this hypothesis using a task in which young and older adult males made either compatible or incompatible responses to the word LEFT or RIGHT shown briefly and variously located in a 4 row × 6 column matrix surrounded by # signs or by letters chosen randomly from the sets A-G or A-Z. Processing speed was measured using P300 latency and reaction time. Experimental effects on these two measures provided support for the hypothesis in revealing that stimulus identification processes were preserved, whereas processes related to translating a stimulus input into a designated response output and then selecting that response were compromised in the elderly.     

Perception-action coupling and S-R compatibility

How is an aiming movement toward a visual target amended when the target suddenly steps to a new position just before or after the movement has started? Three hypotheses are examined: (1) the initial movement needs to be actively terminated before the new movement can be planned and executed, (2) substitution of the initial target position code results, after a normal RT, in the simultaneous termination of the initial movement and initiation of the movement to the new target position, or (3) a second movement from the initial to the second target is initiated after a normal RT, and superimposed on the ongoing movement toward the initial target. The substitution hypothesis assumes a highly continuous and parallel mode of operation of the perceptual-motor system, whereas the other hypotheses assume a distinctly discrete mode of operation. Detailed analyses of double-step movement trajectories clearly favored the substitution hypothesis. These results are discussed with reference to current views on motor control, overlapping-task performance, and the discrete-continuous issue. It is argued that the nature of the perception-action interface depends on the ideomotor compatibility of the task. Perceptual and motor processes operate in a highly continuous and parallel fashion in ideomotor compatible tasks, whereas the interposition of a limited-capacity response selection mechanism results in a discrete and intermittent mode of communication between these processes in non-ideomotor compatible tasks.     

Rote memory and arithmetic fact processing

The goal of the study was to examine the part played by skill in memorizing arbitrary sequences in the efficiency with which normal young adults perform simple arithmetic fact problems. The first experiment showed a clear independent role for sequence memory in all arithmetic fact processing, but a lesser role for semantic retrieval. This result was particularly true for large-answer multiplication problems and subtraction and division problems with large first operands. In a second experiment, which included a visuomotor processing control task, sequence memory predicted processing of all arithmetic problems apart from small additions independently of semantic retrieval, with the most robust independent contribution being to large-answer multiplication problems. The results, which are compatible with Dehaene and colleagues' triple-code model, suggest that rote learning may be a successful way for some people to process arithmetic facts efficiently.     

Emergence of Information-Retrieval Strategies in Numerical Cognition: A Developmental Study

A series of simple addition problems was presented in a reaction time, true-false verification task to subjects in Grades 2 through 4 and in college. This information-processing paradigm was used to measure the solution strategies used for problems that sometimes are solved too rapidly and accurately to allow for meaningful error analysis. A series of structural models representing different processing sequences was tested against reaction times for solution to different two-term addition problems. Young children and adults alike used a memory access process to solve highly overlearned addition problems such as 1 + 1 = 2, but solution strategies of more difficult problems differed by age. Younger children adopted a slow, effortful, implicit counting strategy, with efficiency developing in the middle elementary school years; adults performed in a manner consistent with at least some models of memory retrieval found in the literature. Children were classified into two groups, independently of grade, based on slope values from a regression equation computed on individual subject data. The two groups comprised what appeared to be "fast" and "slow" processors, who differed in terms of speed of processing as well as strategy used. Our findings are discussed in terms of models of semantic memory and the development of automatic information-processing skills.     

Balancing cognitive demands: control adjustments in the stop-signal paradigm

Cognitive control enables flexible interaction with a dynamic environment. In 2 experiments, the authors investigated control adjustments in the stop-signal paradigm, a procedure that requires balancing speed (going) and caution (stopping) in a dual-task environment. Focusing on the slowing of go reaction times after stop signals, the authors tested 5 competing hypotheses for post-stop-signal adjustments: goal priority, error detection, conflict monitoring, surprise, and memory. Reaction times increased after both successful and failed inhibition, consistent with the goal priority hypothesis and inconsistent with the error detection and conflict hypotheses. Post-stop-signal slowing was greater if the go task stimulus repeated on consecutive trials, suggesting a contribution of memory. We also found evidence for slowing based on more than the immediately preceding stop signal. Post-stop-signal slowing was greater when stop signals occurred more frequently (Experiment 1), inconsistent with the surprise hypothesis, and when inhibition failed more frequently (Experiment 2). This suggests that more global manipulations encompassing many trials affect post-stop-signal adjustments.