Mispredicting and misremembering: patients with renal failure overestimate improvements in quality of life after a kidney transplant

OBJECTIVE: People tend to overestimate the impact that future events will have on their quality of life. In the case of a medical treatment like kidney transplant, this should result in biased predictions--overestimates of how much the transplant will benefit quality of life. The authors surveyed kidney transplant patients, both before and after transplant, to test whether they would overestimate the benefits of a successful transplant for their quality of life. DESIGN: The authors interviewed 307 patients on a waiting list for cadaveric renal or renal-pancreatic transplant, and 195 patients one year after a successful transplant. A sub sample of patients were interviewed both before and after transplant. MAIN OUTCOME MEASURES: The survey included measures of quality of life, both in terms of an overall estimate (0-100), and across sub domains, including health, employment, and travel. RESULTS: Cross-sectional results suggested that overall quality of life improved after transplant, but the predictions of pretransplant patients overestimated the magnitude of the improvement (p < .01). In addition, patients predicted large improvements in specific life domains that did not change. These results were confirmed in longitudinal, prospective analyses. Additional analyses showed that posttransplant patients recalled their pretransplant quality of life to be much lower than what they had reported at the time. CONCLUSION: Consistent with an impact bias, patients substantially overestimated the benefits of a successful kidney transplant, both in terms of predictions of life after treatment, and in their memories of QOL before the transplant.     

Obedience as a function of experimenter competence

The purpose of this study was to investigate obedience to an E’s commands as a function of E competency. Based upon Orne’s (1962, 1969) discussion of the demand characteristics inherent in the typical aggression study, it was hypothesized that E incompetence would decrease S obedience. Competence was manipulated by: (1) presenting some Ss with a nervous and inexperienced E, and (2)“accidentally” killing the victim (a rat) midway through the experiment. Thirty-two undergraduate female Ss participated in the experiment—supposedly a study on the physiological effects of stress. Obedi6nce was operationalized as the difference, in simple reaction time, between trials on which Ss were told that their response might result in shock to the rat and trials on which they were told that their response might save the rat from shock. Significant differences in obedience were obtained between competent and incompetent E conditions, and a significant “kill” effect was found in the competent E conditidn. The results of this study suggested that the extreme acts of obedience observed in the laboratory (e.g., Milgram, 1963) occur only when E is perceived as competent. This finding imposes limits on the generalizability of laboratory studies of obedience.     

Task differences on conservation and transitivity problems

Task differences were assessed with 120 first graders in a 2 × 3 × 3 factorial design combining Socioeconomic level (middle vs lower), Concepts (conservation of length, transitivity of length, and conservation of continuous quantity), and Tasks (three tasks for each concept selected on the basis of frequency of usage). As predicted, task by concept interactions were found on all four task response measures. This finding is consistent with Piaget's concept of horizontal decalage and with Flavell and Wohlwill's competence-performance model, which proposes that intermediate phases of stage transition are characterized by considerable intertask differences and initial and final phases by intertask consistency in performance. The importance of investigating the effects of task variables on multiple dependent measures at various age levels and points in time was emphasized. Concept, task, and socioeconomic class differences were also found on some of the measures.