Expertise and error in diagnostic reasoning

An investigation is presented in which a computer simulation model (DIAGNOSER) is used to develop and test predictions for behavior of subjects in a task of medical diagnosis. The first experiment employed a process-tracing methodology in order to compare hypothesis generation and evaluation behavior of DIAGNOSER with individuals at different levels of expertise (students, trainees, experts). A second experiment performed with only DIAGNOSER identified conditions under which errors in reasoning in the first experiment could be related to interpretation of specific data items. Predictions derived from DIAGNOSER's performance were tested in a third experiment with a new sample of subjects. Data from the three experiments indicated that (1) form of diagnostic reasoning was similar for all subjects trained in medicine and for the simulation model, (2) substance of diagnostic reasoning employed by the simulation model was parable with that of the more expert subjects, and (3) errors in subjects' reasoning were attributable to deficiencies in disease knowledge and the interpretation of specific patient data cues predicted by the simulation model.     

Changing One's Mind: Self‐Conscious Belief and Rational Endorsement

Self‐consciously attempting to shape one's beliefs through deliberation and reasoning requires that one stand in a relation to those beliefs that might be signaled by saying that one must inhabit one's beliefs as one's own view. What does this amount to? A broad swath of philosophical thinking about self‐knowledge, norms of belief, self‐consciousness, and related areas assumes that this relation requires one to endorse, or be rationally committed to endorsing, one's beliefs. In fact, however, fully self‐conscious adherence to epistemic norms requires the ability to self‐consciously hold a belief without endorsing that belief as true, as well‐supported by the evidence, or as meeting some other epistemic standard, and there are cases in which no such commitment is rationally required. This ability is necessary if there is to be any such thing as a fully self‐conscious process of changing one's mind.     

The Persistent Case of Major Depression: An Argument for Long-Term Treatment

According to psychotherapy outcome literature, treatments for major depressive disorder (MDD) yield impressive results. Study after study demonstrates the efficacy of brief, evidence-based interventions for depressed individuals. Nevertheless, MDD continues to exact a devastating toll on modern society. The World Health Organization has identified it as the leading cause of disability worldwide. This reality is surprising given the implications from the academic literature. A historical analysis of MDD treatment suggests that most people with MDD experienced complete remission and enhanced outcomes when long-term, psychodynamically influenced treatments prevailed. An analysis of the system that perpetuates the brief intervention model for MDD, managed care, is discussed. This analysis is followed by a case study that illustrates the harm managed care can do to patients with MDD who are not permitted treatment of longer duration. Implications and recommendations for psychologists to intervene at the micro and macro levels are discussed.     

Response–reinforcer dependency and resistance to change

The effects of the response–reinforcer dependency on resistance to change were studied in three experiments with rats. In Experiment 1, lever pressing produced reinforcers at similar rates after variable interreinforcer intervals in each component of a two‐component multiple schedule. Across conditions, in the fixed component, all reinforcers were response‐dependent; in the alternative component, the percentage of response‐dependent reinforcers was 100, 50 (i.e., 50% response‐dependent and 50% response‐independent) or 10% (i.e., 10% response‐dependent and 90% response‐independent). Resistance to extinction was greater in the alternative than in the fixed component when the dependency in the former was 10%, but was similar between components when this dependency was 100 or 50%. In Experiment 2, a three‐component multiple schedule was used. The dependency was 100% in one component and 10% in the other two. The 10% components differed on how reinforcers were programmed. In one component, as in Experiment 1, a reinforcer had to be collected before the scheduling of other response‐dependent or independent reinforcers. In the other component, response‐dependent and ‐independent reinforcers were programmed by superimposing a variable‐time schedule on an independent variable‐interval schedule. Regardless of the procedure used to program the dependency, resistance to extinction was greater in the 10% components than in the 100% component. These results were replicated in Experiment 3 in which, instead of extinction, VT schedules replaced the baseline schedules in each multiple‐schedule component during the test. We argue that the relative change in dependency from Baseline to Test, which is greater when baseline dependencies are high rather than low, could account for the differential resistance to change in the present experiments. The inconsistencies in results across the present and previous experiments suggest that the effects of dependency on resistance to change are not well understood. Additional systematic analyses are important to further understand the effects of the response–reinforcer relation on resistance to change and to the development of a more comprehensive theory of behavioral persistence.     

Considering self‐interests and symbolism together: How instrumental and value‐expressive motives interact to influence supervisors’ justice behavior

Drawing upon functional theories of attitudes and the organizational justice literature, the current research suggests that people's attitudes toward justice likely serve an instrumental function (grounded in self‐interest, rewards maximization, and punishment minimization) as well as a value‐expressive function (grounded in the expression of self‐concept and values). Importantly, these two functions co‐exist and interact to influence supervisors’ justice behavior and the consistency of such behavior via supervisors’ justification for unjust behavior. Findings from a set of experimental and correlational studies confirmed these predictions. The positive effects of supervisors’ value‐expressive function on justice behavior and its consistency were stronger when their instrumental function was lower (vs. higher), and justification for unjust behavior mediated these effects. Also, supplementary analyses showed that the consistency of supervisors’ justice behavior positively predicted subordinates’ overall justice perceptions beyond the effects of the overall level of justice behavior. We conclude by discussing the theoretical and practical implications of these findings.