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.     

Self‐Esteem and Suicide Ideation in Psychiatric Outpatients

Depression, hopelessness, and low self‐esteem are implicated as vulnerability factors for suicide ideation. The association of self‐esteem with suicide ideation after controlling for depressed mood and hopelessness was examined. Adult psychiatric outpatients (N = 338) completed measures of self‐esteem, suicide ideation, hopelessness, and depression. Self‐esteem was operationalized as beliefs about oneself (self‐based self‐esteem) and beliefs about how other people regard oneself (other‐based self‐esteem). Each dimension of self‐esteem was negatively associated with suicide ideation after controlling for depression and hopelessness. Of the two dimensions of self‐esteem, other‐based self‐esteem was the more robust predictor of suicide ideation. These findings suggest that even in the context of depression and hopelessness, low self‐esteem may add to the risk for suicide ideation.     

An Appraisal Account of Individual Differences in Emotional Experience

People can differ tremendously in the emotions they experience, both in general as well as in response to specific events, and such differences have large impact on their lives. Based on recent research on individual differences in appraisal and emotion, we propose a framework to understand the basis for individual differences in emotional experience. In this framework, individual differences in how people appraise their circumstances and in how these appraisals are related to emotional experience are seen as crucial in determining how people differ in both contextualized emotional experience and more stable emotional dispositions. We discuss parallels with other explanatory frameworks, implications for the nature of emotion traits, and directions for future research.     

BETWEEN THE LINES OF AGE: REFLECTIONS ON THE METAPHYSICS OF WORDS

Abstract: The central concern of this paper is the nature of the relation between words on the one hand and their occurrences on the other. I argue here that while Kaplan's “common currency” conception of words is immune to much of the criticism to which Cappelen has subjected it, it runs afoul of the role words play in communication. And I sketch an alternative conception – the type‐continuant model – which shares the virtues but avoids the vices of Kaplan's conception.     

Are we aware of the external factors that influence our food intake?

OBJECTIVES: This research examines the extent to which people accurately report some of the external influences on their food intake. DESIGN: In two studies, specific factors (the presence and behavior of others) were manipulated in order to influence the amount of food that individuals consumed. MAIN OUTCOME MEASURES: The main outcomes of interest were participants' spontaneously generated explanations for their food intake (Study 1; n = 122), and their ratings of the importance of several potential determinants of food intake (Study 2; n = 75). RESULTS: In Study 1, there was high concordance between the amounts eaten by members of a dyad, but very few participants indicated that they were influenced by their partner's behavior; they instead identified hunger and taste as the primary determinants of intake. Study 2 showed that participants' intake was strongly influenced by the behavior of others, but people rated taste and hunger as much more important influences on their intake. CONCLUSIONS: If external environmental factors influence people's food intake without their awareness or acknowledgment, then maintaining a healthy diet can be a challenge, with long-term consequences for health and well-being.