Choices and opportunities: another effect of framing on decisions

Many decisions can be framed either as ‘choices’ between alternative courses of action (e.g. Should I move to New York or stay in Chicago?) or as ‘opportunities’ to pursue a particular course of action (i.e. Should I move to New York?). Although there is no logical difference between these two different decision frames, there may be important psychological differences between them. In four studies, we explore the differences between ‘choices’ and ‘opportunities’. The results of Studies 1 and 2 show that college students view many of the decisions they typically face as opportunities, rather than choices. Further, the results of Study 2 suggest that the frame students adopt is systematically related to the preferences they express. The latter finding led to Studies 3 and 4, where we show that preferences can be influenced by encouraging people to adopt one decision frame rather than another. © 1998 John Wiley & Sons, Ltd.     

A New Multilevel CART Algorithm for Multilevel Data with Binary Outcomes

The multilevel logistic regression model (M-logit) is the standard model for modeling multilevel data with binary outcomes. However, many assumptions and restrictions should be considered when applying this model for unbiased estimation. To overcome these limitations, we proposed a multilevel CART (M-CART) algorithm which combines the M-logit and single level CART (S-CART) within the framework of the expectation-maximization. Simulation results showed that the proposed M-CART provided substantial improvements on classification accuracy, sensitivity, and specific over the M-logit, S-CART, and single level logistic regression model when modeling multilevel data with binary outcomes. This benefit of using M-CART was consistently found across different conditions of sample size, intra-class correlation, and when relationships between predictors and outcomes were nonlinear and nonadditive.     

The gap between medical and monetary choices under risk persists in decisions for others

Decisions under risk in the medical domain have been found to systematically diverge from decisions in the monetary domain. When making choices between monetary options, people commonly rely on a decision strategy that trades off outcomes with their probabilities; when making choices between medical options, people tend to neglect probability information. In two experimental studies, we tested to what extent differences between medical and monetary decisions also emerge when the decision outcomes affect another person. Using a risky choice paradigm for medical and monetary decisions, we compared hypothetical decisions that participants made for themselves to decisions for a socially distant other (Study 1) and to recommendations as financial advisor or doctor (Study 2). In addition, we examined people's information search in a condition in which information about payoff distributions had to be learned from experiential sampling. Formal modeling and analyses of search behavior revealed a similarly pronounced gap between medical and monetary decisions in decisions for others as in decisions for oneself. Our results suggest that when making medical decisions, people try to avoid the worst outcome while neglecting its probability—even when the outcomes affect others rather than themselves.     

God of the hinge: treating LGBTQIA patients

This paper looks at systems of gender within the context of analysis. It explores the unique challenges of individuation faced by transsexual, transgender, gender queer, gender non‐conforming, cross‐dressing and intersex patients. To receive patients generously we need to learn how a binary culture produces profound and chronic trauma. These patients wrestle with being who they are whilst simultaneously receiving negative projections and feeling invisible. While often presenting with the struggles of gender conforming individuals, understanding the specifically gendered aspect of their identity is imperative. An analyst's unconscious bias may lead to iatrogenic shaming. The author argues that rigorous, humble inquiry into the analyst's transphobia can be transformative for patient, analyst, and the work itself. Analysis may, then, provide gender‐variant patients with their first remembered and numinous experience of authentic connection to self. Conjuring the image of a hinge, securely placed in the neutral region of a third space, creates a transpositive analytic temenos. Invoking the spirit of the Trickster in the construction of this matrix supports the full inclusion of gender‐variant patients. Nuanced attunement scaffolds mirroring and the possibility of play. Being mindful that gender is sturdy and delicate as well as mercurial and defined enriches the analyst's listening.     

中医院市场定位的两难选择及其对策

中医院的市场定位处于两难选择之中:中医药技术的潜在优势与现实局限性的矛盾、中医院管理者的价值取向与现实窘况的矛盾、中医院发展历史沉淀与市场竞争的矛盾、政府的中医药政策自身存在的矛盾等。这些矛盾涉及多方行为和利益主体,必须深化改革,以实现中医院的良性发展。     

抗抑郁药应用选择的思考

目前市场上可供选择的抗抑郁药越来越多.从系统方法论、医学模式转变和矛盾重点论的角度来阐述临床上应该如何选择用药,才能使治疗效果和医疗费用更符合个体的情况,达到比较和谐的状态.     

Choices in Life: A Clinical Tool for Facilitating Midlife Review

A critical developmental task of midlife involves reviewing one's past as well as preparing for one's future. The ability to identify past choices, task responsibility for them, and utilize developing patterns in future decision making is seen as a critical component of continued adult development. The Choicemap offers a structured clinical tool to guide such a midlife review. Engaging in this process assists adults in developing choicemaking skills, and provides a powerful clinical intervention.