Do medical decision analyses' largest gains grow from the smallest trees?

Some decision analysts recommend reserving their models for careful, complete study of complex problems. Others believe simple problem analyses provide the greatest gains. To clarify these issues, I tested: (1) whether simple published analyses compared to complex ones, produced results as non-intuitive; and (2) whether non-intuitiveness represented analytic gain (or equivalently, intuitive loss). Very limited data also examined (3) the gain from adding model intricacy for a given problem vs. selecting more complex problems for analysis. To assess two non-intuitiveness measures, 75 subjects (33 physicians and 42) non-physicians stated their intuitive preferences in 40 (22 published and 18 unpublished) medical dilemmas. For both physicians and non-physicians, simpler models (those with lees than 30 terminal branches in the decision tree) had about one third the non-intuitiveness of more complex ones. Three tests also supported the premise that analyses outperform intuition, therefore that on average the formers' non-intuitiveness reflects less analytic gain. In addition, for different models of the same problem, tree complexity did not correlate with gain. Thus, simpler trees may not generally gain less because they inadequately describe problems. Instead, simpler analyses may represent simpler problems, with more similar intuitive and formal solutions. If so, these findings may help us avoid some costly but unnecessary simple analyses.     

Alexithymia as a potential source of symptom over‐reporting: An exploratory study in forensic patients and non‐forensic participants

The traditional interpretation of symptom over‐reporting is that it indicates malingering. We explored a different perspective, namely that over‐reporting of eccentric symptoms is related to deficits in articulating internal experiences (i.e., alexithymia). Given that alexithymia has been linked to sleep problems and that fatigue may fuel inattentive responding to symptom lists, we administered measures of alexithymia (TAS ‐20) and symptom over‐reporting (SIMS ), but also sleep quality (SLEEP ‐50) to forensic psychiatric outpatients (n = 40) and non‐forensic participants (n = 40). Forensic patients scored significantly higher on all three indices than non‐forensic participants. In the total sample as well as in subsamples, over‐reporting correlated positively and significantly with alexithymia, with r s being in the 0.50–0.65 range. Sleep problems were also related to over‐reporting, but in the full sample and in the forensic subsample, alexithymia predicted variance in over‐reporting over and above sleep problems. Although our study is cross‐sectional in nature, its results indicate that alexithymia as a potential source of over‐reporting merits systematic research.     

THE COMMUNITY VIEW REVISITED

Abstract: Joining a vast Wittgensteinian anti‐theoretical movement, John Canfield has argued that it is possible to read the claims that (1) “language is essentially communal” and (2) “it is conceptually possible that a Crusoe isolated from birth should speak or follow rules” in such a way that they are perfectly compatible, and, indeed, that Wittgenstein held them both at once. The key to doing this is to drain them of any theoretical content or implications that would put each claim at odds with the other. I argue here, first of all, that it is not possible to detheorize both (1) and (2) and still hope to say anything illuminating about the nature of language. In fact, Canfield himself does not succeed in detheorizing both (1) and (2) but ends up trivializing (1) and leaving (2) with quite a bit of theoretical content. I further argue, however, that this is getting the matter the wrong way around. Contra Canfield et al., it is only when we recognize this that we can appreciate how radical and innovative Wittgenstein's claims about language really are.     

Strategic Revenue Management under Uncertainty: A Case Study on Real Estate Projects in India

This paper proposes an approach for strategic revenue management under uncertainty for real estate projects. It integrates three modelling techniques: first, artificial neural network integrated support vector machines for forecasting the profit and loss‐making real estate residential projects; second, analytical network process approach using decision making trials and evaluation laboratory methodology for establishing interrelationships among factors; and third, multiobjective genetic algorithm approach for obtaining optimal numbers and types of apartments in a real estate project. We compare the respective revenues generated with the new number of apartments and price from the suggested revenue maximization model and that of the old practiced one through a case study of India. Copyright © 2015 John Wiley & Sons, Ltd.     

Decision Support System and Multi‐Criteria Decision Aid: A State of the Art and Perspectives

The aim of this paper is to highlight the role of the Decision Support System within the field of multi‐criteria decision aid (MCDA). The MCDA tools have been incorporated into systems to create Multi‐Criteria Decision Support Systems (MCDSSs). In our literature review, we noticed that more than 100 papers have been written over a 20‐year period in which MCDSS was used as a decision‐making tool. The present paper describes some real applications of MCDSS in different fields, harmoniously combined with decision‐making methods such as analytic hierarchy process, Utility Additive, and Goal Programming. The present study proposes an integrative MCDSS evaluation through guidance on the tools most useful for a specific user with a particular decision problem. Copyright © 2014 John Wiley & Sons, Ltd.     

Future Well-Being Among People Who Attempt Suicide and Survive: Research Recommendations

Over 48,000 people died by suicide in 2018 in the United States, and more than 25 times that number attempted suicide. Research on suicide has focused much more on risk factors and adverse outcomes than on protective factors and more healthy functioning. Consequently, little is known regarding relatively positive long-term psychological adaptation among people who attempt suicide and survive. We recommend inquiry into the phenomenon of long-term well-being after nonfatal suicide attempts, and we explain how this inquiry complements traditional risk research by (a) providing a more comprehensive understanding of the sequelae of suicide attempts, (b) identifying protective factors for potential use in interventions and prevention, and (c) contributing to knowledge and public education that reduce the stigma associated with suicide-related behaviors.     

Intra‐active refractions

Responding to the analyses that Andreas Losch and Lucas John Mix offer regarding Living with Tiny Aliens: The Image of God for the Anthropocene, this article begins to address how their respective concerns regarding ratiocentric and anthropocentric ideas haunt the construction of a planetary account of the imago Dei. The article then introduces a subsequent line of critique not mentioned by Losch or Mix related to decentering the human individual from accounts of the imago Dei in order to highlight an ongoing challenge for transdisciplinary theological projects that involve astrobiology.     

Maintenance of Relationship and Individual Functioning Gains Following Online Relationship Programs for Low‐Income Couples

Initial evidence suggests that gains in relationship functioning from brief, web‐based programs are maintained through one year following the intervention; however, whether these results generalize to a low‐income sample is unclear. Furthermore, previous research from in‐person couple therapy suggests there may be different shapes of maintenance slopes for behavioral versus acceptance‐based techniques. This study contacted 668 individuals who enrolled in online behavioral (ePREP) or acceptance‐based (OurRelationship) programs one year following completion of the program. Multilevel modeling was used to examine linear and quadratic rates of change in the year following the online intervention as well as total amount of change from pretreatment to 12‐month follow‐up for both relationship and individual functioning. The majority of couples who responded continued to be in a relationship with the same partner (68.3%). Examinations of relationship functioning indicated couples in both programs maintained their gains over follow‐up (i.e., no significant linear or quadratic changes), with medium‐to‐large within‐group effect sizes from pre‐ to one‐year follow‐up. There were no significant differences in relationship outcomes between OurRelationship and ePREP. Similarly, examinations of individual functioning outcomes indicated couples maintained their gains over follow‐up or continued to improve. In total, couples experienced small‐to‐medium within‐group effect sizes from pretreatment to one‐year follow‐up, with larger effects for individuals who were initially distressed. These results suggest that online programs create lasting change for low‐income couples in relationship and individual functioning, with minimal differences between behavioral and acceptance‐based orientations.     

Using a Fork as a Hairbrush: Investigating Dual Routes to Release from Functional Fixedness

Functional fixedness involves difficulty with conceptualizing creative object uses. When it obstructs problem‐solving, individuals must reframe their approach. We examined how different training techniques—chunk decomposition (i.e., considering an object’s basic parts and physical properties) and constraint relaxation (i.e., considering an object’s different functions)—might rely upon different routes to creative reframing. Additionally, we investigated how different forms of cognitive load interact with these dual routes. Participants learned one of three techniques. Chunk decomposition participants created object breakdown diagrams; constraint relaxation participants created object functions lists; and free association (control) participants wrote a word that they associated with each of several concrete nouns. After training, participants attempted to solve five functional fixedness problems. E1 investigated how increasing germane cognitive load via either direct or indirect prompting affected training transfer. Experiment 2 investigated how reducing extraneous cognitive load by providing no transfer instructions and using an eye‐closure strategy. Across both experiments, results supported differences in accuracy and response latency by training. However, chunk decomposition and constraint relaxation did not follow the same pattern, suggesting different mechanisms of the effect. We discuss possible applications to increase innovation in real‐world domains such as education, business, and engineering.     

Adversary effects and the tactics of violent offenders

We examine the implication of adversary effects for target choice, lethal intent, and the use of weapons and allies in violent incidents. Adversary effects refer to the tendency of offenders to make tactical decisions based on the coercive power of victims and potential victims. Using the victim's gender as a proxy for coercive power, we analyzed violent incidents from the National Incident‐Based Reporting System (2005–2014). The sample included over six million assaults, robberies, and homicides. Consistent with adversary effects, offenders who attack males (vs. females) are more likely to (a) kill victims; (b) use guns, knives, blunt objects, poison, and automobiles; (c) use male (but not female) allies; and (d) use multiple allies. The evidence for target choice is mixed: unarmed female offenders, but not unarmed male offenders, are more likely to target females than males. The evidence shows how a simple theoretical principle can parsimoniously account for basic patterns of violence in society related to gender, weapons, and group violence.