Cognitive mediation of alcohol's effects on women's in-the-moment sexual decision making.

Objective: To test a cognitive mediation model examining whether cognitive appraisals mediate alcohol consumption effects on condom request and unprotected sex intentions. Design: Female social drinkers (N = 173) participated in an experiment comparing four beverage conditions: control, placebo, target BAL = .04%, and target BAL = .08%. Subjects projected themselves into a hypothetical sexual encounter with a new sex partner. Measures: Appraisals of the situation's sexual potential, impelling and inhibiting cognitions, and behavioral intentions were assessed at several points. Results: Findings support the theoretical model, indicating that alcohol's effects on direct condom request and unprotected sex intentions were mediated through cognitive appraisals. Conclusion: Prevention interventions should include information about alcohol's effects on cognitions that may lead to ineffective condom negotiation and unprotected sex. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physician decision making and cardiac risk: Effects of knowledge, risk perception, risk tolerance, and fuzzy processing.

Despite training, professionals sometimes make serious errors in risky decision making. The authors investigated judgments and decisions for 9 hypothetical patients at 3 levels of cardiac risk, comparing student and physician groups varying in domain-specific knowledge. Decisions were examined regarding whether they deviated from guidelines, how risk perceptions and risk tolerances determined decisions, and how the latter differed for knowledge groups. More knowledgeable professionals were better at discriminating levels of risk according to external correspondence criteria but committed similar errors in disjunctive probability judgments, violating internal coherence criteria. Also, higher knowledge groups relied on fewer dimensions of information than did lower knowledge groups. Consistent with fuzzy-trace theory, experts achieved better discrimination by processing less information and made sharper all-or-none distinctions among decision categories. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How numeracy influences risk comprehension and medical decision making.

We review the growing literature on health numeracy, the ability to understand and use numerical information, and its relation to cognition, health behaviors, and medical outcomes. Despite the surfeit of health information from commercial and noncommercial sources, national and international surveys show that many people lack basic numerical skills that are essential to maintain their health and make informed medical decisions. Low numeracy distorts perceptions of risks and benefits of screening, reduces medication compliance, impedes access to treatments, impairs risk communication (limiting prevention efforts among the most vulnerable), and, based on the scant research conducted on outcomes, appears to adversely affect medical outcomes. Low numeracy is also associated with greater susceptibility to extraneous factors (i.e., factors that do not change the objective numerical information). That is, low numeracy increases susceptibility to effects of mood or how information is presented (e.g., as frequencies vs. percentages) and to biases in judgment and decision making (e.g., framing and ratio bias effects). Much of this research is not grounded in empirically supported theories of numeracy or mathematical cognition, which are crucial for designing evidence-based policies and interventions that are effective in reducing risk and improving medical decision making. To address this gap, we outline four theoretical approaches (psychophysical, computational, standard dual-process, and fuzzy trace theory), review their implications for numeracy, and point to avenues for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Processing speed and memory mediate age-related differences in decision making.

Decision making under risk changes with age. Increases in risk aversion with age have been most commonly characterized, although older adults may be risk seeking in some decision contexts. An important, and unanswered, question is whether these changes in decision making reflect a direct effect of aging or, alternatively, an indirect effect caused by age-related changes in specific cognitive processes. In the current study, older adults (M = 71 years) and younger adults (M = 24 years) completed a battery of tests of cognitive capacities and decision-making preferences. The results indicated systematic effects of age upon decision quality—with both increased risk seeking and increased risk aversion observed in different tasks—consistent with prior studies. Path analyses, however, revealed that age-related effects were mediated by individual differences in processing speed and memory. When those variables were included in the model, age was no longer a significant predictor of decision quality. The authors conclude that the reduction in decision quality and associated changes in risk preferences commonly ascribed to aging are instead mediated by age-related changes in underlying cognitive capacities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric and psychological factors in patient decision making concerning antidepressant use.

The observation that the use of antidepressants has strongly increased during the past decade implies that on a micro level doctors and patients more often decide that antidepressants are the appropriate treatment. Therefore, it is important to increase insight into patients' decision making regarding the use of antidepressants. The decision making model used in the present study was based on A. Bandura's (1986) social cognitive theory. Two cohorts of patients were recruited and followed for 9 months. Among patients who use antidepressants (N = 166), the stronger pros and weaker cons of discontinuation and self-efficacy predicted more proximal goal intentions. Goal intentions predicted discontinuation after 9 months. Among patients who had used antidepressants in the past (N = 73), stronger pros of discontinuation and the weaker perceived functions of antidepressants predicted a more positive evaluation of their present state, compared with when they still used antidepressants. These temporal comparisons, in turn, predicted renewed use of antidepressants after 9 months. The results provide a framework for supporting and influencing decision making with regard to the use of antidepressants. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use and evaluation of discrete test information in decision making.

Elementary decision theory is applied to the problems of evaluating discrete tests or test items used to classify people into several categories, and choosing which of several treatments is best for persons falling within each response category. The technique explicitly considers the base rates of various criterion groups and the relative seriousness of different types of errors of classification, as well as the proportion of each criterion group falling in each response category. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical decision making in the prediction of falls.

Objective: Examine rehabilitation professionals' capacity to identify risk factors for patient falls. Design: Survey study. Setting: Three academic medical center rehabilitation departments. Participants: Fifty-six rehabilitation specialists representing disciplines typically involved in patient care, including physiatry and occupational, physical, recreation, and speech therapy. Measures: A 2-part, self-report questionnaire with spontaneous and cued rank-order listing of factors related to fall risk. Results: Clinicians did not consider advanced age and history of falling when spontaneously delineating risks for falls. The importance of fall history, but not of advanced age, was recognized through cueing. Conclusions: Clinicians appear aware of strong predictors of fall risk but require cueing to consistently use them. Cueing increased hypothetical predictive accuracy, although clinicians still downplayed some of the most salient predictive factors. Staff education regarding validated fall risk factors and potential errors in clinical decision making can improve patient care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unresolved controversies concerning psychopathy: Implications for clinical and forensic decision making.

At some point in their careers, clinicians who work or consult in forensic and correctional settings will almost certainly encounter individuals who exhibit psychopathic personality features. Because of the widespread use of this disorder to inform legal and clinical decision making, psychologists should be exceedingly familiar with the relevant research literature on this topic before venturing into these settings. This article reviews the empirical bases of several clinically relevant claims and assertions regarding psychopathy and concludes that many areas of research are decidedly more equivocal in their findings than is commonly perceived. Although there is much to be gained by assessing psychopathy in various contexts, clinicians need to be cautious about drawing overzealous and empirically questionable conclusions about an important disorder that also has great potential for abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dopamine modulates effort-based decision making in rats.

Previous research has implicated dopamine as a modulating factor in choice behavior based on effort. The purpose of the present study was to determine the individual contribution of different dopamine receptors to effort-based decision making in rats. Rats were trained in a T-maze to choose a large-reward arm that contained 8 pellets of food over a small-reward arm that contained 2 pellets of food. The rats then were trained to climb progressively higher barriers to obtain the food from the large-reward arm. Using a discounting procedure on each test day, it was found that rats were more likely to choose the small-reward arm after treatment with the D1 antagonist, SCH-23390, or the D2 antagonist, haloperidol. The dopamine agonist, D-amphetamine, biased the rats toward choosing the large-reward arm and blunted the effects of SCH-23390 or haloperidol. Treatment with the D3 receptor antagonist, U99194, or the D3 receptor agonist, 7-OH-DPAT, did not alter choice behavior. These data indicate that D1 and D2 receptors are required for decisions based on effort. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of depression on social economic decision making.

[Correction Notice: An erratum for this article was reported in Vol 119(3) of Journal of Abnormal Psychology (see record 2010-15289-020). In the article, the last revision received date printed on the final page of the article was incorrect due to an error in the production process. The correct publication dates are as follows: Received April 14, 2009; Revision received November 6, 2009; Accepted November 9, 2009.] Although the role of emotion in social economic decision making has been increasingly recognized, the impact of mood disorders, such as depression, on such decisions has been surprisingly neglected. To address this gap, 15 depressed and 23 nondepressed individuals completed a well-known economic task, in which they had to accept or reject monetary offers from other players. Although depressed individuals reported a more negative emotional reaction to unfair offers, they accepted significantly more of these offers than did controls. A positive relationship was observed in the depressed group, but not in controls, between acceptance rates of unfair offers and resting cardiac vagal control, a physiological index of emotion regulation capacity. The discrepancy between depressed individuals' increased emotional reactions to unfair offers and their decisions to accept more of these offers contrasts with recent findings that negative mood in nondepressed individuals can lead to lower acceptance rates. This suggests distinct biasing processes in depression, which may be related to higher reliance on regulating negative emotion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A three-phase model of retirement decision making.

The present article organizes prominent theories about retirement decision making around three different types of thinking about retirement: imagining the possibility of retirement, assessing when it is time to let go of long-held jobs, and putting concrete plans for retirement into action at present. It also highlights important directions for future research on retirement decision making, including perceptions of declining person–environment fit, the role of personality traits, occupational norms regarding retirement, broader criteria for assessing older workers' job performance, couples' joint decision making about retirement, the impact of self-funded and self-guided pension plans on retirement decisions, bridge employment before total withdrawal from the work force, and retirement decisions that are neither entirely forced nor voluntary in nature. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Emotion regulation and decision making under risk and uncertainty.

It is well established that emotion plays a key role in human social and economic decision making. The recent literature on emotion regulation (ER), however, highlights that humans typically make efforts to control emotion experiences. This leaves open the possibility that decision effects previously attributed to acute emotion may be a consequence of acute ER strategies such as cognitive reappraisal and expressive suppression. In Study 1, we manipulated ER of laboratory-induced fear and disgust, and found that the cognitive reappraisal of these negative emotions promotes risky decisions (reduces risk aversion) in the Balloon Analogue Risk Task and is associated with increased performance in the prehunch/hunch period of the Iowa Gambling Task. In Study 2, we found that naturally occurring negative emotions also increase risk aversion in Balloon Analogue Risk Task, but the incidental use of cognitive reappraisal of emotions impedes this effect. We offer evidence that the increased effectiveness of cognitive reappraisal in reducing the experience of emotions underlies its beneficial effects on decision making. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risky decision making assessed with the gambling task in adults with HIV.

Decision making was assessed using a laboratory gambling task in 67 adults with the Human Immunodeficiency Virus (HIV+) and in 19 HIV-seronegative (HIV-) control participants. Neurocognitive test performance across several domains was also analyzed to examine potential cognitive mechanisms of gambling task performance. As predicted, the HIV+ group performed worse on the gambling task, indicating greater risky decision making. Specifically, the HIV+ group selected more cards from the "risky" or disadvantageous deck that included relatively large payoffs but infrequent large penalties. The control group also selected such risky cards but quickly learned to avoid them. Exploratory analyses also indicated that in the HIV+ group, but not in the control group, gambling task performance was correlated with Stroop Interference performance and long delay free recall on the California Verbal Learning Test, suggesting the role of inhibitory processes and verbal memory in the poorer gambling task performance in HIV. These findings indicate the usefulness of the gambling task as a laboratory tool to examine risky decision making and cognition in the HIV population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Quality of decision making and group norms.

Two studies investigated the impact of group norms for maintaining consensus versus norms for critical thought on group decisions in a modification of the biased sampling paradigm (G. Stasser & W. Titus, 1985). Both studies showed that critical norms improved the quality of decisions, whereas consensus norms did not. This effect appeared to be mediated by the perceived value of shared and unshared information: Consensus norm groups valued shared information more highly than critical groups did, and valence was a good predictor of decision outcome. In addition, the 2nd study showed that the group norm manipulation has no impact on individual decisions, consistent with the assumption that this is a group effect. Results suggest that the content of group norms is an important factor influencing the quality of group decision-making processes and that the content of group norms may be related to the group's proneness for groupthink. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Four techniques of group decision making under uncertainty.

4 techniques of group decision-making—authoritarian, leader suggestion, census, and chairman—under risk and uncertainty were compared using a survival situation with 45 aircrews. "1. In a conflict situation, when a group discussion method… is involved, the members' reactions to the alternatives are relatively undifferentiated in contrast to the condition in which the leader alone makes the decision… . 2… . the groups appear to be least favorably disposed toward the authoritarian technique of decision-making… . 3. When the decision-making procedure is group centered the group reaches a decision involving greater personal risk to the members." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impacts on decision making of executives: Probabilities versus outcomes.

The determinants of decision making of executives are of special interest for companies. For a long time choices have been investigated based on theories that assume an equal impact of expected outcomes and expected probabilities (Von Neumann and Morgenstern 1953, Savage 1954, Kahneman and Tversky 1979). The influence of probabilities in decision processes is, however, questioned by a growing body of research (Rottenstreich and Kivetz 2006, Shapira 1995, March and Shapira 1987, 1992). To monitor the information acquisition process of board members and high-ranking executives in the German insurance industry we conducted 51 personal interviews, which included computer-aided simulations. These simulations clearly and objectively support former statements of executives (Shapira 1995) that they focus more on the amount of decision outcomes than on the corresponding probabilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Age differences in affective decision making as indexed by performance on the Iowa Gambling Task.

Contemporary perspectives on age differences in risk taking, informed by advances in developmental neuroscience, have emphasized the need to examine the ways in which emotional and cognitive factors interact to influence decision making. In the present study, a diverse sample of 901 individuals between the ages of 10 and 30 were administered a modified version of the Iowa Gambling Task, which is designed to measure affective decision making. Results indicate that approach behaviors (operationalized as the tendency to play increasingly from the advantageous decks over the course of the task) display an inverted U-shape relation to age, peaking in mid- to late adolescence. In contrast, avoidance behaviors (operationalized as the tendency to refrain from playing from the disadvantageous decks) increase linearly with age, with adults avoiding disadvantageous decks at higher rates than both preadolescents and adolescents. The finding that adolescents, compared to adults, are relatively more approach oriented in response to positive feedback and less avoidant in response to negative feedback is consistent with recent studies of brain development, as well as epidemiological data on various types of risky behavior, and may have important practical implications for the prevention of adolescent risk taking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessing decision making in young adult romantic relationships.

Romantic relationships among young adults are rich with ambiguity and without a clear, universal progression emphasizing the need for active decision making. Lack of active decision making in romantic relationships can lead to increases in constraints (e.g. pregnancy, shared living space or finances) that promote the continuation of relationships that would have otherwise ended, leading to increased risk of relationship distress. Because there is no available assessment of thoughtfulness regarding relationship decisions, the authors of the present studies report data on the development of one such scale, the Relationship Deciding Scale (RDS). Study 1 (N = 995) reveals the factor structure of the RDS and provides reliability data for the emergent subscales. In Study 2 (N = 963), the obtained three-factor structure (Relationship Confidence, Knowledge of Warning Signs, and Deciding) is tested via confirmatory factor analysis, demonstrates convergent and discriminant validity, and is shown to predict relationship characteristics 14 weeks later. Study 3 (N = 805) shows the sensitivity of the three factors to change through examination of the influence of a semester-long intervention targeted at increasing decision making in relationships. Use of this scale for identifying and intervening with couples or individuals who lack active decision making in relationships may decrease their risk for future relationship distress. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

To achieve or not to achieve: A self-regulation perspective on adolescents' academic decision making.

In 2 studies, the authors investigated the utility of the self-regulation model of decision making for explaining and predicting adolescents' academic decision making. Participants were mostly 9th and 11th graders. The 1st study consisted of all boys, and a 2nd similar study consisted of boys and girls. Measures included a newly developed assessment of decision-making skill (the Decision-Making-Competency Inventory), select scales of the Learning and Study Strategies Inventory-High School Version, an assessment of the importance of academic goals, and teacher ratings of achievement behavior. Adolescents' valuing of academic goals and their decision-making competency were typically the best predictors of their achievement behavior. Older adolescent boys did not affirm achievement striving compared with younger adolescent boys and older adolescent girls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The emergence of coherence over the course of decision making.

Previous research has indicated that decision making is accompanied by an increase in the coherence of assessments of the factors related to the decision alternatives. In the present study, the authors investigated whether this coherence shift is obtained before people commit to a decision, and whether it is obtained in the course of a number of other processing tasks. College students were presented with a complex legal case involving multiple conflicting arguments. Participants rated agreement with the individual arguments in isolation before seeing the case and after processing it under various initial sets, including playing the role of a judge assigned to decide the case. Coherence shifts were observed when participants were instructed to delay making the decision (Experiment 1), to memorize the case (Experiment 2), and to comprehend the case (Experiment 3). The findings support the hypothesis that a coherence-generating mechanism operates in a variety of processing tasks, including decision making. (PsycINFO Database Record (c) 2010 APA, all rights reserved)