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Institute
Analysis of physicians' probability estimates of a medical outcome based on a sequence of events
(2022)
IMPORTANCE
The probability of a conjunction of 2 independent events is the product of the probabilities of the 2 components and therefore cannot exceed the probability of either component; violation of this basic law is called the conjunction fallacy. A common medical decision-making scenario involves estimating the probability of a final outcome resulting from a sequence of independent events; however, little is known about physicians' ability to accurately estimate the overall probability of success in these situations.
OBJECTIVE
To ascertain whether physicians are able to correctly estimate the overall probability of a medical outcome resulting from 2 independent events.
DESIGN, SETTING, AND PARTICIPANTS
This survey study consisted of 3 separate substudies, in which 215 physicians were asked via internet-based survey to estimate the probability of success of each of 2 components of a diagnostic or prognostic sequence as well as the overall probability of success of the 2-step sequence. Substudy 1 was performed from April 2 to 4, 2021, substudy 2 from November 2 toll, 2021, and substudy 3 from May 13 to 19, 2021. All physicians were board certified or board eligible in the primary specialty germane to the substudy (ie, obstetrics and gynecology for substudies land 3 and pulmonology for substudy 2), were recruited from a commercial survey service, and volunteered to participate in the study.
EXPOSURES
Case scenarios presented in an online survey.
MAIN OUTCOMES AND MEASURES
Respondents were asked to provide their demographic information in addition to 3 probability estimates. The first substudy included a scenario describing a brow presentation discovered during labor; the 2 conjuncts were the probabilities that the brow presentation would resolve and that the delivery would be vaginal. The second substudy involved a diagnostic evaluation of an incidentally discovered pulmonary nodule; the 2 conjuncts were the probabilities that the patient had a malignant condition and that a technically successful transthoracic needle biopsy would reveal a malignant condition. The third substudy included a modification of the first substudy in an attempt to debias the conjunction fallacy prevalent in the first substudy. Respondents' own probability estimates of the individual events were used to calculate the mathematically correct conjunctive probability.
RESULTS
Among 215 respondents, the mean (SD) age was 54.0 (9.5) years; 142 respondents (66.0%) were male. Data on race and ethnicity were not collected. A total of 168 physicians (78.1%) estimated the probability of the 2-step sequence to be greater than the probability of at least 1 of the 2 component events. Compared with the product of their 2 estimated components, respondents overestimated the combined probability by 12.8% (95% CI, 9.6%-16.1%; P < .001) in substudy 1, 19.8% (95% Cl, 16.6%-23.0%; P < .001) in substudy 2, and 18.0% (95% CI, 13.4%-22.5%; P < .001) in substudy 3, results that were mathematically incoherent (ie, formally illogical and mathematically incorrect).
CONCLUSIONS AND RELEVANCE
In this survey study of 215 physicians, respondents consistently overestimated the combined probability of 2 events compared with the probability calculated from their own estimates of the individual events. This biased estimation, consistent with the conjunction fallacy, may have substantial implications for diagnostic and prognostic decision-making.
The presence of task-irrelevant sound disrupts short-term memory for serial information. Recent studies found that enhanced perceptual task-encoding load (static visual noise added to target items) reduces the disruptive effect of an auditory deviant but does not affect the task-specific interference by changing-state sound, indicating that the deviation effect may be more susceptible to attentional control. This study aimed to further specify the role of attentional control in shielding against different types of auditory distraction, examining speech and nonspeech distractors presented in laboratory and Web based experiments. To further elucidate the role of controlled processes, we tested whether the detrimental effects of distractor sounds-and their modulation by attentional control-reach participants' awareness. We found that changing-state sound and auditory deviants in steady-state sound equally affected both objective recall performance and metacognitive confidence judgments but did not affect the accuracy of confidence judgments. Most importantly, across four experiments, an increase of task load (visual degradation of the to-be-remembered items) did not reduce either type of auditory distraction. A close replication of the original modulation of the deviation effect by perceptual task load (in an online environment) even revealed a stronger deviation effect at high task load, suggesting that the manipulation may have influenced cognitive load and the ability to control distractor interference in memory. In line with a unitary account of auditory distraction, the results suggest that although both types of distraction reach metacognitive awareness, they may be equally unrelated to perceptual load and the availability of attentional resources. <br /> Public Significance Statement Our ability to hold information in short-term memory suffers in the presence of background sound, but it is unclear to what extent auditory distraction depends on attentional control and metacognitive monitoring. This study reassessed a finding, whereby the diversion of attention by deviant sounds is reduced when the focal task becomes more difficult to process (via perceptual degradation). A series of experiments showed that both the effect of auditory deviants and the interference by changing-state sound is largely resistant to a manipulation of task load, indicating that distraction is not susceptible to attentional control. Nevertheless, participants appeared to be well aware of the detrimental sound effects on performance, as reflected in metacognitive confidence judgments. The findings have important implications for theoretical accounts of auditory distraction, indicating that disruption is attributable to automatic attentional capture, which cannot be controlled despite us being aware of it.
One of the ongoing debates about visual consciousness is whether it can be considered as an all-or-none or a graded phenomenon. While there is increasing evidence for the existence of graded states of conscious awareness based on paradigms such as visual masking, only little and mixed evidence is available for the attentional blink paradigm, specifically in regard to electrophysiological measures. Thereby, the all-or-none pattern reported in some attentional blink studies might have originated from specifics of the experimental design, suggesting the need to examine the generalizability of results. In the present event-related potential (ERP) study (N = 32), visual awareness of T2 face targets was assessed via subjective visibility ratings on a perceptual awareness scale in combination with ERPs time-locked to T2 onset (components P1, N1, N2, and P3). Furthermore, a classification task preceding visibility ratings allowed to track task performance. The behavioral results indicate a graded rather than an all-or-none pattern of visual awareness. Corresponding graded differences in the N1, N2, and P3 components were observed for the comparison of visibility levels. These findings suggest that conscious perception during the attentional blink can occur in a graded fashion.
Number to me, space to you
(2022)
Recent work has shown that number concepts activate both spatial and magnitude representations. According to the social co-representation literature which has shown that participants typically represent task components assigned to others together with their own, we asked whether explicit magnitude meaning and explicit spatial coding must be present in a single mind, or can be distributed across two minds, to generate a spatial-numerical congruency effect. In a shared go/no-go task that eliminated peripheral spatial codes, we assigned explicit magnitude processing to participants and spatial processing to either human or non-human co-agents. The spatial-numerical congruency effect emerged only with human co-agents. We demonstrate an inter-personal level of conceptual congruency between space and number that arises from a shared conceptual representation not contaminated by peripheral spatial codes. Theoretical implications of this finding for numerical cognition are discussed.
Background: Some (minority) groups (MGs) are more vulnerable to sexual violence (SV) exposure than others. Othering-based stress (OBS) may mediate the relationship between minority identification and SV. This study aims to assess the prevalence of SV in different MGs to explore the relationship between minority identification and SV, to investigate whether belonging to multiple MGs moderates this relationship, and to explore OBS SV moderation for different MGs. Method: Through an online survey administered to a nationally representative sample in Belgium, data was collected from 4632 persons, of whom 21.01% self-identified as belonging to a MG (SI-Minority). SV prevalence was measured using behaviorally specific questions based on the WHO definition of SV. SI-Minority participants received an additional scale on OBS. Results: SI-Minority participants reported more SV victimization compared to the non-minorities. However, this increased risk was not moderated by minority identification but linked to the socio-demographic SV risk markers common to minority individuals. Multiple-minority participants were found more at risk of SV compared to single-minority respondents. Lesbian, gay, bisexual, pan-/omnisexual, asexual, and other non-heterosexual (LGB+) participants were found more at risk than heterosexual participants. OBS was found to be significantly correlated to SV in sexual and gender minorities and in cultural minorities. Conclusions: This study contributes to our understanding of the relationship between minority identification, OBS, and SV. Studying both specific and common SV vulnerabilities and outcomes within specific societal subgroups and the general population may inform policy makers when allocating resources to those interventions with the largest societal impact.
Individual differences in demographics, personality, and other related beliefs are associated with coronavirus disease 2019 (COVID-19) threat beliefs. However, the relative contributions of these different types of individual differences to COVID-19 threat beliefs are not known. In this study, a total of 1,700 participants in Croatia (68% female; age 18-86 years) completed a survey that included questions about COVID-19 risks, questions about related beliefs including vaccination beliefs, trust in the health system, trust in scientists, and trust in the political system, the HEXACO 60 personality inventory, as well as demographic questions about gender, age, chronic diseases, and region. We used hierarchical regression analyses to examine the proportion of variance explained by demographics, personality, and other related beliefs. All three types of individual differences explained a part of the variance of COVID-19 threat beliefs, with related beliefs explaining the largest part. Personality facets explained a slightly larger amount of variance than personality factors. These results have implications for communication about COVID-19.
Little is known about the current state of research on the involvement of young people in hate speech. Thus, this systematic review presents findings on a) the prevalence of hate speech among children and adolescents and on hate speech definitions that guide prevalence assessments for this population; and b) the theoretical and empirical overlap of hate speech with related concepts. This review was guided by the Cochrane approach. To be included, publications were required to deal with real-life experiences of hate speech, to provide empirical data on prevalence for samples aged 5 to 21 years and they had to be published in academic formats. Included publications were full-text coded using two raters (kappa = .80) and their quality was assessed. The string-guided electronic search (ERIC, SocInfo, Psycinfo, Psyndex) yielded 1,850 publications. Eighteen publications based on 10 studies met the inclusion criteria and their findings were systematized. Twelve publications were of medium quality due to minor deficiencies in their theoretical or methodological foundations. All studies used samples of adolescents and none of younger children. Nine out of 10 studies applied quantitative methodologies. Eighteen publications based on 10 studies were included. Results showed that frequencies for hate speech exposure were higher than those related to victimization and perpetration. Definitions of hate speech and assessment instruments were heterogeneous. Empirical evidence for an often theorized overlap between hate speech and bullying was found. The paper concludes by presenting a definition of hate speech, including implications for practice, policy, and research.
Background The Covid-19 pandemic led to increased work-related strain and psychosocial burden in nurses worldwide, resulting in high prevalences of mental health problems. Nurses in long-term care facilities seem to be especially affected by the pandemic. Nevertheless, there are few findings indicating possible positive changes for health care workers. Therefore, we investigated which psychosocial burdens and potential positive aspects nurses working in long-term care facilities experience during the Covid-19 pandemic. Methods We conducted a mixed-methods study among nurses and nursing assistants working in nursing homes in Germany. The survey contained the third German version of the Copenhagen Psychosocial Questionnaire (COPSOQ III). Using Welch's t-tests, we compared the COPSOQ results of our sample against a pre-pandemic reference group of geriatric nurses from Germany. Additionally, we conducted semi-structured interviews with geriatric nurses with a special focus on psychosocial stress, to reach a deeper understanding of their experiences on work-related changes and burdens during the pandemic. Data were analysed using thematic coding (Braun and Clarke). Results Our survey sample (n = 177) differed significantly from the pre-pandemic reference group in 14 out of 31 COPSOQ scales. Almost all of these differences indicated negative changes. Our sample scored significantly worse regarding the scales 'quantitative demands', 'hiding emotions', 'work-privacy conflicts', 'role conflicts', 'quality of leadership', 'support at work', 'recognition', 'physical demands', 'intention to leave profession', 'burnout', 'presenteeism' and 'inability to relax'. The interviews (n = 15) revealed six main themes related to nurses' psychosocial stress: 'overall working conditions', 'concern for residents', 'management of relatives', 'inability to provide terminal care', 'tensions between being infected and infecting others' and 'technicisation of care'. 'Enhanced community cohesion' (interviews), 'meaning of work' and 'quantity of social relations' (COPSOQ III) were identified as positive effects of the pandemic. Conclusions Results clearly illustrate an aggravation of geriatric nurses' situation and psychosocial burden and only few positive changes due to the Covid-19 pandemic. Pre-existing hardships seem to have further deteriorated and new stressors added to nurses' strain. The perceived erosion of care, due to an overemphasis of the technical in relation to the social and emotional dimensions of care, seems to be especially burdensome to geriatric nurses.
Not much is known about how bystanders' emotional reactions after not intervening in cyberbullying might impact their health issues. Narrowing this gap in the literature, the present study focused on examining the moderating effects of emotional reactions (i.e., guilt, sadness, anger) after not intervening in cyberbullying on the longitudinal relationship between cyberbullying bystanding and health issues (i.e., subjective health complaints, suicidal ideation, non-suicidal self-harm). Participants were 1,067 adolescents between 12 and 15 years old included in this study (M-age = 13.67; 51% girls). The findings showed a positive association between Time 1 cyberbullying bystanding and Time 2 health issues. Guilt moderated the positive relationships among Time 1 cyberbullying bystanding, Time 2 subjective health complaints, suicidal ideation, and non-suicidal self-harm. Time 1 sadness also moderated the relationship between Time 1 cyberbullying bystanding and Time 2 suicidal ideation and non-suicidal self-harm. However, anger did not moderate any of the associations.
Theoretischer Hintergrund:
Selbsterfahrung ist zentraler Bestandteil der Psychotherapieausbildung. Gleichzeitig wurde Selbsterfahrung selten empirisch untersucht.
Fragestellung:
Ziel unserer Studie war es, Bedingungen und Effekte hilfreicher Selbsterfahrung zu explorieren.
Methode:
Vierzehn verhaltenstherapeutische Ausbildungskandidat_innen wurden anhand halbstrukturierter Leitfadeninterviews befragt. Die Auswertung erfolgte mittels qualitativer Inhaltsanalyse nach Mayring (2015).
Ergebnisse:
Verschiedene Bedingungen wurden mit hilfreich erlebter Selbsterfahrung in Zusammenhang gebracht: Merkmale der Selbsterfahrungsleitung (u. a. Durchführungskompetenz), der Organisation, der Teilnehmer_innen (Lernbereitschaft), die behandelten Themen und die eingesetzten Techniken, sowie eine tragfähige Arbeitsbeziehung. Berichtete positive Effekte waren u. a. die Förderung interpersoneller Kompetenzen. Zudem wurden Nebenwirkungen und negative Effekte formuliert (u. a. Erschöpfung).
Schlussfolgerungen:
Bedingungen zur Durchführung von als hilfreich erlebter Selbsterfahrung und Effekte von Selbsterfahrung wurden aus Sicht der Teilnehmer_innen extrahiert.