The Paranoid Optimist: An Integrative Evolutionary Model of Cognitive Biases

Human cognition is often biased, from judgments of the time of impact of approaching objects all the way through to estimations of social outcomes in the future. We propose these effects and a host of others may all be understood from an evolutionary psychological perspective. In this article, we elaborate error management theory (EMT; Haselton & Buss, 2000). EMT predicts that if judgments are made under uncertainty, and the costs of false positive and false negative errors have been asymmetric over evolutionary history, selection should have favored a bias toward making the least costly error. This perspective integrates a diverse array of effects under a single explanatory umbrella, and it yields new content-specific predictions.

Tolerance of Ambiguity: Text Analytic vs Self-Report Measures in Two Nonclinical Groups

Avoidance of ambiguity can be examined by both text analytic and self-report methods. In previous studies using text analytic methods, clinical groups showed a higher avoidance of ambiguity than nonclinical subjects. In nonclinical subjects, however, higher avoidance of ambiguity did not correlate with emotional processes. In these studies, higher avoidance of ambiguity was assessed by a text analytic method (DoTA), which was applied to the Holtzman Inkblot Technique. However, the Inkblot Technique may not activate those cognitive-affective structures in nonclinical subjects required to elicit higher avoidance of ambiguity. Thus, the following discrepant results can be predicted: in nonclinical subjects, DoTA indicators of higher avoidance of ambiguity based on Holtzman Inkblot Technique do not show correlations with self-report measures of higher avoidance of ambiguity such as the Ambiguity Tolerance Questionnaire, the Inventory for the Measurement of Tolerance of Ambiguity (Reis inventory), or self-report measures of related traits of personality such as the Giessen Test. Self-report measures of higher avoidance of ambiguity should show such correlations. Two studies were carried out to test these hypotheses. In Study 1, 80 nonclinical subjects (48 women, M age = 34.5 yr.) were examined using the DoTA text analytic method, the Ambiguity Tolerance Questionnaire-14 and the Giessen Test. In Study 2, 82 nonclinical subjects (43 women, M age = 34.0 yr.) were tested using the Reis inventory. The results obtained in these subjects are consistent with the hypothesis.

Refusal of Medical Blood Transfusions Among Jehovah's Witnesses: Emotion Regulation of the Dissonance of Saving and Sacrificing Life

This study focuses on the requirement of JWs to refuse medical blood transfusions. We identified a life-death cognitive dissonance among JWs, with the opposing cognitions of being willing to sacrifice life by religious standards, while being unwilling to do so. Using a theory that connects cognitive dissonance with the need to regulate difficult emotions to analyze our qualitative data material, we identified two sets of dissonance reduction strategies among the JWs. Set 1 was tied to the individual-group: selective focus on eternal life, a non-blood support and control system, and increased individualization of treatment choices. Set 2 was in the religion versus medicine intersection: denial of risk combined with optimism, perception of blood as dangerous, and use of medical language to underscore religious doctrine.

Coping with unpleasant knowledge: Meat eating among students of environmental studies

This paper presents qualitative research on the attitudes and behaviors of environmental studies graduate students toward meat eating, and their strategies for coping with the cognitive dissonance induced by the issues related to meat eating and production. The research draws on theoretical and empirical research on the issue of meat eating and the psychological processes involved in it, and by analyzing in-depth interviews it reveals that these students exhibit partially different coping strategies than what studies on general population show, as a result of their awareness and their social circle. The results show that even though these people do not usually regard meat eating as wrong or undesirable in principle, they are well aware of the ethical and environmental issues related to it. In their attitudes and behavior the students are significantly influenced by their friends and fellow students amongst whom they perceive avoiding meat as a social norm. A generalization of the results suggests that the psychological dynamics of meat eating among environmentally informed and engaged people in general may be different than in general population. Further research into this group of people is proposed, most importantly from a socio-cultural point of view.

Discordant Feelings in the Lifeworld of Cancer Survivors

This article concerns persons who live in uncertainty following an earlier diagnosis of (and completed treatment for) cancer. Fear of recurrence of the disease underlies the uncertainty and the attendant perception of being profoundly endangered, more ‘at risk’ than anyone else. Such a reflective assessment engenders a sense of separation from the everyday ‘practical consciousness’ that seems effortlessly to be shared by ‘ordinary’ others. The mismatch between the interaction order and individual psychology gives rise to interpersonal emotional dissonance, which forms a significant aspect of the chronic suffering contained in the ‘at-risk illness’ experience of cancer survivors. The article examines the emotional patterns involved in their situation and seeks to elucidate the pain that accompanies their alienation from the lifeworld in which nonetheless they must continue to dwell.

“Saying One Thing and Doing Another”: Examining the Impact of Event Order on Hypocrisy Judgments of Others

This study investigated whether the temporal order of people’s expressed statements and their behaviors affected others’ judgments of hypocrisy, and why. It was proposed that hypocrisy would be greater when a statement establishing a personal standard preceded a behavior violating that standard as opposed to the reverse order. This order effect occurred in three studies, generalizing across two topic areas (healthy living and safe sex) and for both normative and nonnormative statements (pro/anti–safe sex). Mediation analyses indicated that the reverse order mitigated against hypocrisy because the target’s inconsistency was attributed to dispositional change. The discussion addresses additional variables likely to affect hypocrisy and the relationship of this research to hypocrisy paradigms in dissonance.

Bias at the Racetrack: Effects of Individual Expertise and Task Importance on Predecision Reevaluation of Alternatives

These studies were designed to test cognitive dissonance theory’s assertion that alternatives are not reevaluated before a choice. Participants viewed information about horses in a simulated race and rated each one’s chance of winning three times before placing their bet and once after placing it. It was found that ratings of the chosen horse increased within the predecision period as well as after betting. Predecision bolstering occurred even when participants did not expect to bet, and predecision preference increased with task importance and participant expertise. The findings are attributed to maintenance of consistency throughout a cognitive system.

Resistance Can Be Good or Bad: How Theories of Resistance and Dissonance Affect Attitude Certainty

This research investigated how lay theories about resisting persuasion can affect attitude certainty. Specifically, people who believed that resistance was negative (i.e., implies close-mindedness) showed different levels of attitude certainty after resisting persuasive messages than people who believed resistance was positive (i.e., implies intelligence). When people held positive lay theories of resistance and overcame ostensibly strong arguments, they showed increased attitude certainty (compared to those who overcame ostensibly weak arguments). However, individuals who believed that resistance was negative did not show increases in attitude certainty when overcoming strong arguments. Experiment 2 suggests that the effect of lay theories and perceived argument strength on attitude certainty was due to dissonance created by believing that resistance is undesirable but nonetheless resisting persuasion.

Cognitive Dissonance and the Perception of Natural Environments

Two studies demonstrated that the motivation to resolve cognitive dissonance affects the visual perception of physical environments. In Study 1, subjects crossed a campus quadrangle wearing a costume reminiscent of Carmen Miranda. In Study 2, subjects pushed themselves up a hill while kneeling on a skateboard. Subjects performed either task under a high-choice, low-choice, or control condition. Subjects in the high-choice conditions, presumably to resolve dissonance, perceived the environment to be less aversive than did subjects in the low-choice and control conditions, seeing a shorter distance to travel (Study 1) and a shallower slope to climb (Study 2). These studies suggest that the impact of motivational states extends from social judgment down into perceptual processes.

Care erosion in hospitals: Problems in reflective nursing practice and the role of cognitive dissonance

Care erosion - gradual decline in care level - is an important problem in health care today. Unfortunately, the mechanism whereby it occurs is complex and poorly understood. This paper seeks to address this by emphasising problems in reflective nursing practice. Critical reflection on quality of care which should drive good care instead spawns justifications, denial, and trivialisation of deficient care. This perpetuates increasingly poor care levels. We argue that cognitive dissonance theory provides a highly effective understanding of this process and suggest for this approach to be incorporated in all efforts to address care erosion. The paper includes a detailed discussion of examples and implications for practice, in particular the need to restore critical reflection in nursing, the importance of embracing strong values and standards, and the need for increased awareness of signs of care erosion.

Dissonance-Based Eating Disorder Prevention Program Reduces Reward Region Response to Thin Models; How Actions Shape Valuation

Research supports the effectiveness of a dissonance-based eating disorder prevention program wherein high-risk young women with body dissatisfaction critique the thin ideal, which reduces pursuit of this ideal, and the theory that dissonance induction contributes to these effects. Based on evidence that dissonance produces attitudinal change by altering neural representation of valuation, we tested whether completing the Body Project would reduce response of brain regions implicated in reward valuation to thin models. Young women with body dissatisfaction were randomized to this intervention or an educational control condition, completing assessments and fMRI scans while viewing images of thin versus average-weight female models at pre and post. Whole brain analyses indicated that, compared to controls, Body Project participants showed greater reductions in caudate response to images of thin versus average-weight models, though participants in the two conditions showed pretest differences in responsivity of other brain regions that might have contributed to this effect. Greater pre-post reductions in caudate and putamen response to thin models correlated with greater reductions in body dissatisfaction. The finding that the Body Project reduces caudate response to thin models provides novel preliminary evidence that this intervention reduces valuation of media images thought to contribute to body dissatisfaction and eating disorders, providing support for the intervention theory by documenting that this intervention alters an objective biological outcome.

'What's Psychology got to do with it?' Applying psychological theory to understanding failures in modern healthcare settings

The National Health Service (NHS) has, for over four decades, been beset with numerous 'scandals' relating to poor patient care across several diverse clinical contexts. Ensuing inquiries proceed as though each scandal is unique, with recommendations highlighting the need for more staff training, a change of culture within the NHS based upon a 'duty of candour', and proposed criminal sanctions for employees believed to breach good patient care. However, mistakes reoccur and failings in patient safety continue. While inquiries describe what went awry in each case, questions of how and why such failures came to be remain unanswered. Psychology has a role in answering these questions. Applying psychological theory can guide an understanding of the causes that lead to catastrophic failures in healthcare settings. Indeed, what is often neglected in inquiries is the role of human behaviour in contributing to these failures. Drawing upon behavioural, social and cognitive theories, a psychological analysis of key factors, typically present in clinical contexts where serious failures of care occur, is presented. Applying theory and models from the field of psychology can guide further understanding of the precipitants to poor care.

Religion, Sexuality, and Internalized Homonegativity: Confronting Cognitive Dissonance in the Abrahamic Religions

This research was aimed at investigating how religious beliefs and internalized shame predicted homonegativity. An online survey, which consisted of a self-report questionnaire assessing religious orientation, internalized shame, and internalized homonegativity, was completed by 133 Caucasian and Asian gay men. The respondents also were asked to write a short answer in which they had to explain how they integrated their religion and sexual practices. The quantitative analyses of data demonstrated no significant difference in internalized homonegativity among the two cultural groups. Internalized homonegativity was predicted by the main Abrahamic faiths (i.e. Christianity, Islam, and Judaism) and internalized shame. Qualitative analysis showed that gay men who adhere to a monotheistic religious faith follow a different path to reconciling their religion and homosexuality compared to gay men who adhere to Philosophical/New Age religions or to gay men who have no religious faith. The implications of these findings as well as directions for future research studies were discussed.

A randomized controlled trial of a peer co-led dissonance-based eating disorder prevention program for gay men

OBJECTIVE

Gay males have increased risk for eating disorders compared to heterosexual males, establishing a need to develop and empirically evaluate programs to reduce risk for this population. The present study investigated the acceptability and efficacy of a cognitive dissonance-based (DB) intervention (The PRIDE Body Project(©)) in reducing eating disorder risk factors among gay males in a university-based setting.

METHOD

Eighty-seven gay males were randomized to either a 2-session DB intervention (n = 47) or a waitlist control condition (n = 40). Participants completed eating disorder risk factor assessments pre-intervention, post-intervention, and at 4-week follow-up, and those receiving the intervention completed post-treatment acceptability measures.

RESULTS

Acceptability ratings were highly favorable. Regarding efficacy, the DB condition was associated with significantly greater decreases in body dissatisfaction, drive for muscularity, self-objectification, partner-objectification, body-ideal internalization, dietary restraint, and bulimic symptoms compared to waitlist control from pre- to post-intervention. Improvements in the DB group were maintained at 4-week follow-up, with the exception of body-ideal internalization. Body-ideal internalization mediated treatment effects on bulimic symptoms.

CONCLUSION

Results support the acceptability and efficacy of The PRIDE Body Project(©) and provide support for theoretical models of eating pathology in gay men.

[How our subjective coherence is built? The model of cognitive dissonance]

Our conscious, subjective discourse, demonstrates a temporal coherence that distinguishes it from the many unconscious cognitive representations explored by cognitive neuroscience. This subjective coherence, --particularly its dynamics--can be modified in certain psychiatric syndromes including a " dissociative state " (e.g. schizophrenia), or in several neuropsychiatric disorders (e.g. frontal lobe syndrome). The medical and environmental consequences of these changes are significant. However, the psychological and neural mechanisms of this fundamental property remain largely unknown. We explored the dynamics of subjective coherence in an experimental paradigm (the "free choice "paradigm) originating for the field of cognitive dissonance. Using a series of behavioral experiments, conducted in healthy volunteers, we have discovered a key role for the episodic memory in the preference change process when simply making a choice. These results highlight the importance of conscious memory in the construction of subjective consistency, of which the subjects do not yet seem to be the conscious agents.

Existential Threat or Dissociative Response? Examining Defensive Avoidance of Point-of-Care Testing Devices Through a Terror Management Theory Framework

Using a terror management theory framework, this study investigated if providing mortality reminders or self-esteem threats would lead participants to exhibit avoidant responses toward a point-of-care testing device for cardiovascular disease risk and if the nature of the device served to diminish the existential threat of cardiovascular disease. One hundred and twelve participants aged 40-55 years completed an experimental questionnaire. Findings indicated that participants were not existentially threatened by established terror management methodologies, potentially because of cross-cultural variability toward such methodologies. Highly positive appraisals of the device also suggest that similar technologies may beneficially affect the uptake of screening behaviors.

New graduate identity: Discursive mismatch

For many new graduates the transition from nursing student to a professional in practice is marked by conflict and tension. Given that conflict may ensue from differing discursive constructions of new graduates, this article reports a review of discursive construction between new graduates from two institutions with vested interests in nursing graduates--comparing health service organisations and educational institutions in Victoria. Four discourses, common to both sets of texts and constitutive of new graduate identity were identified: these were the discourse of nursing practice; the discourse of the good nurse; the discourse of knowing and thinking; and the discourse of statute and regulation. A discourse peculiar to health service organisations only was identified as an organisational and bureaucratic discourse. This review reports the new graduate, as constructed in education texts, as a rational, independent, critically thinking and knowing care giver. In contrast, in health service organisation texts, the new graduate is constructed as a functional, efficient, organisational operative, providing a nursing service. New graduates are concluded to experience multiple discursive dissonances in their first employment which stem from differing constructions of new graduate identity within institutional discourses. If tensions experienced in the transition as discursively generated are understood, previously unthought of ways preparing and introducing nurses to the work place may ensue.

Reducing eating disorder risk factors: a controlled investigation of a blended task-shifting/train-the-trainer approach to dissemination and implementation

Recent advances in psychological intervention research have led to an increase in evidence-based interventions (EBIs), yet there remains a lag in dissemination and implementation of EBIs. Task-shifting and the train-the-trainer (TTT) model offer two potential strategies for enhancing reach of EBIs. The Body Project, an EBI found to prevent onset of eating disorders, served as the vehicle for this dissemination/implementation study. The primary aim of this study was to determine if training of peer-leaders for the Body Project could be task-shifted to undergraduate students using a hybrid task-shifting/TTT model. Our secondary aim was to determine if subgroups of participants evidenced different trajectories of change through 14-month follow-up. Regarding the first aim, we found almost no evidence to suggest that a presence of a doctoral-level trainer yielded superior participant outcomes compared to training by undergraduates alone. Regarding Aim 2, almost all classes for all variables evidenced improvement or a benign response. Additionally, for three key risk factors (thin-ideal internalization, body dissatisfaction, and ED symptoms) virtually all trajectories showed improvement. This study provides initial support for the use of a blended task-shifting/TTT approach to dissemination and implementation within prevention generally, and further support for broad dissemination of the Body Project specifically.

Psychological intervention - a critical element of rehabilitation in chronic pulmonary diseases

Chronic pulmonary diseases represent a segment of pathology with an increasing prevalence worldwide, this requiring joint efforts from specialists in this field to (a) identify those factors insufficiently explored so far, but critical for their evolution and (b) address them via new therapies. This study aims to explore the existing data regarding the psychological factors involved in the dynamics of chronic pulmonary diseases and the main possibilities of psychological intervention, as a distinct part of pulmonary rehabilitation (PR). 49 articles published on this topic in peer-reviewed journals between 1979 and 2010, indexed in PubMed, ProQuest and EBSCO databases, were examined for evidence. Among psychological factors considered important by study authors were the following: 1) the deficient instruction of the patient, 2) decreased treatment motivation, 3) a marginal social role, 4) a disadaptive cognitive style and 5) psychiatric comorbidity (especially anxiety and depression). Efficient interventions were, for physicians, 1) patient education and 2) designing a personalized self-management plan, and for the clinical psychologists, 1) cognitive-behavioral therapy, 2) biofeedback, 3) family therapy, 4) relaxation and 5) hypnosis. Despite the undeniable effect of these methods in selected cases, the high heterogeneity of designs and personal affiliations of researchers do not allow new generalizations about their efficacy or their routine implementation into PR. Further research including larger samples, more uniform designs, construction of consensual international standards regarding the objectives of PR, and assessments done by experts from multiple study domains could contribute to a better understanding of the role psychological interventions could play in PR.

Effectiveness of a dissonance-based eating disorder prevention program for ethnic groups in two randomized controlled trials

OBJECTIVE

As young women from certain ethnic minority groups have reported less pursuit of the thin ideal and body dissatisfaction than European American young women we tested whether a dissonance-based prevention program designed to reduce thin-ideal internalization among women with body dissatisfaction is less effective for the former relative to the later groups. We also tested whether intervention effects are larger when participants from minority groups worked with a facilitator matched versus not matched on ethnicity.

METHOD

In Study 1, 426 female undergraduates (M age=21.6, SD=5.6) were randomized to clinician-led Body Project groups or an educational control group. In Study 2, 189 female undergraduates were randomized to peer-led Body Project groups or a waitlist control condition.

RESULTS

Although there was some variation in risk factor scores across ethnic groups, ethnic minority participants did not demonstrate consistently higher or lower risk relative to European American participants. Intervention effects did not significantly differ for participants from minority groups versus European American participants in either trial. There was no evidence that effects were significantly larger when minority participants and facilitators were matched on ethnicity.

CONCLUSIONS

Results suggest that the Body Project is similarly effective for African American, Asian American, European American, and Hispanic female college students, and when participants and facilitators are matched or not on minority ethnicity status, implying that this prevention program can be broadly disseminated in this population.

[Cerebral dysfunction after coronary artery bypass graft surgery with cardiopulmonary bypass]

The cardiac surgery is accompanied by multifactorial alteration of the brain, which can present in different clinical types of postoperative cerebral dysfunction. A stroke was diagnosed only after coronary artery bypass graft surgery with cardiopulmonary bypass. Postoperative cognitive dysfunction (including acute cognitive dysfunction and deferred cognitive impairment) was significantly more frequent after surgery with cardiopulmonary bypass. The preoperative use of complex cytoprotective medication Cytoflavin decreased the severity of the deferred cognitive impairment. The data show the prospects of the pharmacological neuroprotection in cardiac surgery with cardiopulmonary bypass.