How Reasoning, Judgment, and Decision Making are Colored by Gist-based Intuition: A Fuzzy-Trace Theory Approach

"It's Not Literally True, But You Get the Gist:" How nuanced understandings of truth encourage people to condone and spread misinformation

People have a more-nuanced view of misinformation than the binary distinction between "fake news" and "real news" implies. We distinguish between the truth of a statement's verbatim details (i.e., the specific, literal information) and its gist (i.e., the general, overarching meaning), and suggest that people tolerate and intentionally spread misinformation in part because they believe its gist. That is, even when they recognize a claim as literally false, they may judge it as morally acceptable to spread because they believe it is true "in spirit." Prior knowledge, partisanship, and imagination increase belief in the gist. We argue that partisan conflict about the morality of spreading misinformation hinges on disagreements not only about facts but also about gists.

Is life going too fast? Exploring the unique and joint contributions of mindfulness, temperament, task load, and metacognitions about time

BACKGROUND

Previous research has shown that mindfulness is associated with slower passage of time in everyday life, and with lower self-reported time pressure. This study investigates some of the potential mechanisms behind these relationships.

METHODS

318 participants submitted their responses to an online survey which collected data regarding passage of time judgments, time pressure, trait mindfulness, temperament, task load, and metacognitions about time. Using commonality and dominance analyses, we explored how these variables contributed, either alone or jointly, to predicting how fast (or slow) time seems to pass for participants, or how pressed for time they felt.

RESULTS

Mindfulness and temperament had some overlaps in their ability to predict passage of time judgments and time pressure for durations at the month and 2-month scales. The temperamental trait of extraversion/surgency, as well as the Non-judging and Non-reacting facets of mindfulness were among the best predictors of passage of time judgments and time pressure. Attention-related variables were mainly related to time perception via their involvement in joint effects with other variables. Results also suggested that metacognitions about time interacted with other variables in predicting passage of time judgments, but only at the month scale. Finally, among all the variables included in this study, task load had the highest degree of involvement in predictions of self-reported time pressure at the week and month scales, but it contributed relatively little to predicting passage of time judgments.

CONCLUSIONS

Results suggest that mindfulness relates to passage of time through its involvement in inferential processes. The data also shows how different factors are related to PoTJ at different time scales. Finally, results suggest the existence of both similarities and differences in how passage of time and time pressure relate to the other included variables.

Making decisions one drink at a time and the "just one drink" effect: A fuzzy-trace theory model of harmful drinking

BACKGROUND

Understanding the decision factors that drive harmful alcohol use among young adults is of practical and theoretical importance. We apply fuzzy-trace theory (FTT) to investigate a potential danger that may arise from the arguably correct notion that a single drink carries no meaningful risk. Decisions that are mentally represented as one drink at a time could contribute to excessive drinking.

METHODS

College students (N = 351) made a series of decisions to take or decline eight hypothetical drinks presented one at a time. Outcome measures included each decision, recent alcohol consumption (weekly drinks, peak blood alcohol content, and binges), and alcohol-related harms (scores on the Brief Young Adult Alcohol Consequences Questionnaire and Alcohol Use Disorders Identification Test). Linear regression models predicted each outcome from sex, perceived risk of a single drink, perceived risk of heavy drinking, perceived consequences of drinking, and general health-related risk sensitivity.

RESULTS

Consistent with FTT, decisions to have a first drink and up to four additional drinks in short succession were each associated with lower perceived risk of one drink-a "just-one drink" effect-independent of perceived risks of heavy drinking, perceived consequences of drinking, and general risk sensitivity. Similarly, all measures of recent alcohol consumption and consequent harms were associated with perceived risk of one drink. Participants reporting "zero risk" of a single drink had worse outcomes on all measures than those reporting at least "low risk."

CONCLUSIONS

Results are consistent with the theoretically informed premise that consumption decisions are typically made one drink at a time rather than by deciding the total number of drinks to be consumed in a sitting. When decisions about alcohol use proceed one drink at a time, a perception of zero risk in a single drink may contribute to heavy drinking.

Can degrading information about patient symptoms in vignettes alter clinical reasoning in paramedics and paramedic students? An experimental application of fuzzy trace theory

BACKGROUND

Research has shown paramedics form rapid intuitive impressions on first, meeting a patient and these impressions subsequently affected their clinical reasoning. We report an experiment where theory-based interventions are developed with the goal of reducing reliance on intuitive reasoning by paramedics and paramedic students in simulated patients.

METHOD

Australian paramedics (n = 213; 49% female) and paramedicine students (n = 83; 55% female) attending paramedic conferences completed a 2 × 2 fully between participants experiment. They saw a written clinical vignette designed to be representative of Acute Coronary Syndrome (ACS) in which key clinical information was precise or degraded (stimulus), they then either chose the single most likely diagnosis from a list, or ranked competing diagnoses (response). Outcome variables were diagnostic rate and response time.

RESULTS

There were no differences in the proportion of participants choosing ACS across the four stimulus-response conditions (0.75 [0.65, 0.84] vs 0.79 [0.68, 0.87] vs, 0.78 [0.65, 0.87] vs 0.72 [0.59, 0.82], p = 0.42) CONCLUSION: This is the first study attempting to experimentally examine clinical reasoning in paramedics using a theory-based intervention. Neither of the interventions tested succeeded in altering measures of clinical reasoning. Similar to previous research on physicians, paramedic reasoning appears robust to manipulation.

Minor Changes Change Memories: Functional Magnetic Resonance Imaging and Behavioral Reflections of Episodic Prediction Errors

Episodic memories can be modified, a process that is potentially driven by mnemonic prediction errors. In the present study, we used modified cues to induce prediction errors of different episodic relevance. Participants encoded episodes in the form of short toy stories and then returned for an fMRI session on the subsequent day. Here, participants were presented either original episodes or slightly modified versions thereof. Modifications consisted of replacing a single object within the episode and either challenged the gist of an episode (gist modifications) or left it intact (surface modifications). On the next day, participants completed a post-fMRI memory test that probed memories for originally encoded episodes. Both types of modifications triggered brain activation in regions we previously found to be involved in the processing of content-based mnemonic prediction errors (i.e., the exchange of an object). Specifically, these were ventrolateral pFC, intraparietal cortex, and lateral occipitotemporal cortex. In addition, gist modifications triggered pronounced brain responses, whereas those for surface modification were only significant in the right inferior frontal sulcus. Processing of gist modifications also involved the posterior temporal cortex and the precuneus. Interestingly, our findings confirmed the posterior hippocampal role of detail processing in episodic memory, as evidenced by increased posterior hippocampal activity for surface modifications compared with gist modifications. In the post-fMRI memory test, previous experience with surface modified, but not gist-modified episodes, increased erroneous acceptance of the same modified versions as originally encoded. Whereas surface-level prediction errors might increase uncertainty and facilitate confusion of alternative episode representations, gist-level prediction errors seem to trigger the clear distinction of independent episodes.

Critical tests of fuzzy trace theory in brain and behavior: uncertainty across time, probability, and development

Uncertainty permeates decisions from the trivial to the profound. Integrating brain and behavioral evidence, we discuss how probabilistic (varied outcomes) and temporal (delayed outcomes) uncertainty differ across age and individuals; how critical tests adjudicate between theories of uncertainty (prospect theory and fuzzy-trace theory); and how these mechanisms might be represented in the brain. The same categorical gist representations of gains and losses account for choices and eye-tracking data in both value-allocation (add money to gambles) and risky-choice tasks, disconfirming prospect theory and confirming predictions of fuzzy-trace theory. The analysis is extended to delay discounting and disambiguated choices, explaining hidden-zero effects that similarly turn on categorical distinctions between some gain and no gain, certain gain and uncertain gain, gain and loss, and now and later. Bold activation implicates dorsolateral prefrontal and posterior parietal cortices in gist strategies that are not just one tool in a grab-bag of cognitive options but rather are general strategies that systematically predict behaviors across many different tasks involving probabilistic and temporal uncertainty. High valuation (e.g., ventral striatum; ventromedial prefrontal cortex) and low executive control (e.g., lateral prefrontal cortex) contribute to risky and impatient choices, especially in youth. However, valuation in ventral striatum supports reward-maximizing and gist strategies in adulthood. Indeed, processing becomes less "rational" in the sense of maximizing gains and more noncompensatory (eye movements indicate fewer tradeoffs) as development progresses from adolescence to adulthood, as predicted. Implications for theoretically predicted "public-health paradoxes" are discussed, including gist versus verbatim thinking in drug experimentation and addiction.

Autobiographical event memory and aging: older adults get the gist

We propose that older adults' ability to retrieve episodic autobiographical events, although often viewed through a lens of decline, reveals much about what is preserved and prioritized in cognitive aging. Central to our proposal is the idea that the so-called gist of an autobiographical event is not only spared with normal aging but also well adapted to serve memory-guided behavior in older age. To support our proposal, we review cognitive and brain evidence indicating an age-related shift toward gist memory. We then discuss why this shift likely arises from more than age-related decline and instead partly reflects a natural, arguably adaptive, outcome of experience, motivation, and mode-of-thinking factors. Our proposal reveals an upside of age-related memory changes and identifies important research questions.

Effect of a Patient Decision Aid on Preferences for Colorectal Cancer Screening Among Older Adults: A Secondary Analysis of a Randomized Clinical Trial

IMPORTANCE

Guidelines recommend individualized decision-making for colorectal cancer (CRC) screening among adults aged 76 to 84 years, a process that includes a consideration of health state and patient preference.

OBJECTIVE

To determine whether a targeted patient decision aid would align older adults' screening preference with their potential to benefit from CRC screening.

DESIGN, SETTING, AND PARTICIPANTS

This is a prespecified secondary analysis from a randomized clinical trial. Participants aged 70 to 84 years who were not up to date with screening and had an appointment within 6 weeks were purposively sampled by health state (poor, intermediate, or good) at 14 community-based primary care practices and block randomized to receive the intervention or control. Patients were recruited from March 1, 2012, to February 28, 2015, and these secondary analyses were performed from January 15 to March 1, 2022.

INTERVENTIONS

Patient decision aid targeted to age and sex.

MAIN OUTCOMES AND MEASURES

The primary outcome of this analysis was patient preference for CRC screening. The a priori hypothesis was that the decision aid (intervention) group would reduce the proportion preferring screening among those in poor and intermediate health compared with the control group.

RESULTS

Among the 424 participants, the mean (SD) age was 76.8 (4.2) years; 248 (58.5%) of participants were women; and 333 (78.5%) were White. The proportion preferring screening in the intervention group was less than in the control group for those in the intermediate health state (34 of 76 [44.7%] vs 40 of 73 [54.8%]; absolute difference, -10.1% [95% CI, -26.0% to 5.9%]) and in the poor health state (24 of 62 [38.7%] vs 33 of 61 [54.1%]; absolute difference, -15.4% [95% CI, -32.8% to 2.0%]). These differences were not statistically significant. The proportion of those in good health who preferred screening was similar between the intervention and control groups (44 of 74 [59.5%] for intervention vs 46 of 75 [61.3%] for control; absolute difference, -1.9% [95% CI, -17.6% to 13.8%]).

CONCLUSIONS AND RELEVANCE

The findings of this secondary analysis of a clinical trial did not demonstrate statistically significant differences in patient preferences between the health groups. Additional studies that are appropriately powered are needed to determine the effect of the decision aid on the preferences of older patients for CRC screening by health state.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT01575990.

Effect of Attentional Focus on Sprint Performance: A Meta-Analysis

Sprinting is often seen in a variety of sports. Focusing one's attention externally before sprinting has been demonstrated to boost sprint performance. The present study aimed to systematically review previous findings on the impact of external focus (EF), in comparison to internal focus (IF), on sprint performance. A literature search was conducted in five electronic databases (APA PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science). A random-effects model was used to pool Hedge's g with 95% confidence intervals (CIs). The meta-analysis included six studies with a total of 10 effect sizes and 166 participants. In general, the EF condition outperformed the IF condition in sprint performance (g = 0.279, 95% CI [0.088, 0.470], p = 0.004). The subgroup analysis, which should be viewed with caution, suggested that the benefits associated with the EF strategy were significant in low-skill sprinters (g = 0.337, 95% CI [0.032, 0.642], p = 0.030) but not significant in high-skill sprinters (g = 0.246, 95% CI [-0.042, 0.533], p = 0.094), although no significant difference was seen between these subgroups (p = 0.670). The reported gain in sprint performance due to attentional focus has practical implications for coaches and athletes, as making tiny adjustments in verbal instructions can lead to significant behavioral effects of great importance in competitive sports.

Guiding Efficient, Effective, and Patient-Oriented Electrolyte Replacement in Critical Care: An Artificial Intelligence Reinforcement Learning Approach

Both provider- and protocol-driven electrolyte replacement have been linked to the over-prescription of ubiquitous electrolytes. Here, we describe the development and retrospective validation of a data-driven clinical decision support tool that uses reinforcement learning (RL) algorithms to recommend patient-tailored electrolyte replacement policies for ICU patients. We used electronic health records (EHR) data that originated from two institutions (UPHS; MIMIC-IV). The tool uses a set of patient characteristics, such as their physiological and pharmacological state, a pre-defined set of possible repletion actions, and a set of clinical goals to present clinicians with a recommendation for the route and dose of an electrolyte. RL-driven electrolyte repletion substantially reduces the frequency of magnesium and potassium replacements (up to 60%), adjusts the timing of interventions in all three electrolytes considered (potassium, magnesium, and phosphate), and shifts them towards orally administered repletion over intravenous replacement. This shift in recommended treatment limits risk of the potentially harmful effects of over-repletion and implies monetary savings. Overall, the RL-driven electrolyte repletion recommendations reduce excess electrolyte replacements and improve the safety, precision, efficacy, and cost of each electrolyte repletion event, while showing robust performance across patient cohorts and hospital systems.

Development of video animations to encourage patient-driven deprescribing: A Team Alice Study

OBJECTIVE

Patient-driven deprescribing initiatives aim to increase patient knowledge and strengthen self-advocacy skills. This article describes the development of three animated videos designed to educate older adults about unsafe prescribing and medication harm, based on the actionable lessons from the death, by polypharmacy, of an older adult in our community.

METHODS

Using a community based participatory research approach (CBPR), members of three senior centers (n = 53) and the Deprescribing Partnership of Western New York (n = 30) were recruited and participated in two rounds of focus groups to guide the video development.

RESULTS

Stakeholder input led to changes in content, wording, and visual presentation. The final versions of the videos emphasize the following messages (1) "New medications and what you should know about the risks", (2) "What you should do when a doctor tells you never to take a certain medication", (3) "What you should know about medications when you are in the hospital."

CONCLUSION

The study highlights the successful process of using CBPR to develop a series of videos designed to provide information on the risks of polypharmacy, and empower older adults to advocate for themselves.

PRACTICE IMPLICATIONS

Animated educational videos are a novel strategy to address medication harm in older adults. This research is a critical first step to increasing patient-led discussions that reduce the incidence of medication harm and inappropriate medication use among older adults.

Diagnosing, fast and slow

Diagnostic error is increasingly recognised as a source of significant morbidity and mortality in medicine. In this article, we will attempt to address several questions relating to clinical decision making; How do we decide on a diagnosis? Why do we so often get it wrong? Can we improve our critical faculties?We begin by describing a clinical vignette in which a medical error occurred and resulted in an adverse outcome for a patient. This case leads us to the concepts of heuristic thinking and cognitive bias. We then discuss how this is relevant to our current clinical paradigm, examples of heuristic thinking and potential mechanisms to mitigate bias.The aim of this article is to increase awareness of the role that cognitive bias and heuristic thinking play in medical decision making. We hope to motivate clinicians to reflect on their own patterns of thinking with an overall aim of improving patient care.

Crafting effective messages to enhance safe infant sleep

BACKGROUND

Health care professionals are continually challenged by the need to provide health information in a way that successfully changes health practices. Research has documented this as a concern in relation to safe infant sleep health campaigns. Often, caregivers' knowledge of recommended practices is not associated with a change in infant sleep choices.

PURPOSE

Health campaigns, including most safe infant sleep efforts, often share specific risk factors and steps for avoiding risk, that is, in a verbatim format. Research has shown that caregivers' behavior may be more likely to change when presented with messages based on their general understanding of risk, that is, gist-based format. This research examines caregivers' responses as related to verbatim- and gist-based safe sleep information.

METHODS

Five hundred forty-one caregivers of infants were shown 12 images depicting infants in safe or unsafe sleep spaces. Images varied across three commercially available spaces, infant race, and presence/absence of one policy-based risk factor.

RESULTS

Differences in caregivers' discernment of safe and unsafe sleep images paralleled reported differences in knowledge of safe sleep recommendations. Discernment of safe/unsafe images was greater for White than Black caregivers, as well as for females in comparison with male caregivers. Gist-based considerations, such as familiarity with the sleeper depicted or infant race, were also associated with caregivers' discernment of safe/unsafe images.

IMPLICATIONS FOR PRACTICE

Attending to both gist- and verbatim-based knowledge regarding safe infant sleep campaign information may help to effectively facilitate caregivers' ability to always create safe sleep spaces for their infants.

Development and preliminary evaluation of an animation (simplifyKDPI) to improve kidney transplant candidate understanding of the Kidney Donor Profile Index

BACKGROUND

Transplant candidates are reluctant to accept kidneys from high Kidney Donor Profile Index (KDPI) donors. Incomplete understanding can lead to transplant delays for older transplant candidates. Patients need access to understandable information to make more informed decisions about KDPI.

METHODS

We developed a KDPI-specific animation with input from six stakeholder groups and conducted a one-group pre-post study with 60 kidney transplant candidates for feasibility and acceptability to improve participant KDPI knowledge, understanding, decisional self-efficacy, and willingness to accept a KDPI > 85% kidney. Data were compared using McNemar's test and Wilcoxon signed-rank test.

RESULTS

Compared with pre-animation scores, post-animation scores were significantly higher for KDPI knowledge for the entire cohort (4.6 vs 6.1, P < .001) and across different levels of age, educational attainment, health literacy, vintage, and technology access. The frequency of positive responses increased pre-post animation for KDPI understanding (55% vs 83%, P < .001) and decisional self-efficacy (47% vs 75%, P < .001). However, willingness to accept KDPI > 85% kidneys (32% vs 36%, P = .83) increased by 2%. After viewing simplifyKDPI, >90% indicated positive ratings on ease of watching, understanding, and engaging.

CONCLUSION

In collaboration with stakeholders, an educational animation about KDPI was developed that was well-received and is promising to impact knowledge.

A Decision-Science Approach to Health-Behavior Change

Behavior change has the potential to radically impact health outcomes. Successfully influencing health behavior requires an understanding of the decision processes underlying health choices and techniques to harness those psychological factors in the service of effective interventions. The way in which information is presented, social consequences of behavior, and methods for guiding behavior without trying to change beliefs and attitudes are examples of using decision science in the service of health.

Brain activation covaries with reported criminal behaviors when making risky choices: A fuzzy-trace theory approach

Criminal behavior has been associated with abnormal neural activity when people experience risks and rewards or exercise inhibition. However, neural substrates of mental representations that underlie criminal and noncriminal risk-taking in adulthood have received scant attention. We take a new approach, applying fuzzy-trace theory, to examine neural substrates of risk preferences and criminality. We extend ideas about gist (simple meaning) and verbatim (precise risk-reward tradeoffs) representations used to explain adolescent risk-taking to uncover neural correlates of developmentally inappropriate adult risk-taking. We tested predictions using a risky-choice framing task completed in the MRI scanner, and examined neural covariation with self-reported criminal and noncriminal risk-taking. As predicted, risk-taking was correlated with a behavioral pattern of risk preferences called "reverse framing" (preferring sure losses over a risky option and a risky option over sure gains, the opposite of typical framing biases) that has been linked to risky behavior in adolescents and is rarely observed in nondisordered adults. Experimental manipulations confirmed processing interpretations of typical framing (gist-based) and reverse-framing (verbatim-based) risk preferences. In the brain, covariation with criminal and noncriminal risk-taking was observed predominantly when subjects made reverse-framing choices. Noncriminal risk-taking behavior was associated with emotional reactivity (amygdala) and reward motivation (striatal) areas, whereas criminal behavior was associated with greater activation in temporal and parietal cortices, their junction, and insula. When subjects made more developmentally typical framing choices, reflecting nonpreferred gist processing, activation in dorsolateral prefrontal cortex covaried with criminal risk-taking, which may reflect cognitive effort to process gist while inhibiting preferred verbatim processing. (PsycINFO Database Record

Tracking Economic Value of Products in Natural Settings: A Wireless EEG Study

Economic decision making refers to the process of individuals translating their preference into subjective value (SV). Little is known about the dynamics of the neural processes that underpin this form of value-based decision making and no studies have investigated these processes outside of controlled laboratory settings. The current study investigated the spatio-temporal dynamics that accompany economic valuation of products using mobile electroencephalography (EEG) and eye tracking techniques. Participants viewed and rated images of household products in a gallery setting while EEG and eye tracking data were collected wirelessly. A Becker-DeGroot-Marschak (BDM) auction task was subsequently used to quantify the individual's willingness to pay (WTP) for each product. WTP was used to classify products into low, low medium, high medium and high economic value conditions. Eye movement related potentials (EMRP) were examined, and independent component analysis (ICA) was used to separate sources of activity from grand averaged EEG data. Four independent components (ICs) of EMRPs were modulated by WTP (i.e., SV) in the latency range of 150-250 ms. Of the four value-sensitive ICs, one IC displayed enhanced amplitude for all value conditions excluding low value, and another IC presented enhanced amplitude for low value products only. The remaining two value-sensitive ICs resolved inter-mediate levels of SV. Our study quantified, for the first time, the neural processes involved in economic value based decisions in a natural setting. Results suggest that multiple spatio-temporal brain activation patterns mediate the attention and aversion of products which could reflect an early valuation system. The EMRP parietal P200 component could reflect an attention allocation mechanism that separates the lowest-value products (IC7) from products of all other value (IC4), suggesting that low-value items are categorized early on as being aversive. While none of the ICs showed linear amplitude changes that parallel SV's of products, results suggest that a combination of multiple components may sub-serve a fine-grained resolution of the SV of products.

In proportion: approaches for displaying patient-reported outcome research study results as percentages responding to treatment

PURPOSE

Patient-reported outcome (PRO) data from clinical trials can promote valuable patient-clinician communication and aid the decision-making process regarding treatment options. Despite these benefits, both patients and doctors face challenges in interpreting PRO scores. The purpose of this study was to identify best practices for presenting PRO results expressed as proportions of patients with changes from baseline (improved/stable/worsened) for use in patient educational materials and decision aids.

METHODS

We electronically surveyed adult cancer patients/survivors, oncology clinicians, and PRO researchers, and conducted one-on-one cognitive interviews with patients/survivors and clinicians. Participants saw clinical trial data comparing two treatments as proportions changed using three different formats: pie charts, bar graphs, icon arrays. Interpretation accuracy, clarity, and format preference were analyzed quantitatively and online survey comments and interviews, qualitatively.

RESULTS

The internet sample included 629 patients, 139 clinicians, and 249 researchers; 10 patients and 5 clinicians completed interviews. Bar graphs were less accurately interpreted than pie charts (OR 0.39; p < .0001) and icon arrays (OR 0.47; p < .0001). Bar graphs and icon arrays were less likely to be rated clear than pie charts (OR 0.37 and OR 0.18; both p < .0001). Qualitative data informed interpretation of these findings.

CONCLUSIONS

For communicating PROs as proportions changed in patient educational materials and decision aids, these results support the use of pie charts.

Choice-Supportive Misremembering: A New Taxonomy and Review

Although the literature on the influence of memory on decisions is well developed, research on the effects of decision making on memory is rather sparse and scattered. Choice-supportive misremembering (i.e., misremembering choice-related information that boosts the chosen option and/or demotes the foregone options) has been observed in several studies and has the potential to affect future choices. Nonetheless, no attempt has been made to review the relevant literature, categorize the different types of choice-supportive misremembering observed, and critically appraise the existing evidence and proposed explanations. Thus, starting from a new theoretically motivated and empirically grounded taxonomy, we review the current research. Our taxonomy classifies choice-supportive misremembering into four conceptually distinct types: misattribution is when information is attributed to the wrong source, fact distortion when the facts are remembered in a distorted manner, false memory when items that were not part of the original decision scenarios are remembered as presented and, finally, selective forgetting is when information is selectively forgotten. After assessing the impact of various potentially moderating factors, we evaluate the evidence for each type of misremembering and conclude that the support for the phenomenon is solid in relation to misattribution when recognition memory is assessed, but significantly weaker for the other three types, and when other memory tests are used to assess memory. Finally, we review the cognitive and emotional explanations proposed for choice-supportive misremembering in the light of the available evidence and identify the main gaps in the current knowledge and the more promising avenues for future research.

Complementarity in false memory illusions

For some years, the DRM illusion has been the most widely studied form of false memory. The consensus theoretical interpretation is that the illusion is a reality reversal, in which certain new words (critical distractors) are remembered as though they are old list words rather than as what they are-new words that are similar to old ones. This reality-reversal interpretation is supported by compelling lines of evidence, but prior experiments are limited by the fact that their memory tests only asked whether test items were old. We removed that limitation by also asking whether test items were new-similar. This more comprehensive methodology revealed that list words and critical distractors are remembered quite differently. Memory for list words is compensatory: They are remembered as old at high rates and remembered as new-similar at very low rates. In contrast, memory for critical distractors is complementary: They are remembered as both old and new-similar at high rates, which means that the DRM procedure induces a complementarity illusion rather than a reality reversal. The conjoint recognition model explains complementarity as a function of three retrieval processes (semantic familiarity, target recollection, and context recollection), and it predicts that complementarity can be driven up or down by varying the mix of those processes. Our experiments generated data on that prediction and introduced a convenient statistic, the complementarity ratio, which measures (a) the level of complementarity in memory performance and (b) whether its direction is reality-consistent or reality-reversed. (PsycINFO Database Record

Overdistribution illusions: Categorical judgments produce them, confidence ratings reduce them

Overdistribution is a form of memory distortion in which an event is remembered as belonging to too many episodic states, states that are logically or empirically incompatible with each other. We investigated a response formatting method of suppressing 2 basic types of overdistribution, disjunction and conjunction illusions, which parallel some classic illusions in the judgment and decision making literature. In this method, subjects respond to memory probes by rating their confidence that test cues belong to specific episodic states (e.g., presented on List 1, presented on List 2), rather than by making the usual categorical judgments about those states. The central prediction, which was derived from the task calibration principle of fuzzy-trace theory, was that confidence ratings should reduce overdistribution by diminishing subjects' reliance on noncompensatory gist memories. The data of 3 experiments agreed with that prediction. In Experiment 1, there were reliable disjunction illusions with categorical judgments but not with confidence ratings. In Experiment 2, both response formats produced reliable disjunction illusions, but those for confidence ratings were much smaller than those for categorical judgments. In Experiment 3, there were reliable conjunction illusions with categorical judgments but not with confidence ratings. Apropos of recent controversies over confidence-accuracy correlations in memory, such correlations were positive for hits, negative for correct rejections, and the 2 types of correlations were of equal magnitude. (PsycINFO Database Record

How hearing about harmful chemicals affects smokers' interest in dual use of cigarettes and e-cigarettes

Substantial harm could result from concurrent cigarette and e-cigarette use (i.e., dual use) were it to undermine smoking cessation. Perceptions of chemical exposure and resulting harms may influence dual use. We conducted a probability-based phone survey of 1164 U.S. adult cigarette smokers in 2014-2015 and analyzed results in 2016. In a between-subjects experiment, smokers heard a hypothetical scenario in which cigarettes and e-cigarettes had the same amount of harmful chemicals or cigarettes had more chemicals than e-cigarettes (10× more, 100× more, or chemicals were present only in cigarettes). Smokers indicated how the scenario would change their interest in dual use and perceived health harms. Few smokers (7%) who heard that the products have the same amount of chemicals were interested in initiating or increasing dual use. However, more smokers were interested when told that cigarettes have 10× more chemicals than e-cigarettes (31%), 100× more chemicals than e-cigarettes (32%), or chemicals were present only in cigarettes (43%) (all p<.001). Individuals told that cigarettes have more chemicals were more likely than those in the "same amount" scenario to perceive that cigarettes would be more harmful than e-cigarettes (79% vs. 41%, OR=5.41, 95% CI=4.08-7.17). These harm perceptions partially explained the relationship between chemical scenario and dual use interest. Smokers associated higher chemical amounts in cigarettes versus e-cigarettes with greater health harms from cigarettes and thus expressed increased interest in dual use. The findings suggest that disclosing amounts of chemicals in cigarette smoke and e-cigarette aerosol could unintentionally encourage dual use.

On the Science of Consciousness: Epistemological Reflections and Clinical Implications

Consciousness has been one of the most important and tantalizing issues ever since the origin of philosophy and medicine. The concept of consciousness and the so-called "hard problem" (i.e., the mind-brain relationship) are highly complex topics that have yet to be elucidated, involving the realms of both science and philosophy with profound epistemological implications. In the lively debate on the foundations of the science of consciousness there are several potential biases of an essentially philosophical nature, such as those related to the paradigm and axioms adopted, and the ostensible logical contradiction between monism and dualism. Their origin dates back largely to Descartes' thinking and the birth of the new sciences as a compromise with the Inquisition, but they have been handed down through the Enlightenment and Positivism. A proper investigation of consciousness and the world of subjectivity demands a careful reflection on the paradigm of scientific medicine to identify possible flaws and overcome the limits of the mechanistic-reductionist approach.

Experience level influences the effect of attentional focus on sprint performance

Two experiments evaluated the influence of attentional focus on 10-meter sprint time and start kinetics in a group of collegiate soccer players and highly experienced sprinters. In Experiment 1, the collegiate soccer players were asked to perform 10-meter sprints under an external focus condition, an internal focus condition and a control condition. For the 10-meter sprint time, the results showed that both the external focus and control conditions resulted in significantly faster sprint times than the internal focus condition. There were no significant differences observed between the external focus and control conditions. There were also no significant differences observed across any of the conditions for a select set of kinetic variables. In Experiment 2, the highly experienced sprinters performed the same 10-meter sprint task using the same instructional conditions as in Experiment 1. For the 10-meter sprint time and kinetic variables, there were no significant differences observed across any of the conditions. These results provide new evidence that experience level mediates the influence of attentional focus on sprint performance.