Decision-making heuristics and biases across the life span

Age-Related Differences in Framing Selective Memory in Terms of Gains and Losses

We examined whether framing younger and older adults learning goals in terms of maximizing gains or minimizing losses impacts their ability to selectively remember high-value information. Specifically, we presented younger and older adults with lists of words paired with point values and participants were either told that they would receive the value associated with each word if they recalled it on a test or that they would lose the points associated with each word if they failed to recall it on the test. We also asked participants to predict the likelihood of recalling each word to determine if younger and older adults were metacognitively aware of any potential framing effects. Results revealed that older adults expected to be more selective when their goals were framed in terms of losses, but younger adults expected to be more selective when their goals were framed in terms of gains. However, this was not the case as both younger and older adults were more selective for high-value information when their goals were framed in terms of maximizing gains compared with minimizing losses. Thus, the framing of learning goals can impact metacognitive decisions and subsequent memory in both younger and older adults.

The less-is-better effect: a developmental perspective

The less-is-better effect emerges when an option of lesser quantitative value is preferred or overvalued relative to a quantitively greater alternative (e.g., 24-piece dinnerware set > 24-piece dinnerware set with 16 additional broken dishes; Hsee, 1998, Journal of Behavioral Decision Making, 11, 107-121). This decisional bias emerges when the option of lesser quantitative value is perceived as qualitatively better (e.g., smaller set of intact dishes > larger set of partially broken dishes). Interestingly, this effect emerges for adult humans when options are evaluated separately but dissipates when options are considered simultaneously. The less-is-better bias has been attributed to the evaluability hypothesis: individuals judge objects on the basis of easy-to-evaluate attributes when judged in isolation, such as the brokenness of items within a set, yet shift to quantitative information when evaluated jointly, such as the overall number of dishes. This bias emerges for adult humans and chimpanzees in a variety of experimental settings but has not yet been evaluated among children. In the current study, we presented a joint evaluation task (larger yet qualitatively inferior option vs. smaller yet qualitatively superior option) to children aged 3 to 9 years old to better understand the developmental trajectory of the less-is-better effect. Children demonstrated the bias across all choice trials, preferring an objectively smaller set relative to a larger yet qualitatively poorer alternative. These developmental findings suggest that young children rely upon salient features of a set to guide decision-making under joint evaluation versus more objective attributes such as quantity/value.

Gambling and Aging: An Overview of a Risky Behavior

Gambling is a field of study that has grown since the 2000s. Much research has focused on adolescents and youth as a vulnerable population. The rate of aging gamblers is increasing; however, evidence-based knowledge of this population is still too sparse. After introducing the issue (1), this article provides a narrative review of older adults' gambling through three sections: (2) older adult gamblers (age, characteristics, and motivations), (3) gambling as a risky decision-making situation, and (4) gambling disorder related to older adults. By drawing on the existing literature from a problematization perspective, this type of review can highlight complex and original research topics and provoke thought and controversy to generate avenues for future research. This narrative review provides an overview of the existing literature on gambling among older adults and offers perspectives on how aging can affect decision-making and thus gambling for this population. Older adults are a specific population, not only in terms of the consequences of gambling disorders but also in terms of the motivations and cognitions underlying gambling behaviors. Studies on behavioral science focusing on decision-making in older adults could help in the development of public policy in terms of targeted prevention.

Emotion, Aging, and Decision Making: A State of the Art Mini-Review

Over the past few decades, interest has begun to surge in understanding the role of emotion in decision making, and more recently in studies across the adult life span. Relevant to age-related changes in decision making, theoretical perspectives in judgment and decision making draw critical distinctions between deliberative versus intuitive/affective processes, as well as integral versus incidental affect. Empirical findings demonstrate the central role of affect in various decision-related domains such as framing and risk taking. To situate this review within an adult life-span context, we focus on theoretical perspectives in adult development regarding emotion and motivation. As a result of age differences in deliberative and emotional processes, taking a life-span perspective is critical to advance a comprehensive and grounded understanding of the role of affect in decision making. Age-related shifts in information processing from negative toward positive material also have consequential implications. By taking a life-span perspective, not only will decision theorists and researchers benefit, but so too will practitioners who encounter individuals of various ages as they make consequential decisions.

What motivates adults to accept influenza vaccine? An assessment of incentives, ease of access, messaging, and sources of information using a discrete choice experiment

Seasonal influenza vaccination rates remain low, and contribute to preventable influenza cases, hospitalizations, and deaths in the US. While numerous interventions have been implemented to increase vaccine uptake, there is a need to determine which interventions contribute most to vaccine willingness, particularly among age groups with vaccination rates that have plateaued at suboptimal levels. This study aimed to quantify the relative effect of multiple interventions on vaccine willingness to receive influenza vaccine in three age groups using a series of hypothetical situations with different behavioral interventions. We assessed the relative impact of four categories of interventions: source of vaccine messages, type of vaccination messages, vaccination incentives, and ease of vaccine access using a discrete choice experiment. Within each category, we investigated the role of four different attributes to measure their relative contribution to willingness to be vaccinated by removing one option from each of the intervention categories. Among the 1,763 Minnesota residents who volunteered for our study, participants expressed vaccine willingness in over 80% of the scenarios presented. Easy access to drop-in vaccination sites had the greatest impact on vaccine willingness in all age groups. Among the younger age group, small financial incentives also contributed to high vaccine willingness. Our results suggest that public health programs and vaccination campaigns may improve their chances of successfully increasing vaccine willingness if they offer interventions preferred by adults, including facilitating convenient access to vaccination and offering small monetary incentives, particularly for young adults.

The challenge of cognitive science for medical diagnosis

The historical tendency to view medicine as both an art and a science may have contributed to a disinclination among clinicians towards cognitive science. In particular, this has had an impact on the approach towards the diagnostic process which is a barometer of clinical decision-making behaviour and is increasingly seen as a yardstick of clinician calibration and performance. The process itself is more complicated and complex than was previously imagined, with multiple variables that are difficult to predict, are interactive, and show nonlinearity. They appear to characterise a complex adaptive system. Many aspects of the diagnostic process, including the psychophysics of signal detection and discrimination, ergonomics, probability theory, decision analysis, factor analysis, causal analysis and more recent developments in judgement and decision-making (JDM), especially including the domain of heuristics and cognitive and affective biases, appear fundamental to a good understanding of it. A preliminary analysis of factors such as manifestness of illness and others that may impede clinicians' awareness and understanding of these issues is proposed here. It seems essential that medical trainees be explicitly and systematically exposed to specific areas of cognitive science during the undergraduate curriculum, and learn to incorporate them into clinical reasoning and decision-making. Importantly, this understanding is needed for the development of cognitive bias mitigation and improved calibration of JDM in clinical practice.

Trust and Food Quality in the Valorisation of Geographical Indication Initiatives

This text delves into the elements on which the notion of quality of a product is built. We believe that, in addition to the standards that regulate a given quality seal, there are other elements that consumers link to the excellence that distinguishes them. In order to deepen these notions, we have chosen two localised agri-food systems (LAS), the first case corresponds to Iberian acorn-ham from Spain and the second to chorizo from Toluca in Mexico. We resorted to a mixed methodology by combining quantitative and qualitative techniques whereby a study of those food systems in two different socio-political contexts was approached. This methodology has allowed us to identify the importance of informal instruments, based not only on institutionalised certification, but on informal mechanisms such as trust and proximity between producers and consumers. The results of this study show how the food quality categories may be guided from various logics depending on the context, categories, and sort of stakeholders involved. Finally, we propose a categorisation of food quality based on the conceptual framework of trust. This categorisation allows the Geographical Indications (GIs) valorisation initiatives to visualise the elements on which they can be guided to work with the different qualities in their LAS.

Age differences in risk taking: now you see them, now you don't

Older age has often, but not always, been associated with less risk taking. Inconsistencies may be due to diversity in the risk-taking measures used and/or individual differences in cognitive abilities. We investigated the robustness of age differences in risk taking across three measures, and tested whether age differences in risk taking remained after accounting for cognitive abilities. Younger (aged 25-36) and older (aged 60+) adults completed behavioral (i.e., Balloon Analogue Risk Task, BART) and self-report (i.e., framing tasks and Choice Dilemmas Questionnaire) measures of risk, as well as several measures of cognitive ability (i.e., analytic thinking, numeracy, processing speed, memory, and attention). Older adults showed significantly less risk taking than younger adults on the behavioral measure of risk, but not on the two self-report measures. Older adults also had significantly lower analytic thinking, slower processing speed, and worse executive control compared to younger adults. Less risk taking on the BART was associated with lower analytic thinking and numeracy, slower processing speed, and worse shifting of attention. Age differences in risk taking on the BART remained after accounting for older adults' lower scores on tests of cognitive abilities. Implications for measuring age differences in risk taking are discussed.

Who Is Willing to Engage in Social Gatherings During the Coronavirus Disease 2019 Lockdown? A Curvilinear Relationship Between Age and Heuristic Processing

BACKGROUND

The Chinese government implemented a lockdown to contain the coronavirus disease 2019 (COVID-19) pandemic during the Chinese Lunar New Year when people have the tradition to visit families and friends. Previous research suggested that heuristic processing increased risky behavioral willingness (e.g., desire to have social gatherings despite the pandemic) and that people's tendency to use heuristic processing varied across different adulthood stages. This study thus investigated the relationships among age, heuristic processing of COVID-19-related information, and the willingness to have social gatherings during the lockdown.

METHODS

A sample of 1,651 participants was recruited from an online crowdsourcing platform between January 31 and February 04 in 2020, with a mean age of 30.69, 47.9% being women. Participants completed an online questionnaire about heuristic processing of COVID-19-related information, willingness to engage in social gatherings during the lockdown, age, and other demographic information.

RESULTS

Age was found to have a U-shaped curvilinear relationship with heuristic processing, and heuristic processing was positively correlated with the willingness to have social gatherings. Further analyses showed that heuristic processing curvilinearly mediated the relationship between age and the willingness to have social gatherings.

CONCLUSION

Compared with young adults, emerging and older adults are more likely to engage in heuristic processing, which in turn, increases the willingness to have social gatherings. Heuristic processing serves as an underlying mechanism to explain the relationship between age and risky behavioral willingness.

Age-related variability in decision-making: Insights from neurochemistry

Despite dopamine's significant role in models of value-based decision-making and findings demonstrating loss of dopamine function in aging, evidence of systematic changes in decision-making over the life span remains elusive. Previous studies attempting to resolve the neural basis of age-related alteration in decision-making have typically focused on physical age, which can be a poor proxy for age-related effects on neural systems. There is growing appreciation that aging has heterogeneous effects on distinct components of the dopamine system within subject in addition to substantial variability between subjects. We propose that some of the conflicting findings in age-related effects on decision-making may be reconciled if we can observe the underlying dopamine components within individuals. This can be achieved by incorporating in vivo imaging techniques including positron emission tomography (PET) and neuromelanin-sensitive MR. Further, we discuss how affective factors may contribute to individual differences in decision-making performance among older adults. Specifically, we propose that age-related shifts in affective attention ("positivity effect") can, in some cases, counteract the impact of altered dopamine function on specific decision-making processes, contributing to variability in findings. In an effort to provide clarity to the field and advance productive hypothesis testing, we propose ways in which in vivo dopamine imaging can be leveraged to disambiguate dopaminergic influences on decision-making, and suggest strategies for assessing individual differences in the contribution of affective attentional focus.

Information use in risky decision making: Do age differences depend on affective context?

The current study focused on the degree to which decision context (deliberative vs. affective) differentially impacted the use of available information about uncertainty (i.e., probability, positive and negative outcome magnitudes, expected value, and variance/risk) when older adults were faced with decisions under risk. In addition, we examined whether individual differences in general mental ability and executive function moderated the associations between age and information use. Participants (N = 96) completed a neuropsychological assessment and the hot (affective) and cold (deliberative) versions of an explicit risk task. Our results did not find a significant Age × Hot/Cold Condition interaction on overall risk-taking. However, we found that older adults were less likely to use the full decision information available regardless of the decision context. This finding suggested more global age differences in information use. Moreover, older adults were less likely to make expected-value sensitive decisions, regardless of the hot/cold context. Finally, we found that low performance on measures of executive functioning, but not general mental ability, appears to be a risk factor for lower information use. This pattern appears in middle age and progressively becomes stronger in older age. The current work provides evidence that common underlying decision processes may operate in risk tasks deemed either affective or deliberative. It further suggests that underlying mechanisms such as information use may be paramount, relative to differences in the affective context. Additionally, individual differences in neuropsychological function may act as a moderator in the tendency to use available information across affective context. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Taking the Biggest First: Age Differences in Preferences for Monetary and Hedonic Sequences

OBJECTIVES

People face decisions about how to sequence payments and events, including when to schedule bigger events relative to smaller ones. We examine age differences in these sequence preferences.

METHODS

We gave a national adult life-span sample (n = 1,296, mean = 53.06 years, standard deviation = 16.33) four scenarios describing a positive or negative hedonic (enjoyable weekends, painful dental procedures) or monetary (receiving versus paying money) event. We considered associations among age, sequence preferences, three self-reported decision-making processes-emphasizing experience, emotion, and reasoning-and two dimensions of future time perspective-focusing on future opportunities and limited time.

RESULTS

Older age was associated with taking the "biggest" event sooner instead of later, especially for receiving money, but also for the other three scenarios. Older age was associated with greater reported use of reason and experience and lesser reported use of emotion. These decision-making processes played a role in understanding age differences in sequence preferences, but future time perspective did not.

DISCUSSION

We discuss "taking the biggest first" preferences in light of prior mixed findings on age differences in sequence preferences. We highlight the distinct roles of experience- and emotion-based decision-making processes. We propose applications to financial and health-care settings.

Understanding irresponsible use of intensive care unit resources in the USA

Use of intensive care unit (ICU) resources in the USA far outpaces that of other countries. This increased use is not accompanied by superior clinical outcomes and is at times discordant with patient desires. This Series paper seeks to identify major drivers of ICU resource use in the USA, and to offer steps towards better aligning ICU resource use with clinical needs and patient preferences. After considering several factors, such as organisational, ethical, and economic factors, we suggest that there are four intersecting drivers of irresponsible use of ICU resources in the USA: first, excess ICU bed capacity and a scarcity of data to understand which patients that truly benefit from ICU compared with ward care; second, clinicians misinterpreting the goals and means of patient autonomy; third, an extreme fear of rationing by the general public; and fourth, fee-for-service driven use of advanced medical technologies and procedures that beget ICU expansion.

Probability discounting of treatment decisions in multiple sclerosis: associations with disease knowledge, neuropsychiatric status, and adherence

RATIONALE

Patients weigh risks and benefits when making treatment decisions. Despite this, relatively few studies examine the behavioral patterns underpinning these decisions. Moreover, individual differences in these patterns remain largely unexplored.

OBJECTIVES

The purpose of this study was to test a probability discounting model to explain the independent influences of risks and benefits when patients make hypothetical treatment decisions. Furthermore, we examine how individual differences in this probability discounting function are associated with patient demographics, clinical characteristics, disease knowledge, neuropsychiatric status, and adherence.

METHODS

Two hundred eight participants with relapsing-remitting multiple sclerosis (MS) indicated their likelihood (0-100%) of taking a hypothetical medication as the probability of mild side effects (11 values from .1 to 99.9%) and reported medication efficacies (11 values from .1 to 99.9%) varied systematically. They also completed a series of questionnaires and cognitive tests.

RESULTS

Individual components of medication treatment decision making were successfully described with a probability discounting model. High rates of discounting based on risks were associated with poor treatment adherence and less disease-specific knowledge. In contrast, high rates of discounting of benefits was associated with poorer cognitive functioning. Regression models indicated that risk discounting predicted unique variance in treatment adherence.

CONCLUSIONS

Insights gained from the present study represent an important early step in understanding individual differences associated with medical decision making in MS. Future research may wish to use this knowledge to inform the development of empirically supported adherence interventions.

Restricting future time perspective reduces failure to act after a missed opportunity

Inaction inertia occurs when missing an attractive opportunity (vs. not having been offered it) decreases the likelihood of acting on another similar opportunity. We experimentally manipulated future time perspective to reduce inaction inertia. Middle-aged and older adults from the Health and Retirement Study were randomly assigned to imagining restricted or expansive time left to live, or to no instructions. Across age, imagining a restricted future (vs. the other two instructions) reduced inaction inertia and future time perspective. Imagining living longer increased future time perspective among relatively younger participants. Consequences of restricted time perspective for decisions and life regrets are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Adolescents' base rate judgments, metastrategic understanding, and stereotype endorsement

Developmental reversals are counterintuitive age trends wherein age is negatively related to optimal responding. We addressed the claims that reversals in judgments and decisions are unlikely between late childhood and adolescence. Children and adolescents indicated the extent to which they endorsed stereotypes salient to adolescents, responded to problems in which base rate evidence conflicted with evidence based on anecdotal evidence (i.e., anecdotal problems) or stereotype-relevant evidence (i.e., stereotypical problems), and indicated the basis for their responses. Normative responses increased with age on anecdotal problems and decreased with age on stereotypical problems, indicating a developmental reversal on the latter problem type. Metaprocedural competence mediated the age-related increases on anecdotal problems and moderated the age-related declines on stereotypical problems; furthermore, on stereotypical problems, endorsement of relevant stereotypes mediated the age-related declines in performance. Findings are discussed from a dual-process perspective that emphasizes gist-based problem representations, a "metacognitive gap," and age-related dissociations between stereotypical problems and metaprocedural competence.

Sensitivity to "sunk costs" in mice, rats, and humans

Sunk costs are irrecoverable investments that should not influence decisions, because decisions should be made on the basis of expected future consequences. Both human and nonhuman animals can show sensitivity to sunk costs, but reports from across species are inconsistent. In a temporal context, a sensitivity to sunk costs arises when an individual resists ending an activity, even if it seems unproductive, because of the time already invested. In two parallel foraging tasks that we designed, we found that mice, rats, and humans show similar sensitivities to sunk costs in their decision-making. Unexpectedly, sensitivity to time invested accrued only after an initial decision had been made. These findings suggest that sensitivity to temporal sunk costs lies in a vulnerability distinct from deliberation processes and that this distinction is present across species.

Cognitive Style and Frame Susceptibility in Decision-Making

The susceptibility of decision-makers' choices to variations in option framing has been attributed to individual differences in cognitive style. According to this view, individuals who are prone to a more deliberate, or less intuitive, thinking style are less susceptible to framing manipulations. Research findings on the topic, however, have tended to yield small effects, with several studies also being limited in inferential value by methodological drawbacks. We report two experiments that examined the value of several cognitive-style variables, including measures of cognitive reflection, subjective numeracy, actively open-minded thinking, need for cognition, and hemispheric dominance, in predicting participants' frame-consistent choices. Our experiments used an isomorph of the Asian Disease Problem and we manipulated frames between participants. We controlled for participants' sex and age, and we manipulated the order in which choice options were presented to participants. In Experiment 1 (N = 190) using an undergraduate sample and in Experiment 2 (N = 316) using a sample of Amazon Mechanical Turk workers, we found no significant effect of any of the cognitive-style measures taken on predicting frame-consistent choice, regardless of whether we analyzed participants' binary choices or their choices weighted by the extent to which participants preferred their chosen option over the non-chosen option. The sole factor that significantly predicted frame-consistent choice was framing: in both experiments, participants were more likely to make frame-consistent choices when the frame was positive than when it was negative, consistent with the tendency toward risk aversion in the task. The present findings do not support the view that individual differences in people's susceptibility to framing manipulations can be substantially accounted for by individual differences in cognitive style.

Identifying new susceptibility genes on dopaminergic and serotonergic pathways for the framing effect in decision-making

The framing effect refers the tendency to be risk-averse when options are presented positively but be risk-seeking when the same options are presented negatively during decision-making. This effect has been found to be modulated by the serotonin transporter gene (SLC6A4) and the catechol-o-methyltransferase gene (COMT) polymorphisms, which are on the dopaminergic and serotonergic pathways and which are associated with affective processing. The current study aimed to identify new genetic variations of genes on dopaminergic and serotonergic pathways that may contribute to individual differences in the susceptibility to framing. Using genome-wide association data and the gene-based principal components regression method, we examined genetic variations of 26 genes on the pathways in 1317 Chinese Han participants. Consistent with previous studies, we found that the genetic variations of the SLC6A4 gene and the COMT gene were associated with the framing effect. More importantly, we demonstrated that the genetic variations of the aromatic-L-amino-acid decarboxylase (DDC) gene, which is involved in the synthesis of both dopamine and serotonin, contributed to individual differences in the susceptibility to framing. Our findings shed light on the understanding of the genetic basis of affective decision-making.

Influential Cognitive Processes on Framing Biases in Aging

Factors that contribute to overcoming decision-making biases in later life pose an important investigational question given the increasing older adult population. Limited empirical evidence exists and the literature remains equivocal of whether increasing age is associated with elevated susceptibility to decision-making biases such as framing effects. Research into the individual differences contributing to decision-making ability may offer better understanding of the influence of age in decision-making ability. Changes in cognition underlying decision-making have been shown with increased age and may contribute to individual variability in decision-making abilities. This study had three aims; (1) to understand the influence of age on susceptibility to decision-making biases as measured by framing effects across a large, continuous age range; (2) to examine influence of cognitive abilities that change with age; and (3) to understand the influence of individual factors such as gender and education on susceptibility to framing effects. 200 individuals (28-79 years of age) were tested on a large battery of cognitive measures in the domains of executive function, memory and complex attention. Findings from this study demonstrated that cognitive abilities such as strategic control and delayed memory better predicted susceptibility to framing biases than age. The current findings demonstrate that age may not be as influential a factor in decision-making as cognitive ability and cognitive reserve. These findings motivate future studies to better characterize cognitive ability to determine decision-making susceptibilities in aging populations.

In search of a consumer-focused food classification system. An experimental heuristic approach to differentiate degrees of quality

The present paper focuses on the problems that arise in food classification systems (FCSs), especially when the food product type has different levels or grades of quality. Despite the principal function of these systems being to assist the consumer (to inform, clarify and facilitate choice and purchase), they frequently have the opposite effect. Thus, the main aim of the present research involves providing orientations for the design of effective food classification systems. To address this objective, considering the context of food product consumption (related to heuristic processing), we conducted an experimental study with 720 participants. We analysed the usefulness of heuristic elements by a factorial 2 (category length: short and long) × 3 (visual signs: colours, numbers and images) design in relation to recall and recognition activities. The results showed that the elements used to make the classification more effective for consumers vary depending on whether the user seeks to prioritize the recall or the recognition of product categories. Thus, long categories with images significantly improve recognition, and short categories with colours improve recall. A series of recommendations are provided that can help to enhance FCSs and to make them more intuitive and easier to understand for consumers. Implications with regard to theory and practice are discussed.

Aging and Decision-Making: A Conceptual Framework for Future Research - A Mini-Review

Age differences in decision-making are of theoretical interest and have important practical implications, but relevant lines of work are distributed across multiple disciplines and often lack integration. The present review proposes an overarching conceptual framework with the aim of connecting disjointed aspects of this field of research. The framework builds on process models of decision-making and specifies potential mechanisms behind age effects as well as relevant moderators including task characteristics and contextual factors. After summarizing the extant literature for each aspect of the framework, compensatory mechanisms and ecological fit between different components of the model are considered. Implications for real-life decision-making, remaining research gaps, and directions for future research are discussed.

Decision-Making Processes in Social Contexts

Over the past half-century, scholars in the interdisciplinary field of Judgment and Decision Making have amassed a trove of findings, theories, and prescriptions regarding the processes ordinary people enact when making choices. But this body of knowledge has had little influence on sociology. Sociological research on choice emphasizes how features of the social environment shape individual behavior, not people's underlying decision processes. Our aim in this article is to provide an overview of selected ideas, models, and data sources from decision research that can fuel new lines of inquiry on how socially situated actors navigate both everyday and major life choices. We also highlight opportunities and challenges for cross-fertilization between sociology and decision research that can allow the methods, findings, and contexts of each field to expand their joint range of inquiry.

Age Differences in Self-Continuity: Converging Evidence and Directions for Future Research

Life-span development is inherently linked to the perception of time and associated temporal construals. Such concepts are multi-faceted in nature and have important practical implications in areas such as time management, financial planning, or medical choices. A large body of research has documented age-related limitations in global time horizons, but age differences in other aspects of temporal construal are comparatively poorly understood. The present article draws attention to developmental trajectories of self-continuity, defined as perceived associations of one's present self with past and future selves. After considering historical roots and contemporary views on self-continuity, we turn to the life-span developmental literature and review several convergent streams of research that provide indirect evidence for age-related increases in self-continuity. We then consider a small body of recent studies which have directly assessed age differences in self-continuity and summarize our current understanding of this phenomenon including associations between explicit and implicit measures, symmetry between past and future self-continuity, and differentiation from other aspects of time perception. We conclude by highlighting open theoretical questions and considering the practical implications of an increased sense of self-continuity with advancing age.

Current Views and Perspectives on E-Mental Health: An Exploratory Survey Study for Understanding Public Attitudes Toward Internet-Based Psychotherapy in Germany

BACKGROUND

Despite the advanced development of evidence-based psychological treatment services, help-seeking persons with mental health problems often fail to receive appropriate professional help. Internet-delivered psychotherapy has thus been suggested as an efficient strategy to overcome barriers to access mental health care on a large scale. However, previous research indicated poor public acceptability as an issue for the dissemination of Internet-delivered therapies. Currently, little is known about the expectations and attitudes toward Internet-delivered therapies in the general population. This is especially the case for countries such as Germany where electronic mental health (e-mental health) treatment services are planned to be implemented in routine care.

OBJECTIVE

This pilot study aimed to determine the expectations and attitudes toward Internet-based psychotherapy in the general population in Germany. Furthermore, it aimed to explore the associations between attitudes toward Internet-based therapies and perceived stress.

METHODS

To assess public attitudes toward Internet-based psychotherapy, we conducted both Web-based and paper-and-pencil surveys using a self-developed 14-item questionnaire (Cronbach alpha=.89). Psychological distress was measured by employing a visual analogue scale (VAS) and the 20-item German version of the Perceived Stress Questionnaire (PSQ). In addition, we conducted explorative factor analysis (principal axis factor analysis with promax rotation). Spearman's rank correlations were used to determine the associations between attitudes toward Internet-based therapies and perceived stress.

RESULTS

Descriptive analyses revealed that most respondents (N=1558; female: 78.95%, 1230/1558) indicated being not aware of the existence of Internet-delivered therapies (83.46%, 1141/1367). The average age was 32 years (standard deviation, SD 10.9; range 16-76). Through exploratory factor analysis, we identified 3 dimensions of public attitudes toward Internet-based therapies, which we labeled "usefulness or helpfulness," "relative advantage or comparability," and "accessibility or access to health care." Analyses revealed negative views about Internet-based therapies on most domains, such as perceived helpfulness. The study findings further indicated ambivalent attitudes: Although most respondents agreed to statements on expected improvements in health care (eg, expanded access), we observed low intentions to future use of Internet-delivered therapies in case of mental health problems.

CONCLUSIONS

This pilot study showed deficient "e-awareness" and rather negative or ambivalent attitudes toward Internet-delivered therapies in the German-speaking general population. However, research targeting determinants of the large-scale adoption of Internet-based psychotherapy is still in its infancy. Thus, further research is required to explore the "black box" of public attitudes toward Internet-delivered therapies with representative samples, validated measures, and longitudinal survey designs.

Role of Emotion and Cognition on Age Differences in the Framing Effect

Framing effect studies indicate that individuals are risk averse for decisions framed as gains but risk-seeking for decisions framed as losses. Findings of age-related differences in susceptibility to framing are mixed. In the current study, we examined emotional arousal in two decision tasks (life saving vs. money gambling) to evaluate the effects of emotion on age differences in the framing effect. When cognitive abilities and styles were controlled, there was a framing effect in the younger group in the life-saving task, a high-emotional arousal task, while older adults did not display this classic framing effect pattern. They showed risk aversion in both positive and negative framing. Age differences existed in the framing effect. Conversely, younger and older adults in the money-gambling task both displayed the framing effect; there was no age difference. When the cognitive abilities were not controlled, the pattern of results in the high-emotional arousal task remained unchanged, while greater framing effects were found, from the perspective of effect size, for older than younger adults in the low-emotional arousal task. Limited cognitive resources would not hamper older adults’ performances when their emotional arousal was high. However, older adults with low-level emotional arousal were more susceptible than younger adults to framing because of declining cognitive capacities. This implied the importance of emotion in older adults’ decision making and supported the selective engagement hypothesis.

What were they thinking? Reducing sunk-cost bias in a life-span sample

We tested interventions to reduce "sunk-cost bias," the tendency to continue investing in failing plans even when those plans have soured and are no longer rewarding. We showed members of a national U.S. life-span panel a hypothetical scenario about a failing plan that was halfway complete. Participants were randomly assigned to an intervention to focus on how to improve the situation, an intervention to focus on thoughts and feelings, or a no-intervention control group. First, we found that the thoughts and feelings intervention reduced sunk-cost bias in decisions about project completion, as compared to the improvement intervention and the no-intervention control. Second, older age was associated with greater willingness to cancel the failing plan across all 3 groups. Third, we found that introspection processes helped to explain the effectiveness of the interventions. Specifically, the larger reduction in sunk-cost bias as observed in the thoughts and feelings intervention (vs. the improvement intervention) was associated with suppression of future-oriented thoughts of eventual success, and with suppression of augmentations of the scenario that could make it seem reasonable to continue the plan. Fourth, we found that introspection processes were related to age differences in decisions. Older people were less likely to mention future-oriented thoughts of eventual success associated with greater willingness to continue the failing plan. We discuss factors to consider when designing interventions for reducing sunk-cost bias. (PsycINFO Database Record

All framing effects are not created equal: Low convergent validity between two classic measurements of framing

Human risk-taking attitudes can be influenced by two logically equivalent but descriptively different frames, termed the framing effect. The classic hypothetical vignette-based task (Asian disease problem) and a recently developed reward-based gambling task have been widely used to assess individual differences in the framing effect. Previous studies treat framing bias as a stable trait that has genetic basis. However, these two paradigms differ in terms of task domain (loss vs. gain) and task context (vignette-based vs. reward-based) and the convergent validity of these measurements remains unknown. Here, we developed a vignette-based task and a gambling task in both gain and loss domains and tested correlations of the framing effect among these tasks in 159 young adults. Our results revealed no significant correlation between the vignette-based task in the loss domain and the gambling task in the gain domain, indicating low convergent validity. The current findings raise the question of how to measure the framing effect precisely, especially in individual difference studies using large samples and expensive neuroscience methods. Our results suggest that the framing effect is influenced by both task domain and task context and future research should be cautious about the operationalization of the framing effect.

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

Fuzzy-trace theory distinguishes verbatim (literal, exact) from gist (meaningful) representations, predicting that reliance on gist increases with experience and expertise. Thus, many judgment-and-decision-making biases increase with development, such that cognition is colored by context in ways that violate logical coherence and probability theories. Nevertheless, this increase in gist-based intuition is adaptive: Gist is stable, less sensitive to interference, and easier to manipulate. Moreover, gist captures the functionally significant essence of information, supporting healthier and more robust decision processes. We describe how fuzzy-trace theory accounts for judgment-and-decision making phenomena, predicting the paradoxical arc of these processes with the development of experience and expertise. We present data linking gist memory processes to gist processing in decision making and provide illustrations of gist reliance in medicine, public health, and intelligence analysis.

Variations in Decision-Making Profiles by Age and Gender: A Cluster-Analytic Approach

Using cluster-analysis, we investigated whether rational, intuitive, spontaneous, dependent, and avoidant styles of decision making (Scott & Bruce, 1995) combined to form distinct decision-making profiles that differed by age and gender. Self-report survey data were collected from 1,075 members of RAND's American Life Panel (56.2% female, 18-93 years, Mage = 53.49). Three decision-making profiles were identified: affective/experiential, independent/self-controlled, and an interpersonally-oriented dependent profile. Older people were less likely to be in the affective/experiential profile and more likely to be in the independent/self-controlled profile. Women were less likely to be in the affective/experiential profile and more likely to be in the interpersonally-oriented dependent profile. Interpersonally-oriented profiles are discussed as an overlooked but important dimension of how people make important decisions.

Determinants of judgment and decision making quality: the interplay between information processing style and situational factors

A framework is presented to better characterize the role of individual differences in information processing style and their interplay with contextual factors in determining decision making quality. In Experiment 1, we show that individual differences in information processing style are flexible and can be modified by situational factors. Specifically, a situational manipulation that induced an analytical mode of thought improved decision quality. In Experiment 2, we show that this improvement in decision quality is highly contingent on the compatibility between the dominant thinking mode and the nature of the task. That is, encouraging an intuitive mode of thought led to better performance on an intuitive task but hampered performance on an analytical task. The reverse pattern was obtained when an analytical mode of thought was encouraged. We discuss the implications of these results for the assessment of decision making competence, and suggest practical directions to help individuals better adjust their information processing style to the situation at hand and make optimal decisions.

New perspectives for motivating better decisions in older adults

Decision-making competence in later adulthood is affected by declines in cognitive skills, and age-related changes in affect and experience can sometimes compensate. However, recent findings suggest that age-related changes in motivation also affect the extent to which adults draw from experience, affect, and deliberative skills when making decisions. To date, relatively little attention has been given to strategies for addressing age-related changes in motivation to promote better decisions in older adults. To address this limitation, we draw from diverse literatures to suggest promising intervention strategies for motivating older recipients’ motivation to make better decisions. We start by reviewing the life-span developmental literature, which suggests that older adults’ motivation to put effort into decisions depends on the perceived personal relevance of decisions as well as their self-efficacy (i.e., confidence in applying their ability and knowledge). Next, we discuss two approaches from the health intervention design literature, the mental models approach and the patient activation approach, which aim to improve motivation for decision making by improving personal relevance or by building self-efficacy or confidence to use new information and skills. Using examples from these literatures, we discuss how to construct interventions to motivate good decisions in later adulthood.

Tonsillectomy versus tonsillotomy: a study of parental preference

OBJECTIVE

To directly sample the preference of representative parents who would be hypothetically considering tonsillotomy versus tonsillectomy for their child and assess the role of parental age, educational level, and risk aversion in making this choice.

METHODS

Parents in a pediatric otolaryngology waiting room were asked to complete an anonymous survey which presented hypothetical scenarios for their child and described the specifics of tonsillectomy and tonsillotomy in terms of post-operative recovery, tonsil regrowth rates, and future strep throat risk. Other questions gathered parental demographic data and assessed risk tolerance.

RESULTS

Two hundred and thirty-four parents completed the survey. A large majority of parents (201 of 234, 85.9%) preferred tonsillectomy over tonsillotomy for their child. Parental education and age were not associated with procedural preference. An increasing self-reported risk aversion score (p=0.003, Fisher's exact test) and a classification as risk averse using validated questions (p=0.034) were both associated with a preference for tonsillectomy over tonsillotomy.

CONCLUSION

Parents of pediatric Otolaryngology patients strongly prefer tonsillectomy over tonsillotomy when described in general terms. This parental choice appears to correlate with risk aversion of the possible long-term complications of tonsillotomy including the need for future treatment of streptococcal pharyngitis and/or regrowth of the tonsils and subsequent revision tonsil surgery.

Option generation in decision making: ideation beyond memory retrieval

According to prescriptive decision theories, the generation of options for choice is a central aspect of decision making. A too narrow representation of the problem may indeed limit the opportunity to evaluate promising options. However, despite the theoretical and applied significance of this topic, the cognitive processes underlying option generation are still unclear. In particular, while a cued recall account of option generation emphasizes the role of memory and executive control, other theoretical proposals stress the importance of ideation processes based on various search and thinking processes. Unfortunately, relevant behavioral evidence on the cognitive processes underlying option generation is scattered and inconclusive. In order to reach a better understanding, we carried out an individual-differences study employing a wide array of cognitive predictors, including measures of episodic memory, semantic memory, cognitive control, and ideation fluency. The criterion tasks consisted of three different poorly-structured decision-making scenarios, and the participants were asked to generate options to solve these problems. The main criterion variable of the study was the number of valid options generated, but also the diversity and the quality of generated options were examined. The results showed that option generation fluency and diversity in the context of ill-structured decision making are supported by ideation ability even after taking into account the effects of individual differences in several other aspects of cognitive functioning. Thus, ideation processes, possibly supported by search and thinking processes, seem to contribute to option generation beyond basic associative memory retrieval. The findings of the study also indicate that generating more options may have multifaceted consequences for choice, increasing the quality of the best option generated but decreasing the mean quality of the options in the generated set.

Getting older isn't all that bad: better decisions and coping when facing "sunk costs"

Because people of all ages face decisions that affect their quality of life, decision-making competence is important across the life span. According to theories of rational decision making, one crucial decision skill involves the ability to discontinue failing commitments despite irrecoverable investments also referred to as "sunk costs." We find that older adults are better than younger adults at making decisions to discontinue such failing commitments especially when irrecoverable losses are large, as well as at coping with the associated irrecoverable losses. Our results are relevant to interventions that aim to promote better decision-making competence across the life span.

"Thinking about numbers is not my idea of fun": need for cognition mediates age differences in numeracy performance

BACKGROUND

Numeracy refers to people's ability to use numbers. Low numeracy has been associated with difficulties in understanding risk-benefit information and making health decisions. Older adults tend to perform worse than younger adults on measures of numeracy, but some theories of aging suggest that older adults may lack motivation for such tasks. We therefore test whether age differences in numeracy performance are mediated by a reduced motivation to think hard about complex problems-as measured by need for cognition.

METHOD

We recruited an age-diverse convenience sample of 306 UK adults. They completed measures of numeracy and need for cognition. They self-reported their educational attainment and other demographics.

RESULTS

Older age was related to lower numeracy and lower need for cognition. The negative relationship between age and numeracy was mediated by need for cognition. These findings held after we controlled for educational attainment and other demographic factors.

DISCUSSION

Older adults may show lower numeracy performance due to lack of motivation. We discuss strategies for improving people's motivation to complete numeracy measures and other numerical tasks.

The combined role of task, child’s age and individual differences in understanding decision processes

It is important to understand the impact of individual differences in decision making from childhood to adulthood. This cohort-based study extends our knowledge by comparing decision making of children across the age range of 8 to 17 years and their parents. Based on prior research and theory focusing on different types of framing effects, we uncover several key differences across ages, including levels of risk taking and sensitivity to expected value differences between risky and riskless choices. Furthermore, we find that measures such as Numeracy and Surgency help explain both age-related and individual differences on our tasks, especially for decisions involving risk. We discuss the role of diverse task measures in understanding how individual difference factors affect different aspects of decision making, including the ability and effort to process numerical information and the ability to suppress affective reactions to stimulus labels.

Very low birthweight: dysregulated gestation versus evolutionary adaptation

Much medical literature attributes persistently high rates of very low birthweight (VLBW) to "dysregulated" gestation. We offer the alternative view that natural selection conserved well-regulated, though nonconscious, decisional biology that protects the reproductive fitness of women by spontaneously aborting gestations that would otherwise yield frail infants, particularly small males. Modern obstetric practice, however, converts some fraction of these erstwhile spontaneous abortions into live births of very small infants. We further propose that the nonconscious decisional biology of gestation exhibits preferences also seen in consciously made decisions. We hypothesize that the incidence of VLBW among male infants should vary with the population's self-reported intentions to assume financial risk. We apply time-series modeling to monthly birth counts by sex and weight from the Swedish Medical Birth Registry between January 1993 and December 2010. We gauge risk aversion with monthly data from the Micro Index of the Swedish Consumer Tendency Survey (MISCT). Consistent with our argument that nonconscious decisional biology shares risk aversion with conscious decisions, we find that the incidence of VLBW among male infants in Sweden varies with the population's self-reported intentions to assume financial risk. We find increases above expected odds of a very low weight infant among males born 1 month after increases above expected levels of self-reported risk aversion in the Swedish population. We offer this finding as support for the argument that persistently high rates of VLBW arise, at least in part, from a combination of medical interventions and mechanisms conserved by natural selection to protect reproductive fitness.

Assessment of capacity in an aging society

Over the past 40 years, the assessment and scientific study of capacity in older adults has emerged as a distinct field of clinical and research activity for psychologists. This new field reflects the convergence of several trends: the aging of American society, the growing incidence and prevalence of dementia, and the patient rights, deinstitutionalization, and disability rights movements. Because of these forces, capacity issues now permeate the fabric of everyday life, whether in the form of guardianship petitions, questions of capacity to consent to treatment, the ability to make a new will, or participation in human research. In seeking to resolve these issues, families, clinicians, and legal professionals increasingly turn to psychologists to assess a capacity and to provide empirically supported judgments that properly balance autonomy and protection for the individual. Psychologists have taken a leading role in the development of functional assessment instruments that measure important aspects of the capacity construct. In addition, psychology has been a major contributor to the scientific study of capacity. In collaboration with colleagues from medicine and law, psychologists have articulated crucial theoretical frameworks that integrate legal, clinical, and ethical dimensions of the capacity problem. This article focuses on the evolution of theory, law, science, and practice in the evaluation of capacity in older adults and its recent culmination in a series of interdisciplinary handbooks sponsored by the American Psychological Association and the American Bar Association.

The multifold relationship between memory and decision making: an individual-differences study

Several judgment and decision-making tasks are assumed to involve memory functions, but significant knowledge gaps on the memory processes underlying these tasks remain. In a study on 568 adults between 25 and 80 years of age, hypotheses were tested on the specific relationships between individual differences in working memory, episodic memory, and semantic memory, respectively, and 6 main components of decision-making competence. In line with the hypotheses, working memory was positively related with the more cognitively demanding tasks (Resistance to Framing, Applying Decision Rules, and Under/Overconfidence), whereas episodic memory was positively associated with a more experience-based judgment task (Recognizing Social Norms). Furthermore, semantic memory was positively related with 2 more knowledge-based decision-making tasks (Consistency in Risk Perception and Resistance to Sunk Costs). Finally, the age-related decline observed in some of the decision-making tasks was (partially or totally) mediated by the age-related decline in working memory or episodic memory. These findings are discussed in relation to the functional roles fulfilled by different memory processes in judgment and decision-making tasks.

Irrational choice under uncertainty correlates with lower striatal D(2/3) receptor binding in rats

Individual differences in dopamine (DA) signaling, including low striatal D(2/3) receptors, may increase vulnerability to substance abuse, although whether this phenotype confers susceptibility to nonchemical addictions is unclear. The degree to which people use "irrational" cognitive heuristics when choosing under uncertainty can determine whether they find gambling addictive. Given that dopaminergic projections to the striatum signal reward expectancy and modulate decision-making, individual differences in DA signaling could influence the extent of such biases. To test this hypothesis, we used a novel task to model biased, risk-averse decision-making in rats. Animals chose between a "safe" lever, which guaranteed delivery of the wager, or an "uncertain" lever, which delivered either double the wager or nothing with 50:50 odds. The bet size varied from one to three sugar pellets. Although the amount at stake did not alter the options' utility, a subgroup of "wager-sensitive" rats increased their preference for the safe lever as the bet size increased, akin to risk aversion. In contrast, wager-insensitive rats slightly preferred the uncertain option consistently. Amphetamine increased choice of the uncertain option in wager-sensitive, but not in wager-insensitive rats, whereas a D(2/3) receptor antagonist decreased uncertain lever choice in wager-insensitive rats alone. Micro-PET and autoradiography using [(11)C]raclopride confirmed a strong correlation between high wager sensitivity and low striatal D(2/3) receptor density. These data suggest that the propensity for biased decision-making under uncertainty is influenced by striatal D(2/3) receptor expression, and provide novel support for the hypothesis that susceptibility to chemical and behavioral addictions may share a common neurobiological basis.

Myopia for the future or hypersensitivity to reward? Age-related changes in decision making on the Iowa Gambling Task

It has been shown that older adults perform less well than younger adults on the Iowa Gambling Task (IGT), a real-world type decision-making task that factors together reward, punishment, and uncertainty. To explore the reasons behind this age-related decrement, we administered to an adult life span sample of 265 healthy participants (Mdn age = 62.00 +/- 16.17 years; range [23-88]) 2 versions of the IGT, which have different contingencies for successful performance: A'B'C'D' requires choosing lower immediate reward (paired with lower delayed punishment); E'F'G'H' requires choosing higher immediate punishment (paired with higher delayed reward). There was a significant negative correlation between age and performance on the A'B'C'D' version of the IGT (r = -.16, p = .01), while there was essentially no correlation between age and performance on the E'F'G'H' version (r = -.07, p = .24). In addition, the rate of impaired performance in older participants was significantly higher for the A'B'C'D' version (23%) compared with the E'F'G'H' version (13%). A parsimonious account of these findings is an age-related increase in hypersensitivity to reward, whereby the decisions of older adults are disproportionately influenced by prospects of receiving reward, irrespective of the presence or degree of punishment.