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Di Crosta A, Marin A, Palumbo R, Ceccato I, La Malva P, Gatti M, Prete G, Palumbo R, Mammarella N, Di Domenico A. Changing Decisions: The Interaction between Framing and Decoy Effects. Behav Sci (Basel) 2023; 13:755. [PMID: 37754033 PMCID: PMC10525293 DOI: 10.3390/bs13090755] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/08/2023] [Accepted: 09/10/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Cognitive biases are popular topics in psychology and marketing, as they refer to systematic cognitive tendencies in human thinking that deviate from logical and rational reasoning. The framing effect (FE) and the decoy effect (DE) are examples of cognitive biases that can influence decision making and consumer preferences. The FE involves how options are presented, while the DE involves the addition of a third option that influences the choice between the other two options. METHODS We investigated the interaction between the FE and the DE in the case of both incongruent (ID) and congruent (CD) decoys in a sample of undergraduates (n = 471). The study had a two (positive vs. negative valence) × three (original, congruent decoy, incongruent decoy) within-subject design. RESULTS The ID option reduces the FE in both positive- and negative-framed conditions compared to the controls, while adding the CD option increases the FE only in the positive-framed condition. Additionally, the inclusion of the CD option enhances the level of decision confidence, whereas no significant differences were found in the ID condition. CONCLUSIONS Our findings gave new insights into the interplay between two of the most frequent cognitive biases.
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Affiliation(s)
- Adolfo Di Crosta
- Department of Psychological Science, Humanities and Territory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy (P.L.M.); (A.D.D.)
- Department of Medicine and Aging Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Anna Marin
- Neuroscience Department, Boston University School of Medicine, Boston, MA 02118, USA
| | - Rocco Palumbo
- Department of Psychological Science, Humanities and Territory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy (P.L.M.); (A.D.D.)
| | - Irene Ceccato
- Department of Psychological Science, Humanities and Territory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy (P.L.M.); (A.D.D.)
| | - Pasquale La Malva
- Department of Psychological Science, Humanities and Territory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy (P.L.M.); (A.D.D.)
| | - Matteo Gatti
- Department of Psychological Science, Humanities and Territory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy (P.L.M.); (A.D.D.)
| | - Giulia Prete
- Department of Psychological Science, Humanities and Territory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy (P.L.M.); (A.D.D.)
| | - Riccardo Palumbo
- Department of Neuroscience, Imaging and Clinical Sciences, University d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Nicola Mammarella
- Department of Psychological Science, Humanities and Territory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy (P.L.M.); (A.D.D.)
| | - Alberto Di Domenico
- Department of Psychological Science, Humanities and Territory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy (P.L.M.); (A.D.D.)
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2
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Marini M, Boschetti C, Gastaldi S, Addessi E, Paglieri F. Context-effect bias in capuchin monkeys (Sapajus spp.): exploring decoy influences in a value-based food choice task. Anim Cogn 2023; 26:503-514. [PMID: 36125642 PMCID: PMC9950244 DOI: 10.1007/s10071-022-01670-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 07/04/2022] [Accepted: 08/04/2022] [Indexed: 11/28/2022]
Abstract
Decision making is known to be liable to several context effects. In particular, adding a seemingly irrelevant alternative (decoy) to a set of options can modify preferences: typically, by increasing choices towards whatever option clearly dominates the decoy (attraction effect), but occasionally also decreasing its appeal and generating a shift in the opposite direction (repulsion effect). Both types of decoy effects violate rational choice theory axioms and suggest dynamic processes of preference-formation, in which the value of each alternative is not determined a priori, but it is instead constructed by comparing options during the decision process. These effects are well documented, both in humans and in other species: e.g., amoebas, ants, honeybees, frogs, birds, cats, dogs. However, evidence of decoy effects in non-human primates remains surprisingly mixed. This study investigates decoy effects in capuchin monkeys (Sapajus spp.), manipulating time pressure across different conditions, to test whether such effects require time-consuming comparative processes among available alternatives. Whereas the time-dependent nature of decoy effects is a robust finding in the human literature, this is its first investigation in non-human animals. Our results show that capuchins exhibit an attraction effect with decoys targeting their preferred food, and that this effect disappears under time pressure; moreover, we observe preliminary evidence of a repulsion effect when decoys target instead the less-preferred food, possibly due to the larger distance between decoy and target in the attribute space. Taken together, these results provide valuable insight on the evolutionary roots of comparative decision making.
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Affiliation(s)
- Marco Marini
- Department of Psychology, Sapienza University of Rome, Rome, Italy ,Goal-Oriented Agents Lab, Istituto di Scienze e Tecnologie della Cognizione, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - Chiara Boschetti
- Department of Philosophy, Communication, and Performing Arts, Roma Tre University, Rome, Italy
| | - Serena Gastaldi
- Unit of Cognitive Primatology, Istituto di Scienze e Tecnologie della Cognizione, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - Elsa Addessi
- Unit of Cognitive Primatology, Istituto di Scienze e Tecnologie della Cognizione, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - Fabio Paglieri
- Goal-Oriented Agents Lab, Istituto di Scienze e Tecnologie della Cognizione, Consiglio Nazionale delle Ricerche, Rome, Italy.
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3
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Zhang Z. Functionally similar yet distinct neural mechanisms underlie different choice behaviors: ALE meta-analyses of decision-making under risk in adolescents and adults. DEVELOPMENTAL REVIEW 2022. [DOI: 10.1016/j.dr.2022.101052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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4
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Marini M, Sapienza A, Paglieri F. There is more to attraction than meets the eye: Studying decoy‐induced attention allocation without eye tracking. JOURNAL OF BEHAVIORAL DECISION MAKING 2022. [DOI: 10.1002/bdm.2299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Marco Marini
- Institute of Cognitive Sciences and Technologies National Research Council Rome Italy
- Department of Psychology Sapienza University of Rome Rome Italy
| | - Alessandro Sapienza
- Institute of Cognitive Sciences and Technologies National Research Council Rome Italy
| | - Fabio Paglieri
- Institute of Cognitive Sciences and Technologies National Research Council Rome Italy
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Perkins AQ, Rich EL. Identifying identity and attributing value to attributes: reconsidering mechanisms of preference decisions. Curr Opin Behav Sci 2021; 41:98-105. [DOI: 10.1016/j.cobeha.2021.04.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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6
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Rigby D, Vass C, Payne K. Opening the 'Black Box': An Overview of Methods to Investigate the Decision-Making Process in Choice-Based Surveys. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2021; 13:31-41. [PMID: 31486021 DOI: 10.1007/s40271-019-00385-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The desire to understand the preferences of patients, healthcare professionals and the public continues to grow. Health valuation studies, often in the form of discrete choice experiments, a choice based survey approach, proliferate as a result. A variety of methods of pre-choice process analysis have been developed to investigate how and why people make their decisions in such experiments and surveys. These techniques have been developed to investigate how people acquire and process information and make choices. These techniques offer the potential to test and improve theories of choice and/or associated empirical models. This paper provides an overview of such methods, with the focus on their use in stated choice-based healthcare studies. The methods reviewed are eye tracking, mouse tracing, brain imaging, deliberation time analysis and think aloud. For each method, we summarise the rationale, implementation, type of results generated and associated challenges, along with a discussion of possible future developments.
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Affiliation(s)
- Dan Rigby
- Economics, School of Social Sciences, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - Caroline Vass
- Division of Population Health, Health Services Research and Primary Care, Manchester Centre for Health Economics, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Katherine Payne
- Division of Population Health, Health Services Research and Primary Care, Manchester Centre for Health Economics, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK
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7
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Suomala J. The Consumer Contextual Decision-Making Model. Front Psychol 2020; 11:570430. [PMID: 33117237 PMCID: PMC7559398 DOI: 10.3389/fpsyg.2020.570430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 09/02/2020] [Indexed: 11/25/2022] Open
Abstract
Consumers can have difficulty expressing their buying intentions on an explicit level. The most common explanation for this intention-action gap is that consumers have many cognitive biases that interfere with rational decision-making. The current resource-rational approach to understanding human cognition, however, suggests that brain environment interactions lead consumers to minimize the expenditure of cognitive energy according to the principle of Occam’s Razor. This means that the consumer seeks as simple of a solution as possible for a problem requiring decision-making. In addition, this resource-rational approach to decision-making emphasizes the role of inductive inference and Bayesian reasoning. Together, the principle of Occam’s Razor, inductive inference, and Bayesian reasoning illuminate the dynamic human-environment relationship. This paper analyzes these concepts from a contextual perspective and introduces the Consumer Contextual Decision-Making Model (CCDMM). Based on the CCDMM, two hypothetical strategies of consumer decision-making will be presented. First, the SIMilarity-Strategy (SIMS) is one in which most of a consumer’s decisions in a real-life context are based on prior beliefs about the role of a commodities specific to real-life situation being encountered. Because beliefs are based on previous experiences, consumers are already aware of the most likely consequences of their actions. At the same time, they do not waste time on developing contingencies for what, based on previous experience, is unlikely to happen. Second, the What-is-Out-there-in-the-World-Strategy (WOWS) is one in which prior beliefs do not work in a real-life situation, requiring consumers to update their beliefs. The principle argument being made is that most experimental consumer research describes decision-making based on the WOWS, when participants cannot apply their previous knowledge and situation-based strategy to problems. The article analyzes sensory and cognitive biases described by behavioral economists from a CCDMM perspective, followed by a description and explanation of the typical intention-action gap based on the model. Prior to a section dedicated to discussion, the neuroeconomic approach will be described along with the valuation network of the brain, which has evolved to solve problems that the human has previously encountered in an information-rich environment. The principles of brain function will also be compared to CCDMM. Finally, different approaches and the future direction of consumer research from a contextual point of view will be presented.
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Affiliation(s)
- Jyrki Suomala
- NeuroLab, Laurea Leppävaara, Laurea University of Applied Sciences, Espoo, Finland
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8
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Wu T, Chen C, Spagna A, Wu X, Mackie M, Russell‐Giller S, Xu P, Luo Y, Liu X, Hof PR, Fan J. The functional anatomy of cognitive control: A domain‐general brain network for uncertainty processing. J Comp Neurol 2020; 528:1265-1292. [DOI: 10.1002/cne.24804] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/12/2019] [Accepted: 10/22/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Tingting Wu
- Department of Psychology, Queens CollegeThe City University of New York Queens New York
| | - Caiqi Chen
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, School of PsychologySouth China Normal University Guangzhou China
| | - Alfredo Spagna
- Department of PsychologyColumbia University in the City of New York New York New York
| | - Xia Wu
- Faculty of PsychologyTianjin Normal University Tianjin China
| | - Melissa‐Ann Mackie
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of Medicine Chicago Illinois
| | - Shira Russell‐Giller
- Department of Psychology, Queens CollegeThe City University of New York Queens New York
| | - Pengfei Xu
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive NeuroscienceShenzhen University Shenzhen China
| | - Yue‐jia Luo
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive NeuroscienceShenzhen University Shenzhen China
| | - Xun Liu
- CAS Key Laboratory of Behavioral Science, Institute of PsychologyUniversity of Chinese Academy of Sciences Beijing China
- Department of PsychologyUniversity of Chinese Academy of Sciences Beijing China
| | - Patrick R. Hof
- Nash Family Department of Neuroscience and Friedman Brain InstituteIcahn School of Medicine at Mount Sinai New York New York
| | - Jin Fan
- Department of Psychology, Queens CollegeThe City University of New York Queens New York
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9
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Marini M, Paglieri F. Decoy effects in intertemporal and probabilistic choices the role of time pressure, immediacy, and certainty. Behav Processes 2019; 162:130-141. [PMID: 30849515 DOI: 10.1016/j.beproc.2019.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/27/2019] [Accepted: 03/04/2019] [Indexed: 11/15/2022]
Abstract
A decoy is an irrelevant option that, when added to a binary choice, is not selected but nonetheless alters the subjects' preferences, systematically biasing towards its target. The decoy effect, also known as attraction effect, is considered an anomaly of rational decision-making, albeit its applicability to real-life choices outside of laboratory settings has been challenged. In particular, when decoys have been studied in choices between outcomes occurring at different points in time, i.e. intertemporal choices, or with different probabilities of realizing their utility, i.e. probabilistic choices, results were mixed: sometimes decoys are impactful, sometimes they are not, and they seem to be more effective in biasing towards, respectively, larger-and-later and larger-and-riskier outcomes, rather than towards sooner-and-smaller or sooner-and-safer rewards. We suggest that this puzzling set of results can be clarified by focusing on two important influencing factors: time pressure and immediacy/certainty. Moreover, we argue that decoy effects constitute an excellent testbed to assess similarities and differences between intertemporal choice and risky decision-making, which constitutes another open issue in the study of human choice. Two studies are presented to support these claims. In Study 1 (N = 92), we demonstrate that asymmetrically dominated decoys influence both intertemporal choice and risky decision-making only in the absence of time pressure, since otherwise the comparative process required for the decoy to have an impact cannot occur, consistently with predictions made by connectionist models of decision. In Study 2 (N = 53), we show that, when the smaller option is no longer presented as immediate/certain (but rather as sooner/safer), the impact of decoys becomes symmetrical - that is, they can prompt subjects to become either more future-oriented/risk-prone or more present-oriented/risk-averse. We conclude by discussing the implications of these findings for our understanding of the multifaceted role of time and chance in decision making.
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Affiliation(s)
- Marco Marini
- Istituto di Scienze e Tecnologie della Cognizione, Consiglio Nazionale delle Ricerche, Roma, Italy.
| | - Fabio Paglieri
- Istituto di Scienze e Tecnologie della Cognizione, Consiglio Nazionale delle Ricerche, Roma, Italy
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10
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Cognitive and Neural Bases of Multi-Attribute, Multi-Alternative, Value-based Decisions. Trends Cogn Sci 2019; 23:251-263. [DOI: 10.1016/j.tics.2018.12.003] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 12/06/2018] [Accepted: 12/10/2018] [Indexed: 11/16/2022]
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11
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Attraction Effect in Risky Choice Can Be Explained by Subjective Distance Between Choice Alternatives. Sci Rep 2017; 7:8942. [PMID: 28827699 PMCID: PMC5567099 DOI: 10.1038/s41598-017-06968-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 06/21/2017] [Indexed: 11/09/2022] Open
Abstract
Individuals make decisions under risk throughout daily life. Standard models of economic decision making typically assume that people evaluate choice options independently. There is, however, substantial evidence showing that this independence assumption is frequently violated in decision making without risk. The present study extends these findings to the domain of decision making under risk. To explain the independence violations, we adapted a sequential sampling model, namely Multialternative Decision Field Theory (MDFT), to decision making under risk and showed how this model can account for the observed preference shifts. MDFT not only better predicts choices compared with the standard Expected Utility Theory, but it also explains individual differences in the size of the observed context effect. Evidence in favor of the chosen option, as predicted by MDFT, was positively correlated with brain activity in the medial orbitofrontal cortex (mOFC) and negatively correlated with brain activity in the anterior insula (aINS). From a neuroscience perspective, the results of the present study show that specific brain regions, such as the mOFC and aINS, not only code the value or risk of a single choice option but also code the evidence in favor of the best option compared with other available choice options.
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12
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Weilbächer RA, Gluth S. The Interplay of Hippocampus and Ventromedial Prefrontal Cortex in Memory-Based Decision Making. Brain Sci 2016; 7:brainsci7010004. [PMID: 28036071 PMCID: PMC5297293 DOI: 10.3390/brainsci7010004] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 12/16/2016] [Accepted: 12/23/2016] [Indexed: 12/21/2022] Open
Abstract
Episodic memory and value-based decision making are two central and intensively studied research domains in cognitive neuroscience, but we are just beginning to understand how they interact to enable memory-based decisions. The two brain regions that have been associated with episodic memory and value-based decision making are the hippocampus and the ventromedial prefrontal cortex, respectively. In this review article, we first give an overview of these brain–behavior associations and then focus on the mechanisms of potential interactions between the hippocampus and ventromedial prefrontal cortex that have been proposed and tested in recent neuroimaging studies. Based on those possible interactions, we discuss several directions for future research on the neural and cognitive foundations of memory-based decision making.
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Affiliation(s)
| | - Sebastian Gluth
- Department of Psychology, University of Basel, Basel 4055, Switzerland.
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Hu J, Lee D, Hu S, Zhang S, Chao H, Li CSR. Individual variation in the neural processes of motor decisions in the stop signal task: the influence of novelty seeking and harm avoidance personality traits. Brain Struct Funct 2016; 221:2607-18. [PMID: 25989852 PMCID: PMC4654717 DOI: 10.1007/s00429-015-1061-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 05/07/2015] [Indexed: 01/06/2023]
Abstract
Personality traits contribute to variation in human behavior, including the propensity to take risk. Extant work targeted risk-taking processes with an explicit manipulation of reward, but it remains unclear whether personality traits influence simple decisions such as speeded versus delayed responses during cognitive control. We explored this issue in an fMRI study of the stop signal task, in which participants varied in response time trial by trial, speeding up and risking a stop error or slowing down to avoid errors. Regional brain activations to speeded versus delayed motor responses (risk-taking) were correlated to novelty seeking (NS), harm avoidance (HA) and reward dependence (RD), with age and gender as covariates, in a whole brain regression. At a corrected threshold, the results showed a positive correlation between NS and risk-taking responses in the dorsomedial prefrontal, bilateral orbitofrontal, and frontopolar cortex, and between HA and risk-taking responses in the parahippocampal gyrus and putamen. No regional activations varied with RD. These findings demonstrate that personality traits influence the neural processes of executive control beyond behavioral tasks that involve explicit monetary reward. The results also speak broadly to the importance of characterizing inter-subject variation in studies of cognition and brain functions.
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Affiliation(s)
- Jianping Hu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06519, USA
- School of Psychology, South China Normal University, Guangzhou, 510631, Guangdong, China
| | - Dianne Lee
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06519, USA
- Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, Bethesda, MD, 20892, USA
| | - Sien Hu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06519, USA
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06519, USA
| | - Herta Chao
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, 06519, USA
- Medical Service, VA Connecticut Health Care Systems, West Haven, CT, 06516, USA
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06519, USA.
- Department of Neurobiology, Yale University School of Medicine, New Haven, CT, 06519, USA.
- Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT, 06519, USA.
- Connecticut Mental Health Center, S112, 34 Park Street, New Haven, CT, 06519-1109, USA.
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Saposnik G, Sempere AP, Raptis R, Prefasi D, Selchen D, Maurino J. Decision making under uncertainty, therapeutic inertia, and physicians' risk preferences in the management of multiple sclerosis (DIScUTIR MS). BMC Neurol 2016; 16:58. [PMID: 27146451 PMCID: PMC4855476 DOI: 10.1186/s12883-016-0577-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 04/21/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The management of multiple sclerosis (MS) is rapidly changing by the introduction of new and more effective disease-modifying agents. The importance of risk stratification was confirmed by results on disease progression predicted by different risk score systems. Despite these advances, we know very little about medical decisions under uncertainty in the management of MS. The goal of this study is to i) identify whether overconfidence, tolerance to risk/uncertainty, herding influence medical decisions, and ii) to evaluate the frequency of therapeutic inertia (defined as lack of treatment initiation or intensification in patients not at goals of care) and its predisposing factors in the management of MS. METHODS/DESIGN This is a prospective study comprising a combination of case-vignettes and surveys and experiments from Neuroeconomics/behavioral economics to identify cognitive distortions associated with medical decisions and therapeutic inertia. Participants include MS fellows and MS experts from across Spain. Each participant will receive an individual link using Qualtrics platform(©) that includes 20 case-vignettes, 3 surveys, and 4 behavioral experiments. The total time for completing the study is approximately 30-35 min. Case vignettes were selected to be representative of common clinical encounters in MS practice. Surveys and experiments include standardized test to measure overconfidence, aversion to risk and ambiguity, herding (following colleague's suggestions even when not supported by the evidence), physicians' reactions to uncertainty, and questions from the Socio-Economic Panel Study (SOEP) related to risk preferences in different domains. By applying three different MS score criteria (modified Rio, EMA, Prosperini's scheme) we take into account physicians' differences in escalating therapy when evaluating medical decisions across case-vignettes. CONCLUSIONS The present study applies an innovative approach by combining tools to assess medical decisions with experiments from Neuroeconomics that applies to common scenarios in MS care. Our results will help advance the field by providing a better understanding on the influence of cognitive factors (e.g., overconfidence, aversion to risk and uncertainty, herding) on medical decisions and therapeutic inertia in the management of MS which could lead to better outcomes.
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Affiliation(s)
- Gustavo Saposnik
- Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, 55 Queen St E, Toronto, ON, M5C 1R6, Canada.
- Neuroeconomics and Decision Neuroscience, Department of Economics, University of Zurich, Zurich, Switzerland.
| | - Angel Perez Sempere
- Department of Neurology, Hospital General Universitario de Alicante, Alicante, Spain
| | - Roula Raptis
- Applied Health Research Center, Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Canada
| | - Daniel Prefasi
- Neuroscience Area, Medical Department, Roche Farma, Madrid, Spain
| | - Daniel Selchen
- Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, 55 Queen St E, Toronto, ON, M5C 1R6, Canada
| | - Jorge Maurino
- Neuroscience Area, Medical Department, Roche Farma, Madrid, Spain
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15
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Zhen S, Yu R. The development of the asymmetrically dominated decoy effect in young children. Sci Rep 2016; 6:22678. [PMID: 26935899 PMCID: PMC4776153 DOI: 10.1038/srep22678] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 02/17/2016] [Indexed: 11/11/2022] Open
Abstract
One classic example of context-independent violations is the asymmetrically dominated decoy effect, in which adding a decoy option (inferior option) to a set of original options often increases the individual’s preference for one option over the other original option. Despite the prevalence of this effect, little is known about its developmental origins. Moreover, it remains contentious whether the decoy effect is a result of biological evolution or is learned from social experience. Here, we investigated the decoy effect in 3- to 7-year-old children (n = 175) and young adults (n = 52) using a simple perceptual task. Results showed that older children (5-year-olds and 7-year-olds), but not younger children (3-year-olds), exhibited a decoy effect. Nevertheless, children as young as age 5 exhibited a decoy effect that was not significantly different from that shown by young adults. These findings suggest that humans start to appreciate the relative values of options at around age 5.
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Affiliation(s)
- Shanshan Zhen
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
| | - Rongjun Yu
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, China.,Department of Psychology, National University of Singapore, Singapore, Singapore.,Singapore Institute for Neurotechnology (SINAPSE), Centre for Life Sciences, National University of Singapore, Singapore, Singapore.,Neurobiology/Aging programme, Center for Life Sciences, National University of Singapore, Singapore, Singapore
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Yu R. Stress potentiates decision biases: A stress induced deliberation-to-intuition (SIDI) model. Neurobiol Stress 2016; 3:83-95. [PMID: 27981181 PMCID: PMC5146206 DOI: 10.1016/j.ynstr.2015.12.006] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 12/28/2015] [Indexed: 02/08/2023] Open
Abstract
Humans often make decisions in stressful situations, for example when the stakes are high and the potential consequences severe, or when the clock is ticking and the task demand is overwhelming. In response, a whole train of biological responses to stress has evolved to allow organisms to make a fight-or-flight response. When under stress, fast and effortless heuristics may dominate over slow and demanding deliberation in making decisions under uncertainty. Here, I review evidence from behavioral studies and neuroimaging research on decision making under stress and propose that stress elicits a switch from an analytic reasoning system to intuitive processes, and predict that this switch is associated with diminished activity in the prefrontal executive control regions and exaggerated activity in subcortical reactive emotion brain areas. Previous studies have shown that when stressed, individuals tend to make more habitual responses than goal-directed choices, be less likely to adjust their initial judgment, and rely more on gut feelings in social situations. It is possible that stress influences the arbitration between the emotion responses in subcortical regions and deliberative processes in the prefrontal cortex, so that final decisions are based on unexamined innate responses. Future research may further test this 'stress induced deliberation-to-intuition' (SIDI) model and examine its underlying neural mechanisms.
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Affiliation(s)
- Rongjun Yu
- Department of Psychology, National University of Singapore, Singapore; Neurobiology/Ageing Programme, Life Sciences Institute, National University of Singapore, Singapore; Singapore Institute for Neurotechnology (SINAPSE), Center for Life Sciences, National University of Singapore, Singapore
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