Behavioral inhibition system and social anxiety among college students: multiple mediating effect of mindfulness and negative cognitive bias / 中华行为医学与脑科学杂志

Objective:To explore the role of mindfulness and negative cognitive bias between behavioral inhibition system and social anxiety among college students.Methods:From October 12th to November 8th of 2012, a total of 747 college students from a university in Tianjin were sampled and assessed using the behavioral inhibition system scale (BIS), the mindful attention awareness scale (MAAS), the negative cognitive processing bias questionnaire (NCPBQ), and the social avoidance and distress scale (SAD). Descriptive statistics, correlation analysis, and tests for mediating effects were performed by SPSS 20.0 and Mplus 8.0.Results:The scores of behavioral inhibition system, social anxiety, mindfulness and negative cognitive bias were (15.3±2.4), (12.7±7.2), (3.4±0.8) and (45.6±11.5), respectively. The scores of BIS, NCPBQ, and SAD were positively correlated with each other ( r=0.27-0.49, all P<0.001). The scores of MAAS were negatively correlated with the scores of BIS, NCBPQ, and SAD ( r=-0.33--0.28, all P<0.001). The behavioral inhibition system exerted its influence on social anxiety through three pathways. The mediating effect size of mindfulness was 0.04, accounting for 16.0% of the total effect. The mediating effect size of negative cognitive bias was 0.17, accounting for 68.0% of the total effect. And the chain mediating effect size of mindfulness and negative cognitive bias was 0.04, accounting for 16.0% of the total effect. Conclusion:The effects of behavioral inhibition system on social anxiety in college students are individually mediated by mindfulness and negative cognitive biases, as well as their chain mediating effects.

Sesgos cognitivos en anestesia, una causa latente de error humano / Cognitive biases in anesthesia, a latent cause of human error

Resumen: Un concepto que ha causado atención en los últimos años es el de los sesgos cognitivos y su influencia en las decisiones y comportamientos diarios de los seres humanos. Los equipos de trabajo en sala de operaciones se forman de diferentes áreas de especialidad y con distintos niveles de experiencia, todos tienen una función y pueden tomar decisiones que afectan al paciente. Este proceso de toma de decisiones se puede basar en experiencia previa, razonamiento clínico y el contexto; la necesidad de realizar diagnósticos y tratamiento rápido en algunas situaciones hace al anestesiólogo particularmente vulnerable a sesgos cognitivos. Presentamos diferentes ejemplos de sesgos cognitivos que se pueden llegar a presentar en sala de operaciones, como puede ser el sesgo de atención, en el cual un estímulo relevante como la necesidad de asegurar la vía aérea puede hacer que el estado hemodinámico del paciente pase desapercibido. El objetivo de este trabajo es crear conciencia particularmente en los anestesiólogos sobre estos sesgos cognitivos, su presencia en el proceso de toma de decisiones en la sala de operaciones y compartimos un par de formas para ayudar a prevenirlos.

Abstract: A concept that has gained attention in the last years is the existance of cognitive biases and their influence in decision making and behaviour of human beings. Teams in the operating room are formed by different medical specialities with varied levels of experience, everyone has a role and every one can make decisions that have an impact in the patient. This decision making process might be based in previous experience, clinical reasoning, and context; the need to make a rapid diagnosis and treatment in some situations makes the anesthesiologist especially vulnerable to cognitive bias. We present different types of cognitive bias that might be present in the operating room for example the attention bias in which a relevant stimulus like the airway management could make the hemodynamic aspect go unnoticed. The goal of this paper is to aware anesthesiologists in particular about this cognitive biases, their presence in the decision making process in the operating room and to share a couple of ways to prevent them.

Antianxiety effect and mechanisms of cognitive bias modification / 中华行为医学与脑科学杂志

Negative cognitive bias is closely linked with the production and development of anxiety disorder.Recently, cognitive bias modification (CBM) has been developed to correct negative cognitive bias in anxiety.By retrieving literature researches, this paper analyzed the progress of cognitive bias modification intervention.Seventy-one literatures published in the last decade and with key words of cognitive bias and anxiety were included.Attentional bias modification and interpretation bias modification are the most useful treatment which could improve negative cognitive bias, however the controversial remains about the training effect of CBM on anxiety symptoms.Researchers have found positive results when cognitive bias modification and cognitive behavior therapy (CBT) are combined to treat anxiety disorder.Researches on the brain mechanism of cognitive bias modification provide the neurophysiological basis for the occurrence of the intervention. Cognitive bias modification help to improve negative cognitive bias in anxiety.Combination of CBM and CBT is an effective method of anxiety treatment.

Overcoming obstacles to creativity in science / Superando obstáculos à criatividade na ciência

Creativity is a crucial issue in science. Scientific research should not be restricted to the logical development and application of known ideas, but should promote new ideas to expand knowledge beyond the existing frontiers. Stimulating scientific creativity means not only giving a boost to creative thinking, but also taking into account the factors that put a brake on creativity. This article is devoted to factors that keep scientific creativity in check and how we could address them. We analyze several obstacles lying inside and outside the researcher's mind. The most important obstacles inside the researcher's mind are epistemological obstacles and cognitive bias (confirmation bias). While the most important obstacle outside are the social norms, i.e. the pressure for the scientific community and, sometimes, the whole society, to conform to the dominant scientific model. We conclude with some proposals to overcome these obstacles.

A criatividade é uma questão crucial na ciência. Sua pesquisa científica não deve se restringir ao desenvolvimento e aplicação lógica de ideias já conhecidas, mas deve promover novas ideias para expandir o conhecimento além das fronteiras existentes. Estimular a criatividade científica significa não apenas estimular o pensamento criativo, mas também levar em conta os fatores que dificultam a criatividade. Este artigo é dedicado aos fatores que mantêm a criatividade científica sob controle e como podemos resolvê-los. Analisamos diversos obstáculos dentro e fora da mente do pesquisador. Os obstáculos mais importantes dentro da mente do pesquisador são os obstáculos epistemológicos e o viés cognitivo (viés de confirmação). Enquanto o obstáculo externo mais importante é composto pelas normas sociais, ou seja, a pressão por parte da comunidade científica e, por vezes, por parte de toda a sociedade, para se adequar ao modelo científico dominante. Concluímos com algumas propostas sobre como superar esses obstáculos.

"Era óbvio que isso iria acontecer": considerações sobre o viés retrospectivo / "It was obvious that this would happen": consideration about the hindsight bias

O viés retrospectivo é o fenômeno de perceber e avaliar eventos diferentemente, uma vez que eles tenham ocorrido. Dada uma falha cognitiva, pessoas tendem a ter distorções da memória e a produzir falsas sensações de inevitabilidade e previsibilidade. Os objetivos deste trabalho foram fazer uma revisão de literatura do viés retrospectivo e discutir as implicações teóricas e práticas do tema. Uma pesquisa, realizada nas principais bases de dados do país, não encontrou nenhum artigo relacionado com o tema. A partir de uma seleção das principais pesquisas internacionais sobre o assunto, foi feita uma análise que mostrou os níveis cognitivos do viés retrospectivo, suas implicações e as estratégias usadas para atenuar o viés. Nas considerações finais, são discutidos o impacto e a importância do conhecimento desse fenômeno no dia a dia de tomadores de decisão e cidadãos, assim como a necessidade de se explorar o tema em pesquisas nacionais.

Hindsight bias is the phenomenon of perceiving and evaluating events differently once they are occurred. Given a cognitive flaw, people tend to have distortions of memory and produce false sensations of inevitability and predictability. The objective of this work is to make a literature review of the hindsight bias and to discuss both theoretical and practical implications of the theme. A search conducted in the Brazilian's main databases did not find any articles related to the topic. From a selection of the main international studies on the subject, an analysis was made showing the cognitive levels of the hindsight bias, its implications and the strategies used to attenuate the bias. In the final considerations, the impact and importance of day-to-day knowledge of the phenomenon and the need to explore the subject in national research are discussed.

Teaching metacognition in clinical decision-making using a novel mnemonic checklist: an exploratory study

<p><b>INTRODUCTION</b>Metacognition is a cognitive debiasing strategy that clinicians can use to deliberately detach themselves from the immediate context of a clinical decision, which allows them to reflect upon the thinking process. However, cognitive debiasing strategies are often most needed when the clinician cannot afford the time to use them. A mnemonic checklist known as TWED (T = threat, W = what else, E = evidence and D = dispositional factors) was recently created to facilitate metacognition. This study explores the hypothesis that the TWED checklist improves the ability of medical students to make better clinical decisions.</p><p><b>METHODS</b>Two groups of final-year medical students from Universiti Sains Malaysia, Malaysia, were recruited to participate in this quasi-experimental study. The intervention group (n = 21) received educational intervention that introduced the TWED checklist, while the control group (n = 19) received a tutorial on basic electrocardiography. Post-intervention, both groups received a similar assessment on clinical decision-making based on five case scenarios.</p><p><b>RESULTS</b>The mean score of the intervention group was significantly higher than that of the control group (18.50 ± 4.45 marks vs. 12.50 ± 2.84 marks, p < 0.001). In three of the five case scenarios, students in the intervention group obtained higher scores than those in the control group.</p><p><b>CONCLUSION</b>The results of this study support the use of the TWED checklist to facilitate metacognition in clinical decision-making.</p>

Modificación de sesgos cognitivos (MSC) en depresión: una revisión crítica de nuevos procedimientos para el cambio de sesgos cognitivos / Cognitive bias modification (CBM) in depression: a critical review of new procedures to change cognitive biases

Los sesgos cognitivos juegan un papel importante como factores de vulnerabilidad en los trastornos emocionales. Recientemente se han empezado a desarrollar intervenciones para la Modificación de Sesgos Cognitivos (MSC), con el objetivo final de mejorar los síntomas clínicos. Aunque estos procedimientos innovadores se han utilizado más en los problemas de ansiedad, existe una investigación creciente sobre su uso en la depresión. En este trabajo efectuamos una revisión del marco teórico, los procedimientos utilizados y los principales resultados de la MSC en la depresión, en especial en la corrección de sesgos atencionales y de interpretación. Finalmente se analizan las limitaciones conceptuales y metodológicas de estas nuevas intervenciones y se discuten sus implicaciones clínicas, teóricas y aplicadas.

Cognitive biases play an important role as vulnerability factors in emotional disorders. Interventions for Cognitive Bias Modification (CBM) have recently begun to be developed with the ultimate goal of improving clinical symptoms. Although these innovative procedures have been applied mainly in anxiety problems, there is increasing research on the application in depression. This work reviews the theoretical framework, the procedures used, and the main results of CBM in depression, especially in the modification of attention and interpretative bias. Finally the conceptual and methodological limitations of these promising interventions procedures are analyzed as well as the clinical, theoretical and applied implications.

Effect of escitalopram treatment on cognitive bias to the emotional facial information in panic disorder / 中华行为医学与脑科学杂志

Objective To investigate the effect of escitalopram treatment on cognitive bias to the emotional facial information in patients with panic disorder. Methods 30 patients met CCMD-3 criteria for panic disorder were enrolled as research group and marched sexual and age 30 healthy persons enrolled as control group. Patients were treated with escitalopram for 8 weeks. All participants measured with dot-probe task of emotional facial information at base and after 8 weeks. RTs and attentional bias scores were compared respectively. Results After 8 weeks,HAMA scores (7. 81 ± 2. 52) in research group were lower than that of at base ( 17. 23 ± 3. 12) (P = 0.002). A repeated measure ANOVA revealed a significant probe site main effect (F(1,58) =4. 34, P = 0.031 ) , RTs of antarafacial site were longer than that of homonymy site. It revealed a significant probe site and group interaction(F(1,58) =16.15, P=0.000) ,a significant emotional facial information type and probe site interaction(F(1,58)=9.25, P =0.015) ,and a significant emotional facial information type × probe site× group interaction(F(1,58) =7. 31, P = 0. 002). LSD test showed that RTs of antarafacial site to fear facial information in research group were longer than that of homonymy site(P = 0.0009). RTs and attention bias scores of antarafacial site to fear facial information after 8 weeks in research group were lower than that of at base(P=0.032,0.008). Conclusion Patients with panic disorder have the cognitive bias to the fear facial emotional stimulus, and escitalopram treatment might improve the cognitive bias.

Diferencias en el estilo atribucional y de la autoestima en una muestra de pacientes delirantes / Comparative analysis of attributional and self-esteem in a sample of patients with delusions and control subjets

Introduction The attributional along with the self-esteem (that plays a central role in the development and maintenance of the pathological state) is a very important mediating element in the delusion, so we find the necessity to realise basic studies of these processes. In the field of psychology, and mainly in the personality area, the atributional has a great relevance, when understanding the causal attributions like mechanisms of facing that guide the conduct of the subject. In this way, we see the importance that supposes the study of the dysfunctional attribution to be able to replace it on the other adaptive, mainly in the pathologies where delusions beliefs exist. In the present investigation the influence has been analyzed that carries out the variable attributional and the self-esteem in the delusional ideas (defined by the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders [DSM-IV] as <

Introducción El estilo atribucional y la autoestima (que cumple un papel central en el desarrollo y mantenimiento del estado patológico) son elementos mediadores muy importantes en el delirio. De ahí la necesidad de realizar estudios básicos de dichos procesos. En el campo de la psicología, y en concreto en el área de personalidad, el estilo atribucional es de gran relevancia al entender las atribuciones causales como mecanismos de afrontamiento que guían la conducta del sujeto. Por ello, la importancia que supone el estudio de la atribución disfuncional para poder sustituirla por otra adaptativa, sobre todo en las patologías donde existen creencias delirantes. En la presente investigación se ha analizado el papel que desempeñan la variable estilo atribucional y la autoestima en las ideas del irantes en una muestra de pacientes delirantes en comparación con un grupo control. Pacientes y métodos En esta investigación se ha examinado la autoestima y los sesgos atribucionales en una muestra de 20 pacientes delirantes (85% son hombres y 15% mujeres de edad media de 36.20 años) ingresados en la unidad de Rehabilitación de un Hospital Psiquiátrico de Santiago de Compostela (España) y se ha comparado con 40 sujetos control normales igualados en edad y sexo con el grupo experimental que no poseen historia psiquiátrica, ni ningún trastorno que requiera tratamiento. Se trata de un estudio comparativo, observacional, transversal y homodémico según la clasificación propuesta por Feinstein y con un diseño de casos y controles. Los instrumentos aplicados en el estudio fueron: a) la Escala de Autoestima de Rosenberg (Rosenberg Self-esteem Scale, EA), b) el Cuestionario de Estilo Atribucional (Attributional Questionnaire, ASQ) y c) la Escala de Síndrome Positivo y Negativo en la Esquizofrenia (Positive and Negative Syndrome Scale for Schizophrenia, PANSS). Todos los instrumentos empleados para el estudio cuentan con sus correspondientes datos de fiabilidad y validez. Resultados Los resultados de esta investigación muestran que los pacientes delirantes realizaron atribuciones más externas para los eventos negativos que el grupo control normal, y más internas para los positivos. Los pacientes delirantes realizaron una atribución causal en estabilidad y globalidad para los sucesos negativos similar a la de los normales. Sin embargo, ante eventos positivos se han encontrado diferencias significativas entre ambos grupos en relación con la estabilidad, no así para la globalidad. Asimismo, los pacientes delirantes, al igual que el grupo control normal, manifestaron una alta autoestima. Conclusión La hipótesis planteada por Bentall no se ha podido constatar en esta investigación, ya que al analizar la variable autoestima observamos que sus puntuaciones son similares al grupo control de sujetos normales. Según el estilo atribucional, se concluye que los sujetos delirantes tienden a culpar por sus fallos y errores a las demás personas o a otras circunstancias. Por el contrario, cuando ellos tienen éxito en alguna situación, consideran que se debe a ellos mismos, y atribuyen los eventos favorables a nivel interno. Las conclusiones del análisis de la dimensión globalidad, la cual determina la generalización temporal de la expectativa, no cumplen la hipótesis en la cual se afirmaba que los sujetos delirantes, al igual que los normales, realizaban atribuciones excesivamente globales tanto para hechos positivos como para negativos, pero no manifiestan un sesgo exagerado hacia la excesiva globalidad.

Dysfunctional Attitudes and Cognitive Bias in Major Depressive Disorder / 中国心理卫生杂志

Objective:To examine whether dysfunctional attitudes and cognitive bias change with fluctuations in depressive symptoms. Methods:122 patients with MDD (major depressive disorder) were assessed with DAS (dysfunctional attitude scale),CBQ (cognitive bias questionnaire) ,and HRSD (Hamilton rating scale for depression) before and after the 8-week treatment. 51 normal subjects were assessed with the DAS, CBQ and SDS as controls.Results:(1) Compared with normal controls, at the baseline MDD patients had significantly higher total DAS scores (158.2?34.6 vs. 119.3?23.4,t=8.559, P=0.000) and the score of CBQ (5.19?3.77 vs. 1.69?1.83, t=8.208, P=0.000). (2) After 8 weeks, the HRSD scores of patients reduced to Median 7.0, and the DAS and CBQ scores significantly lower than those in baseline (DAS total score from 158.2?34.6 to 143.3?29.3, t=3.611, P=0.000; the median of CBQ decreased from 5.0 to 3.0;z=4.670, P=0.000). (3) The DAS score (131.1?25.7) and CBQ score (median 3.0) of full recovery patients with full recovery remained higher than those of controls (t=2.397, P=0.018 ;z=3.990, P=0.000).Conclusion:Dysfunctional attitudes and cognitive bias were influenced by fluctuations in stata or demonstrateing stability over time. They were all state-trait features.

The Discussion on the Entry Point of Medical Ethics Education from the Medical Students' Cognitive Bias on Medical Ethics Study / 中国医学伦理学

The medical students are the future medical talent,so they need medical ethics education.This thesis lists medical students' cognitive bias on medical ethics study and enlightens some effective measures on it to achieve the educational purpose.