A pitfall of cognitive bias during the pandemic: Two cases of Plasmodium falciparum malaria coinfected or misdiagnosed with COVID-19.

We report two the cases of patients with imported Plasmodium falciparum malaria during the COVID-19 pandemic. One was coinfected with COVID-19 and the other was misdiagnosed with COVID-19; either way, the diagnosis of malaria was delayed. These cases suggest that physicians should beware of cognitive biases during pandemics and carefully evaluate febrile patients. Malaria should be considered in any febrile patient returning from a malaria-endemic area.

An Emotional Bias Modification for Children With Attention-Deficit/Hyperactivity Disorder: Co-design Study.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is one of the common neurodevelopment disorders. Children with ADHD typically have difficulties with emotional regulation. Previous studies have investigated the assessment for underlying emotional biases using the visual probe task. However, one of the significant limitations of the visual probe task is that it is demanding and repetitive over time. Previous studies have examined the use of gamification methods in addressing the limitations of the emotional bias visual probe task. There has also been increased recognition of the potential of participatory action research methods and how it could help to make the conceptualized interventions more relevant. OBJECTIVE: The primary aim of this study was to collate health care professionals' perspectives on the limitations of the existing visual probe task and to determine if gamification elements were viable to be incorporated into an emotional bias modification task. METHODS: A co-design workshop was conducted. Health care professionals from the Department of Development Psychiatry, Institute of Mental Health, Singapore, were invited to participate. Considering the COVID-19 pandemic and the restrictions, a web-based workshop was conducted. There were 3 main phases in the workshops. First, participants were asked to identify limitations and suggest potential methods to overcome some of the identified limitations. Second, participants were shown examples of existing gaming interventions in published literature and commercial stores. They were also asked to comment on the advantages and limitations of these interventions. Finally, participants were asked if gamification techniques would be appropriate. RESULTS: Overall, 4 health care professionals consented and participated. Several limitations were identified regarding the conventional emotional bias intervention. These included the nature of the task parameters, included stimulus set, and factors that could have an impact on the accuracy of responding to the task. After examining the existing ADHD games, participants raised concerns about the evidence base of some of the apps. They articulated that any developed ADHD game ought to identify the specific skill set that was targeted clearly. Regarding gamification strategies, participants preferred economic and performance-based gamification approaches. CONCLUSIONS: This study has managed to elucidate health care professionals' perspectives toward refining a conventional emotional bias intervention for children with ADHD. In view of the repetitiveness of the conventional task, the suggested gamification techniques might help in influencing task adherence and reduce the attrition rates.

Multiple models for outbreak decision support in the face of uncertainty.

Policymakers must make management decisions despite incomplete knowledge and conflicting model projections. Little guidance exists for the rapid, representative, and unbiased collection of policy-relevant scientific input from independent modeling teams. Integrating approaches from decision analysis, expert judgment, and model aggregation, we convened multiple modeling teams to evaluate COVID-19 reopening strategies for a mid-sized United States county early in the pandemic. Projections from seventeen distinct models were inconsistent in magnitude but highly consistent in ranking interventions. The 6-mo-ahead aggregate projections were well in line with observed outbreaks in mid-sized US counties. The aggregate results showed that up to half the population could be infected with full workplace reopening, while workplace restrictions reduced median cumulative infections by 82%. Rankings of interventions were consistent across public health objectives, but there was a strong trade-off between public health outcomes and duration of workplace closures, and no win-win intermediate reopening strategies were identified. Between-model variation was high; the aggregate results thus provide valuable risk quantification for decision making. This approach can be applied to the evaluation of management interventions in any setting where models are used to inform decision making. This case study demonstrated the utility of our approach and was one of several multimodel efforts that laid the groundwork for the COVID-19 Scenario Modeling Hub, which has provided multiple rounds of real-time scenario projections for situational awareness and decision making to the Centers for Disease Control and Prevention since December 2020.

Measuring feelings about choices and risks: The Berlin Emotional Responses to Risk Instrument (BERRI).

We introduce a brief instrument specifically validated for measuring positive and negative feelings about risks-the Berlin Emotional Responses to Risk Instrument (BERRI). Based on seven studies involving diverse adults from three countries (n = 2120), the BERRI was found to robustly estimate anticipatory affective reactions derived from subjective evaluations of positive (i.e., assured, hopeful, and relieved) and negative emotions (i.e., anxious, afraid, and worried). The brief BERRI outperformed a 14-item assessment, uniquely tracking costs/benefits associated with cancer screening among men and women (Studies 1 and 2). Predictive validity was further documented in paradigmatic risky choice studies wherein options varied over probabilities and severities across six contexts (health, social, financial, technological, ethical, and environmental; Study 3). Studies 4-6, conducted during the Ebola epidemic and COVID-19 pandemic, indicated BERRI responses were sensitive to subtle effects caused by emotion-related framing manipulations presented in different cultures and languages (the United States, Spain, and Poland). Study 7 indicated BERRI responses remained stable for 2 weeks. Although the BERRI can provide an estimate of overall affect, choices were generally better explained by the unique influences of positive and negative affect. Overall, results suggest the novel, brief instrument can be an efficient tool for high-stakes research on decision making and risk communication.

Biased social comparison in the moment of crisis: The better-than-average effect and COVID-19

The better-than-average effect (BTAE) is a mechanism where people perceive oneself as better than others. The BTAE could be one of the phenomena explaining why people follow-in the moment of a global health crisis-guidelines ("I am superior to others, and I [will]) take extra precautions, e.g., a vaccine shot"). In this paper, we investigate the BTAE with 3,066 respondents. In Study 1, in all countries, across two measurements in time, the BTAE was present: Participants rated their involvement in self-protection as greater in comparison to others. Study 2 replicated this effect, proving its robustness. Participants estimated their willingness to vaccinate as higher than others. The BTAE was a significant predictor of willingness to vaccinate. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Illusory perception of visual patterns in pure noise is associated with COVID-19 conspiracy beliefs.

Just as perceptual heuristics can lead to visual illusions, cognitive heuristics can lead to biased judgements, such as "illusory pattern perception" (i.e., seeing patterns in unrelated events). Here we further investigated the common underlying mechanism behind irrational beliefs and illusory pattern perception in visual images. For trials in which no object was present in the noise, we found that the tendency to report seeing an object was positively correlated with the endorsement of both COVID-19 specific conspiracy theories and paranormal beliefs. The present results suggest that the cognitive bias to see meaningful connections in noise can have an impact on socio-political cognition as well as on perceptual decision making.

Are Fear Campaigns Effective for Increasing Adherence to COVID-Related Mitigation Measures?

BACKGROUND: Using fear to increase the uptake of preventative health behaviours is a longstanding practice, which could be useful in mitigating the spread of COVID-19. However, the impact of fear campaigns beyond behavioural outcomes has rarely been considered. It is possible that these threatening health messages could heighten health-related anxiety by inducing a tendency to interpret ambiguous stimuli in a threatening manner. This research aimed to evaluate the effects of fear-based articles about COVID-19, on intentions to adhere to mitigation measures and interpretation bias-a core maintenance factor in health anxiety. METHOD: Two pilot studies were conducted with the aim of validating our novel COVID-related measures and assessing engagement with the threat manipulation. Following this, 375 community members were recruited through social media for the main study. Participants were then randomly allocated to read an article about COVID which was manipulated on both threat and efficacy. After reading the article, participants then completed measures of interpretation bias and intentions to engage in COVID-19 mitigation measures. RESULTS: Although the threatening articles consistently produced greater COVID-related threat, they only generated a stronger interpretation bias in the first pilot study. Importantly, threat-based communications failed to enhance intentions to perform mitigation measures in any of the studies. Likewise, reading an article which bolstered self-efficacy did not increase intentions, compared to reading a low efficacy article. CONCLUSION: This research suggests that fear appeals are unlikely to increase intentions to perform COVID-related mitigation measures.

Biased Social Comparison in the Moment of Crisis

The better-than-average effect (BTAE) is a mechanism where people perceive oneself as better than others. The BTAE could be one of the phenomena explaining why people follow - in the moment of a global health crisis - guidelines ("I am superior to others, and I [will]) take extra precautions, e.g., a vaccine shot"). In this paper, we investigate the BTAE with 3,066 respondents. In Study 1, in all countries, across two measurements in time, the BTAE was present: Participants rated their involvement in self-protection as greater in comparison to others. Study 2 replicated this effect, proving its robustness. Participants estimated their willingness to vaccinate as higher than others. The BTAE was a significant predictor of willingness to vaccinate.

Who falls for fake news? Psychological and clinical profiling evidence of fake news consumers.

Awareness of the potential psychological significance of false news increased during the coronavirus pandemic, however, its impact on psychopathology and individual differences remains unclear. Acknowledging this, the authors investigated the psychological and psychopathological profiles that characterize fake news consumption. A total of 1452 volunteers from the general population with no previous psychiatric history participated. They responded to clinical psychopathology assessment tests. Respondents solved a fake news screening test, which allowed them to be allocated to a quasi-experimental condition: group 1 (non-fake news consumers) or group 2 (fake news consumers). Mean comparison, Bayesian inference, and multiple regression analyses were applied. Participants with a schizotypal, paranoid, and histrionic personality were ineffective at detecting fake news. They were also more vulnerable to suffer its negative effects. Specifically, they displayed higher levels of anxiety and committed more cognitive biases based on suggestibility and the Barnum Effect. No significant effects on psychotic symptomatology or affective mood states were observed. Corresponding to these outcomes, two clinical and therapeutic recommendations related to the reduction of the Barnum Effect and the reinterpretation of digital media sensationalism were made. The impact of fake news and possible ways of prevention are discussed.

Availability Bias and the COVID-19 Pandemic: A Case Study of Legionella Pneumonia.

Cognitive biases, such as the availability heuristic or availability bias, can inadvertently affect patient outcomes. These biases may be magnified during times of heightened awareness of a particular disease. Failure to identify cognitive biases when managing patients during the coronavirus disease 2019 (COVID-19) pandemic can delay the institution of the right treatment option and result in poor health outcomes. We present a case of delayed diagnosis of Legionella pneumonia due to COVID-19-related availability bias. We discuss some methods to mitigate the effects of this bias and the importance of challenging trainees to recognize these pitfalls in medical training.

The COVID-19 prevention campaign in Mexico: content analysis based on behavioral economics

During the Covid-19 pandemic, in order to reduce infections and consequences, various public policies are implemented, including messages to develop desirable prevention behaviors. Behavioral economics theory points out the importance of considering people's cognitive biases that distance them from rational decisions and have a negative impact on the implementation of suitable behaviors. The present research work carried out a qualitative content analysis in messages to combat the spread of the COVID-19 disease, which the Government of Mexico transmitted through the internet. Infographics and official videos were analyzed to identify if the contributions of behavioral economics were considered. The analysis made it possible to identify the biases that were most present and the behavioral tools that sought to mitigate them, but still in a limited way. The benefits of considering this theoretical approach when designing and evaluating these messages are recognized.

Science denial: Why it happens and what to do about it

Science denial, doubt, and resistance have been persistent and growing problems in the United States, as well as in other countries. At no time, however, have the consequences been as deadly as in 2020, with a global pandemic ravaging the world's population, spreading rapidly when unchecked, fueled by denial of its lethality and the steps needed to contain it. At the same time, the effects of climate change continue unabated, threatening life on this planet. The scientific and medical community warned that the virus was dangerous and that unprecedent steps were immediately necessary to limit the potential catastrophic impact. The United States was slow to act, however, in terms of testing, contact tracing, travel limitations, and orders to stay at home. As the virus wreaks havoc on the world and individuals both deny its existence and avoid preventative measures, we are increasingly aware of the need to explore and interpret the conditions for science denial, doubt, and resistance. This book sheds light on key psychological reasons that have been the subject of the research independently and collaboratively over the years: cognitive biases, evaluating science claims, science knowledge, motivated reasoning, social identity, beliefs about knowledge and science, and the effect of attitudes and emotions. It also offers action steps for individuals, educators, science communicators, and policy makers to support public understanding of science. The idea for this book came from individual and collaborative work over two decades. Many long conversations at conferences and meetings about public understanding and misunderstanding of science, coupled with complementary research agendas in the psychology of thinking and learning about science, leads to collaborate on an article for Policy Insights from the Behavioral and Brain Sciences, entitled "Public Understanding of Science: Policy and Educational Implications". (PsycInfo Database Record (c) 2022 APA, all rights reserved)

La toma de decisiones, liderazgo y comportamientos en las organizaciones en tiempos de incertidumbre

The orientation that this paper follows, is to expose the challenges that are presented to managers to make decisions and exercise their leadership role, in contexts of high uncertainty, such as the one that has taken place with the abrupt appearance of the pandemic generated by the Covid19 virus. In the same way, a balance is made of the organizational behaviors that can eventually harm good management performance, as can happen with the presence of cognitive biases, that is, with the wrong interpretations of the information with which the manager operates. © 2021 Universidad Central de Venezuela. All rights reserved.

Unrealistic pessimism and obsessive-compulsive symptoms during the COVID-19 pandemic: Two longitudinal studies.

OBJECTIVE: Unrealistic pessimism (UP) is an aspect of overestimation of threat (OET) that has been associated with obsessive-compulsive disorder/symptoms (OCD/OCS). During the COVID-19 pandemic, UP may have played an important role in the course of OCD. To investigate the relationship, we conducted two longitudinal studies assuming that higher UP predicts an increase in OCS. METHOD: In Study 1, we investigated UP in the general population (N = 1,184) at the start of the pandemic asking about overall vulnerability to infection with SARS-CoV-2 and UP regarding infection and outcome of severe illness. Further, OCS status (OCS+/-) was assessed at the start of the pandemic and 3 months later. In Study 2, we investigated UP in individuals with OCD (N = 268) regarding the likelihood of getting infected, recovering, or dying from an infection with SARS-CoV-2 at the start of the pandemic and re-assessed OCS 3 months later. RESULTS: In Study 1, UP was higher in the OCS+ compared to the OCS- group, and estimates of a higher overall vulnerability for an infection predicted a decrease in OCS over time. UP regarding severe illness predicted an increase in symptoms over time. In Study 2, UP was found for a recovery and death after an infection with SARS-CoV-2, but not for infection itself. CONCLUSIONS: Exaggeration of one's personal vulnerability rather than OET per se seems pivotal in OCD, with UP being associated with OCD/OCS+ as well as a more negative course of symptomatology over the pandemic in a nonclinical sample. PRACTITIONER POINTS: Unrealistic optimism, a bias common in healthy individuals, is thought to be a coping mechanism promoting well-being in the face of danger or uncertainty. The current study extends findings that its inversion, unrealistic pessimism, may play an important role in obsessive-compulsive disorder and may also be involved in the development of the disorder. This study highlights the importance that prevention programs during a pandemic should include targeting unrealistic pessimism.

An Online Assessment to Evaluate the Role of Cognitive Biases and Emotion Regulation Strategies for Mental Health During the COVID-19 Lockdown of 2020: Structural Equation Modeling Study.

BACKGROUND: Extant research supports causal roles of cognitive biases in stress regulation under experimental conditions. However, their contribution to psychological adjustment in the face of ecological major stressors has been largely unstudied. OBJECTIVE: We developed a novel online method for the ecological examination of attention and interpretation biases during major stress (ie, the COVID-19 lockdown in March/April 2020) and tested their relations with the use of emotion regulation strategies (ie, reappraisal and rumination) to account for individual differences in psychological adjustment to major COVID-19-related stressors (ie, low depression and anxiety, and high well-being and resilience). METHODS: Participants completed an online protocol evaluating the psychological impact of COVID-19-related stressors and the use of emotion regulation strategies in response to them, during the initial weeks of the lockdown of March/April 2020. They also completed a new online cognitive task designed to remotely assess attention and interpretation biases for negative information. The psychometric properties of the online cognitive bias assessments were very good, supporting their feasibility for ecological evaluation. RESULTS: Structural equation models showed that negative interpretation bias was a direct predictor of worst psychological adjustment (higher depression and anxiety, and lower well-being and resilience; χ29=7.57; root mean square error of approximation=0.000). Further, rumination mediated the influence of interpretation bias in anxiety (P=.045; 95% CI 0.03-3.25) and resilience (P=.001; 95% CI -6.34 to -1.65), whereas reappraisal acted as a mediator of the influence of both attention (P=.047; 95% CI -38.71 to -0.16) and interpretation biases (P=.04; 95% CI -5.25 to -0.12) in well-being. CONCLUSIONS: This research highlights the relevance of individual processes of attention and interpretation during periods of adversity and identifies modifiable protective factors that can be targeted through online interventions.

The Influence of Cognitive Heuristics and Biases on Palliative Social Workers' Support of Patient and Caregiver Decision Making: The Pulse Oximeter Buying Trend during the COVID-19 Pandemic.

A phenomenon occurring early in the pandemic involving media-based recommendations of pulse oximeters, devices purported to detect a dangerous Covid-19 symptom, invites attention to effects of decision-making shortcuts, or cognitive heuristics, and associated cognitive biases or errors, on patient/caregiver healthcare decisions. Heuristics also affect palliative/medical social workers' recommendations to patients/caregivers. This article looks at availability, confirmation, affect, false consensus and framing biases, and suggestions for debiasing decision making. Implications for other healthcare decisions are considered.

Moral decisions in the age of COVID-19: Your choices really matter.

The moral decisions we make during this period, such as deciding whether to comply with quarantine rules, have unprecedented societal effects. We simulate the "escape from Milan" that occurred on March 7th-8th 2020, when many travelers moved from a high-risk zone (Milan) to southern regions of Italy (Campania and Lazio) immediately after an imminent lockdown was announced. Our simulations show that fewer than 50 active cases might have caused the sudden spread of the virus observed afterwards in these regions. The surprising influence of the actions of few individuals on societal dynamics challenges our cognitive expectations - as in normal conditions, collective dynamics are rather robust to the decisions of few "cheaters". This situation therefore requires novel educational strategies that increase our awareness and understanding of the unprecedented effects of our individual moral decisions.

[Coronavirus: Predictive brain and terror management]. / Coronavirus : cerveau prédictif et gestion de la terreur.

Emerging infectious diseases like Covid-19 cause a major threat to global health. When confronted with new pathogens, individuals generate several beliefs about the epidemic phenomenon. Many studies have shown that individual protective behaviors largely depend on these beliefs. Due to the absence of treatment and vaccine against these emerging pathogens, the relation between these beliefs and these behaviors represents a crucial issue for public health policies. In the premises of the Covid-19 pandemic, several preliminary studies have highlighted a delay in the perception of risk by individuals, which potentially holds back the implementing of the necessary precautionary measures: people underestimated the risks associated with the virus, and therefore also the importance of complying with sanitary guidelines. During the peak of the pandemic, the salience of the threat and of the risk of mortality could then have transformed the way people generate their beliefs. This potentially leads to upheavals in the way they understand the world. Here, we propose to explore the evolution of beliefs and behaviors during the Covid-19 crisis, using the theory of predictive coding and the theory of terror management, two influential frameworks in cognitive science and in social psychology.