Hoarders Only Discount Consumables and Are More Patient for Money.

Individuals with hoarding disorder (HD) excessively acquire and retain goods while also exhibiting characteristics of impulsivity and addiction. However, HD individuals do not always perform impulsively in experiments, they do not appear interested in money, and they exhibit many features of risk-aversion and future-planning. To examine impulsivity in HD, we compared validated community participants high and low in hoarding tendencies on questionnaire measures of hoarding and impulsivity as well as a standard experimental measure of impulsivity (intertemporal discounting) that was modified to compare decisions about money, pens, and snacks. Common discounting effects were replicated. Compared to the low hoarding group, the high hoarding group was more impatient for consumables (pens and snacks) but they were more patient for money. This increased patience for money in high hoarding individuals is in contrast to all other studies on discounting in disordered populations, but consistent with the phenomenology of HD. HD does not appear to be driven by a fundamental inability to wait, but rather a specific, potent desire for consumable rewards.

Imagining life with an ostomy: does a video intervention improve quality-of-life predictions for a medical condition that may elicit disgust?

OBJECTIVE: To test a video intervention as a way to improve predictions of mood and quality-of-life with an emotionally evocative medical condition. Such predictions are typically inaccurate, which can be consequential for decision making. METHOD: In Part 1, people presently or formerly living with ostomies predicted how watching a video depicting a person changing his ostomy pouch would affect mood and quality-of-life forecasts for life with an ostomy. In Part 2, participants from the general public read a description about life with an ostomy; half also watched a video depicting a person changing his ostomy pouch. Participants' quality-of-life and mood forecasts for life with an ostomy were assessed. RESULTS: Contrary to our expectations, and the expectations of people presently or formerly living with ostomies, the video did not reduce mood or quality-of-life estimates, even among participants high in trait disgust sensitivity. Among low-disgust participants, watching the video increased quality-of-life predictions for ostomy. CONCLUSION: Video interventions may improve mood and quality-of-life forecasts for medical conditions, including those that may elicit disgust, such as ostomy. PRACTICE IMPLICATIONS: Video interventions focusing on patients' experience of illness continue to show promise as components of decision aids, even for emotionally charged health states such as ostomy.

Physicians recommend different treatments for patients than they would choose for themselves.

BACKGROUND: Patients facing difficult decisions often ask physicians for recommendations. However, little is known regarding the ways that physicians' decisions are influenced by the act of making a recommendation. METHODS: We surveyed 2 representative samples of US primary care physicians-general internists and family medicine specialists listed in the American Medical Association Physician Masterfile-and presented each with 1 of 2 clinical scenarios. Both involved 2 treatment alternatives, 1 of which yielded a better chance of surviving a fatal illness but at the cost of potentially experiencing unpleasant adverse effects. We randomized physicians to indicate which treatment they would choose if they were the patient or they were recommending a treatment to a patient. RESULTS: Among those asked to consider our colon cancer scenario (n = 242), 37.8% chose the treatment with a higher death rate for themselves but only 24.5% recommended this treatment to a hypothetical patient (χ(2)(1) = 4.67, P = .03). Among those receiving our avian influenza scenario (n = 698), 62.9% chose the outcome with the higher death rate for themselves but only 48.5% recommended this for patients (χ(2)(1) = 14.56, P < .001). CONCLUSIONS: The act of making a recommendation changes the ways that physicians think regarding medical choices. Better understanding of this thought process will help determine when or whether recommendations improve decision making.

The benefits of discussing adjuvant therapies one at a time instead of all at once.

Breast cancer patients must often decide between multiple adjuvant therapy options to prevent cancer recurrence. Standard practice, as implemented in current decision support tools, is to present information about all options simultaneously, but psychology research suggests that sequential decision processes might improve decision making. We tested whether asking women to consider hormonal therapy and chemotherapy separately would improve women's risk knowledge and/or affect treatment intentions. We conducted an Internet-administered experimental survey of a demographically diverse sample of 1,781 women ages 40-74. Participants were randomized to experience a standard, comprehensive decision process versus sequential (one at a time) decisions regarding adjuvant therapy options for a hypothetical breast cancer patient with an estrogen receptor-positive (ER+) tumor. We assessed comprehension of key statistics, perceptions of treatment effectiveness, and perceived interest in adjuvant chemotherapy, as well as participants' numeracy levels. When participants made sequential decisions, they demonstrated greater comprehension of decision-relevant risk statistics, as compared to when they made decisions all at once (all P's < 0.001). Among higher-numeracy participants, those making sequential decisions were less interested in chemotherapy (P < 0.001). Lower-numeracy participants who considered all options simultaneously were insensitive to the degree of risk reduction, but those who made sequential decisions were sensitive (P = 0.03). In conclusion, presenting adjuvant therapy options sequentially improves women's comprehension of incremental treatment benefit and increases less numerate women's sensitivity to the magnitude of the achievable risk reduction over standard, all at once approaches. Sequential approaches to adjuvant therapy decisions may reduce use of chemotherapy among those at low risk for recurrence.

The perception of scatterplots.

Four experiments investigated the perception of correlations from scatterplots. All graphic properties, other than error variance, that have been shown to affect subjective but not objective correlation (r) were held constant. Participants in Experiment 1 ranked 21 scatterplots according to the magnitude of r. In Experiments 2 and 3, participants made yes/no judgments to indicate whether a scatterplot was high (signal) or low (noise). Values of r for signal and noise scatterplots varied across participants. Differences between correlations for signal and for noise scatterplots were constant in r in Experiment 2, and constant in r2 in Experiment 3. Standard deviations of the ranks in Experiment 1 and d' values in Experiments 2 and 3 showed that discriminability increased with the magnitude of r. In Experiment 4, faculty and graduate students in psychology and sociology made point estimates of r for single scatterplots. Estimates were negatively accelerated functions of objective correlation.