Bias and discrimination against men with overweight in the military.

Research on weight-bias against men and/or in the military is scarce. Such a bias might cause some military members, who are otherwise fit to perform their duties, to suffer from discrimination and undue stress. We showed military personnel a picture of a soldier who had either normal weight or overweight. In both conditions, the description of the soldier stated that his physical fitness and job-related skills were good. Nonetheless, the soldier's suitability for promotion was rated lower in the overweight condition. These findings improve our understanding of the impact of bias on the mental and physical health of men with overweight.

Service Members Prefer a Psychotherapist Who Is a Veteran.

The military is experiencing high rates of mental illness, yet service members and veterans with mental health problems often choose not to seek treatment. Based on clinical-psychology models of client-therapist matching and cultural competency, we hypothesized that willingness to seek treatment among military personnel is higher when the potential psychotherapist is a discharged veteran. Seventy-seven military personnel (73% men, 70% White, Mage = 34.2) took part in the study. As hypothesized, the majority of participants indicated that they would prefer to see a psychologist who is a veteran. When responding to vignettes, ratings of the psychotherapist's ability to understand the client (a soldier post-deployment), of his ability to help such a client, and of whether the client should seek treatment from this psychotherapist were higher when the psychotherapist was a veteran compared to when he had no military experience. There were no between-group differences in age, years of service, deployment history, or attitudes toward psychotherapy in general. Similarly, gender and education level had no effect on the results. These findings imply that having the opportunity to receive treatment by a psychotherapist who is a veteran may remove barriers for treatment and encourage more service members and veterans to seek and obtain the help that they need. This can be done by communicating these findings to the military population and by encouraging therapists who have military experience to make this fact known to their potential clients.

The Biggest Loser Thinks Long-Term: Recency as a Predictor of Success in Weight Management.

Only a minority of participants in behavioral weight management lose weight significantly. The ability to predict who is likely to benefit from weight management can improve the efficiency of obesity treatment. Identifying predictors of weight loss can also reveal potential ways to improve existing treatments. We propose a neuro-psychological model that is focused on recency: the reliance on recent information at the expense of time-distant information. Forty-four weight-management patients completed a decision-making task and their recency level was estimated by a mathematical model. Impulsivity and risk-taking were also measured for comparison. Weight loss was measured in the end of the 16-week intervention. Consistent with our hypothesis, successful dieters (n = 12) had lower recency scores than unsuccessful ones (n = 32; p = 0.006). Successful and unsuccessful dieters were similar in their demographics, intelligence, risk taking, impulsivity, and delay of gratification. We conclude that dieters who process time-distant information in their decision making are more likely to lose weight than those who are high in recency. We argue that having low recency facilitates future-oriented thinking, and thereby contributes to behavior change treatment adherence. Our findings underline the importance of choosing the right treatment for every individual, and outline a way to improve weight-management processes for more patients.

Cognitive processes underlying impaired decision-making under uncertainty in gambling disorder.

OBJECTIVE: Pathological gamblers display at the Iowa Gambling Task (IGT) a strong preference for choices featuring high immediate rewards, but higher unpredictable and more delayed losses. The present study aimed, by applying the Expectancy-Valence (EV) model to the IGT, at identifying impaired components of decision-making under uncertainty in pathological gamblers. METHODS: Twenty pathological gamblers and 20 non-gamblers performed the IGT. The EV model breaks down IGT performance into three cognitive processes: (i) the subjective weight that the individual assigns to gains versus losses (gain/loss parameter), (ii) the degree of prominence given to recently-obtained information, compared to past experience (recency parameter), and (iii) the consistency between learning and responding (consistency parameter). RESULTS: Pathological gamblers obtained higher scores on the gain/loss parameter as compared to controls, indicating higher sensitivity to monetary gains. This measure was also correlated with the degree of gambling dependence severity. No between-group difference was observed in the recency and the consistency parameters. CONCLUSION: These findings suggest that pathological gamblers' strong preference for choices featuring high rewards but higher losses during the IGT is due to hypersensitivity for large monetary gains, which might reflect a hypersensitivity in their reward systems. In contrast, we found in pathological gamblers no evidence of inability to integrate information across time, a function that has been shown previously to be linked to damage in the prefrontal cortex.

Decision-making, sensitivity to reward and attrition in weight management.

OBJECTIVE: Attrition is a common problem in weight management. Understanding the risk factors for attrition should enhance professionals' ability to increase completion rates and improve health outcomes for more individuals. A model that draws upon neuropsychological knowledge on reward-sensitivity in obesity and overeating to predict attrition is proposed. METHODS: A total of 52 participants in a weight-management program completed a complex decision-making task. Decision-making characteristics-including sensitivity to reward-were further estimated using a quantitative model. Impulsivity and risk-taking measures were also administered. RESULTS: Consistent with the hypothesis that sensitivity to reward predicted attrition, program dropouts had higher sensitivity to reward than completers (P < 0.03). No differences were observed between completers and dropouts in initial BMI, age, employment status, or the number of prior weight-loss attempts (P ≥ 0.07). Completers had a slightly higher education level than dropouts, but its inclusion in the model did not increase predictive power. Impulsivity, delay of gratification, and risk taking did not predict attrition, either. CONCLUSIONS: Findings link attrition in weight management to the neural mechanisms associated with reward-seeking and related influences on decision-making. Individual differences in the magnitude of response elicited by rewards may account for the relative difficulty experienced by dieters in adhering to treatment.

The cognitive processes underlying affective decision-making predicting adolescent smoking behaviors in a longitudinal study.

This study investigates the relationship between three different cognitive processes underlying the Iowa Gambling Task (IGT) and adolescent smoking behaviors in a longitudinal study. We conducted a longitudinal study of 181 Chinese adolescents in Chengdu City, China. The participants were followed from 10th to 11th grade. When they were in the 10th grade (Time 1), we tested these adolescents' decision-making using the IGT and working memory capacity using the Self-ordered Pointing Test (SOPT). Self-report questionnaires were used to assess school academic performance and smoking behaviors. The same questionnaires were completed again at the 1-year follow-up (Time 2). The Expectancy-Valence (EV) Model was applied to distill the IGT performance into three different underlying psychological components: (i) a motivational component which indicates the subjective weight the adolescents assign to gains vs. losses; (ii) a learning-rate component which indicates the sensitivity to recent outcomes vs. past experiences; and (iii) a response component which indicates how consistent the adolescents are between learning and responding. The subjective weight to gains vs. losses at Time 1 significantly predicted current smokers and current smoking levels at Time 2, controlling for demographic variables and baseline smoking behaviors. Therefore, by decomposing the IGT into three different psychological components, we found that the motivational process of weight gain vs. losses may serve as a neuropsychological marker to predict adolescent smoking behaviors in a general youth population.

Processing of time within the prefrontal cortex: recent time engages posterior areas whereas distant time engages anterior areas.

Studies of prefrontal cortex (PFC) lesion patients suggest that information conveying high immediacy, certainty, or tangibility engages the more posterior part of the PFC, whereas information that is more abstract or complex engages the anterior part. We examined whether the anterior and posterior subdivisions of the PFC have distinct roles in processing temporal information during decision making in healthy individuals. We hypothesized that the more the locus of activation is in the posterior (as opposed to anterior) PFC, the more the decision maker will be affected by recent information at the expense of past outcomes. Participants performed a complex decision task while their PFC activity was monitored using fMRI. Results indicate that individual differences in the effect of recent outcomes correspond to differences in the locus of activation, with elevated recency associated with more posterior loci of activation.

Obesity and risk taking. A male phenomenon.

There is a growing tendency to regard overeating as an addiction, with obesity as its primary symptom. We propose that similar to other addictions, obesity is associated with excessive risk-taking in men, though not in women. To examine this suggestion we conducted two studies, one involving a sample of overweight and normal-weight students, and the other involving obese adults drawn from a dataset of health care clients, and a control sample of normal-weight adults. In both of these studies, we found that overweight and obese men took more risk in a laboratory task than normal-weight men, while overweight and obese women did not differ from normal-weight women in this respect. At the same time, obese women (but not overweight women) displayed higher impulsivity levels than normal-weight women. These findings shed light on the cognitive characteristics of obesity in men, and accent the importance of taking gender into account when developing research paradigms and treatment methods for obesity.

On the value of nonremovable reminders for behavior modification: an application to nail-biting (onychophagia).

The authors examined the effectiveness of a novel behavior modification method for dysfunctional and impulsive habits, based on nonremovable reminders (NrRs). NrRs were implemented by having participants wear nonremovable wristbands designated to constantly remind them of their resolution to quit the targeted habit (nail-biting). Participants were 80 nail-biters who resolved to quit. The NrR approach was contrasted with an aversion-based behavioral modification technique. Recovery was assessed after 3 and 6 weeks of treatment and in a 5-month follow-up. The NrR method was associated with lower drop-out rate and was as successful as the aversion-based method altogether. When considering only non-dropouts, the aversion-based method was more effective. This suggests that the use of constantly present reminders broadens the target population that can benefit from reminders in the course of behavior modification.