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PubMed1991

Contribution of perceptual fluency to recognition judgments.

Following a shallow (count vowels) or deep (read) study task, old and new words were tested for both fluency of perception and recognition memory. Subjects first identified a test word as it came gradually into view and then judged it as old or new. Old words were identified faster than new words, indicating implicit, perceptual memory for old words. Independently of this effect, words judged old were identified faster than words judged new, especially after shallow study. Eight experiments examined the possible causal relationship between perceptual fluency and recognition judgements. Experiments 1 to 4 showed that fast identifications per se do not promote old judgments. Accelerating the identification of test items by semantically priming them or making them come more quickly into view did not affect recognition judgments. Experiment 5 showed that the usual association of fast identifications with old judgments is not an artifact of item selection because the association disappeared when the identifications and judgements were segregated into different phases of the test task. Experiments 6 and 7 showed tha the likelihood of old judgments increases directly with the pretested perceptibility of test words, but only after shallow study. Experiment 8 showed that the dependency of recognition judgments on perceptual fluency continues to hold when the requirement to identify the words before judging them is eliminated. We conclude that fluency of perception contributes to recognition judgments, but only when the fluency is produced naturally (e.g., through perceptual memory) and explicit memory is minimal.

Adult↗
PubMed1985

The role of verbal labels in the judgment of orientation and location.

In an earlier study it was found that judgments of right-left orientations and locations were more difficult than judgments of up-down only when spatial words were used in the tasks. Experiments are reported in which pictures of many objects were presented to eliminate the possibility that subjects in previous studies had used strategies specific to single-stimulus tasks. In experiment 1, right-left orientations were judged more slowly than up-down orientations both when the spatial words were used and when arbitrary letters replaced the spatial words. In experiment 2, judgments of the right-left locations of pictures took longer than judgments of their up-down locations only when spatial words were used in the task; the right-left difficulty was eliminated when arbitrary letters replaced the words. The differential effect of words and letters in location judgments seems to be due to the different coding strategies adopted by subjects under the two conditions. It is concluded that a right-left difficulty does not depend on the use of spatial terms: word and letter conditions yield different results only when the task permits different judgments to be made under the two conditions.

Cognition↗
PubMed2006

Audience response system technology improves accuracy and reliability of trauma outcome judgments.

BACKGROUND: Peer-review judgments are necessary for effective trauma performance improvement (PI), but may be influenced by peer pressure and the tendency to vote with the majority. Incorporation of Audience Response System (ARS) technology into trauma PI should result in improved outcome assessments. METHODS: We compared 30 months of nonanonymous trauma care judgments with 30 months of anonymous judgments obtained with the use of a keypad-based ARS. Statistical methods included the chi2 test and the Wilcoxon rank sum test. RESULTS: Use of the ARS resulted in a 28% reduction in deaths judged nonpreventable and a 24% reduction in trauma care judged to be appropriate (p < 0.0001). Unanimous outcome judgments were also significantly reduced (p < 0.0001). CONCLUSIONS: Outcome judgments obtained anonymously were significantly more divergent and less positive than those obtained nonanonymously. Anonymously derived outcome judgments may provide a better opportunity to identify adverse outcomes and thereby potentially improve trauma PI and trauma care.

Data Collection↗
PubMed1983

Clinical judgment in rheumatoid arthritis. II. Judging 'current disease activity' in clinical practice.

Two rheumatologists made judgments about 'current disease activity' in real patients and 'paper patients' with rheumatoid arthritis. Analysis of each set of judgments provides a model of judgment policy which contains only 3 clinical variables but explains over 94% of the variance in judgments. The judgment policy models differ markedly from each other and from the clinicians' own perceptions of their behaviour. Judgment policy modelling offers a means of improving co-ordination between clinical investigators within and between centres.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Predictors of patient treatment preferences and spouse substituted judgments: the case of dialysis continuation.

OBJECTIVES: To examine the factors predicting preferences for continued hemodialysis treatment among patients with endstage renal disease (ESRD) and to compare these factors to those predicting their spouses' predictions of patients' preferences (substituted judgments). DESIGN: Descriptive, cross-sectional. PARTICIPANTS: Total of 291 hemodialysis patients, aged 55 years and older, and their spouses. MEASUREMENT: Hypothetical scenarios were designed to elicit preferences for dialysis continuation under various health conditions. Other measures included the Philadelphia Geriatric Center Negative Affect Scale, Kidney Disease Symptoms Scale, Brief Multidimensional Measure of Religiousness, single-item global subjective health and quality-of-life measures, 2-item fear of end-of-life suffering measure, and selected demographics. RESULTS: Patients' preferences and spouses' judgments were only moderately correlated (r = 0.33). Multiple regression analyses revealed that patients' preferences to continue dialysis were positively related to education, subjective quality of life, and religious participation and negatively related to months of ESRD treatment and fear of end-of-life suffering (R(2) = 0.15). Spouses' substituted judgments regarding patients' dialysis continuation preferences were positively related to African American race and spouses' perceptions of patients' quality of life and negatively related to months of ESRD treatment, spouses' perception of patients' negative affect, and spouses' own fear of end-of-life suffering. CONCLUSION: Patients and surrogates used different criteria in formulating judgments about continuation of life-sustaining treatment and had different perceptions about the patients' condition. Furthermore, the substituted judgments of spouses were influenced by their own characteristics. These processes may explain inaccurate substituted judgments.

Boston↗
PubMed1999

[Medical judgment and legal security. Physicians as gatekeepers in the distribution of public goods].

We wanted to explore general practitioners' discretionary judgments about the eligibility of patients applying for disability pension, and to examine if variations in such judgments are correlated with the physicians' personal values and moral standards. Data were collected by a postal questionnaire, which included two vignettes focusing on whether the "applicant" fulfils the eligibility criteria for disability benefit. Variations in judgments were then analysed in correlation to the GP's view on normative questions concerning the physicians' role as gatekeepers, the disability pension as a source of income, and an indicator of the GP's scepticism to the disability pension. 360 general practitioners from eight different counties in Norway participated. The response rate was 62 per cent. The assessment of the vignettes revealed great variation. Four out of ten general practitioners concluded that the first vignette fulfilled the medical eligibility criteria, while three out of ten came to the opposite conclusion. For the second vignette the results were reversed. For both vignettes, three out of ten were not able to answer "yes" or "no" because of uncertainty. Further, the variation in judgments was correlated with an indicator of the GPs' personal values and moral standards. The stronger expressed disability pension scepticism, the more restrictive interpretation of the medical eligibility criteria. A decision on entitlement to disability pension pertains to the distribution of public goods. The general practitioners' discretionary judgments are crucial in this decision-making. When doctors let their political and moral standards influence their judgment, they act arbitrarily and in conflict with ideals of equal treatment and legal security.

Adult↗
PubMed2000

The mother-child interaction and clinical judgment during acute pediatric illnesses.

OBJECTIVES: For acutely ill children living in less than optimal environments, mothers and pediatricians may have a heightened perception of illness severity, a lower specificity of clinical judgments, and a tendency to over-utilize resources. We examined the mother-child interaction in order to understand the relation of less optimal environments to clinical judgment and resource use. STUDY DESIGN: At the 2-week and 6-, 15-, and 24-month well child visits of 316 children, the mother-well child interaction was assessed by using the Biringen's Emotional Availability Scales (EAS). Data were gathered regarding maternal depression and sense of competence, infant temperament, maternal social support, life events, the home environment, and demographics. At ill visits, the mother-ill child interaction was assessed by using the EAS, and mothers and pediatricians independently assessed illness severity using the Acute Illness Observation Scales. Resource use during the illness was evaluated. RESULTS: One thousand nine hundred eight-three acute illnesses were assessed. A less optimal mother-child interaction was significantly (P <.05 for all comparisons) associated with poorer reliability of mothers' judgments, lower specificity of mothers' judgments (71% vs 85%) and pediatricians' judgments (92% vs 97%), and greater use of resources (eg, for hospitalizations, 2.6% of visits vs 0.7%). Adverse maternal, infant, and demographic characteristics were associated with a less optimal mother-well child (r = 0.68) and mother-ill child (r = 0.80) interaction, a heightened perception of illness severity, and greater resource use. CONCLUSION: Less optimal environments adversely affect the mother-child interaction; a poor mother-child interaction is correlated with low specificity of clinical judgment and over-utilization of resources.

Acute Disease↗
PubMed1989

Clinical judgment and decision making in neuropsychology.

We review the literature on clinical judgment and statistical/actuarial prediction both in clinical psychology and in neuropsychology and we attempt to place these findings within the broader context of judgment theory. Current research on judgment in neuropsychology is consistent with research in other areas that documents the limitations of humans as judges and argues for increased utilization of actuarial methods and decision aids. In addition, there are virtually no data suggesting judgmental accuracy is related to experience, acknowledged expertise, or confidence in the accuracy of one's predictions. We attempt to identify judgment practices which contribute to diagnostic error in neuropsychology and we make recommendations that neuropsychologists can use to increase their judgmental accuracy. Research priorities in this area are discussed.

Journal Article↗
PubMed1991

Understanding differences in moral judgments: the role of informational assumptions.

This study examined differences in moral judgments as they relate to informational assumptions. It was hypothesized that (1) differences in moral judgments are related to differences in informational assumptions, (2) moral judgments change if the information believed to be true changes, and (3) the relation between informational assumptions and moral judgments is not affected by age. 72 subjects (aged 11-9, 15-10, and 21-3) evaluated events concerning welfare, justice, and rights and reevaluated them in light of the opposite information. A significant relation was found between the evaluations and the informational assumptions, and 80% of the evaluations changed in response to informational changes. The relation between evaluations and informational assumptions was significant within each age group. These findings demonstrated that informational assumptions are a source of variation in moral judgments and underscored the need to distinguish between the 2 types of judgments when studying differences in moral reasoning.

Adolescent↗
PubMed1982

[The effects of familiar-size cue on children's judgments of size and distance].

The present study is concerned with the effects of familiar-size cue on the judgments of size and distance for the children of an elementary school. Thirty-two 1 st-, 3rd-, and 6 th-grade children served as subjects. The experiment consisted of repeating alternations of the two steps: A judgmental step in which the subject judged the size and distance of transparencies of familiar objects, and an informational step in which the subject was acquainted visually or haptically with the real sizes of a toy car and a toy dog from which the transparencies were made. The results revealed that: (1) The younger children tended to make judgments resulted from the normal sizes of the familiar objects that they encounter in their daily life, while the older children based their judgments on the size information given by looking on or touching the real toys. (2) Visual size information was superior to haptic size information both in size and distance judgments. (3) Familiar-size cue may be effective in relative rather than absolute size and distance judgments.

Child↗
PubMed2002

Functional networks in emotional moral and nonmoral social judgments.

Reading daily newspaper articles often evokes opinions and social judgments about the characters and stories. Social and moral judgments rely on the proper functioning of neural circuits concerned with complex cognitive and emotional processes. To examine whether dissociable neural systems mediate emotionally charged moral and nonmoral social judgments, we used a visual sentence verification task in conjunction with functional magnetic resonance imaging (fMRI). We found that a network comprising the medial orbitofrontal cortex, the temporal pole and the superior temporal sulcus of the left hemisphere was specifically activated by moral judgments. In contrast, judgment of emotionally evocative, but non-moral statements activated the left amygdala, lingual gyri, and the lateral orbital gyrus. These findings provide new evidence that the orbitofrontal cortex has dedicated subregions specialized in processing specific forms of social behavior.

Adult↗
PubMed2005

Measuring unconscious knowledge: distinguishing structural knowledge and judgment knowledge.

This paper investigates the dissociation between conscious and unconscious knowledge in an implicit learning paradigm. Two experiments employing the artificial grammar learning task explored the acquisition of unconscious and conscious knowledge of structure (structural knowledge). Structural knowledge was contrasted to knowledge of whether an item has that structure (judgment knowledge). For both structural and judgment knowledge, conscious awareness was assessed using subjective measures. It was found that unconscious structural knowledge could lead to both conscious and unconscious judgment knowledge. When structural knowledge was unconscious, there was no tendency for judgment knowledge to become more conscious over time. Furthermore, conscious rather than unconscious structural knowledge produced more consistent errors in judgments, was facilitated by instructions to search for rules, and after such instructions was harmed by a secondary task. The dissociations validate the use of these subjective measures of conscious awareness.

Adult↗
PubMed2006

Factors affecting hospital staff judgments about sickle cell disease pain.

Judgments about people with pain are influenced by contextual factors that can lead to stigmatization of patients who present in certain ways. Misplaced staff perceptions of addiction may contribute to this, because certain pain behaviors superficially resemble symptoms of analgesic addiction. We used a vignette study to examine hospital staff judgments about patients with genuine symptoms of analgesic addiction and those with pain behaviors that merely resemble those symptoms. Nurses and doctors at hospitals in London, UK, judged the level of pain, the likelihood of addiction, and the analgesic needs of fictitious sickle cell disease patients. The patient descriptions included systematic variations to test the effects of genuine addiction, pain behaviors resembling addiction, and disputes with staff, which all significantly increased estimates of addiction likelihood and significantly decreased estimates of analgesic needs. Participants differentiated genuine addiction from pain behaviors resembling addiction when making judgments about addiction likelihood but not when making judgments about analgesic needs. The treatment by staff of certain pain behaviors as symptoms of analgesic addiction is therefore a likely contributory cause of inadequate or problematic hospital pain management. The findings also show what a complex task it is for hospital staff to make sensitive judgments that incorporate multiple aspects of patients and their pain. There are implications for staff training, patient education, and further research.

Adolescent↗
PubMedDate not supplied

Debias the environment instead of the judge: an alternative approach to reducing error in diagnostic (and other) judgment.

Questions about how to improve human judgment and reasoning are of theoretical and practical interest, notwithstanding the continuing controversy over whether people are "rational". Improving judgment may involve modifying people's processes to fit their environments better, or vice versa. We illustrate the latter approach in a study of diagnostic reasoning in which subjects learned to distinguish two fictitious diseases. Prior findings suggest that people may judge the likelihood of a diagnostic category on the presence or absence of features that are typical of, rather than diagnostic of, the category. We varied the structure of the information provided to subjects without attempting to modify their judgmental processes. In an "independent" format, subjects learned about each disease separately; in a "contrastive" format, information about the two diseases was juxtaposed to highlight distinctive features. Subjects in the two conditions formed different disease concepts. Diagnoses following contrastive training were much closer to the statistically prescribed judgments based on likelihood ratios. Interventions that modify the environment may provide an alternative approach where it is difficult to modify people's processes. Effective design of such interventions is one motivation for directing research toward understanding how task characteristics affect the use of and the outcomes of judgment and reasoning processes.

Adult↗
PubMed1985

Phonemic awareness and spelling: children's judgments do not always agree with adults.

The ability to make explicit judgments about speech sounds is important in learning to read and write an alphabetic system. However, even when children can make consistent judgments about sounds their judgments do not always agree with those of adults. In this study, some children from groups of kindergartners (mean age 5 years, 10 months) and first graders (mean age 6, 7) stated that /tr/ (as in "truck") did not begin with the sound /t/. This judgment was reflected in these children's spellings: They tended to spell /t/ before /r/ with CH, reflecting its affrication. Parallel results were found for /dr/. Further, some children judged that /c/ (as in "chill") and /j/ (as in "Jill") began with /t/ and /d/, respectively. They used the letters T and D to spell these sounds. Thus, children's attention to a phonetic level may result in judgments of speech sounds and spellings that are different from those of adults.

Achievement↗
PubMed2004

Neural substrates in judgment process while playing go: a comparison of amateurs with professionals.

A professional go player shows incomparable ability in judgment during go game. Positron emission tomography (PET) was used to investigate the neural substrates of professional go player's judgment process. Eight professional go players and six amateur players were instructed to think over silently in the opening-stage game (fuseki, territorial planning) problems and the life-or-death (tsume, checkmate judgment) problems presented on the monitor in front of them for 60 s of H2 15O PET scans and to state the answer afterwards. We found that in the territorial planning problems the parietal activation was equally observed in both groups with the additional prefrontal activation in the amateur group, and in the checkmate-decision problems the precuneus and cerebellum were activated in professionals while the premotor and parietooccipital cortices (visuospatial processing region) were extensively activated in amateurs. The comparison of the two groups showed stronger activations in the precuneus and cerebellum in the professionals in contrast to the premotor activation in amateurs during checkmate judgment. In addition, the cerebellum was remarkably activated in the higher ranking professional players. These findings suggested the cerebellum and precuneus play important roles in processing of accurate judgment by visual imagery and nonmotor learning memory processes in professional go players.

Adult↗
PubMed2004

The development of moral judgment during nursing education in Finland.

This study describes moral judgment among first- and last-year nursing students in Finland and examines the effects of ethics teaching on the development of moral judgment. The data for this quantitative cross-sectional study were collected using the Defining Issues Test (DIT), which is based on Kohlberg's theory of moral reasoning stages. The questionnaires were sent to four polytechnics, which offer nursing education in southern Finland. A total of 52 first-year students and 54 last-year students participated. The results showed that students who had had to deal with ethical dilemmas in their practical training had higher moral judgment than students who did not. Last-year students had higher moral judgment than first-year students. Last-year students resorted to principle-based thinking more often than first-year students in resolving DIT dilemmas. The differences between the two groups were statistically significant. The results indicate that nursing education may has an effect upon students' moral judgment.

Adult↗
PubMed2005

Quantifiable change in functional brain response to empathic and forgivability judgments with resolution of posttraumatic stress disorder.

Previous functional neuroimaging studies of posttraumatic stress disorder (PTSD) have mainly focused on symptom-provocation paradigms in combat-related PTSD. We sought to elucidate the effect of non-combat-related PTSD on the physiology of social cognition. Thirteen patients with PTSD underwent functional magnetic resonance imaging (fMRI) while they engaged in tasks that (i) involve speculation on another's intention, (ii) invoke empathy and (iii) involve making judgments of the forgivability of others' actions; each versus 'baseline' social reasoning judgments. A post-therapy fMRI scan followed a course of modified cognitive behavioural therapy. Post-therapy, we found increased activation in brain regions predicted on the basis of foregoing work in healthy subjects. These included significant left middle temporal gyrus activation in post-therapy response to empathy judgments and posterior cingulate gyrus activation in post-therapy response to forgivability judgments. The specific regions of the human brain activated by empathy and forgivability judgments changed with symptom resolution in PTSD. Time and therapy are likely contributory factors that lead to a degree of 'normalisation' of the neural response to these social cognition tasks.

Adult↗