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PubMed2001

Mind over grammar: reasoning in aphasia and development.

Research on propositional reasoning (involving 'theory of mind' understanding) in adult patients with aphasia reveals that reasoning can proceed in the absence of explicit grammatical knowledge. Conversely, evidence from studies with deaf children shows that the presence of such knowledge is not sufficient to account for reasoning. These findings are in keeping with recent research on the development of naming, categorization and imitation, indicating that children's reasoning about objects and actions is guided by inferences about others' communicative intentions. We discuss the extent to which reasoning is supported by, and tied to, language in the form of conversational awareness and experience rather than grammar.

Journal Article↗

PubMed1997

Probabilistic reasoning in obsessive-compulsive and delusional disorders.

BACKGROUND: Delusional disorder (DD) and obsessive-compulsive disorder (OCD) have been investigated in previous studies using probabilistic reasoning paradigms and abnormalities in each group have been reported. No study to date has compared results between these groups. This study compares patients with these disorders with those who have both phenomena. METHODS: Thirty subjects with DD, 29 with OCD and 16 with obsessive and delusional features were compared with 30 normal controls in a study of probabilistic reasoning using two different computer-based tasks involving a Bayesian paradigm. RESULTS: Deluded subjects showed a 'jump to conclusions' reasoning style, but on a test that added a consequence to their choices did not differ from normals. OCD subjects deviated from Bayesian and control norms to a greater degree than did DD subjects. In subjects with mixed psychopathology, the presence of both phenomena appeared to 'normalize' these probability estimates. CONCLUSIONS: Our findings extend those of others but require cautious interpretation as to the role of probabilistic reasoning in the genesis of delusions or obsessions. Obsessionals in both the OCD and Mixed groups, showed substantial deviation from Bayesian norms, suggesting that obsessionality leads to a reasoning style that is less 'normal' than that of delusionals. Further work is required to investigate clinical correlates of these findings which provide modest support for the proposal that the combination of obsessions and delusions confers greater functional advantages than simply having delusions or obsessions.

Adult↗

PubMed2002

Managed care's reconstruction of human existence: the triumph of technical reason.

To achieve its goals of managing and restricting access to psychiatric care, managed care organizations rely on an instrument, the outpatient treatment report, that carries significant implications about how they view psychiatric patients and psychiatric care. In addition to involving ethical transgressions such as violation of patient confidentiality, denial of access to care, spurious use of concepts like quality of care, and harassment of practitioners, the managed care approach also depends on an overly technical, instrumental interpretation of human beings and psychiatric treatment. It is this grounding of managed care in technical reason that I will explore in this study. I begin with a review of a typical outpatient treatment report and show how, with its dependence on the DSM-IV, on behavioral symptoms and patient 'functioning', on the biomedical model of psychiatric illness, and on gross quantitative measures, the report results in a crude, skeletonized view of the human being as a congeries of behavioral symptoms and functions. I then develop the managed care construal of human existence further by showing its grounding in technical reason, exploring the latter in its modern embodiment and deriving it and its opposite, practical reason, from Aristotle's distinction between technical and practical reason, techne and phronesis. In this analysis of the role of technical reason in managed care, I point out that managed care did not have to develop its rationale de novo but could rather lift its arguments, e.g. the biomedical model, from contemporary psychiatry and simply apply them in a restrictive manner. Finally, I conclude this study by arguing for psychiatry's status as a discipline of practical knowledge.

Diagnostic and Statistical Manual of Mental Disord↗

PubMed2004

Counterfactual and mental state reasoning in children with autism.

The contributions of counterfactual conditional reasoning (CCR), belief understanding, and inferential reasoning to the performance of children with autism (CWA) on standard false belief tasks were investigated. To assess the roles of these three factors, we compared the performance of CWA on physical-state CCR tasks (which do not require either an understanding of belief or inferential reasoning); on Wellman and Bartsch's (1988) nonstandard tests of false belief (which require an understanding of belief, but not CCR or inferential reasoning), and on standard tests of false belief tasks. The CWA were impaired relative to controls on the physical-state CCR and standard false-belief tasks, but not on the nonstandard false-belief tasks, and the CWA's performance on the physical-state CCR and standard false-belief tasks correlated highly, even when the effects of verbal ability were partialled out. Finally, the CWA's performance on standard false-belief tasks was more impaired than their performance on the physical-state CCR tasks. We concluded that impaired performance on standard false-belief tasks in autism is associated with defective competence in CCR (or some of its component skills), plus defective competence in inferential reasoning and possibly generativity, but that impaired performance is not caused by an inadequate understanding of belief. The results are discussed in relation to other hypotheses concerning the cause or causes of impaired performance on standard false-belief tasks in children with autism.

Autistic Disorder↗

PubMed2004

The reasonable woman standard: effects on sexual harassment court decisions.

Some federal courts have used a reasonable woman standard rather than the traditional reasonable man or reasonable person standard to determine whether hostile environment sexual harassment has occurred. The current research examined the impact of the reasonable woman standard on federal district court decisions, controlling for other factors found to affect sexual harassment court decisions. Results indicated that there was a weak relationship between whether a case followed a reasonable woman precedent-setting case and the likelihood that the court decision favored the plaintiff. The implications of our findings for individuals and organizations involved in sexual harassment claims are discussed.

Data Collection↗

PubMed2000

Reasons for placement and replacement of restorations in student clinics in Manchester and Athens.

Data on reasons for the placement and replacement of restorations provide insight into patterns of clinical practice. This study investigated reasons for the provision of restorations in student clinics at the Universities of Manchester and Athens. Using the methods first described by Mjör, data were collected in relation to all initial and replacement restorations placed in adult patients in the main teaching clinics in the 2 schools over a 3-month period. The principal reason for intervention was recorded, according to approved treatment plans. Data were collected on 2620 restorations, 1431 (55%) of which were placed in Manchester. Primary caries was the main reason for the placement of initial restorations: 82% in Athens and 48% in Manchester (p<0.001). The principal reason for restoration replacement was secondary caries, accounting for 54% in Manchester and 33% in Athens (p<0.001). Other differences between the schools, included the ratio of initial placement to replacement restorations (Manchester 1:1.1; Athens 1:0.6: p<0.01) and significantly more 2-surface class II restorations having been placed in Manchester (p<0.001). Class III and IV restorations predominated in Athens. It is concluded, despite the acknowledged limitations of the methods employed, that the patterns of placement and replacement of restorations and the use of materials differ between the dental schools of Manchester and Athens. The differences are considered to relate more to local patterns of dental disease and patient selection for student clinics than to any differences in teaching philosophy. Subsequent studies of the type reported, despite acknowledged limitations would provide insight into the impact on patient care of the teaching of new materials, techniques and treatment philosophies.

Adolescent↗

PubMed1998

Representations as mediators of adolescent deductive reasoning.

In Experiment 1, preadolescents, middle adolescents, and late adolescents were presented 3 deductive reasoning tasks. With some important exceptions, conditional reasoning improved with age on problems containing permission conditional relations, and reasoning fallacies increased with age on problems containing causal conditional relations. The results of Experiments 2a and 2b indicated that problem type (i.e., permission or causal) does not mediate the activation of conditional reasoning skills. Rather, valid conditional inferences are more common on problems for which plausible alternative antecedents can be generated than on problems for which alternative antecedent generation is difficult. Conditional rules for which alternative antecedent generation is difficult may be misrepresented as biconditionals, resulting in biconditional rather than conditional reasoning.

Adolescent↗

PubMed1995

Effects of introspecting about reasons: inferring attitudes from accessible thoughts.

Previous research has shown that analyzing reasons can change people's attitudes, but the exact mechanisms of this effect have not been entirely clear. It was hypothesized that introspecting about reasons focuses people's attention on thoughts that are accessible in memory and increases the extent to which people view their accessible thoughts as applicable to their current attitudes. In Study 1, college students formed initial impressions of a target person, and then positive or negative thoughts about the target person were made memorable. After a delay, half of the participants analyzed reasons for their attitude and half recalled the target person's behaviors. As predicted, people who analyzed reasons reported attitudes toward the target person that were based more on what they could recall about her. Study 2 showed that this effect occurs regardless of whether people initially form an online impression. Implications for the effects of analyzing reasons and for attitude formation are discussed.

Adolescent↗

PubMed2000

Personal theories, intellectual ability, and epistemological beliefs: adult age differences in everyday reasoning biases.

Age-related differences in everyday reasoning biases were explored. In each of 2 social domains, examination of theoretical beliefs and biases along 2 dimensions of scientific reasoning, involving the law of large numbers and the evaluation of experimental evidence, revealed that, across age groups, scientific reasoning was used to reject evidence that contradicted prior beliefs; relatively cursory reasoning was used to accept belief-consistent evidence. Biased reasoning was more common among middle-aged and older adults than among young adults. Dispositions to engage in analytic processing were negatively related to biases, but intellectual abilities and bias were not related. The findings support a 2-process view of adult cognitive development and suggest that the tendency to rely on heuristic information processing increases with age.

Adult↗

PubMed1994

Working memory and bias in reasoning across the life span.

Age differences in syllogistic reasoning in relation to crystallized and fluid ability were studied in 278 adults from 19 to 96 years of age. Two reasoning tasks, the evaluation and the construction of conclusions for syllogisms of varying complexity and believability, a vocabulary test, and 3 tasks of working memory were administered. The magnitude of age-related variance on selected reasoning tasks was only partially reduced by statistically controlling measures of both working memory and vocabulary. Additional age-related effects on reasoning were found to be significantly associated with number of mental models and bias produced by conflict between belief and logic. A significant bias was also found toward acceptance of invalid syllogisms as valid, even when contents were abstract. These sources of error in logic are discussed in relation to Johnson-Laird's (1983) theory of mental models and Evan's (1989) account of bias in human reasoning.

Adult↗

PubMed2003

Reasoning with premises that are not empirically true: evidence for the role of inhibition and retrieval.

Two studies examined conditional reasoning with false premises. In Study 1, 12- and 16-year-old adolescents made "if-then" inferences after producing an alternative antecedent for the major premise. Older participants made more errors on the simple modus ponens inference than did younger ones. Reasoning with a false premise reduced this effect. Study 2 examined the relation between performance on a negative priming task (S. P. Tipper, 1985) and reasoning with contrary-to-fact premises in 9- and 11-year-olds. Overall, there was a correlation between the relative effect of negative priming on reaction times and the number of knowledge-based responses to the reasoning problems. The results of these studies are consistent with the idea that reasoning with premises that are not true requires an interaction between information retrieval and inhibition.

Adolescent↗

PubMed2002

Logic and human reasoning: an assessment of the deduction paradigm.

The study of deductive reasoning has been a major paradigm in psychology for approximately the past 40 years. Research has shown that people make many logical errors on such tasks and are strongly influenced by problem content and context. It is argued that this paradigm was developed in a context of logicist thinking that is now outmoded. Few reasoning researchers still believe that logic is an appropriate normative system for most human reasoning, let alone a model for describing the process of human reasoning, and many use the paradigm principally to study pragmatic and probabilistic processes. It is suggested that the methods used for studying reasoning be reviewed, especially the instructional context, which necessarily defines pragmatic influences as biases.

Cognition↗

PubMed2004

Cultivating expertise in informal reasoning.

People generally develop some degree of competence in general informal reasoning and argument skills, but how do they go beyond this to attain higher expertise? Ericsson has proposed that high-level expertise in a variety of domains is cultivated through a specific type of practice, referred to as "deliberate practice." Applying this framework yields the empirical hypothesis that high-level expertise in informal reasoning is the outcome of extensive, deliberate practice. This paper reports results from two studies evaluating the hypothesis. University student participants completed 12 weeks of deliberate practice in informal reasoning. Quantity of practice was recorded by computer, and additionally assessed via self-report. The hypothesis was supported: Students in both studies showed a large improvement, and practice, as measured by computer, was related to amount of improvement in informal reasoning. These findings support adopting a deliberate practice approach when attempting to teach or learn expertise in informal reasoning.

Adult↗

PubMed2001

The reasons for extraction of permanent teeth in Scotland: a 15-year follow-up study.

AIMS: Although Scotland has the highest proportion of edentulous adults in the UK, the frequency of edentulousness has fallen by 21% during the last 20 years. This study, carried out in 1999, was designed to establish whether the reasons for tooth loss have also changed since 1984 when they were last determined. METHODS: The Scottish Dental Practice Board provided the names of every fourth dentist on its list among which 425 general dental practitioners were identified. They were asked to record permanent tooth extractions for 1 week, specifying the age, sex and dental attendance of patients who underwent extractions and the reasons for these extractions. 352 dentists took part: a response rate of 82.8%. RESULTS: The study confirmed that there has been a reduction in the number of extractions between 1984 and 1999: there were 25% fewer teeth extracted per patient and 30% fewer per dentist per week. From 0-20 years of age, orthodontics has replaced caries as the commonest reason for extraction and in all age groups over 20 years, caries has become the commonest reason in contrast to 1984 when periodontal disease was the principal reason in patients over 40 years old. CONCLUSIONS: Caries and its sequelae remain the most important cause of tooth loss throughout adult life in Scotland and, therefore, caries prevention and maintenance of restorations are of great importance at all ages.

Adolescent↗

PubMed1987

Verbal and perceptual analogical reasoning and proportional metaphor comprehension in young children.

In contrast to the common assumption that young children have little or no ability to reason by analogy or to comprehend proportional metaphors, the present study demonstrated that children as young as age 5 years have an emerging ability to solve both verbal and perceptual proportional analogy problems and to detect the meanings of proportional metaphoric sentences. These results were largely because the experimental tasks were designed to minimize the number of factors that would restrict the performance of young children. The results indicated that the years between 5 and 7 mark a steady improvement in analogical reasoning and proportional metaphor comprehension, but that children ages 5, 6, and 7 display a wide-ranging ability in these areas. It was also found that perceptual analogical reasoning was statistically related to verbal analogical reasoning and to proportional metaphor comprehension, and that perceptual analogical reasoning and proportional metaphor comprehension were both statistically related to receptive vocabulary development.

Child↗

PubMed2002

Reasons for pregnancy termination, contraceptive habits and contraceptive failure among Swedish women requesting an early pregnancy termination.

BACKGROUND: More than 30 000 legal abortions are performed every year in Sweden despite sexual education in schools, widespread youth-clinics and family planning services that are free of charge. The aim of this study was to investigate reasons for induced abortion, contraceptive habits and reasons for contraceptive failure among women presenting for induced abortion. METHODS: A questionnaire was administered to 591 Swedish-speaking women consecutively attending three different health care providers concerning an induced abortion during spring 2000. RESULTS: The response rate was 88% (n = 518). As many as 43%, among daily smokers 53%, had experienced one or more previous legal abortions. The majority of the women (97%) had discussed the decision about abortion with someone. The most cited reasons contributing to their decision were financial concerns, worries about the relationship and bad timing of the pregnancy. Though 85% had used contraception during the previous year, 36% of the women had not used any contraceptive method at the time of conception. The main reason given for not using contraception was the belief that they could not at that time become pregnant (35%). Ninety percent of the women planned to use contraception after the abortion. CONCLUSION: Women's decisions regarding induced abortion are multifactorial. One important reason was "poor economy". One out of three did not use any contraception, as they believed they could not become pregnant. Women presenting for induced abortion are a risk-group for further terminations. Counseling must include information about the fertile window, effective contraceptives and the emergency contraceptive pill.

Abortion Applicants↗

PubMed2001

Measurement of clinical reflective capacity early in training as a predictor of clinical reasoning performance at the end of residency: an experimental study on the script concordance test.

BACKGROUND: The script concordance (SC) test was conceived to measure knowledge organization, the presence of links between items of knowledge which allow for interpretation of data in clinical decision making situations. Earlier studies have shown that the SC test has good psychometric qualities and overcomes some of the limitations of simulation clinical testing. This study explores the predictive validity of the test. OBJECTIVES: To verify whether scores obtained by students at the end of clerkship predict their clinical reasoning performance at the end of residency. DESIGN: Comparison of scores obtained on a SC test taken at the end of clerkship with those obtained 2 years later at the end of residency on two clinical reasoning assessments of known validity, called the short-answer management problems (SAMPs) and the simulated office orals (SOOs), and an objective structured clinical examination (OSCE) aimed at assessing hands-on skills and clinical reasoning. Data were treated by Pearson correlation analysis. SUBJECTS AND SETTING: A cohort of 24 students from a medical school in Quebec was followed up to the end of their residency in family medicine, completed in several schools across Quebec. RESULTS: The observed Pearson correlation coefficients of the SC test were statistically significant (0.451, P=0.013; 0.447; P=0.015) when compared with the SAMPs and the SOOs, respectively. They were not statistically significant (0.340, P=0.052) when compared with the OSCE. CONCLUSION: The authors assumed that the richness of knowledge organization, as indicated by SC test scores, would predict part of the performance on the measures of clinical reasoning (SAMP and SOO), but would predict less well performance on the OSCE which measures both clinical skills and clinical reasoning. Data found in the study are coherent with this hypothesis. This is evidence in favour of the construct validity of the SC test. It also indicates that, in the context of certification assessment, if a candidate has shown good organization of clinical knowledge at an early point in training, it can be expected that he/she will show good organization at subsequent measurements of this kind of knowledge. This appears to be true even if the later measures bear on a wider clinical domain.

Clinical Clerkship↗

PubMed1999

Reasons for outpatient referrals from generalists to specialists.

OBJECTIVE: To determine the relative importance of medical and nonmedical factors influencing generalists' decisions to refer, and of the factors that might avert unnecessary referrals. DESIGN: Prospective survey of all referrals from generalists to subspecialists over a 5-month period. SETTING: University hospital outpatient clinics. PARTICIPANTS: Fifty-seven staff physicians in general internal medicine, family medicine, dermatology, orthopedics, gastroenterology, and rheumatology. MEASUREMENTS AND MAIN RESULTS: For each referral, the generalist rated a number of medical and nonmedical reasons for referral, as well as factors that may have helped avert the referral; the specialist seeing the patient then rated the appropriateness, timeliness, and complexity of the referral. Both physicians rated the potential avoidability of the referral by telephone consultation. Generalists were influenced by a combination of both medical and nonmedical reasons for 76% of the referrals, by only medical reasons in 20%, and by only nonmedical reasons in 3%. In 33% of all referrals, generalists felt that training in simple procedures or communication with a generalist or specialist colleague would have allowed them to avoid referral. Specialists felt that the vast majority of referrals were timely (as opposed to premature or delayed) and of average complexity. Although specialists rated most referrals as appropriate, 30% were rated as possibly appropriate or inappropriate. Generalists and specialists failed to agree on the avoidability of 34% of referrals. CONCLUSIONS: Generalists made most referrals for a combination of medical and nonmedical reasons, and many referrals were considered avoidable. Increasing procedural training for generalists and enhancing informal channels of communication between generalists and subspecialists might result in more appropriate referrals at lower cost.

Ambulatory Care↗