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PubMed1983

Moral judgment maturity of process and reactive schizophrenics.

Premorbid adjustment, paranoid symptomatology, and role orientation were examined as major predictors of moral judgment maturity in 40 male schizophrenics. In addition, control predictors included age, intelligence (block design and vocabulary), length of hospitalization, length of illness, social position (education and occupation), and severity of illness. A multiple regression equation of premorbid adjustment, block design and vocabulary combined, and education was the best predictor of moral judgment maturity. These results suggest the importance of cognitive and social skills in the development of moral judgment maturity in schizophrenics.

Adult↗
PubMed1999

The influences of behavior valence and actor race on black and white children's moral and liking judgments.

Preschoolers, 1st graders, and 4th graders were shown line drawings that depicted 2 prosocial and 2 aggressive behaviors. Black actors or White actors were depicted in the scenarios, and a brief description of each behavior was read to the child. For each scenario, children rated their liking for the actor and the morality of the actor's behavior. Findings indicated that children at each age level significantly differentiated the actors by behavior valence for moral and liking judgements. However, the moral judgements of White preschoolers were more differentiated by behavior valence than the judgments of Black preschoolers. Also, there was more differentiation of actors by behavior valence for liking judgments as the age levels of the children increased. Black actors received more negative moral judgments than did White actors only at the preschool level.

Black or African American↗
PubMedDate not supplied

Generation effect and frequency judgment in young and elderly adults.

In Experiment 1, young and old adults both generated and read the same words either two, five, or eight times (with frequencies combined orthogonally) and then judged the frequency of either the generated or read words. In Experiment 2, young and old adults generated and read different words either one, two, or three times and judged the frequency of both the generated and read words. In both experiments, generation, compared to reading, increased the slope of frequency judgments comparably for the two age groups. In Experiment 1, neither age group could discriminate read from generated frequency. In Experiment 2, a 24-h retention interval reduced the slope of frequency judgments, but did not interact with either age or generation efforts. These results seem most consistent with a semantic activation explanation of the generation effect and a familiarity-based judgment about frequency of occurrence.

Adult↗
PubMedDate not supplied

Age differences in the accuracy of confidence judgments.

Age differences in accuracy were investigated by having older (M = 68.6 years) and younger (M = 21.5 years) adults make confidence judgments about the correctness of their responses to two sets of general knowledge items. For one set, prior to making their confidence judgments, subjects made mental strategy judgements indicating how they had selected their answers (i.e., they guessed, used intuition, made an inference, or immediately recognized the response as correct). Results indicate that older subjects were more accurate than younger subjects in predicting the correctness of their responses; however, making mental strategy judgments did not result in increased accuracy for either age group. Additional analyses explored the relationship between accuracy and other individual difference variables. The results of this investigation are consistent with recent theories of postformal cognitive development that suggest older adults have greater insight into the limitations of their knowledge.

Adult↗
PubMed1997

Metalinguistic judgments in normal aging and Alzheimer's disease.

This study compared sentence acceptability judgments from young and healthy older adults and older adults with dementia due to probable Alzheimer's disease. Two types of sentences were contrasted: one type involved contrasts among verb alternations in which semantic distinctions between verbs regulate the acceptability of phrase structure variations; the second type involved contrasts among directional transformations in which constraints on the movement of noun phrases determine the linear order of main and embedded clauses. The primary findings were that metalinguistic judgments by healthy older adults as well as those with probable Alzheimer's reflected processing demands on working memory. In addition, metalinguistic judgments by adults with probable Alzheimer's reflected the breakdown of semantic information about verbs.

Adolescent↗
PubMed1982

Adult age differences in frequency judgments of categorical representations.

Adult age differences were examined for relative frequency judgments on a task in which categories had either zero, one, three, or five instances in a study list. Judgments required selecting from pairs of category names which member had the greater representation of instances in the prior list. Contrary to the results obtained in earlier studies using a task in which discrete events vary in frequency of occurrence, an age difference favoring young adults over elderly adults in accuracy of frequency judgments was found for categories. Neither instructional variation (incidental learning vs. intentional learning) nor variation in priming (cuing vs. noncuing with the list of categories prior to the study trial) yielded either main effects or interaction effects with age. The results were interpreted in terms of an age deficit in either the storage or the retrieval of memory traces of category names established by the automatic elicitation of implicit associative responses to instances of taxonomic categories.

Adolescent↗
PubMed2001

Physician-reviewers' perceptions and judgments about quality of care.

OBJECTIVE: Although Peer Review Organizations (PROs) and researchers rely on physicians to assess quality of care, little is known about what physicians think about when they judge quality. We sought to identify features of individual cases that are associated with physicians' judgments. DESIGN: Using 1994 Medicare data, we selected hospitalizations for 1134 beneficiaries in 42 acute care hospitals in California and Connecticut. The sample was enriched with 17 surgical and six medical complications identified using diagnosis and procedure codes. PRO physicians confirmed quality problems using a structured implicit chart review instrument and provided written open-ended comments about each case. We coded physicians' comments for factors presumed to influence judgments about quality. RESULTS: In crude and adjusted comparisons, reviewers questioned quality more frequently in cases with serious or fatal outcomes, technical mishaps and inadequate documentation. Among surgical (but not medical) patients, they were less likely to record poor quality among patients presenting with an acute illness. CONCLUSION: Factors other than the adequacy of key processes of care are associated with physician-reviewers' judgments about quality.

Acute Disease↗
PubMed1979

Agreement measurement and the judgment process.

This paper reviews the rationale for correcting for chance agreement beween two raters. It is suggested that under certain conditions correction for chance agreement is both unnecessary and inappropriate. When a chance correction is indicated, the chosen measure should be one that can be shown to be logically in accord with the two judges' method of determining each case's disposition. Two agreement measures, kappa (K) and Maxwell's Random Error Coefficient of Agreement (RE), are described in common terms and are then compared in terms of their assumptions about the judgment process. The plausibility of K's assumptions are challenged, and K's use is discouraged on the grounds that judgment table data are not treated in a way compatible with the process by which the table was constructed during the judgment process itself. Use of Maxwell's RE is recommended under conditions of equal proportions in the disagreement cells.

Humans↗
PubMed1994

Value judgment in the Oregon Medicaid experiment.

Oregon proposed a unique social experiment in which combinations of medical conditions and treatments were prioritized. Under the proposed program, providers would not be reimbursed for services relevant to 17% of the condition-treatment pairs. The program was designed to expand access and allow significantly more residents to qualify for Medicaid. The original Oregon proposal used four levels of human judgment: community values assessed in town meetings; ratings of the desirability of health states; medical judgment of treatment efficacy; and subjective reordering of the list by Oregon Health Services Commissioners. In August 1992, the Department of Health and Human Services rejected Oregon's application to proceed with the experiment, objecting to the use of one of the four types of subjective data: ratings of the desirability of health states. A revised application that eliminated this one subjective component was approved in March 1993. This paper demonstrates that among the four levels of judgment, the ratings of health states were supported by the most evidence of reliability and validity. Implications for future prioritization experiments are discussed.

Community Participation↗
PubMed1998

Comparison of professional judgment versus an algorithm for nutrition status classification.

OBJECTIVES: The classification of a patient's nutrition status is important for identifying patients who require nutrition care, for designing effective nutrition interventions, and for measuring severity of illness. The objective of this study was to evaluate the reliability and validity of two variants of the Department of Veterans Affairs' nutrition status classification: professional judgment versus an algorithm. METHODS: The study consisted of two phases, both of which included providing a sample of approximately 60 registered dietitians and 60 clinical dietetic technicians with data on 16 (phase I) and 20 (phase II) patients, to which they assigned nutrition statuses using both professional judgment and the algorithm. Improvements in instructions and training were implemented between the two phases. Interrater reliability of the responses was calculated, and content validity was measured by comparing the staff's responses with those of an expert panel. RESULTS: Reliability improved significantly between phases for both professional judgment and the algorithm. Greater reliability and validity were observed with use of the algorithm, by both dietitians and technicians, during both phases. CONCLUSION: Classification of a patient's nutrition status is important in the delivery of cost-effective health care. The Department of Veterans Affairs' nutrition status classification is a good one for assessing nutrition status quickly and reliably, especially when an algorithm is used. The results underscore the advantages of a classification system based on an algorithm when the system is designed to be used by many different staff across multiple facilities.

Adult↗
PubMedDate not supplied

Influence of attention and judgment on perception of breathlessness in healthy individuals and patients with chronic obstructive pulmonary disease.

BACKGROUND: Cognitive processes mediate judgments of sensation intensity and the perception of breathlessness. These processes depend on focused attention to make a determination, which has not been systematically investigated. OBJECTIVE: To examine the effect of attention on the perception of breathlessness given alterations in attentional focus based on the subject's experience with the perception. METHODS: Magnitude estimation techniques with inspiratory airflow resistance were used to examine the influence of variations in attentional focus on the judgments associated with the perception of breathlessness. Two experimental magnitude estimation conditions were used to alter the focus of attention and compare it with traditional techniques as a control condition (CC). The subject's typical breathing pattern (EXP-T) and clearest memory of breathlessness (EXP-M) were used as references in the experimental conditions. RESULTS: Findings revealed a significant main effect for condition (CC vs. EXP-T: F= 4.82, p < .01; CC vs. EXP-M: F= 14.82, p < .01) and an interaction effect for group by condition (CC vs. EXP-T: F = 4.82, p < .03; CC vs. EXP-M: F = 5.15, p < .03). Post hoc analysis revealed significant differences only for the chronic obstructive pulmonary disease (COPD) group in both comparisons. CONCLUSIONS: Findings indicate that different focuses of attention based on previous exposure to sensations have an impact on judgments used to determine the intensity of a sensation given similar presentation of stimuli, and thus contribute to alterations in the perception of breathlessness.

Aged↗
PubMed1997

The perception and judgment of senior baccalaureate student nurses in clinical decision making.

This descriptive, exploratory study sought to validate Brooks's theory of intrapersonal perceptual awareness, a middle-range theory derived from King's interacting systems framework and to extend King's work by making perception (sensory and intuitive), judgment (cognitive and affective), and decision making explicit concepts in the personal system. The results supported the theory's central premise and clarified the interaction between perception and judgment but did not support bringing perception, judgment, and decision making into the personal system as proposed. Self emerged as the core concept, and the results are used to recommend a proposed reconceptualization of King's personal system as self.

Decision Making↗
PubMed1975

Complexity, extremity, and affect in male and female judgments.

Two studies were conducted to elucidate aspects of the interpersonal judement process as it is applied to and by males and females. Measurement of judgments by means of the Role Construct Repertory Test allowed consideration of cognitive complexity scores, as well as the use of extreme ratings and a total affective rating. Consistent findings from both studies suggest that males and females differ in their use of extreme scores and total affective ratings, but not in complexity. Characteristics of the stimulus person affect each of the three dependent measures. Interrelationships among the three judgmental measures provide information about the methodological and conceptual interplay of various factors in interpersonal judgment.

Adolescent↗
PubMedDate not supplied

Exploring NANDA's definition of nursing diagnosis: linking diagnostic judgments with the selection of outcomes and interventions.

Nursing diagnoses are described by definition as the basis for selection of interventions to achieve health outcomes. Processes used to link diagnostic judgments with desired outcomes and interventions can be holistic or reductionistic. A model of clinical inference is presented to illustrate the interrelated nature of judgments about diagnoses, desired outcomes, and interventions. Implications for development of diagnostic and taxonomic tools to guide holistic judgments are explored.

Clinical Competence↗
PubMed1995

Rational non-interventional paternalism: why doctors ought to make judgments of what is best for their patients.

This paper argues that doctors ought to make all things considered value judgments about what is best for their patients. It illustrates some of the shortcomings of the model of doctor as 'fact-provider'. The 'fact-provider' model fails to take account of the fact that practising medicine necessarily involves making value judgments; that medical practice is a moral practice and requires that doctors reflect on what ought to be done, and that patients can make choices which fail to express their autonomy and which are based on mistaken judgments of value. If doctors are properly to respect patient autonomy and to function as moral agents, they must make evaluations of what their patients ought to do, all things considered. This paper argues for 'rational, non-interventional paternalism'. This is a practice in which doctors form conceptions of what is best for their patients and argue rationally with them. It differs from old-style paternalism in that it is not committed to doing what is best.

Choice Behavior↗
PubMed2004

Cortical regions for judgments of emotions and personality traits from point-light walkers.

Humans are able to use nonverbal behavior to make fast, reliable judgments of both emotional states and personality traits. Whereas a sizeable body of research has identified neural structures critical for emotion recognition, the neural substrates of personality trait attribution have not been explored in detail. In the present study, we investigated the neural systems involved in emotion and personality trait judgments. We used a type of visual stimulus that is known to convey both emotion and personality information, namely, point-light walkers. We compared the emotion and personality trait judgments made by subjects with brain damage to those made by neurologically normal subjects and then conducted a lesion overlap analysis to identify neural regions critical for these two tasks. Impairments on the two tasks dissociated: Some subjects were impaired at emotion recognition, but judged personality normally; other subjects were impaired on the personality task, but normal at emotion recognition. Moreover, these dissociations in performance were associated with damage to specific neural regions: Right somatosensory cortices were a primary focus of lesion overlap in subjects impaired on the emotion task, whereas left frontal opercular cortices were a primary focus of lesion overlap in subjects impaired on the personality task. These findings suggest that attributions of emotional states and personality traits are accomplished by partially dissociable neural systems.

Adult↗
PubMed2006

Neural bases of motivated reasoning: an FMRI study of emotional constraints on partisan political judgment in the 2004 U.S. Presidential election.

Research on political judgment and decision-making has converged with decades of research in clinical and social psychology suggesting the ubiquity of emotion-biased motivated reasoning. Motivated reasoning is a form of implicit emotion regulation in which the brain converges on judgments that minimize negative and maximize positive affect states associated with threat to or attainment of motives. To what extent motivated reasoning engages neural circuits involved in "cold" reasoning and conscious emotion regulation (e.g., suppression) is, however, unknown. We used functional neuroimaging to study the neural responses of 30 committed partisans during the U.S. Presidential election of 2004. We presented subjects with reasoning tasks involving judgments about information threatening to their own candidate, the opposing candidate, or neutral control targets. Motivated reasoning was associated with activations of the ventromedial prefrontal cortex, anterior cingulate cortex, posterior cingulate cortex, insular cortex, and lateral orbital cortex. As predicted, motivated reasoning was not associated with neural activity in regions previously linked to cold reasoning tasks and conscious (explicit) emotion regulation. The findings provide the first neuroimaging evidence for phenomena variously described as motivated reasoning, implicit emotion regulation, and psychological defense. They suggest that motivated reasoning is qualitatively distinct from reasoning when people do not have a strong emotional stake in the conclusions reached.

Acoustic Stimulation↗
PubMed2006

Consequences, action, and intention as factors in moral judgments: an FMRI investigation.

The traditional philosophical doctrines of Consequentialism, Doing and Allowing, and Double Effect prescribe that moral judgments and decisions should be based on consequences, action (as opposed to inaction), and intention. This study uses functional magnetic resonance imaging to investigate how these three factors affect brain processes associated with moral judgments. We find the following: (1) Moral scenarios involving only a choice between consequences with different amounts of harm elicit activity in similar areas of the brain as analogous non-moral scenarios; (2) Compared to analogous non-moral scenarios, moral scenarios in which action and inaction result in the same amount of harm elicit more activity in areas associated with cognition (such as the dorsolateral prefrontal cortex) and less activity in areas associated with emotion (such as the orbitofrontal cortex and temporal pole); (3) Compared to analogous non-moral scenarios, conflicts between goals of minimizing harm and of refraining from harmful action elicit more activity in areas associated with emotion (orbitofrontal cortex and temporal pole) and less activity in areas associated with cognition (including the angular gyrus and superior frontal gyrus); (4) Compared to moral scenarios involving only unintentional harm, moral scenarios involving intentional harm elicit more activity in areas associated with emotion (orbitofrontal cortex and temporal pole) and less activity in areas associated with cognition (including the angular gyrus and superior frontal gyrus). These findings suggest that different kinds of moral judgment are preferentially supported by distinguishable brain systems.

Adolescent↗