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Psychological cue use and implications for a clinical decision support system.

Effective clinical decision making depends upon identifying possible outcomes for a patient, selecting relevant cues, and processing the cues to arrive at accurate judgements of each outcome's probability of occurrence. These activities can be considered as classification tasks. This paper describes a new model of psychological classification that explains how people use cues to determine class or outcome likelihoods. It proposes that clinicians respond to conditional probabilities of outcomes given cues and that these probabilities compete with each other for influence on classification. The model explains why people appear to respond to base rates inappropriately, thereby overestimating the occurrence of rare categories, and a clinical example is provided for predicting suicide risk. The model makes an effective representation for expert clinical judgements and its psychological validity enables it to generate explanations in a form that is comprehensible to clinicians. It is a strong candidate for incorporation within a decision support system for mental-health risk assessment, where it can link with statistical and pattern recognition tools applied to a database of patients. The symbiotic combination of empirical evidence and clinical expertise can provide an important web-based resource for risk assessment, including multi-disciplinary education and training.

Bias↗

The effects of cueing target location and response mode on interference and negative priming using a visual selection paradigm.

Two experiments are reported that examine the effects of cueing the location of a target in the prime display on interference and subsequent negative priming . The prime and probe displays comprised two words, a target and a distractor. In the prime display, the two words were either the same (response compatible) or different (response incompatible). The target in the probe display was unrelated to the prime distractor (control), the same word as the distractor (ignored repetition), or semantically related to the distractor (ignore semantic repetition). In Experiment 1, cueing the location of the prime target significantly reduced the interference effect but not the subsequent identity negative priming (NP) effect. In contrast, not cueing the prime target resulted in the elimination of the identity NP. There was no evidence of semantic NP in this experiment. In Experiment 2, where a categorization response was required, significant interference was obtained in the prime display that was not influenced by cueing the location of the target. Although there was significant semantic NP, identity NP failed to reach significance. The two experiments were analysed together, and findings are discussed in relation to current models of negative priming.

Analysis of Variance↗

The differential effects of simultaneous and successive cueing on the detection of bilateral symmetry in dot patterns.

Corballis and Roldan (1975) obtained speeded judgements of whether dot patterns were bilaterally symmetrical about, or translated across, a line. Reaction times (RTs) were ordered V (vertical) > D (diagonal) > H (horizontal) where ">" means faster than. Similar results occurred with blocked axis orientations, suggesting subjects cannot prepare by rotating a mental frame of reference. Blocking trials may have been ineffective because blocking cannot provide incremental benefits over those already provided by axis lines. Four experiments show that the usual axis orientation ordering of V > H > D is markedly attentuated by simultaneous but not successive axis lines. Also, axis cue lines and axis blocking are not equivalent treatments. Instead, unblocked line cues require finite processing time whereas, under blocking, subjects can prepare for the expected orientation. There was no suggestion anywhere of the V > D > H axis ordering that Corballis and Roldan reported. Successive axis line cues may only direct attention to the orientation being cued, but simultaneous line cues may change the stimulus itself, thus providing an additional means of visual processing that facilitates symmetry detection at non-vertical axis orientations.

Adult↗

Overcoming misinformation effects in eyewitness memory: effects of encoding time and event cues.

Eyewitness memory is often distorted when misleading information is presented to subjects after encoding. Three experiments explored ways to overcome these misinformation effects. In Experiment 1, subjects viewed slides of a robbery, at a rate of four or seven seconds per slide. Five minutes later subjects were given a recognition test with few (1-3) or numerous (6-13) event cues. Providing numerous retrieval cues improved overall performance, but did not reduce the effects of misinformation. With week-long delays (Experiment 2) numerous retrieval cues did eliminate misinformation effects, but only when subjects viewed slides at the slower rate (seven seconds per slide). Experiment 3 essentially replicated this pattern, using a modified test to eliminate any biasing effects of distractors. Given adequate encoding and numerous retrieval cues, misinformation effects were eliminated, suggesting that under some conditions misinformation makes event memory inaccessible, but not unavailable.

Crime↗

Experimental application of virtual reality for nicotine craving through cue exposure.

Research has shown that many smokers experience an increase in the desire to smoke when exposed to smoking-related cues. Cue exposure treatment (CET) refers to the manualized, repeated exposure to smoking-related cues, aimed at the reducing cue reactivity by extinction. In this study, we constructed a virtual reality system for evoking a desire of nicotine, which was based on the results of a Questionnaire of Nicotine-craving. And we investigated the effectiveness of the virtual reality system as compared to classical device (pictures). As a result, we reached the conclusion that virtual reality elicits more craving symptoms than the classical devices.

Adult↗

Cue integration for the perception and control of self-movement in ageing and Alzheimer's disease.

The perception and control of self-movement relies on visual cues derived from the radial patterns of optic flow and from the relative motion of objects within view. Optic flow and object motion processing impairments might limit independent self-movement in a manner like that seen in ageing and in Alzheimer's disease. We used optic flow and object motion stimuli to simulate aspects of the self-movement scene. Stimulus salience was individualized to present comparable stimuli to young [n = 18; mean age = 25.6, standard error of measurement (SEM) = 1.4], middle-aged (n = 17; mean age = 53.9, SEM = 0.9), older adult (n = 30; mean age = 72.4, SEM = 1.4) and Alzheimer's disease (n = 15; mean age 75.2, SEM = 1.6) subjects. All groups were tested in two tasks: pointing towards the simulated direction of self-movement and steering the simulated self-movement towards a straight-ahead direction. We found that young and middle-aged subjects show similar pointing accuracy using either optic flow or object motion, but steer better with object motion than with optic flow. Older adult subjects show better performance with optic flow than object cues for pointing (P < 0.001), but their performance improves when both cues are combined in the pointing (P = 0.012) and steering (P = 0.02) tasks. Alzheimer's disease patients show poorer performance with optic flow and object motion than all other groups and do not benefit from the combined presentation of cues for either pointing or steering. We conclude that ageing and Alzheimer's disease are associated with distinct profiles of visual processing deficits that limit the ability to use optic flow and object motion to perceive and control self-movement.

Adult↗

Fragments of a larger whole: retrieval cues constrain observed neural correlates of memory encoding.

Laying down a new memory involves activity in a number of brain regions. Here, it is shown that the particular regions associated with successful encoding depend on the way in which memory is probed. Event-related functional magnetic resonance imaging signals were acquired while subjects performed an incidental encoding task on a series of visually presented words denoting objects. A recognition memory test using the Remember/Know procedure to separate responses based on recollection and familiarity followed 1 day later. Critically, half of the studied objects were cued with a corresponding spoken word, and half with a corresponding picture. Regardless of cue, activity in prefrontal and hippocampal regions predicted subsequent recollection of a word. Type of retrieval cue modulated activity in prefrontal, temporal, and parietal cortices. Words subsequently recognized on the basis of a sense of familiarity were at study also associated with differential activity in a number of brain regions, some of which were probe dependent. Thus, observed neural correlates of successful encoding are constrained by type of retrieval cue, and are only fragments of all encoding-related neural activity. Regions exhibiting cue-specific effects may be sites that support memory through the degree of overlap between the processes engaged during encoding and those engaged during retrieval.

Adult↗

Visual form discrimination from luminance or disparity cues: functional anatomy by PET.

With the purpose of elucidating the functional fields involved in the discrimination of visual form based either on luminance or binocular disparity cues, we used PET to measure changes in regional cerebral blood flow (rCBF) in ten volunteers while they performed visual discrimination tasks. The averaged standardized subtraction images (delta rCBF) were analysed for statistically significant changes between the form tasks and their reference tasks. Twenty cortical fields in the visual association areas and the prefrontal cortex were engaged by the discrimination of visual form based upon disparity cues, whereas only four fields showed increased activity during the discrimination of visual form created by luminance cues. The only functional field activated in both conditions was in the left fusiform gyrus. The present findings extend our earlier observations, namely that disparate functional networks of activated fields in the human brain can perform the discrimination of visual form perceptually defined by different visual cues.

Adult↗

Task-dependent laterality for cue decoding during spoken language processing.

The task-dependent laterality of the auditory cortices was investigated by measuring the magnetic fields elicited by three forms of a Japanese verb, which differed in terms of prosodic and phonetic cues. Significant task-dependent magnetic fields were found in both hemispheres during a prosody-related task, but only in the left during a phoneme-related task. The latency was similar to the mismatch negatively which reflects the neural activity of automatic cue decoding. These results suggest that task-dependent schemata are activated at least partially in parallel with automatic cue-decoding processes such that those in the left hemisphere process linguistic information irrespective of acoustic cues whereas those in the right hemisphere process prosodic information.

Adult↗

Covert and overt orienting to gaze direction cues and the effects of fixation offset.

We examined covert and overt orienting in response to non-predictive gaze direction cues and investigated whether the subcortical superior colliculus (SC) plays a role in this type of orienting. Participants viewed a centrally presented gazing schematic face and responded to targets appearing at gazed-at or non-gazed-at locations either by making a keypress response while maintaining central fixation or by making an eye movement to the target. For both response conditions, the fixation stimulus (the gazing face) either remained on the screen or was extinguished at the time of target presentation, a manipulation known to engage and disengage the SC. Results revealed that participants making manual responses oriented covertly to the gazed-at location regardless of the fixation condition, and that participants making eye movements oriented overtly only if the fixation stimulus remained on the screen. Overt gaze-triggered orienting was not enhanced relative to covert orienting, and the fixation offset effect was not reduced for averted gaze cues relative to straight gaze cues. These findings suggest that gaze direction cues do not activate or predisengage the oculomotor system, and thus that orienting to gaze direction does not engage the SC. This is consistent with the view that gaze-triggered orienting is a unique form of reflexive orienting that depends crucially on cortical processes.

Adult↗

Low dose of heroin inhibits drug-seeking elicited by cues after prolonged withdrawal from heroin self-administration in rats.

Environmental stimuli and conditioned cues associated with heroin can induce drug-seeking behavior, but how heroin lapse interacts with cues is unclear. Rats were trained to nose-poke for i.v. heroin for 14 days and then tested for heroin seeking after withdrawal from heroin self-administration. Heroin seeking induced by cues persisted over several weeks after withdrawal, and the responding was not easily extinguished after 4 weeks withdrawal. A single injection of heroin (250 micro g/kg) enhanced the responding at early stage of withdrawal, but a low dose of heroin (50, 250 micro g/kg) suppressed the responding induced by contextual or conditioned cues at 4 weeks of withdrawal. The results suggest that prolonged withdrawal may increase the risk of relapse to heroin seeking.

Animals↗

The novel mGluR2/3 agonist LY379268 attenuates cue-induced reinstatement of heroin seeking.

In humans, drug-associated stimuli can provoke heroin relapse during abstinence. In rats, cues paired with heroin self-administration reinstate heroin seeking in a relapse model. The neurobiological mechanisms involved in this reinstatement, however, are largely unknown. Here, we determined the effect of LY379268, an mGluR2/3 agonist that decreases evoked glutamate release, on cue-induced reinstatement of heroin seeking. Systemic injections of LY379268 attenuated reinstatement of heroin seeking induced by exposure to a discrete tone-light cue that was previously paired with heroin infusions during self-administration training. In contrast, LY379268 had no effect on heroin self-administration. Results indicate that glutamate plays an important role in cue-induced reinstatement of heroin seeking and suggest that mGluR2/3 agonists should be considered for the treatment of opiate relapse.

Amino Acids↗

The contribution of amplitude envelope cues to sentence identification in young and aged listeners.

OBJECTIVE: The purpose of this study was to examine the importance of amplitude envelope cues to sentence identification for aged listeners. We also examined the effect of increasing alterations (i.e., compression ratio) and amount of available frequency content (i.e., number of channels) for this population. DESIGN: Thirty-six listeners were classified according to their age (35 or younger versus 65 and older) and hearing status (normal hearing versus hearing impaired). Within each hearing status, mean hearing threshold thresholds for the young and aged listeners were matched as closely as possible through 4 kHz to control for sensitivity differences across age, and all listeners passed a cognitive screening battery. Accuracy of synthetic sentence identification was measured using stimuli processed to restrict spectral information. Performance was measured as a function of age, hearing status, amount of spectral information, and degradation of the amplitude envelope (using fast-acting compression with compression ratios ranging from 1:1 to 5:1). RESULTS: Mean identification scores decreased significantly with increasing age, the presence of hear- c ing loss, the removal of spectral information, and with increasing distortion of the amplitude envelope (i.e., higher compression ratios). There was a consistent performance gap between young and aged listeners, regardless of the magnitude of change to the amplitude envelope. This suggests that some cue other than amplitude envelope variations is inaccessible to the aged listeners. CONCLUSIONS: Although aged listeners performed more poorly overall, they did not show greater susceptibility to alterations in amplitude-envelope cues, such as those produced by fast-acting amplitude compression systems. It is therefore unlikely that compression parameters such as attack and release time or compression ratio would need to be a differentially programmed for aged listeners. Instead, the data suggest two possibilities: aged listeners have difficulty accessing the fine-structure temporal cues present in speech, and/or performance is degraded by age-related loss of function at a central processing level.

Adult↗

Defective response to social cues in Möbius' syndrome.

A case of Möbius' syndrome is presented, with the mask-like facies and poor social relationships consistent with this diagnosis. Previous thought has implicated the inability to transmit facial cues as a cause for impoverished social functioning. The authors hypothesize that the inability to transmit is related to an inability to receive cues. They repeated a paradigm used previously to test ability to interpret facial cues. The otherwise intelligent patient could not perform a task previously performed by approximately 300 other subjects. These findings suggest that the rehabilitation of Möbius patients should include education in interpreting social cues.

Adult↗

Effect of one single auditory cue on movement kinematics in patients with Parkinson's disease.

OBJECTIVE: The purpose of this study was to determine whether one single auditory cue affected movement kinematics of more than one step in a sequential upper limb task in patients with Parkinson's disease. DESIGN: A counter-balanced repeated-measures design was employed. A total of 16 male patients with Parkinson's disease and 16 age-matched male and female controls performed the task under two conditions. In the signal-present condition, the participants were instructed to start the movement when they heard a bell ring. In the signal-absent condition, there was no bell ringing, and they were told to start the movement when they were ready. Kinematic performances for the first two movement segments (i.e., reaching for the pen and bringing the pen to the paper) were compared between conditions. RESULTS: The results indicated that the presence of the single auditory cue affected movement kinematics of the patients with Parkinson's disease but not that of the controls. When given external cueing, the patients elicited faster, more forceful, more efficient, more stable, but less smooth movement. CONCLUSIONS: The results suggest that therapists should provide external cues according to their treatment goals. In addition, researchers should be aware of the influence of start signals when designing subsequent experiments.

Acoustic Stimulation↗

Cue combination in the motion correspondence problem.

Image motion is a primary source of visual information about the world. However, before this information can be used the visual system must determine the spatio-temporal displacements of the features in the dynamic retinal image, which originate from objects moving in space. This is known as the motion correspondence problem. We investigated whether cross-cue matching constraints contribute to the solution of this problem, which would be consistent with physiological reports that many directionally selective cells in the visual cortex also respond to additional visual cues. We measured the maximum displacement limit (Dmax) for two-frame apparent motion sequences. Dmax increases as the number of elements in such sequences decreases. However, in our displays the total number of elements was kept constant while the number of a subset of elements, defined by a difference in contrast polarity, binocular disparity or colour, was varied. Dmax increased as the number of elements distinguished by a particular cue was decreased. Dmax was affected by contrast polarity for all observers, but only some observers were influenced by binocular disparity and others by colour information. These results demonstrate that the human visual system exploits local, cross-cue matching constraints in the solution of the motion correspondence problem.

Color↗

A modified version of the unique cue theory accounts for olfactory compound processing in honeybees.

We investigated the capability of honeybees to discriminate between single odorants, binary olfactory mixtures, and ternary olfactory mixtures in olfactory conditioning of the proboscis extension reflex. In Experiment 1, three single odorants (A+, B+, and C+) and three binary mixtures of these odors (AB+, AC+, and BC+) were reinforced while the ternary compound, consisting of all three odors (ABC-), was nonreinforced. In Experiment 2, only one single odorant (A+) and one binary olfactory compound (BC+) were reinforced while the ternary compound (ABC-) consisting of the single odor and the binary compound was nonreinforced. We studied whether bees can solve these problems and whether the course of differentiation can be predicted by the unique cue theory, a modified unique cue theory, or Pearce's configural theory. Honeybees were not able to differentiate reinforced from nonreinforced stimuli in Experiment 1. However, summation to ABC observed at the beginning of training contradicts the predictions of Pearce's configural theory. In Experiment 2, differentiation between the single odorant A and the ternary compound developed more easily than between the binary compound BC and ABC. This pattern of differentiation is in line with a modified unique cue theory and Pearce's configural theory. Summation to ABC at the beginning of training, however, again was at odds with Pearce's configural theory. Thus, olfactory compound processing in honeybees can best be explained by a modified unique cue theory.

Animals↗

A latent cue preference based on sodium depletion in rats.

Three experiments show latent (or incidental) learning of salt-cue relationships using a conditioned cue-preference paradigm. Rats drank a salt solution while confined in one compartment and water in an adjacent, distinct compartment on alternate days. When given access to the two compartments with no solutions present, sodium-deprived rats preferred their salt-paired compartments; normal rats preferred their water-paired compartments. Reversing the deprivation states of the two groups reversed their preferences. These results show that rats can latently acquire associations between environmental cues and the taste of salt, and can use this information flexibly to guide behavior based upon internal cues produced by sodium deprivation.

Animals↗