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PubMed1996

The effect of distractor frequency on judgments of target laterality based on interaural delays.

A two-dimensional stimulus-classification paradigm was used to examine the ability of listeners to judge the laterality of an interaurally delayed low-frequency target component presented concurrently with a distractor component. Of primary interest was the effect on performance of the frequency difference (Delta f) between the target and distractor. In one set of conditions, the target was fixed at 753 Hz and the distractor was 353, 553, 653, 703, 803, 853, 953, or 1153 Hz (fixed within a block of trails). In a second set of conditions, the distractor was fixed at 753 Hz and the target frequency was 353, 553, 653, 703, 803, 953, or 1153 Hz. The listeners were presented with a target component with an interaural delay that varied from trial to trial, taking on one of ten values, five leading to the left ear and five leading to the right. A distractor component was simultaneously presented with an interaural delay that also took on one of the same ten values. Delays ranged from -90 to (+)90 microseconds in 20-microsecond steps. during a block of 100 trials, each of the possible combinations of target and distractor delay was presented once and only once in a random order. Listeners were instructed to make left-right judgments based on the target delay. Each condition was repeated ten times, and the slopes of the best linear boundaries between left and right responses were used to derive the relative weights given to the target and distractor. The duration of the signals was 200 microseconds. Two of the eight listeners weighted the target heavily when the target and distractor were spectrally remote but gave the two components equal weight when the different in frequency was small. These two listeners yielded similar target weights regardless of which component was designated as the target. One listener gave nearly equal weight to the target and the distractor regardless of Delta f. Five of the listeners gave greater weight to the higher of the two frequencies regardless of which was assigned as the target. This high-frequency dominance is explained in terms of cross-correlation functions based on the composite two-tone waveforms.

Adult↗

PubMed1999

On becoming non-judgmental: some difficulties for an ethics of counselling.

The growth in the availability of counselling services has been accompanied by growing concern about the conduct of counsellors, which in turn has led to the expressed need for an ethics of counselling. This paper will argue that there is an inherent tension between this need and the central tenets of one variety of counselling, client-centred counselling. The tension is identifiable on the basis of an inquiry into the nature of moral judgment which results in the recognition of the implicit value base in client-centred counselling. It is only when this value base is made explicit that any adequate ethics of counselling becomes a viable possibility.

Attitude of Health Personnel↗

PubMed2001

Problems for judgment and decision making.

This review examines recent developments during the past 5 years in the field of judgment and decision making, written in the form of a list of 16 research problems. Many of the problems involve natural extensions of traditional, originally rational, theories of decision making. Others are derived from descriptive algebraic modeling approaches or from recent developments in cognitive psychology and cognitive neuroscience.

Affect↗

PubMed1994

Effects of caffeine on perceptual judgment.

The present study examined the effects of caffeine on the estimation of felt width of blocks employing haptic presentation. Following a between-subject design, 160 male postgraduate students classified as high or low impulsives received either placebo or one of four doses of caffeine citrate (1, 2, 3 and 4 mg/kg body weight). A double-blind procedure was adopted for drug administration. Caffeine produced differential effects on the performance of high and low impulsives, facilitated performance (decreased error in perceptual judgment) in high impulsives but had no influence on the performance of low impulsives. The dose-response trends also followed different patterns in the two groups of subjects.

Adult↗

PubMed2007

Temporal order is coded temporally in the brain: early event-related potential latency shifts underlying prior entry in a cross-modal temporal order judgment task.

The speeding-up of neural processing associated with attended events (i.e., the prior-entry effect) has long been proposed as a viable mechanism by which attention can prioritize our perception and action. In the brain, this has been thought to be regulated through a sensory gating mechanism, increasing the amplitudes of early evoked potentials while leaving their latencies unaffected. However, the majority of previous research has emphasized speeded responding and has failed to emphasize fine temporal discrimination, thereby potentially lacking the sensitivity to reveal putative modulations in the timing of neural processing. In the present study, we used a cross-modal temporal order judgment task while shifting attention between the visual and tactile modalities to investigate the mechanisms underlying selective attention electrophysiologically. Our results indicate that attention can indeed speed up neural processes during visual perception, thereby providing the first electrophysiological support for the existence of prior entry.

Adolescent↗

PubMed2004

How can we know what we need to know? Reflections on clinical judgment formation.

What distinguishes a psychoanalyst from any other psychologically minded, empathic human being? This seemingly simple question goes to the heart of our profession, the way we see ourselves as competent clinicians. To understand a patient's material beyond ordinary empathy--that is, to come to a clinical judgment--we need to step out of the dyadic, countertransference situation and reflect what we've experienced in reference to our clinical theories. An analytic vignette shows how a theoretical background can be used to understand and interpret to a patient in a way that is deeply meaningful.

Cognition↗

PubMed1994

Effects of temporal speed instruction on temporal length judgment.

Given the flexible use of an inverse rule relating temporal speed and temporal length in some psychological studies, an hypothesized effect of an instruction regarding temporal speed on temporal length judgment was tested. By subjects asked to compare the speeds (rates of passage) and then to estimate the two temporal lengths (durations) of two successive intervals, there was greater use of the inverse rule and increased accuracy in estimating the first of the two intervals. The results have important implications for effortful processing of temporal information.

Adult↗

PubMed2003

Inductive reasoning and judgment interference: experiments on Simpson's paradox.

In a series of experiments on inductive reasoning, participants assessed the relationship between gender, success, and a covariate in a situation akin to Simpson's paradox: Although women were less successful then men according to overall statistics, they actually fared better then men at either of two universities. Understanding trivariate relationships of this kind requires cognitive routines similar to analysis of covariance. Across the first five experiments, however, participants generalized the disadvantage of women at the aggregate level to judgments referring to the different levels of the covariate, even when motivation was high and appropriate mental models were activated. The remaining three experiments demonstrated that Simpson's paradox could be mastered when the salience of the covariate was increased and when the salience of gender was decreased by the inclusion of temporal cues that disambiguate the causal status of the covariate.

Adult↗

PubMed2003

Effects of objective feedback and "single other" or "average other" social comparison feedback on performance judgments and helping behavior.

In two studies, participants received positive or negative feedback about their performance on a verbal task and then provided hints to another person on a subsequent, different task. It was expected that participants would give more helpful hints after positive than after negative feedback but that this would be more apparent when the feedback was based on performance comparisons with the "average participant" than on comparisons with another person or an objective standard. This effect was expected to be mediated by judgments of one's performance on the first task. These predictions were supported. Participants seemed aware of the effect of feedback on their hint choices, and their hint choices did not alter their affect levels. Also, participants receiving comparative (single or aggregated target) feedback exhibited changes in self-ascribed importance of the performance domain. Implications for social comparison theory and self-evaluation maintenance theory are discussed.

Analysis of Variance↗

PubMed2006

An ingroup advantage for confidence in emotion recognition judgments: the moderating effect of familiarity with the expressions of outgroup members.

The confidence we have in our assessment of an interaction partner's emotional state can have important consequences for the quality of the interaction. Two studies assessed the hypothesis that immigrants are more confident in their judgment of others' emotional facial expressions if the expresser is a member of their cultural ingroup rather than a member of the host community or another cultural group. In addition, the effects of the perceived familiarity with the type of expression, the length of residence in the host country, the quality of cross-cultural contact, the level of acculturation, and the intensity of the facial expressions were assessed. Overall, the results revealed an ingroup advantage effect for confidence ratings as well as support for the notion that individuals are more confident when judging expressions that they consider as more frequently displayed in everyday life. Furthermore, individuals were more confident when judging happiness expressions as well as more intense expressions in general.

Adult↗

PubMedDate not supplied

Assessing the likelihood of an important clinical outcome: new insights from a comparison of clinical and actuarial judgment.

PURPOSE: To assess and rank the performance of different methods of predicting the probability of death following a specified surgical procedure. METHOD: Actuarial estimates of the probability of early mortality for 40 patients were derived from 2 sources: a large published surgical series and a smaller series from the center where surgery was performed. Surgeons and cardiologists also provided probability estimates for these patients. RESULTS: Estimates derived from the published literature were too optimistic and did not differentiate between patients more, or less, likely to die (i.e., failed to discriminate). Doctors' judgments were unbiased but failed to discriminate. Local actuarial estimates (influenced by only 1 or 2 variables) were unbiased, did discriminate, but exhibited more random variation. CONCLUSIONS: The preferred source of estimates depends upon which aspect of accuracy is of greatest importance. Differences in patient selection and error in the identification of risk factors mean that published results will not always appropriately predict surgical risk at other institutions. Risk stratification may be more robust when based on a small set of cross-validated predictors rather than a larger set of predictors that includes some whose reliability has not been confirmed.

Actuarial Analysis↗

PubMedDate not supplied

What difference do two days make? The inertia of physicians' sequential prognostic judgments for critically ill patients.

Medical authorities have asserted the importance of observing a patient's clinical course over time. Distinguished committees have suggested that changes over time in physicians' prognostic estimates should influence decisions to transfer patients out of intensive care units (ICUs). This study evaluated how the opportunity to observe patients over time affected physicians' prognostic estimates for a cohort of 269 critically ill patients sequentially admitted to a medical-surgical ICU in a teaching hospital. As soon as possible after admission and again 48 hours later, the authors obtained a quantitative estimate of the probability of survival through hospital discharge from each patient's house officer and primary attending physician, and the critical care attending physician on duty. They independently determined each patient's survival. From this population they analyzed 181 pairs of judgments made by the same house officers, 211 pairs by the same primary attendings, and 172 pairs by the same critical care attendings. The physicians' 48-hour estimates were little changed from their previous estimates for the same patients. The correlation coefficient for the house officers' paired estimates was 0.84 (p less than 0.0001); for the critical care attendings' estimates 0.84 (p less than 0.0001), and for the primary attendings' estimates, 0.90 (p less than 0.0001). Forty-eight hours did not substantially reduce the disagreements present between estimates made by different physicians for the same patient. No group of physicians substantially improved the reliability or the discriminating power of its later estimates. The physicians in the study could not take advantage of sequential clinical information over time. These results point out the need to teach physicians how to better integrate and process sequential clinical data.

Critical Care↗

PubMedDate not supplied

Clinical assessment of the probability of coronary artery disease: judgmental bias from personal knowledge.

Probability estimates of angiographic coronary artery disease made by experienced, board-certified staff cardiologists were compared with those of cardiologists in training (fellows). In addition, estimates made before coronary angiography were compared with those made several months later based on written clinical summaries of 15 items of objective clinical and test data. Cardiologists were asked to estimate the probabilities of coronary artery disease, multivessel disease, and triple-vessel or left main disease. The study population consisted of 510 consecutive patients without valvular disease referred for the first time for coronary angiography to three hospitals. Both staff and fellows consistently overestimated the pre-angiographic probability of coronary artery disease. The probabilities estimated from patient summaries were always significantly lower than the pre-angiographic assessments. Only staff cardiologists reliably assessed the probabilities of coronary artery disease during the second assessment (p less than 0.05). Thus, estimates of disease probability based on clinical judgment vary according to the source of information, and these estimates are more accurate when physicians have objective data on hand and do not know the identities of the patients.

Coronary Angiography↗

PubMedDate not supplied

The psychology of good judgment: frequency formats and simple algorithms.

Mind and environment evolve in tandem--almost a platitude. Much of judgment and decision making research, however, has compared cognition to standard statistical models, rather than to how well it is adapted to its environment. The author argues two points. First, cognitive algorithms are tuned to certain information formats, most likely to those that humans have encountered during their evolutionary history. In particular, Bayesian computations are simpler when the information is in a frequency format than when it is in a probability format. The author investigates whether frequency formats can make physicians reason more often the Bayesian way. Second cognitive algorithms need to operate under constraints of limited time, knowledge, and computational power, and they need to exploit the structures of their environments. The author describes a fast and frugal algorithm. Take The Best, that violates standard principles of rational inference but can be as accurate as sophisticated "optimal" models for diagnostic inference.

Algorithms↗

PubMed2001

Cognitive complexity and the validity of clinicians' judgments.

Efforts to explain why some neuropsychologists are more accurate than others have been unsuccessful. In the present study, the relation between the cognitive complexity of clinicians and the validity of their judgments was investigated. Forty-two neuropsychologists completed a measure of cognitive complexity. The hypothesis that neuropsychologists who are high in cognitive complexity will be more accurate than those who are low in cognitive complexity was not supported. It is not clear why cognitive complexity was not significantly related to the validity of diagnostic ratings: One explanation is that the measure of cognitive complexity used in this study was inadequate but another possibility is that neuropsychologists who are low in cognitive complexity may still be able to achieve high levels of accuracy if they attend to normative data when they interpret test results.

Adult↗

PubMed1998

Judgment of line orientation in patients with unilateral cerebrovascular lesions.

This study examined the relationship between visual neglect and ability to judge the angular orientation of lines in patients with unilateral cerebrovascualar lesions. Participants were 75 patients with right-hemisphere cerebrovascular lesions (RCVA) and 39 patients with left-hemisphere cerebrovascular lesions (LCVA). All were administered the Judgment of Line Orientation test (JLO). Results revealed that twice as many RCVA patients (56%) exhibited impairment on the JLO as did LCVA patients (26%). In RCVA patients, much lower performance was seen in patients with left visual neglect. Among LCVA patients, no relationship was found between JLO performance and the presence of visual neglect. Correlations between JLO scores and WAIS-R variables suggested that JLO performance may be related in part to general cognitive factors, as well as to other perceptual and spatial abilities.

Aged↗

PubMed2005

DAS28 best reflects the physician's clinical judgment of response to infliximab therapy in rheumatoid arthritis patients: validation of the DAS28 score in patients under infliximab treatment.

This study is based on an expanded access program in which 511 patients suffering from active refractory rheumatoid arthritis (RA) were treated with intravenous infusions of infliximab (3 mg/kg+methotrexate (MTX)) at weeks 0, 2, 6 and every 8 weeks thereafter. At week 22, 474 patients were still in follow-up, of whom 102 (21.5%), who were not optimally responding to treatment, received a dose increase from week 30 onward. We aimed to build a model to discriminate the decision to give a dose increase. This decision was based on the treating rheumatologist's clinical judgment and therefore can be considered as a clinical measure of insufficient response. Different single and composite measures at weeks 0, 6, 14 and 22, and their differences over time were taken into account for the model building. Ranking of the continuous variables based on areas under the curve of receiver-operating characteristic (ROC) curve analysis, displayed the momentary DAS28 (Disease Activity Score including a 28-joint count) as the most important discriminating variable. Subsequently, we proved that the response scores and the changes over time were less important than the momentary evaluations to discriminate the physician's decision. The final model we thus obtained was a model with only slightly better discriminative characteristics than the DAS28. Finally, we fitted a discriminant function using the single variables of the DAS28. This displayed similar scores and coefficients as the DAS28. In conclusion, we evaluated different variables and models to discriminate the treating rheumatologist's decision to increase the dose of infliximab (+MTX), which indicates an insufficient response to infliximab at 3 mg/kg in patients with RA. We proved that the momentary DAS28 score correlates best with this decision and demonstrated the robustness of the score and the coefficients of the DAS28 in a cohort of RA patients under infliximab therapy.

Antibodies, Monoclonal↗

PubMed2001

Can malingering be identified with the judgment of line orientation test?

The purpose of this study was to evaluate recently proposed (Meyers, Galinsky, & Volbrecht, 1999) cutoff scores for biased responding on the Judgment of Line Orientation Test (JLO). A large sample of individuals involved in head injury litigation (N = 294) took the JLO and 2 tests designed to detect biased responding, the Computerized Assessment ofResponse Bias (CARB) and the Word Memory Test (WMT), as part ofa comprehensive neuropsychological evaluation. Patients were divided into groups on the basis of brain injury severity and whether or not they scored in the suspicious range on the CARB or WMT. The patients who were identified as providing biased responding on the CARB or WMT also scored significantly lower on the JLO. However, the Meyers et al. (1999) cutoff score correctly identified only 9.9% ofthis group, with a 1% possible false-positive rate. A different cutoff score was selected that had .22 sensitivity and .96 specificity. Overall, these results suggest that the JLO has limited utility as a screenfor biased responding; however, clinicians are encouraged to evaluate these scores carefully if they do not seem to make biological or psychometric sense.

Brain Injuries↗