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"When looking back on my past life I regret...": retrospective regret in the second half of life.

The study investigated the frequency, themes, and attributions for significant regrets in a random probability sample of 3,917 German and Dutch nationals between the ages of 40 and 85 years. It was found that 14% did not have any regrets in spontaneous memory, and that this increased with the age of the respondents. With respect to mentioned regrets, older people, women, and those living in the former East Germany were more likely to recall externally attributed events; younger participants, men, West Germans, and the Dutch recalled more internally attributed events. Largely, memories related to 4 major themes: (a) mistakes, behavior, and bad decisions in general; (b) hard times; (c) social relationships; and (d) missed educational opportunities. The importance of these themes, however, varied according to age, gender, and regional belonging. Differences in the kind of attribution and in the centrality of themes are discussed in terms of lifespan theory, death preparation, and cultural differences.

Age Factors↗

Regret in men treated for localized prostate cancer.

PURPOSE: We identify the predictors of medical regret in men treated for localized prostate cancer. MATERIALS AND METHODS: Patients previously treated for early stage prostate cancer were assessed for treatment regret using validated items. Univariate and multivariate analyses identified associations between regret and demographic characteristics, clinical outcomes, medical knowledge, and general and disease specific health related quality of life as measured by the general health perceptions domain of the RAND 36-Item Health Survey and a validated short form of the University of California, Los Angeles Prostate Cancer Index. RESULTS: Of 96 respondents (mean age 64 years, mean followup 2.8 years) 16% expressed regret with treatment decisions. Regretful men were almost twice as likely as nonregretful men to have less than a college education (60% versus 33%, p = 0.05) and worse current health related quality of life (p <0.05). In addition, regretful men tended to be unable to recall the most recent prostate specific antigen accurately (p = 0.06). Men with and without regret did not differ in other demographic characteristics, treatment choice or clinical outcomes. Regretful men were more likely to say they would choose a different treatment if they could. In multivariate analyses worse quality of life predicted regret but decline in quality of life with time was not associated with regret. CONCLUSIONS: Men expressing regret over treatment choice for localized prostate cancer have poorer health related quality of life. Further study is needed to identify factors that predict posttreatment regret. Such information will allow patients and physicians to individualize treatment decisions, optimize quality of life and avoid medical regret.

Aged↗

Avoidance of anticipated regret: the ordering of prostate-specific antigen tests.

OBJECTIVE: When making decisions, people are known to try to minimize the regret that would be provoked by unwanted consequences of these decisions. The authors explored the strength and determinants of such anticipated regret in a study of physicians' decisions to order prostate-specific antigen (PSA) tests. METHODS: 32 US and 33 French primary care physicians indicated the likelihood they would order a PSA for 32 hypothetical men presenting for routine physical exams. They then indicated how much regret they would feel if they found advanced prostate cancer in 12 other patients for whom they had chosen not to order PSAs several years before. The latter patients differed according to age (55, 65, or 75 years), a prior request or not for PSA testing, and no or some irregularity of the prostate on the earlier rectal exam. RESULTS: ANOVA found that regret was higher when the patient had requested a PSA, the prostate was irregular, and the patient was younger. Shape had less effect when the patient had requested a PSA. US physicians had more regret than the French, patient request had a greater impact on the Americans, and increasing patient age reduced regret more among the French. In a 1-way correlation, the regret score was associated with the likelihood of ordering PSAs for both the French (r = 0.64, P < 0.005) and the Americans (r = 0.42, P< 0.02). In a regression analysis too, the regret score was the most important predictor of the likelihood of ordering a PSA (beta = 0.37, P < 0.0001). CONCLUSIONS: Regret over failing to diagnose aggressive prostate cancer is associated with a policy of ordering PSAs. This regret appears to be culturally sensitive.

Aged↗

Are Actions Regretted More Than Inactions?

Several researchers have claimed that negative outcomes produce greater regret when they result from actions rather than from failures to act (Gleicher et al., 1990; Kahneman & Tversky, 1982; Landman, 1987). We investigated this claim by asking participants to write descriptions of strongly regretted events in their own lives and to rate the intensity of the regrets. Participants reported more inaction than action regrets, and, contrary to prior research findings, regrets produced by actions and inactions were equally intense. We conjecture that many factors that affect the content of real-life regrets are eliminated in studies of hypothetical regret. In real life, actions and inactions do not generally produce the same outcomes. Furthermore, actions and inactions may differ in how easily one can anticipate the potential for harm. Specifically, it is plausible that people control their actions to avoid potential regrets, leaving themselves vulnerable to regrets from inactions. Copyright 1999 Academic Press.

Journal Article↗

Poststerilization regret: findings from the United States Collaborative Review of Sterilization.

OBJECTIVE: To evaluate the cumulative probability of regret after tubal sterilization, and to identify risk factors for regret that are identifiable before sterilization. METHODS: We used a prospective, multicenter cohort study to evaluate the cumulative probability of regret within 14 years after tubal sterilization. Participants included 11,232 women aged 18-44 years who had tubal sterilizations between 1978 and 1987. Actuarial life tables and Cox proportional hazards models were used to identify those groups at greatest risk of experiencing regret. RESULTS: The cumulative probability of expressing regret during a follow-up interview within 14 years after tubal sterilization was 20.3% for women aged 30 or younger at the time of sterilization and 5.9% for women over age 30 at sterilization (adjusted relative risk [RR] 1.9; 95% confidence interval [CI] 1.6, 2.3). For the former group, the cumulative probability of regret was similar for women sterilized during the postpartum period (after cesarean, 20.3%, 95% CI 14.5, 26.0; after vaginal delivery, 23.7%, 95% CI 17.6, 29.8) and for women sterilized within 1 year after the birth of their youngest child (22.3%, 95% CI 16.4, 28.2). For women aged 30 or younger at sterilization, the cumulative probability of regret decreased as time since the birth of the youngest child increased (2-3 years, 16.2%, 95% CI 11.4, 21.0; 4-7 years, 11.3%, 95% CI 7.8, 14.8; 8 or more years, 8.3%, 95% CI 5.1, 11.4) and was lowest among women who had no previous births (6.3%, 95% CI 3.1, 9.4). CONCLUSION: Although most women expressed no regret after tubal sterilization, women 30 years of age and younger at the time of sterilization had an increased probability of expressing regret during follow-up interviews within 14 years after the procedure.

Actuarial Analysis↗

Regret among 547 Danish sterilized women.

To help identify potential regretters of female sterilization, the women sterilized at Frederiksborg County Hospital, Hørsholm, Denmark, from 1978 through 1982 were contacted by questionnaires, and their medical records were reviewed. Ninety-two per cent (547/594) responded. The median observation time was 50 months. Five per cent of the women (n = 28) regretted the sterilization. The risk of regretting the sterilization was significantly increased among women who at sterilization experienced marital disharmony (12.5% regretted), had a child less than one year old (14.7% regretted), had the sterilization performed in connection with another surgical procedure (16.1% regretted), were outside the social groupings (17.0% regretted), or had no paid work (10.0% regretted). No association between number of children at the time of sterilization, prior number of contraceptives used, abortion at sterilization, and later regret was found. Twenty-five per cent of the regretters had had psychiatric problems prior to the sterilization. The regretters were sterilized shortly after their request (median 1 month) compared to 3 months among non-regretters. The main reason for regret of sterilization was the desire for more children, independent of a change in marital status. Sequelae to the sterilization was a common complaint. Refertilization was requested by 1% of the sterilized women. The study suggests that the psychosocial situation should be carefully evaluated in women requesting sterilization. A time lag from request to the sterilization should be mandatory and a thorough pre-sterilization counseling including information about possible sequelae and alternative contraceptives should be given.

Adaptation, Psychological↗

Emotional Reactions to the Outcomes of Decisions: The Role of Counterfactual Thought in the Experience of Regret and Disappointment.

Regret and disappointment are emotions that can be experienced in response to an unfavorable outcome of a decision. Previous research suggests that both emotions are related to the process of counterfactual thinking. The present research extends this idea by combining it with ideas from regret and disappointment theory. The results show that regret is related to behavior-focused counterfactual thought in which the decision-maker's own actions are changed, whereas disappointment is related to situation-focused counterfactual thought in which aspects of the situation are changed. In Study 1 participants (N = 130) were asked to recall an autobiographical episode of either a regretful or a disappointing event. When asked to undo this event, regret participants predominantly changed their own actions, whereas disappointment participants predominantly changed aspects of the situation. In Study 2 all participants (N = 50) read a scenario in which a person experiences a negative event. Participants who were instructed to undo the event by changing the person's actions reported more regret than disappointment, while participants who were instructed to undo the event by changing aspects of the situation reported more disappointment than regret. Study 3 (N = 140) replicated the findings from Study 2 with a different scenario, and a design in which regret and disappointment were measured between rather than within subjects. In the discussion we address the relation among counterfactual thinking, attributions and affective reactions to decision outcomes, and the implications for decision research. Copyright 1998 Academic Press.

Journal Article↗

Looking forward to looking backward: the misprediction of regret.

Decisions are powerfully affected by anticipated regret, and people anticipate feeling more regret when they lose by a narrow margin than when they lose by a wide margin. But research suggests that people are remarkably good at avoiding self-blame, and hence they may be better at avoiding regret than they realize. Four studies measured people's anticipations and experiences of regret and self-blame. In Study 1, students overestimated how much more regret they would feel when they "nearly won" than when they "clearly lost" a contest. In Studies 2, 3a, and 3b, subway riders overestimated how much more regret and self-blame they would feel if they "nearly caught" their trains than if they "clearly missed" their trains. These results suggest that people are less susceptible to regret than they imagine, and that decision makers who pay to avoid future regrets may be buying emotional insurance that they do not actually need.

Adult↗

[Change in feelings of regret over time: relation to decision-making style, behavior, and coping methods].

This study investigated the change in feelings of regret over time in relation to decision-making style, critical thinking, behavior, and coping methods with the regret. Seventy undergraduate students completed a questionnaire on critical thinking, decision-making styles, feelings of regret and the coping methods in five different situations: entrance examinations, declarations of love, skiing, career changes, and investments. Results showed the following. First, in situations which normally occur only once (i.e., entrance examinations), subjects who indicated inaction felt increased regret over time, but those who indicated action felt decreased regret. Conversely, in situations which occur regularly (i.e., declarations of love and skiing), both of those who indicated action and inaction felt decreased regret. Second, people who indicated action coped with their regret using the method of rationalization more often than those who indicated inaction. In situations which normally occur only once, analytic decision-makers tended to cope with their regret by improving their behavior more than intuitive decision-makers. Finally, critical thinkers tended to adopt an analytic style more often than an intuitive style.

Adaptation, Psychological↗

Reconsidering the Relation between Regret and Responsibility.

Recently Connolly, Ordóñez, and Coughlan challenged the view that regret is partly determined by perceived responsibility for the regretted outcome [Connolly, T. Ordóñez, L. D., & Coughlan, R. (1997). Regret and responsibility in the evaluation of decision outcomes. Organizational Behavior and Human Decision Processes, 70, 73-85]. In a series of experiments they manipulated whether actors arrived at an outcome through their own decision or through a "computer assignment" over which they had no influence. This decision agency manipulation did not affect their "regret measure." We show in two experiments that this null-effect is due to the fact that regret was measured by means of a general happiness assessment. In the present research we replicated the basic design of their experiments and also found no effects of decision agency on the happiness assessment. However, the results showed the predicted effects of decision agency when regret was directly measured. Moreover, a measure of disappointment seemed to indicate the opposite effect: People are more disappointed when a negative outcome is caused by a computer assignment than when caused by their own choice. The role of regret and disappointment in decision making is discussed. Copyright 1998 Academic Press.

Journal Article↗

Testing the Compatibility Test: How Instructions, Accountability, and Anticipated Regret Affect Prechoice Screening of Options.

Subjects screened a set of jobs, retaining those for which they wished to apply and rejecting those that were no longer under consideration. In Experiment 1, subjects who indicated the jobs for which they would apply/not apply screened out fewer jobs than those with instructions to reject/not reject or those with instructions simply to screen (control). There were no differences between the reject and control conditions. Experiment 2 used a design similar to that of Experiment 1, but subjects were made accountable for their screening judgments. The reject-apply discrepancy remained, but the accountability manipulation made the subjects more stringent in their screening compared to those who were not accountable for their judgments. In Experiment 3, subjects were told to consider either the regret resulting from retaining a bad option (regret bad) or the regret from rejecting a good option (regret good). Subjects in the regret bad condition rejected more jobs than did subjects in the regret good condition, but not more than subjects in the control condition. As predicted by image theory, the normal screening process appears to be to screen out the bad options rather than screen in the good options. This is demonstrated by screening in the control condition being similar to screening under the reject instructions (Experiment 1) and under regret bad instructions (Experiment 3), since these conditions were shown to focus attention on the bad options. Copyright 1999 Academic Press.

Journal Article↗

Sexual regret in college students.

A questionnaire study was conducted to assess the relationship between sexual regret and sexual behaviors and demographic factors among 348 college-aged students prior to attending an educational program about sexual health issues. Analyses conducted on the portion of the sample who were sexually active (n = 270) indicated that the majority (71.9%, n = 194) has regretted their decision to engage in sexual activity at least once. The most cited reasons for regret by students included their sexual decision making as inconsistent with their morals (37%), an acknowledgment that alcohol influenced their decision (31.7%), the realization they did not want the same thing as their partner (27.9%), the lack of condom use (25.5%), feeling pressure by their partner (23.0%), and their desire to wait until marriage to have sex (15.4%). The only significant sex difference was that women reported regret due to feeling pressured by a partner more often than men. Multiple and logistic regression analyses indicated that the only significant predictor of regret regarding one's sexual decisions was the number of sexual partners. These results demonstrate the need for sexual educators to incorporate sexual regret into their curricula as the phenomenon of regret is more common than pregnancy and sexually transmitted diseases, the usual focus of sexuality education.

Adult↗

A comparison of women's regret after vasectomy versus tubal sterilization.

OBJECTIVE: To compare the 5-year cumulative probability of regret and risk factors for regret among women whose husbands underwent vasectomy with women after tubal sterilization. METHODS: A total of 525 women whose husbands underwent vasectomy were compared with 3672 women who underwent tubal sterilization in a prospective, multicenter, cohort study. RESULTS: The cumulative probability of a woman expressing regret within 5 years after her husband's vasectomy was 6.1% (95% confidence interval [CI] 3.6, 8.6), which was similar to the 5-year cumulative probability of regret among women after tubal sterilization (7.0%, 95% CI 5.8, 8.1). Women who reported substantial conflict with their husbands before vasectomy were more than 25 times more likely to request that their husband have a reversal than women who did not report such conflict (rate ratio 25.3, 95% CI 2.9, 217.2). Similarly, women who reported substantial conflict with their husbands or partners before tubal sterilization were more then three times as likely to regret their decision and more than five times as likely to request a reversal than women who did not report such conflict (rate ratio 3.1, 95% CI 1.4, 7.0, and rate ratio 5.4, 95% CI 1.6, 17.6, respectively). CONCLUSION: Most women did not express regret after their husband's vasectomy and the probability of regret was similar to sterilized women. However, when there was substantial conflict between a woman and her husband before vasectomy or tubal sterilization, the probability of subsequent request for reversal was increased.

Adolescent↗

Acceptable regret in medical decision making.

When faced with medical decisions involving uncertain outcomes, the principles of decision theory hold that we should select the option with the highest expected utility to maximize health over time. Whether a decision proves right or wrong can be learned only in retrospect, when it may become apparent that another course of action would have been preferable. This realization may bring a sense of loss, or regret. When anticipated regret is compelling, a decision maker may choose to violate expected utility theory to avoid regret. We formulate a concept of acceptable regret in medical decision making that explicitly introduces the patient's attitude toward loss of health due to a mistaken decision into decision making. In most cases, minimizing expected regret results in the same decision as maximizing expected utility. However, when acceptable regret is taken into consideration, the threshold probability below which we can comfortably withhold treatment is a function only of the net benefit of the treatment, and the threshold probability above which we can comfortably administer the treatment depends only on the magnitude of the risks associated with the therapy. By considering acceptable regret, we develop new conceptual relations that can help decide whether treatment should be withheld or administered, especially when the diagnosis is uncertain. This may be particularly beneficial in deciding what constitutes futile medical care.

Brain Ischemia↗

What we regret most... and why.

Which domains in life produce the greatest potential for regret, and what features of those life domains explain why? Using archival and laboratory evidence, the authors show that greater perceived opportunity within life domains evokes more intense regret. This pattern is consistent with previous publications demonstrating greater regret stemming from high rather than low opportunity or choice. A meta-analysis of 11 regret ranking studies revealed that the top six biggest regrets in life center on (in descending order) education, career, romance, parenting, the self, and leisure. Study Set 2 provided new laboratory evidence that directly linked the regret ranking to perceived opportunity. Study Set 3 ruled out an alternative interpretation involving framing effects. Overall, these findings show that people's biggest regrets are a reflection of where in life they see their largest opportunities; that is, where they see tangible prospects for change, growth, and renewal.

Cognitive Dissonance↗

Living with treatment decisions: regrets and quality of life among men treated for metastatic prostate cancer.

PURPOSE: To examine variation in men's long-term regret of treatment decisions, ie, surgical versus chemical castration, for metastatic prostate cancer and its associations with quality of life. METHODS: Survey of previously treated patients to assess treatment decisions and quality of life, supplemented with focus groups. Two items addressing whether a patient wished he could change his mind and the belief that he would have been better off with the treatment not chosen were combined in classifying survey respondents as either satisfied or regretful. Chi(2) and t tests were used to test associations between regret and treatment history, complications, and quality of life. RESULTS: Survey respondents included 201 men aged 45 to 93 years (median, 71 years), who had begun treatment (71% chemical castration, 29% orchiectomy) a median of 2 years previously. Most reported complications: hot flashes (70%), nausea (34%), and erectile dysfunction (81%). Most were satisfied with the treatment decision, but 23% expressed regret. Regretful men more frequently reported surgical (43%) versus chemical (36%) castration (P: = .030) and nausea in the past week (54% v 32%; P: = .010) but less frequently reported erectile dysfunction (56% v 72%; P: = .048). Regretful men indicated poorer scores on every measure of generic and prostate cancer-related quality of life. Qualitative analyses revealed substantial uncertainty about the progress of their disease and the quality of the decisions in which patients participated. CONCLUSION: Regret was substantial and associated with treatment choice and quality of life. It may derive from underlying psychosocial distress and problematic communication with physicians when decisions are being reached and over subsequent years.

Aged↗

Regret after decision to have a tubal sterilization.

To determine characteristics associated with regretting sterilization that can be determined preoperatively, we analyzed data from the Collaborative Review of Sterilization (CREST), a multicenter, prospective, observational study. Of 5022 women, 2.0% regretted having had a tubal sterilization at 1 year after the procedure and 2.7% did so after 2 years. Using a multivariate analysis to identify risk factors for regret, we found that almost all characteristics were more closely associated with regret at 1 year than at 2 years postoperatively. Of the characteristics we examined that could be objectively determined preoperatively, we considered only age less than 30 years and (for whites) a concurrent cesarean section to be risk factors for regret at 2 years after sterilization. However, in absolute terms, less than 10% of women with both those risk factors regretted having the procedure.

Adolescent↗