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Psychonomic Bulletin & Review Jun 2018The most widely used account of decision-making proposes that people choose between alternatives by accumulating evidence in favor of each alternative until this... (Review)
Review
The most widely used account of decision-making proposes that people choose between alternatives by accumulating evidence in favor of each alternative until this evidence reaches a decision boundary. It is frequently assumed that this decision boundary stays constant during a decision, depending on the evidence collected but not on time. Recent experimental and theoretical work has challenged this assumption, showing that constant decision boundaries are, in some circumstances, sub-optimal. We introduce a theoretical model that facilitates identification of the optimal decision boundaries under a wide range of conditions. Time-varying optimal decision boundaries for our model are a result only of uncertainty over the difficulty of each trial and do not require decision deadlines or costs associated with collecting evidence, as assumed by previous authors. Furthermore, the shape of optimal decision boundaries depends on the difficulties of different decisions. When some trials are very difficult, optimal boundaries decrease with time, but for tasks that only include a mixture of easy and medium difficulty trials, the optimal boundaries increase or stay constant. We also show how this simple model can be extended to more complex decision-making tasks such as when people have unequal priors or when they can choose to opt out of decisions. The theoretical model presented here provides an important framework to understand how, why, and whether decision boundaries should change over time in experiments on decision-making.
Topics: Decision Making; Humans; Models, Psychological; Reward; Time Factors
PubMed: 28730465
DOI: 10.3758/s13423-017-1340-6 -
Seminars in Nephrology Nov 2022Advance care planning, shared decision making, and serious illness conversations are communication processes designed to promote patient-centered care. In... (Review)
Review
Advance care planning, shared decision making, and serious illness conversations are communication processes designed to promote patient-centered care. In onconephrology, patients face a series of complex medical decisions regarding their care at the intersection of oncology and nephrology. Clinicians who aim to ensure that patient preferences and values are integrated into treatment planning must work within a similarly complex care team comprising multiple disciplines. In this review, we describe key decision points in a patient's care trajectory, as well as guidance on how and when to engage in advance care planning, shared decision making, and serious illness discussions. Further research on these processes in the complex context of onconephrology is needed.
Topics: Humans; Decision Making, Shared; Advance Care Planning; Patient Care Planning; Patient-Centered Care; Communication; Decision Making
PubMed: 37121171
DOI: 10.1016/j.semnephrol.2023.151349 -
Psychiatry Research. Neuroimaging Nov 2021The experience of doubt, the lack of confidence in one's perceptions, internal states, memory and attention, can be due to the variability in occurrence of a phenomenon...
The experience of doubt, the lack of confidence in one's perceptions, internal states, memory and attention, can be due to the variability in occurrence of a phenomenon or can be driven by the internal experience of uncertainty based on subjective evaluation of the environment. Although the experience of some doubt is adaptive in normal cognitive functioning, excessive doubt can significantly impair decision-making and in extreme cases give rise to psychopathology. Although neuroimaging studies have provided some insight into the network of brain areas that is engaged when decision-making involves uncertainty, it remains unclear if dysfunction in these areas also gives rise to the experience and pathological expression of doubt. This study examined the neural correlates of doubt using neuroimaging during the performance of a forced-choice perceptual decision-making task under varying levels of uncertainty in participants who reported either low or high doubt. Participants reporting high doubt exhibited increased activation in the bilateral inferior parietal lobule (IPL) during perceptual decision-making which was not observed in participants who reported low doubt. Furthermore, activity in the IPL in high doubt participants was associated with clinical measures of doubt and showed functional connectivity differences between the high and low doubt groups. The findings of the current study suggest a key role of the IPL and provide a network of brain regions that may play a role in the experience and expression of doubt.
Topics: Brain; Brain Mapping; Decision Making; Humans; Magnetic Resonance Imaging; Uncertainty
PubMed: 34464764
DOI: 10.1016/j.pscychresns.2021.111370 -
Health Affairs (Project Hope) Mar 2020
Topics: Decision Making; Decision Making, Shared; Humans; Patient Participation; Policy
PubMed: 32119606
DOI: 10.1377/hlthaff.2019.01783 -
Journal of Clinical Epidemiology Jan 2022To explore and characterize published evidence on the ways decision analysis has been used to inform shared decision-making. (Review)
Review
OBJECTIVE
To explore and characterize published evidence on the ways decision analysis has been used to inform shared decision-making.
STUDY DESIGN AND SETTING
For this scoping review, we searched five bibliographic databases (from inception until February 2021), reference lists of included studies, trial registries, a thesis database and websites of relevant interest groups. Studies were eligible if they evaluated the application of decision analysis in a shared decision-making encounter. Pairs of reviewers independently screened and selected studies for inclusion, extracted study information using a data extraction form developed by the research team and assessed risk of bias for all studies with an experimental or quasi-experimental design. Data were narratively synthesized.
RESULTS
We identified 27 studies that varied greatly with regard to their patient population, design, content and delivery. A range of outcomes were evaluated to explore the effectiveness and acceptability of decision analytic interventions, with little information about the implementation process. Most studies found that decision analysis was broadly beneficial.
CONCLUSION
Despite the compelling rationale on the potential for decision analysis to support shared decision-making, rigorous randomized controlled trials are needed to confirm these interventions' effectiveness, while qualitative studies should seek to understand their potential implementation.
Topics: Decision Making; Decision Making, Shared; Decision Support Techniques; Humans
PubMed: 34628018
DOI: 10.1016/j.jclinepi.2021.10.001 -
Trends in Neurosciences Feb 2022Suboptimal decision-making strategies have been proposed to contribute to the pathophysiology of addiction. Decision-making, however, arises from a collection of... (Review)
Review
Suboptimal decision-making strategies have been proposed to contribute to the pathophysiology of addiction. Decision-making, however, arises from a collection of computational components that can independently influence behavior. Disruptions in these different components can lead to decision-making deficits that appear similar behaviorally, but differ at the computational, and likely the neurobiological, level. Here, we discuss recent studies that have used computational approaches to investigate the decision-making processes underlying addiction. Studies in animal models have found that value updating following positive, but not negative, outcomes is predictive of drug use, whereas value updating following negative, but not positive, outcomes is disrupted following drug self-administration. We contextualize these findings with studies on the circuit and biological mechanisms of decision-making to develop a framework for revealing the biobehavioral mechanisms of addiction.
Topics: Animals; Behavior, Addictive; Decision Making; Humans; Reinforcement, Psychology; Substance-Related Disorders
PubMed: 34920884
DOI: 10.1016/j.tins.2021.11.007 -
Annals of the New York Academy of... Mar 2020Decision making is a fundamental cognitive function, which not only determines our day-to-day choices but also shapes the trajectories of our movements, our lives, and... (Review)
Review
Decision making is a fundamental cognitive function, which not only determines our day-to-day choices but also shapes the trajectories of our movements, our lives, and our societies. While immense progress has been made in recent years on our understanding of the mechanisms underlying decision making, research on this topic is still largely split into two halves. Good-based models largely state that decisions are made between representations of abstract value associated with available options; while action-based models largely state that decisions are made at the level of action representations. These models are further divided between those that state that a decision is made before an action is specified, and those that regard decision making as an evolving process that continues until movement completion. Here, we review computational models, behavioral findings, and results from neural recordings associated with these frameworks. In synthesizing this literature, we submit that decision making is best understood as a continuous, graded, and distributed process that traverses a landscape of behaviorally relevant options, from their presentation until movement completion. Identifying and understanding the intimate links between decision making and action processing has important implications for the study of complex, goal-directed behaviors such as social communication, and for elucidating the underlying mechanisms by which decisions are formed.
Topics: Cognition; Computer Simulation; Decision Making; Humans; Movement
PubMed: 30312476
DOI: 10.1111/nyas.13973 -
Cognitive Research: Principles and... Jul 2022The tendency to devaluate delayed rewards, a phenomenon referred to as 'discounting behaviour', has been studied by wide-ranging research examining individuals choosing...
The tendency to devaluate delayed rewards, a phenomenon referred to as 'discounting behaviour', has been studied by wide-ranging research examining individuals choosing between sooner but smaller or later but larger rewards. Despite the fact that many real-life choices are embedded in a social context, the question of whether or not social collaboration can have an impact on such choices has not been addressed empirically. With this research, we aimed to fill this gap experimentally by implementing a novel choice selection procedure in order to study the interactive dynamics between two participants. This selection procedure allowed us to dissect the sequence of decision-making into its elements, starting from the very first individual preference to the solution of possible conflicting preferences in the dyad. In Experiment 1, we studied group decision-making on classical intertemporal choices to reveal the possible benefit of social collaboration on discounting and identified that the knowledge of the social situation in collective decision-making causes a reduction in discounting. In a pre-registered Experiment 2, we compared classical intertemporal choices with choices in a gamified version of a discounting paradigm in which the participants had a real-time experience trial by trial and for which a normative reference was present. We found that collective decision-making had a substantial impact on intertemporal decision-making, but was shaped by different types of choices. Classical intertemporal choices were rather susceptible to the contextual factors of decision-making, whereas in the gamified version that included a normative reference the decisions were reliably influenced by social collaboration and resulted in a lower discounting. The results in this paradigm replicate our original findings from former research.
Topics: Decision Making; Delay Discounting; Humans; Reward; Social Environment; Time Factors
PubMed: 35900639
DOI: 10.1186/s41235-022-00422-5 -
The European Journal of Neuroscience Jan 2017Different cognitive impairments have been reported as a result of long-term MDMA/ecstasy use. Increased impulsivity and altered decision-making have been shown to be... (Review)
Review
Different cognitive impairments have been reported as a result of long-term MDMA/ecstasy use. Increased impulsivity and altered decision-making have been shown to be associated with the development and maintenance of addictive disorders pointing toward the necessity to understand a potential impairment of decision-making due to MDMA use. Thus, assessing the long-term effects of MDMA is crucial in order to evaluate its controversially discussed therapeutic use. The aim of this systematic review was to summarize the scientific literature on potential effects of chronic MDMA use on higher order decision-making processes in humans. Therefore, a systematic search for controlled trials relevant to the topic has been performed. Only studies using specific tasks on decision-making were included that involved subjects in the drug-free interval with drug-naïve, and/or polydrug control groups. A total of 12 studies could be identified that met the inclusion criteria, all of which were cross-sectional studies. The findings on decision-making disturbances in MDMA users were heterogeneous. Seven studies reported increased risky decisions, whereas five studies did not find MDMA-specific influences on decision-making. Increased impulsivity was observed both in MDMA groups and in (poly)drug control groups in almost all studies. Thus, the current state of research does not allow for the conclusion that long-term use of MDMA affects decision-making behavior in general. More detailed specifications as well as further investigations of the relevant processes are needed. Significant tendencies toward risky decision-making among long-term MDMA use have been observed, but need to be confirmed by studies using a longitudinal design.
Topics: Animals; Cognition Disorders; Decision Making; Humans; Memory Disorders; N-Methyl-3,4-methylenedioxyamphetamine; Neuropsychological Tests; Time
PubMed: 27859780
DOI: 10.1111/ejn.13480 -
Applied Neuropsychology. Child 2022Adaptive decision-making strategies are critical for dealing with the complexity of the social world. The present study investigated the use of decision-making...
Adaptive decision-making strategies are critical for dealing with the complexity of the social world. The present study investigated the use of decision-making strategies in preschoolers and their association to prosocial behavior and peer problems. Eighty-six preschoolers aged 3- and 4-years completed the preschool decision-making task (PGT), a child variant of the Iowa Gambling task . Win-stay/lose-shift responses along with exploration (consecutive choices from the advantageous deck) and exploitation (shifting between options) were examined. Preschoolers showed a range of strategies, with 4-year-olds adapting their approach as the game progressed and making better use of feedback in comparison to 3-year-olds. Children who differed in terms of choices from the advantageous deck were distinguished by different combinations of exploration and exploitation. Furthermore, unique combinations of decision-making strategies also distinguished children who were rated as high versus low in prosocial behavior as well as children rated as having a high versus low level of peer problems. The findings suggest that consideration of strategies used in decision-making tasks could provide useful insight in a clinical setting, particularly for populations with social difficulties.
Topics: Child; Child, Preschool; Decision Making; Gambling; Humans
PubMed: 34505556
DOI: 10.1080/21622965.2021.1973470