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ELife Dec 2023Perceptual decisions about sensory input are influenced by fluctuations in ongoing neural activity, most prominently driven by attention and neuromodulator systems. It...
Perceptual decisions about sensory input are influenced by fluctuations in ongoing neural activity, most prominently driven by attention and neuromodulator systems. It is currently unknown if neuromodulator activity and attention differentially modulate perceptual decision-making and/or whether neuromodulatory systems in fact control attentional processes. To investigate the effects of two distinct neuromodulatory systems and spatial attention on perceptual decisions, we pharmacologically elevated cholinergic (through donepezil) and catecholaminergic (through atomoxetine) levels in humans performing a visuo-spatial attention task, while we measured electroencephalography (EEG). Both attention and catecholaminergic enhancement improved decision-making at the behavioral and algorithmic level, as reflected in increased perceptual sensitivity and the modulation of the drift rate parameter derived from drift diffusion modeling. Univariate analyses of EEG data time-locked to the attentional cue, the target stimulus, and the motor response further revealed that attention and catecholaminergic enhancement both modulated pre-stimulus cortical excitability, cue- and stimulus-evoked sensory activity, as well as parietal evidence accumulation signals. Interestingly, we observed both similar, unique, and interactive effects of attention and catecholaminergic neuromodulation on these behavioral, algorithmic, and neural markers of the decision-making process. Thereby, this study reveals an intricate relationship between attentional and catecholaminergic systems and advances our understanding about how these systems jointly shape various stages of perceptual decision-making.
Topics: Humans; Attention; Electroencephalography; Donepezil; Atomoxetine Hydrochloride; Neurotransmitter Agents; Decision Making
PubMed: 38038722
DOI: 10.7554/eLife.87022 -
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 -
Hospital Pediatrics May 2022Our objective was to elicit clinicians' and parents' perspectives about decision-making related to hospitalization for children with bronchiolitis and the use of shared...
OBJECTIVES
Our objective was to elicit clinicians' and parents' perspectives about decision-making related to hospitalization for children with bronchiolitis and the use of shared decision-making (SDM) to guide these decisions.
METHODS
We conducted individual, semistructured interviews with purposively sampled clinicians (pediatric emergency medicine physicians and nurses) at 2 children's hospitals and parents of children age <2 years with bronchiolitis evaluated in the emergency department at 1 hospital. Interviews elicited clinicians' and parents' perspectives on decision-making and SDM for bronchiolitis. We conducted an inductive analysis following the principles of grounded theory until data saturation was reached for both groups.
RESULTS
We interviewed 24 clinicians (17 physicians, 7 nurses) and 20 parents. Clinicians identified factors in 3 domains that contribute to hospitalization decision-making for children with bronchiolitis: demographics, clinical factors, and social-emotional factors. Although many clinicians supported using SDM for hospitalization decisions, most reported using a clinician-guided decision-making process in practice. Clinicians also identified several barriers to SDM, including the unpredictable course of bronchiolitis, perceptions of parents' preferences for engaging in SDM, and parents' emotions, health literacy, preferred language, and comfort with discharge. Parents wanted the opportunity to express their opinions during decision-making about hospitalization, although they often felt comfortable with the clinician's decision when adequately informed.
CONCLUSIONS
Although clinicians and parents of children with bronchiolitis are supportive of SDM, most hospitalization decision-making is clinician guided. Future investigation should evaluate how to address barriers and implement SDM in practice, including training clinicians in this SDM approach.
Topics: Bronchiolitis; Child; Child, Preschool; Decision Making; Decision Making, Shared; Hospitalization; Humans; Patient Participation
PubMed: 35441213
DOI: 10.1542/hpeds.2021-006475 -
Dementia (London, England) Nov 2023Little is known about the decision-making processes around seeking more supportive care for dementia. Persons with dementia are often left out of decision-making...
Little is known about the decision-making processes around seeking more supportive care for dementia. Persons with dementia are often left out of decision-making regarding seeking more supportive care as their dementia progresses. This paper provides a description of findings from the Decision-making in Alzheimer's Research project (DMAR) investigating the process of decision-making about transitions to more supportive care. We conducted 61 qualitative interviews with two stakeholder groups: 24 persons with dementia, and 37 informal caregivers to explore supportive care decisions and associated decision-making factors from the perspectives of persons with dementia and their caregivers. We identified four main decisions that persons with dementia and their informal caregivers played a role in: (1) sharing household responsibilities; (2) limiting routine daily activities; (3) bringing in formal support; and (4) moving to a care facility. Based on our findings we developed a schematized roadmap of decision-making that we used to guide the discussion of our findings. Four crosscutting themes emerged from our analysis: unknowns and uncertainties, maintaining life as you know it, there's no place like home and resource constraints. These results will be incorporated into the development of instruments whose goal is to identify preferences of persons with dementia and their caregivers, in order to include persons with dementia in care decisions even as their dementia progresses.
Topics: Humans; Decision Making; Caregivers; Dementia; Uncertainty
PubMed: 37656956
DOI: 10.1177/14713012231193139 -
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 -
Animal Cognition Sep 2021When choosing among multi-attribute options, integrating the full information may be computationally costly and time-consuming. So-called non-compensatory decision rules...
When choosing among multi-attribute options, integrating the full information may be computationally costly and time-consuming. So-called non-compensatory decision rules only rely on partial information, for example when a difference on a single attribute overrides all others. Such rules may be ecologically more advantageous, despite being economically suboptimal. Here, we present a study that investigates to what extent animals rely on integrative rules (using the full information) versus non-compensatory rules when choosing where to forage. Groups of mice were trained to obtain water from dispensers varying along two reward dimensions: volume and probability. The mice's choices over the course of the experiment suggested an initial reliance on integrative rules, later displaced by a sequential rule, in which volume was evaluated before probability. Our results also demonstrate that while the evaluation of probability differences may depend on the reward volumes, the evaluation of volume differences is seemingly unaffected by the reward probabilities.
Topics: Animals; Choice Behavior; Decision Making; Mice; Probability; Reward
PubMed: 33721139
DOI: 10.1007/s10071-021-01482-8 -
Developmental Cognitive Neuroscience Aug 2023Human behavior is supported by both goal-directed (model-based) and habitual (model-free) decision-making, each differing in its flexibility, accuracy, and computational...
Human behavior is supported by both goal-directed (model-based) and habitual (model-free) decision-making, each differing in its flexibility, accuracy, and computational cost. The arbitration between habitual and goal-directed systems is thought to be regulated by a process known as metacontrol. However, how these systems emerge and develop remains poorly understood. Recently, we found that while children between 5 and 11 years displayed robust signatures of model-based decision-making, which increased during this developmental period, there were substantial individual differences in the display of metacontrol. Here, we inspect the neurocognitive basis of model-based decision-making and metacontrol in childhood and focus this investigation on executive functions, fluid reasoning, and brain structure. A total of 69 participants between the ages of 6-13 completed a two-step decision-making task and an extensive behavioral test battery. A subset of 44 participants also completed a structural magnetic resonance imaging scan. We find that individual differences in metacontrol are specifically associated with performance on an inhibition task and individual differences in thickness of dorsolateral prefrontal, temporal, and superior-parietal cortices. These brain regions likely reflect the involvement of cognitive processes crucial to metacontrol, such as cognitive control and contextual processing.
Topics: Child; Humans; Adolescent; Decision Making; Brain; Executive Function; Motivation; Parietal Lobe
PubMed: 37352654
DOI: 10.1016/j.dcn.2023.101269 -
Scientific Reports Feb 2022For a certain kind of decision event, the decision maker does not know the internal mechanism and knowledge information of the decision events.When this kind of decision...
For a certain kind of decision event, the decision maker does not know the internal mechanism and knowledge information of the decision events.When this kind of decision events gives multiple selection branches, it is found that there is a decision psychological tendency to find the most common features by comparing the selection branches. Based on this, a zero-knowledge decision making (ZKDM) method is proposed. By defining the feature points and feature sets of the selection branches of the decision events, the characteristic moments of the system are constructed and the branch with the most common characteristics is obtained. It is observed that through the findings of investigation the probability of arriving at the correct choice based on the ZKDM method is high. The effectiveness of the ZKDM method may be related to the fact that the designers of decision events usually determine the correct selection branch first, before changing it to design other branches. A questionnaire survey of 279 respondents reveals that more than half of them actually adopt such a design idea. Furthermore, a separate questionnaire survey of 465 decision-makers reveal that 19.14% of the respondents clearly adopt ZKDM.
Topics: Choice Behavior; Decision Making; Humans; Intuition; Knowledge; Psychophysics; Surveys and Questionnaires
PubMed: 35210448
DOI: 10.1038/s41598-022-06753-z -
American Journal of Surgery Apr 2023With the COVID19 pandemic, use of telehealth has expanded rapidly in subspecialties with limited prior telehealth experience. While telehealth offers many opportunities... (Review)
Review
With the COVID19 pandemic, use of telehealth has expanded rapidly in subspecialties with limited prior telehealth experience. While telehealth offers many opportunities to improve patient convenience, access, and comfort, the virtual platform poses unique challenges for shared decision making. In this review article, we describe what occurs within a standard in-person breast surgery consult and propose a model for an ideal virtual breast surgery consult, including strategies to foster patient engagement and shared decision making. Our model incorporates pre-visit preparation, deliberate pauses, and targeted engagement as ways to encourage patients to integrate information and actively participate in treatment decisions. Intentional strategies such as these must be adopted to improve shared decision making on the virtual platform.
Topics: Humans; Female; Breast Neoplasms; Decision Making, Shared; Decision Making; COVID-19; Referral and Consultation
PubMed: 38577977
DOI: 10.1016/j.amjsurg.2022.10.014 -
Zeitschrift Fur Evidenz, Fortbildung... Jun 2022Shared decision making has been on the policy agenda in the UK for at least twelve years, but it lacked a comprehensive approach to delivery. That has changed over the...
Shared decision making has been on the policy agenda in the UK for at least twelve years, but it lacked a comprehensive approach to delivery. That has changed over the past five years, and we can now see significant progress across all aspects of a comprehensive approach, including leadership at policy, professional and patient levels; infrastructure developments, including the provision of training, tools and campaigns; and practice improvements, such as demonstrations, measurement and coordination. All these initiatives were necessary, but the last, central coordination, would appear to be key to success.
Topics: Decision Making; Decision Making, Shared; Germany; Humans; Patient Participation; United Kingdom
PubMed: 35610131
DOI: 10.1016/j.zefq.2022.04.024