Testing three coping strategies for time pressure in categorizations and similarity judgments.

This article compares three psychological mechanisms to make multi-attribute inferences under time pressure in the domains of categorization and similarity judgments. Specifically, we test if people under time pressure attend to fewer object features (attention focus), if they respond less precisely (lower choice sensitivity), or if they simplify a psychological similarity function (simplified similarity). The simpler psychological similarity considers the number of matching features but ignores the actual feature value differences. We conducted three experiments (two of them preregistered) in which we manipulated time pressure: one was a categorization task, which was designed based on optimal experimental design principles, and the other two involved a similarity judgment task. Computational cognitive modeling following an exemplar-similarity framework showed that the behavior of most participants under time pressure is in line with a lower choice sensitivity, this means less precise response selection, especially when people make similarity judgments. We find that the variability of participants' behavior increases with time pressure, to a point where participants are unlikely to make inferences anymore but instead start choosing readily available response options repeatedly. These findings are consistent with related research in other cognitive domains, such as risky choices, and add to growing evidence that time pressure and other forms of cognitive load do not necessarily alter core cognitive processes themselves but rather affect the precision of response selection.

Physiotherapy and combined cognitive-behavioural therapy for patients with chronic pelvic pain syndrome: results of a non-randomised controlled feasibility trial.

OBJECTIVE: To explore feasibility in terms of delivering and evaluating a combination of physiotherapy and psychotherapy for patients with chronic pelvic pain syndrome (CPPS). DESIGN: Prospective non-randomised controlled pilot study. SETTING: Tertiary care facility with a specialised interdisciplinary outpatient clinic for patients with CPPS. PARTICIPANTS: A total of 311 patients was approached; 60 participated. 36 patients were included in the intervention group (mean age ±SD 48.6 years±14.8; 52.8% female) and 24 in the control group (mean age ±SD 50.6 years±14.5; 58.3% female). Fourteen participants were lost to follow-up. INTERVENTIONS: Participants were non-randomly allocated to the intervention group with two consecutive treatment modules (physiotherapy and cognitive behavioural therapy) with a duration of 9 weeks each or to the control group (treatment as usual). MAIN OUTCOME MEASURES: Feasibility was operationalised in terms of delivering and evaluating the therapeutic combination. Regarding eligibility as the first aspect of feasibility, willingness to participate, dropout and satisfaction were assessed; for the second aspect, standardised self-report questionnaires measuring health-related quality of life, depression severity and pain were applied. RESULTS: Although eligibility and willingness-to-participate rates were low, satisfaction of the participants in the intervention group was high and dropout rates were low. Results indicated a small and non-significant intervention effect in health-related quality of life and significant effects regarding depression severity and pain. CONCLUSIONS: The combination of physiotherapy and psychotherapy for patients with CPPS seems to be feasible and potentially promising with regard to effect. However, a subsequent fully powered randomised controlled trial is needed. TRIAL REGISTRATION NUMBER: German Clinical Trials Register (DRKS00009976) and ISRCTN (ISRCTN43221600).

The similarity-updating model of probability judgment and belief revision.

People often take nondiagnostic information into account when revising their beliefs. A probability judgment decreases due to nondiagnostic information represents the well-established "dilution effect" observed in many domains. Surprisingly, the opposite of the dilution effect called the "confirmation effect" has also been observed frequently. The present work provides a unified cognitive model that allows both effects to be explained simultaneously. The suggested similarity-updating model incorporates two psychological components: first, a similarity-based judgment inspired by categorization research, and second, a weighting-and-adding process with an adjustment following a similarity-based confirmation mechanism. Four experimental studies demonstrate the model's predictive accuracy for probability judgments and belief revision. The participants received a sample of information from one of two options and had to judge from which option the information came. The similarity-updating model predicts that the probability judgment is a function of the similarity of the sample to the options. When one is presented with a new sample, the previous probability judgment is updated with a second probability judgment by taking a weighted average of the two and adjusting the result according to a similarity-based confirmation. The model describes people's probability judgments well and outcompetes a Bayesian cognitive model and an alternative probability-theory-plus-noise model. The similarity-updating model accounts for several qualitative findings, namely, dilution effects, confirmation effects, order effects, and the finding that probability judgments are invariant to sample size. In sum, the similarity-updating model provides a plausible account of human probability judgment and belief revision. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Competitive retrieval strategy causes multimodal response distributions in multiple-cue judgments.

Research on quantitative judgments from multiple cues suggests that judgments are simultaneously influenced by previously abstracted knowledge about cue-criterion relations and memories of past instances (or exemplars). Yet extant judgment theories leave 2 questions unanswered: (a) How are past exemplars and abstracted cue knowledge combined to form a judgment? (b) Are all past exemplars retrieved from memory to form the judgment (integrative retrieval) or is the judgment based on one exemplar (competitive retrieval)? To address these questions we propose and test a new model, CX-COM (combining Cue abstraction with eXemplar memory assuming COMpetitive memory retrieval). In a first step, CX-COM recalls only a single exemplar from memory. In a second step, the initially retrieved judgment is adjusted based on abstracted cue knowledge. Qualitatively, we show that CX-COM naturally captures judgment patterns that have been previously attributed to multiple strategies. Next, we tested CX-COM quantitatively in 2 experiments and found that it accounts well for people's judgment behavior. In the second experiment we additionally tested 2 qualitative predictions of CX-COM: The existence of multimodal response distributions within participants and systematic variability in judgments depending on the distance between similar exemplars in memory. The empirical results confirm CX-COM's assumptions. In sum, the evidence suggests that CX-COM is a viable new model for quantitative judgments and shows the importance of considering judgment variability in addition to average responses in judgment research. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Somatic and psychosocial determinants of symptom severity and quality of life in male and female patients with chronic pelvic pain syndrome.

AIMS: To investigate the combined impact of somatic and psychosocial factors on symptom severity and physical and mental quality of life (QoL) in male and female patients with chronic pelvic pain syndrome (CPPS). METHODS: We examined 234 patients aged 18 to 84 years attending an interdisciplinary outpatient clinic for patients with CPPS in Hamburg, Germany. Using self-reports, we assessed CPPS symptom severity (NIH-CPSI), with the female counterpart of each male anatomical site used in the questionnaire for women; physical and mental QoL (SF-12) as well as symptoms of depression (PHQ-9) and anxiety (GAD-7); pain catastrophizing cognitions (PCS); social support (F-SozU) and medication intake. The presence of trigger and tender points was assessed in a physiotherapy examination. Hierarchical multiple regression analysis was calculated to analyze the contribution of somatic and psychosocial variables on CPPS symptom severity. Analyses were repeated with physical and mental QoL as outcomes. RESULTS: In the overall model, the intake of pain medication (B = 3.78, SE = 1.25, p = .006), the presence of depressive symptoms (B = 0.40, SE = 0.15, p = .01) and pain catastrophizing (B = 0.18, SE = 0.05, p = .001) significantly predicted CPPS symptom severity. Corresponding analyses revealed a differential pattern of factors predicting physical and mental QoL, whereas higher levels of depressive symptoms were consistently associated with diminished mental (B = -0.63; p < .001) and physical QoL (B = -0.85; p < .001). CONCLUSION: Present results emphasize the importance of psychosocial factors, in particular of depression, in CPPS symptom severity and both physical and mental QoL and give support to an integrated treatment concept encompassing both psychological support and somatic aspects of the disease.

Mental disorders in patients with chronic pelvic pain syndrome (CPPS).

OBJECTIVE: Chronic pelvic pain syndrome (CPPS) is a debilitating pain condition with prevalence rates between 2.0% and 26.6%. Studies indicate that CPPS is often associated with psychosocial factors, but little is known about the presence of full-blown mental disorders in female and male patients with CPPS. Therefore, the aim of this study was to investigate the frequencies of mental disorders in patients with CPPS. METHODS: Cross-sectional data were collected from patients visiting a specialized outpatient clinic. Frequencies of mental disorders were investigated using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and compared to the general population. Furthermore, self-rating questionnaires were used to assess somatic symptom severity (PHQ-15), depression severity (PHQ-9) and anxiety severity (GAD-7). RESULTS: Data from 178 CPPS patients (60.1% female; age M=49.1, SD=18.0) were analyzed. Of the total sample, 95.2% (95% CI 90.8-97.9) suffered from at least one mental disorder. The most prevalent mental disorders were somatoform disorders (91.7%; 95% CI 86.4-95.4), followed by mood disorders (50.6%; 95% CI 42.8-58.4) and anxiety disorders (32.1%; 95% CI 25.2-39.8). The self-reported symptom burden was also significantly higher than in the general population. Compared to men, women met the diagnoses of somatoform (p=0.012) and anxiety disorders (p=0.027) significantly more often and reported a significantly higher total somatic symptom severity (p=0.001). CONCLUSION: Our results provide evidence for a clinically relevant psychosocial symptom burden in patients with CPPS, indicating the need for the examination of psychopathologies and multi-professional treatment for this patient group.

[Chronic Pelvic Pain Syndrome and Personality--Association of Somatic Symptoms and Psychic Structure]. / Chronische Unterbauchschmerzen und Persönlichkeit - Zusammenhänge zwischen körperlichen Beschwerden und psychischer Struktur.

BACKGROUND: Despite its high prevalence, little is known about the aetiology and maintenance of Chronic Pelvic Pain Syndrome (CPPS). CPPS is is considered to be a multi-causal syndrome with discomfort and pain in the pelvis. Recent literature suggests that psychosocial factors are important for understanding CPPS. For example, CPPS has been associated with deficits in mentalization and bonding experiences. Our study aims to characterize features of personality disorders according to DSM-IV and psychic structure according to OPD-2 in CPPS patients. Furthermore, we examine the association of personality aspects with urological symptoms (NIH Questionnaire) and pain perception (MPQ Questionnaire). MATERIALS & METHODS: Personality aspects were assessed in a total of 109 patients from our CPPS outpatient clinic using standardized questionnaires. To characterize CPPS patients, we compared the sample's scores with reference groups, mostly the general population. In addition, the associations between personality aspects and both the urologic symptoms and pain perception were assessed using correlations. Missing data were replaced using multiple imputation methods. RESULTS: Compared to reference values, we found 'experiencing emotions' and 'creating relationships' as specific deficits in CPPS patients. Furthermore, patients' self-image (more dominant, higher depressive mood) differs from the general population. A higher pain perception was correlated with deficits in most personality aspects we measured. However, this was not the case for the severity of urological symptoms. DISCUSSION & CONCLUSION: Compared to the reference values, only a few personality aspects differed in CPPS patients but there was a correlational association between different personality traits and pain perception. Despite the extend of symptoms, pain perception is associated with difficulty (emotional ability) in dealing with emotions, self-management and relationships. These personality aspects should be taken into account when planning therapy.