Do Misconceptions About Health-Related Quality of Life Affect General Population Valuations of Health States?

OBJECTIVES: Healthcare resource allocation decisions are often informed by the expected gains in patients' quality-adjusted life-years. Misconceptions about ill-health's consequences for quality of life (QOL) may however affect evaluations of health states by the general population and hence affect resource allocation decisions informed by quality-adjusted life-years. We examine whether people selectively misestimate the QOL consequences of moderate anxiety or depression compared with other dimensions of health, and we test whether informing people of actual changes in QOL associated with health states changes appraisals of their relative undesirability. METHODS: UK general population participants (N = 1259; in 2017) expressed preferences over moderate problems: anxiety or depression, self-care, and pain or discomfort. A randomized control trial design was used whereby a control group was given a functional description of each health state, and 2 intervention groups were additionally given information on the actual differences in either life satisfaction (LS) or day affect (DA) associated with experiencing each health state. RESULTS: The LS (DA) group reported a higher preference for avoiding living with moderate anxiety or depression, being 13.4% (13.9%) more likely to choose it as most undesirable. CONCLUSION: Informing people of the change in LS or DA associated with health states before they appraise them is a feasible way to obtain informed preferences.

A rank based social norms model of how people judge their levels of drunkenness whilst intoxicated.

BACKGROUND: A rank based social norms model predicts that drinkers' judgements about their drinking will be based on the rank of their breath alcohol level amongst that of others in the immediate environment, rather than their actual breath alcohol level, with lower relative rank associated with greater feelings of safety. This study tested this hypothesis and examined how people judge their levels of drunkenness and the health consequences of their drinking whilst they are intoxicated in social drinking environments. METHODS: Breath alcohol testing of 1,862 people (mean age = 26.96 years; 61.86 % male) in drinking environments. A subset (N = 400) also answered four questions asking about their perceptions of their drunkenness and the health consequences of their drinking (plus background measures). RESULTS: Perceptions of drunkenness and the health consequences of drinking were regressed on: (a) breath alcohol level, (b) the rank of the breath alcohol level amongst that of others in the same environment, and (c) covariates. Only rank of breath alcohol level predicted perceptions: How drunk they felt (b 3.78, 95 % CI 1.69 5.87), how extreme they regarded their drinking that night (b 3.7, 95 % CI 1.3 6.20), how at risk their long-term health was due to their current level of drinking (b 4.1, 95 % CI 0.2 8.0) and how likely they felt they would experience liver cirrhosis (b 4.8. 95 % CI 0.7 8.8). People were more influenced by more sober others than by more drunk others. CONCLUSION: Whilst intoxicated and in drinking environments, people base judgements regarding their drinking on how their level of intoxication ranks relative to that of others of the same gender around them, not on their actual levels of intoxication. Thus, when in the company of others who are intoxicated, drinkers were found to be more likely to underestimate their own level of drinking, drunkenness and associated risks. The implications of these results, for example that increasing the numbers of sober people in night time environments could improve subjective assessments of drunkenness, are discussed.

Being paid relatively well most of the time: Negatively skewed payments are more satisfying.

How does the structure of a series of payments influence its recipient's satisfaction? A common hypothesis is that each payment will be compared with a single "standard" or "reference" payment (e.g., the average payment). Cognitive models of judgment such as range frequency theory predict in contrast that the entire payment distribution will influence evaluation of each individual payment. Two experiments examined satisfaction with a series of payments. In both experiments, most payments were either relatively high in the experienced distribution (the distribution was negatively skewed) or relatively low (positively skewed). The total and average payment was held constant. Experiment 1 found that average satisfaction with individual payments was higher when the payments were negatively skewed, consistent with range frequency theory, and earlier findings were extended by comparing range frequency theory with a range-based model, a rank-based model, and a reference point model at the individual level. Experiment 2 examined satisfaction with whole sequences of payments and found that receiving a negatively skewed sequence was more satisfying overall than receiving a positively skewed sequence. It is concluded that negatively skewed payment distributions are more satisfying, as predicted by cognitive models of judgment.

Income inequality and status seeking: searching for positional goods in unequal U.S. States.

It is well established that income inequality is associated with lower societal well-being, but the psychosocial causes of this relationship are poorly understood. A social-rank hypothesis predicts that members of unequal societies are likely to devote more of their resources to status-seeking behaviors such as acquiring positional goods. We used Google Correlate to find search terms that correlated with our measure of income inequality, and we controlled for income and other socioeconomic factors. We found that of the 40 search terms used more frequently in states with greater income inequality, more than 70% were classified as referring to status goods (e.g., designer brands, expensive jewelry, and luxury clothing). In contrast, 0% of the 40 search terms used more frequently in states with less income inequality were classified as referring to status goods. Finally, we showed how residual-based analysis offers a new methodology for using Google Correlate to provide insights into societal attitudes and motivations while avoiding confounds and high risks of spurious correlations.

Serotonin and social norms: tryptophan depletion impairs social comparison and leads to resource depletion in a multiplayer harvesting game.

How do people sustain resources for the benefit of individuals and communities and avoid the tragedy of the commons, in which shared resources become exhausted? In the present study, we examined the role of serotonin activity and social norms in the management of depletable resources. Healthy adults, alongside social partners, completed a multiplayer resource-dilemma game in which they repeatedly harvested from a partially replenishable monetary resource. Dietary tryptophan depletion, leading to reduced serotonin activity, was associated with aggressive harvesting strategies and disrupted use of the social norms given by distributions of other players' harvests. Tryptophan-depleted participants more frequently exhausted the resource completely and also accumulated fewer rewards than participants who were not tryptophan depleted. Our findings show that rank-based social comparisons are crucial to the management of depletable resources, and that serotonin mediates responses to social norms.

Money, well-being, and loss aversion: does an income loss have a greater effect on well-being than an equivalent income gain?

Higher income is associated with greater well-being, but do income gains and losses affect well-being differently? Loss aversion, whereby losses loom larger than gains, is typically examined in relation to decisions about anticipated outcomes. Here, using subjective-well-being data from Germany (N = 28,723) and the United Kingdom (N = 20,570), we found that losses in income have a larger effect on well-being than equivalent income gains and that this effect is not explained by diminishing marginal benefits of income to well-being. Our findings show that loss aversion applies to experienced losses, challenging suggestions that loss aversion is only an affective-forecasting error. By failing to account for loss aversion, longitudinal studies of the relationship between income and well-being may have overestimated the positive effect of income on well-being. Moreover, societal well-being might best be served by small and stable income increases, even if such stability impairs long-term income growth.

Incomparability and Incommensurability in Choice: No Common Currency of Value?

Models of decision-making typically assume the existence of some common currency of value, such as utility, happiness, or inclusive fitness. This common currency is taken to allow comparison of options and to underpin everyday choice. Here we suggest instead that there is no universal value scale, that incommensurable values pervade everyday choice, and hence that most existing models of decision-making in both economics and psychology are fundamentally limited. We propose that choice objects can be compared only with reference to specific but nonuniversal "covering values." These covering values may reflect decision-makers' goals, motivations, or current states. A complete model of choice must accommodate the range of possible covering values. We show that abandoning the common-currency assumption in models of judgment and decision-making necessitates rank-based and "simple heuristics" models that contrast radically with conventional utility-based approaches. We note that if there is no universal value scale, then Arrow's impossibility theorem places severe bounds on the rationality of individual decision-making and hence that there is a deep link between the incommensurability of value, inconsistencies in human decision-making, and rank-based coding of value. More generally, incommensurability raises the question of whether it will ever be possible to develop single-quantity-maximizing models of decision-making.

The role of episodic memory sampling in evaluation.

Many models of choice assume that people retrieve memories of past experiences and use them to guide evaluation and choice. In this paper, we examine whether samples of recalled past experiences do indeed underpin our evaluations of options. We showed participants sequences of numerical values and asked them to recall as many of those values as possible and also to state how much they would be willing to pay for another draw from the sequence. Using Bayesian mixed effects modeling, we predicted participants' evaluation of the sequences at the group level from either the average of the values they recalled or the average of the values they saw. Contrary to the predictions of recall-based models, people's evaluations appear to be sensitive to information beyond what was actually recalled. Moreover, we did not find consistent evidence that memory for specific items is sufficient to predict evaluation of sequences. We discuss the implications for sampling models of memory and decision-making and alternative explanations.

Political Attitudes and Disease Threat: Regional Pathogen Stress Is Associated With Conservative Ideology Only for Older Individuals.

What environmental factors are associated with individual differences in political ideology, and do such associations change over time? We examine whether reductions in pathogen prevalence in U.S. states over the past 60 years are associated with reduced associations between parasite stress and conservatism. We report a positive association between infection levels and conservative ideology in the United States during the 1960s and 1970s. However, this correlation reduces from the 1980s onwards. These results suggest that the ecological influence of infectious diseases may be larger for older people who grew up (or whose parents grew up) during earlier time periods. We test this hypothesis by analyzing the political affiliation of 45,000 Facebook users, and find a positive association between self-reported political affiliation and regional pathogen stress for older (>40 years) but not younger individuals. It is concluded that the influence of environmental pathogen stress on ideology may have reduced over time.

Social norm influences on evaluations of the risks associated with alcohol consumption: applying the rank-based decision by sampling model to health judgments.

AIMS: The research first tested whether perceptions of other people's alcohol consumption influenced drinkers' perceptions of the riskiness of their own consumption. Second, the research tested how such comparisons are made-whether, for example, people compare their drinking to the 'average' drinker's or 'rank' their consumption amongst other people's. The latter untested possibility, suggested by the recent Decision by Sampling Model of judgment, would imply different cognitive mechanisms and suggest that information should be presented differently to people in social norm interventions. METHODS: Study 1 surveyed students who provided information on (a) their own drinking, (b) their perceptions of the distribution of drinking in the UK and (c) their perceived risk of various alcohol-related disorders. Study 2 experimentally manipulated the rank of 'target' units of alcohol within the context of units viewed simultaneously. RESULTS: In both studies, the rank of an individual's drinking in a context of other drinkers predicted perceptions of developing alcohol-related disorders. There was no evidence for the alternative hypothesis that people compared with the average of other drinkers' consumptions. The position that subjects believed they occupied in the ranking of other drinkers predicted their perceived risk, and did so as strongly as how much they actually drank. CONCLUSIONS: Drinking comparisons are rank-based, which is consistent with other judgments in social, emotional and psychophysical domains. Interventions should be designed to work with people's natural ways of information processing, through providing clients with information on their drinking rank rather than how their drinking differs from the average.

How are personality judgments made? A cognitive model of reference group effects, personality scale responses, and behavioral reactions.

This article suggests that personality judgments are wholly relative, being the outcome of a comparison of a given individual to a reference group of others. The underlying comparison processes are the same as those used to judge psychophysical stimuli (as outlined by range frequency theory and decision by sampling accounts). Five experimental studies show that the same person's personality is rated differently depending on how his or her behavior (a) ranks within a reference group and (b) falls within the overall range of behavior shown by other reference group members. Results were invariant across stimulus type and response options (7-point Likert scale, 990-point allocation task, or dichotomous choice). Simulated occupational scenarios led participants to give different-sized bonuses and employ different people as a function of context. Future research should note that personality judgments (as in self-report personality scales) only represent perceived standing relative to others or alternatively should measure personality through behavior or biological reactivity. Personality judgments cannot be used to compare different populations when the population participants have different reference groups (as in cross-cultural research).

Contextual effects on the perceived health benefits of exercise: the exercise rank hypothesis.

Many accounts of social influences on exercise participation describe how people compare their behaviors to those of others. We develop and test a novel hypothesis, the exercise rank hypothesis, of how this comparison can occur. The exercise rank hypothesis, derived from evolutionary theory and the decision by sampling model of judgment, suggests that individuals' perceptions of the health benefits of exercise are influenced by how individuals believe the amount of exercise ranks in comparison with other people's amounts of exercise. Study 1 demonstrated that individuals' perceptions of the health benefits of their own current exercise amounts were as predicted by the exercise rank hypothesis. Study 2 demonstrated that the perceptions of the health benefits of an amount of exercise can be manipulated by experimentally changing the ranked position of the amount within a comparison context. The discussion focuses on how social norm-based interventions could benefit from using rank information.

Social sampling and expressed attitudes: Authenticity preference and social extremeness aversion lead to social norm effects and polarization.

A cognitive model of social influence (Social Sampling Theory [SST]) is developed and applied to several social network phenomena including polarization and contagion effects. Social norms and individuals' private attitudes are represented as distributions rather than the single points used in most models. SST is explored using agent-based modeling to link individual-level and network-level effects. People are assumed to observe the behavior of their social network neighbors and thereby infer the social distribution of particular attitudes and behaviors. It is assumed that (a) people dislike behaving in ways that are extreme within their neighborhood social norm (social extremeness aversion assumption), and hence tend to conform and (b) people prefer to behave consistently with their own underlying attitudes (authenticity preference assumption) hence minimizing dissonance. Expressed attitudes and behavior reflect a utility-maximizing compromise between these opposing principles. SST is applied to a number of social phenomena including (a) homophily and the development of segregated neighborhoods, (b) polarization, (c) effects of norm homogeneity on social conformity, (d) pluralistic ignorance and false consensus effects, (e) backfire effects, (f) interactions between world view and social norm effects, and (g) the opposing effects on subjective well-being of authentic behavior and high levels of social comparison. More generally, it is argued that explanations of social comparison require the variance, not just the central tendency, of both attitudes and beliefs about social norms to be accommodated. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Rank-based alternatives to mean-based ensemble models of satisfaction with earnings: Comment on Putnam-Farr and Morewedge (2020).

How much satisfaction do we derive from a new salary or from receiving a bonus payment in an experiment? People do not judge monetary amounts in isolation but compare them to other amounts-judgments are context sensitive. A key question is, however, how context affects judgment. Across eight experiments, Putnam-Farr and Morewedge (2020) showed that people's self-reported satisfaction with a sum of money is predicted by the difference between that amount and the highest or lowest amount received by others. The authors found no evidence that people's judgments are sensitive to the ranked position of a monetary amount among other rewards. Putnam-Farr and Morewedge explained their results with reference to the ensemble representation literature, which shows that people can accurately estimate summary statistics, such as the maximum or mean, of stimulus distributions. In this commentary, we argue that their proposed interpretation is inconsistent with extensive theoretical and empirical research showing that judgments of stimuli reflect the relative ranked position of those stimuli within a comparison context. Building on this research, we show that the experimental results reported by Putnam-Farr and Morewedge can be explained on the assumption that people use contextual information to infer a distribution of monetary amounts and judge individual amounts by their relative ranked position within that inferred distribution. This inferred distribution theory accounts for empirical results reported in the original study while remaining consistent with the general and well-established principle of rank-based judgment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Of tinfoil hats and thinking caps: Reasoning is more strongly related to implausible than plausible conspiracy beliefs.

People who strongly endorse conspiracy theories typically exhibit biases in domain-general reasoning. We describe an overfitting hypothesis, according to which (a) such theories overfit conspiracy-related data at the expense of wider generalisability, and (b) reasoning biases reflect, at least in part, the need to reduce the resulting dissonance between the conspiracy theory and wider data. This hypothesis implies that reasoning biases should be more closely associated with belief in implausible conspiracy theories (e.g., the moon landing was faked) than with more plausible ones (e.g., the Russian Federation orchestrated the attack on Sergei Skripal). In two pre-registered studies, we found that endorsement of implausible conspiracy theories, but not plausible ones, was associated with reduced information sampling in an information-foraging task and with less reflective reasoning. Thus, the relationship between belief in conspiracy theories and reasoning is not homogeneous, and reasoning is not linked specifically to the "conspiracy" aspect of conspiracy theories. Instead, it may reflect an adaptive response to the tension between implausible theories and other beliefs and data.

Restoring primacy in amnesic free recall: evidence for the recency theory of primacy.

Primacy and recency effects at immediate recall are thought to reflect the independent functioning of a long-term memory store (primacy) and a short-term memory store (recency). Key evidence for this theory comes from amnesic patients who show severe long-term memory storage deficits, coupled with profoundly attenuated primacy. Here we challenge this dominant dual-store theory of immediate recall by demonstrating that attenuated primacy in amnesic patients can reflect abnormal working memory rehearsal processes. D.A., a patient with severe amnesia, presented with profoundly attenuated primacy when using her preferred atypical noncumulative rehearsal strategy. In contrast, despite her severe amnesia, she showed normal primacy when her rehearsal was matched with that of controls via an externalized cumulative rehearsal schedule. Our data are in keeping with the "recency theory of primacy" and suggest that primacy at immediate recall is dependent upon medial temporal lobe involvement in cumulative rehearsal rather than long-term memory storage.

The Endowment Effect and Beliefs About the Market.

The endowment effect occurs when people assign a higher value to an item they own than to the same item when they do not own it, and this effect is often taken to reflect an ownership-induced change in the intrinsic value people assign to the object. However recent evidence shows that valuations made by buyers and sellers are influenced by market prices provided for the individual products, suggesting a role for beliefs about the markets. Here we elicit individuals' beliefs about whole distributions of market prices, enabling us to quantify whether or not a given transaction constitutes a "good deal" and to demonstrate how an endowment effect may reflect such considerations. In a meta-analysis and three laboratory experiments, we show for the first time that ownership has no effect on beliefs about either: (a) the quality of the item or (b) the appropriate market price for the item. Instead, we show that sellers demand a price for the item that matches their beliefs about the item's relative quality and the distribution of market prices in the market. Buyers, in contrast, offer less than what they believe the appropriate market price is. Thus, we argue that the endowment effect may largely reflect "adaptively rational" behavior on the part of both buyers and sellers (given their beliefs about relevant markets) rather than any ownership-induced bias or change in intrinsic preferences.

Inequality and Social Rank: Income Increases Buy More Life Satisfaction in More Equal Countries.

How do income and income inequality combine to influence subjective well-being? We examined the relation between income and life satisfaction in different societies, and found large effects of income inequality within a society on the relationship between individuals' incomes and their life satisfaction. The income-satisfaction gradient is steeper in countries with more equal income distributions, such that the positive effect of a 10% increase in income on life satisfaction is more than twice as large in a country with low income inequality as it is in a country with high income inequality. These findings are predicted by an income rank hypothesis according to which life satisfaction is derived from social rank. A fixed increment in income confers a greater increment in social position in a more equal society. Income inequality may influence people's preferences, such that in unequal countries people's life satisfaction is determined more strongly by their income.

No temporal decay in verbal short-term memory.

Many models of short-term memory (STM) ascribe an important role to temporal decay and forgetting because of the passage of time alone. We argue against decay as the primary form of forgetting from STM, and suggest that new experimental methodologies and recent models provide new perspectives on the old issue of the causes of forgetting. We show that several classic sources of evidence for time-based forgetting can be re-interpreted in terms of an interference-based view, and that new experiments provide compelling evidence against decay. We conclude that progress requires moving beyond demonstrations of qualitative effects and focusing instead on testing quantitative predictions of models.

Money and happiness: rank of income, not income, affects life satisfaction.

Does money buy happiness, or does happiness come indirectly from the higher rank in society that money brings? We tested a rank-income hypothesis, according to which people gain utility from the ranked position of their income within a comparison group. The rank hypothesis contrasts with traditional reference-income hypotheses, which suggest that utility from income depends on comparison to a social reference-group norm. We found that the ranked position of an individual's income predicts general life satisfaction, whereas absolute income and reference income have no effect. Furthermore, individuals weight upward comparisons more heavily than downward comparisons. According to the rank hypothesis, income and utility are not directly linked: Increasing an individual's income will increase his or her utility only if ranked position also increases and will necessarily reduce the utility of others who will lose rank.