Autistic people differ from non-autistic people subjectively, but not objectively in their reasoning.

LAY ABSTRACT: Autistic people often experience challenges in social contexts, and when decisions need to be made quickly. There is evidence showing that autistic people have a tendency for greater deliberation and lower intuition, compared to non-autistic people. This has led to the researchers' proposal that autism is associated with an enhanced level of rationality. However, these theories have been mostly explored through the lens of either only non-social domain or only social domain. To address this gap, we recruited autistic adults and carefully matched them with non-autistic adults for comparison. We used a task representing both social and non-social interactions in a comparison structure and asked participants' moral judgements on scenarios' main characters. This was complemented by subjective and objective measures of reasoning. Our findings did not reveal meaningful differences between groups in terms of deliberation. However, we did observe that autistic participants self-reported lower levels of intuition, compared to non-autistic participants. Autistic people consistently rate themselves as less intuitive than their counterparts. Nevertheless, objective evidence supporting this across tasks and studies is inconsistent.

Uncovering the roles of automatic attitudes and controlled processes in the regulation of physical activity behavior in children.

Despite substantial research efforts to increase engagement in physical activity (PA), children are not sufficiently active. Dual-process theories suggest that PA behavior regulation occurs through both controlled (i.e., reflective, conscious) and automatic (i.e., non-reflective, less conscious) processes. Automatic processes depend on affective valuations and attitudes towards PA and have been shown to predict PA behavior. However, their role in PA behavior regulation in children remains unclear. Therefore, the current study investigated the unique association of automatic attitudes towards PA on self-reported seven-day PA recall, after accounting for the effects of known controlled precursors of PA (i.e., explicit attitudes, PA self-efficacy, and PA intentions). In a cross-sectional design, 69 children (age = 10.8 ± 0.6 years) completed the Single-Category Implicit Association Task (SC-IAT) and self-reported measures of PA and controlled precursors of PA. In a hierarchical regression analysis, controlled processes accounted for 28.3 % of the variance in PA behavior. Although the bivariate association between automatic attitudes and PA was not significant, the association between them became significant but negative in the fully adjusted model (b = -1.70; p = 0.025). The fully adjusted model accounted for 35.0 % of the variance in PA. In summary, the findings indicated that both controlled and automatic processes predicted PA in children, although the association with automatic attitudes was not in the expected direction in the adjusted model. Future studies are warranted to further understand the role of automatic processes in the regulation of PA behavior in children.

Bereavement dyadic coping questionnaire: Development and validation.

Most theories and empirical studies of bereavement coping focus on the individual, although researchers have highlighted the importance of family-level coping and proposed the concept of bereavement dyadic coping (BDC). We developed and validated a 25-item Bereavement Dyadic Coping Questionnaire (BDCQ). The procedure includes item generation, expert review, and examination of the psychometric properties in 241 bereaved persons in bereaved families from China. Factor analysis revealed four factors: direct loss-oriented, indirect loss-oriented, restoration-oriented, and collaborative. The questionnaire had satisfactory internal consistency, test-retest reliability, and convergent and divergent validity. The BDCQ is the first of its kind to measure dyadic coping in the context of bereavement, permitting future quantitative explorations of bereavement dyadic coping and its influence on bereaved individuals and families.

Predicting physical activity behavior among university students using the multi-process action control framework.

Most university students do not engage in enough physical activity (PA) despite the known physical and mental health benefits. Action control theories such as the Multi-Process Action Control (M-PAC) framework have been proposed to better understand the translation of intentions into action by incorporating post-intentional processes. However, the explanatory power of the M-PAC framework beyond traditional social cognitive constructs has received limited attention. This study examined the predictive utility of the M-PAC framework for explaining variance in self-reported and device-measured PA behavior among university students. A total of 2418 undergraduate students (Mean age = 19.1 ± 1.73 [SD] years) completed an online survey that included a self-reported measure of moderate-to-vigorous PA (MVPA) as well as constructs outlined in the M-PAC framework: instrumental and affective attitudes, perceived capability and opportunity, behavioral regulation, habit and identity. A subsample (n = 376) also wore an ActiGraph wGT3x-BT accelerometer on their non-dominant wrist for seven full days to assess MVPA. Robust linear regression models were computed to investigate associations between M-PAC framework constructs and PA behavior. Findings showed the M-PAC framework explained as high as 14.3 % and 37.9 % of the variance in device-measured and self-reported MVPA, respectively. Regulatory (behavioral regulation), and reflexive (habit and identity) processes were significant predictors of self-reported MVPA when examining the full M-PAC framework, whereas the role identity dimension of PA identity was the only significant predictor of device-assessed MVPA. Taken together, these results reinforce the importance of post-intentional processes, specifically role identity, in understanding PA behavior among university students.

Which diagnoses and arguments regarding severe mental disorder do forensic psychiatric experts in Sweden consider in different cases? A qualitative vignette study.

The decision-making process of experts in forensic psychiatric investigations (FPI) is complex and reasoning regarding psychiatric diagnosis and severe mental disorder (SMD, the judicial concept central to legal exemption in Swedish law) has severe ramifications. Nevertheless, the qualitative aspects of FPI experts' decision-making process have seldom been studied systematically. METHOD: The participants (N = 41) were FPI experts: forensic psychiatrists (n = 15), forensic psychologists (n = 15) and forensic social workers (n = 11). Using three case vignettes and qualitative content analysis, it was explored how case-specific characteristics could affect which hypotheses FPI experts generated regarding a) psychiatric diagnosis and b) severe mental disorder and c) which information sources they required. Each case vignette described a diagnostically ambiguous case but indicated emphasis on: psychotic symptoms (case 1); personality disorder symptoms (case 2) and neurodevelopmental disorder symptoms (case 3). RESULTS: Experts reasoned in a similar manner regarding generating hypotheses and required information, but also in a case-adapted manner. Experts considered various diagnostic alternatives, and some (e.g. psychosis) were mentioned for all three cases. Other diagnoses were only suggested as hypotheses in certain cases (e.g. case 3: intellectual disability). DISCUSSION: In Sweden, a core basis for SMD is psychotic-like functioning, and psychosis was suggested as a hypothesis for all three cases. Experts reasoned in similar ways regarding SMD in all cases, considering various perspectives for and against SMD. Some case-specific arguments for and against SMD adapted to the psychopathological circumstances were found. These could be related to aspects of the SMD concept that become important to ascertain when the type of psychopathology indicated in the case vignette was present; for example, ascertaining reality monitoring for a person with potential delusions of being followed by a criminal gang requires investigation of criminal history and related conflicts. Taken together, FPI-experts considered a broad range of psychiatric diagnoses in various cases. Their reasoning regarding SMD was both based on general and case-specific (or psychopathology-specific) factors.

Physical symptoms in prolonged grief disorder: a case report.

BACKGROUND: Prolonged grief disorder (PGD) was added as a new disorder to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) in 2022. PGD is defined as an intense yearning or longing for the deceased and preoccupation with thoughts or memories of the deceased. The official diagnostic criteria for PGD do not include physical symptoms, but it is sometimes associated with somatic symptoms. CASE DESCRIPTION: We present the case of a patient suffering from facsimile illness who lost her husband due to the deterioration of a brain tumor. She suffers from similar physical symptoms (severe headache reminiscent of a brain tumor, and hypertension) as her deceased husband. We focused on the dual process model in which grief exposure and behavioral activation began, ensuring an oscillation between loss-oriented grief (e.g., crying, feeling a continuing bond) and restoration-oriented grief (e.g., attending to life changes, new roles/identities/relationships). Outpatient psychotherapy based on the dual-process model of grief improved her physical symptoms. CONCLUSIONS: This case report highlights the physical symptoms experienced by those bereaved by a deceased loved one. Exposure therapy and behavioral activation approaches based on the dual-process model of grief response were effective in reducing the physical symptoms of facsimile illness. Physical symptoms in deceased family members triggered by bereavement are often overlooked and need to be recognized.

Attitude, Habit Strength, and the Relationship Between Intention and Leisure-Time Physical Activity Behavior Among College Students.

According to the dual-process theories, many scholars proposed that physical activity behavior tends to be governed by an interplay of intentional planning and habitual action. The major purpose of this study was to determine the moderation effects of habit strength on the relationship between leisure time moderate-to-vigorous physical activity (MVPA) intention and behavior and the impacts of cognitive and affective attitude on PA habit strength, utilizing a latent interaction modeling approach. A total of 1803 undergraduate students completed this study. All variables were measured using validated self-report questionnaires. Structural equation modeling and Hayes' PROCESS program (model 1) were conducted to address the research questions. Habit strength significantly and positively moderated the effects of intention on leisure time MVPA behavior (ß = .08, p < .01). The association between intention and PA behavior became stronger as habit strength increased. Affective attitude positively and significantly influenced habit strength (ß = .71, p < .01). The effect of cognitive attitude on habit strength was significant and negative with a small effect size (ß = -.08, p < .01). Findings indicated that habit strength positively moderated the relationship between PA intention and behavior, suggesting that stronger habit strength may amplify the association between PA intention and actual PA behavior. Affective attitude toward PA significantly influenced habit strength, whereas cognitive attitude exhibited minimal negative impact on habit strength. These findings contribute to our understanding of the interaction effects between deliberative and automatic processes in regulating PA behavior, as well as the nuanced relationship between attitude and habit development.

BMI and explicit-implicit cues on food choice: The fake food buffet in the United Kingdom and Indonesia.

We examined whether people with high BMI sampled from two different countries were more susceptible to behavioural change via an implicit, rather than explicit, intervention. We measured BMI and used three types of cue interventions (implicit vs explicit healthy lifestyle cue vs neutral cue) to examine their impact on our participants' food choice using the Fake Food Buffet. Healthiness of the meal chosen was measured by the percentage of healthy food items in the meal. Portion size of their chosen meal was operationalised by the total number of food items chosen and its total calorie content was also estimated. Participants were recruited from the United Kingdom (N = 264) and Indonesia (N = 264). Our results indicated that while explicit food cues were overall more effective, implicit cues were a more effective strategy to change food choice behaviours among individuals with high BMI. Participants with high BMI were more likely to regulate the healthiness of their meal and less likely to regulate its portion size or calorie content. The efficacy of our healthy eating interventions was cross-culturally generalizable. Our study supports previous research that implicit cues of a healthy lifestyle might be a more effective behavioural change strategy for individuals with high BMI.

"I'm completely off base here on what this child is capable of": A qualitative analysis of how medical ableism manifests in PICU clinicians' care of children with severe neurological impairment.

BACKGROUND: Children with severe neurological impairment (SNI) are at heightened risk of experiencing medical ableism from clinicians in the pediatric intensive care unit (PICU), where barriers such as time scarcity and heavy workloads limit clinicians' ability to provide personalized care. OBJECTIVE: To examine medical ableism and strategies to support PICU clinicians in understanding the lives of children with SNI and their families. METHODS: This US-based, single-center, qualitative study included PICU clinicians identified by the parents/caregivers of a child with SNI. Semi-structured 1:1 60-min interviews about the challenges of caring for children with SNI were conducted virtually. Coded data were extracted, thematically analyzed, and further conceptualized using the Dual Process Theory (DPT) bias reduction framework. RESULTS: Nineteen PICU clinicians participated. Three major themes emerged: 1) assumptions and misconceptions about children with SNI and their families, 2) barriers to providing personalized care, and 3) clinician-suggested strategies to honor the lives of children with SNI. These themes aligned with the DPT framework. As outlined in the DPT, system 1 "fast thinking" errors occur when quick observations inform decisions (e.g., snap judgments about a child's capabilities). Second, barriers (e.g., insufficient time for meaningful interactions) may prevent clinicians from providing unbiased care. Third, system 2 "slow thinking," where complex decision-making occurs, and can be enhanced through personalization strategies (e.g., viewing visuals of the child at baseline health). CONCLUSIONS: Increasing clinician awareness of their potential implicit biases and utilizing bias reduction strategies to mitigate medical ableism in care are critical areas for future research.

Clinical reasoning in real-world practice: a primer for medical trainees and practitioners.

Clinical reasoning is a crucial skill and defining characteristic of the medical profession, which relates to intricate cognitive and decision-making processes that are needed to solve real-world clinical problems. However, much of our current competency-based medical education systems have focused on imparting swathes of content knowledge and skills to our medical trainees, without an adequate emphasis on strengthening the cognitive schema and psychological processes that govern actual decision-making in clinical environments. Nonetheless, flawed clinical reasoning has serious repercussions on patient care, as it is associated with diagnostic errors, inappropriate investigations, and incongruent or suboptimal management plans that can result in significant morbidity and even mortality. In this article, we discuss the psychological constructs of clinical reasoning in the form of cognitive 'thought processing' models and real-world contextual or emotional influences on clinical decision-making. In addition, we propose practical strategies, including pedagogical development of a personal cognitive schema, mitigating strategies to combat cognitive bias and flawed reasoning, and emotional regulation and self-care techniques, which can be adopted in medical training to optimize physicians' clinical reasoning in real-world practice that effectively translates learnt knowledge and skill sets into good decisions and outcomes.

Applying process dissociation to self-sacrificial moral dilemmas: Extending the dual-process model.

There is considerable evidence linking cognitive reflection with utilitarian judgments in dilemmas that involve sacrificing someone else for the greater good. However, the evidence is mixed on the question of whether cognitive reflection is associated with utilitarian judgments in self-sacrificial dilemmas. We employed process dissociation to extract a self-sacrificial utilitarian (SU) parameter, an altruism (A) parameter, an other-sacrificial (OU) utilitarian parameter, and a deontology (D) parameter. In Study 1, the cognitive reflection test (CRT) positively correlated with both SU and OU (replicated in Studies 2 and 4, pre-registered). In Study 2, we found that instructing participants to rely on reason increased SU and OU (replicated in Study 4, pre-registered). In Study 3, we found that SU and OU positively correlated with giving in the single-game version of the public goods game (replicated in Study 4, pre-registered), which provides behavioral validation that they are genuine moral tendencies. Together, these studies constitute strong cumulative evidence that SU and OU are both valid measures that are associated with reliance on cognitive reflection.

You can't nudge into vaccination: Comparing the effects of nudge types and Covid-19 vaccination attitudes on vaccine willingness.

Nudges can be an effective strategy to promote vaccination. However, it is necessary to better identify the characteristics of nudges that produce the strongest effects and how they interact with individuals' attitudes. Here we sequentially test the effectiveness of three nudge characteristics (framing, nudge type, and presentation modality) and the role of participants' attitudes toward Covid-19 vaccination, social solidarity and authoritarianism in vaccination decisions. In studies 1-4, participants were presented with a nudge manipulating a target characteristic (e.g. positive/negative framing, nudge type) and measuring willingness to vaccinate and related variables compared a control nudge. Study 5 used a single combined nudge reflecting the combination of successful nudges in previous studies. Results over all studies show that nudging has unreliable effects while vaccine attitudes are more reliably linked to all measures of vaccines willingness. These results suggest that attitudes play a more reliable role on effective adoption of vaccinations.

Feasibility and acceptability of a theory-based online tool for reducing stress-induced eating.

Stress-induced eating is associated with various health risks like obesity and cardiovascular disease, exacerbated by the overconsumption of unhealthy foods. This study sought to investigate replacement coping strategies for stress-induced eating that participants can seek to implement using behaviour change techniques like implementation intentions. The study adopted a feasibility and acceptability design, with 258 participants (88.37% female) aged 17-75 years old who self-reported stress-induced eating. Participants were asked to identify cues for their stress-induced eating and evaluate the acceptability of eight potential replacement coping strategies. After selecting their preferred strategy, participants formed implementation intentions, linking the strategy with their previously identified cues. There were six themes of cues for stress-induced eating as identified by participants, including a range of external and internal stressors. Themes regarding the acceptability of the replacement coping strategies were organised based on constructs from integrated social cognition theories. Participant responses reflected cognitive and affective attitudes, and control and normative beliefs behind engagement in coping behaviour; further, automatic and volitional processes were described by participants as playing a role in whether a coping strategy was deemed as useful. Plans formulated by participants commonly detailed specific situations and strategies to utilise, though few described start times or durations of their plan. Action planning was found to significantly increase following formation of implementation intentions, and participants' descriptions supported the feasibility and acceptability of utilising implementation intentions to adopt alternative coping strategies to stress-induced eating. Future research should conduct a randomised controlled trial to assess the efficacy of the implementation intentions intervention in promoting uptake of replacement coping strategies to reduce stress-induced eating.

Testing the Effect of Cue Consistency on the Past Behavior-Habit-Physical Activity Relationship.

Behavior performed in the presence of consistent cues is a core element for successful habit development, with the repeated presence of consistent cues facilitating the activation of automatic responses in future. Yet, little is known about the effects of different cue types on habit. Using a two-wave prospective PLS-SEM model with a sample of 68 undergraduate students, we assessed the mediating effects of habit on the past-behavior-to-physical-activity relationship, and how the mediating effects of habit were moderated by the consistent presence of different forms of cues. Habit mediated the effects of past behavior on physical activity, with a significantly stronger mediating effect of habit in those reporting undertaking physical activity at the same time of day, doing the same activity, and in the same mood. Consistent place, people, and part of routine did not moderate the effects of habit. The results provide formative evidence for a key assertion of the habit theory that consistent contextual and internal cues are a cornerstone of habitual development and action, but they also indicate the importance of examining different forms of cues and their impact on the formation and enaction of habits as some cues may be more relevant than others.

Fast & slow decisions under risk: Intuition rather than deliberation drives advantageous choices.

Would you take a gamble with a 10% chance to gain $100 and a 90% chance to lose $10? Even though this gamble has a positive expected value, most people would avoid taking it given the high chance of losing money. Popular "fast-and-slow" dual process theories of risky decision making assume that to take expected value into account and avoid a loss aversion bias, people need to deliberate. In this paper we directly test whether reasoners can also consider expected value benefit intuitively, in the absence of deliberation. To do so, we presented participants with bets and lotteries in which they could choose between a risky expected-value-based choice and a safe loss averse option. We used a two-response paradigm where participants made two choices in every trial: an initial intuitive choice under time-pressure and cognitive load and a final choice without constraints where they could freely deliberate. Results showed that in most trials participants were loss averse, both in the intuitive and deliberate stages. However, when people opted for the expected-value-based choice after deliberating, they had predominantly already arrived at this choice intuitively. Additionally, loss averse participants often showed an intuitive sensitivity to expected value (as reflected in decreased confidence). Overall, these results suggest that deliberation is not the primary route for expected-value-based responding in risky decision making. Risky decisions may be better conceptualized as an interplay between different types of "fast" intuitions rather than between two different types of "fast" and "slow" thinking per se.

How do students reason about statistical sampling with computer simulations? An integrative review from a grounded cognition perspective.

Interactive computer simulations are commonly used as pedagogical tools to support students' statistical reasoning. This paper examines whether and how these simulations enable their intended effects. We begin by contrasting two theoretical frameworks-dual processes and grounded cognition-in the context of people's conceptions about statistical sampling, setting the stage for the potential benefits of simulations in learning such conceptions. Then, we continue with reviewing the educational literature on statistical sampling simulations. Our review tentatively suggests benefits of the simulations for building statistical habits of mind. However, challenges seem to persist when more specific concepts and skills are investigated. With and without simulations, students have difficulty forming an aggregate view of data, interpreting sampling distributions, showing a process-based understanding of the law of large numbers, making statistical inferences, and context-independent reasoning. We propose that grounded cognition offers a framework for understanding these findings, highlighting the bidirectional relationship between perception and conception, perceptual design features, and guided perceptual routines for supporting students' meaning making from simulations. Finally, we propose testable instructional strategies for using simulations in statistics education.

The effect of cognitive load, ego depletion, induction and time restriction on moral judgments about sacrificial dilemmas: a meta-analysis.

Greene's influential dual-process model of moral cognition (mDPM) proposes that when people engage in Type 2 processing, they tend to make consequentialist moral judgments. One important source of empirical support for this claim comes from studies that ask participants to make moral judgments while experimentally manipulating Type 2 processing. This paper presents a meta-analysis of the published psychological literature on the effect of four standard cognitive-processing manipulations (cognitive load; ego depletion; induction; time restriction) on moral judgments about sacrificial moral dilemmas [n = 44; k = 68; total N = 14, 003; M(N) = 194.5]. The overall pooled effect was in the direction predicted by the mDPM, but did not reach statistical significance. Restricting the dataset to effect sizes from (high-conflict) personal sacrificial dilemmas (a type of sacrificial dilemma that is often argued to be best suited for tests of the mDPM) also did not yield a significant pooled effect. The same was true for a meta-analysis of the subset of studies that allowed for analysis using the process dissociation approach [n = 8; k = 12; total N = 2, 577; M(N) = 214.8]. I argue that these results undermine one important line of evidence for the mDPM and discuss a series of potential objections against this conclusion.

The attentional guidance and facilitating effects of group behavioral cues on individual college pedestrians' jaywalking decisions.

OBJECTIVE: Jaywalking is an important cause of pedestrian-related automobile accidents. Exploring the factors that influence jaywalking behavior and suggesting appropriate improvement measures are critical for reducing automobile accidents involving pedestrians. METHODS: This study divided traffic situations into high-risk and low-risk situations. Each situation contained three visual attention cues: vehicle, traffic light, and group behavior. Based on this, the role of visual cues in guiding pedestrians' attention and influencing their decisions during jaywalking was examined. Sixty participants, with an average age of 19, were recruited. They were shown 84 crosswalk videos randomly while their crossing decisions and eye movement data were recorded. RESULTS: In low-risk situations, pedestrians spent more attention on group behavioral cues when making jaywalking decisions. The rate of jaywalking increased with the number of other jaywalking pedestrians. In high-risk situations, the pedestrians' total fixation duration at vehicle hazard cues was longer when making jaywalking decisions, and the jaywalking rate decreased. CONCLUSIONS: The results indicate that pedestrians' jaywalking decisions were based on other pedestrians' illegal crossing cues and automatic associative processes in low-risk situations. The higher the number of people crossing the street, the higher the number of pedestrians illegally crossing the road. In high-risk situations, pedestrians paid more attention to vehicle hazard cues before making jaywalking decisions, and fewer illegal crossings. The jaywalking decisions were based on a risk assessment, a controlled analytical process. The results verify the effect of visual cues on pedestrians' attentional guidance and decision-making in different traffic situations, as well as the effectiveness of visual attention in predicting decision intention. The findings provide a theoretical basis and data reference for pedestrian safety education and constructing an intelligent driving pedestrian trajectory prediction model.

Stimulus Complexity Can Enhance Art Appreciation: Phenomenological and Psychophysiological Evidence for the Pleasure-Interest Model of Aesthetic Liking.

We tested predictions deriving from the "Pleasure-Interest Model of Aesthetic Liking" (PIA Model), whereby aesthetic preferences arise from two fluency-based processes: an initial automatic, percept-driven default process and a subsequent perceiver-driven reflective process. One key trigger for reflective processing is stimulus complexity. Moreover, if meaning can be derived from such complexity, then this can engender increased interest and elevated liking. Experiment 1 involved graffiti street-art images, pre-normed to elicit low, moderate and high levels of interest. Subjective reports indicated a predicted enhancement in liking across increasing interest levels. Electroencephalography (EEG) recordings during image viewing revealed different patterns of alpha power in temporal brain regions across interest levels. Experiment 2 enforced a brief initial image-viewing stage and a subsequent reflective image-viewing stage. Differences in alpha power arose in most EEG channels between the initial and deliberative viewing stages. A linear increase in aesthetic liking was again seen across interest levels, with different patterns of alpha activity in temporal and occipital regions across these levels. Overall, the phenomenological data support the PIA Model, while the physiological data suggest that enhanced aesthetic liking might be associated with "flow-feelings" indexed by alpha activity in brain regions linked to visual attention and reducing distraction.