A novel strategy to optimize critical information on over the counter labels for older adults.

Background and Aims: Labels designed to communicate critical information are paramount for the safe and effective use of over-the-counter medications; in recognition of this, the content and formatting of over the counter (OTC) labels sold in interstate commerce has been regulated for decades. Yet, available studies suggest that consumers frequently rely on limited information during decision making, failing to access the information required in the Drug Facts Label. This is particularly important for older consumers, who are at greater risk for adverse reactions to medicines. In two experiments we objectively evaluate how novel label designs that employ highlighting and a warning label placed on the package's front impact older consumers' attention to, and use of, critical information. Methods: In Experiment 1, 68 OTC patients (65+) engaged with a computer-based task answering yes/no scenario-based questions about a drug's appropriateness. In Experiment 2, 63 OTC patients (65+) conducted a forced-choice task where one of two drugs presented on a computer screen was appropriate for a provided scenario while the other was not. Both tasks required participants to access and use critical label information (i.e., warnings or active ingredients) to respond correctly. Dependent variables analyzed were the proportion of correct responses and time to correct response. Results: Highlighting or placing critical information on the front of the package significantly improved response accuracy and time to correct response in Experiment 1 as compared to responses utilizing the standard label. For Experiment 2, participants were faster and more accurate when critical information was highlighted. Conclusions: Results provide direct measures of the efficacy of novel labeling strategies. This information is relevant for regulations which dictate label design in ways that enhance ease and safety of use of medications for older adults.

Revisiting the self-generation effect in proofreading.

The self-generation effect refers to the finding that people's memory for information tends to be better when they generate it themselves. Counterintuitively, when proofreading, this effect may make it more difficult to detect mistakes in one's own writing than in others' writing. We investigated the self-generation effect and sources of individual differences in proofreading performance in two eye-tracking experiments. Experiment 1 failed to reveal a self-generation effect. Experiment 2 used a studying manipulation to induce overfamiliarity for self-generated text, revealing a weak but non-significant self-generation effect. Overall, word errors (i.e., wrong words) were detected less often than non-word errors (i.e., misspellings), and function word errors were detected less often than content word errors. Fluid intelligence predicted proofreading performance, whereas reading comprehension, working memory capacity, processing speed, and indicators of miserly cognitive processing did not. Students who made more text fixations and spent more time proofreading detected more errors.

Quitting thresholds in visual search are impacted by target present detection times but not their variability.

Models of visual search posit that target absent responses occur when the quitting threshold for the trial is reached before a target is detected, and that feedback about missed targets allows the quitting threshold to be adaptively set to the difficulty of the search task. While these models may effectively capture processes in lab-based tasks, in real-world searches feedback is often impossible to provide. Instead, observers have little information about their errors, and may only be aware of when they successfully detect the target. We posit that in the absence of feedback the time required to find a target might influence quitting thresholds. In three experiments, we investigate how manipulating the mean time and the standard deviation of time to detect a target influence quitting thresholds in target absent trials. To vary target detection times while holding the search stimuli constant, we used an eye-movement contingent change to surreptitiously introduce a target near fixation at a particular time. Results show that decreasing the mean time to find a target also decreases the number of items inspected and reaction time in target absent trials, the hallmark of a shift in the quitting threshold. By contrast, varying the standard deviation around a fixed mean had no impact on target absent search times. These findings suggest that people are sensitive to the typical time required to find a target in a given task and use that information to flexibly adjust target absent quitting thresholds, but people are not sensitive to the variability.

Identifying over-the-counter information to prioritize for the purpose of reducing adverse drug reactions in older adults: A national survey of pharmacists.

BACKGROUND: Over-the-counter (OTC) medication use is associated with risks of adverse drug reactions (ADRs), particularly among older adults. The Drug Facts Label (DFL) is supposed to provide consumers with information that would avoid ADRs, yet research suggests that consumers frequently fail to interact with this critical information. We postulate that emphasizing critical information by placing it on the front of the package may increase its usage. Before doing so, the most critical information from the DFL needs to be identified. OBJECTIVES: This study aimed to determine which information from the DFL is most critical in reducing ADRs at the time of purchase or use by older adults. METHODS: A national survey of practicing pharmacists knowledgeable about OTC medication use by older adults asked participants to rank order the importance of the DFL sections to reduce ADRs in older adults. Open-ended questions focused on identifying ways of improving OTC medication labeling. Quantitative rankings were used to calculate the content validity ratio and analyzed using Wilcoxon signed rank tests. Qualitative results were categorized into themes. RESULTS: A total of 318 responses (12% response rate) were analyzed. There was high consensus that uses and purpose, active ingredient, warnings, and directions for use were the most important sections of the DFL. Within the warning section, 2 specific warnings, "Do not use" and "Ask a doctor or pharmacist," were deemed most important. Similarly, qualitative themes focused on seeking health care provider assistance or were specific to age-related precautions. CONCLUSIONS: Prioritizing warnings that highlight the importance of possible drug-drug and drug-disease precautions and the need to seek medical advice before taking OTC medications were deemed most critical. Moving this type of information to the front of the package may help reduce ADRs among older adults.

Using change detection to objectively evaluate whether novel over-the-counter drug labels can increase attention to critical health information among older adults.

Over-the-counter (OTC) drugs have many benefits but also carry risks, such as adverse drug reactions, which are more prevalent in older adults. Because these products do not require the oversight of a physician or pharmacist, labeling plays a key role in communicating information required for their safe and effective use. Research suggests that current labels are not terribly effective at communicating potential risk. One reason for their lack of effectiveness is that few consumers attend to critical information (active ingredients and warnings) when making purchases. In two experiments, we used a change detection task to objectively evaluate how novel label designs that employ highlighting and a warning label placed on the package's front impact attention to critical information among older participants (65 and older). The change detection task is a unique form of visual search which allowed us to assess the attentional priority of critical information among participants who were not explicitly instructed to search for this critical information. This unique aspect of the task is important given research suggesting that consumers rarely have the explicit goal of seeking out warnings and active ingredients when making OTC selections. Our results provide empirical support that both highlighting critical information and positioning it on the package's front increase its attentional prioritization relative to current, commercial practice. Given that attending to the critical information is prerequisite to utilizing that information, strategies that elicit attention in this way are likely to reduce medication errors.

Empirical evaluation of the presence of a label containing standard drinks on pour accuracy among US college students.

PURPOSE: Alcohol concentration has traditionally been labeled in the form of alcohol by volume (ABV). This format can cause difficulty in evaluating accuracy of a pour because it doesn't directly connect with recommendations related to "standard drinks," the approach used by the US CDC and others organizations which intend to facilitate responsible drinking behaviors. Strategies which more directly connect guidelines related to healthy drinking behaviors to alcohol labeling are needed. OBJECTIVE: Assess how a label identifying the number of standard drinks per container impacts the ability of undergraduate students to accurately pour a standard drink. DESIGN: This study employed a 3 x 2 x 2 experimental design. Undergraduates were asked to pour a standard drink from mock products from three alcohol categories (beer, wine and liquor); products were presented in two types of label (traditional ABV vs. standard drinks/container) at two concentrations of alcohol content (high and low). RESULTS: We calculated standardized pour errors (pour errors in standard drink units). Analysis of these standardized pour errors suggested that 1) people tended to underpour beverages of low concentration across product categories and overpour those high in concentration. 2) When the standard drink label was present, pour accuracy was improved, when compared with pours from containers affixed with ABV labels in low alcohol concentrations across all product categories (beer, wine and liquor). 3) For treatments that comprised high concentrations of alcohol, the standard drink label significantly increased accuracy only for beer. However, it is worth noting that beer with an ABV label was the condition with the most dramatic overpours, and these problematic overpours were dramatically reduced by the addition of a standard drink label. CONCLUSIONS: Our work empirically supports the notion that Undergraduate students are better able to accurately assess and pour a standard drink of alcohol from bottles incorporating a label which includes standard drinks/container vs. those with traditional ABV labeling. That said, the effect is quite different for each alcohol category: beer, wine, and liquor and depends on whether the product is high or low in concentration of alcohol for its category; as such, policy makers should consider alcohol categories and concentrations from a public health perspective when recommending changes to labeling.

A novel, unbiased approach to evaluating subsequent search misses in dual target visual search.

Research in radiology and visual cognition suggest that finding one target during visual search may result in increased misses for a second target, an effect known as subsequent search misses (SSM). Here, we demonstrate that the common method of calculating second-target detection performance is biased and could produce spurious SSM effects. We describe the source of that bias and document factors that influence its magnitude. We use a modification of signal-detection theory to develop a novel, unbiased method of calculating the expected value for dual-target performance under the null hypothesis. We then apply our novel method to two of our data sets that showed modest SSM effects when calculated in the traditional manner. Our correction reduced the effect size to the point that there was no longer a significant SSM effect. We then applied our method to a published data set that had a larger effect size when calculated using the traditional calculation as well as when using an alternative calculation that was recently proposed to account for biases in the traditional method. We find that both the traditional method and the recently proposed alternative substantially overestimate the magnitude of the SSM effect in these data, but a significant SSM effect persisted even with our calculation. We recommend that future SSM studies use our method to ensure accurate effect-size estimates, and suggest that the method be applied to reanalyze published results, particularly those with small effect sizes, to rule out the possibility that they were spurious.

Value-based attention capture: Differential effects of loss and gain contingencies.

There is evidence that attention can be captured by a feature that is associated with reward. However, it is unclear how associating a feature with loss impacts attentional capture. Some have found evidence for attentional capture by loss-associated stimuli, suggesting that attention is biased toward stimuli predictive of consequence, regardless of the valence of that consequence. However, in those studies, efficient attention to the loss-associated stimulus reduced the magnitude of the loss during training, so attention to the loss-associated stimulus was rewarded in relative terms. In Experiment 1 we associated a color with loss, gain, or no consequence during training and then investigated whether attention is captured by each color. Importantly, our training did not reward, even in a relative sense, attention to the loss-associated color. Although we found robust attentional capture by gain-associated colors, we found no evidence for capture by loss-associated colors. A second experiment showed that the observed effects cannot be explained by selection history and, hence, are specific to value learning. These results suggest that the learning mechanisms of value-based attentional capture are driven by reward, but not by loss or the predictability of consequences in general.

Individual differences predict low prevalence visual search performance and sources of errors: An eye-tracking study.

Targets in real-world visual search tasks, such as baggage screening, may appear on as few as 2% of searches (Hofer & Schwaninger, 2005). Rare targets are missed more frequently than common targets, a phenomenon known as the low prevalence effect. Given the importance of rare target detection, researchers have sought to increase performance through technological improvements, experimental manipulations, and individual differences approaches. Here we focus on the individual differences approach, which has shown that it is possible to predict an individual's low prevalence search accuracy in a T among Ls search using basic cognitive tasks. Here, we address limitations of previous work by using both basic Ts and Ls and more representative baggage screening items. Results show we can account for 53% of variance in low prevalence search accuracy. Eye-tracking results show that fluid intelligence and near transfer search performance predict selection errors (misses caused by never inspecting the target) while working memory capacity and near transfer search performance predict identification errors (misses caused by misidentifying an inspected target). We conclude that the individual differences approach can be an effective tool to select who will perform well in real-world searches. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Persistent guidance of attention in visual statistical learning.

When repeatedly selected features have predictive value, an observer can learn to prioritize them. However, relatively little is known about the mechanisms underlying this persistent statistical learning. In two experiments, we investigated the boundary conditions of statistical learning. Each task included a training phase where targets appeared more frequently in one of two target colors, followed by a test phase where targets appeared equally in both colors. A posttest survey probed awareness of target color probability differences. Experiment 1 tested whether statistical learning requires the predictive feature to be inherently bound to the target. Participants searched for a horizontal or vertical line among diagonal distractors and reported its length (long or short). In the bound condition, targets and distractors were colored, whereas targets were presented in white font and surrounded by colored boxes in the unbound condition. Experiment 2 tested whether reducing task difficulty by simplifying the judgment (horizontal or vertical) would eliminate statistical learning. The results suggested that statistical learning is robust to manipulations of binding, but is attenuated when task difficulty is reduced. Finally, we found evidence that explicit awareness may contribute to statistical learning, but its effects are small and require large sample sizes for adequate detection. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Individual differences point to two separate processes involved in the resolution of binocular rivalry.

Although binocular rivalry is different from other perceptually bistable phenomena in requiring interocular conflict, it also shares numerous features with those phenomena. This raises the question of whether, and to what extent, the neural bases of binocular rivalry and other bistable phenomena overlap. Here we examine this question using an individual-differences approach. In a first experiment, observers reported perception during four binocular rivalry tasks that differed in the features and retinal locations of the stimuli used. Perceptual dominance durations were highly correlated when compared between stimuli that differed in location only. Correlations were substantially weaker, however, when comparing stimuli comprised of different features. Thus, individual differences in binocular-rivalry perception partly reflect a feature-specific factor that is not shared among all variants of binocular rivalry. Our second experiment again included several binocular rivalry variants, but also a different form of bistability: moving plaid rivalry. Correlations in dominance durations between binocular rivalry variants that differed in feature content were again modest. Moreover, and surprisingly, correlations between binocular rivalry and moving plaid rivalry were of similar magnitude. This indicates a second, more general, factor underlying individual differences in binocular rivalry perception: one that is shared across binocular rivalry and moving plaid rivalry. We propose that the first, feature-specific factor corresponds to feature-tuned mechanisms involved in the treatment of interocular conflict, whereas the second, general factor corresponds to mechanisms involved in representing surfaces. These latter mechanisms would operate at a binocular level and be central to both binocular rivalry and other forms of bistability.

Attention to colors induces surround suppression at category boundaries.

We investigated how attention to a visual feature modulates representations of other features. The feature-similarity gain model predicts a graded modulation, whereas an alternative model asserts an inhibitory surround in feature space. Although evidence for both types of modulations can be found, a consensus has not emerged in the literature. Here, we aimed to reconcile these different views by systematically measuring how attention modulates color perception. Based on previous literature, we also predicted that color categories would impact attentional modulation. Our results showed that both surround suppression and feature-similarity gain modulate perception of colors but they operate on different similarity scales. Furthermore, the region of the suppressive surround coincided with the color category boundary, suggesting a categorical sharpening effect. We implemented a neural population coding model to explain the observed behavioral effects, which revealed a hitherto unknown connection between neural tuning shift and surround suppression.

Chasing red herrings: Can visual distracters extend the time children take to open child resistant vials?

BACKGROUND: Unintentional exposure to medications is a noted problem in pediatric populations despite the prevalent use of child-resistant (CR) packaging and educational campaigns informing consumers about appropriate storage. OBJECTIVE: Conduct a proof-of concept study that evaluates how package designs that engage the attention of children in meaningless ways affect opening time and number of openings. STUDY DESIGN: Non-CR vials with or without distracters were provided to 108 children (24-51 months) in pairs. Each participant was handed a vial and instructed to "do whatever you want to with it." Successful opening and time to opening were recorded. Data were analyzed using generalized linear mixed models. RESULTS: Older children were approximately four times more likely than younger children to successfully open a vial with a visual distracter (P = 0.049); when distracters were not present, no evidence for differences was apparent between age groups (P = 0.64). For successful openings of either age group, distracter presence significantly prolonged time to opening (P = 0.0375); vials containing distracters took nearly three times longer to open than those without. CONCLUSIONS: Existing CR designs almost exclusively rely on late stages of information processing (e.g. difficult to understand or open). Our results suggest that packaging designs that target early stage processing (i.e. perception) represent a potential paradigm for creating effective CR designs. It should be acknowledged that visual distracters, by their very nature, have the potential to act as "attractive nuisances" (i.e. if it were to be so effective that it drew children to the hazard). Further studies designed to specifically investigate this possibility are advised.

Revisiting individual differences in the time course of binocular rivalry.

Simultaneously showing an observer two incompatible displays, one to each eye, causes binocular rivalry, during which the observer regularly switches between perceiving one eye's display and perceiving the other. Observers differ in the rate of this perceptual cycle, and these individual differences have been reported to correlate with differences in the perceptual switch rate for other bistable perception phenomena. Identifying which psychological or neural factors explain this variability can help clarify the mechanisms underlying binocular rivalry and of bistable perception generally. Motivated by the prominent theory that perceptual switches during binocular rivalry are brought about by neural adaptation, we investigated whether perceptual switch rates are correlated with the strength of neural adaptation, indexed by visual aftereffects. We found no compelling evidence for such correlations. Moreover, we did not corroborate previous findings that switch rates are correlated between binocular rivalry and other forms of bistable perception. This latter nonreplication prompted us to perform a meta-analysis of existing research into correlations among forms of bistable perception, which revealed that evidence for such correlations is much weaker than is generally believed. By showing no common factor linking individual differences in binocular rivalry and in our other paradigms, these results fit well with other work that has shown such common factors to be rare among visual phenomena generally.

The bandwidth of VWM consolidation varies with the stimulus feature: Evidence from event-related potentials.

Our previous work suggests that 2 colors can be consolidated into visual short-term memory (VSTM) in parallel without a loss of memory precision, whereas consolidation of 2 orientations is performed in a strictly serial manner. Those experiments compared VSTM performance for simultaneously and sequentially presented stimuli. However, there is still controversy about whether the bandwidth for consolidation is determined by the type of information. To further investigate this issue, here we measured electroencephalography while participants attempted to consolidate 1, 2 or 4 simultaneously presented colors (Experiment 1) or orientations (Experiment 2) under limited presentation times. We used the contralateral delay activity (CDA) as an electrophysiological marker of the number of items that were consolidated. For colored stimuli, the CDA amplitude increased between set-size 1 and 2 but did not further increase for set size 4. By contrast, for orientation, the CDA amplitude remained at the set size 1 amplitude as set size increased to 2 or 4 items. Furthermore, in a long exposure duration (300 ms) condition that did not limit the consolidation process, the CDA amplitude pattern indicated that VSTM capacity is limited to about 3 colored items and about 2 orientation items in our paradigm. Thus, the CDA effects observed in the short presentation time was not limited by VSTM storage, but rather by consolidation. These results are consistent with our previous behavioral research and suggest that the bandwidth of VSTM consolidation is determined by the stimulus feature. (PsycINFO Database Record

Eye movement feedback fails to improve visual search performance.

Many real-world searches (e.g., radiology and baggage screening) have rare targets. When targets are rare, observers perform rapid, incomplete searches, leading to higher miss rates. To improve search for rare (10% prevalence) targets, we provided eye movement feedback (EMF) to observers during their searches. Although the nature of the EMF varied across experiments, each method informed observers about the regions of the display that had not yet been inspected. We hypothesized that feedback would help guide attention to unsearched areas and increase the proportion of the display searched before making a target-absent response, thereby increasing accuracy. An eye tracker was used to mark fixated areas by either removing a semiopaque gray overlay (Experiments 1 and 4) as portions of the display were fixated or by adding the overlay once the eye left a segment of the image (Experiments 2 and 4). Experiment 3 provided automated EMF, such that a new region was uncovered every 540 milliseconds. Across experiments, we varied whether people searched for "Waldo" in images from "Where's Waldo?" search books or searched for a T among offset Ls. We found weak evidence that EMF improves accuracy in Experiment 1. However, in the remaining experiments, EMF had no effect (Experiment 4), or even reduced accuracy (Experiments 2 and 3). We conclude that the one positive result we found is likely a Type I error and that the EMF method that we used is unlikely to improve visual search performance.

Investigating the relationship between media multitasking and processes involved in task-switching.

Although multitasking with media has increased dramatically in recent years (Rideout, Foehr, & Roberts, 2010), the association between media multitasking and cognitive performance is poorly understood. In addition, the literature on the relationship between media multitasking and task-switching, one measure of cognitive control, has produced mixed results (Alzahabi & Becker, 2013; Minear et al., 2013; Ophir, Nass, & Wagner, 2009). Here we use an individual differences approach to investigate the relationship between media multitasking and task-switching performance by first examining the structure of task-switching and identifying the latent factors that contribute to switch costs. Participants performed a series of 3 different task-switching paradigms, each designed to isolate the effects of a specific putative mechanism (e.g., advanced preparation) related to task-switching performance, as well as a series of surveys to measure media multitasking and intelligence. The results suggest that task-switching performance is related to 2 somewhat independent factors, namely an advanced preparation factor and passive decay factor. In addition, multitasking with media was related to a faster ability to prepare for tasks, resulting in faster task-switching performance without a cost to accuracy. Media multitasking and intelligence were both unrelated to passive decay factors. These findings are consistent with a 2-component model of task-switching (Sohn & Anderson, 2001), as well as an automatic/executive framework of cognitive control (Schneider & Shiffrin, 1977). (PsycINFO Database Record

Individual differences predict low prevalence visual search performance.

Critical real-world visual search tasks such as radiology and baggage screening rely on the detection of rare targets. When targets are rare, observers search for a relatively short amount of time and have a high miss rate, a pattern of results known as the low prevalence effect. Attempts to improve the search for rare targets have been unsuccessful or resulted in an increase in detections at the price of more false alarms. As an alternative to improving visual search performance through experimental manipulations, an individual differences approach found that those with higher working memory capacity were better at finding rare targets. We build on the individual differences approach and assess 141 observers' visual working memory capacity (vWMC), vigilance, attentional control, big five personality traits, and performance in both high and low prevalence search tasks. vWMC, vigilance, attentional control, high prevalence visual search performance, and level of introversion were all significant predictors of low prevalence search accuracy, and together account for more than 50% of the variance in search performance. With the exception of vigilance, these factors are also significant predictors of reaction time; better performance was associated with longer reaction times, suggesting these factors identify observers who maintain relatively high quitting thresholds, even with low target prevalence. Our results suggest that a quick and easy-to-administer battery of tasks can identify observers who are likely to perform well in low prevalence search tasks, and these predictor variables are associated with higher quitting thresholds, leading to higher accuracy.

Target-present guessing as a function of target prevalence and accumulated information in visual search.

Target prevalence influences visual search behavior. At low target prevalence, miss rates are high and false alarms are low, while the opposite is true at high prevalence. Several models of search aim to describe search behavior, one of which has been specifically intended to model search at varying prevalence levels. The multiple decision model (Wolfe & Van Wert, Current Biology, 20(2), 121--124, 2010) posits that all searches that end before the observer detects a target result in a target-absent response. However, researchers have found very high false alarms in high-prevalence searches, suggesting that prevalence rates may be used as a source of information to make "educated guesses" after search termination. Here, we further examine the ability for prevalence level and knowledge gained during visual search to influence guessing rates. We manipulate target prevalence and the amount of information that an observer accumulates about a search display prior to making a response to test if these sources of evidence are used to inform target present guess rates. We find that observers use both information about target prevalence rates and information about the proportion of the array inspected prior to making a response allowing them to make an informed and statistically driven guess about the target's presence.

Working Memory Capacity Predicts Selection and Identification Errors in Visual Search.

As public safety relies on the ability of professionals, such as radiologists and baggage screeners, to detect rare targets, it could be useful to identify predictors of visual search performance. Schwark, Sandry, and Dolgov found that working memory capacity (WMC) predicts hit rate and reaction time in low prevalence searches. This link was attributed to higher WMC individuals exhibiting a higher quitting threshold and increasing the probability of finding the target before terminating search in low prevalence search. These conclusions were limited based on the methods; without eye tracking, the researchers could not differentiate between an increase in accuracy due to fewer identification errors (failing to identify a fixated target), selection errors (failing to fixate a target), or a combination of both. Here, we measure WMC and correlate it with reaction time and accuracy in a visual search task. We replicate the finding that WMC predicts reaction time and hit rate. However, our analysis shows that it does so through both a reduction in selection and identification errors. The correlation between WMC and selection errors is attributable to increased quitting thresholds in those with high WMC. The correlation between WMC and identification errors is less clear, though potentially attributable to increased item inspection times in those with higher WMC. In addition, unlike Schwark and coworkers, we find that these WMC effects are fairly consistent across prevalence rates rather than being specific to low-prevalence searches.