Ecological validity of common behavioral decision making tasks: evidence across two samples.

BACKGROUND: Clinicians and scholars routinely use behavioral decision tasks to assess real-world decision making capabilities. However, many common behavioral decision making tasks lack data on the extent to which they predict real-world risky behaviors. Across two pre-registered studies, and two timepoints, we assessed decision making abilities using common behavioral tasks and predicted participants' real-world risky decision making from task performance. METHOD: In Study 1, 918 Mechanical Turk (MTurk) workers completed three decision making tasks in addition to assessments of real-world risk behavior: preventive health behaviors, COVID-19 vaccination status, and virtual social distancing task performance. In Study 2, 221 college student participants completed the Study 1 tasks plus additional assessments of decision making and real world risk and protective behaviors. RESULTS: Across both studies, the selected behavioral decision tasks rarely predicted real world behavior and, when they did, the relationship was weak at best. CONCLUSIONS: These data suggest that these behavioral decision making tasks may not be good predictors of real world risky behavior at present, with some evidence that the specificity of the behavior being assessed matters (i.e. the closer the task was to the specific behavior being predicted), calling for additional ecological validity research, with a greater variety of tasks in the future.

One-size fits all? Evaluating group differences in an integrated social cognition model to understand COVID-19 vaccine intention and uptake.

Vaccine programs significantly reduce disease burden within a population. The COVID-19 vaccine facilitated a return to "normal"; however, vaccine coverage remains below target levels. Identifying predictors of vaccine uptake is vital for individual and community health. The present study used the Reasoned Action Approach and integrated hazard-specific risk perception, to predict COVID-19 vaccine intention and uptake behavior. Informed by the diffusion of innovations theory, differences in associations and model effects were tested by early adopter status of the seasonal influenza vaccine. We recruited participants online within the United States for a longitudinal survey study. The integrated social cognition model provided an acceptable to ideal fit for both groups but performed better among the not early adopter group with better fit statistics, mostly stronger effect sizes, and greater variance accounted for in intention to vaccinate against COVID-19. Instrumental attitudes toward the COVID-19 vaccine predicted intention for both groups, and uptake among the non-early adopters. Capacity predicted intention among early adopters, and behavior among non-early adopters. Among non-early adopters, subjective norms had a direct effect on intention and an indirect effect on vaccine uptake behavior. Intervention research to support COVID-19 vaccine uptake focusing on the utility of vaccines, fostering self-efficacy, and providing normative information is warranted.

Test-Retest Reliability of Common Behavioral Decision-Making Tasks: A Multi-Sample, Repeated Measures Study.

OBJECTIVE: Decision-making is responsible for the best and worst of human nature. The field of decision science has done much to elucidate the psychological process of decision-making, variables that affect decision-making, and outcomes of disadvantageous decision-making. However, understanding any psychological process requires creation of reliable measures. Few studies focus on the test-retest reliability of behavioral decision-making tasks despite their utility in repeated assessment batteries. METHOD: The present study examined the extent to which common behavioral decision-making tasks are reliable across time. Across two samples and two time points, participants completed multiple decision-making assessments. RESULTS: Results revealed moderate at best evidence of test-retest reliability across a 10-week interval in any of the tasks assessed. CONCLUSIONS: These findings raise large questions for the field of behavioral decision-making and the utility for tasks to track changes in decision-making across time in clinical populations.

Cognitive chicken or the emotional egg? How reconceptualizing decision-making by integrating cognition and emotion can improve task psychometrics and clinical utility.

Decision-making is an executive function, tapping into cognitive, emotional, and personality-based components. This complexity, and the varying operational definitions of the construct, is reflected in the rich array of behavioral decision-making tasks available for use in research and clinical settings. In many cases, these tasks are "subfield-specific," with tasks developed by cognitive psychologists focusing on cognitive aspects of decision-making and tasks developed by clinical psychologists focusing on interactions between emotional and cognitive aspects. Critically, performance across different tasks does not consistently correlate, obfuscating the ability to compare scores between measures and detect changes over time. Differing theories as to what cognitive and/or emotional aspects affect decision-making likely contribute to this lack of consistency across measures. The low criterion-related validity among decision-making tasks and lack of consistent measurement of the construct presents challenges for emotion and decision-making scholars. In this perspective, we provide several recommendations for the field: (a) assess decision-making as a specific cognitive ability versus a taxonomy of cognitive abilities; (b) a renewed focus on convergent validity across tasks; (c) further assessment of test-retest reliability versus practice effects on tasks; and (d) reimagine future decision-making research to consider the research versus clinical implications. We discuss one example of decision-making research applied to clinical settings, acquired brain injury recovery, to demonstrate how some of these concerns and recommendations can affect the ability to track changes in decision-making across time.

Poorer decision making among college students during the COVID-19 pandemic: Evidence for "pandemic-brain".

OBJECTIVE: Did living through the COVID-19 pandemic cause healthy college students to experience "pandemic-brain," a phenomenon characterized by difficulties with various cognitive abilities? Did students shift from deliberative to more impulsive decision making? PARTICIPANTS: We compared a pre-pandemic sample of 722 undergraduate students to 161 undergraduate students recruited in Fall 2020, during the COVID-19 pandemic. METHOD: We compared scores on the Adult Decision Making Competence scale among participants who completed the task pre-pandemic or across two time points in Fall 2020, during the pandemic. RESULTS: Decision making was less consistent and more reliant on gain/loss framing during the pandemic compared to pre-pandemic, but college students were no less confident in their decisions. No significant changes in decision making occurred during the pandemic. CONCLUSIONS: These decision making changes could increase the risk of making an impulsive choice with negative health consequences affecting demands on student health centers and imperiling learning environments.

Are correlations among behavioral decision making tasks moderated by simulated cognitive impairment?

Behavioral decision making tasks are common in research settings, with only the Iowa Gambling Task available for clinical assessments. However, correlations among these tasks are low, indicating each may assess a distinct component of decision making. In addition, it is unclear whether these tasks are sensitive to invalid performance or even simulated impairment. The present study examined relationships among decision making tasks and whether simulated impairment moderates the relationships among them. Across two studies (Study 1: n = 166, Study 2: n = 130), undergraduate student participants were asked to try their best or to simulate a specific diagnosis (Attention-Deficit/Hyperactivity Disorder; Study 1), decision making impairment (Study 2), or general cognitive impairment (Study 2). They then completed a battery of tests including embedded and standalone performance validity tests (PVTs) and three behavioral decision making tasks. Across studies, participants simulating impairment were not distinguishable from controls on any of the behavioral tasks. Few significant correlations emerged among tasks across studies and the pattern of relationships between tasks did not differ on the basis of simulator or PVT failure status. Collectively, our findings suggest that these tasks may not be vulnerable to simulated cognitive impairment, and that the tasks measure largely non-overlapping aspects of decision making.

Contextual Factors Affecting Risky Decision Making: The Influence of Music on Task Performance and Perceived Distraction.

Previous research has investigated factors that contribute to the development of different risk-taking behaviors, such as can occur on lab-based behavioral risky decision making tasks. On several of the most common tasks, participants must develop an adequate understanding of the relative risks and benefits associated with each decision in order to learn to decide advantageously. However, contextual factors can affect the decision making process and one's ability to weigh the risks and benefits of a decision. The present study investigates the extent to which music may be an additional contextual factor that can disrupt decision making and other executive functions. Across four studies we examine whether having music playing passively in the background or having participants actively listen to music affects performance on measures of risky decision making, working memory, processing speed, and problem solving. Participants reported greater distraction for rock music than classical music in the passive listening studies but did not report any differences in distraction across conditions in the active listening studies. Despite this self-reported increased level of distraction, few significant differences were found in task performance across groups and across studies. The Angling Risk Task (ART) was sensitive to differences in risk by condition, with music leading to greater risk-taking in a passive listening study, but less risk-taking in an active listening study, compared to no music. The extent to which music serves as a contextual factor disrupting performance on measures of risky decision making and other executive functions may depend in part on whether individuals are actively versus passively listening to the music.

Stability of Risk Perception Across Pandemic and Non-pandemic Situations Among Young Adults: Evaluating the Impact of Individual Differences.

Previous research suggests a higher perceived risk associated with a risky behavior predicts a lower likelihood of involvement in that behavior; however, this relationship can vary based on personality characteristics such as impulsivity and behavioral activation. During the COVID-19 pandemic, individuals began to re-evaluate the level of risk associated with everyday behaviors. But what about risks associated with "typical" risk-taking behaviors? In the present study, 248 undergraduate student participants completed measures of impulsivity, behavioral activation and inhibition, propensity to take risks, numeracy, and perceptions of and involvement in both risk-taking behavior and health promoting behavior (e.g., blood donation, registering as an organ donor, vaccination). Our study revealed that higher behavioral inhibition and greater propensity to take risks predicted greater likelihood of involvement in COVID-19-related risk behaviors, even after accounting for perceived risks and benefits of the behavior. Greater likelihood of involvement in social risk behaviors was predicted by greater numeracy and risk-taking propensity. Identifying as male, a greater propensity to take risks, and greater impulsivity predicted increased health/safety risk behaviors. Younger age, lower risk-taking propensity, and lower impulsivity were associated with a greater likelihood of donating blood. For the likelihood of registering to become an organ donor, increasing risk perception, both before and during the pandemic, was associated with greater likelihood of registering, but greater risk-taking propensity was associated with a decreased likelihood of organ donation registration. For flu vaccination, a greater propensity to take risks was associated with a greater likelihood of flu vaccination during the 2020-2021 flu season. Both cognitive and personality factors can predict involvement in risk-taking and health-promotion behaviors, warranting their continued examination.

The Performance of College Students on the Iowa Gambling Task: Differences Between Scoring Approaches.

The Iowa Gambling Task (IGT) is one of the most common behavioral decision-making tasks used in clinical and research settings. Less-than-expected performance among healthy adults generates concerns about the validity of this task, and it is possible the particular scoring approach utilized could impact interpretation. We examined how performance patterns changed across several scoring approaches, utilizing a large, college student sample, both with (n = 406) and without (n = 1,547) a self-reported history of psychiatric or other diagnosis. Higher net scores were seen when participants selected decks with a low loss frequency than decks with high long-term outcomes; however, participants overall underperformed the IGT normative data sample. Receiver operating characteristic curves examining multiple scoring approaches revealed no threshold of impaired performance that both maximized sensitivity and minimized false positive rate on the IGT. Scoring approach matters in the determination of impaired decision making via the IGT in adults.

"Like a Freshman Who Didn't Get a Freshman Orientation": How Transfer Student Capital, Social Support, and Self-Efficacy Intertwine in the Transfer Student Experience.

Community colleges and other open-access two-year campuses provide an important pathway to higher education; however, a surprisingly small proportion of these students successfully transfer to and graduate from a bachelor's degree-granting institution. The present study examined barriers and challenges students faced as they built their sense of self-efficacy as transfer students. We conducted interviews with 65 prospective or recent transfer students, including "internal" transfers (moving from an open-access predominantly two-year campus to their university's flagship campus) and "external" transfers (moving from a community college to the university's most selective campus). Our results indicate that both internal and external transfer students experienced challenges in terms of obtaining accurate information about transfer (transfer student capital, or "TSC"), but these challenges were easier to overcome for internal transfers, in part due to their social support networks. While both sets of transfer students utilized social support networks as an informal source of TSC, internal transfer students reported a more extensive social support network. Gaining accurate information about transfer and being supported by members of their social networks seemed to boost self-efficacy for transfer as well as adjustment during the post-transfer experience period. Recommendations for sending and receiving institutions are provided.

Cognitive-perceptual and disorganized schizotypal traits are nonlinearly related to atypical semantic content on tasks of semantic fluency.

Language deficits emerge early in the course of schizophrenia, yet research findings in those at-risk for schizophrenia, such as those with schizotypy, are mixed. The purpose of the present study was to elucidate the relationship of language ability, measured via semantic fluency, to schizotypy, examining both linear and non-linear relations. Semantic fluency data from 295 individuals with varying amounts of schizotypal traits were analyzed utilizing traditional methods (i.e., counting words generated that fit a specific semantic category). The content of semantic fluency responses was also analyzed via a semantic infrequency score (i.e., how infrequent participant responses were relative to all responses generated for the category in the study sample) and a total semantic productivity score (i.e., how many unique words generated overall, including those that did not fit the semantic category). Using traditional methods of scoring, schizotypy was not related to semantic fluency. However, schizotypy was non-linearly related to semantic infrequency and productivity, reflecting atypical semantic activation and processing. In particular, cognitive-perceptual and disorganized, but not interpersonal, traits were related to semantic infrequency and productivity. Valuable content-based information is missed when only analyzing semantic fluency data via the traditional method in the schizophrenia spectrum population. Cognitive-perceptual and disorganized traits, attenuated thought disorder symptoms, evidence the strongest relationship to semantic fluency, further illustrating the link between language and schizophrenia symptoms along the schizophrenia spectrum.

Narcissism, the Experience of Pain, and Risky Decision Making.

Personality characteristics and situational factors are known to influence performance on behavioral decision making tasks; however, variability exists in the relationship between narcissism and decision making. In addition, recent research suggests that the presence of acute pain can negatively affect decisions, and even the threat of pain can also cause changes in decision making. Narcissists are known to experience social pain differently than non-narcissists, but relatively little is known about how physical pain is experienced. The present study examined the influence of both pain and narcissism on risky decision making task performance. Participants (n = 248) completed assessments of the narcissistic admiration and rivalry concept as well as vulnerable narcissism. They were asked to complete a pain recall task before administration of the Balloon Analog Risk Task (BART), Columbia Card Task (CCT), Game of Dice Task (GDT), and Iowa Gambling Task (IGT). Although individuals who recalled a socially painful experience took less risks on the IGT across trials, no effect of narcissism was seen on any of the tasks. Recalling a physically or socially painful situation did not negatively affect decision making on the BART, CCT, or GDT. Results are discussed in the context of previous research on narcissism, pain, and cognitive task performance.

Country and Sex Differences in Decision Making Under Uncertainty and Risk.

Whether males and females differ in decision-making remains highly debatable. However, a male advantage in decision making is observed in animal as well as human models of the iowa gambling task (IGT), and, in case of the latter, the difference is observed across a wide range of age groups. It is unclear if these sex differences on the IGT are malleable to environmental influences such as sociocultural factors. We tested sex differences during the uncertainty and risk phases of the IGT in data pooled from three countries that reflected high, moderate, to low gender-equity (Germany, United States, and India: N = 531, female = 269). Comparing the net scores in uncertainty vs. risk blocks (first two vs. last two blocks) confirmed the male-advantage on the IGT across the three countries, specifically in the risk blocks, with the highest male-advantage observed for Germany. Results are discussed in terms of sex differences in reaction to uncertainty vs. risk, and the counter-intuitive effect of gender-equitable environment suggesting that national/environmental factors might influence advantageous decision making, but in ways that accentuate rather than abate sex differences.

Risky decision-making and delusion proneness: An initial examination.

Delusion proneness is an individual-differences characteristic, existing on a continuum from no delusional thoughts to a diagnosis of schizophrenia. Previous research found individuals high in delusion proneness request less information to make decisions, potentially making a decision without sufficient information (jumping to conclusions). The present study examined risky decision-making as a function of delusion proneness. Participants (n = 102) completed the Peters Delusions Inventory to assess delusion proneness, and the Iowa Gambling Task (IGT) and Game of Dice Task (GDT) to assess risky decision-making. Although no significant results emerged on the GDT, those scoring higher in delusion proneness decided more advantageously on the IGT than those scoring lower in delusion proneness. Exploratory analyses indicated no significant relationship between gender and task performance. The present study provides further insight into risky decision making as a function of delusion proneness.

Manipulating the decision making process: Influencing a "gut" reaction.

The present series of studies sought to examine how external factors influence behavioral decision making task performance. Utilizing the Iowa Gambling Task (IGT) to assess risky decision making, we examined the influence of a dual task paradigm (Study 1, Study 2), shifting task focus to decision making speed versus accuracy (Study 3), and varied intertrial intervals (Study 4). College student participants completed the IGT and decision making speed and the patterns of IGT selections by deck in the earlier (decision making under ambiguity) and later (decision making under risk) trials were examined. Participants completing the IGT while simultaneously completing a dual working memory task made slower decisions and failed to learn, compared to the single task participants, that Deck C was an advantageous deck. Participants told to focus on being as accurate as possible in their decisions selected more from Deck C, whereas participants told to focus on making the quickest possible decision selected more from Deck D. Manipulating the intertrial interval, giving participants more time to learn from feedback, did not affect decision making speed or accuracy. Implications for our understanding of how individuals decide on the IGT and how heuristics may develop are presented.

Effects of acute pain and pain-related fear on risky decision-making and effort during cognitive tests.

Introduction: The experience of acute pain and pain-related fear negatively impact cognition and behavior; however, little research has examined their impacts on risky decision-making and effort. The present study investigated the effects of acute pain and pain-related fear on risky decision-making and effort during cognitive tests. Method: Levels of pain-related fear were assessed. Healthy participants (n = 146) experienced acute pain induced via cold pressor task, and then were randomly assigned to one of the four conditions to induce pain-related fear: Pain Threat (n = 36), Pain Threat with Control (n = 39), Cognitive Threat with Control (n = 34), and Control (n = 36). Participants then completed measures of effort (Word Memory Test [WMT], self-reported effort) and risky decision-making (Iowa Gambling Task [IGT], Balloon Analogue Risk Task [BART]). Results: Collapsed across condition, participants did not learn to decide advantageously on the IGT following an acute pain experience. During the early trials (1-40) on the IGT, participants in the Pain Threat condition made riskier decisions. Higher levels of pain during the cold pressor task predicted less risky decisions on the BART, and participants in the Cognitive Threat with Control condition made less risky decisions. Participants in the Pain Threat with Control condition self-reported lower effort on cognitive tests, yet no group-based differences were seen in WMT performance. Greater pain-related fear predicted greater self-reported effort and better WMT performance, but no effects were seen on decision-making task performance. Conclusions: The experience of pain and the threat of additional pain can lead to changes in risky decision-making and effort on cognitive tasks. This threat of additional pain could activate underlying pain-related fear, creating hypervigilance to and avoidance of pain that affects subsequent task performance. Implications for research and clinical evaluation of acute pain and pain-related fear are discussed.

Meta-analysis of cognitive performance in fibromyalgia.

INTRODUCTION: Fibromyalgia is a condition with symptoms of pain, physical function difficulties, and emotional problems, but is also characterized by complaints of poor cognition (often called "FibroFog"). Over the last two decades, a number of studies have examined cognitive differences between individuals with and without fibromyalgia. The purpose of the current study was to conduct a quantitative synthesis of these differences across multiple cognitive domains. METHOD: Following Cochrane guidelines, we identified 37 eligible studies for analysis where persons with fibromyalgia (total n = 964) were compared to participants from age-matched control groups without fibromyalgia (total n = 1025) on a range of neuropsychological measures. Group differences between persons with fibromyalgia and healthy controls were examined for cognitive domains including processing speed, long- and short-term memory, and executive functions (inhibitory control, set shifting, updating, and accessing). Random-effect meta-analyses were conducted to determine effect sizes for these differences in cognitive performance. RESULTS: Fibromyalgia was significantly and negatively associated with performance on all domains of cognitive function. The largest effect size was found for inhibitory control (g = 0.61), followed by memory (g = 0.51 for short-term, 0.50 for long-term memory). The smallest cognitive difference between those with fibromyalgia and controls was for set shifting (g = 0.30). CONCLUSION: These findings support the hypothesis that the self-reported cognitive impact of fibromyalgia is also found in objective neuropsychological measures. Routine screening for cognitive dysfunction in those with fibromyalgia may be warranted in addition to assessment of the traditional fibromyalgia symptoms.

Women's leadership in neuropsychology: historical perspectives, present trends, and future directions.

OBJECTIVE: Although psychology has become a female-dominated field, this pattern of gender representation has not held true within the specialty of neuropsychology. In recent years more women have been pursuing careers in neuropsychology, and while the balance of male and female neuropsychologists as a whole has shifted, it is unclear whether the gender composition of leadership has also changed. Our goal was to survey various neuropsychological organizations, training programs, editorial boards, and organizations granting board certification to determine the current gender composition of leadership positions within neuropsychology. METHOD: A literature review was conducted to examine past trends of gender composition in neuropsychology, psychology, medicine, and academia. Data on current gender compositions of the field were culled from publicly available websites and through personal communication with representatives from major psychological and neuropsychological organizations. RESULTS: We found that the overall composition of the field has changed over time, but notable gender disparities in leadership positions remain. Women still comprise the minority of leadership positions within most neuropsychological organizations, editorial boards for neuropsychology journals, and fellow positions in major neuropsychological organizations. More equitable representation has been achieved in the directorships of training programs and ABPP/ABCN board certification. CONCLUSION: We review the historical trends in gender discrepancies in leadership in neuropsychology and discuss these within the broader arenas of academia, research, and medicine. We conclude with a summary addressing potential causes for these discrepancies, including work-life balance issues, discrimination, institutional bias, and various other factors. We also provide pragmatic suggestions to help address these continued disparities.

The vulnerability of self-reported disability measures to malingering: a simulated ADHD study.

OBJECTIVE: Making diagnostic and accommodation decisions for potential Attention-Deficit/Hyperactivity Disorder (ADHD) in adults is difficult, as the assessor often relies more on self-reported symptoms and functional disability than in childhood evaluations. Malingering of ADHD occurs frequently in the educational setting and for a variety of reasons, including the potential benefits of access to stimulant medications and academic accommodations. METHOD: The present study utilized a simulation design to examine the potential for malingering of self-reported functional disability on the World Health Organization Disability Schedule 2.0 (WHODAS). Participants were 167 students from two Midwestern universities. Thirty-six self-reported a previous diagnosis of ADHD, and the remaining 131 students were randomly assigned to one of three conditions: best effort, malingering for the purpose of receiving stimulant medication, or malingering for the purpose of receiving extra time accommodations. RESULTS: Individuals in both malingering groups reported higher levels of disability on all domains of the WHODAS compared to healthy controls and individuals with ADHD. There were no significant differences between malingering groups. CONCLUSIONS: Results suggest the WHODAS is susceptible to non-credible responses and should not be relied upon solely as a measure of disability in the context of ADHD evaluations.

Test-Retest Reliability of Common Behavioral Decision Making Tasks.

OBJECTIVE: To examine test-retest reliability of common behavioral decision making tasks. METHOD: A total of 98 undergraduate students completed two administrations of the Iowa Gambling Task (IGT), Balloon Analogue Risk Task (BART), Columbia Card Task (CCT), and Game of Dice Task (GDT), three weeks apart. RESULTS: The BART, CCT, and GDT showed moderately strong correlations across time. On the IGT, no correlations were seen between Time 1 Trials 1-40 and Time 2 performance; however, weak correlations were observed between Time 1 Trials 41-100 and Time 2 performance. Paired-samples t-tests indicated participants were riskier at Time 1 than Time 2 on the IGT and GDT, but riskier at Time 2 on the BART. CONCLUSIONS: The BART, CCT, and GDT showed moderate test-retest reliability, with the IGT showing weak reliability during the decision making under risk trials only. Implications for repeated test administration in clinical and non-clinical settings are discussed.