II: Decision Making/Processing Flashcards
What is decision making?
- The gathering and evaluating of evidence or data in an effort to make a decision
- Includes heuristic processes (discussed last time) as well as analytic processes
- Many decisions require a combination of both heuristic and analytic processes
What Dominates Reasoning?
Reasoning is dominated by information that is present in the environment
Tend to neglect information that is not available
Easier to notice the appearance of something than the removal of something
Application to Therapy
Failure to attend to absence of events/information
Trained to notice and illicit missing information
Intake protocols
Frequently miss our own omissions
Information-Present Effects
Constraining Effects of Information-Present
Thinking if often grounded by that which is present, neglecting that which is absent
At least two constraining effects:
Salient Examples
Prior Hypotheses
Salient Examples
Thinking is typically guided by a current view
Providing examples may limit thinking/perspectives
Hypothesized diagnosis focuses attention on relevant features and influences interpretations
Implications for accepting referrals?
Prior Hypotheses
When gathering data to test tentative hypothesis, tend to be strongly influenced by focal hypothesis
Tend to test hypothesis by thinking of/looking for results that would be obtained if hypothesis true
Two problems ensue
- -> Selective Testing
- -> Positive Testing
Client Case Study
- Working with a client exhibiting a set of behaviors such as feeling increasingly agitated and anxious
- Entertain several possible hypotheses and ultimately select treatment plan that moves client to goal state (more important than actual diagnosis?)
- Develop working hypothesis of an anxiety disorder, given that 70% of those with an anxiety disorder will manifest aforementioned behaviors
Evaluating Gathered Evidence
Given that 70% of the time, someone with an anxiety disorder will demonstrate the pattern of behavior observed in client, are there grounds to proceed with treatment for an anxiety disorder?
What is the probability that the client has an anxiety disorder?
Deciding Requires More Information
What is the Base-Rate? The probability that the diagnosis is true in the general population
What is the Diagnosticity of the Evidence? The degree to which evidence discriminates between diagnosis and other hypotheses (False Positive Rate)
Case Specific Information, Base Rate, Diagnosticity are necessary elements to make a decision
Overemphasis on Case-Specific Data
Often overvalue case-specific information at the expense of other data sources
Muslim terrorists example
Tend to undervalue base-rate information
Logic Underlying Base-Rates
Scenario 1: Low Base-Rate (20%)
START with 100 people.
they either have…
–> Anxiety disorder (20%) OR
–> No Anxiety disorder (80%)
of the people that have anxiety disorder,
they either are…
–> Agitated (14%)
–> Not agitated (6%)
of the people who do not have anxiety disorder,
they either are…
–> Agitated (40%)
–> Not agitated (40%)
Main point behind base-rate logic
MAIN POINT!!!!
Most people who are agitated DO NOT have anxiety disorder because it (in this case) has a low base-rate.
The opposite applies for high base-rate scenarios.
Using Base-Rates in Clinical Practice
Prevalence of a condition should inform judgments about the validity of case-specific information
How do base-rates vary among subpopulations?
When do base-rates need not be incorporated into decision making?
Diagnosticity of Evidence
Often fail to consider the odds that the evidence would be observed if the hypotheses were false
If the evidence is likely to occur regardless of whether hypothesis is true, then it is not very useful
Why is diagnosticity so important in therapeutic settings?
Prior Beliefs
Therapists beliefs, expectations, and theories influence judgments, as well as evaluation and interpretation of evidence
Prior beliefs encourage people to act in a belief-preserving manner
- Testing hypotheses
- Detecting relationships
- Evaluating and weighing evidence
