Over‐selective Responding in a Diagnostic Judgment Task

Abstract

Medical diagnoses are often made on the basis of the presence of multiple symptoms. However, little is known about how the presence of multiple simultaneous symptoms may influence a bias in determining which symptoms are identified, in part due to a lack of an experimental analogue of this process. The current article presents a laboratory analogue of this process and explores whether over-selectivity influences the ability to identify symptoms indicative of particular illnesses. In two experiments, participants completed a diagnosis task that required them to rate the degree to which symptoms predicted illnesses, with predictor symptoms being presented either singly or in compound. In both experiments, over-selectivity was observed; one symptom of the compound received lower ratings, compared to the other element of the compound and the single predictor, while the other component received comparable ratings with the element. These findings are discussed in relation to associative accounts of over-selectivity and as a procedure to study biases in medical decision making.

Previous mindfulness experience interacts with brief mindfulness induction when reducing stimulus overselectivity

“…It has a long history as a therapeutic intervention (Bishop et al, ; Van Dam et al, ) for a variety of psychological problems (e.g., Kabat‐Zinn et al, ; Winnebeck, Fissler, Gärtner, Chadwick, & Barnhofer, ). Importantly, in the current context, Levy, Jennings, and Langer () and Quigley and Reed () reported that more items were recalled and recognised by individuals undergoing mindfulness during informationally challenging situations. Additionally, Schofield et al () demonstrated that a brief mindfulness induction increased detection of unexpected distracters, when load was high due to visual tracking.…”

“…For example, Drew et al () found that 83% radiologists performing a familiar detection task failed to see a very large gorilla inserted in the stimulus slide. That mindfulness helped improve control by all elements of the complex stimulus array presented and suggests that it may have some utility in improving the degree to which information is encoded during such circumstances (Kuyken et al, ; Levy et al, ; Quigley & Reed, ). However, it also suggests that this may be especially effective when the participant has had some previous experience of the technique.…”

“…Important real‐world examples of only a subset of the available information coming to control behaviour (overselection) include when individuals are given information by medical professionals (Beeney, Bakry, & Dunn, ; Hall & Walton, ; Osborne & Reed, ), which can be a major concern relating to treatment compliance, adherence, and concordance (Hall & Walton, ; Swar, Hameed, & Reychav, ; Varshney, ). This latter issue has important medical and financial implications for health services, where critical information relating to the diagnosis or treatment can be missed by patients and medical practitioners during consultations (e.g., Braido, Lavorini, Blasi, Baiardini, & Canonica, ; Drew et al, ; Osborne & Reed, ; Polonsky & Henry, ; Quigley & Reed, ).…”

Over-selectivity decreases with increased training: A role for within-compound associations

“…This would address problems in combining results from nonhuman overshadowing and human over-selectivity experiments, which use different procedures from one another, making the theoretical implications of any parallels unclear. Previously, Quigley and Reed (2017) have studied over-selectivity in a human judgment procedure, that is similar to procedures used to study human cue-competition (e.g., Van Hamme & Wasserman, 1994). Although this human judgment over-selectivity procedure is not identical to those used in previous cue competition studies, it bears strong similarities to the type of tasks these latter procedures employ, and, given it has demonstrated an over-selectivity effect, it was deemed suitable to employ for the current purposes.…”

“…For example, it is not common to present the stimuli for just 500ms at the corners of the screen. This procedure has been used previously for examination of judgements (Quigley & Reed, 2017), and does allow the advantage of extending generality of the findings, but replication with a more standard procedure would seem warranted.…”