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Regulating Emotions during Difficult Multiattribute Decision Making: The Role of Pre-Decisional Coherence Shifting.

ABSTRACT: Almost all real-life decisions entail attribute conflict; every serious choice alternative is better than its competitors on some attribute dimensions but worse on others. In pre-decisional "coherence shifting," the decision maker gradually softens that conflict psychologically to the point where one alternative is seen as dominant over its competitors, or nearly so. Specifically, weaknesses of the eventually chosen alternative come to be perceived as less severe and less important while its strengths seem more desirable and significant. The research described here demonstrates that difficult multiattribute decision problems are aversive and that pre-decisional coherence shifting aids individuals in regulating that emotional discomfort. Across three studies, attribute conflict was confirmed to be aversive (Study 1), and skin conductance responses and ratings of decision difficulty both decreased in participants who coherence shifted (Study 2). Coherence shifting was also diminished among decision makers who were depleted of regulatory resources, known to be required for common emotion regulation mechanisms. Further, coherence shifting was shown to be relatively common among people who reported strong suppression tendencies in everyday emotion regulation (Study 3). Overall, the data suggest that, at least in part, coherence shifting serves as a tool that helps decision makers manage the pre-decisional discomfort generated by attribute conflict. Theoretical and practical implications are discussed.

SUBMITTER: Carpenter SM

PROVIDER: S-EPMC4795763 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Regulating Emotions during Difficult Multiattribute Decision Making: The Role of Pre-Decisional Coherence Shifting.

Carpenter Stephanie M SM Yates J Frank JF Preston Stephanie D SD Chen Lydia L

PloS one 20160317 3

Almost all real-life decisions entail attribute conflict; every serious choice alternative is better than its competitors on some attribute dimensions but worse on others. In pre-decisional "coherence shifting," the decision maker gradually softens that conflict psychologically to the point where one alternative is seen as dominant over its competitors, or nearly so. Specifically, weaknesses of the eventually chosen alternative come to be perceived as less severe and less important while its str ...[more]

PMID: 26986752

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Project description:BackgroundBoth patients and surrogate decision-makers experience decisional conflict when making a major medical treatment decision with life or death implications. The relationship between health literacy and decisional conflict while making a major medical treatment decision is not understood.ObjectiveTo identify the prevalence of individuals making major medical treatment decisions for themselves or someone else and to explore the relationships between decisional conflict and circumstances of the decision as well as the decision-maker.DesignTwo-phase survey study: in phase 1, we screened for who made a major treatment decision; in phase 2, we asked eligible respondents about their experience making the decision.ParticipantsAddress-based random sample of 4000 Wisconsin residents; 1072 completed phase 1 and 464 completed phase 2.Main measuresWe asked respondents about types of decisions made, the most difficult decision made, and characteristics of the decision-maker and the decision. We included the Decisional Conflict Scale and four domains of the Health Literacy Questionnaire. Open-ended questions also allowed respondents to describe their experiences.Key resultsAbout 43% of respondents reported making a major medical treatment decision. Decisions about major surgery and life support were regarded as the most difficult decisions. Respondents who made the decision for a spouse/partner (β = 6.65, p = 0.012), parent (β = 9.27, p < 0.001), or someone else (β = 10.7, p < 0.001) had higher decisional conflict. Respondents who reported higher ability to actively engage with healthcare providers (β = - 5.24, p = 0.002) and to understand health information well enough to know what to do (β = - 6.12, p = 0.001) had lower decisional conflict.ConclusionsThe need to make major treatment decisions is likely to increase and making decisions on someone else's behalf appeared to be especially difficult. Improving communication to encourage patient and family engagement in the decision-making conversation, particularly for individuals with limited health literacy, may be helpful.

Project description:To identify the relationships between advance directive status, demographic characteristics and decisional burden (role stress and depressive symptoms) of surrogate decision-makers (SDMs) of patients with chronic critical illness.Although the prevalence of advance directives among Americans has increased, SDMs are ultimately responsible for complex medical decisions of the chronically critically ill patient. Decisional burden has lasting psychological effects on SDMs. There is insufficient evidence on the influence of advance directives on the decisional burden of surrogate decision-makers of patients with chronic critical illness.The study was a secondary data analysis of cross-sectional data. Data were obtained from 489 surrogate decision-makers of chronically critically ill patients at two academic medical centres in Northeast Ohio, United States, between September 2005-May 2008.Data were collected using demographic forms and questionnaires. A single-item measure of role stress and the Center for Epidemiological Studies Depression (CESD) scale were used to capture the SDM's decisional burden. Descriptive statistics, t-tests, chi-square and path analyses were performed.Surrogate decision-makers who were nonwhite, with low socioeconomic status and low education level were less likely to have advance directive documentation for their chronically critically ill patient. The presence of an advance directive mitigates the decisional burden by directly reducing the SDM's role stress and indirectly lessening the severity of depressive symptoms.Most SDMs of chronically critically ill patients will not have the benefit of knowing the patient's preferences for life-sustaining therapies and consequently be at risk of increased decisional burden.Study results are clinically useful for patient education on the influence of advance directives. Patients may be informed that SDMs without advance directives are at risk of increased decisional burden and will require decisional support to facilitate patient-centred decision-making.

Project description:Objectives: The mainstream position on regret in psychological literature is that its necessary conditions are agency and responsibility, that is, to choose freely but badly. Without free choice, other emotions, such as disappointment, are deemed to be elicited when the outcome is worse than expected. In two experiments, we tested the opposite hypothesis that being forced by external circumstances to choose an option inconsistent with one's own intentions is an important source of regret and a core component of its phenomenology, regardless of the positivity/negativity of the post-decision outcome. Along with regret, four post-decision emotions - anger toward oneself, disappointment, anger toward circumstances, and satisfaction - were investigated to examine their analogies and differences to regret with regard to antecedents, appraisals, and phenomenological aspects. Methods: Through the scenario methodology, we manipulated three variables: choice (free/forced), outcome (positive/negative), and time (short/long time after decision-making). Moreover, we investigated whether responsibility, decision justifiability, and some phenomenological aspects (self-attribution, other attribution, and contentment) mediated the effect exerted by choice, singularly or in interaction with outcome and time, on the five emotions. Each study was conducted with 336 participants, aged 18-60. Results: The results of both studies were similar and supported our hypothesis. In particular, regret elicited by forced choice was always high, regardless of the valence of outcome, whereas free choice elicited regret was high only with a negative outcome. Moreover, regret was unaffected by responsibility and decision justifiability, whereas it was affected by the three phenomenological dimensions. Conclusion: Our results suggest that (1) the prevailing theory of regret is too binding, since it posits as necessary some requirements which are not; (2) the antecedents and phenomenology of regret are broader than it is generally believed; (3) decision-making produces a complex emotional constellation, where the different emotions, singularly and/or in combination, constitute the affective responses to the different aspects of decision-making.

Dataset Information

Regulating Emotions during Difficult Multiattribute Decision Making: The Role of Pre-Decisional Coherence Shifting.

Publications

Regulating Emotions during Difficult Multiattribute Decision Making: The Role of Pre-Decisional Coherence Shifting.

Similar Datasets

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