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Do adolescents always take more risks than adults? A within-subjects developmental study of context effects on decision making and processing.

ABSTRACT: Adolescents take more risks than adults in the real world, but laboratory experiments do not consistently demonstrate this pattern. In the current study, we examine the possibility that age differences in decision making vary as a function of the nature of the task (e.g., how information about risk is learned) and contextual features of choices (e.g., the relative favorability of choice outcomes), due to age differences in psychological constructs and physiological processes related to choice (e.g., weighting of rare probabilities, sensitivity to expected value, sampling, pupil dilation). Adolescents and adults made the same 24 choices between risky and safe options twice: once based on descriptions of each option, and once based on experience gained from sampling the options repeatedly. We systematically varied contextual features of options, facilitating a fine-grained analysis of age differences in response to these features. Eye-tracking and experience-sampling measures allowed tests of age differences in predecisional processes. Results in adolescent and adult participants were similar in several respects, including mean risk-taking rates and eye-gaze patterns. However, adolescents' and adults' choice behavior and process measures varied as a function of decision context. Surprisingly, age differences were most pronounced in description, with only marginal differences in experience. Results suggest that probability weighting, expected-value sensitivity, experience sampling and pupil dilation patterns may change with age. Overall, results are consistent with the notion that adolescents are more prone than adults to take risks when faced with unlikely but costly negative outcomes, and broadly point to complex interactions between multiple psychological constructs that develop across adolescence.

SUBMITTER: Rosenbaum GM

PROVIDER: S-EPMC8328301 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundDual processing theory of human cognition postulates that reasoning and decision-making can be described as a function of both an intuitive, experiential, affective system (system I) and/or an analytical, deliberative (system II) processing system. To date no formal descriptive model of medical decision-making based on dual processing theory has been developed. Here we postulate such a model and apply it to a common clinical situation: whether treatment should be administered to the patient who may or may not have a disease.MethodsWe developed a mathematical model in which we linked a recently proposed descriptive psychological model of cognition with the threshold model of medical decision-making and show how this approach can be used to better understand decision-making at the bedside and explain the widespread variation in treatments observed in clinical practice.ResultsWe show that physician's beliefs about whether to treat at higher (lower) probability levels compared to the prescriptive therapeutic thresholds obtained via system II processing is moderated by system I and the ratio of benefit and harms as evaluated by both system I and II. Under some conditions, the system I decision maker's threshold may dramatically drop below the expected utility threshold derived by system II. This can explain the overtreatment often seen in the contemporary practice. The opposite can also occur as in the situations where empirical evidence is considered unreliable, or when cognitive processes of decision-makers are biased through recent experience: the threshold will increase relative to the normative threshold value derived via system II using expected utility threshold. This inclination for the higher diagnostic certainty may, in turn, explain undertreatment that is also documented in the current medical practice.ConclusionsWe have developed the first dual processing model of medical decision-making that has potential to enrich the current medical decision-making field, which is still to the large extent dominated by expected utility theory. The model also provides a platform for reconciling two groups of competing dual processing theories (parallel competitive with default-interventionalist theories).

Project description:BACKGROUND:Our study examined the use of decision-making styles, as identified by Scott and Bruce (1995) (i.e. differentiating between a rational, intuitive, dependent, avoidant and spontaneous decision-making style), within the context of colorectal cancer (CRC) screening participation. In the field of cancer screening, informed decision-making is considered important, which follows the Rational Decision model. Subsequently, gaining more insight into decision-making styles being used in real life, could improve support to people when making their screening decision. In addition, we examined whether the decision-making style that people used was associated with their experienced decisional conflict. METHODS:An online survey was carried out among a sample of first-time CRC screening invitees (1282 respondents, response rate 49%). We assessed people's decision-making styles, CRC screening participation, education level, self-reported health literacy, and decisional conflict, and examined the possible associations between them. RESULTS:In our study, people who had to decide about CRC screening scored high on using both a rational and intuitive decision-making style. Respondents scoring higher on using a spontaneous or dependent decision-making style were more likely to have participated in CRC screening, while respondents scoring higher on using an avoidant decision-making style were more likely not to have participated in CRC screening. However, differences were small. Generally, people in our study experienced low decisional conflict. CONCLUSION:Our eligible CRC screening population scored high on using both a rational and intuitive decision-making style. To optimise support to people, public education materials could be appealing more to the intuitive processes at hand. That being said, the current education materials aimed at informed/rational decision-making do not necessarily seem to create a problem, as people generally experienced low decisional conflict. Possible concerns regarding the use of a spontaneous, dependent or avoidant decision-making style could be that these styles might be contributing to less informed decisions. However, it is relevant to consider that the found differences are small and that any possible concern applies to a relatively small group of people.

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Do adolescents always take more risks than adults? A within-subjects developmental study of context effects on decision making and processing.

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