Unrealistic optimism about treatment risks for acute appendicitis.
Ontology highlight
ABSTRACT:
SUBMITTER: Rosen JE
PROVIDER: S-EPMC9565953 | biostudies-literature | 2022 Apr
REPOSITORIES: biostudies-literature
Publications
Unrealistic optimism about treatment risks for acute appendicitis.
Rosen Joshua E JE Agrawal Nidhi N Flum David R DR Liao Joshua M JM
The British journal of surgery 20220401 5
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Project description:Unrealistic optimism is the tendency to perceive oneself as safer than others in situations that equally threaten everybody. By reducing fear, this bias boosts one's well-being; however, it is also a deterrent to one's health. Three experiments were run in a mixed-design on 1831 participants to eliminate unrealistic optimism (measured by two items-probability of COVID-19 infection for oneself and for others; within-subjects) toward the probability of COVID-19 infection via articles/videos. A between-subject factor was created by manipulation. Ostensibly, daily newspaper articles describing other people diligently following medical recommendations (experiment 1) and videos showing people who did not follow these recommendations (experiment 2) reduced unrealistic optimism. The third experiment, which included both articles and videos, replicated these results. These results can be applied to strategies for written and video communications that can be used by governments and public health agencies as best practices concerning not only COVID-19 but also any subsequent public health threat while promoting proactive, optimal, and healthy functioning of the individual.
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Project description:Risk perception and consequently engagement in behaviors to avoid illness often do not match actual risk of infection, morbidity, and mortality. Unrealistic optimism occurs when individuals falsely believe that their personal outcomes will be more favorable than others' in the same risk category. Natural selection could favor overconfidence if its benefits, such as psychological resilience, outweigh its costs. However, just because optimism biases may have offered fitness advantages in our evolutionary past does not mean that they are always optimal. The current project examined relationships among personal risk for severe COVID-19, risk perceptions, and preventative behaviors. We predicted that those with higher risk of severe COVID-19 would exhibit unrealistic optimism and behave in ways inconsistent with their elevated risk of morbidity and mortality. Clinical risk scores for severe COVID-19 were calculated and compared with COVID-19 threat appraisal, compliance with shelter-in-place orders (March 13-May 22, 2020) and travel restrictions, compliance with public health recommendations, and potential covariates like self-rated knowledge about COVID-19 in a robust dataset including 492 participants from McLennan County, TX, USA. While those with high clinical risk acknowledged their greater likelihood of experiencing severe illness if infected, they actually reported lower perceived likelihood of becoming infected in the first place. While it is possible that those with higher clinical risk scores truly are less likely to become infected, the pattern and significance of these results held after controlling for possible occupational exposure, household size, and other factors related to infection probability. Higher clinical risk also predicted more recent travel within Texas and lower distress during the pandemic (i.e., feeling less stressed, depressed, and helpless). Additional behavioral data suggested that those with higher clinical risk scores did not generally behave differently than those with lower scores during the shelter-in-place order. While unrealistic optimism may provide some short-term psychological benefits, it could be dangerous due to improper assessment of hazardous situations; inferring that optimism bias has evolutionary origins does not mean that unrealistic optimism is "optimal" in every situation. This may be especially true when individuals face novel sources (or scales) of risk, such as a global pandemic.
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Project description:Unrealistic optimism is a pervasive human trait that influences domains ranging from personal relationships to politics and finance. How people maintain unrealistic optimism, despite frequently encountering information that challenges those biased beliefs, is unknown. We examined this question and found a marked asymmetry in belief updating. Participants updated their beliefs more in response to information that was better than expected than to information that was worse. This selectivity was mediated by a relative failure to code for errors that should reduce optimism. Distinct regions of the prefrontal cortex tracked estimation errors when those called for positive update, both in individuals who scored high and low on trait optimism. However, highly optimistic individuals exhibited reduced tracking of estimation errors that called for negative update in right inferior prefrontal gyrus. These findings indicate that optimism is tied to a selective update failure and diminished neural coding of undesirable information regarding the future.
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Project description:One of the most accepted findings across psychology is that people are unrealistically optimistic in their judgments of comparative risk concerning future life events-they judge negative events as less likely to happen to themselves than to the average person. Harris and Hahn (2011), however, demonstrated how unbiased (non-optimistic) responses can result in data patterns commonly interpreted as indicative of optimism due to statistical artifacts. In the current paper, we report the results of 5 studies that control for these statistical confounds and observe no evidence for residual unrealistic optimism, even observing a 'severity effect' whereby severe outcomes were overestimated relative to neutral ones (Studies 3 & 4). We conclude that there is no evidence supporting an optimism interpretation of previous results using the prevalent comparison method.
| S-EPMC5344342 | biostudies-literature
Project description:BackgroundAcute appendicitis often presents with vague abdominal pain, which fosters diagnostic challenges to clinicians regarding early detection and proper intervention. This is even more problematic with individuals with severe psychiatric disorders who have reduced sensitivity to pain due to long-term or excessive medication use or disturbed bodily sensation perceptions. This study aimed to determine whether psychiatric disorder, psychotropic prescription, and treatment compliance increase the risks of complicated acute appendicitis.MethodsThe diagnosis records of acute appendicitis from four university hospitals in Korea were investigated from 2002 to 2020. A total of 47,500 acute appendicitis-affected participants were divided into groups with complicated and uncomplicated appendicitis to determine whether any of the groups had more cases of psychiatric disorder diagnoses. Further, the ratio of complicated compared to uncomplicated appendicitis in the mentally ill group was calculated regarding psychotropic dose, prescription duration, and treatment compliance.ResultsAfter adjusting for age and sex, presence of psychotic disorder (odds ratio [OR]: 1.951; 95% confidence interval [CI]: 1.218-3.125), and bipolar disorder (OR: 2.323; 95% CI: 1.194-4.520) was associated with a higher risk of having complicated appendicitis compared with absence of psychiatric disorders. Patients who are taking high-daily-dose antipsychotics, regardless of prescription duration, show high complicated appendicitis risks; High-dose antipsychotics for < 1 year (OR: 1.896, 95% CI: 1.077-3.338), high-dose antipsychotics for 1-5 years (OR: 1.930, 95% CI: 1.144-3.256). Poor psychiatric outpatient compliance was associated with a high risk of complicated appendicitis (OR: 1.664, 95% CI: 1.014-2.732).ConclusionsThis study revealed a close relationship in the possibility of complicated appendicitis in patients with severe psychiatric disorders, including psychotic and bipolar disorders. The effect on complicated appendicitis was more remarkable by the psychiatric disease entity itself than by psychotropic prescription patterns. Good treatment compliance and regular visit may reduce the morbidity of complicated appendicitis in patients with psychiatric disorders.
| S-EPMC9721022 | biostudies-literature
Project description:Acute appendicitis has been considered by surgeons a progressive disease leading to perforation for more than 100 years. In the last decades the theories about this concept gained attention, especially in adults. However, appendectomy for acute appendicitis remains the most common urgent/emergent surgical procedure. At present, accumulating evidences are showing the changing in clinical practice towards the non-operative management of several cases of acute appendicitis either non-complicated or complicated. The present review aims to show the literature results regarding the non-operative management of acute appendicitis in non-complicated and in complicated cases.
| S-EPMC6502196 | biostudies-literature
Project description:Appendicitis is a prevalent surgical emergency. Although appendectomy has traditionally been the go-to treatment, recent studies suggest antibiotics can be equally effective for uncomplicated cases. However, evidence is scant regarding patients with hematologic disorders. This study delves into the surgical risks tied to appendicitis in patients with underlying hematologic conditions. A retrospective analysis was carried out on patients diagnosed with appendicitis and hematologic disorders from January 2000 to June 2021. Patients were pinpointed using ICD-10 diagnostic codes, and surgical procedures were identified based on the hospital's surgical fee codes. Hematologic conditions were sorted into risk levels, and patient treatments were scrutinized. Among the 131 initially identified patients, 89 were included in the study. Out of these, 75 underwent surgical procedures, while 14 received non-surgical treatments. The surgical group displayed better preoperative laboratory outcomes. Clinical characteristics, hematologic disease risk, and severity of appendicitis appeared not to be related to surgical complications. Patients without surgical complications showed improvement in preoperative absolute neutrophil count (ANC) and platelet counts. Lower preoperative ANCs and platelet counts were associated with extended hospital stays. For patients with hematologic disorders diagnosed with appendicitis, thorough preoperative laboratory evaluations followed by minimally invasive appendectomy appear to be a safe route without heightening the risk of severe complications compared to non-surgical management.
| S-EPMC10605880 | biostudies-literature
Project description:BackgroundAppendectomy is the gold standard for treatment of acute appendicitis. However, recent studies favor primary antibiotic therapy. The aim of this observational study was to explore changes in the numbers of operations for acute appendicitis in the period 2010-2017, paying special attention to disease severity.MethodsData from diagnosis-related group statistics were used to analyze the trends, mortality, and complication rates in the surgical treatment of appendicitis in Germany between 2010 and 2017. All cases of appendectomy after a diagnosis of appendicitis were included.ResultsAltogether, 865 688 inpatient cases were analyzed. The number of appendectomies went down by 9,8%, from 113 614 in 2010 to 102 464 in 2017, while the incidence fell from 139/100 000 in 2010 to 123/100 000 in 2017 (standardized by age group). This decrease is due to the lower number of operations for uncomplicated appendicitis (79 906 in 2017 versus 93 135 in 2010). Hospital mortality decreased both in patients who underwent surgical treatment of complicated appendicitis (0.62% in 2010 versus 0.42% in 2017) and in those with a complicated clinical course (5.4% in 2010 versus 3.4% in 2017).ConclusionDecisions on the treatment of acute appendicitis in German hospitals follow the current trend towards non-surgical management in selected patients. At the same time, the care of acute appendicitis has improved with regard to overall hospital morbidity and hospital mortality.
| S-EPMC8283679 | biostudies-literature
Project description:The worldwide COVID-19 pandemic (and its consequences, such as lockdown and public health regimes) was a novel and stressful situation for most of people, and, as such, it significantly affected both cognitive and emotional functioning of individuals. In our study, we explored unrealistic optimism bias (the cognitive error giving people a feeling of invulnerability) and any declared preventive behaviours undertaken in order to minimise the risk of contagion. We also measured twelve specific emotions (differing in valence and origin) and the feeling of the anxiety caused by the coronavirus. The results allowed us to confirm the occurrence of unrealistic optimism bias (being significantly stronger for men than women), which correlated negatively with the declared number of preventive behaviours. Unrealistic optimism was also positively correlated with negative automatic emotions and negatively correlated with positive reflective emotions. We created models accounting for the variance of general anxiety, finding significant predictors for both separate groups of younger and older adults (negative emotions, both automatic and reflective; and preventive behaviours). However, there was an effect of positive emotions (both automatic and reflective) having a protective role from the feeling of general anxiety, which was significant for the older group only. Our findings may be a valuable cue for coping with crisis situations.
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Project description:Unrealistic Optimism (UO) appears when comparing participants' risk estimates for themselves with an average peer, which typically results in lower risk estimates for the self. This article reports nuanced effects when comparison varies in terms of the gender of the peer. In three studies (total N = 2,468, representative sample), we assessed people's risk estimates for COVID-19 infections for peers with the same or other gender. If a peer's gender is not taken into account, previous studies were replicated: Compared with others, participants perceived themselves as less likely to get infected with COVID-19. Interestingly, this effect was qualified by gender: Respondents perceived women as less threatened than men because women are perceived as more cautious and compliant with medical guidelines.
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