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Educational Challenge: Each year, adverse events are reported in healthcare, of which many relate to healthcare workforce cognitive bias. The active involvement of workforce and consumers in the review and co-design of effective training for the healthcare workforce to recognise, monitor, and manage unconscious bias is required., Proposed Solution: We used participatory action research to co-design an innovative, interprofessional simulation based on 'real world' clinical incidents and lived experiences to improve the delivery of safe, high quality, consumer-focused healthcare. Following ethics approval, content analysis of serious adverse patient safety events involving cognitive bias was conducted. These data informed audio-recorded interviews with the healthcare workforce and consumers to explore their experiences of cognitive bias. Following thematic analysis, key themes of communication, stigma, diagnostic overshadowing, and fragmented systems were uncovered. Guided by consumers, these themes were interwoven into a simulation scenario that included real places, stories, and verbatim quotes delivered through mixed media artefacts. This heightened the immersive and experiential learning that aimed to uncover unconscious bias and help learners recognise its impact on clinical decisions and practice., Potential Benefits and Next Steps: To our knowledge, this is the first interprofessional, co-designed simulation to specifically address cognitive bias in current and future healthcare workforce. Plans to translate this research into a practical framework on how to work with key stakeholders (including consumers) to identify 'real-world' health service risks and co-design targeted simulations to address these gaps are described, including lessons learned.

Background: Correctly recognising that alcohol or other substances are causing problems is a necessary condition for those problems to spur beneficial behaviour change. Yet such recognition is neither immediate nor straightforward. Recognition that one's alcohol or drug use is causing negative consequences often occurs gradually. Contemporary addiction neuroscience has yet to make progress in understanding and addressing these recognition barriers, despite evidence that a lack of problem recognition is a primary impediment to seeking treatment., Summary: Based on our recent empirical work, this article shows how recognition barriers can emerge from dual constraints on how we learn about the negative consequences of our actions. One constraint is imposed by the characteristics of negative consequences themselves. A second constraint is imposed by the characteristics of human cognition and information processing. In some people, the joint action of these constraints causes a lack of correct awareness of the consequences of their behaviour and reduced willingness to update that knowledge and behaviour when confronted with counterevidence., Key Messages: This "cognitive pathway" can drive persistent, maladaptive choice., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Cognitive bias refers to human thinking patterns, as well as pitfalls, that are reproducible. Importantly, cognitive bias is not intentionally discriminatory and is necessary to properly interpret the world around us, including microscopic slides. Thus, it is a useful exercise to examine cognitive bias in pathology, as exemplified in dermatopathology., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Rationale and Objective: Image interpretation is a fundamental aspect of radiology. The treatment and management of patients relies on accurate and timely imaging diagnosis. However, errors in radiological reports can negatively impact on patient health outcomes. These misdiagnoses can be caused by several different errors, but cognitive biases account for 74 % of all image interpretation errors. There are many biases that can impact on a radiologist's perception and cognitive processes. Several recent narrative reviews have discussed these cognitive biases and have offered possible strategies to mitigate their effects. However, these strategies remain untested. Therefore, the purpose of this scoping review is to evaluate the current knowledge on the extent that cognitive biases impact on medical image interpretation., Material and Methods: Scopus and Medline Databases were searched using relevant keywords to identify papers published between 2012 and 2022. A subsequent hand search of the narrative reviews was also performed. All studies collected were screened and assessed against the inclusion and exclusion criteria., Results: Twenty-four publications were included and categorised into five main themes: satisfaction of search, availability bias, hindsight bias, framing bias and other biases. From these studies, there were mixed results regarding the impact of cognitive biases, highlighting the need for further investigation in this area. Moreover, the limited and untested debiasing methods offered by a minority of the publications and narrative reviews also suggests the need for further research. The potential of role of artificial intelligence is also highlighted to further assist radiologists in identifying and mitigating these cognitive biases., Conclusion: Cognitive biases can impact radiologists' image interpretation, however the effectiveness of debiasing strategies remain largely untested., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Cognitive bias research draws upon the notion that altered information processing is key for understanding psychological functioning and well-being. However, little attention has been paid to the question of whether the frequently used experimental paradigms hold adequate psychometric properties. The present study examined the psychometric properties of three widely used cognitive bias tasks: the Approach-Avoidance Task (AAT), the visual dot-probe-task, and the Implicit Association Test (IAT). Approach, attentional, and association biases towards valenced stimuli were repeatedly measured at five different time points in a sample of 79 healthy young adults. Two different devices were used for assessment: a personal computer (PC) and a touchscreen-based tablet. Reliability estimates included internal consistency and temporal stability. Validity was inferred from convergence across different behavioral tasks and correlations between bias scores and self-reported psychological traits. Reliability ranged widely amongst tasks, assessment devices, and measurement time points. While the dot-probe-task appeared to be completely unreliable, bias scores obtained from the PC-based version of the AAT and both (PC and touchscreen) versions of the IAT showed moderate reliability. Almost no associations were found across information processing tasks or between implicit and explicit measures. Cognitive bias research should adopt a standard practice to routinely estimate and report psychometric properties of experimental paradigms, investigate feasible ways to develop more reliable tools, and use tasks that are suitable to answer the precise research question asked., (© 2022. The Author(s).)

A cognitive bias describes "shortcuts" subconsciously applied to new scenarios to simplify decision-making. Unintentional introduction of cognitive bias in surgery may result in surgical diagnostic error that leads to delayed surgical care, unnecessary procedures, intraoperative complications, and delayed recognition of postoperative complications. Data suggest that surgical error secondary to the introduction of cognitive bias results in significant harm. Thus, debiasing is a growing area of research which urges practitioners to deliberately slow decision-making to reduce the effects of cognitive bias., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2022 Elsevier Inc. All rights reserved.)

In sports medicine and rehabilitation of musculoskeletal conditions, training, knowledge and expertise of clinicians are the guarantors of good clinical practice. But are they really? Since the 1970s, a growing body of sociological and behavioral science has developed the concepts of cognitive biases and thinking errors. In a nutshell, it tries to explain how we approach decision-making using shortcuts, or heuristics. Our brains will alternatively use 2 systems to think and decide: system 1 is fast, intuitive and emotional, whereas system 2 is slow, logical and conscious. We may think clinicians use the latter systematically, but they actually use system 1 in many situations. Whether due to intrinsic thinking errors or external forces that cloud our judgment, we are under unconscious influences and so are all the stakeholders in the rehabilitation setting, including the patient/athlete. We present some of the most prevalent biases that pervade clinical decision-making and attempt to give a bit of background context starting from the typical tension between academic authority and personal experience. The field of sports performance is also riddled with beliefs, egocentrism and a general tendency to search for magic bullets that will bring the marginal gains and edge over the competition. This plays into the rehabilitation of patient-athletes in different ways. Finally, there are ways to mitigate the effect of cognitive biases to improve decision-making. This must include better communication, shared decisions and ultimately the understanding that we should drive our profession to deliver high-value care tailored to the patients, in line with the best evidence at the best possible cost. Hopefully, we can shed some light without too many of our own biases on the complexities of thinking in sports medicine and rehabilitation., Competing Interests: Conflict of Interest None declared., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Diagnostic errors harm patients. While the underlying causes of diagnostic error and the settings in which they occur are diverse, the use of a cognitive forcing function in the form of a diagnostic time-out can mitigate the risk of diagnostic error. Barriers to the implementation of diagnostic time-outs remain. In our survey of neonatal intensive care unit (NICU) providers, perceived time constraints were universally cited as a barrier. Attending neonatologists and neonatology nurse practitioners reported decreased perception of the risk of diagnostic error impacting patient outcomes, relative to the perception among neonatology fellowship trainees. Future directions include addressing concerns over the perceived time investment required for a diagnostic time-out and increasing provider appreciation of the nature and impact of diagnostic error on patient outcomes., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Loneliness is common in youth, with suggestions that these negative emotions confer vulnerability for anxiety and depression. Here, we investigated for the first time whether, consistent with psychological models of loneliness, biased interpretations of social situations could prospectively predict loneliness in youth. 104 young people completed measures of loneliness and interpretations of ambiguous social and non-social (bodily or health-related) situations at three time-points with intervals of three months between each. As government-imposed social distancing measures (to control the COVID-19 outbreak) occurred between Times 2 and 3 (but not between Times 1 and 2), this enabled us to assess whether restricted social activity could provoke greater predictive power of biased interpretational styles on loneliness. Using cross-lagged panel models, we showed that after estimating paths representing within-time across-variable ("concurrent") paths and across-time within-variable ("stability") paths, there were no significant cross-lag 'causal' paths between earlier interpretational style and later loneliness. Between Time 2 and 3, we demonstrated a significant cross-lag 'consequential' path between earlier loneliness and later threatening interpretations of social situations, but this became non-significant after controlling for concurrent anxiety and depression. Biased interpretational style may reflect a concurrent maintenance factor of youth loneliness., (Copyright © 2021. Published by Elsevier Ltd.)

The putative association between hormones and cognitive performance is controversial. While there is evidence that estradiol plays a neuroprotective role, hormone treatment has not been shown to improve cognitive performance. Current research is flawed by the evaluation of combined hormonal effects throughout the menstrual cycle or in the menopausal transition. The stimulation phase of a fertility treatment offers a unique model to study the effect of estradiol on cognitive function. This quasi-experimental observational study is based on data from 44 women receiving IVF in Zurich, Switzerland. We assessed visuospatial working memory, attention, cognitive bias, and hormone levels at the beginning and at the end of the stimulation phase of ovarian superstimulation as part of a fertility treatment. In addition to inter-individual differences, we examined intra-individual change over time (within-subject effects). The substantial increases in estradiol levels resulting from fertility treatment did not relate to any considerable change in cognitive functioning. As the tests applied represent a broad variety of cognitive functions on different levels of complexity and with various brain regions involved, we can conclude that estradiol does not show a significant short-term effect on cognitive function., (Copyright © 2021. Published by Elsevier Inc.)

An increased awareness of the cognitive biases of clinical decision making over the last decade has not resulted in a corresponding decrease in clinician error. The inappropriate use of cognitive bias labels in adverse incident reviews can result in unintentional or intentional blame., (© 2021 Australasian College for Emergency Medicine.)

Background: Cognitive bias (CB) is increasingly recognized as an important source of medical error and up to 75% of errors in internal medicine are thought to be cognitive in origin (O'Sullivan ED, Schofield SJ. Cognitive bias in clinical medicine. J R Coll Physicans Edinb. 2018;48;225-232). However, primary data regarding the true incidence of bias is lacking. A prospective evaluation of CB in the management of surgical cases with complications has not been reported. This study reports the incidence and distribution of various types of CBs, and evaluates their impact on management errors and standard of care (SOC)., Methods: A prospectively collected series of 736 general surgical cases with complications from three university hospitals was analyzed. Surgical residents evaluated cases for 22 types of CBs (Croskerry P. The importance of cognitive errors in diagnosis and strategies to minimize them. Acad Med. 2003;78:775-780). Supervising quality officers validated all quality assessments. Data were assessed for the incidence of CBs, error assessments (diagnostic, technical, judgment, system, communication, therapeutic, and professionalism), and SOC., Results: CB was attributed in 32.7% (241/736) of all cases with complications. The most common CBs identified, both singly and in groups, were anchoring, confirmation, omission, commission, overconfidence, premature closure, hindsight, diagnosis momentum, outcome, and ascertainment bias. The attribution of CB was correlated to a statistically significant increase in the incidence of management errors by the surgical team and lower SOC assessments., Conclusions: CBs are identified in the management of cases with complications and are associated with an increase in management errors and a degradation in SOC. Insight into the types of CBs and their association with the type and severity of management errors may prove useful in improving quality care., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Despite the influence of Beck's cognitive models of depression, the presence and magnitude of the specific proposed cognitive biases have not been systematically investigated. After a systematic search in PsycInfo and PubMED, studies reporting self-reported outcomes on cognitive biases and depressive symptoms in depressed and/or healthy groups were included. From a total of 4840 records, two different meta-analyses were conducted. 23 studies on 4865 participants provided data about catastrophising and depression (g = 0.95, 95% CI [0.64; 1.26]) and 40 studies on 4678 participants provided data about interpretation bias in depression (g = 0.78, 95% CI [0.43; 1.13]). Moderation analyses showed that the relationship between catastrophising and depression was higher in studies with more women, when the corresponding author was from a Western country, and when the instrument to measure depression was the DSM criteria, the SCL-90, the BDI, or the DASS. The relationship between interpretation bias and depressive symptoms was significant only in studies comparing depressed and healthy groups, and when using specific instruments to measure symptoms (DSM/RDC criteria plus a scale cut-off score) and cognitive bias (CDQ/CBQ, SCT, AST-D, other). Some limitations are acknowledged, but risk of publication bias was found to be low, and these results support the utility of some self-reported measures of cognitive biases in depression., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Although efficacious treatments for major depression are available, efficacy is suboptimal and recurrence is common. Effective preventive strategies could reduce disability associated with the disorder, but current options are limited. Cognitive bias modification (CBM) is a novel and safe intervention that attenuates biases associated with depression. This study investigated whether the delivery of a CBM programme designed to attenuate negative cognitive biases over a period of 1 year would decrease the incidence of major depression among adults with subthreshold symptoms of depression., Methods: Randomised double-blind controlled trial delivered an active CBM intervention or a control intervention over 52 weeks. Two hundred and two community-dwelling adults who reported subthreshold levels of depression were randomised (100 intervention, 102 control). The primary outcome of interest was the incidence of major depressive episode assessed at 11, 27 and 52 weeks. Secondary outcomes included onset of clinically significant symptoms of depression, change in severity of depression symptoms and change in cognitive biases., Results: Adherence to the interventions was modest though did not differ between conditions. Incidence of major depressive episodes was low. Conditions did not differ in the incidence of major depressive episodes. Likewise, conditions did not differ in the incidence of clinically significant levels of depression, change in the severity of depression symptoms or change in cognitive biases., Conclusions: Active CBM intervention did not decrease the incidence of major depressive episodes as compared to a control intervention. However, adherence to the intervention programme was modest and the programme failed to modify the expected mechanism of action.

Causal illusion has been proposed as a cognitive mediator of pseudoscientific beliefs. However, previous studies have only tested the association between this cognitive bias and a closely related but different type of unwarranted beliefs, those related to superstition and paranormal phenomena. Participants (n = 225) responded to a novel questionnaire of pseudoscientific beliefs designed for this study. They also completed a contingency learning task in which a possible cause, infusion intake, and a desired effect, headache remission, were actually non-contingent. Volunteers with higher scores on the questionnaire also presented stronger causal illusion effects. These results support the hypothesis that causal illusions might play a fundamental role in the endorsement of pseudoscientific beliefs., (© 2020 The British Psychological Society.)

In human psychology, the link between cognition and emotions is broadly accepted. However, the idea of using the interaction between cognition and emotions as a tool for a better understanding of animal emotions or for welfare assessment is relatively new. The first avian species used in cognitive bias tests was the European starling followed by the domestic chicken and other species. The most frequently used paradigm is the affect-induced judgment bias. There are many variations of the judgment bias tests in birds. The test itself is preceded by discrimination training. Discrimination tasks vary from visual cue discrimination, discrimination of time intervals to spatial location discrimination. During the discrimination training, birds flip or do not flip the lids of the food dishes, and their latency to approach the cues in a straight alley maze, in a two-choice arena, or different locations in spatial judgment task arena are measured. Alternately, the birds fulfill operant tasks in a Skinner box. Before or after the discrimination training phase, birds are subjected to manipulations that are hypothesized to induce positive or negative emotional states. In the last stage, birds are subjected to judgment bias tests. The assumption is that animals in a negative affective state would more likely respond to ambiguous cues, as if they predict the negative event, than animals in a more positive state. However, the results of some avian studies are inconsistent, particularly those studying the effect of environmental enrichment. In starlings, each of the three studies has supplied conflicting results. In poultry, none of the four studies demonstrated a positive effect of environmental enrichment on emotional states. Only the study using unpredictable stressors in combination with environmental complexity showed that animals kept in a more complex environment are more optimistic. Manipulation of the social environment seems to be more effective in judgment bias induction. Conflicting results could be attributable to the design of the tests, the manner of affect induction, or the data analysis. Further optimization and validation of avian cognitive bias tests could help to avoid problems such as the loss of ambiguity. New methods of attention and memory bias testing are promising. However, regardless of the abovementioned complications, a cognitive bias paradigm is a valuable tool, which can help us better understand avian emotions and assess poultry welfare., (© The Author(s) 2020. Published by Oxford University Press on behalf of the American Society of Animal Science. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

We investigated the association between cognitive control and individual differences in cortisol response to stress in participants with generalised anxiety disorder (GAD) and in never-disordered controls (CTL). To assess cognitive control, participants completed an affective version of the reading span task, which measures working memory capacity (WMC) in the presence of negative and neutral distractors. Participants then completed a standard psychosocial stressor and provided salivary cortisol samples throughout. The relation between WMC and cortisol response to stress was dependent on diagnostic group and distractor valence. Within the GAD group, greater WMC in the presence of neutral distractors was associated with attenuated cortisol response to stress, and greater WMC in the presence of negative distractors was associated with faster cortisol recovery from stress. In contrast, within the CTL group, WMC was unrelated to cortisol stress reactivity or recovery.

In this invited essay I plead for a renewed attention to mental representations in research into psychopathology and its treatment. With the cognitive revolution in the second half of the previous century most psychological models of psychopathology were based on people's capacity to form mental representations of the world. However, much research effort was put into investigating cognitive biases instead of investigating mental representations, and attention shifted towards such biases, including claims that they are causal in psychopathology. Similar claims were made about emotion regulation difficulties. Moreover, in many treatment models that were developed the focus was more on cognitive biases and emotion regulation, than on underlying representations. In this essay I argue that the causal status of cognitive biases, emotion regulation, and similar phenomena is overestimated, and that in clinical reality such phenomena can be best conceptualized as output of activated mental representations. Moreover, I argue that the disappointing effectiveness and protection to relapse of many current psychological treatments are related to not addressing the underlying mental representation. Next I discuss aspects of mental representations that are important for understanding and treating psychopathology, after which I discuss the clinical implications. I sketch how better understanding the specificities of mental representations can help us to improve psychological treatments, and I make some suggestions for future research., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The effectiveness of cognitive bias modification for interpretation (CBM-I), a treatment method employed to reduce social anxiety (SA), has been examined. However, the neural correlates of CBM-I remain unclear, and we aimed to elucidate brain activities during intervention and activity changes associated with CBM-I effectiveness in a pre-post intervention comparison. Healthy participants divided into two groups (CBM, control) were scanned before, during and after intervention using functional magnetic resonance imaging. Ambiguous social situations followed by positive outcomes were repeatedly imagined by the CBM group during intervention, while half of the outcomes in the control group were negative. Whole-brain analysis revealed that activation of the somatomotor and somatosensory areas, occipital lobe, fusiform gyrus and thalamus during intervention was significantly greater in the CBM than in the control group. Furthermore, altered activities in the somatomotor and somatosensory areas, occipital lobe and posterior cingulate gyrus during interpreting ambiguous social situations showed a significant group × change in SA interaction. Our result suggests that when facing ambiguous social situations, positive imagery instilled by CBM-I is recalled, and interpretations are modified to contain social reward. These findings may help to suggest an alternative manner of enhancing CBM-I effectiveness from a cognitive-neuroscience perspective., (© The Author(s) 2020. Published by Oxford University Press.)

A large number of theories about the development and maintenance of paranormal beliefs have been raised in the literature. There is, however, a lack of studies designed to integrate the different perspectives. We reviewed the literature and explored a series of factors in a sample of 180 individuals. Seven variables showed significant correlation indices at α = .01. A regression analysis revealed subjective paranormal experience as the variable that contributed the most to the explanation of paranormal belief, z = .43, 95% confidence interval (CI) [.24, .56]. Need for achievement (z = .31, 95% CI [.11, to .46]), conditional reasoning (z = .10, 95% CI [.09, .28]), and schizotypy (z = .29, 95% CI [.09, .45]) also contributed significantly in the equation. The associations found between the subscales of the Needs Questionnaire and belief in the paranormal support the hipothesis that paranormal belief may serve basic psychological needs. Similarly, the association found in the case of schizotypy suggests that paranormal belief might be held within the context of psychopathology. There was no evidence, however, supporting the hypothesis of a reasoning deficit in believers. It was concluded that, once paranormal beliefs develop, there is an interaction between belief and experience that strongly contributes towards its maintenance., (© 2019 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.)

Internet addiction and Internet gaming disorders are increasingly prevalent. Whilst there has been much focus on the use of conventional psychological approaches in the treatment of individuals with these addictive disorders, there has also been ongoing research exploring the potential of cognitive bias modification amongst individuals with Internet and gaming addiction. Some studies have documented the presence of cognitive biases and the effectiveness of bias modification for Internet addiction and gaming disorders. However, there have not been any reviews that have synthesized the findings related to cognitive biases for Internet addiction and Internet gaming disorders. It is important for us to undertake a scoping review as an attempt to map out the literature for cognitive biases in Internet addiction and gaming disorders. A scoping review was undertaken, and articles were identified using a search through the following databases: PubMed, MEDLINE, and PsycINFO. Six articles were identified. There were differences in the methods of ascertaining whether an individual has an underlying Internet or gaming addiction, as several different instruments have been used. With regards to the characteristics of the cognitive bias assessment task utilized, the most common task used was that of the Stroop task. Of the six identified studies, five have provided evidence documenting the presence of cognitive biases in these disorders. Only one study has examined cognitive bias modification and provided support for its effectiveness. Whilst several studies have provided preliminary findings documenting the presence of cognitive biases in these disorders, there remains a need for further research evaluating the effectiveness of bias modification, as well as the standardization of the diagnostic tools and the task paradigms used in the assessment.

Objective: Individuals with active major depressive disorder (MDD) have shown affective biases in cognitive flexibility and memory, particularly for negatively valenced stimuli. We evaluated whether impairments in affective flexibility would remain even during remission (rMDD), potentially representing trait- or scar-like effects of illness., Method: Participants completed the Emotion Card Sort Test (ECST), a measure of cognitive flexibility containing emotionally valenced stimuli, and the Emotion Word Stimulus Test (EWST), a measure of affective biases in delayed recall and recognition memory, and several self-report measures., Results: Healthy controls (HCs; n = 35) and individuals with rMDD (n = 93) did not differ on performance for any of the three word types on the ECST or EWT. However, individuals with rMDD demonstrated greater negative bias on EWT recognition trials relative to HCs (d = .36). On self-report measures, individuals with rMDD exhibited greater levels of neuroticism, problems with attentional control, pessimistic attributional style, and negative automatic thoughts compared to HCs., Conclusions: These results provide initial evidence that some performance, but not self-reported, indices of affective bias may improve during remission from MDD. Results of this study could suggest that some components of affective bias may represent state feature of illness and others trait-like risk or scar features., Practitioner Points: This study suggests that self-reported affective biases may persist in remission of major depressive disorder (rMDD). Affective attentional biases and affective memory biases were not demonstrated in individuals with rMDD, with the exception of a bias for recognizing negatively versus neutrally valenced stimuli., Cautions or Limitations: A limitation of this study was its cross-sectional design. Under ideal conditions, the same individuals would be studied in both the active and remitted phases of illness. Another limitation of this study was the smaller number of healthy controls relative to individuals with rMDD., (© 2019 The British Psychological Society.)

Over the past decade, the potential impact of cognitive bias in forensic science has instigated much discussion and debate between academics, scientists and those in the justice sector. Evidence of bias influencing subjective decision-making across a range of forensic disciplines has been described in the literature. Forensic service organisations are being urged to address cognitive bias in subjective decision-making by designing processes or procedures to limit access to (irrelevant) contextual information or reduce dependence on cognitive functions. Although some laboratories have implemented bias mitigating strategies, with varying impact on operational efficiency, there has been no systematic assessment of the risk posed by cognitive bias. Forensic Science SA assessed the potential impact of bias on forensic interpretations across multiple disciplines, using a risk management framework. This process proved useful in assessing the effectiveness of existing bias mitigating strategies and identified the latent level of risk posed. While all forensic organisations should seek to implement bias limiting measures that are simple, cost-effective and do not adversely impact efficiency, using a risk-based approach has contextualised the limited benefit of introducing resource hungry measures, as postulated in the literature. That is not to suggest that forensic organisations should dismiss the potential influence of cognitive bias but they need to strike an appropriate balance between risk and return, as they do with any business risk., (Crown Copyright © 2019. Published by Elsevier B.V. All rights reserved.)

Introduction: Age has been found to moderate the relation between cognitive biases and psychopathology, yet little is known about normative age-related change in these biases during adolescence. Adolescence might be a key developmental period for changes in negatively biased information-processing, and understanding the trajectories of these processes in a typically developing population is a pre-requisite for further comprehending their association with psychopathology., Methods: This study explores the effect of age on seven cognitive biases in a diverse community sample from the United Kingdom (N = 540) aged 10-17 years (309 were female) using self-report measures., Results: Age demonstrated a positive linear association with three biases: threat interpretation, negative attributions and overgeneralizing scores., Conclusions: Important changes take place during adolescence that may increase young people's negative cognitive biases. Empirical data on normative age-related changes in cognitive biases should be integrated into theoretical models of biased information-processing and psychopathology., (Copyright © 2019 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

Cognitive bias is a well-documented automatic process that can have serious negative consequences in a variety of settings. For example, cognitive bias within a forensic science setting can lead to examiners' judgements being swayed by details that they have learned while working on the case, and which go beyond the physical evidence being examined. Although cognitive bias has been studied in many forensic disciplines, such as fingerprints, bullet comparison, and document examination, knowledge of cognitive bias within forensic toxicology is lacking. Here, we address this knowledge gap by assessing the reported use of contextual information by an international group of forensic toxicologists attending the 54th conference of The International Association of Forensic Toxicologists (TIAFT) in Brisbane in 2016. In a first study, participants read a set of simple post-mortem toxicology results (two drug concentrations in blood) and then indicated what information they would normally use when interpreting these results in their day-to-day casework. Using a questionnaire, we then surveyed the familiarity of toxicologists with contextual bias and captured any suggested bias-minimizing procedures for use in forensic toxicology laboratories. Thirty-six participants from 23 different countries and with a range of 1-35 years' forensic toxicology reporting experience volunteered. Analysis of their responses showed that the majority of participants reported using some contextual information in their interpretation of these post-mortem toxicology results (range = 3-15 pieces of information, median ± SD = 11 ± 3), the most common being the deceased's history of prescription or illicit drug use. More than three-quarters of participants reported being familiar with the concept of contextual bias, although few (n = 9) worked in laboratories that had a formal policy covering it. Over half of participants knew of at least one bias-minimizing procedure specifically for forensic toxicology casework, but only a quarter (overall) reported using bias-minimizing procedures in their laboratories. Our results provide substantial evidence that although practising forensic toxicologists are familiar with contextual bias, many report that they still engage in behaviours that could lead to cognitive bias (e.g., through the use of contextual information, through lack of explicit policies or bias-minimizing procedures). We anticipate that our work will form the basis of further research involving a larger sample of participants and examining other potentially relevant factors such as sex/gender, country and accreditation of laboratories., (Copyright © 2019 The Chartered Society of Forensic Sciences. Published by Elsevier B.V. All rights reserved.)

Anomalies in future-oriented cognition are implicated in the maintenance of emotional disturbance within cognitive models of depression. Thinking about the future can involve mental imagery or verbal-linguistic mental representations. Research suggests that future thinking involving imagery representations may disproportionately impact on-going emotional experience in daily life relative to future thinking not involving imagery (verbal-linguistic representation only). However, while higher depression symptoms (dysphoria) are associated with impaired ability to deliberately generate positive relatively to negative imagery representations of the future (when instructed to do so), it is unclear whether dysphoria is associated with impairments in the tendency to do so spontaneously (when not instructed to deliberately generate task unrelated cognition of any kind). The present study investigated dysphoria-linked individual differences in the tendency to experience spontaneous future-oriented cognition as a function of emotional valence and representational format. Individuals varying in dysphoria level reported the occurrence of task unrelated thoughts (TUTs) in real time while completing a sustained attention go/no-go task, during exposure to auditory cues. Results indicate higher levels of dysphoria were associated with lower levels of positive bias in the number of imagery-based future TUTs reported, reflecting higher negative imagery-based future TUT generation (medium to large effect size), and lower positive imagery-based TUT generation (small to medium effect size). Further, this dysphoria-linked bias appeared to be specific in temporal orientation (future, not past) and representational format (imagery, not non-imagery). Reduced tendency to engage in positive relative to negative imagery-based future thinking appears to be implicated in dysphoria.

The extent to which cognitive biases may influence decision-making in forensic science is an important question with implications for training and practice. We conducted a systematic review of the literature on cognitive biases in forensic science disciplines. The initial literature search including electronic searching of three databases (two social science, one science) and manual review of reference lists in identified articles. An initial screening of title and abstract by two independent reviewers followed by full text review resulted in the identification of 29 primary source (research) studies. A critical methodological deficiency, serious enough to make the study too problematic to provide useful evidence, was identified in two of the studies. Most (n = 22) conducted analyses limited to practitioners (n = 17), forensic science trainees (n = 2), or both forensic science practitioners and students (n = 3); other analyses were based on university student or general population participants. Latent fingerprint analysis was examined in 11 studies, with 1-3 other studies found in 13 other disciplines or domains. This set of studies provides a robust database, with evidence of the influence of confirmation bias on analysts conclusions, specifically among the studies with practitioners or trainees presented with case-specific information about the "suspect" or crime scenario (in 9 of 11 studies examining this question), procedures regarding use of exemplar(s) (in 4 of 4 studies), or knowledge of a previous decision (in 4 of 4 studies). The available research supports the idea of susceptibility of forensic science practitioners to various types of confirmation bias and of the potential value of procedures designed to reduce access to unnecessary information and control the order of providing relevant information, use of multiple comparison samples rather than a single suspect exemplar, and replication of results by analysts blinded to previous results., (Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.)

Objectives: Depression, which is common following acquired brain injury (ABI), has been shown to predict cognitive impairment, rehabilitation outcome, and quality of life. Whilst many studies have examined links between depression and cognitive-affective processing in the non-ABI population, their applicability to this important clinical group, where cognitive difficulties can be marked, remains unknown. Here, we investigated biases in prospective cognition, which is known to be disrupted in (non-ABI) depression yet important for well-being., Design: Cross-sectional design with three groups (depressed ABI, non-depressed ABI, and non-ABI control participants). Continuous data were additionally analysed in correlation analyses., Methods: Individuals with ABI varying in extent of self-reported depression and matched non-ABI control participants completed assessments of mood and prospective cognition (anticipating and imagining future events), alongside background tests of executive function and fluid intelligence., Results: Relative to non-depressed ABI and control participants, depressed ABI individuals demonstrated a reduced positive bias in prospective cognition: whereas non-depressed ABI and control participants generated more examples of likely or possible positive versus negative future events, there was no evidence for such a positive bias in depressed ABI participants. Non-depressed ABI and control participants also reported more vivid mental imagery for positive versus negative future scenarios, whereas such a pattern was not evident in depressed ABI participants. This pattern emerged despite background impairments in fluid intelligence and executive function associated with ABI., Conclusions: These findings (1) elucidate depression-linked cognitive-affective processes following ABI, where cognitive difficulties are common, and (2) highlight psychological processes associated with depression that are common to ABI and non-ABI populations., Practitioner Points: Clinical implications A relative negative bias in future-directed cognition is associated with depressed mood in individuals with chronic ABI. Such processes may contribute to the onset and maintenance of depression following ABI. These findings suggest it may be important to consider a role for prospective cognition in psychological interventions for depression following ABI. Limitations of the study The extent to which depressed mood following ABI is associated with biases in other cognitive domains remains unclear. Whether similar patterns would be observed in acute patients with more profound cognitive difficulties requires further investigation. Despite large effect sizes, our sample size is modest; these effects thus require replication in larger groups., (© 2018 The Authors. British Journal of Clinical Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Background: The success of internet-based mental health interventions in practice-that is, in the wild-depends on the uptake and retention of the application and the user's focused attention in the moment of use. Incorporating game-based motivational design into digital interventions delivered in the wild has been shown to increase uptake and retention in internet-based training; however, there are outstanding questions about the potential of game-based motivational strategies to increase engagement with a task in the moment of use and the effect on intervention efficacy., Objective: Designers of internet-based interventions need to know whether game-based motivational design strategies can increase in-the-moment engagement and thus improve digital interventions. The aim of this study was to investigate the effects of 1 motivational design strategy (avatar customization) in an example mental health intervention (computerized cognitive training for attention bias modification)., Methods: We assigned 317 participants to either a customized avatar or an assigned avatar condition. After measuring state anxiety (State-Trait Anxiety Inventory), we randomly assigned half of the participants in each condition to either an attentional retraining condition (Attention Bias Modification Training) or a control condition. After training, participants were exposed to a negative mood induction using images with strong negative valance (International Affective Picture System), after which we measured state anxiety again., Results: Avatar customization decreased posttraining state anxiety when controlling for baseline state anxiety for those in the attentional retraining condition; however, those who did not train experienced decreased resilience to the negative mood induction (F 1,252 =6.86, P=.009, η p 2 =.027). This interaction effect suggests that customization increased task engagement with the intervention in the moment of use. Avatar customization also increased avatar identification (F 5,252 =12.46, P<.001, R 2 =.23), regardless of condition (F 1,252 =.79, P=.38). Avatar identification reduced anxiety after the negative mood induction for participants who underwent training but increased poststimulus anxiety for participants who did not undergo training, further suggesting that customization increases engagement in the task (F 1,252 =6.19, P=.01). The beneficial effect of avatar customization on training was driven by participants who were low in their basic satisfaction of relatedness (F 10,248 =18.5, P<.001, R 2 =.43), which is important because these are the participants who are most likely in need of digital interventions for mental health., Conclusions: Our results suggest that applying motivational design-specifically avatar customization-is a viable strategy to increase engagement and subsequently training efficacy in a computerized cognitive task., (©Max Valentin Birk, Regan Lee Mandryk. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 08.01.2019.)

Several studies on age-related cognitive decline in dogs involve laboratory dogs and prolonged training. We developed two spatial tasks that required a single 1-h session. We tested 107 medium-large sized dogs: "young" (N=41, aged 2.5-6.5 years) and "old" (N=66, aged 8-14.5 years). Our results indicated that, in a discrimination learning task and in a reversal learning task, young dogs learned significantly faster than the old dogs, indicating that these two tasks could successfully be used to investigate differences in spatial learning between young and old dogs. We also provide two novel findings. First, in the reversal learning, the dogs trained based on the location of stimuli learned faster than the dogs trained based on stimulus characteristics. Most old dogs did not learn the task within our cut-off of 50 trials. Training based on an object's location is therefore more appropriate for reversal learning tasks. Second, the contrast between the response to the positive and negative stimuli was narrower in old dogs, compared to young dogs, during the reversal learning task, as well as the cognitive bias test. This measure favors comparability between tasks and between studies. Following the cognitive bias test, we could not find any indication of differences in the positive and negative expectations between young and old dogs. Taken together, these findings do not support the hypothesis that old dogs have more negative expectations than young dogs and the use of the cognitive bias test in older dogs requires further investigation.

The identification of cognitive bias has become an important measure of animal welfare. Negative cognitive biases develop from a tendency for animals to process novel information pessimistically. Judgment-bias testing is the commonplace methodology to detect cognitive biases. However, concerns with these methods have been frequently-reported; one of which being the discrepancy between male and female cognitive expression. The current study assessed the factors of social status and oestrus, to investigate whether oestrous cycle rotation, or subordination stress encouraged an increase in pessimistic responses. Female Sprague-Dawley rats (n = 24) were trained on an active-choice judgment bias paradigm. Responses to the ambiguous probe were recorded as optimistic or pessimistic. Oestrous phase was determined by assessing vaginal cytology in stained vaginal cell smears. Rats in the dioestrous phase and those rats considered to be subordinate demonstrated an increased percentage of pessimistic responses. However, no interaction between these factors was observed. This suggests that oestrous cyclicity can influence the judgment biases of female animals; a previously unreported finding. On this basis, researchers should be encouraged to account for both oestrous phase cyclicity and social status as an additional fixed effect in study design., (Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.)

Background Diagnostic errors are a significant cause of patient harm. Cognitive processes often contribute to diagnostic errors but studying and mitigating the effects of these errors is challenging. Computerized virtual patients may provide insight into the diagnostic process without the potential for patient harm, but the feasibility and utility of using such cases in practicing physicians has not been well described. Methods We developed a series of computerized virtual cases depicting common presentations of disease that included contextual factors that could result in diagnostic error. Cases were piloted by practicing physicians in two phases and participant impressions of the case platform and cases were recorded, as was outcome data on physician performance. Results Participants noted significant challenges in using the case platform. Participants specifically struggled with becoming familiar with the platform and adjusting to the non-adaptive and constraining processes of the model. Although participants found the cases to be typical presentations of problems commonly encountered in practice, the correct diagnosis was identified in less than 33% of cases. Conclusions The development of virtual patient cases for use by practicing physicians requires substantial resources and platforms that account for the non-linear and adaptive nature of reasoning in experienced clinicians. Platforms that are without such characteristics may negatively affect diagnostic performance. The novelty of such platforms may also have the potential to increase cognitive load. Nonetheless, virtual cases may have the potential to be a safe and robust means of studying clinical reasoning performance.

Background Clinical medicine has long recognized the potential for cognitive bias in the development of new treatments, and in response developed a tradition of blinding both clinicians and patients to address this specific concern. Although cognitive biases have been shown to exist which impact the accuracy of clinical diagnosis, blinding the diagnostician to potentially misleading information has received little attention as a possible solution. Recently, within the forensic sciences, the control of contextual information (i.e. information apart from the objective test results) has been studied as a technique to reduce errors. We consider the applicability of this technique to clinical medicine. Content This article briefly describes the empirical research examining cognitive biases arising from context which impact clinical diagnosis. We then review the recent awakening of forensic sciences to the serious effects of misleading information. Comparing the approaches, we discuss whether blinding to contextual information might (and in what circumstances) reduce clinical errors. Summary and outlook Substantial research indicates contextual information plays a significant role in diagnostic error and conclusions across several medical specialties. The forensic sciences may provide a useful model for the control of potentially misleading information in diagnosis. A conceptual analog of the forensic blinding process (the "agnostic" first reading) may be applicable to diagnostic investigations such as imaging, microscopic tissue examinations and waveform recognition. An "agnostic" approach, where the first reading occurs with minimal clinical referral information, but is followed by incorporation of the clinical history and reinterpretation, has the potential to reduce errors.

Cognitive bias is increasingly recognised as an important source of medical error, and is both ubiquitous across clinical practice yet incompletely understood. This increasing awareness of bias has resulted in a surge in clinical and psychological research in the area and development of various 'debiasing strategies'. This paper describes the potential origins of bias based on 'dual process thinking', discusses and illustrates a number of the important biases that occur in clinical practice, and considers potential strategies that might be used to mitigate their effect., Competing Interests: No financial or competing interests declared

Background: Baclofen has shown promise in the treatment of alcohol dependence. However, its precise (neuro-) psychological working mechanism is still under debate., Aims: This study aimed to get a better understanding of baclofen's working mechanism by examining the effect of baclofen on cognitive biases. It was hypothesized that baclofen, compared to placebo, would lead to weaker cognitive biases. Furthermore, given a suggested anxiolytic effect of baclofen, we expected that anxiety would moderate this effect., Methods: From a larger randomized clinical trial (RCT) with 151 participants, a subset of 143 detoxified alcohol-dependent patients, either taking baclofen or placebo, was examined. Attentional bias for alcohol (500 and 1500 ms), alcohol approach tendencies, implicit alcohol-relaxation associations and trait anxiety were assessed before the administration of baclofen or placebo. Four weeks later, 94 patients were still abstinent (53 in the baclofen and 41 in the placebo condition) and cognitive biases were assessed again., Results: At baseline, patients showed a vigilance-avoidance pattern for the attentional bias (at 500 and 1500 ms, respectively) and alcohol-negative associations. After 4 weeks, an indication for an attentional bias away from alcohol at 500 ms was found only in the baclofen group; however, cognitive biases did not differ significantly between treatment groups. No moderating role of anxiety on cognitive biases was found., Conclusions: Baclofen did not lead to a differential change in cognitive biases compared with placebo, and trait anxiety levels did not moderate this. A better understanding of the working mechanism of baclofen and predictors of treatment success would allow prescribing of baclofen in a more targeted manner.

Failure carries undeniable stigma and is difficult to confront for individuals, teams, and organizations. Disciplines such as commercial and military aviation, medicine, and business have long histories of grappling with it, beginning with the recognition that failure is inevitable in every human endeavor. Although conservation may arguably be more complex, conservation professionals can draw on the research and experience of these other disciplines to institutionalize activities and attitudes that foster learning from failure, whether they are minor setbacks or major disasters. Understanding the role of individual cognitive biases, team psychological safety, and organizational willingness to support critical self-examination all contribute to creating a cultural shift in conservation to one that is open to the learning opportunity that failure provides. This new approach to managing failure is a necessary next step in the evolution of conservation effectiveness., (© 2017 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.)

Objective: The field of cognitive science has provided important insights into mental processes underlying the interpretation of imaging examinations. Despite these insights, diagnostic error remains a major obstacle in the goal to improve quality in radiology. In this article, we describe several types of cognitive bias that lead to diagnostic errors in imaging and discuss approaches to mitigate cognitive biases and diagnostic error., Conclusion: Radiologists rely on heuristic principles to reduce complex tasks of assessing probabilities and predicting values into simpler judgmental operations. These mental shortcuts allow rapid problem solving based on assumptions and past experiences. Heuristics used in the interpretation of imaging studies are generally helpful but can sometimes result in cognitive biases that lead to significant errors. An understanding of the causes of cognitive biases can lead to the development of educational content and systematic improvements that mitigate errors and improve the quality of care provided by radiologists.

Many animals display a suite of increased vigilance and/or activity responses in relation to upcoming events, termed "anticipatory behavior." Anticipatory behavior toward positive events has been suggested as a cross-species measure of affective state as it likely reflects the balance of the reward-sensitivity system: various studies suggest that animals in poorer welfare situations show higher or excessive levels of anticipation for positive events. Another tool for evaluating animals' affective state is cognitive bias testing, and although it has been attempted, a link has not yet been made between cognitive bias and anticipatory behavior levels. Bottlenose dolphins (Tursiops truncatus) in captivity increase the performance of behaviors such as surface-looking and spy-hopping in anticipation of training sessions during which food is provided. In this study we measured anticipatory behavior frequency in bottlenose dolphins prior to positive reinforcement training sessions, and assessed whether frequency of anticipatory behavior correlated with their performance on cognitive bias tasks. We found that higher frequencies of anticipatory behavior for training sessions was significantly associated with more pessimistic judgements in cognitive bias tests, supporting previous findings linking higher reward sensitivity with negative affective states. Anticipatory behavior is an easily measured activity and could represent a welfare indicator in dolphins as well as other animals in captive environments., (© 2018 Wiley Periodicals, Inc.)

Most research into cognitive biases has used Western samples, despite potential East-West socio-cultural differences. One reason is the lack of appropriate measures for non-Westerners. This study is about cross-linguistic equivalence which needs to be established before assessing cross-cultural differences in future research. We developed parallel Mandarin and English measures of interpretation bias and attention bias using back-translation and decentering procedures. We assessed task equivalence by administering both sets of measures to 47 bilingual Mandarin-English speakers. Interpretation bias measurement was similar and reliable across language versions, confirming suitability of the Mandarin versions for future cross-cultural research. By contrast, scores on attention bias tasks did not intercorrelate reliably, suggesting that nonverbal stimuli such as pictures or facial expressions of emotion might present better prospects for cross-cultural comparison. The development of the first set of equivalent measures of interpretation bias in an Eastern language paves the way for future research investigating East-West differences in biased cognition.

Background: Cognitive biases are mostly automatic processes that result in individuals giving increased attention to threatening stimuli, with the difficulties in disengaging from these stimuli. Recent reviews have reported the presence for attention bias in several psychiatric conditions and provided evidence that such biases could be subjected to modification. Web-based and mobile based bias modification have mixed efficacy and gamification techniques proposed as a solution. There remains a gap in knowledge pertaining to the gamified applications for bias modification that are commercially available., Objective: An analysis of their gamification approach will help in identification of common gaming elements adopted for use., Methods: To identify commercial applications, a manual cross-sectional search was conducted between 1 and 11 November 2017 on the Google Play store. The following search terminologies were used: "Attention bias" and "Cognitive bias". The classification of the gamification technique for both the published applications and commercial applications were based on the six approaches described by Wouter et al. [17] and the 17 gamification techniques described by Hoffman et al. [18]., Results: A total of nine applications were included in the current review. Five out of the nine applications involved the addition of gaming elements to an evidence-based task, and three involved the usage of intrinsic integration while leaving the evidence-based task intact. Other common gamification strategies used are that of the inclusion of digital rewards (n= 8) and the provision of feedback (n= 7). The average number of gamification techniques across all the nine applications is 3.2., Conclusions: Even though most commercial applications appear to have their basis on a validated gamification approach for the delivery of attention bias modification, there remains a need for further research in evaluating these applications clinically.

Diagnostic errors have a significant impact on health care outcomes and patient care. The underlying causes and development of diagnostic error are complex with flaws in health care systems, as well as human error, playing a role. Cognitive biases and a failure of decision-making shortcuts (heuristics) are human factors that can compromise the diagnostic process. We describe these mechanisms, their role with the clinician, and provide clinical scenarios to highlight the various points at which biases may emerge. We discuss strategies to modify the development and influence of these processes and the vulnerability of heuristics to provide insight and improve clinical outcomes., (Copyright © 2017 Elsevier Inc. All rights reserved.)

This chapter examines the importance of studying hand preference together with different expressions of behavior. Cognitive differences between left- and right-handed primates are discussed. As shown in several species of primate, eye preference, but not hand preference, is biased at the level of the population and reflects hemispheric asymmetry of processing. Hand preference, determined from simple grasping of pieces of food and taking them to the mouth, is consistent for individuals but it is not population biased. It is a measure of an individual's preference to use a particular hemisphere, and hence which cognitive processes are characteristic of the individual. Compared to left-handed subjects, right-handed subjects are more active in exploring novel objects, show more social facilitation of behavior, have a positive cognitive bias, and express lower levels of fear and stress responses. In marmosets, learning of food searching tasks is not associated with hand preference. Strength of hand preference, rather than its direction, is linked to the ability to perform two tasks at once, viz., detection of a predator while searching for food. Marmosets with strong hand preferences are able to perform these two tasks at once but those with weak or no hand preference are unable to do so., (© 2018 Elsevier B.V. All rights reserved.)

Construct: Authors examined whether a new vignette-based instrument could isolate and quantify heuristic bias., Background: Heuristics are cognitive shortcuts that may introduce bias and contribute to error. There is no standardized instrument available to quantify heuristic bias in clinical decision making, limiting future study of educational interventions designed to improve calibration of medical decisions. This study presents validity data to support a vignette-based instrument quantifying bias due to the anchoring, availability, and representativeness heuristics., Approach: Participants completed questionnaires requiring assignment of probabilities to potential outcomes of medical and nonmedical scenarios. The instrument randomly presented scenarios in one of two versions: Version A, encouraging heuristic bias, and Version B, worded neutrally. The primary outcome was the difference in probability judgments for Version A versus Version B scenario options., Results: Of 167 participants recruited, 139 enrolled. Participants assigned significantly higher mean probability values to Version A scenario options (M = 9.56, SD = 3.75) than Version B (M = 8.98, SD = 3.76), t(1801) = 3.27, p = .001. This result remained significant analyzing medical scenarios alone (Version A, M = 9.41, SD = 3.92; Version B, M = 8.86, SD = 4.09), t(1204) = 2.36, p = .02. Analyzing medical scenarios by heuristic revealed a significant difference between Version A and B for availability (Version A, M = 6.52, SD = 3.32; Version B, M = 5.52, SD = 3.05), t(404) = 3.04, p = .003, and representativeness (Version A, M = 11.45, SD = 3.12; Version B, M = 10.67, SD = 3.71), t(396) = 2.28, p = .02, but not anchoring. Stratifying by training level, students maintained a significant difference between Version A and B medical scenarios (Version A, M = 9.83, SD = 3.75; Version B, M = 9.00, SD = 3.98), t(465) = 2.29, p = .02, but not residents or attendings. Stratifying by heuristic and training level, availability maintained significance for students (Version A, M = 7.28, SD = 3.46; Version B, M = 5.82, SD = 3.22), t(153) = 2.67, p = .008, and residents (Version A, M = 7.19, SD = 3.24; Version B, M = 5.56, SD = 2.72), t(77) = 2.32, p = .02, but not attendings., Conclusions: Authors developed an instrument to isolate and quantify bias produced by the availability and representativeness heuristics, and illustrated the utility of their instrument by demonstrating decreased heuristic bias within medical contexts at higher training levels.

Extinction of learning is a common, yet under-reported limitation of judgment bias testing methods Repeated exposure to the ambiguous probe of a judgment bias paradigm encourages the animal to cease display of the required behaviours. However, there remains a need to repeatedly test animals to achieve statistical power. A delicate balance therefore needs to be struck between over- and under-exposure of the animals to the test conditions. This study presents the data of rats, a common animal subject of judgment bias testing. Rats were exposed to the ambiguous probe of a common, active-choice judgment bias test for 11 consecutive days. There was a significant increase in the latency to respond to the ambiguous probe following day 8, with no significant increase experienced for either the positive or less-positive probes. Following day 8 there was a significant increase in both optimistic and pessimistic latencies in response to the ambiguous probe. Therefore, repeated exposure to the ambiguous probe caused an increased latency in response even though optimistic interpretations were recorded. This implies that the use of response latency alone as a measure in judgment bias testing can falsely identify pessimism. Researchers should modify experimental design to include both choice and latency measures., (Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.)

Background: Optimal psychological development is dependent upon a complex interplay between individual and situational factors. Investigating the development of these factors in adolescence will help to improve understanding of emotional vulnerability and resilience. The CogBIAS longitudinal study (CogBIAS-L-S) aims to combine cognitive and genetic approaches to investigate risk and protective factors associated with the development of mood and impulsivity-related outcomes in an adolescent sample., Methods: CogBIAS-L-S is a three-wave longitudinal study of typically developing adolescents conducted over 4 years, with data collection at age 12, 14 and 16. At each wave participants will undergo multiple assessments including a range of selective cognitive processing tasks (e.g. attention bias, interpretation bias, memory bias) and psychological self-report measures (e.g. anxiety, depression, resilience). Saliva samples will also be collected at the baseline assessment for genetic analyses. Multilevel statistical analyses will be performed to investigate the developmental trajectory of cognitive biases on psychological functioning, as well as the influence of genetic moderation on these relationships., Discussion: CogBIAS-L-S represents the first longitudinal study to assess multiple cognitive biases across adolescent development and the largest study of its kind to collect genetic data. It therefore provides a unique opportunity to understand how genes and the environment influence the development and maintenance of cognitive biases and provide insight into risk and protective factors that may be key targets for intervention.

Slaughter is a crucial step in the meat production chain that could induce psychological stress on each animal, resulting in a physiological response that can differ among individuals. The aim of this study was to investigate the relationship between an animal's emotional state, the subsequent psychological stress at slaughter and the cellular damage as an effect. In all, 36 entire male pigs were reared at an experimental farm and a cognitive bias test was used to classify them into positive bias (PB) or negative bias (NB) groups depending on their decision-making capabilities. Half of the animals, slaughtered in the same batch, were used for a complete study of biomarkers of stress, including brain neurotransmitters and some muscle biomarkers of oxidative stress. After slaughter, specific brain areas were excised and the levels of catecholamines (noradrenaline (NA) and dopamine (DA)) and indoleamines (5-hydroxyindoleacetic acid and serotonin (5HT)) were analyzed. In addition, muscle proteasome activity (20S), antioxidant defence (total antioxidant activity (TAA)), oxidative damage (lipid peroxidation (LPO)) and autophagy biomarkers (Beclin-1, microtubule-associated protein I light chain 3 (LC3-I) and LC3-II) were monitored during early postmortem maturation (0 to 24 h). Compared with PB animals, NB pigs were more susceptible to stress, showing higher 5HT levels (P<0.01) in the hippocampus and lower DA (P<0.001) in the pre-frontal cortex. Furthermore, NB pigs had more intense proteolytic processes and triggered primary muscle cell survival mechanisms immediately after slaughter (0 h postmortem), thus showing higher TAA (P<0.001) and earlier proteasome activity (P<0.001) and autophagy (Beclin-1, P<0.05; LC3-II/LC3-I, P<0.001) than PB pigs, in order to counteract the induced increase in oxidative stress, that was significantly higher in the muscle of NB pigs at 0 h postmortem (LPO, P<0.001). Our study is the first to demonstrate that pig's cognitive bias influences the animal's susceptibility to stress and has important effects on the postmortem muscle metabolism, particularly on the cell antioxidant defences and the autophagy onset. These results expand the current knowledge regarding biomarkers of animal welfare and highlight the potential use of biomarkers of the proteasome, the autophagy (Beclin-1, LC3-II/LC3-I ratio) and the muscle antioxidant defence (TAA, LPO) for detection of peri-slaughter stress.

Clinical decisions often rely on pattern recognition, simple rules of thumb, tacit knowledge and habit. In many instances, such intuitive decisions are fast and accurate, but they can be subject to cognitive biases leading to delivery of care of low value at odds with scientific evidence of best practice. If programmes, such as EVOLVE (Evaluating Evidence, Enhancing Efficiencies) and Choosing Wisely are to have maximal impact in minimising low value care, such biases, and the factors that hide and accentuate them, need to be exposed and addressed in a collegiate and non-judgemental manner., (© 2017 Royal Australasian College of Physicians.)

Cognitive models of insomnia consistently suggest that negative expectations regarding the consequences of poor sleep contribute to the maintenance of insomnia. To date, however, no research has sought to determine whether insomnia is indeed characterised by such a negative sleep-related expectancy bias, using objective cognitive assessment tasks which are more immune to response biases than questionnaire assessments. Therefore, the current study employed a reaction-time task assessing biased expectations among a group with clinically significant insomnia symptoms (n = 30) and a low insomnia symptoms group (n = 40). The task involved the presentation of scenarios describing the consequences of poor sleep, and non-sleep related activities, which could be resolved in a benign or a negative manner. The results demonstrated that the high insomnia symptoms group were disproportionately fast to resolve sleep-related scenarios in line with negative outcomes, as compared to benign outcomes, relative to the low insomnia symptoms group. The two groups did not differ in their pattern of resolving non-sleep related scenarios. This pattern of findings is entirely consistent with a sleep-specific expectancy bias operating in individuals with clinically significant insomnia symptoms, and highlights the potential of cognitive-experimental assessment tasks to objectively index patterns of biased cognition in insomnia., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Rejection sensitivity and negative cognitive biases have been identified as important risk factors for depression. Rejection sensitivity is defined as the tendency to anxiously anticipate, easily perceive, and overreact to rejection. Although prior studies have found an association between one component of rejection sensitivity, the tendency to anxiously anticipate rejection, and depression, little is known about the mechanisms through which anxious anticipation of rejection might confer depression risk. One possibility is that rejection anticipation leads to negatively biased interpretations, a cognitive risk factor for depression. Results from two studies (one cross-sectional, one longitudinal) indicate that negative interpretation biases mediate the association between the anxious anticipation of rejection and depressive symptoms. These findings indicate that interpretation biases represent a mechanism through which anxious anticipation of rejection confers risk for depression, and suggest that interventions designed to challenge negative interpretations may help to decrease depression risk among individuals who anticipate rejection.