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Biomedical subjects

George Loewenstein

Publications and source records attributed to George Loewenstein.

At least 19 recordsLinked to original sources
PubMed2007

Neural predictors of purchases.

Microeconomic theory maintains that purchases are driven by a combination of consumer preference and price. Using event-related fMRI, we investigated how people weigh these factors to make purchasing decisions. Consistent with neuroimaging evidence suggesting that distinct circuits anticipate gain and loss, product preference activated the nucleus accumbens (NAcc), while excessive prices activated the insula and deactivated the mesial prefrontal cortex (MPFC) prior to the purchase decision. Activity from each of these regions independently predicted immediately subsequent purchases above and beyond self-report variables. These findings suggest that activation of distinct neural circuits related to anticipatory affect precedes and supports consumers' purchasing decisions.

Adolescent↗
PubMed2006

Neuroeconomics: cross-currents in research on decision-making.

Despite substantial advances, the question of how we make decisions and judgments continues to pose important challenges for scientific research. Historically, different disciplines have approached this problem using different techniques and assumptions, with few unifying efforts made. However, the field of neuroeconomics has recently emerged as an inter-disciplinary effort to bridge this gap. Research in neuroscience and psychology has begun to investigate neural bases of decision predictability and value, central parameters in the economic theory of expected utility. Economics, in turn, is being increasingly influenced by a multiple-systems approach to decision-making, a perspective strongly rooted in psychology and neuroscience. The integration of these disparate theoretical approaches and methodologies offers exciting potential for the construction of more accurate models of decision-making.

Brain↗
PubMed2006

Prisoners' positive illusions of their post-release success.

Prisoners' forecasts of post-release success may have implications for how they respond to imprisonment, release, and parole decisions. We examined sentenced US and UK prisoners' forecasts of recidivism, and how well UK prisoners believed they would fare compared to the average other prisoner. In both samples, forecasts of recidivism were unrealistically optimistic when compared to official statistics on recidivism. UK prisoners also demonstrated a self-enhancement bias by forecasting that they were less likely to re-offend than other prisoners. Prisoners' forecasts of recidivism were predicted by only a few of the pre-prison, in-prison, and post-prison factors that have been shown to be associated with actual recidivism. We discuss the implications of these findings and propose avenues for future research.

Adaptation, Psychological↗
PubMed2006

Misremembering colostomies? Former patients give lower utility ratings than do current patients.

Community members often evaluate health conditions more negatively than do the patients who have them. The authors investigated whether experience with a health condition reduces this discrepancy by surveying colostomy patients by mail (n = 195), some of whom (n = 100) had their colostomies reversed and normal bowel function restored. The authors also surveyed a community sample recruited via the Internet (n = 567). They then compared all 3 groups' utility value for life with a colostomy by using the time trade-off utility measure and by examining ratings of current quality of life. Despite having direct experience with the health condition, former colostomy patients provided much lower utility valuations than did current patients. In fact, their valuations were similar to those given by a community sample. Rather than accurately remembering their actual experiences with colostomies, the former patients may have applied a theory of how colostomies had influenced their lives; this is consistent with other research on theory driven recall bias.

Adult↗
PubMed2005

The dark side of emotion in decision-making: when individuals with decreased emotional reactions make more advantageous decisions.

Can dysfunction in neural systems subserving emotion lead, under certain circumstances, to more advantageous decisions? To answer this question, we investigated how individuals with substance dependence (ISD), patients with stable focal lesions in brain regions related to emotion (lesion patients), and normal participants (normal controls) made 20 rounds of investment decisions. Like lesion patients, ISD made more advantageous decisions and ultimately earned more money from their investments than the normal controls. When normal controls either won or lost money on an investment round, they adopted a conservative strategy and became more reluctant to invest on the subsequent round, suggesting that they were more affected than lesion patients and ISD by the outcomes of decisions made in the previous rounds.

Alcoholism↗
PubMed2005

Ignorance of hedonic adaptation to hemodialysis: a study using ecological momentary assessment.

Healthy people generally underestimate the self-reported well-being of people with disabilities and serious illnesses. The cause of this discrepancy is in dispute, and the present study provides evidence for 2 causes. First, healthy people fail to anticipate hedonic adaptation to poor health. Using an ecological momentary assessment measure of mood, the authors failed to find evidence that hemodialysis patients are less happy than healthy nonpatients are, suggesting that they have largely, if not completely, adapted to their condition. In a forecasting task, healthy people failed to anticipate this adaptation. Second, although controls understated their own mood in both an estimation task and a recall task, patients were quite accurate in both tasks. This relative negativity in controls' estimates of their own moods could also contribute to their underestimation of the moods and overall well-being of patients.

Adaptation, Psychological↗
PubMed2005

Hot-cold empathy gaps and medical decision making.

Prior research has shown that people mispredict their own behavior and preferences across affective states. When people are in an affectively "cold" state, they fail to fully appreciate how "hot" states will affect their own preferences and behavior. When in hot states, they underestimate the influence of those states and, as a result, overestimate the stability of their current preferences. The same biases apply interpersonally; for example, people who are not affectively aroused underappreciate the impact of hot states on other people's behavior. After reviewing research documenting such intrapersonal and interpersonal hot-cold empathy gaps, this article examines their consequences for medical, and specifically cancer-related, decision making, showing, for example, that hot-cold empathy gaps can lead healthy persons to expose themselves excessively to health risks and can cause health care providers to undertreat patients for pain.

Decision Making↗
PubMed2005

Misimagining the unimaginable: the disability paradox and health care decision making.

Good decision making often requires accurate predictions about how potential outcomes will make one feel. However, people often mispredict the emotional impact of unfamiliar circumstances. For example, they often overestimate the emotional impact that chronic illnesses and disability will have on their lives. In the present article, the authors look at possible sources of error in both the happiness reports of patients with chronic illness or disability and the happiness predictions of healthy people asked to imagine the same illnesses and disabilities. On balance, the available evidence suggests that, whereas patients misreport their well-being, healthy people also mispredict the emotional impact that chronic illness and disability will have on their lives.

Adaptation, Psychological↗
PubMed2005

Effects of smoking urge on temporal cognition.

The authors examined temporal aspects of smoking urge. In Experiment 1, smokers assigned to high- or low-urge conditions were informed they would be allowed to smoke in 2.5 min. They next completed measures of time perception. High-urge smokers reported 45 s to pass significantly more slowly than did low-urge smokers. In Experiment 2, the high-urge smokers from Experiment 1 anticipated that their urges would climb steadily over the next 45 min if they were not permitted to smoke. Another group of high-urge smokers actually reported their urges over 45 min. These urge ratings did not show the steady rise anticipated by the first group. Results suggest that smoking urge may affect time perception and that craving smokers overpredict the duration and intensity of their own future smoking urges if they abstain.

Adolescent↗
PubMed2005

Disability and sunshine: can hedonic predictions be improved by drawing attention to focusing illusions or emotional adaptation?

People frequently mispredict the long-term emotional impact of circumstances. The authors examine 2 causes of such mispredictions-a focusing illusion and underappreciation of adaptation. In Experiment 1, the authors found, in 852 adults, that quality of life estimates (for living with disability) were not increased by reducing focusing illusions. In Experiment 2, the authors found, in 698 adults, that people's disability estimates were increased by asking them to reflect on adaptation. In Experiment 3, the authors found, across 312 Midwestern college students, that both approaches reduced the participants' predictions of the life satisfaction of their peers living in southern California. In the case of living in a better climate, the results suggest that attention to either cause influences people's predictions, whereas in the case of chronic disability, the results suggest that it is easier to get people to appreciate adaptation than it is to reduce focusing illusions.

Adaptation, Psychological↗
PubMed2005

Investment behavior and the negative side of emotion.

Can dysfunction in neural systems subserving emotion lead, under certain circumstances, to more advantageous decisions? To answer this question, we investigated how normal participants, patients with stable focal lesions in brain regions related to emotion (target patients), and patients with stable focal lesions in brain regions unrelated to emotion (control patients) made 20 rounds of investment decisions. Target patients made more advantageous decisions and ultimately earned more money from their investments than the normal participants and control patients. When normal participants and control patients either won or lost money on an investment round, they adopted a conservative strategy and became more reluctant to invest on the subsequent round; these results suggest that they were more affected than target patients by the outcomes of decisions made in the previous rounds.

Affect↗
PubMed2004

Separate neural systems value immediate and delayed monetary rewards.

When humans are offered the choice between rewards available at different points in time, the relative values of the options are discounted according to their expected delays until delivery. Using functional magnetic resonance imaging, we examined the neural correlates of time discounting while subjects made a series of choices between monetary reward options that varied by delay to delivery. We demonstrate that two separate systems are involved in such decisions. Parts of the limbic system associated with the midbrain dopamine system, including paralimbic cortex, are preferentially activated by decisions involving immediately available rewards. In contrast, regions of the lateral prefrontal cortex and posterior parietal cortex are engaged uniformly by intertemporal choices irrespective of delay. Furthermore, the relative engagement of the two systems is directly associated with subjects' choices, with greater relative fronto-parietal activity when subjects choose longer term options.

Adult↗
PubMed2004

Quality of death: assessing the importance placed on end-of-life treatment in the intensive-care unit.

CONTEXT: The value of good end-of-life (EOL) care could be underestimated if its effects are assessed using the standard metric of quality-adjusted survival, especially if the time horizon is limited to the duration of the EOL care. This issue is particularly problematic in the intensive-care unit (ICU) where death is frequent, care is difficult, and costs are high. OBJECTIVES: The objectives of this study were to test whether people would trade healthy life expectancy for better EOL care, to understand how much life expectancy they would trade relative to domains of good care, and to determine the association of respondent characteristics to time traded. DESIGN AND SUBJECTS: We used a computerized survey instrument describing hypothetical patient experiences in the ICU used to assess attitudes of a general population sample (n = 104) recruited in Pittsburgh, Pennsylvania. MEASURES: We used life expectancy traded (from a baseline of 80 healthy years followed by a 1-month fatal ICU stay) for improving ICU care in 4 domains: pain and discomfort, daily surroundings, treatment decisions, and family support. RESULTS: Three fourths of respondents (n = 78) were prepared to shorten healthy life for better EOL care. Median time traded in individual domains ranged from 7.2 to 7.7 months overall and 9.6 to 11.4 months when restricted to those willing to trade. Median time traded for improvement in all domains was 8.3 months overall and 24.0 months by those willing to trade. In multivariable analyses, respondents who were older, nonwhite, or had children traded significantly less time, whereas those who did not perceive the ICU to be a caring environment traded more time. CONCLUSIONS: Good EOL care is highly valued, both in terms of medical and nonmedical domains, as suggested by previous work and confirmed by our data showing respondents trading quantities of healthy life several times longer than the duration of the EOL period itself. The considerable interperson variation highlights the importance of soliciting individual preferences about EOL care.

Adult↗
PubMed2004

Heart strings and purse strings: Carryover effects of emotions on economic decisions.

We examined the impact of specific emotions on the endowment effect, the tendency for selling prices to exceed buying or "choice" prices for the same object. As predicted by appraisal-tendency theory, disgust induced by a prior, irrelevant situation carried over to normatively unrelated economic decisions, reducing selling and choice prices and eliminating the endowment effect. Sadness also carried over, reducing selling prices but increasing choice prices--producing a "reverse endowment effect" in which choice prices exceeded selling prices. The results demonstrate that incidental emotions can influence decisions even when real money is at stake, and that emotions of the same valence can have opposing effects on such decisions.

Adolescent↗
PubMed2003

Whose quality of life? A commentary exploring discrepancies between health state evaluations of patients and the general public.

There is often a discrepancy between quality of life estimates from patients and the general public. These discrepancies are of concern to the disability community, who worry that the public does not understand how valuable life can be for people with disabilities; policy planners, who must decide whose quality of life estimates to use in economic analysis; and practitioners and patients facing difficult medical decisions, who may have to worry that people have difficulty imagining unfamiliar health states. We outline several factors that may contribute to these discrepancies. Discrepancies might occur because patients and the public interpret health state descriptions differently--for example, making different assumptions about the recency of onset of the health state, or about the presence of comorbidities. Discrepancies might also arise if patients adapt to illness and the public does not predict this adaptation; because of response shift in how people use quality of life scales; because of a focusing illusion whereby people forget to consider obvious aspects of unfamiliar health states; because of contrast effects, whereby negative life events make people less bothered by less severe negative life events; and because of different vantage points, with patients viewing their illness in terms of the benefits that would result from regaining health, while the public views the illness in terms of the costs associated with losing good health. Decisions about whose values to measure for the purposes of economic analyses, and how to measure discrepancies, should take these potential contributing factors into account.

Adaptation, Psychological↗
PubMed2003

Social projection of transient drive states.

The authors hypothesized that people's predictions of how other people feel in emotionally arousing situations are often based on people's predictions of how they themselves would feel in those situations. Indeed, most participants in Study 1 reported predicting hungry hikers' feelings by mentally trading places with them, imagining what their own feelings would be in the hikers' situation. Because people's predictions of their own feelings tend to be biased in the direction of their current drive states, we hypothesized that mentally trading places would lead to social projection of transient drive states. In Study 2, participants' predictions of whether thirst or hunger would be more bothersome to hikers lost without food or water were biased in the direction of participants' own exercise-induced thirst. Furthermore, participants' predictions of how they would feel in the hikers' situation statistically mediated the effect of exercise on their predictions of the hikers' feelings.

Adult↗