Regrets or no regrets? No regrets! The fate of rejected manuscripts.
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Are Actions Regretted More Than Inactions?
Several researchers have claimed that negative outcomes produce greater regret when they result from actions rather than from failures to act (Gleicher et al., 1990; Kahneman & Tversky, 1982; Landman, 1987). We investigated this claim by asking participants to write descriptions of strongly regretted events in their own lives and to rate the intensity of the regrets. Participants reported more inaction than action regrets, and, contrary to prior research findings, regrets produced by actions and inactions were equally intense. We conjecture that many factors that affect the content of real-life regrets are eliminated in studies of hypothetical regret. In real life, actions and inactions do not generally produce the same outcomes. Furthermore, actions and inactions may differ in how easily one can anticipate the potential for harm. Specifically, it is plausible that people control their actions to avoid potential regrets, leaving themselves vulnerable to regrets from inactions. Copyright 1999 Academic Press.
Journal Article↗
Poststerilization regret: findings from the United States Collaborative Review of Sterilization.
OBJECTIVE: To evaluate the cumulative probability of regret after tubal sterilization, and to identify risk factors for regret that are identifiable before sterilization. METHODS: We used a prospective, multicenter cohort study to evaluate the cumulative probability of regret within 14 years after tubal sterilization. Participants included 11,232 women aged 18-44 years who had tubal sterilizations between 1978 and 1987. Actuarial life tables and Cox proportional hazards models were used to identify those groups at greatest risk of experiencing regret. RESULTS: The cumulative probability of expressing regret during a follow-up interview within 14 years after tubal sterilization was 20.3% for women aged 30 or younger at the time of sterilization and 5.9% for women over age 30 at sterilization (adjusted relative risk [RR] 1.9; 95% confidence interval [CI] 1.6, 2.3). For the former group, the cumulative probability of regret was similar for women sterilized during the postpartum period (after cesarean, 20.3%, 95% CI 14.5, 26.0; after vaginal delivery, 23.7%, 95% CI 17.6, 29.8) and for women sterilized within 1 year after the birth of their youngest child (22.3%, 95% CI 16.4, 28.2). For women aged 30 or younger at sterilization, the cumulative probability of regret decreased as time since the birth of the youngest child increased (2-3 years, 16.2%, 95% CI 11.4, 21.0; 4-7 years, 11.3%, 95% CI 7.8, 14.8; 8 or more years, 8.3%, 95% CI 5.1, 11.4) and was lowest among women who had no previous births (6.3%, 95% CI 3.1, 9.4). CONCLUSION: Although most women expressed no regret after tubal sterilization, women 30 years of age and younger at the time of sterilization had an increased probability of expressing regret during follow-up interviews within 14 years after the procedure.
Actuarial Analysis↗
Regret among 547 Danish sterilized women.
To help identify potential regretters of female sterilization, the women sterilized at Frederiksborg County Hospital, Hørsholm, Denmark, from 1978 through 1982 were contacted by questionnaires, and their medical records were reviewed. Ninety-two per cent (547/594) responded. The median observation time was 50 months. Five per cent of the women (n = 28) regretted the sterilization. The risk of regretting the sterilization was significantly increased among women who at sterilization experienced marital disharmony (12.5% regretted), had a child less than one year old (14.7% regretted), had the sterilization performed in connection with another surgical procedure (16.1% regretted), were outside the social groupings (17.0% regretted), or had no paid work (10.0% regretted). No association between number of children at the time of sterilization, prior number of contraceptives used, abortion at sterilization, and later regret was found. Twenty-five per cent of the regretters had had psychiatric problems prior to the sterilization. The regretters were sterilized shortly after their request (median 1 month) compared to 3 months among non-regretters. The main reason for regret of sterilization was the desire for more children, independent of a change in marital status. Sequelae to the sterilization was a common complaint. Refertilization was requested by 1% of the sterilized women. The study suggests that the psychosocial situation should be carefully evaluated in women requesting sterilization. A time lag from request to the sterilization should be mandatory and a thorough pre-sterilization counseling including information about possible sequelae and alternative contraceptives should be given.
Adaptation, Psychological↗
Emotional Reactions to the Outcomes of Decisions: The Role of Counterfactual Thought in the Experience of Regret and Disappointment.
Regret and disappointment are emotions that can be experienced in response to an unfavorable outcome of a decision. Previous research suggests that both emotions are related to the process of counterfactual thinking. The present research extends this idea by combining it with ideas from regret and disappointment theory. The results show that regret is related to behavior-focused counterfactual thought in which the decision-maker's own actions are changed, whereas disappointment is related to situation-focused counterfactual thought in which aspects of the situation are changed. In Study 1 participants (N = 130) were asked to recall an autobiographical episode of either a regretful or a disappointing event. When asked to undo this event, regret participants predominantly changed their own actions, whereas disappointment participants predominantly changed aspects of the situation. In Study 2 all participants (N = 50) read a scenario in which a person experiences a negative event. Participants who were instructed to undo the event by changing the person's actions reported more regret than disappointment, while participants who were instructed to undo the event by changing aspects of the situation reported more disappointment than regret. Study 3 (N = 140) replicated the findings from Study 2 with a different scenario, and a design in which regret and disappointment were measured between rather than within subjects. In the discussion we address the relation among counterfactual thinking, attributions and affective reactions to decision outcomes, and the implications for decision research. Copyright 1998 Academic Press.
Journal Article↗
Reconsidering the Relation between Regret and Responsibility.
Recently Connolly, Ordóñez, and Coughlan challenged the view that regret is partly determined by perceived responsibility for the regretted outcome [Connolly, T. Ordóñez, L. D., & Coughlan, R. (1997). Regret and responsibility in the evaluation of decision outcomes. Organizational Behavior and Human Decision Processes, 70, 73-85]. In a series of experiments they manipulated whether actors arrived at an outcome through their own decision or through a "computer assignment" over which they had no influence. This decision agency manipulation did not affect their "regret measure." We show in two experiments that this null-effect is due to the fact that regret was measured by means of a general happiness assessment. In the present research we replicated the basic design of their experiments and also found no effects of decision agency on the happiness assessment. However, the results showed the predicted effects of decision agency when regret was directly measured. Moreover, a measure of disappointment seemed to indicate the opposite effect: People are more disappointed when a negative outcome is caused by a computer assignment than when caused by their own choice. The role of regret and disappointment in decision making is discussed. Copyright 1998 Academic Press.
Journal Article↗
Testing the Compatibility Test: How Instructions, Accountability, and Anticipated Regret Affect Prechoice Screening of Options.
Subjects screened a set of jobs, retaining those for which they wished to apply and rejecting those that were no longer under consideration. In Experiment 1, subjects who indicated the jobs for which they would apply/not apply screened out fewer jobs than those with instructions to reject/not reject or those with instructions simply to screen (control). There were no differences between the reject and control conditions. Experiment 2 used a design similar to that of Experiment 1, but subjects were made accountable for their screening judgments. The reject-apply discrepancy remained, but the accountability manipulation made the subjects more stringent in their screening compared to those who were not accountable for their judgments. In Experiment 3, subjects were told to consider either the regret resulting from retaining a bad option (regret bad) or the regret from rejecting a good option (regret good). Subjects in the regret bad condition rejected more jobs than did subjects in the regret good condition, but not more than subjects in the control condition. As predicted by image theory, the normal screening process appears to be to screen out the bad options rather than screen in the good options. This is demonstrated by screening in the control condition being similar to screening under the reject instructions (Experiment 1) and under regret bad instructions (Experiment 3), since these conditions were shown to focus attention on the bad options. Copyright 1999 Academic Press.
Journal Article↗
A comparison of women's regret after vasectomy versus tubal sterilization.
OBJECTIVE: To compare the 5-year cumulative probability of regret and risk factors for regret among women whose husbands underwent vasectomy with women after tubal sterilization. METHODS: A total of 525 women whose husbands underwent vasectomy were compared with 3672 women who underwent tubal sterilization in a prospective, multicenter, cohort study. RESULTS: The cumulative probability of a woman expressing regret within 5 years after her husband's vasectomy was 6.1% (95% confidence interval [CI] 3.6, 8.6), which was similar to the 5-year cumulative probability of regret among women after tubal sterilization (7.0%, 95% CI 5.8, 8.1). Women who reported substantial conflict with their husbands before vasectomy were more than 25 times more likely to request that their husband have a reversal than women who did not report such conflict (rate ratio 25.3, 95% CI 2.9, 217.2). Similarly, women who reported substantial conflict with their husbands or partners before tubal sterilization were more then three times as likely to regret their decision and more than five times as likely to request a reversal than women who did not report such conflict (rate ratio 3.1, 95% CI 1.4, 7.0, and rate ratio 5.4, 95% CI 1.6, 17.6, respectively). CONCLUSION: Most women did not express regret after their husband's vasectomy and the probability of regret was similar to sterilized women. However, when there was substantial conflict between a woman and her husband before vasectomy or tubal sterilization, the probability of subsequent request for reversal was increased.
Adolescent↗
Acceptable regret in medical decision making.
When faced with medical decisions involving uncertain outcomes, the principles of decision theory hold that we should select the option with the highest expected utility to maximize health over time. Whether a decision proves right or wrong can be learned only in retrospect, when it may become apparent that another course of action would have been preferable. This realization may bring a sense of loss, or regret. When anticipated regret is compelling, a decision maker may choose to violate expected utility theory to avoid regret. We formulate a concept of acceptable regret in medical decision making that explicitly introduces the patient's attitude toward loss of health due to a mistaken decision into decision making. In most cases, minimizing expected regret results in the same decision as maximizing expected utility. However, when acceptable regret is taken into consideration, the threshold probability below which we can comfortably withhold treatment is a function only of the net benefit of the treatment, and the threshold probability above which we can comfortably administer the treatment depends only on the magnitude of the risks associated with the therapy. By considering acceptable regret, we develop new conceptual relations that can help decide whether treatment should be withheld or administered, especially when the diagnosis is uncertain. This may be particularly beneficial in deciding what constitutes futile medical care.
Brain Ischemia↗
Living with treatment decisions: regrets and quality of life among men treated for metastatic prostate cancer.
PURPOSE: To examine variation in men's long-term regret of treatment decisions, ie, surgical versus chemical castration, for metastatic prostate cancer and its associations with quality of life. METHODS: Survey of previously treated patients to assess treatment decisions and quality of life, supplemented with focus groups. Two items addressing whether a patient wished he could change his mind and the belief that he would have been better off with the treatment not chosen were combined in classifying survey respondents as either satisfied or regretful. Chi(2) and t tests were used to test associations between regret and treatment history, complications, and quality of life. RESULTS: Survey respondents included 201 men aged 45 to 93 years (median, 71 years), who had begun treatment (71% chemical castration, 29% orchiectomy) a median of 2 years previously. Most reported complications: hot flashes (70%), nausea (34%), and erectile dysfunction (81%). Most were satisfied with the treatment decision, but 23% expressed regret. Regretful men more frequently reported surgical (43%) versus chemical (36%) castration (P: = .030) and nausea in the past week (54% v 32%; P: = .010) but less frequently reported erectile dysfunction (56% v 72%; P: = .048). Regretful men indicated poorer scores on every measure of generic and prostate cancer-related quality of life. Qualitative analyses revealed substantial uncertainty about the progress of their disease and the quality of the decisions in which patients participated. CONCLUSION: Regret was substantial and associated with treatment choice and quality of life. It may derive from underlying psychosocial distress and problematic communication with physicians when decisions are being reached and over subsequent years.
Aged↗
Regret after decision to have a tubal sterilization.
To determine characteristics associated with regretting sterilization that can be determined preoperatively, we analyzed data from the Collaborative Review of Sterilization (CREST), a multicenter, prospective, observational study. Of 5022 women, 2.0% regretted having had a tubal sterilization at 1 year after the procedure and 2.7% did so after 2 years. Using a multivariate analysis to identify risk factors for regret, we found that almost all characteristics were more closely associated with regret at 1 year than at 2 years postoperatively. Of the characteristics we examined that could be objectively determined preoperatively, we considered only age less than 30 years and (for whites) a concurrent cesarean section to be risk factors for regret at 2 years after sterilization. However, in absolute terms, less than 10% of women with both those risk factors regretted having the procedure.
Adolescent↗
Regret, substance abuse, and readiness to change in a dually diagnosed sample.
The transtheoretical stages of change model posits that increased readiness to change is associated with greater awareness of the negative consequences of substance use. Experiencing regrets implies a greater awareness of these consequences. Eighty dually diagnosed patients completed a 22-item Measure of Substance-Related Regret (MSR) that assessed the intensity, type, idiographic importance of, and emotions associated with regrets related to substance use and the Brief Readiness to Change Questionnaire. The MSR yielded a global measure of regret that accounted for statistically significant amounts of variance in total readiness-to-change scores (R2 = .30). Global scores also predicted precontemplation and contemplation stage scores, whereas total fear scores associated with regrets predicted action scores. Regret seems to play a complex yet important role in the decision to change substance abuse.
Adult↗
The temporal pattern to the experience of regret.
Through telephone surveys, written questionnaires, and face-to-face interviews, it was found that people's biggest regrets tend to involve things they have failed to do in their lives. This conflicts with research on counterfactual thinking that indicates that people regret unfortunate outcomes that stem from actions taken more than identical outcomes that result from actions foregone. These divergent findings were reconciled by demonstrating that people's regrets follow a systematic time course: Actions cause more pain in the short-term, but inactions are regretted more in the long run. Support for this contention was obtained in 2 scenario experiments that assessed people's beliefs about the short- and long-term regrets of others and in an experiments that asked Ss about their own regrets of action and inaction from 2 time periods. Several mechanisms that can account for this temporal pattern are discussed.
Adult↗
Decisional regret and quality of life after participating in medical decision-making for early-stage prostate cancer.
OBJECTIVE: To determine the effect of men's reported levels of involvement in medical decision-making and quality of life (QoL) on their levels of decisional regret after definitive treatment. PATIENTS AND METHODS: Men referred to a hospital-based resource centre completed QoL and decisional-regret measures after definitive treatment for localized prostate cancer. Data from these questionnaires were linked with a previous study conducted to determine if providing individualized information to men newly diagnosed with prostate cancer would lower their levels of psychological distress and enable them to become more active participants in treatment decision-making. The preferred role in medical decision-making and QoL had previously been measured at the time of diagnosis and the assumed role at 4 months after the definitive treatment decision. This postal survey was conducted approximately 18 months after diagnosis. RESULTS: Of 74 men, 67 (91%) responded; the mean (sd) time since definitive treatment was 10.3 (4.7) months and the mean age of the men 62.5 (6.9) years. Radical prostatectomy was the most frequent treatment (72%). Most (94%) patients participated in medical decision-making either actively or collaboratively and did not regret their treatment choice. The type of definitive treatment received had no effect on decisional regret; patients' QoL scores were similar to the levels before treatment. Levels of sexual function were significantly lower after definitive treatment, but urinary incontinence was not significantly affected. Men who had neoadjuvant hormone therapy reported having significantly more treatment-related symptoms. CONCLUSIONS: There is no evidence that providing information to facilitate participation in medical decision-making causes decisional regret or psychological distress within the first year after definitive treatment. A longitudinal follow-up of these patients is required to adequately assess the long-term effects of treatment on QoL and decisional regret.
Adult↗
Risk factors for regret after tubal sterilization: 5 years of follow-up in a prospective study.
The Collaborative Review of Sterilization is a prospective, multicenter study that interviewed 7,590 women before they underwent tubal sterilization and then conducted yearly follow-up interviews that included questions on sterilization regret. These women contributed 26,641 observations (for up to 5 years after the procedure, 1978 to 1988) to an analysis of the presterilization characteristics most consistently associated with poststerilization regret. Young age at the time of sterilization was the strongest predictor of regret, regardless of parity or marital status; among women 20 to 24 years of age at sterilization, an average of 4.3% reported regret over the follow-up period. The rate of regret was significantly lower for women 30 to 34 years of age (2.4%).
Adult↗
Issues of regret in women with contralateral prophylactic mastectomies.
BACKGROUND: Patients with a history of carcinoma of one breast have an estimated risk of 0.5% to 0.75% per year of developing a contralateral breast cancer. This risk prompts many women to consider contralateral prophylactic mastectomy (CPM) as a preventive measure. Virtually nothing is known about patient acceptance following CPM. We have developed a National Prophylactic Mastectomy Registry comprised of a volunteer population of 817 women from 43 states who have undergone prophylactic (unilateral or bilateral) mastectomy. METHODS: Of the 346 women with CPM who responded to national notices, 296 women returned detailed questionnaires. The information obtained included patient demographics, family history, reproductive history, ipsilateral breast cancer staging and treatment, as well as issues involving the CPM. RESULTS: At median follow-up of 4.9 years, the respondents were primarily married (79%), white (97%) women who had some level of college education or above (81%). These women cited the following reasons for choosing CPM: (1) physician advice regarding the high risk of developing contralateral breast cancer (30%); (2) fear of developing more breast cancer (14%); (3) desire for cosmetic symmetry (10%); (4) family history (7%); (5) fibrocystic breast disease (4%); (6) a combination of all of these reasons (32%); (7) other (2%); and (8) unknown (1%). Eighteen of the 296 women (6%) expressed regrets regarding their decision to undergo CPM. Unlike women with bilateral prophylactic mastectomies, regrets tended to be less common in the women with whom the discussion of CPM had been initiated by their physician (5%) than in the women who had initiated the discussion themselves (8%) (P = ns). Family history and stage of index lesion had no impact on regret status. The reasons for regret included: (1) poor cosmetic result, either of the CPM or of the reconstruction (39%); (2) diminished sense of sexuality (22%); (3) lack of education regarding alternative surveillance methods or CPM efficacy (22%); and (4) other reasons (17%). CONCLUSIONS: To minimize the risk of regrets in women contemplating CPM, it is imperative that these women be counseled regarding an estimation of contralateral breast cancer risk, the alternatives to CPM, and the efficacy of CPM. In addition, these women should have realistic expectations of the cosmetic outcomes of surgery and understand the potential impact on their body image.
Adult↗
The experience of regret: what, when, and why.
This article reviews evidence indicating that there is a temporal pattern to the experience of regret. Actions, or errors of commission, generate more regret in the short term; but inactions, or errors of omission, produce more regret in the long run. The authors contend that this temporal pattern is multiply determined, and present a framework to organize the divergent causal mechanisms that are responsible for it. In particular, this article documents the importance of psychological processes that (a) decrease the pain of regrettable action over time, (b) bolster the pain of regrettable inaction over time, and (c) differentially affect the cognitive availability of these two types of regrets. Both the functional and cultural origins of how people think about regret are discussed.
Affect↗
Long-term regret among 216 sterilized women. A six-year follow-up investigation.
Six years after tubal sterilization 16 of 208 women reported serious regret. The desire for another child in a new relationship was given as the main reason for later regret, although other causes were also reported. No association between age, parity, time or type of tubal sterilization and later regret was demonstrated. However, a greater proportion of regretters than of the remainder had been recommended the sterilization by a doctor at abortion application. The regretters had undergone more abortions before their sterilization, and the study revealed more unstable marriages with consequently less support from the spouse at sterilization in the regretting group. Post-sterilization regret is discussed within the framework of life events and social support.
Adult↗