Cognitive pitfall

There has been significant progress in understanding the effects of childhood poverty on neurocognitive development. This progress has captured the attention of policymakers and promoted progressive policy reform. However, the prevailing emphasis on the harms associated with childhood poverty may have inadvertently perpetuated a deficit-based narrative, focused on the presumed shortcomings of children and families in poverty. This focus can have unintended consequences for policy (e.g., overlooking strengths) as well as public discourse (e...

Psychometrics and the consequences of its use as the method of quantitative empirical psychology has been continuously criticized by both psychologists and psychometrists. However, the scope of the possible solutions to these issues has been mostly focused on the establishment of methodological-statistical best practices for researchers, without any regard to the pitfalls of previous stages of measurement as well as theory development of the targeted phenomenon. Conversely, other researchers advance the idea that, since psychometrics is riddled with many issues, the best way forward is a complete rework of the discipline even if it leaves psychologists and other practitioners without any way to measure quantitatively for a long period of time...

Cognitive bias may lead to medical error, and awareness of cognitive pitfalls is a potential first step to addressing the negative consequences of cognitive bias (see Part 1). For decision-making processes that occur under uncertainty, which encompass most physician decisions, a so-called "adaptive toolbox" is beneficial for good decisions. The adaptive toolbox is inclusive of broad strategies like cultural humility, emotional intelligence, and self-care that help combat implicit bias, negative consequences of affective bias, and optimize cognition...

The deep tendon reflex (DTR) is a more objective indicator than sensory and muscle assessments for lumbar spine disorders. Further, unlike sensory and muscle assessments that require patient cooperation, the DTR can be assessed even in patients with impaired consciousness or cognition. Therefore, DTR assessment with a hammer is an essential neurological test for lumbar spinal diseases. However, despite the usefulness of DTR assessment, few reports have described the significance of increased, diminished, or absent deep lower extremity reflexes in lumbar spine diseases...

We present the case of a 76 year old male with mild cognitive impairment and delirium referred to Consultation-Liaison Psychiatry for assessment of capacity to choose discharge. Cases involving "dispositional capacity" are complex and increasingly frequent, with momentous consequences for patients and their families, but rarely discussed in the literature. In this article, experts in functional assessment, cognition, and ethics provide guidance for this commonly encountered clinical scenario based on their experience and available literature...

The hope of reaching diverse and large target groups has motivated civic education practitioners to offer their content on social media. The question has therefore long ceased to be whether civic education should take place on the internet, but rather how civic education goals can be implemented digitally to foster civic literacy. At first glance, the possibility of reaching a broad audience in a short time seems tempting. At a second glance, social media reveals several challenges that can impair educational processes...

A paradigmatic account may suffice to explain behavioral evolution in early Homo. We propose a parsimonious account that (1) could explain a particular, frequently-encountered, archeological outcome of behavior in early Homo - namely, the fashioning of a Paleolithic stone 'handaxe' - from a biological theoretic perspective informed by the free energy principle (FEP); and that (2) regards instances of the outcome as postdictive or retrodictive, circumstantial corroboration. Our proposal considers humankind evolving as a self-organizing biological ecosystem at a geological time-scale...

OBJECTIVE: To illustrate how experts efficiently navigate a "slowing down moment" to obtain optimal surgical outcomes using the neurovascular bundle sparing during a robotic prostatectomy as a case study. DESIGN: A series of semistructured interviews with four expert uro-oncologists were completed using a cognitive task analysis methodology. Cognitive task analysis, CTA, refers to the interview and extraction of a general body of knowledge. Each interview participant completed four 1 to 2-hour semistructured CTA interviews...

Youth who have histories of trauma exposure face unique barriers and needs in navigating the juvenile justice system. Accordingly, reliance on recidivism as the primary "success" metric falls short for trauma-impacted youth and may actually prolong their justice involvement. Caregivers and juvenile justice professionals (i.e., judges, attorneys, detention and probation staff, case managers, and mental health clinicians) often struggle to identify and adequately address these challenges and pitfalls. This policy brief provides an overview of specialized considerations for traumatized youth with respect to common policies and practices, namely mandated placement, treatment, and timelines...

Intertemporal choice refers to the decision-making process involving trade-offs between rewards available at different points in time (such as choosing between smaller immediate rewards versus larger rewards later on). Empirical evidence often deviates from the exponential preferences predicted by the normative model. A hyperbolic discount function better mirrors individual behavior, explaining temporal inconsistency - whereby preferences vary over time by applying a higher discount in the present. Hyperbolic preferences are associated with addictive behaviors, such as smoking and alcohol consumption, as well as depression or attention deficit hyperactivity disorder...

Given current demographic shifts, the number of older adults continues to grow, with almost half of patients over 65 being diagnosed with some form of arthritis. Rheumatic diseases pose unique diagnostic challenges in older patients due to the convergence of physiologic changes of aging, confounding difficulties to care, and atypical disease manifestations. This review summarizes the current published evidence to guide clinicians in evaluating geriatric patients with rheumatologic concerns, focusing on inflammatory arthritis...

OBJECTIVES: Intraneural ganglionic cysts are non-neoplastic cysts that can cause signs and symptoms of peripheral neuropathy. However, the scarcity of such cases can lead to cognitive biases. Early surgical exploration of space occupying lesions plays an important role in identification and improving the outcomes for intraneural ganglionic cysts. CASE PRESENTATION: This patient presented with loss of sensation on the right sole with tingling numbness for six months...

OBJECTIVES: Lung cancer is the leading cause of cancer-related death and poses significant challenges in diagnosis and management. Although muscle metastases are exceedingly rare and typically not the initial clinical manifestation of neoplastic processes, their recognition is crucial for optimal patient care. METHODS: We present a case report in which we identify the unique scenario of a 60-year-old man with shoulder pain and a deltoid muscle mass, initially suggestive of an undifferentiated pleomorphic sarcoma...

OBJECTIVES: Limitations in human cognition commonly result in clinical reasoning failures that can lead to diagnostic errors. A metacognitive structured reflection on what clinical findings fit and/or do not fit with a diagnosis, as well as how discordance of data can help advance the reasoning process, may reduce such errors. CASE PRESENTATION: A 60-year-old woman with Hashimoto thyroiditis, diabetes, and generalized anxiety disorder presented with diffuse arthralgias and myalgias...

Almaatouq et al. argue that an "integrative experiment design" approach can help generating cumulative empirical and theoretical knowledge. Here, we discuss the novelty of their approach and scrutinize its promises and pitfalls. We argue that setting up a "design space" may turn out to be theoretically uninformative, inefficient, and even impossible. Designing truly diagnostic experiments provides a better alternative.

HOW TO DEAL WITH MEMORY COMPLAINTS. Memory complaint is a common condition in the general population and can indicate normal brain aging as well as incurable neurodegenerative disease or curable disorders. Therefore, the role of any primary care physician is crucial for the referral to further investigations. Furthermore, the pitfall of underdiagnosis, often related to the current incurability of the suspected cause, is contrary to all current guidelines. When facing a memory complaint, the primary care consultation has four objectives: to identify the possible red flags amongst the memory complaint and the memory complaint severity, to objectify a neurocognitive disorder associated with the memory complaint using cognitive tests, to search for associated signs, and to screen for obvious, frequent, and curable causes of memory complaint...

OBJECTIVE: Normative data for older adults may be tainted by inadvertent inclusion of undiagnosed individuals at the very early stage of a neurodegenerative process. To avoid this pitfall, we developed norms for a cohort of older adults without MCI/dementia at 3-year follow-up. METHODS: A randomly selected sample of 1041 community-dwelling individuals (age ≥ 65) received a full neurological and neuropsychological examination on two occasions [mean interval = 3...

Computational models are powerful tools for understanding human cognition and behavior. They let us express our theories clearly and precisely and offer predictions that can be subtle and often counter-intuitive. However, this same richness and ability to surprise means our scientific intuitions and traditional tools are ill-suited to designing experiments to test and compare these models. To avoid these pitfalls and realize the full potential of computational modeling, we require tools to design experiments that provide clear answers about what models explain human behavior and the auxiliary assumptions those models must make...

OBJECTIVES: To explore gamification as an alternative approach to healthcare education and its potential applications to critical care. DATA SOURCES: English language manuscripts addressing: 1) gamification theory and application in healthcare and critical care and 2) implementation science focused on the knowledge-to-practice gap were identified in Medline and PubMed databases (inception to 2023). STUDY SELECTION: Studies delineating gamification underpinnings, application in education or procedural mentoring, utilization for healthcare or critical care education and practice, and analyses of benefits or pitfalls in comparison to other educational or behavioral modification approaches...

In this article we investigate the societal implications of empathic artificial intelligence (AI), asking how its seemingly empathic expressions make people feel. We highlight AI's unique ability to simulate empathy without the same biases that afflict humans. While acknowledging serious pitfalls, we propose that AI expressions of empathy could improve human welfare.