Electrophysiological correlates of confidence differ across correct and erroneous perceptual decisions

Every decision we make is accompanied by an estimate of the likelihood that our decision is accurate or appropriate. This likelihood estimate is termed our degree of decision confidence. Recent work has uncovered event-related potential (ERP) correlates of confidence both during decision formation and after a decision has been made. However, the interpretation of these findings is complicated by methodological issues related to ERP amplitude measurement that are prevalent across existing studies. To more accurately characterise the neural correlates of confidence, we presented participants with a difficult perceptual decision task that elicited a broad range of confidence ratings. We identified a frontal ERP component within an onset prior to the behavioural response, which exhibited more positive-going amplitudes in trials with higher confidence ratings. This frontal effect also biased measures of the centro-parietal positivity (CPP) component at parietal electrodes via volume conduction. Amplitudes of the error positivity (Pe) component that followed each decision were negatively associated with confidence for trials with decision errors, but not for trials with correct decisions. We provide evidence for both pre- and post- decisional neural correlates of decision confidence that are observed in trials with correct and erroneous decisions, respectively. Our findings suggest that certainty in having made a correct response is associated with frontal activity during decision formation, whereas certainty in having committed an error is instead associated with the post-decisional Pe component. We additionally show that some previously reported associations between decision confidence and CPP/Pe component amplitudes are (at least partly) a consequence of ERP amplitude measurement-related confounds.

Atypical action updating in a dynamic environment associated with adolescent obsessive-compulsive disorder

Background Computational research had determined that adults with obsessive-compulsive disorder (OCD) display heightened action updating in response to noise in the environment and neglect meta-cognitive information (such as confidence) when making decisions. These features are proposed to underlie patients compulsions despite knowledge they are irrational. Nonetheless, it is unclear whether this extends to adolescents with OCD as research in this population is lacking. Thus, this study aimed to investigate the interplay between action and confidence in adolescents with OCD. Methods Twenty-seven adolescents with OCD and 46 controls completed a predictive-inference task, designed to probe how subjects actions and confidence ratings fluctuate in response to unexpected outcomes. We investigated how subjects update actions in response to prediction errors (indexing mismatches between expectations and outcomes) and used parameters from a Bayesian model to predict how confidence and action evolve over time. Confidence-action association strength was assessed using a regression model. We also investigated the effects of serotonergic medication. Results Adolescents with OCD showed significantly increased learning rates, particularly following small prediction errors. Results were driven primarily by unmedicated patients. Confidence ratings appeared equivalent between groups, although model-based analysis revealed that patients confidence was less affected by prediction errors compared to controls. Patients and controls did not differ in the extent to which they updated actions and confidence in tandem. Conclusions Adolescents with OCD showed enhanced action adjustments, especially in the face of small prediction errors, consistent with previous research establishing just-right compulsions, enhanced error-related negativity, and greater decision-uncertainty in paediatric-OCD. These tendencies were ameliorated in patients receiving serotonergic medication, emphasising the importance of early intervention in preventing disorder-related cognitive deficits. Confidence ratings were equivalent between young patients and controls, mirroring findings in adults OCD research.

Optimal confidence for unaware visuomotor deviations

Numerous studies have shown that humans can successfully correct deviations to ongoing movements without being aware of them, suggesting limited conscious monitoring of visuomotor performance. Here, we ask whether such limited monitoring impairs the capacity to judiciously place confidence ratings to reflect decision accuracy (metacognitive sensitivity). To this end, we recorded functional magnetic resonance imaging data while thirty-one participants reported visuomotor cursor deviations and rated their confidence retrospectively. We show that participants use a summary statistic of the unfolding visual feedback (the maximum cursor error) to detect deviations but that this information alone is insufficient to explain detection performance. The same summary statistics is used by participants to optimally adjust their confidence ratings, even for unaware deviations. At the neural level, activity in the ventral striatum tracked high confidence, whereas a broad network including the anterior prefrontal cortex encoded cursor error but not confidence, shedding new light on a role of the anterior prefrontal cortex for action monitoring rather than confidence. Together, our results challenge the notion of limited action monitoring and uncover a new mechanism by which humans optimally monitor their movements as they unfold, even when unaware of ongoing deviations.

Opportunities for Enhanced Transition of Care Preparation for Adolescents and Emerging Adults With Type 1 Diabetes: Use of the READDY Transition Tool

There is an ongoing need to determine best practices for effective transition from pediatric to adult care for adolescents and emerging adults EAs with type 1 diabetes given the potential for poor health outcomes post-transfer. This study evaluated self-reported confidence ratings as measured by the Readiness of Emerging Adults with Diabetes Diagnosed in Youth (READDY) tool among adolescents and EAs with type 1 diabetes and the association of the confidence ratings with clinical and demographic characteristics, as well as provider documentation of relevant anticipatory guidance topics. The READDY is a diabetes-specific tool used to collect patient-reported confidence in transition preparation topics to target educational interventions. These interventions are divided into four domains: Diabetes Knowledge, Health System Navigation, Insulin Self-Management, and Health Behaviors. A retrospective chart review was conducted of patients 15–24 years of age with type 1 diabetes who completed the READDY between January 2017 and January 2018 at a single center. Overall patient-reported confidence levels were high. However, adolescents and EAs endorsed their lowest levels of confidence on items assessing knowledge of alcohol, tobacco, sexual health, and the impact of diabetes on pregnancy (females only), with the percentages of low scores of 20.7, 25.9, 35.9, and 42.9%, respectively. Documentation of provider counseling about screening and prevention of diabetes comorbidities, alcohol use, and tobacco use was associated with scores in the higher range for the corresponding item in the READDY. These findings highlight an opportunity to create interventions related to developmentally important topics for adolescents and EAs with type 1 diabetes to enhance successful transition preparation.

Opportunities for Enhanced Transition of Care Preparation for Adolescents and Emerging Adults With Type 1 Diabetes: Use of the READDY Transition Tool

There is an ongoing need to determine best practices for effective transition from pediatric to adult care for adolescents and emerging adults EAs with type 1 diabetes given the potential for poor health outcomes post-transfer. This study evaluated self-reported confidence ratings as measured by the Readiness of Emerging Adults with Diabetes Diagnosed in Youth (READDY) tool among adolescents and EAs with type 1 diabetes and the association of the confidence ratings with clinical and demographic characteristics, as well as provider documentation of relevant anticipatory guidance topics. The READDY is a diabetes-specific tool used to collect patient-reported confidence in transition preparation topics to target educational interventions. These interventions are divided into four domains: Diabetes Knowledge, Health System Navigation, Insulin Self-Management, and Health Behaviors. A retrospective chart review was conducted of patients 15–24 years of age with type 1 diabetes who completed the READDY between January 2017 and January 2018 at a single center. Overall patient-reported confidence levels were high. However, adolescents and EAs endorsed their lowest levels of confidence on items assessing knowledge of alcohol, tobacco, sexual health, and the impact of diabetes on pregnancy (females only), with the percentages of low scores of 20.7, 25.9, 35.9, and 42.9%, respectively. Documentation of provider counseling about screening and prevention of diabetes comorbidities, alcohol use, and tobacco use was associated with scores in the higher range for the corresponding item in the READDY. These findings highlight an opportunity to create interventions related to developmentally important topics for adolescents and EAs with type 1 diabetes to enhance successful transition preparation.

I think I understand: Investigating misconceptions regarding hypothesis test concepts among university students

Hypothesis testing is an essential tool among researchers and practitioners alike, with its use being being widely taught in many a programme at university level. However, past studies have shown that students hold misconceptions about important statistical concepts. This present study aims to reconfirm past efforts in this area, specifically in a South East Asian higher education institution. To test how well undergraduate university students’ understood key concepts in hypothesis testing, an online multiple choice questionnaire was deployed. The questionnaire also asked for students’ confidence ratings for each question, allowing us to distinguish the confident versus non-confident incorrect responses. A follow- up interview was then conducted to give deeper insights into reasons behind respondents’ errors. The main finding is that there are significantly more confident wrong answers than non-confident ones – highly indicative of the presence of misconceptions among respondents. Among them, students firmly believed that statistical inference procedures provide a direct calculational proof of the null hypothesis. Additionally, students have difficulty formulating correct hypotheses to be tested, and have poor grasp of the role of significance levels in hypothesis testing. Whether or not students were taking a quantitative-focused programme, or had prior statistics training, had no bearing on their score. Despite this, confidence ratings were significantly higher in both groups.

Implementing Confidence Assessment in Low-Stakes, Formative Mathematics Assessments

Confidence assessment (CA) involves students stating alongside each of their answers a confidence rating (e.g. 0 low to 10 high) to express how certain they are that their answer is correct. Each student’s score is calculated as the sum of the confidence ratings on the items that they answered correctly, minus the sum of the confidence ratings on the items that they answered incorrectly; this scoring system is designed to incentivize students to give truthful confidence ratings. Previous research found that secondary-school mathematics students readily understood the negative-marking feature of a CA instrument used during one lesson, and that they were generally positive about the CA approach. This paper reports on a quasi-experimental trial of CA in four secondary-school mathematics lessons (N = 475 students) across time periods ranging from 3 weeks up to one academic year, compared to business-as-usual controls. A meta-analysis of the effect sizes across the four schools gave an aggregated Cohen’s d of –0.02 [95% CI –0.22, 0.19] and an overall Bayes Factor B01 of 8.48. This indicated substantial evidence for the null hypothesis that there was no difference between the attainment gains of the intervention group and the control group, relative to the alternative hypothesis that the gains were different. I conclude that incorporating confidence assessment into low-stakes classroom mathematics formative assessments does not appear to be detrimental to students’ attainment, and I suggest reasons why a clear positive outcome was not obtained.

A Psychometric Look at Principal Professional Development

This study evaluates aspects related to P12 principals’ professional development needs in South Carolina regarding the three domains of school leadership: management, instructional leadership, and program administration. A survey to rate principals’ current leadership knowledge, rank order their professional development needs, and provide a confidence rating regarding their abilities was given to over 1,100 principals and 85 superintendents. Through examining relationships with a psychometric model, results derived latent leadership ability scores and self-reported confidence ratings of principals as well as the superintendents’ leadership scores and confidence ratings of their principals. This study found a significant discrepancy between principals’ and superintendents’ confidence ratings and their corresponding leadership ability scores, respectively. A further analysis of the rank-ordered professional development needs highlighted instructional leadership to be the most needed topic for professional development. Finally, atypical response patterns regarding principal’s current leadership knowledge are also identified through person-fit analysis to provide additional information regarding P-12 principals’ professional development needs.