The Role of Expectation and Beliefs on the Effects of Non-Invasive Brain Stimulation

Non-invasive brain stimulation (NIBS) techniques are used in clinical and cognitive neuroscience to induce a mild magnetic or electric field in the brain to modulate behavior and cortical activation. Despite the great body of literature demonstrating promising results, unexpected or even paradoxical outcomes are sometimes observed. This might be due either to technical and methodological issues (e.g., stimulation parameters, stimulated brain area), or to participants’ expectations and beliefs before and during the stimulation sessions. In this narrative review, we present some studies showing that placebo and nocebo effects, associated with positive and negative expectations, respectively, could be present in NIBS trials, both in experimental and in clinical settings. The lack of systematic evaluation of subjective expectations and beliefs before and after stimulation could represent a caveat that overshadows the potential contribution of placebo and nocebo effects in the outcome of NIBS trials.

People adaptively use information to improve their internal and external states

Information can strongly impact peoples’ affect, their level of uncertainty and their decisions. It is assumed that people seek information with the goal of improving all three. But are they successful at achieving this goal? Answering this question is important for assessing the impact of self-driven information consumption on people’s well-being. Here, over four experiments (total N = 518) we show that participants accurately predict the impact of information on their internal states (e.g., affect and cognition) and external outcomes (e.g., material rewards), and use these predictions to guide information-seeking choices. A model incorporating participants’ subjective expectations regarding the impact of information on their affective, cognitive, and material outcomes accounted for information-seeking choices better than standard models currently used in the literature, which include objective proxies of those subjective measures. This model also accounted for individual differences in information-seeking choices. By balancing considerations of the impact of information on affective, cognitive and material outcomes when seeking knowledge, participants became happier, more certain and earned more points when they purchased information relative to when they did not, suggesting they adopted an adaptive strategy.

People adaptively use information to improve their internal states and external outcomes

Information can strongly impact peoples’ affect, their level of uncertainty and their decisions. It is assumed that people seek information with the goal of improving all three. But are they successful at achieving this goal? Answering this question is important for assessing the impact of self-driven information consumption on people’s well-being. Here, over four experiments (total N = 518) we show that participants accurately predict the impact of information on their internal states (e.g., affect and cognition) and external outcomes (e.g., material rewards), and use these predictions to guide information-seeking choices. A model incorporating participants’ subjective expectations regarding the impact of information on their affective, cognitive, and material outcomes accounted for information-seeking choices better than standard models currently used in the literature, which include objective proxies of those subjective measures. This model also accounted for individual differences in information-seeking choices. By balancing considerations of the impact of information on affective, cognitive and material outcomes when seeking knowledge, participants became happier, more certain and earned more points when they purchased information relative to when they did not, suggesting they adopted an adaptive strategy.

1264 A Cross-Sectional Study of Psychological Expectations of Orthognathic Surgery Patients Based on Their Typology

Aim Orthognathic surgery corrects craniofacial deformity which compromises breathing or masticatory function. Patients typology influences their expectations for physical and psychological transformation before and after surgery and is an emerging area of research. This study aims to evaluate: 1) subjective expectations and/or perceived outcomes and 2) whether orthognathic surgery meets patients’ expectations. Method A questionnaire-based cross-sectional survey was administered pre- and post-operatively. Patients were classified according to typology, namely metamorphosizers - patients with high expectation of psychological and physical changes, evolvers - opposite of metamorphosizers, pragmatists - low expectation of psychological and high expectation of physical changes, and shedders - opposite of pragmatists. A chi-square test was used to examine whether orthognathic surgery met patients’ expectations. Results A total of 27 patients consisting of 19 pre-operative and 8 post-operative completed the survey over an 11-month study period (females = 11; males = 16; mean age= 22.5 years; range = 17-52). Typologically, metamorphosizers dominated, 48%, followed by shedders, 30%, evolvers, 13% and pragmatists, 9%. This indicates that most patients, 78% (metamorphosizers and shedders) had high expectations of psychological change pre-operatively [X2 (2, N = 90) = 43.9, p < .0001)] and perceptions of psychological change post-operatively [X2 (2, N = 90) = 48.8, p < .0001)]. Conclusions Most patients in this study anticipated and perceived psychological changes after orthognathic surgery. Understanding patient typology may help the orthognathic surgeon understand, address and improve post-operative psychological outcomes in their patients.

The Economic Effects of Firm-Level Uncertainty: Evidence Using Subjective Expectations

This paper uses over two decades of Italian survey data on business managers' expectations to measure subjective firm-level uncertainty and quantify its economic effects. We document that firm-level uncertainty persists for a few years and varies across firms' demographic characteristics. Uncertainty induces long-lasting economic effects over a broad array of real and financial variables. The source of uncertainty matters with firms responding only to downside uncertainty, that is, uncertainty about future adverse outcomes. Economy-wide uncertainty, constructed aggregating firm-level uncertainty, is countercyclical but uncorrelated with typical proxies in the literature, and accounts for a sizable amount of GDP variation during crises.

Promoting Platform Takeoff and Self-Fulfilling Expectations: Field Experimental Evidence

A platform might have the potential to bring enormous value to its users. However, without a well-orchestrated launch strategy that coordinates a sufficient number of users onto the platform, this potential will not be realized. The theoretical literature predicts that one approach to coordinating platform take-off is to influence the market’s subjective focal expectations of the future installed base of users. This paper reports on a field experiment investigating the causal role of subjective expectations in the launch of a new platform venture, in which invitations to join a newly launched platform were sent to 16,349 individuals. The invitations included randomized statements regarding the size of the future expected installed base (along with disclosures of the current installed base). I find that simple, subjective, uncommitted, and relatively costless statements broadcasted by the platform with the goal of influencing market expectations were indeed able to influence platform takeoff and overcome an initial chicken-and-egg problem. These broadcasted subjective statements regarding future installed base had a larger influence on adoption rates than did disclosures of the true current installed base during early adoption. However, these subjective statements of expected future installed base ceased to have any effect once the true current installed base grew large. I discuss implication for the promotion, marketing, and evangelism of new platform ventures. This paper was accepted by Duncan Simester, marketing.

Az élettartammal és az időskori betegségteherrel kapcsolatos szubjektív várakozások

Összefoglaló. Bevezetés: A lakosság idősödésével növekvő betegségteher egyéni és társadalmi szinten is fokozódó nyomást jelent. Célkitűzés: Felmérni a hazai általános felnőtt lakosságnak a korlátozottsággal, a gondozási igényekkel és a munkavégzéssel kapcsolatos időskori szubjektív várakozásait. Módszer: Online keresztmetszeti felmérést végeztünk. A korlátozottsággal kapcsolatos várakozásokat a hivatalos szakstatisztikákban alkalmazott globális tevékenységkorlátozottsági mutató (Global Activity Limitation Indicator, GALI) segítségével elsőként vizsgáltuk. A jelen és szubjektíve várt munkavégzést, gondozási igényt, gondozói tevékenységet, valamint a jelen egészségi állapotot és szociodemográfiai helyzetet vizsgáló kérdéseket is feltettünk. Statisztikai analízis: A mintában mért adatokat lokális polinom segítségével simítottuk, és a 60/70/80/90 éves korra adott szubjektív várakozásokkal hasonlítottuk össze. A szubjektív várakozásokat meghatározó tényezőket intervallumregresszióval becsültük. Eredmények: 1000 kitöltőtől 914 érvényes választ kaptunk. Az átlagéletkor (± szórás) 51,2 (± 15,2) év, a minta 55,8%-a nő volt. A férfiak között a fizetett munkát végzők (p<0,001), a nők között az informális gondozók aránya volt magasabb (p = 0,010). Az átlagos (± szórás) szubjektíve várható élettartam (81,0 ± 11,1 év) a minta statisztikailag várható élettartamánál (79,6 ± 3,7 év) 1,3 évvel volt hosszabb (p<0,001), azonban az átlagos, szubjektíve várható egészséges élettartam (64,6 ± 15,2 év) 5,3 évvel volt rövidebb a statisztikailag várható értéknél (70,0 ± 4,2 év; p<0,001). A szubjektíve várható egészséges élettartamot és gondozási igényt elsősorban a válaszadók jelenlegi egészségi állapota befolyásolta. Az életmód és a szubjektíve várható egészséges élettartam között nőknél nem találtunk összefüggés, míg a túlzott gyakorisággal alkoholt fogyasztó vagy elhízott férfiak hosszabb egészséges élettartamra számítottak. A szubjektív várakozások meghatározó tényezői jelentős nemi különbségeket mutattak. Következtetés: Az egészséggel, munkával és gondozással kapcsolatos szubjektív várakozások eltérőek a populációban mért valós adatoktól, és különböznek a nemek között. Orv Hetil. 2021; 162(23): 911–923. Summary. Introduction: The growing disease burden due to ageing populations poses a challenge on both individuals and societies. Objective: To explore the general population’s subjective expectations concerning disability, care needs and employment at older ages. Method: We conducted an online cross-sectional survey. We were the first to measure subjective health expectations using the Global Activity Limitation Indicator (GALI) of official health statistics. Respondents’ actual status and subjective expectations concerning employment, care needs and informal caregiver status, self-perceived health and sociodemographic factors were queried. Statistical analysis: We estimated sample characteristics by local polynomial smoothing and compared with subjective expectations at ages of 60/70/80/90 years. Determinants of subjective expectations were analyzed via interval regression. Results: From 1000 subjects, 914 provided valid responses. Mean (± SD) age was 51.2 (± 15.2) years, and 55.8% of respondents were women. Paid employment was more frequent among men (p<0.001), while informal caregiver status among women (p = 0.010). Mean (± SD) subjective life expectancy (81.0 ± 11.1 years) was 1.3 years longer (p<0.001) than actuarial life-expectancy (79.6 ± 3.7 years), while mean subjective healthy life expectancy (sHLE) (64.6 ± 15.2 years) was 5.3 years shorter than actuarial healthy life expectancy (70.0 ± 4.2 years; p<0.001). sHLE and care needs were mainly determined by respondents’ self-perceived health. Lifestyle risks were not associated with sHLE in women, while pervasive drinker or obese men expected longer healthy life span. Determinants of sHLE showed considerable gender differences. Conclusion: Subjective expectations concerning health, employment and care needs differ from actual values of the general population, with considerable gender differences. Orv Hetil. 2021; 162(23): 911–923.

The informational content of subjective expectations for health service use

Background This study aims to evaluate the informational content of people’s subjective probability expectations for using various health services. Methods Using a sample of 1,528 Australian adults (25-64 years), I compared stated probabilities of visiting various health service providers (hospitals, dentists, optometrists, physiotherapists and related care providers, naturopaths and massage therapists) with past utilization and with predicted utilization estimated out-of-sample. I also estimated whether past utilization and subjective expectations were predicted by the same covariates. Finally, I estimated whether subjective expectations had predictive power for the choice to purchase private health insurance conditional on past utilization and other controls. Results Subjective expectations closely reflect patterns of observed utilization, are predicted by the same covariates as observed utilization, and correlate with objective measures of risk. Subjective expectations also add predictive power to models estimating insurance take-up, even after conditioning on prior health care use and other risk factors. Conclusion The findings are indicative that on average people form quite accurate expectations, and support collecting subjective expectations about health services in household surveys for use in applied research.

Survival Pessimism and the Demand for Annuities

The “annuity puzzle” refers to the fact that annuities are rarely purchased despite the longevity insurance they provide. Most explanations for this puzzle assume that individuals have accurate expectations about their future survival. We provide evidence that individuals misperceive their mortality risk, and study the demand for annuities in a setting where annuities are priced by insurers on the basis of objectively-measured survival probabilities but in which individuals make purchasing decisions based on their own subjective survival probabilities. Subjective expectations have the capacity to explain significant rates of non-annuitization, yielding a quantitatively important explanation for the annuity puzzle.