The KOALA-study: study protocol for a comprehensive study of cognitive biases in adolescent anorexia nervosa patients compared to healthy and clinical controls

Background Anorexia nervosa (AN) is characterized by dysfunctional cognitions including cognitive biases at various levels of information processing. However, less is known about the specificity of these biases, i.e., if they occur for eating-disorder-related information alone or also for non-eating-disorder-related emotional information in AN patients (content-specificity) and if they are unique to individuals with AN or are also shown by individuals with other mental disorders (disorder-specificity). Methods The present study systematically assesses cognitive biases in 12–18-year-old female adolescents with AN on three levels of information processing (attention, interpretation, and memory) and with regard to two types of information content (eating-disorder-related, i.e., stimuli related to body weight and shape, and non-eating-disorder-related). To address not only content- but also disorder-specificity, adolescents with AN will be compared not only to a healthy control group but also to a clinical control group (adolescents with major depression or particular anxiety disorders). Cognitive biases are assessed within a single experimental paradigm based on the Scrambled Sentences Task. During the task eye movements are recorded in order to assess attention biases while interpretation biases are derived from the behavioural outcome. An incidental free recall test afterwards assesses memory biases. We expect adolescents with AN to show more pronounced negative cognitive biases on all three levels of information processing and for both types of content compared to healthy adolescents. In addition, we expect the specificity of biases to translate into differential results for the two types of content: AN patients are expected to show stronger biases for disorder-related stimuli but similar or less pronounced biases for non-disorder-related stimuli compared to the clinical control group. Discussion This is the first study to comprehensively assess cognitive biases in adolescents with AN. It will have essential implications not only for cognitive-behavioural models of AN but also for subsequent studies aiming to modify cognitive biases in this population, thereby addressing important maintaining factors already at an early stage of the disorder.

Investor memory of past performance is positively biased and predicts overconfidence

We document a memory-based mechanism associated with investor overconfidence. In Studies 1 and 2, investors were asked to recall their most important trades in the recent past and then reported investing confidence and trading frequency. After the study, they looked up and reported the actual returns of these trades. In both studies, investors were biased to recall returns as higher than achieved, and larger memory biases were associated with greater overconfidence and trading frequency. The design of Study 2 allowed us to separately investigate the effects of two types of memory biases: distortion and selective forgetting. Both types of bias were present and were independently associated with overconfidence and trading frequency. Study 3 was an incentive-compatible experiment in which overconfidence and trading frequency were reduced when participants looked up previous consequential trades compared to when they reported them from memory.

Stressful life events precede gambling problems, and continued gambling problems exacerbate stressful life events; a life course calendar study

Do stressful life events cause gambling problems, or do gambling problems cause stressful life events? This study used a retrospective design to examine the temporal order of these associations. Specifically, the study employed a life course calendar in a self-directed online survey to minimise memory biases common in retrospective designs. A total of 1,564 US respondents who had gambled at any point in their life (51.0% female, median age 46) were asked whether, for each year of their adult life, they had experienced each of eight stressful life events, and whether they had engaged in casual or heavy gambling, drinking or drug use, with heavy gambling defined in line with a problem gambling definition. We found that five stressful life events were associated with the onset of heavy gambling: work issues, financial issues, legal issues, relationship issues and the death of a loved one. The same five stressful life events predict the cessation of an episode of heavy gambling, indicating a possible tendency for gambling problems to self-resolve in the presence of stress. Insights are also gained into comorbidities with alcohol and drug use, and the course of stressful life events and gambling and substance use throughout the life course, albeit with a non-representative sample. The methodology allows tentative conclusions in terms of possible causation pathways, indicating that stressful life events may play a role both in the onset and the maintenance (or cessation) of gambling problems.

Memory Fidelity Reveals Qualitative Changes in Interactions Between Items in Visual Working Memory

Memory for objects in a display sometimes reveals attraction—the objects are remembered as more similar to one another than they actually were—and sometimes reveals repulsion—the objects are remembered as more different from one another. The conditions that lead to these opposing memory biases are poorly understood; there is no theoretical framework that explains these contrasting dynamics. In three experiments (each N = 30 adults), we demonstrate that memory fidelity provides a unifying dimension that accommodates the existence of both types of visual working memory interactions. We show that either attraction or repulsion can arise simply as a function of manipulations of memory fidelity. We also demonstrate that subjective ratings of fidelity predict the presence of attraction or repulsion on a trial-by-trial basis. We discuss how these results bear on computational models of visual working memory and contextualize these results within the literature of attraction and repulsion effects in long-term memory and perception.

Cognitive Biases in Blood-Injection-Injury Phobia: A Review

Blood-injection-injury (BII) phobia can lead to avoidance of crucial medical procedures and to detrimental health consequences, even among health workers. Yet unlike other specific phobias, BII phobia has been understudied. Specifically, while cognitive biases have been extensively investigated in other anxiety disorders, little is known about the same biases in BII phobia. The current article reviews cognitive biases in BII phobia and suggest future directions for further study and treatment. The reviewed biases include attention, expectancy, memory, perception, and interpretation biases. The investigation of these biases is highly relevant, as cognitive biases have been found to interact with anxiety symptoms. Results showed that attention, expectancy, and memory biases are involved in BII phobia, while no studies were found on interpretation nor perception biases. Mixed results were found for attention bias, as different studies found different components of attention bias, while others found no attention bias at all. Similarly, some studies found a-priori/a-posteriori expectancy biases, while other studies found only one type of bias. A better understanding of the cognitive particularities of BII phobia may lead to better treatments and ultimately reduce avoidance of needles and blood-related situations, thereby enabling individuals with BII phobia to undergo potentially life-saving medical procedures.

Optimistic amnesia: how online and offline processing shape belief updating and memory biases in immediate and long-term optimism biases

When people are confronted with feedback that counters their prior beliefs, they preferentially rely on desirable rather than undesirable feedback in belief updating, i.e. an optimism bias. In two pre-registered EEG studies employing an adverse life event probability estimation task, we investigated the neurocognitive processes that support the formation and the change of optimism biases in immediate and 24 h delayed tests. We found that optimistic belief updating biases not only emerged immediately but also became significantly larger after 24 h, suggesting an active role of valence-dependent offline consolidation processes in the change of optimism biases. Participants also showed optimistic memory biases: they were less accurate in remembering undesirable than desirable feedback probabilities, with inferior memories of undesirable feedback associated with lower belief updating in the delayed test. Examining event-related brain potentials (ERPs) revealed that desirability of feedback biased initial encoding: desirable feedback elicited larger P300s than undesirable feedback, with larger P300 amplitudes predicting both higher belief updating and memory accuracies. These results suggest that desirability of feedback could bias both online and offline memory-related processes such as encoding and consolidation, with both processes contributing to the formation and change of optimism biases.

Perceptual Comparisons Modulate Memory Biases Induced by Overlapping Visual Input

Despite the active neural mechanisms that support the temporary maintenance of stimulus-specific information, visual working memory (VWM) content can be systematically biased towards novel perceptual input. These memory biases are commonly attributed to interference that arises when perceptual input is physically similar to current VWM content. However, recent work has suggested that deliberately comparing the similarity of VWM representations to novel perceptual input modulates the size of memory biases above and beyond stimulus-driven effects. Here, we sought to determine the modulatory nature of deliberate perceptual comparisons by comparing the size of memory biases following deliberate comparisons to those induced instead when novel perceptual input is ignored (Experiment 1) or encoded into VWM (Experiment 2). We find that individuals reported larger attraction biases in their VWM representation following deliberate perceptual comparisons than when they ignored or remembered the perceptual input. An analysis of participants’ perceptual comparisons revealed that memory biases were amplified when the perceptual input was endorsed as similar—but not dissimilar—to the current VWM representation. This pattern persisted even after the physical similarity between the VWM representation and perceptual input was matched across trials, confirming that perceptual comparisons themselves played a causal role in modulating memory biases. Together, these findings are consistent with the view that using a VWM representation to evaluate novel perceptual input risks exaggerating the featural overlap between them.