What Does that Symptom Mean? Classifying Ambiguous Information in the Clinical Setting

1. What Does that Symptom Mean? Classifying Ambiguous Information in the Clinical Setting Jessecae K. Marsh Texas Tech University

2. Interpreting ambiguous symptoms Panic attack Heart attack Chest pain and constriction Patient has history of depression Patient has history of high cholesterol

3. Interpreting ambiguous symptoms Panic attack Heart attack Chest pain and constriction Patient has history of depression Patient has history of high cholesterol

4. Interpreting ambiguous symptoms Panic attack Heart attack Chest pain and constriction Patient has history of depression Patient has history of high cholesterol

5. Interpreting ambiguous symptoms Panic attack Heart attack ? ? Chest pain and constriction Drinks to excess

6. Two Studies • Causal theories in everyday causal reasoning • Marsh & Ahn (2009) • Influence of context in clinicians’ reasoning • With Andres De Los Reyes

7. Two Studies • Causal theories in everyday causal reasoning • Marsh & Ahn (2009) • Influence of context in clinicians’ reasoning • With Andres De Los Reyes

8. Reasoning about causal events Cheng (1997); Collins & Shanks (2002); Jenkins & Ward (1965); Rescorla & Wagner (1972)

9. Reasoning about causal events = ? How do causal theories help classify ambiguous events?

10. Experiment Overview Participants saw easily classified data intermixed with ambiguous data

11. Tall bacteria cause protein presence

12. Tall bacteria cause protein presence

13. Tall bacteria cause protein presence Tall with protein

14. Tall bacteria cause protein presence No Tall with protein

15. Tall bacteria cause protein presence No Tall with protein Short with no protein

16. Categorizing Ambiguous Events Participants saw easily classified data intermixed with ambiguous data Asked to estimate how many trials they saw of the four information types

17. Categorizing Ambiguous EventsResults Observed trial frequencies

18. Categorizing Ambiguous EventsResults Observed trial frequencies Reported frequencies

19. Categorizing Ambiguous Events Results Observed trial frequencies Reported frequencies Middle height counted as tall

20. Categorizing Ambiguous Events Results Observed trial frequencies

21. Categorizing Ambiguous Events Results Observed trial frequencies Reported frequencies Middle height counted as short

22. Categorizing Ambiguous Events Results Reported frequencies Reported frequencies Middle height counted as tall Middle height counted as short

23. Categorizing Ambiguous EventsPerceptual similarity judgments Pretest Ambiguous conditions

24. Summary of Marsh & Ahn (2009) • A hypothesis can be used to assimilate ambiguous information into a current theory

25. Summary of Marsh & Ahn (2009) Drinks to excess Anxiety Panic attack Heart attack Chest pain and constriction Drinks to excess

26. Summary of Marsh & Ahn (2009) Drinks to excess Anxiety Panic attack Heart attack Chest pain and constriction Drinks to excess

27. Summary of Marsh & Ahn (2009) Drinks to excess Anxiety Panic attack Heart attack Chest pain and constriction Drinks to excess

28. Two Studies • People will use causal theories to interpret ambiguous information in lay causal reasoning settings. • Marsh & Ahn (2009) • Clinicians will use non-diagnostic, contextual information to interpret diagnostic information • With Andres De Los Reyes

29. The context of clinical symptoms In collaboration with Andres De Los Reyes, Ph.D. (University of Maryland) How does the context in which diagnostic features present affect clinicians diagnostic judgments?

30. Symptoms of Conduct Disorder stays out at night run away from home overnight truant from school stolen without confronting a victim bullies others initiates fights lies or "cons" others broken into someone else's house, building, or car destroyed others' property (other than by fire setting) stolen while confronting a victim used a weapon fire setting cruel to people cruel to animals forced someone into sexual activity

31. General Study Overview • Have clinicians rate criterial symptoms of CD in high association and low association context. • Evaluate whether: • context affects evaluation of criterial symptoms in general. • context affects features differently.

32. Preliminary Results • We found that clinicians were affected by context. • High context received higher ratings than low. • Not all features were affected equally • Some features seem to be impervious to context.

33. Summary of Clinicians’ Context Panic attack Heart attack Chest pain and constriction Drinks to excess Jogs on a regular basis Enjoys outdoor sports Extremely motivated in life

34. Summary of Clinicians’ Context Panic attack Heart attack Chest pain and constriction Drinks to excess Jogs on a regular basis Enjoys outdoor sports Extremely motivated in life

35. Thank you.