Spontaneous and deliberate future thinking: A dual process account

© 2019 Springer Nature.This is the final published version of an article published in Psychological Research, licensed under a Creative Commons Attri-bution 4.0 International License. Available online at: https://doi.org/10.1007/s00426-019-01262-7.In this article, we address an apparent paradox in the literature on mental time travel and mind-wandering: How is it possible that future thinking is both constructive, yet often experienced as occurring spontaneously? We identify and describe two ‘routes’ whereby episodic future thoughts are brought to consciousness, with each of the ‘routes’ being associated with separable cognitive processes and functions. Voluntary future thinking relies on controlled, deliberate and slow cognitive processing. The other, termed involuntary or spontaneous future thinking, relies on automatic processes that allows ‘fully-fledged’ episodic future thoughts to freely come to mind, often triggered by internal or external cues. To unravel the paradox, we propose that the majority of spontaneous future thoughts are ‘pre-made’ (i.e., each spontaneous future thought is a re-iteration of a previously constructed future event), and therefore based on simple, well-understood, memory processes. We also propose that the pre-made hypothesis explains why spontaneous future thoughts occur rapidly, are similar to involuntary memories, and predominantly about upcoming tasks and goals. We also raise the possibility that spontaneous future thinking is the default mode of imagining the future. This dual process approach complements and extends standard theoretical approaches that emphasise constructive simulation, and outlines novel opportunities for researchers examining voluntary and spontaneous forms of future thinking.Peer reviewe

Cancer patients' needs during hospitalisation: a quantitative and qualitative study

BACKGROUND: The evaluation of cancer patients needs, especially during that delicate period when they are hospitalized, allows the identification of those areas of care that require to be improved. Aims of the study were to evaluate the needs in cancer inpatients and to improve the understanding of the meanings of the needs expressed. METHODS: The study was conducted during a "sample day", with all the cancer patients involved having been hospitalized at the Istituto Nazionale Tumori of Milan (INT) for at least 48 hours beforehand. The study was carried out using quantitative and qualitative methodologies. The quantitative part of the study consisted in making use of the Needs Evaluation Questionnaire (NEQ), a standardized questionnaire administered by the INT Psychology Unit members, supported by a group of volunteers from the Milan section of the Italian League Against Cancer. The aim of the qualitative part of the study, by semi-structured interviews conducted with a small sample of 8 hospitalized patients, was to improve our understanding of the meanings, implications of the needs directly described from the point of view of the patients. Such an approach determines the reasons and conditions of the dissatisfaction in the patient, and provides additional information for the planning of improvement interventions. RESULTS: Of the 224 eligible patients, 182 (81%) completed the questionnaire. Four of the top five needs expressed by 40% or more of the responders concerned information needs (diagnosis, future conditions, dialogue with doctors, economic-insurance solutions related to the disease). Only one of the 5 was concerned with improved "hotel" services (bathrooms, meals, cleanliness). Qualitative analysis showed that the most expressed need (to receive more information on their future conditions) has the meaning to know how their future life will be affected more than to know his/her actual prognosis. CONCLUSIONS: Some of the needs which emerged from this investigation could be immediately satisfied (the need for psychological support, the need for economic aid, the need for spiritual support), while others will have to be faced in the longer term; for example, the presence of a high percentage of needs in patient-physician relationships and/or information-communication issues, could be resolved by setting up structured introductory training courses for all clinicians in the institution. On the other hand, the needs related to the living infrastructure (bathrooms, meals, etc...) could encourage the Institution to improve its services

Processos de subjetivação e relações micropolíticas do modo de atenção psicossocial

This article aims to problematize the micropolitical relationships produced in the Psychosocial Care Center (caps), Alegrete-RS, focusing on ethical principles in relation with customers and teamwork, identifying similarities and differences with the propositions of psychosocial care. This study follows a qualitative, descriptive and analytical approach. Interviews were conducted with users and workers, as well as participant observation. Aspects of subjective mobilization, innovation and the creation of relationships that produce ruptures in institutional practices were found, increasing subjectivation, negotiation, agency, resistance, and invention of various relationship and interaction devices in society, producing existential territories in the psychosocial care perspective. Micropolitical relations serve as agents for the production of meaning and the valorization of knowledges and enhancement of knowledge meaning, featuring an ethical stance regarding relationsEl artículo tiene como objetivo problematizar las relaciones micropolíticas producidas en el Centro de Atención Psicosocial (caps) de Alegrete-RS, enfoncando los principios éticos de las relaciones de los trabajadores con la clientela y en el trabajo en equipo, identificando las aproximaciones y los distanciamientos con las propuestas de atención psicosocial. Se trata de un estudio de abordaje cualitativo, descriptivo y analítico. Se realizaron entrevistas con los usuarios y trabajadores, y observación participante. Se encontraron aspectos de movilización subjetiva, innovación y creación de relaciones que producen rupturas en las prácticas institucionales, potencializando la subjetivación, los agenciamientos, las resistencias y la invención de diversos dispositivos de relación e interacción en la sociedad, produciendo territorios existenciales en la perspectiva de la atención psicosocial. Las relaciones micropolíticas trabajan para agenciar procesos de producción de sentido y valorización de los saberes, caracterizando una postura ética en el ámbito de las relacionesO artigo objetiva problematizar as relações micropolíticas produzidas no Centro de Atenção Psicossocial (caps), de Alegrete-RS, com foco nos princípios éticos da relação dos trabalhadores com a clientela e no trabalho em equipe, identificando aproximações e distanciamentos com as proposições da atenção psicossocial. Trata-se de um estudo de abordagem qualitativa, descritiva e analítica. Realizaram-se entrevistas com usuários e trabalhadores, e observação participante. Encontraram-se aspectos de mobilização subjetiva, inovação e criação de relações que produzem rupturas nas práticas institucionais, potencializando subjetivação, agenciamentos, resistências e invenção de dispositivos diversos de relação e interação na sociedade, produzindo territórios existenciais, na perspectiva da atenção psicossocial. As relações micropolíticas trabalham para agenciar processos de produção de sentido e valorização de saberes, caracterizando uma postura ética no âmbito das relaçõe

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified