Agent-Centered Decision Making in Normal and Abnormal Cognition

Much of human cognition is “agent-centered,” subjective, and in that sense relative, directed at deciding, “What is best for me”. This is very different  from  “veridical”  cognition,  directed  at  finding  an  objectively  correct solution inherent in the task and independent of the agent. The frontal lobes in particular are central to agent-centered decision making. Yet very little is available  in  the  arsenal  of  cognitive  paradigms  used  in  the  cognitive neuroscience  research  and  in  clinical  neuropsychology  test  design  to examine  “agent-centered”  decision  making.  Current  paradigms  and  tests used  to  measure  decision  making  clinically  and  experimentally  are veridical  in  nature  and  as  such  miss  the  essence  of  “agent-centered” cognition.  The  dearth  of  “agent-centered”  cognitive  paradigms  severely limits  our  ability  to  understand  fully  the  function  and  dysfunction  of  the frontal  lobes.  The  Cognitive  Bias  Task  (CBT)  is  an  agent-centered paradigm  designed  to  fill  this  gap.  CBT  has  been  used  as  a  cognitive activation task in fMRI, SPECT, and EEG, as well as in studies of normal development,  addiction,  dementia,  focal  lesions,  and  schizophrenia.  This resulted  in  a  range  of  findings  that  eluded  more  traditional  “veridical” paradigms and are reviewed here.  Key Words:  Decision Making;  Cognitive Bias Task; Cognition    La Toma de Decisiones Centrada en el Agente en la Cognición Normal y  Anormal:  Gran  parte  de  la  cognición  humana  está  "centrada  en  el agente", es subjetiva, y en ese sentido, está dirigida a decidir: "¿Qué es  lo mejor para mí?". Esta es una perspectiva muy diferente a la de la cognición "verídica",  que  está  más  dirigida  a  encontrar  una  solución  objetivamente correcta,  inherente  a  la  tarea,  e  independiente  del  agente.  Los  lóbulos frontales,  en  particular,  son  fundamentales  para  la  toma  de  decisiones "centrada en el agente". Sin embargo, existen pocos paradigmas cognitivos en  el  marco  de  la  neurociencia  cognitiva  y  de  la  neuropsicología  clínica, que  se  hayan  diseñado  para  evaluar  la  toma  de  decisiones  "centrada  en  el agente".  Los  paradigmas  actuales  y  las  pruebas  utilizadas  para  medir  la toma  de  decisiones  clínica  y  experimentalmente  son  "verídicos"  en  su naturaleza  y,  por  lo  mismo,  no  son  adecuados  para  la  evaluación  de  la cognición "centrada en el agente". La escasez de paradigmas "centrados en el agente" limita severamente nuestra capacidad de entender plenamente la función  y  la  disfunción  de  los  lóbulos  frontales.  Al  respecto,  la  Tarea  de Sesgo Cognitivo (o Cognitive Bias Task, CBT) es un paradigma "centrado en el agente" diseñado para llenar este vacío. La CBT se ha utilizado como una tarea de activación cognitiva en estudios de IRMf, SPECT y EEG, así como  en  estudios  del  desarrollo  normal,  adicciones,  demencia, lesiones focales, y esquizofrenia. Consecuentemente, se han obtenido hallazgos que evitan  algunas  de  las  limitaciones  de  los  paradigmas  más  tradiciones, "verídicos", y que se revisan en este artículo. Palabras claves:  Toma de Decisiones; Tarea Con Preferencia Cognitiva; Cognición

At-Risk Tackling Techniques in American Football

Background: In American football, fewer fatalities and severe injuries have been seen annually since 1976, after data from 1971 through 1975 were retrospectively reviewed to better understand the mechanisms involved in catastrophic cervical spine injury and rules were enacted to prohibit certain types of aggressive tackling. The National Football Head and Neck Injury Registry was established in 1975. Purpose: To assess (1) tackling techniques that coaches were teaching at 3 levels-youth level (YL; 4th to 5th grades), middle school (MS; 6th to 8th grades), and high school (HS; 9th to 12th grades); (2) tackling techniques used during games; and (3) the successful tackle rates of these techniques. Study design: Descriptive epidemiology study. Methods: Surveys were distributed via email to 500 coaches of YL, MS, and HS football teams in Texas. Coaches provided video recordings of football games, and all tackle attempts were graded by a single reviewer who watched game videos; 1000 consecutive tackles were observed for each group. Survey data included how coaches instructed their players to tackle, the types of tackles, the number of tackles versus missed tackles, the head position, and the initial contact. Data were analyzed with the chi-square test. A subset of 100 consecutive tackles at each level of play was reviewed by 2 blinded reviewers to assess intra- and interrater reliabilities. Results: In all groups, coaches responded that they preferred to teach the at-risk "head across the bow" tackling technique (83% YL, 81% MS, 75% HS). Coaches stated that they instructed players to "keep your head up," as currently recommended, 89% in YL, 100% in MS, and 81% in HS. During games, players used head-up, inside-shoulder tackles more successfully across all groups (97.5% YL, 99.5% MS, 98.8% HS). While intra- and interrater reliabilities were in the good range, these scores were lower in the youth group. Conclusion: Our study supports the effectiveness of tackling with the head up and making the initial contact with the inside shoulder. Lower reliability ratings for the youth group were likely due to lower video quality and the lack of players' tackling experience

Statements of Agreement From the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015

Conventional management for concussion involves prescribed rest and progressive return to activity. Recent evidence challenges this notion and suggests that active approaches may be effective for some patients. Previous concussion consensus statements provide limited guidance regarding active treatment

Agent-Centered Decision Making in Normal and Abnormal Cognition

La Toma de Decisiones Centrada en el Agente en la Cognición Normal y Anormal: Gran parte de la cognición humana está "centrada en el agente", es subjetiva, y en ese sentido, está dirigida a decidir: "¿Qué es lo mejor para mí?". Esta es una perspectiva muy diferente a la de la cognición "verídica", que está más dirigida a encontrar una solución objetivamente correcta, inherente a la tarea, e independiente del agente. Los lóbulos frontales, en particular, son fundamentales para la toma de decisiones "centrada en el agente". Sin embargo, existen pocos paradigmas cognitivos en el marco de la neurociencia cognitiva y de la neuropsicología clínica, que se hayan diseñado para evaluar la toma de decisiones "centrada en el agente". Los paradigmas actuales y las pruebas utilizadas para medir la toma de decisiones clínica y experimentalmente son "verídicos" en su naturaleza y, por lo mismo, no son adecuados para la evaluación de la cognición "centrada en el agente". La escasez de paradigmas "centrados en el agente" limita severamente nuestra capacidad de entender plenamente la función y la disfunción de los lóbulos frontales. Al respecto, la Tarea de Sesgo Cognitivo (o Cognitive Bias Task, CBT) es un paradigma "centrado en el agente" diseñado para llenar este vacío. La CBT se ha utilizado como una tarea de activación cognitiva en estudios de IRMf, SPECT y EEG, así como en estudios del desarrollo normal, adicciones, demencia, lesiones focales, y esquizofrenia. Consecuentemente, se han obtenido hallazgos que evitan algunas de las limitaciones de los paradigmas más tradiciones, "verídicos", y que se revisan en este artículo.Much of human cognition is �agent-centered,� subjective, and in that sense relative, directed at deciding, �What is best for me�. This is very different from �veridical� cognition, directed at finding an objectively correct solution inherent in the task and independent of the agent. The frontal lobes in particular are central to agent-centered decision making. Yet very little is available in the arsenal of cognitive paradigms used in the cognitive neuroscience research and in clinical neuropsychology test design to examine �agent-centered� decision making. Current paradigms and tests used to measure decision making clinically and experimentally are veridical in nature and as such miss the essence of �agent-centered� cognition. The dearth of �agent-centered� cognitive paradigms severely limits our ability to understand fully the function and dysfunction of the frontal lobes. The Cognitive Bias Task (CBT) is an agent-centered paradigm designed to fill this gap. CBT has been used as a cognitive activation task in fMRI, SPECT, and EEG, as well as in studies of normal development, addiction, dementia, focal lesions, and schizophrenia. This resulted in a range of findings that eluded more traditional �veridical� paradigms and are reviewed here

Altered adaptive but not veridical decision-making in substance dependent individuals.

Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't;Drug addiction is associated with impaired judgment in unstructured situations in which success depends on self-regulation of behavior according to internal goals (adaptive decision-making). However most executive measures are aimed at assessing decision-making in structured scenarios, in which success is determined by external criteria inherent to the situation (veridical decision-making). The aim of this study was to examine the performance of Substance Abusers (SA, n = 97) and Healthy Comparison participants (HC, n = 81) in two behavioral tasks that mimic the uncertainty inherent in real-life decision-making: the Cognitive Bias Task (CB) and the Iowa Gambling Task (IGT) (administered only to SA). A related goal was to study the interdependence between performances on both tasks. We conducted univariate analyses of variance (ANOVAs) to contrast the decision-making performance of both groups; and used correlation analyses to study the relationship between both tasks. SA showed a marked context-independent decision-making strategy on the CB's adaptive condition, but no differences were found on the veridical conditions in a subsample of SA (n = 34) and HC (n = 22). A high percentage of SA (75%) also showed impaired performance on the IGT. Both tasks were only correlated when no impaired participants were selected. Results indicate that SA show abnormal decision-making performance in unstructured situations, but not in veridical situations.This study has been supported by grant BSO2003-07169 from the Spanish Ministry of Science and Technology, whose principal researcher is Dr. Miguel Pérez GarcíaYe

Latent Structure of a Brief Clinical Battery of Neuropsychological Tests Administered In-Home Via Telephone

Objective: To examine the factor structure and sociodemographic correlates of a battery of clinical neuropsychological tests administered in-home and via telephone. Method: Participants included 280 healthy adults who completed a 35-40 min battery consisting of seven auditory-verbal neuropsychological tests (i.e., 10 variables) that included digit span, list learning and memory, prospective memory, verbal fluency, and oral trail making. Results: After removing oral trail making part A, a three-factor model comprised of executive functions, memory and attention demonstrated the best fit to the data. Nevertheless, the shared variance between the nine remaining neuropsychological variables was also adequately explained by a single-factor model and a two-factor model comprised of executive functions and memory. Factor scores were variably associated with education, race/ethnicity, and IQ, but not with sex or age. Conclusions: Findings provide preliminary support for the feasibility and factor structure and sociodemographic correlates of a brief telephone-based screening neuropsychological battery comprised mostly of commonly administered clinical measures. Future studies are needed to determine the reliability, sensitivity, and ecological relevance of this battery, as well as equivalency to in-person assessment