Crash risk by driver age, gender, and time of day using a new exposure methodology

Introduction: Concerns have been raised that the nonlinear relation between crashes and travel exposure invalidates the conventional use of crash rates to control for exposure. A new metric of exposure that bears a linear association to crashes was used as basis for calculating unbiased crash risks. This study compared the two methods – conventional crash rates and new adjusted crash risk – for assessing the effect of driver age, gender, and time of day on the risk of crash involvement and crash fatality. Method: We used police reports of single-car and multi-car crashes with fatal and nonfatal driver injuries that occurred during 2002–2012 in Great Britain. Results: Conventional crash rates were highest in the youngest age group and declined steeply until age 60–69 years. The adjusted crash risk instead peaked at age 21–29 years and reduced gradually with age. The risk of nighttime driving, especially among teenage drivers, was much smaller when based on adjusted crash risks. Finally, the adjusted fatality risk incurred by elderly drivers remained constant across time of day, suggesting that their risk of sustaining a fatal injury due to a crash is more attributable to excess fragility than to crash seriousness. Conclusions: Our findings demonstrate a biasing effect of low travel exposure on conventional crash rates. This implies that conventional methods do not yield meaningful comparisons of crash risk between driver groups and driving conditions of varying exposure to risk. The excess crash rates typically associated with teenage and elderly drivers as well as nighttime driving are attributed in part to overestimation of risk at low travel exposure. Practical Applications: Greater attention should be directed toward crash involvement among drivers in their 20s and 30s as well as younger drivers. Countermeasures should focus on the role of physical vulnerability in fatality risk of elderly drivers

Hand-in-hand in the golden years: Cognitive interdependence, partner involvement in retirement planning, and the transition into retirement

This research examined the influence of cognitive interdependence—a mental state reflecting a collective representation of the self-in-relationship—on the anticipation for and experiences with the transition into retirement. Among soon-to-be retirees (Study 1), greater cognitive interdependence was associated with seeing partners as more instrumental to one’s goals both pre- and post-retirement, anticipating greater goal alignment post-retirement, and having directly involved partners in retirement planning to a greater extent than those relatively lower in cognitive interdependence. Among recent retirees (Study 2), retrospective cognitive interdependence was associated with post-retirement goal alignment and goal instrumentality, and the extent to which they believed they had directly involved their partners in retirement planning. However, it was post-retirement goal alignment that was associated with greater ease of retirement and subjective well-being. Finally, soon-to-be retirees relatively high in cognitive interdependence responded to concerns about their retirement (i.e., goal discordance and high retirement ambivalence) by wanting to involve their partners in their retirement plans to a greater extent (Study 3). These studies highlight the importance of romantic partners across the lifespan, and how partners might influence retirement planning, the transition to retirement, and well-being among recent retirees

Communicating clinical trial outcomes: Effects of presentation method on physicians’ evaluations of new treatments

Physicians expect a treatment to be more effective when its clinical outcomes are described as relative rather than as absolute risk reductions. We examined whether effects of presentation method (relative vs. absolute risk reduction) remain when physicians are provided the baseline risk information, a vital piece of statistical information omitted in previous studies. Using a between-subjects design, ninety five physicians were presented the risk reduction associated with a fictitious treatment for hypertension either as an absolute risk reduction or as a relative risk reduction, with or without including baseline risk information. Physicians reported that the treatment would be more effective and that they would be more willing to prescribe it when its risk reduction was presented to them in relative rather than in absolute terms. The relative risk reduction was perceived as more effective than absolute risk reduction even when the baseline risk information was explicitly reported. We recommend that information about absolute risk reduction be made available to physicians in the reporting of clinical outcomes. Moreover, health professionals should be cognizant of the potential biasing effects of risk information presented in relative risk terms

How Do Psychiatrists Apply the Minimum Clinically Important Difference to Assess Patient Responses to Treatment?

Symptom report scales are used in clinical practice to monitor patient outcomes. Using them permits the definition of a minimum clinically important difference (MCID) beyond which a patient may be judged as having responded to treatment. Despite recommendations that clinicians routinely use MCIDs in clinical practice, statisticians disagree about how MCIDs should be used to evaluate individual patient outcomes and responses to treatment. To address this issue, we asked how clinicians actually use MCIDs to evaluate patient outcomes in response to treatment. Sixty-eight psychiatrists made judgments about whether hypothetical patients had responded to treatment based on their pre- and posttreatment change scores on the widely used Positive and Negative Syndrome Scale. Psychiatrists were provided with the scale’s MCID on which to base their judgments. Our secondary objective was to assess whether knowledge of the patient’s genotype influenced psychiatrists’ responder judgments. Thus, psychiatrists were also informed of whether patients possessed a genotype indicating hyperresponsiveness to treatment. While many psychiatrists appropriately used the MCID, others accepted a far lower posttreatment change as indicative of a response to treatment. When psychiatrists accepted a lower posttreatment change than the MCID, they were less confident in such judgments compared to when a patient’s posttreatment change exceeded the scale’s MCID. Psychiatrists were also less likely to identify patients as responders to treatment if they possessed a hyperresponsiveness genotype. Clinicians should recognize that when judging patient responses to treatment, they often tolerate lower response thresholds than warranted. At least some conflate their judgments with information, such as the patient’s genotype, that is irrelevant to a post hoc response-to-treatment assessment. Consequently, clinicians may be at risk of persisting with treatments that have failed to demonstrate patient benefits

Does Medical Risk Perception and Risk Taking Change with Age?

Across adulthood, people face increasingly more risky medical problems and decisions. However, little is known about changes in medical risk taking across adulthood. Therefore, the current cross‐sectional study investigated age‐related differences in medical risk taking with N = 317 adults aged 20–77 years using newly developed scenarios to assess medical risk taking, and additional measures designed to evaluate risk‐taking behavior in the medical domain. Greater expected benefits on the Domain‐Specific Risk‐Taking Scale—Medical (DOSPERT‐M) predicted more active risk taking, whereas higher perceived risk predicted less active risk taking. Next, we examined differences in active and passive risk taking, where passive risk taking refers to risk taking that is associated with inaction. Age was associated with less passive risk taking, but not with active risk taking, risk perception, or expected benefits on the DOSPERT‐M. Participants were overall more likely to opt for taking medical action than not, even more so for a scenario about a vaccine for a deadly flu than for a scenario about a chemotherapy treatment for cancer. Overall, participants were more likely to accept medication (vaccine or chemotherapy) for their child than for themselves. Increasing age was associated with a lower likelihood of accepting the treatment or vaccine for oneself. Taken together, our study provides important insights about changes in medical risk taking across adulthood when people face an increasing number of complex and risky medical decisions

Perception of Risk for Older Adults: Differences in Evaluations for Self versus Others and across Risk Domains

Background and Objectives: Proxy decision-making may be flawed by inaccurate perceptions of risk. This may be particularly true when older adults are the targets of the decisions, given the pervasive negative stereotypes about older adults. Methods: In study 1, individuals aged 18- to 87 years (as target persons) as well as one of their close social partners (as informants) reported on the risks they perceived for the target person in various life domains. Study 2 additionally explored potential differences in how people make risky decisions on behalf of younger and older adult targets. Younger (age 18–35 years) and older (age 60–81 years) adults (as target persons of the risk evaluations) as well as informants reported on risk perceptions and the likelihood of risk-taking for health, financial, and social scenarios concerning the target persons. Congruence between self-rated and informant-rated risk perceptions and risk-taking were computed on a dyadic as well as a group level. Results: Informants’ risk perceptions were positively associated with the risks their partners perceived for themselves. Informants and their partners agreed that social risks vary little across adulthood, but they disagreed in terms of recreational, financial, and health risks, and in terms of the decisions they would make. Conclusion: Family members, partners, and close friends are sensitive to vulnerabilities of their social partners, but in some domains and according to their partners’ age they perceive a greater (or smaller) risk than their partners perceive for themselves. In situations requiring surrogate decision-making, people may decide differently from how their social partners would decide for themselves

Risk-Exposure Density and Mileage Bias in Crash Risk for Older Drivers

Driver crash rates per mile indicate high crash risk in older age. A reliance on mileage alone may underestimate risk exposure of older drivers as they tend to avoid highways and travel more on non-freeways (e.g., urban roads) that present greater hazards. We introduce risk exposure density as an index of exposure that incorporates mileage, frequency of travel, and travel duration. Population-wide driver fatalities in the U.S. during 2002?2012 were assessed per driver age (16?20, 21?29, 30?39, 40?49, 50?59, 60?69, >70 years) and gender. Mileage, frequency, and duration of travel per person were used to assess risk exposure. Mileage-based fatal crash risk increased greatly among male (RR=1.73; 95% CI:1.62,1.83) and female (RR=2.08; 95% CI:1.97,2.19) drivers from age 60?69 years to age >70 years. Adjusting for their density of risk exposure, fatal crash risk increased only slightly from age 60?69 years to age >70 years among male (RR=1.09; 95% CI:1.03,1.15) and female (RR=1.22; 95% CI:1.16,1.29) drivers. While ubiquitous in epidemiology research, mileage-based assessments can produce misleading accounts of driver risk. Risk exposure density incorporates multiple components of travel and reduces bias caused by any single indicator of risk exposure

Who will I be when I retire? The role of organizational commitment, group memberships and retirement transition framing on older worker’s anticipated identity change in retirement

Retirement is an eagerly awaited life transition for many older workers, but some may anticipate their exit from the workforce will result in loss of meaningful work-based activities and social interactions. For older workers more committed to their organization, retirement might represent a threat to maintaining a consistent, positive identity. Across three pre-registered studies of US adults aged 49 to 75, we investigated the relationship between organizational commitment and anticipated identity changes in retirement. Studies 1 and 2 (N = 1059) found that older workers largely anticipated positive changes to their identity in retirement. In Study 2, we divided older workers into two conditions and used a framing manipulation to present retirement as either a ‘role exit’ or a ‘role entry’. In the ‘role exit’ condition, older workers less committed to their organization anticipated more positive changes when they held more group memberships compared to those with fewer group memberships. Those in the ‘role entry’ condition anticipated significantly more positive changes to their identity in retirement than those in the ‘role exit’ condition, but did not anticipate more positive changes based on organizational commitment or group memberships. More group memberships, but not lower organizational commitment, was associated with more positive anticipation of identity changes in retirement. Study 3 (N = 215) surveyed older adults after they had retired, finding that identity changes experienced post-retirement were less positive than those anticipated by older workers. We discuss the theoretical and applied implications of these findings for older workers’ retirement decisions and wellbeing

Can I Count on Getting Better? Association between Math Anxiety and Poorer Understanding of Medical Risk Reductions

Lower numerical ability is associated with poorer understanding of health statistics, such as risk reductions of medical treatment. For many people, despite good numeracy skills, math provokes anxiety that impedes an ability to evaluate numerical information. Math-anxious individuals also report less confidence in their ability to perform math tasks. We hypothesized that, independent of objective numeracy, math anxiety would be associated with poorer responding and lower confidence when calculating risk reductions of medical treatments. Methods. Objective numeracy was assessed using an 11-item objective numeracy scale. A 13-item self-report scale was used to assess math anxiety. In experiment 1, participants were asked to interpret the baseline risk of disease and risk reductions associated with treatment options. Participants in experiment 2 were additionally provided a graphical display designed to facilitate the processing of math information and alleviate effects of math anxiety. Confidence ratings were provided on a 7-point scale. Results. Individuals of higher objective numeracy were more likely to respond correctly to baseline risks and risk reductions associated with treatment options and were more confident in their interpretations. Individuals who scored high in math anxiety were instead less likely to correctly interpret the baseline risks and risk reductions and were less confident in their risk calculations as well as in their assessments of the effectiveness of treatment options. Math anxiety predicted confidence levels but not correct responding when controlling for objective numeracy. The graphical display was most effective in increasing confidence among math-anxious individuals. Conclusions. The findings suggest that math anxiety is associated with poorer medical risk interpretation but is more strongly related to confidence in interpretations

Questioning the preparatory function of counterfactual thinking

Why do individuals mentally modify reality (e.g., “If it hadn’t rained, we would have won the game”)? According to the dominant view, counterfactuals primarily serve to prepare future performance. In fact, individuals who have just failed a task tend to modify the uncontrollable features of their attempt (e.g., “If the rules of the game were different, I would have won it”), generating counterfactuals that are unlikely to play any preparatory role. By contrast, they generate prefactuals that focus on the controllable features of their ensuing behavior (e.g., “If I concentrate more, I will win the next game”). Here, we test whether this tendency is robust and general. Studies 1a and 1b replicate this tendency and show that it occurs regardless of whether individuals think about their failures or their successes. Study 2 shows that individuals generate relatively few controllable counterfactuals, unless explicitly prompted to do so. These results raise some questions regarding the generality of the dominant view according to which counterfactuals mainly serve a preparatory function