将建议采纳作为决策神经科学与心理能力之间的桥梁。

Advice-taking as a bridge between decision neuroscience and mental capacity.

机构信息

Wellcome Centre for Human Neuroimaging, University College London, London WC1N 3BG, UK.

Institute of Mental Health, University College London, London W1T 7NF, UK.

出版信息

Int J Law Psychiatry. 2019 Nov-Dec;67:101504. doi: 10.1016/j.ijlp.2019.101504. Epub 2019 Nov 26.

Abstract

A person's capacity to process advice is an important aspect of decision making in the real world. For example, in decisions about treatment, the way patients respond to the advice of family, friends and medical professionals may be used (intentionally or otherwise) as a marker of the "use or weigh" requirement of decision-making capacity. Here we explore neuroscientific research on decision-making to identify features of advice-taking that help conceptualize this requirement. We focus on studies of the neural and computational basis of decision-making in laboratory settings. These studies originally investigated simple perceptual decisions about ambiguous stimuli, but have more recently been extended to more complex "value-based" decisions involving the comparison of subjective preferences. Value-based decisions are a useful model system for capacity-related decision-making as they do not have an objectively 'correct' answer and are instead based on subjective preferences. In this context, advice-taking can be seen as a process in which new evidence for one or other option is integrated, leading to altered behaviour or choices. We use this framework to distinguish between different types of advice-taking: private compliance consists of updating one's privately held beliefs based on new evidence, whereas in the case of public compliance, people change their behaviour at a surface level without shifting their privately-held beliefs. Importantly, both types of advice-taking may lead to similar outcomes but rely on different decision processes. We suggest that understanding how multiple mechanisms drive advice-taking holds promise for targeting decision-making support and improving our understanding of the use and weigh requirement in cases of contested capacity.

摘要

一个人处理建议的能力是现实世界中决策的一个重要方面。例如,在治疗决策中,患者对家人、朋友和医疗专业人员建议的反应方式(有意或无意)可被用作决策能力的“使用或权衡”要求的标志。在这里,我们探讨了决策的神经科学研究,以确定有助于概念化这一要求的接受建议的特征。我们专注于实验室环境中决策的神经和计算基础的研究。这些研究最初调查了对模糊刺激的简单感知决策,但最近已扩展到更复杂的“基于价值”的决策,涉及对主观偏好的比较。基于价值的决策是与能力相关的决策的一个有用的模型系统,因为它们没有客观的“正确”答案,而是基于主观偏好。在这种情况下,接受建议可以被视为一个过程,其中一个或另一个选项的新证据被整合,从而导致行为或选择的改变。我们使用这个框架来区分不同类型的接受建议:私人遵从包括根据新证据更新个人持有的信念,而在公共遵从的情况下,人们在表面上改变行为,而不改变其私下持有的信念。重要的是,这两种类型的接受建议都可能导致类似的结果,但依赖于不同的决策过程。我们认为,理解多种机制如何驱动接受建议有望成为决策支持的目标,并提高我们对有争议能力情况下的使用和权衡要求的理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2715/7661837/f3ec749737fc/gr1.jpg

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