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1.  Investment and repayment in a trust game after ventromedial prefrontal damage 
Although trust and reciprocity are ubiquitous in social exchange, their neurobiological substrate remains largely unknown. Here, we investigated the effect of damage to the ventromedial prefrontal cortex (vmPFC)—a brain region critical for valuing social information—on individuals’ decisions in a trust game and in a risk game. In the trust game, one player, the investor, is endowed with a sum of money, which she can keep or invest. The amount she decides to invest is tripled and sent to the other player, the trustee, who then decides what fraction to return to the investor. In separate runs, ten patients with focal bilateral damage to the vmPFC and control participants made decision while playing in the role of either investor or trustee with different anonymous counterparts in each run. A risk game was also included in which the investor faced exactly the same decisions as in the trust game, but a random device (i.e., a computer), not another player, determined the final payoffs. Results showed that vmPFC patients’ investments were not modulated by the type of opponent player (e.g., human vs. computer) present in the environment. Thus, vmPFC patients showed comparable risk-taking preferences both in social (trust game) and nonsocial (risk game) contexts. In stark contrast, control participants were less willing to take risk and invest when they believed that they were interacting with people than a computer. Furthermore, when acted as trustee, vmPFC patients made lower back transfers toward investors, thereby showing less reciprocity behavior. Taken together, these results indicate that social valuation and emotion subserved by vmPFC have a critical role in trusting and reciprocity decisions. The present findings support the hypothesis that vmPFC damage may impair affective systems specifically designed for mediating social transaction with other individuals.
doi:10.3389/fnhum.2013.00593
PMCID: PMC3782646  PMID: 24093013
trust; risk; reciprocity; social valuation; vmPFC; lesion studies
2.  What if I Get Busted? Deception, Choice, and Decision-Making in Social Interaction 
Deception is an essentially social act, yet little is known about how social consequences affect the decision to deceive. In this study, participants played a computerized game of deception without constraints on whether or when to attempt to deceive their opponent. Participants were questioned by an opponent outside the scanner about their knowledge of the content of a display. Importantly, questions were posed so that, in some conditions, it was possible to be deceptive, while in other conditions it was not. To simulate a realistic interaction, participants could be confronted about their claims by the opponent. This design, therefore, creates a context in which a deceptive participant runs the risk of being punished if their deception is detected. Our results show that participants were slower to give honest than to give deceptive responses when they knew more about the display and could use this knowledge for their own benefit. The condition in which confrontation was not possible was associated with increased activity in subgenual anterior cingulate cortex. The processing of a question which allows a deceptive response was associated with activation in right caudate and inferior frontal gyrus. Our findings suggest the decision to deceive is affected by the potential risk of social confrontation rather than the claim itself.
doi:10.3389/fnins.2012.00058
PMCID: PMC3328780  PMID: 22529772
deception; confrontation; social interaction; decision-making
3.  The World – Socio-economically and politically: What you need to know 
The gravest challenge facing the USA and the nations of the world is the coming economic crisis of the world economies, if present policies are pursued. Few are aware or believe that this event could happen. The spread of centralized government control of the economies, the growth of the welfare state worldwide, the expenditures on entitlements beyond what any nation or even most states can afford, the cost of wars, the rapidly climbing debt of the USA and other countries and their inability to pay for these excessive expenses, the actions of many countries to print “fiat” (false) money to pay for their debts, the raising of taxes to pay for these debts, the rise in immigration to developed countries from the undeveloped world, the associated costs to their societies of this immigration, the promises made by politicians to get elected that cannot be fulfilled, and the desire of the public to have what they want, now, paid for by credit cards (debt), are all contributing to the coming economic crisis.
The unfunded promised benefits to the citizens of the USA in Medicare, Medicaid, Social Security, and pensions plus the USA debt amount to about $140 trillion. The total value of all the assets of all the people in the USA is $99 trillion dollars. So, one can see that the people of the USA do not have the resources to pay their expenses. Besides, these entitlements, the rest of the expenses are paid for with borrowed or printed (fiat) money that has little chance of being repaid unless perhaps by subsequent generations or by increases in taxes. Efforts to correct this coming economic crisis by austerity and sacrifice have been rejected by the public and the politicians worldwide. The Governments and the Press have participated in deception of the public about these issues in order to maintain their positions of power, for the truth would destroy them. No solution is in sight except more spending and valueless money printing.
This unchecked desire for more of everything without the responsibility to work or pay for these entitlements, has touched many countries and people with a few exceptions. This problem is the result of a worldwide breakdown of ethics and morality in society and a desire of the few for centralized control and power over the people. No country has instituted a solution to these problems that results in reducing expenditures or the growing debts. As many have stated in this paper, this policy cannot be sustained. The result of this scenario will be a worldwide economic crisis.
Fundamental to this impending economic crisis is the failure of centrally controlled economies and socialistic programs. Those selected groups, who benefit from having control, are the politicians, bankers, some selected industry leaders, and socialist planners, who will stop at nothing to maintain power and control over the people. Liberty of the people is in jeopardy worldwide. Read the evidence presented and decide if this summary is correct.
The troubling question is, “What will happen if the world economy collapses?” Will this crisis be a time for the few to take more control of the people through fear, crisis decisions, misinformation, prevention of the public from protecting themselves with guns, and pervasive spying technology on each citizen or will more democratic governments arise from the failure of centralized control, the welfare state, and the loss of liberty? Such crises have been repeated throughout 4000 years of recorded history. What happened in those past times? Read the quotations of Vladimir Lenin, developer of Marxism–Leninism, the foundation of Communism and judge what you have read from his statements.
An alternative to this dismal scenario is little discussed also in the Press. Why not? In the past 150 years, the alternative has happened with a rapid growth in democracy, communications technology, and life expectancy from advances in science and medicine. To unleash this huge human potential, at this time, will require individual freedom to create and innovate with the opportunity for risk and reward in an environment aided by unrestrictive governments even at the community and organizational levels. History records the success of the alternatives in the great leadership and creativity of humankind. The USA and the world are at the critical choice for their futures. We are experiencing the results of centrally controlling governments worldwide that are not working. Is it time for an alternative option? Read the evidence in this paper and decide for yourself.
Reading this paper will take you time, but you will not read all of this information elsewhere. It is key to your future. Decide for yourself what you should do after reading it. The URLs of many of the references are included so that you can read further about the many subjects presented yourself.
doi:10.4103/2152-7806.119730
PMCID: PMC3815094  PMID: 24231906
Economics; politics; socialism; socioeconomics; welfare
4.  The Role of Self-Blaming Moral Emotions in Major Depression and Their Impact on Social-Economical Decision Making 
People with major depressive disorder (MDD) are more prone to experiencing moral emotions related to self-blame, such as guilt and shame. DSM-IV-TR recognizes excessive or inappropriate guilt as one of the core symptoms of current MDD, whereas excessive shame is not part of the criteria for MDD. However, previous studies specifically assessing shame suggested its involvement in MDD. In the first part of this review, we will consider literature discussing the role of self-blaming moral emotions in MDD. These self-blaming moral emotions have been purported to influence people when they make social and financial decisions in cognitive studies, particularly those using neuroeconomical paradigms. Such paradigms aim to predict social behavior in activities of daily living, by using important resource tangibles (especially money) in laboratory conditions. Previous literature suggests that guilt promotes altruistic behavior via acting out reparative tendencies, whereas shame reduces altruism by means of increasing social and interpersonal distance. In the second part of this review, we will discuss the potential influence of self-blaming moral emotions on overt behavior in MDD, reviewing clinical and experimental studies in social and financial decision-making, in which guilt, and shame were manipulated. This is not a well-established area in the depression literature, however in this opinion paper we will argue that studies of moral emotions and their impact on behavioral decision-making are of potential importance in the clinical field, by linking specific symptoms of a disorder to a behavioral outcome which may lead to stratification of clinical diagnoses in the future.
doi:10.3389/fpsyg.2013.00310
PMCID: PMC3670430  PMID: 23750148
guilt; shame; major depressive disorder; neuroeconomics; social-economical decision making; neuroimaging
5.  Global Health Governance and the Commercial Sector: A Documentary Analysis of Tobacco Company Strategies to Influence the WHO Framework Convention on Tobacco Control 
PLoS Medicine  2012;9(6):e1001249.
Heide Weishaar and colleagues did an analysis of internal tobacco industry documents together with other data and describe the industry's strategic response to the proposed World Health Organization Framework Convention on Tobacco Control.
Background
In successfully negotiating the Framework Convention on Tobacco Control (FCTC), the World Health Organization (WHO) has led a significant innovation in global health governance, helping to transform international tobacco control. This article provides the first comprehensive review of the diverse campaign initiated by transnational tobacco corporations (TTCs) to try to undermine the proposed convention.
Methods and Findings
The article is primarily based on an analysis of internal tobacco industry documents made public through litigation, triangulated with data from official documentation relating to the FCTC process and websites of relevant organisations. It is also informed by a comprehensive review of previous studies concerning tobacco industry efforts to influence the FCTC. The findings demonstrate that the industry's strategic response to the proposed WHO convention was two-fold. First, arguments and frames were developed to challenge the FCTC, including: claiming there would be damaging economic consequences; depicting tobacco control as an agenda promoted by high-income countries; alleging the treaty conflicted with trade agreements, “good governance,” and national sovereignty; questioning WHO's mandate; claiming the FCTC would set a precedent for issues beyond tobacco; and presenting corporate social responsibility (CSR) as an alternative. Second, multiple tactics were employed to promote and increase the impact of these arguments, including: directly targeting FCTC delegations and relevant political actors, enlisting diverse allies (e.g., mass media outlets and scientists), and using stakeholder consultation to delay decisions and secure industry participation.
Conclusions
TTCs' efforts to undermine the FCTC were comprehensive, demonstrating the global application of tactics that TTCs have previously been found to have employed nationally and further included arguments against the FCTC as a key initiative in global health governance. Awareness of these strategies can help guard against industry efforts to disrupt the implementation of the FCTC and support the development of future, comparable initiatives in global health.
Please see later in the article for the Editors' Summary
Editors' Summary
Background
Every year, about 5 million people die worldwide from tobacco-related causes and, if current trends continue, annual deaths from tobacco-related causes will increase to 10 million by 2030. In response to this global tobacco epidemic, the World Health Organization (WHO) has developed an international instrument for tobacco control called the Framework Convention on Tobacco Control (FCTC). Negotiations on the FCTC began in 1999, and the international treaty—the first to be negotiated under the auspices of WHO—entered into force on 27 February 2005. To date, 174 countries have become parties to the FCTC. As such, they agree to implement comprehensive bans on tobacco advertising, promotion, and sponsorship; to ban misleading and deceptive terms on cigarette packaging; to implement health warnings on tobacco packaging; to protect people from tobacco smoke exposure in public spaces and indoor workplaces; to implement taxation policies aimed at reducing tobacco consumption; and to combat illicit trade in tobacco products.
Why Was This Study Done?
Transnational tobacco corporations (TTCs) are sometimes described as “vectors” of the global tobacco epidemic because of their drive to maximize shareholder value and tobacco consumption. Just like conventional disease vectors (agents that carry or transmit infectious organisms), TTCs employ a variety of tactics to ensure the spread of tobacco consumption. For example, various studies have shown that TTCs have developed strategies that attempt to limit the impact of tobacco control measures such as the FCTC. However, to date, studies investigating the influence of TTCs on the FCTC have concentrated on specific countries or documented specific tactics. Here, the researchers undertake a comprehensive review of the diverse tactics employed by TTCs to undermine the development of the FCTC. Such a review is important because its results should facilitate the effective implementation of FCTC measures and could support the development of future tobacco control initiatives and of global initiatives designed to control alcohol-related and food-related disease and death.
What Did the Researchers Do and Find?
The researchers analyzed documents retrieved from the Legacy Tobacco Documents Library (a collection of internal tobacco industry documents released as a result of US litigation cases) dealing with the strategies employed by TTCs to influence the FCTC alongside data from the websites of industry, consultancy, and other organizations cited in the documents; the official records of the FCTC process; and previous studies of tobacco industry efforts to influence the FCTC. Their analysis reveals that the strategic response of the major TTCs to the proposed FCTC was two-fold. First, the TTCs developed a series of arguments and “frames” (beliefs and ideas that provide a framework for thinking about an issue) to challenge the FCTC. Core frames included claiming that the FCTC would have damaging economic consequences, questioning WHO's mandate to develop a legally binding international treaty by claiming that tobacco was not a cross-border problem, and presenting corporate social responsibility (the commitment by business to affect the environment, consumers, employees, and society positively in addition to making money for shareholders) as an alternative to the FCTC. Second, the TTCs employed multiple strategies to promote and increase the impact of these arguments and frames, such as targeting FCTC delegations and enlisting the help of diverse allies including media outlets and scientists.
What Do These Findings Mean?
These findings illustrate the variety and complexity of the tobacco industry's efforts to undermine the FCTC and show the extent to which TTCs combined and coordinated tactics on a global stage that they had previously used on a national stage. Indeed, “the comprehensiveness and scale of the tobacco industry's response to the FCTC suggests that it is reasonable to speak of a ‘globalisation of tobacco industry strategy’ in combating the development of effective tobacco control policies,” write the researchers. Awareness of the strategies employed by TTCs to influence the FCTC should help guard against industry efforts to disrupt the implementation of the FCTC and should support the development of future global tobacco control initiatives. More generally, these findings should support the development of global health initiatives designed to tackle cardiovascular disease, cancer, chronic respiratory diseases and diabetes – non-communicable diseases that together account for 60% of global deaths and are partly driven by the commercial activities of food, alcohol, and tobacco corporations.
Additional Information
Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1001249.
The World Health Organization provides information about the dangers of tobacco (in several languages) and about the Framework Convention on Tobacco Control
For information about the tobacco industry's influence on policy, see the 2009 World Health Organization report Tobacco interference with tobacco control
The Framework Convention Alliance provides more information about the FCTC
The Legacy Tobacco Documents Library is a public, searchable database of tobacco company internal documents detailing their advertising, manufacturing, marketing, sales, and scientific activities
The UK Centre for Tobacco Control Studies is a network of UK universities that undertakes original research, policy development, advocacy, and teaching and training in the field of tobacco control
SmokeFree, a website provided by the UK National Health Service, offers advice on quitting smoking and includes personal stories from people who have stopped smoking
Smokefree.gov, from the US National Cancer Institute, offers online tools and resources to help people quit smoking and not start again
doi:10.1371/journal.pmed.1001249
PMCID: PMC3383743  PMID: 22745607
6.  Considering the case for an antidepressant drug trial involving temporary deception: a qualitative enquiry of potential participants 
Background
Systematic reviews of randomised placebo controlled trials of antidepressant medication show small and decreasing differences between pharmacological and placebo arms. In part this finding may relate to methodological problems with conventional trial designs, including their assumption of additivity between drug and placebo trial arms. Balanced placebo designs, which include elements of deception, may address the additivity question, but pose substantial ethical and pragmatic problems. This study aimed to ascertain views of potential study participants of the ethics and pragmatics of various balanced placebo designs, in order to inform the design of future antidepressant drug trials.
Methods
A qualitative approach was employed to explore the perspectives of general practitioners, psychiatrists, and patients with experience of depression. The doctors were chosen via purposive sampling, while patients were recruited through participating general practitioners. Three focus groups and 12 in-depth interviews were conducted. A vignette-based topic guide invited views on three deceptive strategies: post hoc, authorised and minimised deception. The focus groups and interviews were tape-recorded and transcribed. Transcripts were analysed thematically using Framework.
Results
Deception in non-research situations was typically perceived as acceptable within specific parameters. All participants could see the potential utility of introducing deception into trial designs, however views on the acceptability of deception within antidepressant drug trials varied substantially. Authorized deception was the most commonly accepted strategy, though some thought this would reduce the effectiveness of the design because participants would correctly guess the deceptive element. The major issues that affected views about the acceptability of deception studies were the welfare and capacity of patients, practicalities of trial design, and the question of trust.
Conclusion
There is a trade-off between pragmatic and ethical responses to the question of whether, and under what circumstances, elements of deception could be introduced into antidepressant drug trials. Ensuring adequate ethical safeguards within balanced placebo designs is likely to diminish their ability to address the crucial issue of additivity. The balanced placebo designs considered in this study are unlikely to be feasible in future trials of antidepressant medication. However there remains an urgent need to improve the quality of antidepressant drug trials.
doi:10.1186/1472-6963-7-64
PMCID: PMC1871586  PMID: 17470280
7.  “Have You Ever Seen This Face?” – Individual Differences and Event-Related Potentials during Deception 
Deception studies emphasize on the importance of event-related potentials (ERP) for a reliable differentiation of the underlying neuro-cognitive processes. The stimulus-locked parietal P3 amplitude has been shown to reflect stimulus salience but also attentional control available for stimulus processing. Known stimuli requiring truthful responses (targets) and known stimuli requiring deceptive responses (probes) were hypothesized to be more salient than unknown stimuli. Thus, a larger P3 was predicted for known truthful and deceptive stimuli than for unknown stimuli. The Medial Frontal Negativity (MFN) represents the amount of required cognitive control and was expected to be more negative to known truthful and deceptive stimuli than to unknown stimuli. Moreover, we expected higher sensitivity to injustice (SI-perpetrator) and aversiveness (Trait-BIS) to result in more intense neural processes during deception. N = 102 participants performed a deception task with three picture types: probes requiring deceptive responses, targets requiring truthful responses to known stimuli, and irrelevants being associated with truthful responses to unknown stimuli. Repeated-measures ANOVA and fixed-links modeling suggested a more positive parietal P3 and a more negative frontal MFN to deceptive vs. irrelevant stimuli. Trait-BIS and SI-perpetrator predicted an increase of the P3 and a decrease of the MFN from irrelevants to probes. This suggested an intensification of stimulus salience and cognitive control across picture types in individuals scoring either higher on Trait-BIS or higher on SI-perpetrator. In contrast, individuals with both higher Trait-BIS and higher SI-perpetrator scores showed a less negative probe-MFN suggesting that this subgroup invests less cognitive control to probes. By extending prior research we demonstrate that personality modulates stimulus salience and control processes during deception.
doi:10.3389/fpsyg.2012.00570
PMCID: PMC3526901  PMID: 23267339
deception; P3; MFN; individual differences; fixed-links modeling
8.  Situational and Dispositional Determinants of Intentional Deceiving 
PLoS ONE  2011;6(4):e19465.
Does opportunity make the thief or are people dispositionally prone to deceive? The interaction between personality and the circumstances surrounding deception is crucial to understand what promotes dishonesty in our society. Due to its inherent spontaneity and sociality, deceptive behaviour may be hardly reproducible in experimental settings. We developed a novel paradigm in the form of an interactive game where participants can choose whether to lie to another person in situations of loss vs. gain, and of no-reputation-risk vs. reputation-risk linked to the disclosure of their deceptive behaviour to others. Thus, our ecological paradigm allowed subjects to spontaneously decide when to lie and face the challenge of deceiving others. In the case of loss, participants lied to reverse the outcome in their favour. Deception was lower in the reputation-risk condition where personality traits concerning social interactions also played an important role.
The results suggest that deception is definitely promoted by unfavourable events, and that maintaining one's own reputation encourages honesty, particularly in socially inclined individuals.
doi:10.1371/journal.pone.0019465
PMCID: PMC3084863  PMID: 21559381
9.  Neural correlates of deception in social contexts in normally developing children 
Deception is related to the ability to inhibit prepotent responses and to engage in mental tasks such as anticipating responses and inferring what another person knows, especially in social contexts. However, the neural correlates of deception processing, which requires mentalizing, remain unclear. Using functional magnetic resonance imaging (fMRI), we examined the neural correlates of deception, including mentalization, in social contexts in normally developing children. Healthy right-handed children (aged 8–9 years) were scanned while performing interactive games involving deception. The games varied along two dimensions: the type of reply (deception and truth) and the type of context (social and less social). Participants were instructed to deceive a witch and to tell the truth to a girl. Under the social-context conditions, participants were asked to consider what they inferred about protagonists' preferences from their facial expressions when responding to questions. Under the less-social-context conditions, participants did not need to consider others' preferences. We found a significantly greater response in the right precuneus under the social-context than under less-social-context conditions. Additionally, we found marginally greater activation in the right inferior parietal lobule (IPL) under the deception than under the truth condition. These results suggest that deception in a social context requires not only inhibition of prepotent responses but also engagement in mentalizing processes. This study provides the first evidence of the neural correlates of the mentalizing processes involved in deception in normally developing children.
doi:10.3389/fnhum.2013.00206
PMCID: PMC3656341  PMID: 23730281
deception; fMRI; mentalizing; children; social context
10.  Enhanced subgenual cingulate response to altruistic decisions in remitted major depressive disorder 
NeuroImage : Clinical  2014;4:701-710.
Background
Major depressive disorder (MDD) is associated with functional abnormalities in fronto-meso-limbic networks contributing to decision-making, affective and reward processing impairments. Such functional disturbances may underlie a tendency for enhanced altruism driven by empathy-based guilt observed in some patients. However, despite the relevance of altruistic decisions to understanding vulnerability, as well as everyday psychosocial functioning, in MDD, their functional neuroanatomy is unknown.
Methods
Using a charitable donations experiment with fMRI, we compared 14 medication-free participants with fully remitted MDD and 15 demographically-matched control participants without MDD.
Results
Compared with the control group, the remitted MDD group exhibited enhanced BOLD response in a septal/subgenual cingulate cortex (sgACC) region for charitable donation relative to receiving simple rewards and higher striatum activation for both charitable donation and simple reward relative to a low level baseline. The groups did not differ in demographics, frequency of donations or response times, demonstrating only a difference in neural architecture.
Conclusions
We showed that altruistic decisions probe residual sgACC hypersensitivity in MDD even after symptoms are fully remitted. The sgACC has previously been shown to be associated with guilt which promotes altruistic decisions. In contrast, the striatum showed common activation to both simple and altruistic rewards and could be involved in the so-called “warm glow” of donation. Enhanced neural response in the depression group, in areas previously linked to altruistic decisions, supports the hypothesis of a possible association between hyper-altruism and depression vulnerability, as shown by recent epidemiological studies.
Highlights
•Patients show enhanced activation in the sgACC while making altruistic decisions.•Patients show elevated STR response to equitable decisions.•These abnormal neural responses may be associated with depression vulnerability.
doi:10.1016/j.nicl.2014.04.010
PMCID: PMC4053655  PMID: 24936421
Charitable donation; Major depression; Reward processing; Subgenual anterior cingulate; Striatum
11.  Summary of the 1983 Annual Reports of the Medicare Board of Trustees 
This summary presents an overview of the information contained in the annual reports of the trustees required under Title XVIII of the Social Security Act, Health Insurance for the Aged and Disabled, commonly known as Medicare. There are two basic programs under Medicare: Hospital insurance (HI), which pays for inpatient hospital care and other related care of those 65 years of age and over and of the long-term disabled.Supplementary medical insurance (SMI), which pays for physicians' services, outpatient hospital services, and other medical expenses of those 65 years of age and over and of the long-term disabled.
The HI program is financed primarily by payroll taxes, with the taxes paid by current workers used to pay benefits to current beneficiaries. However, the HI program maintains a trust fund that provides a small reserve against fluctuations. This type of financing is generally known as pay-as-you-go financing. By contrast, the SMI program is financed on an accrual basis with a contingency margin. This means that the SMI trust fund should always be somewhat greater than the claims that have been incurred by enrollees but not yet paid by the program. The trust funds hold all of the income not currently needed to pay benefits and related expenses. The assets of the funds may not be used for any other purpose; however, they may be invested in certain interest-bearing obligations of the U.S. Government.
The Secretaries of Treasury, Labor, and Health and Human Services serve as trustees of the HI and SMI trust funds. The Secretary of Treasury is the managing trustee. The Administrator of the Health Care Financing Administration, the agency charged with administering the Medicare program, is the secretary of the Board of Trustees.
PMCID: PMC4191327  PMID: 10310524
12.  Photographic memory, money, and liposuction: survey of medical students' wish lists 
BMJ : British Medical Journal  1999;319(7225):1593-1595.
Objectives
To examine whether medical students made fewer altruistic wishes and more money oriented wishes in later years of the medical course than students in earlier years.
Design
Anonymous questionnaire survey.
Setting
Auckland University School of Medicine.
Participants
520 medical students from 6 years of the course responded to the questionnaire item “If you had three wishes what would you wish for?”
Main outcome measures
Proportion of wishes in various categories.
Results
The three most popular categories of wishes were happiness (34% of students), money (32%), and altruistic wishes (31%). Rates of altruistic wishes (odds ratio=1.05, 95% confidence interval 0.94 to 1.18; P=0.36) and wishes for money (odds ratio=0.96, 0.86 to 1.08; P=0.52) did not vary over the years of the course. Female medical students were more likely than males to make altruistic wishes (36% v 26%; χ2=5.68, P=0.02), intimacy wishes (25% v 18%; χ2=3.74, P=0.05), and happiness wishes (42% v 26%; χ2=18.82, P=0.0001). Men were more likely than women to make sexual wishes (5% v 0.8%; χ2=7.34, P=0.01).
Conclusions
We found no evidence that students were less altruistic and more money oriented in the later years of the medical course.
PMCID: PMC28301  PMID: 10600951
13.  Exploring the movement dynamics of deception 
Both the science and the everyday practice of detecting a lie rest on the same assumption: hidden cognitive states that the liar would like to remain hidden nevertheless influence observable behavior. This assumption has good evidence. The insights of professional interrogators, anecdotal evidence, and body language textbooks have all built up a sizeable catalog of non-verbal cues that have been claimed to distinguish deceptive and truthful behavior. Typically, these cues are discrete, individual behaviors—a hand touching a mouth, the rise of a brow—that distinguish lies from truths solely in terms of their frequency or duration. Research to date has failed to establish any of these non-verbal cues as a reliable marker of deception. Here we argue that perhaps this is because simple tallies of behavior can miss out on the rich but subtle organization of behavior as it unfolds over time. Research in cognitive science from a dynamical systems perspective has shown that behavior is structured across multiple timescales, with more or less regularity and structure. Using tools that are sensitive to these dynamics, we analyzed body motion data from an experiment that put participants in a realistic situation of choosing, or not, to lie to an experimenter. Our analyses indicate that when being deceptive, continuous fluctuations of movement in the upper face, and somewhat in the arms, are characterized by dynamical properties of less stability, but greater complexity. For the upper face, these distinctions are present despite no apparent differences in the overall amount of movement between deception and truth. We suggest that these unique dynamical signatures of motion are indicative of both the cognitive demands inherent to deception and the need to respond adaptively in a social context.
doi:10.3389/fpsyg.2013.00140
PMCID: PMC3608909  PMID: 23543852
deception; non-linear measures; Dynamical Systems Theory; embodiment; recurrence quantification analysis; multiscale entropy analysis; body and facial movements; time series analysis
14.  Increasing access to modern contraceptives: the potential role of community solidarity through altruistic contributions 
Background
There is an urgent need for universal access to modern contraceptives in Nigeria, to facilitate the achievement of the Millennium Development Goals and other national goals. This study provides information on the potential role of community solidarity in increasing access to contraceptives for the most-poor people through exploration of the role of altruism by determining level of altruistic willingness to pay (WTP) for modern contraceptives across different geographic contexts in Nigeria.
Methods
It was a cross-sectional national survey which took place in six states spread across the six-geopolitical zones of the country. In each state, an urban and a rural area were selected for the study, giving a total of 6 urban and 6 rural sites. A pre-tested interviewer-administered questionnaire was used to collect information from at least 720 randomly selected householders from each state. The targeted respondent in a household was a female primary care giver of child bearing age (usually the wives), or in her absence, another female household member of child bearing age. A scenario on altruistic WTP was presented before the value was elicited using a binary with open-ended follow-up question format. Test of validity of elicited altruistic WTP was undertaken using Tobit regression.
Findings
More than 50 % of the respondents across all the states were willing to contribute some money so that the very poor would be provided with modern contraceptives. The average amount of money that people were willing to contribute annually was 650 Naira (US$4.5). Mean altruistic WTP differed across SES quintiles and urban-rural divide (p < .01). Multiple regression analysis showed that age was negatively related to altruistic WTP (p < 0.05). However, years of schooling, being employed by government or being a big business person, prior experience of paying for contraceptives and socioeconomic status had statistically significant effects on altruistic WTP (p < 0.05).
Conclusion
There is room for community solidarity to ensure that the very poor benefit from modern contraceptives and assure universal coverage with modern contraceptives. The factors that determine altruistic WTP should be harnessed to ensure that altruistic contributions are actually made. The challenge will be how to collect and pool the altruistic contributions for purchasing and delivering modern contraceptives to the most-poor, within the context of community financing.
doi:10.1186/1475-9276-11-34
PMCID: PMC3413613  PMID: 22768829
Contraceptives; Altruism; Altruistic WTP; Willingness to pay; Community Solidarity
15.  Detecting Deception in Movement: The Case of the Side-Step in Rugby 
PLoS ONE  2012;7(6):e37494.
Although coordinated patterns of body movement can be used to communicate action intention, they can also be used to deceive. Often known as deceptive movements, these unpredictable patterns of body movement can give a competitive advantage to an attacker when trying to outwit a defender. In this particular study, we immersed novice and expert rugby players in an interactive virtual rugby environment to understand how the dynamics of deceptive body movement influence a defending player’s decisions about how and when to act. When asked to judge final running direction, expert players who were found to tune into prospective tau-based information specified in the dynamics of ‘honest’ movement signals (Centre of Mass), performed significantly better than novices who tuned into the dynamics of ‘deceptive’ movement signals (upper trunk yaw and out-foot placement) (p<.001). These findings were further corroborated in a second experiment where players were able to move as if to intercept or ‘tackle’ the virtual attacker. An analysis of action responses showed that experts waited significantly longer before initiating movement (p<.001). By waiting longer and picking up more information that would inform about future running direction these experts made significantly fewer errors (p<.05). In this paper we not only present a mathematical model that describes how deception in body-based movement is detected, but we also show how perceptual expertise is manifested in action expertise. We conclude that being able to tune into the ‘honest’ information specifying true running action intention gives a strong competitive advantage.
doi:10.1371/journal.pone.0037494
PMCID: PMC3372470  PMID: 22701569
16.  Transnational Tobacco Company Interests in Smokeless Tobacco in Europe: Analysis of Internal Industry Documents and Contemporary Industry Materials 
PLoS Medicine  2013;10(9):e1001506.
In light lobbying by transnational tobacco companies to remove the European Union ban on the sale of snus (a smokeless tobacco product), Silvy Peeters and Anna Gilmore explore the motivation behind tobacco companies' interests in smokeless tobacco products in Europe.
Please see later in the article for the Editors' Summary
Background
European Union (EU) legislation bans the sale of snus, a smokeless tobacco (SLT) which is considerably less harmful than smoking, in all EU countries other than Sweden. To inform the current review of this legislation, this paper aims to explore transnational tobacco company (TTC) interests in SLT and pure nicotine in Europe from the 1970s to the present, comparing them with TTCs' public claims of support for harm reduction.
Methods and Results
Internal tobacco industry documents (in total 416 documents dating from 1971 to 2009), obtained via searching the online Legacy Tobacco Documents Library, were analysed using a hermeneutic approach. This library comprises documents obtained via litigation in the US and does not include documents from Imperial Tobacco, Japan Tobacco International, or Swedish Match. To help overcome this limitation and provide more recent data, we triangulated our documentary findings with contemporary documentation including TTC investor presentations. The analysis demonstrates that British American Tobacco explored SLT opportunities in Europe from 1971 driven by regulatory threats and health concerns, both likely to impact cigarette sales negatively, and the potential to create a new form of tobacco use among those no longer interested in taking up smoking. Young people were a key target. TTCs did not, however, make SLT investments until 2002, a time when EU cigarette volumes started declining, smoke-free legislation was being introduced, and public health became interested in harm reduction. All TTCs have now invested in snus (and recently in pure nicotine), yet both early and recent snus test markets appear to have failed, and little evidence was found in TTCs' corporate materials that snus is central to their business strategy.
Conclusions
There is clear evidence that BAT's early interest in introducing SLT in Europe was based on the potential for creating an alternative form of tobacco use in light of declining cigarette sales and social restrictions on smoking, with young people a key target. We conclude that by investing in snus, and recently nicotine, TTCs have eliminated competition between cigarettes and lower-risk products, thus helping maintain the current market balance in favour of (highly profitable) cigarettes while ensuring TTCs' long-term future should cigarette sales decline further and profit margins be eroded.
Please see later in the article for the Editors' Summary
Editors' Summary
Background
Every year, about 5 million people die from cancer, heart disease, and other tobacco-related diseases. In recent years, to reduce this growing loss of life, international and national bodies have drawn up various tobacco control conventions and directives. For example, the European Union (EU) Directives on tobacco control call for member states to ban tobacco advertising, promotion, and sponsorship and to adopt taxation policies aimed at reducing tobacco consumption. The 2001 EU Tobacco Products Directive also bans the sale of snus, a form of smokeless tobacco (SLT), in all EU countries except Sweden. Snus, which originated in Sweden in the early 19th century, is a moist tobacco product that is placed under the upper lip. Although snus is considerably less harmful than smoking, the sale of snus was banned in the EU in 1992 because of fears that it might cause cancer and was being marketed to young people. When Sweden joined the EU in 1994, exemption from the ban was made a condition of the membership treaty.
Why Was This Study Done?
Transnational tobacco companies (TTCs) have been investing in European snus manufacturers since 2002 and more recently in pure nicotine products, and it has been suggested that, faced with declining cigarette markets in Europe and elsewhere, TTCs are preparing for a “post-cigarette era”. Since 2008, TTCs have been lobbying EU member states and the European Commission to remove the ban on snus sales, arguing that public health would be improved if governments allowed potentially reduced-harm products like snus onto the market. At the end of 2012, however, the European Commission proposed that the ban on snus sales should be continued. Here, to help inform this controversial policy debate, the researchers explore the interest of TTCs in SLT and pure nicotine in Europe from the 1970s to the present by examining internal tobacco documents and compare these interests with public claims of support for harm reduction made by TTCs.
What Did the Researchers Do and Find?
By searching the Legacy Tobacco Documents Library (internal tobacco industry documents released following US litigation cases), the researchers identified 416 documents that detail the historical interest of TTCs in SLT and pure nicotine and their efforts to enter European markets, and to influence national and EU public-health policy. The researchers analyzed these documents using a “hermeneutic” approach—methodical reading and re-reading of the documents to identify themes and sub-themes. Finally, they used TTC investor presentations and other documents to confirm these themes and to provide recent data on TTC investment in SLT. British American Tobacco (BAT) explored the opportunities for marketing SLT products in Europe from 1971 onwards. This exploration was driven by regulatory threats and health concerns, both of which were likely to impact tobacco sales, and by the potential to create a new form of tobacco use among people no longer interested in taking up smoking. TTCs did not begin to invest in SLT, however, until 2002, a time when EU cigarette sale volumes started to decline, smoke-free legislation was being introduced, and tobacco harm reduction first became a major public-health issue. All the TTCs have now invested in snus even though snus test markets appear to have failed and even though there is little evidence in corporate materials that snus is central to the business strategy of TTCs.
What Do These Findings Mean?
These findings suggest that BAT's early interest in SLT in Europe was driven by business concerns and was based on the potential for creating an alternative form of tobacco use among people—particularly young people—who would no longer take up smoking because of health concerns. They also suggest that TTC investments in snus were defensive—by buying up snus manufacturers and more recently nicotine producers, TTCs have eliminated competition between cigarettes and lower-risk products, thereby helping to maintain the current market balance in favor of cigarettes while ensuring the long-term future of TTCs should cigarette sales decline further. Although these findings are limited by the possibility that some relevant documents may have been omitted from this analysis, they nevertheless raise the concern that, if TTC investment in SLT continues, competition between cigarettes and SLT will reduce the potential for harm reduction to benefit public health. Legalization of snus sales in the European Union may therefore have considerably less benefit than envisaged.
Additional Information
Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1001506.
The World Health Organization provides information about the dangers of tobacco (in several languages) and about the Framework Convention on Tobacco Control, an international treaty for tobacco control; for information about the tobacco industry's influence on policy, see the 2009 World Health Organization report Tobacco interference with tobacco control
Details of European Union legislation on the manufacture, presentation, and sale of tobacco products is available (in several languages)
Wikipedia has pages on tobacco harm reduction and on snus (note: Wikipedia is a free online encyclopedia that anyone can edit; available in several languages)
The Legacy Tobacco Documents Library is a searchable public database of tobacco company internal documents detailing their advertising, manufacturing, marketing, sales, and scientific activities
The UK Centre for Tobacco Control Studies is a network of UK universities that undertakes original research, policy development, advocacy, and teaching and training in the field of tobacco control
SmokeFree, a website provided by the UK National Health Service, offers advice on quitting smoking and includes personal stories from people who have stopped smoking
Smokefree.gov, from the US National Cancer Institute, offers online tools and resources to help people quit smoking
TobaccoTactics.org, an online resource managed by the University of Bath, provides up-to-date information on the tobacco industry and their tactics to influence tobacco regulation
doi:10.1371/journal.pmed.1001506
PMCID: PMC3769209  PMID: 24058299
17.  Altruism Among Relatives And Non-Relatives 
Behavioural processes  2008;79(2):120-123.
Hamilton’s (1964) kin-selection theory predicts that altruism will be greater with greater genetic overlap (degree of kinship) between giver and receiver. Kin may be identified in terms of social distance – the closer you feel to someone else, a) the greater your genetic overlap with them should be, and b) the more altruistic you should be toward them. The present experiment determined the amount of their own (hypothetical) monetary reward undergraduates were willing to forgo in order to give $75 to other people at various social distances. We found that a) genetic relationship and b) altruism varied inversely with social distance; the closer you feel toward someone else, the closer their relation to you is likely to be, and the more altruistic you are likely to be toward them. However, even at the same social distance, participants were willing to forgo significantly more money for the benefit of relatives than for the benefit of non-relatives. These results are consistent with kin-selection theory and imply that altruism is determined by factors in addition to social distance.
doi:10.1016/j.beproc.2008.06.002
PMCID: PMC2561243  PMID: 18625292
altruism; kin-recognition; kin-selection; relatedness; social discounting; social distance
18.  Learning to interpret one's own outcome as unjustified amplifies altruistic compensation: a training study 
Interpretational tendencies in ambiguous situations were investigated as causal mechanisms of altruistic compensation. We used a training procedure to induce a tendency to interpret one's own advantages as unjustified. In a subsequent mixed-game, participants had to decide whether to invest their own money to compensate a victim of a norm violation. The amount of one's own resources invested as an altruistic compensation was enhanced after the training procedure compared to controls. These findings suggest that interpretational patterns with regard to injustice determine prosocial behavior. The training procedure offers a potential intervention strategy for enhancing altruistic compensation in bystander situations in which people must invest their own resources to restore justice.
doi:10.3389/fpsyg.2013.00951
PMCID: PMC3868017  PMID: 24391614
altruistic compensation; prosocial behavior; information processing; interpretational tendency; downward comparison
19.  Arrhenius-kinetics evidence for quantum tunneling in microbial “social” decision rates 
Social-like bacteria, fungi and protozoa communicate chemical and behavioral signals to coordinate their specializations into an ordered group of individuals capable of fitter ecological performance. Examples of microbial “social” behaviors include sporulation and dispersion, kin recognition and nonclonal or paired reproduction. Paired reproduction by ciliates is believed to involve intra- and intermate selection through pheromone-stimulated “courting” rituals. Such social maneuvering minimizes survival-reproduction tradeoffs while sorting superior mates from inferior ones, lowering the vertical spread of deleterious genes in geographically constricted populations and possibly promoting advantageous genetic innovations. In a previous article, I reported findings that the heterotrich Spirostomum ambiguum can out-complete mating rivals in simulated social trials by learning behavioral heuristics which it then employs to store and select sets of altruistic and deceptive signaling strategies. Frequencies of strategy use typically follow Maxwell-Boltzmann (MB), Fermi-Dirac (FD) or Bose-Einstein (BE) statistical distributions. For ciliates most adept at social decision making, a brief classical MB computational phase drives signaling behavior into a later quantum BE computational phase that condenses or favors the selection of a single fittest strategy. Appearance of the network analogue of BE condensation coincides with Hebbian-like trial-and-error learning and is consistent with the idea that cells behave as heat engines, where loss of energy associated with specific cellular machinery critical for mating decisions effectively reduces the temperature of intracellular enzymes cohering into weak Fröhlich superposition. I extend these findings by showing the rates at which ciliates switch serial behavioral strategies agree with principles of chemical reactions exhibiting linear and nonlinear Arrhenius kinetics during respective classical and quantum computations. Nonlinear Arrhenius kinetics in ciliate decision making suggest transitions from one signaling strategy to another result from a computational analogue of quantum tunneling in social information processing.
doi:10.4161/cib.3.6.12842
PMCID: PMC3038058  PMID: 21331234
chemical reaction; classical and quantum information; decision making; extreme biology; infectious disease; learning and memory; mate selection; primitive intelligences; protozoa; signaling games; social heuristics; soft matter physics; quantum biology
20.  Altruistic punishment in patients with Parkinson's disease with and without impulsive behaviour 
Neuropsychologia  2010;49(1):103-107.
Punishing violators of social norms when there is personal cost is known as altruistic punishment. We tested patients with Parkinson's disease (PD) with and without impulsive-compulsive behaviours (ICBs) and matched control subjects, on and off their regular dopamine replacement therapy on a task, in which the patients decided whether or not to invest a sum of money with a trustee. The sum was then quadrupled and the trustee could decide whether or not to return a portion of the investment. Participants could punish the trustee after they were informed of the trustee's decision. We found that PD patients without ICBs on or off medication punished more often than controls, whereas PD patients with ICBs punished more than controls on medication, but similar to controls off medication. These results suggest a role for dopamine in altruistic punishment decisions in PD patients with impulsive compulsive behaviour.
doi:10.1016/j.neuropsychologia.2010.10.012
PMCID: PMC3005080  PMID: 20965203
21.  Deceptively simple … The “deception-general” ability and the need to put the liar under the spotlight 
This Focused Review expands upon our original paper (You can't kid a kidder": Interaction between production and detection of deception in an interactive deception task. Frontiers in Human Neuroscience, 6:87). In that paper we introduced a new socially interactive, laboratory-based task, the Deceptive Interaction Task (DeceIT), and used it to measure individuals' ability to lie, their ability to detect the lies of others, and potential individual difference measures contributing to these abilities. We showed that the two skills were correlated; better liars made better lie detectors (a “deception general” ability) and this ability seemed to be independent of cognitive (IQ) and emotional (EQ) intelligence. Here, following the Focused Review format, we outline the method and results of the original paper and comment more on the value of lab-based experimental studies of deception, which have attracted criticism in recent years. While acknowledging that experimental paradigms may fail to recreate the full complexity and potential seriousness of real-world deceptive behavior, we suggest that lab-based deception paradigms can offer valuable insight into ecologically-valid deceptive behavior. The use of the DeceIT procedure enabled deception to be studied in an interactive setting, with motivated participants, and importantly allowed the study of both the liar and the lie detector within the same deceptive interaction. It is our thesis that by addressing deception more holistically—by bringing the liar into the “spotlight” which is typically trained exclusively on the lie detector—we may further enhance our understanding of deception.
doi:10.3389/fnins.2013.00152
PMCID: PMC3756307  PMID: 24009549
“deception-general” ability; signal detection theory; deception; lying; social cognition
22.  Packaging Health Services When Resources Are Limited: The Example of a Cervical Cancer Screening Visit 
PLoS Medicine  2006;3(11):e434.
Background
Increasing evidence supporting the value of screening women for cervical cancer once in their lifetime, coupled with mounting interest in scaling up successful screening demonstration projects, present challenges to public health decision makers seeking to take full advantage of the single-visit opportunity to provide additional services. We present an analytic framework for packaging multiple interventions during a single point of contact, explicitly taking into account a budget and scarce human resources, constraints acknowledged as significant obstacles for provision of health services in poor countries.
Methods and Findings
We developed a binary integer programming (IP) model capable of identifying an optimal package of health services to be provided during a single visit for a particular target population. Inputs to the IP model are derived using state-transition models, which compute lifetime costs and health benefits associated with each intervention. In a simplified example of a single lifetime cervical cancer screening visit, we identified packages of interventions among six diseases that maximized disability-adjusted life years (DALYs) averted subject to budget and human resource constraints in four resource-poor regions. Data were obtained from regional reports and surveys from the World Health Organization, international databases, the published literature, and expert opinion. With only a budget constraint, interventions for depression and iron deficiency anemia were packaged with cervical cancer screening, while the more costly breast cancer and cardiovascular disease interventions were not. Including personnel constraints resulted in shifting of interventions included in the package, not only across diseases but also between low- and high-intensity intervention options within diseases.
Conclusions
The results of our example suggest several key themes: Packaging other interventions during a one-time visit has the potential to increase health gains; the shortage of personnel represents a real-world constraint that can impact the optimal package of services; and the shortage of different types of personnel may influence the contents of the package of services. Our methods provide a general framework to enhance a decision maker's ability to simultaneously consider costs, benefits, and important nonmonetary constraints. We encourage analysts working on real-world problems to shift from considering costs and benefits of interventions for a single disease to exploring what synergies might be achievable by thinking across disease burdens.
Jane Kim and colleagues analyzed the possible ways that multiple health interventions might be packaged together during a single visit, taking into account scarce financial and human resources.
Editors' Summary
Background.
Public health decision makers in developed and developing countries are exploring the idea of providing packages of health checks at specific times during a person's lifetime to detect and/or prevent life-threatening diseases such as diabetes, heart problems, and some cancers. Bundling together tests for different diseases has advantages for both health-care systems and patients. It can save time and money for both parties and, by associating health checks with life events such as childbirth, it can take advantage of a valuable opportunity to check on the overall health of individuals who may otherwise rarely visit a doctor. But money and other resources (for example, nurses to measure blood pressure) are always limited, even in wealthy countries, so decision makers have to assess the likely costs and benefits of packages of interventions before putting them into action.
Why Was This Study Done?
Recent evidence suggests that women in developing countries would benefit from a once-in-a-lifetime screen for cervical cancer, a leading cause of cancer death for this population. If such a screening strategy for cervical cancer were introduced, it might provide a good opportunity to offer women other health checks, but it is unclear which interventions should be packaged together. In this study, the researchers have developed an analytic framework to identify an optimal package of health services to offer to women attending a clinic for their lifetime cervical cancer screen. Their model takes into account monetary limitations and possible shortages in trained personnel to do the health checks, and balances these constraints against the likely health benefits for the women.
What Did the Researchers Do and Find?
The researchers developed a “mathematical programming” model to identify an optimal package of health services to be provided during a single visit. They then used their model to estimate the average costs and health outcomes per woman of various combinations of health interventions for 35- to 40-year-old women living in four regions of the world with high adult death rates. The researchers chose breast cancer, cardiovascular disease, depression, anemia caused by iron deficiency, and sexually transmitted diseases as health conditions to be checked in addition to cervical cancer during the single visit. They considered two ways—one cheap in terms of money and people; the other more expensive but often more effective—of checking for or dealing with each potential health problem. When they set a realistic budgetary constraint (based on the annual health budget of the poorest countries and a single health check per woman in the two decades following her reproductive years), the optimal health package generated by the model for all four regions included cervical cancer screening done by testing for human papillomavirus (an effective but complex test), treatment for depression, and screening or treatment for anemia. When a 50% shortage in general (for example, nurses) and specialized (for example, doctors) personnel time was also included, the health benefits of the package were maximized by using a simpler test for cervical cancer and by treating anemia but not depression; this freed up resources in some regions to screen for breast cancer or cardiovascular disease.
What Do These Findings Mean?
The model described by the researchers provides a way to explore the potential advantages of delivering a package of health interventions to individuals in a single visit. Like all mathematical models, its conclusions rely heavily on the data used in its construction. Indeed, the researchers stress that, because they did not have full data on the effectiveness of each intervention and made many other assumptions, their results on their own cannot be used to make policy decisions. Nevertheless, their results clearly show that the packaging of multiple health services during a single visit has great potential to maximize health gains, provided the right interventions are chosen. Most importantly, their analysis shows that in the real world the shortage of personnel, which has been ignored in previous analyses even though it is a major problem in many developing countries, will affect which health conditions and specific interventions should be bundled together to provide the greatest impact on public health.
Additional Information.
Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.0030434.g001.
The World Health Organization has information on choosing cost-effective health interventions and on human resources for health
The American Cancer Society offers patient information on cervical cancer
The Alliance for Cervical Cancer Prevention includes information about cervical cancer prevention programs in developing countries
doi:10.1371/journal.pmed.0030434
PMCID: PMC1635742  PMID: 17105337
23.  Temporal discounting in major depressive disorder 
Psychological Medicine  2013;44(9):1825-1834.
Background
Major depressive disorder (MDD) is associated with abnormalities in financial reward processing. Previous research suggests that patients with MDD show reduced sensitivity to frequency of financial rewards. However, there is a lack of conclusive evidence from studies investigating the evaluation of financial rewards over time, an important aspect of reward processing that influences the way people plan long-term investments. Beck's cognitive model posits that patients with MDD hold a negative view of the future that may influence the amount of resources patients are willing to invest into their future selves.
Method
We administered a delay discounting task to 82 participants: 29 healthy controls, 29 unmedicated participants with fully remitted MDD (rMDD) and 24 participants with current MDD (11 on medication).
Results
Patients with current MDD, relative to remitted patients and healthy subjects, discounted large-sized future rewards at a significantly higher rate and were insensitive to changes in reward size from medium to large. There was a main effect of clinical group on discounting rates for large-sized rewards, and discounting rates for large-sized rewards correlated with severity of depressive symptoms, particularly hopelessness.
Conclusions
Higher discounting of delayed rewards in MDD seems to be state dependent and may be a reflection of depressive symptoms, specifically hopelessness. Discounting distant rewards at a higher rate means that patients are more likely to choose immediate financial options. Such impairments related to long-term investment planning may be important for understanding value-based decision making in MDD, and contribute to ongoing functional impairment.
doi:10.1017/S0033291713002584
PMCID: PMC4035754  PMID: 24176142
Delay discounting; hopelessness; major depressive disorder; reward processing
24.  Lack of relationship between psychological denial and unawareness of illness in schizophrenia-spectrum disorders 
Psychiatry research  2009;169(1):33-38.
Numerous theories have been proposed to explain the unawareness of illness that is commonly seen in schizophrenia-spectrum disorders, including the theory that unawareness is the result of a psychological denial mechanism used to mitigate the emotional consequences of having a psychiatric illness. The present study was an attempt to determine whether increased denial (in the form of self-deception) is associated with impaired awareness, consistent with the denial theory. Participants included 40 patients with schizophrenia-spectrum disorders and 25 healthy comparison participants. Patients’ levels of awareness and symptom attribution were assessed through interview, and all participants completed self-report questionnaires measuring mood symptoms as well as their use of self-deception. Awareness of negative symptoms was associated with increased depression. However, self-deception was not significantly correlated with awareness measures. When patients were divided on the basis of their awareness and attribution scores, no group differences emerged regarding use of self-deception. The patient group and the healthy comparison group did not differ in their use of self-deception. The current results do not support the psychological denial theory of unawareness of illness in schizophrenia-spectrum disorders.
doi:10.1016/j.psychres.2008.07.010
PMCID: PMC2829772  PMID: 19616309
Schizophrenia; Awareness; Insight; Denial; Deception; Depression
25.  Social Discounting and the Prisoner’s Dilemma Game 
Altruistic behavior has been defined in economic terms as “…costly acts that confer economic benefits on other individuals” (Fehr & Fischbacher, 2003). In a prisoner’s dilemma game, cooperation benefits the group but is costly to the individual (relative to defection), yet a significant number of players choose to cooperate. We propose that people do value rewards to others, albeit at a discounted rate (social discounting), in a manner similar to discounting of delayed rewards (delay discounting). Two experiments opposed the personal benefit from defection to the socially discounted benefit to others from cooperation. The benefit to others was determined from a social discount function relating the individual’s subjective value of a reward to another person and the social distance between that individual and the other person. In Experiment 1, the cost of cooperating was held constant while its social benefit was varied in terms of the number of other players, each gaining a fixed, hypothetical amount of money. In Experiment 2, the cost of cooperating was again held constant while the social benefit of cooperating was varied by the hypothetical amount of money earned by a single other player. In both experiments, significantly more participants cooperated when the social benefit was higher.
doi:10.1002/jeab.3
PMCID: PMC3893109  PMID: 23344990
altruism; cooperation; patterns of behavior; prisoner’s dilemma; social discounting

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