E veryday, we make thousands of decisions. From deciding what to wear in the morning to what breakfast to eat to what to say to our angry parents or colleagues to whether to pet a doggo on the street. We then see the results of these decisions and the emotions it invokes then we go at it again the next day.
Decision making is, “the process of making choices by identifying a decision, gathering information, and assessing alternative resolutions.”
Sonia Bishop, an associate professor of psychology at University of California, Berkeley, recently published the results of a study as part of a group of researchers who focused on decision making in people with mental illnesses. The study asked participants with mental illnesses such as anxiety and depression to partake in a computer exercise and try to make good decisions.
We spoke with Bishop about the results of her study, COVID-19’s effect on decision-making, and if we can get better at our choices.
This interview has been edited for length and clarity.
Why were you interested in studying the subject?
My colleague Tim Behrens had been looking at normative processes involved in decision making and how people adapt their decisions between stable environments and volatile environments. It occurred to me that one of the things anxious people report is that they have trouble understanding unexpected bad outcomes.
Whether we are in a volatile or stable environment, studying this gives us a lot of information about how one should behave in such environments.
How do people make decisions in general?
People do implicit calculations they aren’t even aware of. The calculation is about how probable an outcome is, and how good or bad it is against how probable another outcome is and how good or bad it could be.
For example, your options on a given evening you’re thinking of watching Netflix, it can be somewhat rewarding and there’s no risk of catching anything. Or it could be going out and seeing friends but not be socially distant. So, one might feel that they haven’t seen that friend for so long, it’ll be more rewarding than just staying at home. But it’ll have a much higher level of risk attached to it.
We think of decision-making processes involving weighing up those probabilities and payoffs.
We’re not used to finding ourselves with the probability of things in our lives changing so often.
How did you evaluate the quality of a decision?
It depends on the outcomes you use. If you’re using rewarding outcomes, a good decision is which obtains a reward. The tasks we used had two choices, in each task one led to a reward. So in that context, a good choice is the one that gets you reward.
We asked participants to play a game on a computer screen where they repeatedly choose between two shapes — a circle and a square. Selecting one shape would give them a mild to moderate electrical shock, and the other a monetary prize. They had to learn through trial and error which would lead to a monetary prize or an electric shock.
In a stable environment, one of the two shapes will give a positive outcome 75% of the time, so you can gradually learn for contingencies. However in a volatile situation, the relationship between which shape you choose and what outcome you get changes repeatedly.
So, why is COVID-19 such a volatile environment?
Because it changes your calculus and makes it difficult to make the right decision. We’re not used to finding ourselves with the probability of things in our lives changing so often. One day it’s good to go out and one day it could kill you.
What did you find? Why did people with mental illnesses make the decisions they did?
They weren’t able to track the statistics of the outcomes, to mentally update the probability, and to know how rapidly to update them. For example, when our world is rapidly changing, we need to update our probability estimates faster.
Most people can do this implicitly, but this mechanism isn’t working for people with high anxiety or depression. People who are emotionally resilient can more easily think of the process behind other decisions which gave them a good outcome, and use that information to adapt in difficult environments.
In a lot of context, an expected negative outcome might be just due to chance.
What is the result of this bad decision-making for people with mental illnesses?
Not knowing how to make good decisions adds stress to their lives. This ties in with why individuals with anxiety and depression tend to worry a lot, and go back and forth over the potential options and find it hard to settle for a choice and go over the options in their mind again and again.
How can they improve their decision making?
It really depends on the context. In a lot of context, an expected negative outcome might be just due to chance. For example, if someone in your life is having a bad day, if they snap at you, then we can rely on strategies like waiting for it to happen twice in a row to start worrying about it.
In case of something like COVID-19, where we have such high negative outcomes, we have to adapt different strategies such as relying on government guidance, or specialists rather than believing our instincts.
Cognitive behavioural therapy (CBT) is one of the gold standards of treating both anxiety and depression, where people are asked to keep a diary of activities they engage in, their emotions about what they think will happen in certain situations versus how they actually turn out, and the challenge processes around that. One idea is that we can incorporate this in decision making.
When you have an expected bad outcome, it could either be just chance, or it could be probabilities having changed. Then the mental health professional can give patients strategies like heuristics, so they can incorporate changes in the environment in their decision-making process.
In other situations for example, like relationships, people who are anxious or depressed often catastrophize and jump to conclusions that everything is going wrong and has changed, and so their CBT could involve helping people understand that they’re assessing a situation too quickly.
Also read: Can We Biohack Our Mental Health?