A Call to Address AI “Hallucinations” and How Healthcare Professionals Can Mitigate Their Risks

Hatem, R., Simmons, B., & Thornton, J. E. (2023).

Cureus, 15(9), e44720.

https://doi.org/10.7759/cureus.44720

Abstract

Artificial intelligence (AI) has transformed society in many ways. AI in medicine has the potential to improve medical care and reduce healthcare professional burnout but we must be cautious of a phenomenon termed "AI hallucinations"and how this term can lead to the stigmatization of AI systems and persons who experience hallucinations. We believe the term "AI misinformation" to be more appropriate and avoids contributing to stigmatization. Healthcare professionals can play an important role in AI’s integration into medicine, especially regarding mental health services, so it is important that we continue to critically evaluate AI systems as they emerge.

The article is linked above.

Here are some thoughts:

In the rapidly evolving landscape of artificial intelligence, the phenomenon of AI inaccuracies—whether termed "hallucinations" or "misinformation"—represents a critical challenge that demands nuanced understanding and responsible management. While technological advancements are progressively reducing the frequency of these errors, with detection algorithms now capable of identifying inaccuracies with nearly 80% accuracy, the underlying issue remains complex and multifaceted.

The ethical implications of AI inaccuracies are profound, particularly in high-stakes domains like healthcare and legal services. Professionals must approach AI tools with a critical eye, understanding that these technologies are sophisticated assistants rather than infallible oracles. The responsibility lies not just with AI developers, but with users who must exercise judgment, validate outputs, and recognize the inherent limitations of current AI systems.

Ultimately, the journey toward more accurate AI is ongoing, requiring continuous learning, adaptation, and a commitment to ethical principles that prioritize human well-being and intellectual integrity. As AI becomes increasingly integrated into our professional and personal lives, our approach must be characterized by curiosity, critical thinking, and a deep respect for the complex interplay between human intelligence and artificial systems.

Changing Multicultural Guidelines: Clinical and Research Implications for Evidence-Based Psychotherapies

La Roche, M. J. (2024).

Practice Innovations.

Advance online publication.

https://doi.org/10.1037/pri0000255

Abstract

The American Psychological Association’s (APA’s) release of the multicultural guidelines (Multicultural Guidelines: An Ecological Approach to Context, Identity, and Intersectionality, American Psychological Association, 2017, and Guidelines on Race and Ethnicity in Psychology: Promoting Responsiveness and Equity, American Psychological Association, 2019) are a welcomed advance to the conceptualization and practice of culture in psychology. These guidelines mark a significant expansion of the previous Multicultural Guidelines (Guidelines on Multicultural Education, Training, Research, Practice and Organizational Change for Psychologists, American Psychological Association, 2002), which include important advances for the development of multicultural psychotherapies. It is argued that these revisions make them substantially distinct from previous guidelines (American Psychological Association, 1990, 2002) and entail a new generation of multicultural psychotherapies, herein called cultural psychotherapies. Furthermore, these guidelines are particularly timely and applicable to cope with social/racial unrest and in promoting international collaborations. However, in the process of broadening cultural approaches, confusion is created in already contested and evolving cultural concepts. The goal of this article is to clarify and examine the practice implications of cultural psychotherapies and differentiate them from their two predecessors, universalist psychotherapies and racial and ethnic minority psychotherapies. Psychotherapies are distinguished by describing the APA’s multicultural guidelines and contrasting them through two dimensions: (a) meaning of cultural constructs and (b) research methods and evidence.

Impact Statement

Even though a growing number of effective psychotherapy practices have been developed, overall minoritized groups have not benefited from them. Racial/ethnic minority health disparities remain a public health crisis. Nevertheless, during the past decades, psychologists have researched a wide range of interventions to ameliorate racial/ethnic health disparities. As a means to organize the growing diversity of clinical recommendations, the three most frequently used psychotherapeutic approaches with minoritized groups are differentiated, namely, universalist psychotherapies, racial ethnic minority psychotherapies, and cultural psychotherapies. The clinical implications of each are differentiated. Although it is argued that cultural psychotherapies are the most effective and inclusive of the three, significant challenges are highlighted as means to stimulate and clarify future studies and refine clinical work.

The article is paywalled.

Here are some thoughts:

The American Psychological Association's (APA) release of the updated multicultural guidelines in 2017 and 2019 represents a significant advancement in the field of psychology, particularly in addressing cultural competence and diversity. These guidelines mark an important evolution from previous versions and have several key implications:

Expanded conceptualization of culture: The new guidelines take a more comprehensive approach to culture, moving beyond just race and ethnicity to include intersectionality and a broader range of identities and contexts. This reflects a more nuanced understanding of how multiple cultural factors interact to shape individuals' experiences.

Ecological approach: By adopting an ecological model, the guidelines emphasize the importance of considering multiple layers of context in understanding human behavior and experience. This approach recognizes that individuals are influenced by and interact with various systems, from immediate family to broader societal structures.

Focus on intersectionality: The guidelines highlight the complex interplay of multiple identities and how they shape experiences of privilege and oppression. This perspective encourages psychologists to consider the unique combinations of identities that each individual holds.

Emphasis on cultural humility: The guidelines promote a stance of cultural humility, encouraging psychologists to engage in ongoing self-reflection and recognize the limitations of their own cultural knowledge. This approach fosters openness to learning from clients and research participants.

Broader applicability: These guidelines are designed to be relevant across various domains of psychology, including practice, research, education, and organizational change. This comprehensive scope ensures that cultural competence is integrated throughout the field.

Timely response to social issues: The updated guidelines are particularly relevant in addressing current social and racial unrest, providing a framework for psychologists to engage with these issues more effectively.

While these guidelines represent a significant step forward, they also present challenges. The broadened conceptualization of culture may lead to some confusion in already complex cultural concepts. Additionally, the implementation of these guidelines in practice and research may require significant shifts in approach and methodology.

Overall, the APA's multicultural guidelines are a crucial tool for advancing cultural competence in psychology. They encourage a more holistic, context-sensitive approach to understanding human diversity and promote more equitable and effective psychological services and research.

Moral Attitudes Toward Pharmacologically Assisted Couples Therapy: An Experimental Bioethics Study of Real-World “Love Drugs”

Buyukbabani, M. B., Earp, B. D.,  et al.

(2024). AJOB Neuroscience, 15(4), 239–243.

https://doi.org/10.1080/21507740.2024.2402221

PRÉCIS

In a recent study, Lantian and colleagues (Citation2024) measured public attitudes toward the use of ‘love drugs’ as introduced through the work of Earp, Savulescu, and their collaborators. Use of a “revolutionary pill” (described as “100% reliable”) to bring about love is seen as less morally acceptable than psychological therapy toward the same end, and this is partly explained by perceptions that the pill-induced love is less authentic. However, the “pill” in question bears little resemblance to the real-world uses of love drugs discussed by Earp and Savulescu, such as MDMA-assisted couples therapy. In this partial replication and extension study, we show that more ecologically valid ‘love drugs’ scenarios lead to much higher ratings of moral acceptability and perceived authenticity of the resulting love.

From the Discussion section

In this study, we asked participants to judge an ecologically valid scenario modeled on the realistic prospect of MDMA-assisted couples therapy (IdealCase), as well as an unrealistic scenario based on an individual’s one-sided, stand-alone use of a “100% reliable” pill described as “revolutionary” (LantianS2), replicating Study 2 of Lantian et al. (Citation2024). We found that public attitudes toward the hypothetical use of pharmacology for purposes of relationship enhancement differ dramatically depending on how the case is described (see Lewis et al. Citation2023 on the need for ecologically valid scenarios in experimental bioethics).

In this UK convenience sample, participants viewed the decision to undergo drug-assisted couples therapy as more morally justified (and the character making the decision as more moral) than a decision to take a “revolutionary pill” to increase feelings of love; they felt that they would be more willing to undergo such therapy themselves, and were more in favor of allowing it than banning it; and they viewed the resulting feeling of love as being much more authentic and durable (though no more intense).

Here are some thoughts:

For clinical psychologists, the study by Lantian et al. (2024) and its subsequent replication by Earp and Savulescu offer valuable insights into public perceptions of pharmacological interventions in relationship therapy. The original study found that participants viewed a fictional "revolutionary pill" for rekindling love as less morally acceptable than traditional psychological therapy, primarily due to concerns about the authenticity of drug-induced love. However, the replication study demonstrated that more realistic scenarios, particularly those involving drug-assisted couples therapy, were perceived much more favorably.

These findings have significant implications for clinical practice. The research suggests that public attitudes towards pharmacological interventions in relationship therapy are heavily influenced by how these interventions are framed and presented. When described as an adjunct to professional therapy rather than a standalone treatment, and when the effects are portrayed as dependent on the user's mindset and active engagement, such interventions are viewed as more morally acceptable and potentially effective.

Medical Aid in Dying: New Frontiers in Medicine, Law, and Culture

Buchbinder, M., & Cain, C. (2023). 

Annual Review of Law and Social Science, 19(1), 

195–214.

https://doi.org/10.1146/annurev-lawsocsci-110722-083932

Abstract

 

Medical aid in dying (MAID) has been a productive target for social scientific inquiry at the intersections of law and medicine over the past two decades. Insofar as MAID crystallizes and reflects personal and cultural understandings of key concepts such as individualism, dependency, dignity, and care, it is a rich site for social scientific theorizing. This article reviews and assesses the contributions of social scientific perspectives to research on MAID. We propose that social scientific research on MAID offers four distinctive contributions: its descriptive (rather than normative) orientation, its focus on cultural meanings, its insights into processes of knowledge production, and its comparative lens. The article's major sections describe (a) attitudes toward MAID, (b) MAID-related social movements, (c) legalization approaches, and (d) lived experiences of MAID in permissive jurisdictions. We conclude by reflecting on how MAID scholarship can inform social inquiry into other areas in which law and medicine converge.

Here are some thoughts:

Medical Aid in Dying (MAID) has emerged as a significant focus of social scientific inquiry at the intersection of law and medicine over the past two decades. It serves as a rich nexus for exploration, reflecting cultural understandings of key concepts such as individualism, dependency, dignity, and care. Social scientific research on MAID offers four distinctive contributions: a descriptive rather than normative orientation, a focus on cultural meanings, insights into processes of knowledge production, and a comparative lens. The major areas covered in this paper include attitudes toward MAID, related social movements, approaches to legalization, and lived experiences in jurisdictions where MAID is permitted. 

This scholarship not only enhances our understanding of MAID itself but also informs broader social inquiries into other areas where law and medicine intersect. Overall, the study of MAID highlights its significance as a topic for social scientific research and its potential to illuminate evolving social norms and practices surrounding end-of-life care.

Places in the United States where MAID is legal: Washington (2009), Montana (2009), Vermont (2013), California (2015), Colorado (2016), Washington DC (2017), Hawaii (2018), Maine (2019), New Jersey (2019), and New Mexico (2021).

AI threatens to cement racial bias in clinical algorithms. Could it also chart a path forward?

Katie Palmer

STATNews.com

Originally posted 11 Sept 24

Here is an excerpt:

In the past four years, clinical medicine has been forced to reckon with the role of race in simpler iterations of these algorithms. Common calculators, used by doctors to inform care decisions, sometimes adjust their predictions depending on a patient’s race — perpetuating the false idea that race is a biological construct, not a social one.

Machine learning techniques could chart a path forward. They could allow clinical researchers to crunch reams of real-world patient records to deliver more nuanced predictions about health risks, obviating the need to rely on race as a crude — and sometimes harmful — proxy. But what happens, Gallifant asked his table of students, if that real-world data is tainted, unreliable? What happens to patients if researchers train their high-powered algorithms on data from biased tools like the pulse oximeter?

Over the weekend, Celi’s team of volunteer clinicians and data scientists explained, they’d go hunting for that embedded bias in a massive open-source clinical dataset, the first step to make sure it doesn’t influence clinical algorithms that impact patient care. The pulse oximeter continued to make the rounds to a student named Ady Suy — who, some day, wants to care for people whose concerns might be ignored, as a nurse or a pediatrician. “I’ve known people that didn’t get the care that they needed,” she said. “And I just really want to change that.”

At Brown and in events like this around the world, Celi and his team have been priming medicine’s next cohort of researchers and clinicians to cross-examine the data they intend to use. As scientists and regulators sound alarm bells about the risks of novel artificial intelligence, Celi believes the most alarming thing about AI isn’t its newness: It’s that it repeats an age-old mistake in medicine, continuing to use flawed, incomplete data to make decisions about patients.

“The data that we use to build AI reflects everything about the systems that we would like to disrupt,” said Celi: “Both the good and the bad.” And without action, AI stands to cement bias into the health care system at disquieting speed and scale.

The info is here.

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In a recent event at Brown University, physician and data scientist Leo Celi led a workshop aimed at educating high school students and medical trainees about the biases present in medical data, particularly concerning the use of pulse oximeters, which often provide inaccurate readings for patients with darker skin tones. Celi emphasized the importance of addressing these biases as machine learning algorithms increasingly influence patient care decisions. The workshop involved hands-on activities where participants analyzed a large clinical dataset to identify embedded biases that could affect algorithmic predictions. Celi and his team highlighted the need for future researchers to critically examine the data they use, as flawed data can perpetuate existing inequities in healthcare. The event underscored the urgent need for diverse perspectives in AI development to ensure algorithms are fair and equitable, as well as the importance of improving data collection methods to better represent marginalized groups.

Does Valuing Happiness Lead to Well-Being?

Huang, K. (2024).

Psychological Science.

https://doi.org/10.1177/09567976241263784

Abstract

Happiness has become one of the most important life goals worldwide. However, does valuing happiness lead to better well-being? This study investigates the effect of valuing happiness on well-being using a population-based longitudinal survey of Dutch adults (N = 8,331) from 2019 to 2023. Random-intercept cross-lagged panel models indicated that those who valued happiness generally exhibited higher well-being as manifested by life satisfaction, more positive affect, and less negative affect. However, increases in valuing happiness did not result in changes in life satisfaction 1 year later and had mixed emotional consequences (i.e., increasing both positive and negative affect). Additional analyses using fixed-effects models indicated that valuing happiness had contemporaneous positive effects on well-being. These findings indicate that endorsing happiness goals may have immediate psychological benefits but may not necessarily translate into long-term positive outcomes.

Here are some thoughts:

The effect of valuing happiness on well-being can be mixed, with some studies suggesting that it can lead to short-term benefits but not long-term ones, while others suggest that it can have a negative effect: 

Short-term benefits

Valuing happiness can lead to immediate benefits, such as increased life satisfaction, positive affect, and decreased negative affect. This is because people may prioritize activities that can boost happiness. 

Long-term negative effects

However, valuing happiness may not necessarily lead to long-term positive outcomes. In fact, some studies suggest that valuing happiness can lead to a decrease in positive feelings and happiness, and an increase in depressive symptoms and loneliness. 

Paradoxical effect

The effect of valuing happiness on well-being can be paradoxical, and is influenced by culture. For example, one study found that valuing happiness was associated with lower hedonic balance, lower psychological well-being, less satisfaction with life, and higher levels of depression symptoms. 

Toward an understanding of collective intellectual humility

Krumrei-Mancuso, E. J., et al. (2024).

Trends in Cognitive Sciences.

https://doi.org/10.1016/j.tics.2024.09.006

Abstract

The study of intellectual humility (IH), which is gaining increasing interest among cognitive scientists, has been dominated by a focus on individuals. We propose that IH operates at the collective level as the tendency of a collective’s members to attend to each other’s intellectual limitations and the limitations of their collective cognitive efforts. Given people’s propensity to better recognize others’ limitations than their own, IH may be more readily achievable in collectives than individuals. We describe the socio-cognitive dynamics that can interfere with collective IH and offer the solution of building intellectually humbling environments that create a culture of IH that can outlast the given membership of a collective. We conclude with promising research directions.

Highlights

• Like individuals, collectives can possess intellectual humility.
• A collective’s intellectual humility is not strictly reducible to the sum of the intellectual humility of its members.
• Collective intellectual humility is the tendency of members of a collective to attend to one another’s intellectual limitations and the intellectual limitations of their collective cognitive efforts.
• Given people’s propensity to better recognize others’ limitations than their own, intellectual humility may be more achievable in collectives than in individuals.
• Social support and institutional scaffolding are crucial to promoting collective intellectual humility.

Here are some thoughts:

The research on collective intellectual humility (IH) offers valuable insights for practicing psychologists, particularly in group settings. Psychologists can focus on fostering environments that encourage collective IH by cultivating diverse perspectives within teams, establishing norms that value open criticism, transparency, and accountability, and facilitating inclusive discussions where all members feel comfortable sharing their views.

Creating intellectually humbling environments is another critical area where psychologists can contribute. This involves scaffolding critical thinking by introducing tools and frameworks that prompt groups to consider alternative viewpoints and potential weaknesses in their reasoning. Additionally, developing reward systems that recognize and reinforce intellectually humble behaviors within the group can further promote a culture of humility.

The free will capacity: A uniquely human adaption.

Sheldon, K. M. (2024).

American Psychologist, 79(7), 928–941.

https://doi.org/10.1037/amp0001296

Abstract

Herein, I characterize free will (FW) is an evolved functional capacity within the mature human mind, which provides us with numerous adaptive benefits. The FW capacity was selected for because it enables us to respond effectively to momentary contingencies, via on-the-spot deliberation. But FW also extricates us from the present moment, enabling us to generate and decide between imagined long-term futures. Based upon a compatibilist philosophical definition of FW, I present a creative process model of how the FW capacity works, the goal breakthrough model. I show that the goal breakthrough model is consistent with extant neuroscientific research on the brain networks involved in creative cognition and choice. I also show that (a) exercising one’s FW is a basic psychological need, as evidenced by the fact that thwarting peoples’ autonomy can be harmful, and that (b) the FW process is influenced by peoples’ broad goals and narrative identities, providing a way for we conscious people to causally affect our lives and the world. Finally, I show how this framework integrates recent arguments that FW may be a uniquely human adaptation, ranging from neuroscience and cognitive to personality, social, and cultural perspectives.

Public Significance Statement

This article argues that free will, properly understood, is an evolved capacity within the human mind. Also, it is partially commanded by conscious processes. This gives humans direct efficacy in the operation of their minds and their lives.

Here are some thoughts:

This article is important to practicing psychology in the context of providing psychotherapy services for several key reasons. It presents free will as an evolved functional capacity of the human mind, rather than an abstract philosophical concept, giving therapists a concrete way to understand and work with clients' decision-making processes. The goal breakthrough model provides a framework for understanding how people generate and choose between potential futures, which therapists can use to help clients explore options and make decisions aligned with their values and long-term goals.

The emphasis on exercising free will as a basic psychological need underscores the importance of supporting client autonomy in therapy and helping clients develop a sense of agency in their lives. By linking free will to broader goals and narrative identities, the text offers valuable insights for therapists working to help clients develop coherent life stories and make choices consistent with their sense of self. 

The presentation of free will as partially under conscious control empowers clients to actively shape their lives, which can be motivating and hopeful for those struggling with feelings of helplessness or lack of control. The integration of neuroscience, cognitive, personality, social, and cultural perspectives provides a holistic view of free will, informing more comprehensive and effective therapeutic approaches.

Finally, the creative process model of free will aligns with existing research on brain networks involved in creative cognition and choice, lending scientific credibility to therapeutic interventions aimed at enhancing decision-making skills.

Overall, this framework offers therapists a scientifically-informed, empowering way to conceptualize and work with clients' ability to make choices and direct their lives, which is fundamental to many therapeutic goals and processes.

Longitudinal single-subject neuroimaging study reveals effects of daily environmental, physiological, and lifestyle factors on functional brain connectivity

Triana AM, et al. (2024)

PLoS Biol 22(10): e3002797.

https://doi.org/10.1371/journal.pbio.3002797

Abstract

Our behavior and mental states are constantly shaped by our environment and experiences. However, little is known about the response of brain functional connectivity to environmental, physiological, and behavioral changes on different timescales, from days to months. This gives rise to an urgent need for longitudinal studies that collect high-frequency data. To this end, for a single subject, we collected 133 days of behavioral data with smartphones and wearables and performed 30 functional magnetic resonance imaging (fMRI) scans measuring attention, memory, resting state, and the effects of naturalistic stimuli. We find traces of past behavior and physiology in brain connectivity that extend up as far as 15 days. While sleep and physical activity relate to brain connectivity during cognitively demanding tasks, heart rate variability and respiration rate are more relevant for resting-state connectivity and movie-watching. This unique data set is openly accessible, offering an exceptional opportunity for further discoveries. Our results demonstrate that we should not study brain connectivity in isolation, but rather acknowledge its interdependence with the dynamics of the environment, changes in lifestyle, and short-term fluctuations such as transient illnesses or restless sleep. These results reflect a prolonged and sustained relationship between external factors and neural processes. Overall, precision mapping designs such as the one employed here can help to better understand intraindividual variability, which may explain some of the observed heterogeneity in fMRI findings. The integration of brain connectivity, physiology data and environmental cues will propel future environmental neuroscience research and support precision healthcare.

The research is here.

Here are some thoughts:

This innovative longitudinal study investigates the dynamic relationship between brain functional connectivity and various environmental, physiological, and behavioral factors over a 133-day period. By employing a precision mapping approach focused on a single individual, the researchers collected high-frequency data using fMRI scans, smartphones, and wearables.

The study reveals that brain connectivity is significantly influenced by external factors such as sleep, physical activity, and physiological states, with these effects extending up to 15 days in the past. This research is particularly important for psychologists as it highlights the need to consider environmental and lifestyle factors when studying brain function and behavior.

The longitudinal design provides valuable insights into intraindividual variability, often overlooked in group-level studies. By integrating multiple data sources, the study demonstrates the potential for a more comprehensive understanding of brain-behavior relationships. The findings have implications for research methodology, suggesting that recent behavioral and physiological patterns should be considered as potential confounds in fMRI studies. Additionally, the study's approach and findings are relevant to understanding and monitoring mental health disorders. The openly accessible dataset and the potential for using wearables and smartphones as cost-effective monitoring tools open up new avenues for research and clinical applications in psychology and neuroscience.