Week+6+optional+Riis+et+al++2005++hemodialysis

Week+6+optional+Riis+et+al++2005++hemodialysis - Journal of...

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Ignorance of Hedonic Adaptation to Hemodialysis: A Study Using Ecological Momentary Assessment Jason Riis University of Michigan George Loewenstein Carnegie Mellon University Jonathan Baron University of Pennsylvania Christopher Jepson University of Pennsylvania School of Medicine Angela Fagerlin and Peter A. Ubel University of Michigan and Veterans Affairs Medical Center, Ann Arbor Healthy people generally underestimate the self-reported well-being of people with disabilities and serious illnesses. The cause of this discrepancy is in dispute, and the present study provides evidence for 2 causes. First, healthy people fail to anticipate hedonic adaptation to poor health. Using an ecological momentary assessment measure of mood, the authors failed to find evidence that hemodialysis patients are less happy than healthy nonpatients are, suggesting that they have largely, if not completely, adapted to their condition. In a forecasting task, healthy people failed to anticipate this adaptation. Second, although controls understated their own mood in both an estimation task and a recall task, patients were quite accurate in both tasks. This relative negativity in controls’ estimates of their own moods could also contribute to their underestimation of the moods and overall well-being of patients. In the same year that Brickman, Coates, and Janoff-Bulman (1978) published the famously counterintuitive result that persons with paraplegia are not that much less happy than lottery winners, Sackett and Torrance (1978) demonstrated that there are other serious health conditions that do not seem to be as badly experi- enced by the people living with them as healthy people would expect. For example, patients on dialysis rated their quality of life as .56 (on a scale from 0 to 1), whereas healthy people estimated that the quality of life of a patient on dialysis would be just .39. Similar discrepancies have been demonstrated for other serious health conditions (Boyd, Sutherland, Heasman, Tritcher, & Cum- mins, 1990; Buick & Petrie, 2002) and for some less serious health conditions (Baron et al., 2003). Although the existence of the discrepancy is well established at this point, its cause is not (Ubel, Loewenstein, & Jepson, 2003). The most common explanation for the discrepancy is that it re- flects bias on the part of healthy people—that is, that healthy people think that health impairments are worse than they are. Research in diverse domains has documented a general tendency for people to underestimate their own and others’ speed of adap- tation to negative as well as positive outcomes (Gilbert, Pinel, Wilson, Blumberg, & Wheatley, 1998; Sieff, Dawes, & Loewen- stein, 1999). A related mechanism is the focusing illusion (Schkade & Kahneman, 1998; Wilson, Wheatley, Meyers, Gilbert, & Axsom, 2000): When estimating the impact of any one life event on their overall well-being, people tend to focus disproportionately on aspects of life that would change as a result of the event and to ignore aspects that would remain the same, thus exaggerating the impact of the event (but see Ubel et al., 2001, and Baron et al.,
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