Rocio Garcia-Retamero

• University of Granada

Differences in the early development of children are crucial for early detection of autism spectrum disorder (ASD). Previous studies have shown large differences between children later diagnosed with ASD and their typically developing peers in the early use of canonical vocalizations (i.e., vocalizations that include well-formed consonant-vowel syl...

Children with autism spectrum disorder (ASD) show significant linguistic and motor impairments compared to children with typical development (TD). Findings from studies of siblings of children with ASD show similarities to conclusions from studies of children with ASD. The current meta-analysis reviewed studies reporting linguistic and/or motor ski...

Background Individuals with cancer often experience stress throughout the cancer trajectory and have a high risk of experiencing depression.Objective The aim of this study was to examine the relationship between allostatic load (AL), a measure of cumulative stress-related physiologic dysregulation of different body systems, and symptoms of depressi...

Background: In acute coronary syndrome the time elapsed between the start of symptoms and the moment the patient receives treatment is an important determinant of survival and subsequent recovery. However, many patients do not receive treatment as quickly as recommended, mostly due to substantial prehospital delays such as waiting to seek medical a...

We introduce a brief instrument specifically validated for measuring positive and negative feelings about risks—the Berlin Emotional Responses to Risk Instrument (BERRI). Based on seven studies involving diverse adults from three countries (n = 2120), the BERRI was found to robustly estimate anticipatory affective reactions derived from subjective...

We investigated what factors may foster or hinder physicians’ cancer screening risk literacy–specifically the ability to understand evidence regarding screening effectiveness and make evidence-based recommendations to patients. In an experiment, physicians in training (interns and residents) read statistical information about outcomes from screenin...

Numerical skills are essential to make informed decisions in our daily life. Unfortunately, many people lack basic numeracy, which limits their ability to accurately interpret risks (i.e., risk literacy). In this paper, we provide an overview of research investigating the role of numeracy in two prominent domains, where most research was concentrat...

Objective People's beliefs about cancer can affect the actions they take to prevent and detect the disease. We investigated socio‐economic inequalities in beliefs about cancer and its causes in the general population. Methods We analyzed data from the representative probabilistic Spanish Oncobarometer survey ( N = 4769, 2020) and the non‐probabili...

Deliberate ignorance is the willful choice not to know the answer to a question of personal relevance. The question of whether a man is the biological father of his child is a sensitive issue in many cultures and can lead to litigation, divorce, and disinheritance. Thanks to DNA tests, men are easily able to resolve the uncertainty. Psychological t...

Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are the most prevalent neurodevelopmental disorders. There is a growing body of literature investigating factors affecting quality of life in families (FQoL) with a child with these disorders. However, there are no studies that trace their knowledge anatomy. Thus, we...

Introducción: Un creciente cuerpo de investigación sugiere que los niños con trastorno del espectro autista (TEA) presentan una alta probabilidad de tener dificultades en la lectura y su aprendizaje (p.ej., comprensión de la lectura). Además, en estos niños es común apreciar una menor diferenciación en el tono y las características prosódicas del t...

Statistical numeracy skills have been found to be among the most robust general predictors of risk understanding and decision-making quality. However, some research suggests that when numerate people hold extreme worldviews they could use their skills to engage in motivated (biased) reasoning about controversial topics like climate change, further...

Objective People differ in whether they understand graphical or numerical representations of statistical information better. However, assessing these skills is often not feasible when deciding which representation to select or use. This study investigates whether people choose the representation they understand better, whether this choice can impro...

Background: Most risk factors for cardiovascular disease (CVD) are modifiable, suggesting that the burden of CVD could be substantially reduced through cardiovascular screening and healthier lifestyle. People who have social support are more likely to adhere to cardiovascular prevention recommendations, but it is not clear whether the benefit of s...

Background: Individuals with cancer often experience stress throughout the cancer trajectory and have a high risk of experiencing depression. Objective: The aim of this study was to examine the relationship between allostatic load (AL), a measure of cumulative stress-related physiologic dysregulation of different body systems, and symptoms of de...

Background: About half of all cancers are diagnosed in adults older than 65, making them the age group at highest risk of developing this disease. Nurses from different specialties can support individuals and communities in the prevention and early detection of cancer and should be aware of the common knowledge gaps and perceived barriers among ol...

We investigated the relations between numeracy and superior judgment and decision making in two large community outreach studies in Holland ( n =5408). In these very highly educated samples (e.g., 30–50% held graduate degrees), the Berlin Numeracy Test was a robust predictor of financial, medical, and metacognitive task performance (i.e., lotteries...

We introduce the Berlin Numeracy Test, a new psychometrically sound instrument that quickly assesses statistical numeracy and risk literacy. We present 21 studies ( n =5336) showing robust psychometric discriminability across 15 countries (e.g., Germany, Pakistan, Japan, USA) and diverse samples (e.g., medical professionals, general populations, Me...

We introduce a brief instrument specifically validated for measuring positive and negative feelings about risks—the Berlin Emotional Responses to Risk Instrument (BERRI). Based on seven studies involving diverse adults from three countries (n = 2120), the BERRI was found to robustly estimate anticipatory affective reactions derived from subjective...

Many adult cancer patients present one or more physical comorbidities. Besides interfering with treatment and prognosis, physical comorbidities could also increase the already heightened psychological risk of cancer patients. To test this possibility, we investigated the relationship between physical comorbidities with depression symptoms in a samp...

Families of children with autism spectrum disorder (ASD) often experience much more negative perceptions of their family quality of life (FQoL). To investigate key factors that may shape these experiences, we conducted a case–control study of sixty-one Spanish families (29 with a child with ASD) using a broad psychosocial assessment (e.g., ASD seve...

The evolution of societal gender roles over time changes perceptions about the characteristics of men and women and how they behave. Previous studies on the dynamics of gender stereotypes have investigated people’s perceptions about men and women at specific time points (i.e., thinking in the past, present and future). However, studies comparing re...

Aims: Physical and psychiatric comorbidities are common in cancer patients and could impact their treatment and prognosis. However, the evidence base regarding the influence of comorbidities in the management and health service use of patients is still scant. In this research we investigated how physical comorbidities are related to the mental hea...

The ongoing pandemic of COVID-19 has already had serious worldwide health, socio-economic, political, and educational consequences. In the present study, we investigated what factors can motivate young adults to comply with the recommended preventive measures against coronavirus infection. Even though young people are less likely to suffer severe m...

In acute coronary syndromes (ACSs), longer decision delay – the time patients wait before seeking medical attention after symptoms have started – increases the risk of complications and death. However, many patients wait much longer than recommended and research is needed investigating how patient decision delay can be reduced. In a cross-sectional...

In this chapter, we discuss the role of cognitive abilities in financial decision making. First, we present the Cattell–Horn–Carroll theory of cognitive abilities. This umbrella taxonomy integrates two important models: Cattell–Horn’s model of fluid and crystallized intelligence and Carroll’s Three-Stratum Theory. We focus mostly on the Gf (fluid i...

Purpose Autism spectrum disorder (ASD) often has a significant impact on all family members, including parents and siblings of the person who suffers the disorder. This case–control study explores potential factors that help explain the impact of having an older sibling with ASD on several developmental domains, and to test whether these factors co...

Background In acute coronary syndrome the time elapsed between the start of symptoms and the moment in which the patient receives treatment is an important determinant of survival and subsequent recovery. However, many patients do not receive treatment as quickly as recommended, mostly due to substantial prehospital delays such as waiting to seek m...

Objectives Both pre‐hospital decision delay – the time patients wait before seeking medical attention after symptoms have started – and high psychological distress after the cardiac episode predict poor prognosis of patients with acute coronary syndromes (ACS). We aimed to identify psychosocial markers of these prognostic factors. Design A cross‐s...

Los problemas lingüísticos menos severos son detectados a menudo en la edad escolar por los docentes, quienes presentan sobrecarga laboral. Estas dificultades se asocian con consecuencias negativas en el desarrollo curricular posterior. El principal objetivo de este trabajo es investigar si es posible ofrecer a los profesores un screening breve par...

The aim of the present study is to merge two strands of research that have evolved in tandem (a) the consequences of numeracy; and (b) the effect of information load on the consumer decision‐making process. The study analyses the interaction effect between these two factors on decision accuracy and on a set of cognitive and affective variables of t...

A recent systematic search of orthopedic surgery literature suggests that scientific risk reporting often deviates from best practices in specific ways (Petrova, Joeris, Sanchez, Salamanca-Fernandez, & Garcia-Retamero, 2018). These deviations could cause dangerous biases in health professionals' risk interpretations and risk communication practices...

We investigated what factors may foster or hinder physicians’ cancer screening risk literacy–specifically the ability to understand evidence regarding screening effectiveness and make evidence-based recommendations to patients. In an experiment, physicians in training (interns and residents) read statistical information about outcomes from screenin...

Cardiac patients who have social support generally have better prognosis than patients who lack social support. Several theoretical mechanisms have been proposed to explain this protective effect, including the capacity of social support to buffer the negative effects of stress. We tested this buffering effect in a study of patients hospitalized fo...

Objective: To evaluate the effectiveness of a psychological intervention focused on stress management in women who are candidates for in vitro fertilisation (IVF). Method: Pre–post study with two groups (n = 26). The psychological intervention group (IG) received a 90-minute session that included psychoeducation, relaxation training and coping skil...

Numerical skills are essential to make informed decisions in our daily life. Unfortunately, many people lack basic numeracy, which limits their ability to accurately interpret risks (i.e., risk literacy). In this paper, we provide an overview of research investigating the role of numeracy in two prominent domains, where most research was concentrat...

People with low statistical numeracy have difficulties understanding numerical information. For instance, they often misunderstand the probability of experiencing side effects, which could reduce adherence to medical treatments. We investigated whether presenting information about probability using a method based on the direct experience of events...

Parents are the first to indicate concerns about their child’s development in up to 80% of children with autism spectrum disorder (ASD). They often notice symptoms related to ASD around the first two years, but the average age of diagnosis is 3.5 years old. This study examined the relationships between parents’ early concerns and the time lag betwe...

Purpose The numerical format in which risks are communicated can affect risk comprehension and perceptions of medical professionals. We investigated what numerical formats are used to report absolute risks in empirical articles, estimated the frequency of biasing formats and rated the quality of figures used to display the risks. Design Descriptiv...

In this chapter, we discuss why risks are often not communicated in a transparent and understandable way and why this is problematic. At the core of the chapter are four examples that illustrate how risk communication can be improved. These examples are (a) the use of natural frequencies in the context of diagnostic reasoning, (b) the use of visual...

Research suggests that people are less sensitive to variations in probability in affect‐rich compared with affect‐poor risky choices. This effect is modeled by a more curved probability weighting function (PWF). We investigated the role of different numeric competencies and the effectiveness of several intervention strategies to decrease this affec...

The present study investigated skilled and adaptive strategy selection in risky decision making. We proposed that people with high objective numeracy, a strong predictor of general decision making skill, would have a broad repertoire of choice strategies and adaptively select these strategies depending on the importance of the decision. Thus more o...

Parent Responsiveness (PR) has been the target of many early intervention studies for children with autism spectrum disorder (ASD) (Green et al., 2010; Siller, Hutman & Sigman, 2013). A common finding from these studies is that such interventions can effectively increase responsive behaviors in parents of children at-risk for ASD at the interventio...

Introduction: Physicians and medical students need to understand numerical and graphical health data in order to provide patients with correct information. Objective: The graphical and numerical skills of medical students and residents from a private university in Lima, Peru, were determined in this investigation. Method: Cross-sectional, desc...

Over the past decade several landmark studies have advanced our scientific understanding of decision making skill, its measurement, and its acquisition (eg, Skilled Decision Theory). Here we present an integrative review of skilled human decision making in experts and non-experts, with emphasis on four emerging insights.(1) Among non-experts, norma...

Objective: A shared decision-making approach is suggested for multiple sclerosis (MS) patients. To properly evaluate benefits and risks of different treatment options accordingly, MS patients require sufficient numeracy - the ability to understand quantitative information. It is unknown whether MS affects numeracy. Therefore, we investigated wheth...

Several tests exist that can help detect Down syndrome and other chromosomal disorders during the first weeks of pregnancy. Non-invasive prenatal testing (NIPT) is gaining popularity because of its improved accuracy over traditional screening methods and its improved safety compared to invasive tests that carry some risk of miscarriage. In a recent...

Background: Previous research has shown that format effects, such as the "1-in-X" effect-whereby "1-in-X" ratios lead to a higher perceived probability than "N-in-N*X" ratios-alter perceptions of medical probabilities. We do not know, however, how prevalent this effect is in practice; i.e., how often health professionals use the "1-in-X" ratio. M...

Objective: Many patients have low numeracy, which impedes their understanding of important information about health (e.g., benefits and harms of screening). We investigated whether physicians adapt their risk communication to accommodate the needs of patients with low numeracy, and how physicians' own numeracy influences their understanding and co...

Diagnostic information from prenatal screening for Down syndrome can help families prepare for the birth of a child with special needs or help them decide whether they want to continue with the pregnancy. Currently in the UK women are offered the combined screening test (a blood test and an ultrasound) that categorizes them into “higher risk” or “l...

Lay summary: We reviewed studies reporting linguistic and/or motor skills in siblings of children with autism spectrum disorder (ASD) compared to those in siblings of children with typical development. The results showed that as a group, those infants who have siblings with ASD have less advanced linguistic and motor skills. These differences are...

Background Effective risk communication is essential for informed decision making. Unfortunately, many people struggle to understand typical risk communications because they lack essential decision-making skills. Objective The aim of this study was to review the literature on the effect of numeracy on risk literacy, decision making, and health out...

Background Many patients delay seeking medical attention during acute coronary syndromes (ACS), profoundly increasing their risk for death and major disability. Although research has identified several risk factors, efforts to improve patient decision making have generally been unsuccessful, prompting a call for more research into psychological fac...

When we make risky decisions for others, we tend to follow social norms about risks. This often results in making different decisions for others than we would make for ourselves in a similar situation (i.e., self-other discrepancies). In an experiment, we investigated self-other discrepancies in young adults’ decisions to purchase a vaccine against...

Seaman et al. (2015) compared 23 older adults living independently to 23 older adults living in a retirement community on their risky decision making. Results from the Balloon Analog Risk Task (BART; Lejuez et al., 2002) showed that older adults living in the retirement community were more risk-averse, at least partially due to higher initial perce...

Background: Visual aids tend to help diverse and vulnerable individuals understand risk communications, as long as these individuals have a basic understanding of graphs (i.e., graph literacy). Tests of objective graph literacy (OGL) can effectively identify individuals with limited skills, highlighting vulnerabilities and facilitating custom-tail...

Contrary to people's intuitions, many screenings can have both benefits (e.g., lives saved) and harms (e.g., unnecessary treatments). Statistical information is often provided to ensure informed decision making. However, few theoretical models have addressed the role of comprehension of such information in screening decisions. In an experiment, we...

Objectives: To investigate the relationship between Type D (distressed) personality and cardiac biomarkers of disease severity in patients with acute coronary syndrome. To identify potential mechanisms behind the effect of Type D personality on cardiovascular disease (CVD). Design: Cross-sectional. Methods: Patients (N = 215) with acute corona...

Objective: To effectively practice evidence-based medicine, surgeons need to understand and be able to communicate health-relevant numerical information. We present the first study examining risk literacy in surgeons by assessing numeracy and surgical risk comprehension. Our study also investigated whether visual aids improve risk comprehension in...

We review the results of our research program investigating the effects of brief risk awareness interventions for sexually active young adults-the age group most at-risk for sexually transmitted infections (STIs). Our review examines the influence of framed messages, individual differences, and visual aids on key attitudes, behavioral intentions, a...

The Human Papilloma Virus (HPV) is the most common sexually transmitted infection (STI) and can cause cervical cancer. Two vaccines are available to protect against the most common strands of the virus. Vaccination programs differ across Europe but most neglect young adults, who are the group with the highest risk of contracting STIs. Our aim was t...

Educational programs for preventing sexually transmitted infections (STIs) have often been implemented in different settings and populations. Mathematica Policy Research and Child Trends conducted a systematic review of 289 evidence-based interventions aiming to reduce STIs and sexual risk behavior in adolescents in the United States. These interve...

Visual aids can improve comprehension of risks associated with medical treatments, screenings, and lifestyles. Do visual aids also help decision makers accurately assess their risk comprehension? That is, do visual aids help them become well calibrated? To address these questions, we investigated the benefits of visual aids displaying numerical inf...

Decisions about cancer screenings often involve the consideration of complex and counterintuitive evidence. We investigated psychological factors that promote the comprehension of benefits and harms associated with common cancer screenings and their influence on shared decision making. In experiment 1, 256 men received information about PSA-based p...

Icon arrays have been found to improve risk understanding and reduce judgment biases across a wide range of studies. Unfortunately, individuals with low graph literacy experience only limited benefits from such displays. To enhance the efficacy and reach of these decision aids, the authors developed and tested 3 types of dynamic design features-tha...

There is compelling evidence showing that health literacy influences health outcomes. However, there is a dearth of research investigating this issue in the vast literature on numeracy-the ability to accurately interpret numerical information about risk, a skill that is only moderately correlated with health literacy. In a cross-sectional study, we...

Dual-process theories have dominated the study of risk perception and risk-taking over the last two decades. However, there is a lack of objective brain-level evidence supporting the two systems of processing in every-day risky behavior. To address this issue, we propose the dissociation between evaluative and urgent behaviors as evidence of dual p...

La habilidad para comprender gráficos, así como también el entendimiento de expresiones numéricas de riesgo, tales como probabilidades, porcentajes y frecuencias, son esenciales en el área médica. Los médicos y estudiantes de medicina necesitan comprender y entender la importancia de la información numérica y gráfica relacionado a temas de salud (p...

A la hora de realizar juicios y tomar decisiones sobre la salud, debemos procesar y comprender información numérica. Por ejemplo, habitualmente recibimos información sobre el riesgo de padecer una enfermedad en probabilidades, porcentajes o fracciones. Sin embargo, muchas personas presentan deficiencias a la hora de comprender esta información. E...

Purpose: There is compelling evidence showing that health literacy influences health outcomes. However, there is a dearth of research investigating this issue in the vast literature on numeracy-the ability to accurately interpret and make good decisions based on numerical information about risk, a skill that is only moderately correlated with healt...

People overweigh small and underweigh large risks, resulting in probability weighting functions with an inverted S-shape. This bias is stronger for affect-rich outcomes: For two outcomes of the same monetary value, people are less sensitive to probability variation for affect-rich than for affect-poor outcomes (e.g., winning a $100 voucher toward a...

Every day thousands of individuals need to make critical decisions about their health based on numerical information, yet recent surveys have found that over half the population of the United States is unable to complete basic math problems. How does this lack of numerical ability (also referred to as low numeracy, quantitative illiteracy or statis...

Every day thousands of individuals need to make critical decisions about their health based on numerical information, yet recent surveys have found that over half the population of the United States is unable to complete basic math problems. How does this lack of numerical ability (also referred to as low numeracy, quantitative illiteracy or statis...

En la actualidad la investigación sobre la influencia de los rasgos de personalidad positivos sobre la enfermedad coronaria (EC) es escasa. La resiliencia se define como la capacidad para autodesarrollarse con éxito a pesar de las circunstancias adversas. En un estudio, los autores han investigado el efecto de la resiliencia en varios indicadores d...

In a large three week longitudinal study, we investigated the efficacy of framed messages for promoting condom use in sexually active young adults. We also investigated the influence of key risk literacy skills (i.e., numeracy and graph literacy) and visual aids (i.e., icon arrays) on the efficacy of framed messages. Finally, we investigated the un...

Background: Although shared decision making offers clinical benefits, there is a lack of research investigating physicians' roles in interactions with their patients. Research examining what characterizes physicians who involve patients in decision making is also limited. The authors investigated surgeons' preferred and usual roles in interactions...

Resumen En este artículo, revisamos una serie de estudios en los que se ha analizado el efecto de diversos factores relacionados con el evaluador y la persona evaluada (tales como el sexo, el contexto organizational donde trabaja, o la nacionalidad), sobre la evaluación que se hace de hombres y mujeres candidatos a un puesto de liderazgo. Nos hemos...

Since the Enlightenment, rationality has been set above intuition and associated with male thought, while intuition has become linked with female thought. Do these stereotypes still exist today? If they do, are they the same for different domains of life? And are they stable across age groups, gender, and culture? We investigated these questions in...

Studies reveal high levels of inadequate health literacy and numeracy in African Americans and older veterans. The authors aimed to investigate the distribution of health literacy, numeracy, and graph literacy in these populations. They conducted a cross-sectional survey of veterans receiving outpatient care and measured health literacy, numeracy,...

Following international trends, the HPV (human papilloma virus) vaccine was introduced in Europe for protection against infection from common strands of the HPV virus which can lead to cervical cancer. Young women aged 18-26 years are at greatest risk of infection by the HPV virus yet have been neglected in research, policy, and practice. To explor...

Informed decision making requires that people understand health risks. Unfortunately, many people are not risk literate and are biased by common risk communication practices. In this article, we review a collection of studies investigating the benefits of visual aids for communicating health risks to diverse vulnerable people (e.g., varying in abil...

Extensive evidence suggests that people often rely on their causal beliefs in their decisions and causal judgments. To date, however, there is a dearth of research comparing the impact of causal beliefs in different domains. We conducted two experiments to map the influence of domain-specific causal beliefs on the evaluation of empirical evidence w...

In a large longitudinal study involving young adults, we conducted an eight-hour STD educational intervention and examined the impact of the intervention on the efficacy of a message for promoting condom use. The message was framed in positive or negative terms and was presented visually or in numbers (percentages or frequencies). Results indicated...

Experts recommend that adults have their global cardiovascular risk assessed. We investigated whether icon arrays increase understanding, recall, perception of CVR, and behavioral intent as compared with numerical information. Male outpatient veterans, at an intermediate to high cardiovascular risk participated in a randomized controlled trial of a...