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Modeling the Effects of Melanoma Education on Visual Detection: A Gradient Shift Analysis

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Abstract

Early detection is critical to successful treatment of melanoma, and at-risk individuals often are educated about melanoma by showing them examples of symptom-free and highly symptomatic lesions. We explain why, according to principles of stimulus control, this common practice could discourage the detection of newly developed symptoms and present an experiment modeling the predicted effects. Using images depicting a continuum of melanoma symptom severity, we familiarized participants with a symptomatic lesion (S+), and then conducted generalization tests to determine how often they would label other degrees of symptom severity as the same as (unchanged from) S+. During training for a group that was modeled after typical melanoma education efforts, S- was an asymptomatic lesion. For passive and active control groups, respectively, S- was either absent or a more severely symptomatic lesion. In generalization tests, gradient shift occurred such that stimuli similar to S- were especially unlikely to be called “same.” For the target group, this resulted in reduced labeling of mildly symptomatic lesions as symptomatic. We discuss the implications of these findings for melanoma education efforts.

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Notes

  1. Following the generalization gradients of Fig. 2, it might be objected that using a moderately symptomatic lesion as S+ would result in patients overlooking highly symptomatic lesions (e.g., Fig. 2, right side of middle panel). Here, for two reasons, we suggest that parallels break down between our laboratory model and everyday circumstances. First, our stimuli were presented as abstract shapes, free of any experimentally provided cancer context. In the everyday world, people know about cancer and its potentially deadly consequences. Thus, unusual changes in the skin, once they are noticed, may be alarming. Second, physicians do not generally complain of patients being unable to recognize fairly advanced melanoma as unusual. These factors are likely to leave highly symptomatic lesions as easy to recognize. Of course, this proposition can be experimentally tested, in part by replicating our Standard Education procedures while describing the stimuli as related to skin cancer and modifying the response to explicitly identify possible instances of cancer.

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Acknowledgments

Portions of this study were completed in partial fulfillment of the first author’s doctoral degree requirements at the University of Kansas. The authors express sincere gratitude to Kathryn Saunders, David Jarmolowicz, Steven Fawcett, and Kimberly Engelman for their comments on the design and analysis of this study.

This investigation was supported by the University of Kansas New Faculty General Research Fund allocation #2302290 and General Research Fund allocation #2301722.

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  1. Jonathan R. Miller

    Present address: Department of Behavioral Psychology, Kennedy Krieger Institute, 707 N. Broadway, Baltimore, MD, 21205, USA

Authors and Affiliations

  1. University of Kansas, Lawrence, KS, USA

    Jonathan R. Miller & Derek D. Reed

  2. Illinois State University, Normal, IL, USA

    Thomas S. Critchfield

  3. Department of Applied Behavioral Science, University of Kansas, 4048 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS, 66045-7555, USA

    Derek D. Reed

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Correspondence to Jonathan R. Miller or Derek D. Reed.

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Miller, J.R., Reed, D.D. & Critchfield, T.S. Modeling the Effects of Melanoma Education on Visual Detection: A Gradient Shift Analysis. Psychol Rec 65, 323–335 (2015). https://doi.org/10.1007/s40732-014-0108-x

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