Using fuzzy-trace theory to understand and improve health judgments, decisions, and behaviors: A literature review.

Abstract

Objective Fuzzy-trace theory is a dual-process model of memory, reasoning, judgment, and decision making that contrasts with traditional expectancy-value approaches. We review the literature applying fuzzy-trace theory to health with three aims: evaluating whether the theory’s basic distinctions have been validated empirically in the domain of health; determining whether these distinctions are useful in assessing, explaining, and predicting health-related psychological processes; and determining whether the theory can be used to improve health judgments, decisions, or behaviors, especially in comparison to other approaches. Methods We conducted a literature review using PubMed, PsycInfo, and Web of Science to identify empirical peer-reviewed papers that applied fuzzy-trace theory, or central constructs of the theory, to investigate health judgments, decisions, or behaviors. Results 79 studies were identified, over half published since 2012, spanning a wide variety of conditions and populations. Study findings supported the prediction that verbatim and gist representations are distinct constructs that can be retrieved independently using different cues. Although gist-based reasoning was usually associated with improved judgment and decision making, four sources of bias that can impair gist reasoning were identified. Finally, promising findings were reported from intervention studies that used fuzzy-trace theory to improve decision making and decrease unhealthy risk taking. Conclusions Despite large gaps in the literature, most studies supported all three aims. By focusing on basic psychological processes that underlie judgment and decision making, fuzzy-trace theory provides insights into how individuals make decisions involving health risks and suggests innovative intervention approaches to improve health outcomes.

Effects of probabilities, adverse outcomes, and status quo on perceived riskiness of medications: Testing explanatory hypotheses concerning gist, worry, and numeracy

“…In addition, more research is needed regarding how one knows what the “right” gist should be, and how these representations are derived. There are established procedures that consistently yield predictive gist representations from a wide variety of respondents; these techniques include mathematical modeling (e.g., see Blalock & Reyna, 2016; Reyna & Brainerd, 2011). Deriving the right gist has also involved consulting experts and evidence-based clinical guidelines to summarize the essential bottom line—the gist—of decision-relevant information (e.g., Reyna & Lloyd, 2006).…”

“…Theoretically speaking, these qualitative gists were designed to incorporate the essence or bottom line of the medication’s risks and benefits, as opposed to precisely trading off magnitudes of risks and benefits. The endpoints were modeled on all-or-none categorical gist representations, the simplest level of gist, found to govern decision making in multiple contexts (e.g., Reyna & Mills, 2014; Wolfe et al, 2015; for a review, see Blalock & Reyna, 2016). The options ranged from seeing the risk as essentially nil to seeing the risk as all-encompassing (Stone, Yates, & Parker, 1994).…”

The effect of counseling on willingness to use a hypothetical medication and perceptions of medication safety

“…[32][33][34][35] Research suggests that judgment and decision making is influenced most by those memory representations that are activated by characteristics of the decision-making context (e.g., environmental cues). 21 Thus, it seems likely that the impact of medication risk communications depends on a combination of (1) the information explicitly provided and (2) individuals' preexisting mental representations, rather than either of these factors in isolation.…”

“…18,19 Overestimates of risk likelihood can make patients less willing to take a medication. 16,20 In a previous study by this research team that was guided by fuzzy trace theory (FTT), [21][22][23] it was demonstrated that simply informing individuals that a specific adverse effect may occur M A N U S C R I P T…”

On Judgments of Approximately Equal

“…People generally prefer to reason with the least precise gist representation that allows them to accomplish a cognitive task, such as making a choice (Reyna, Chick, Corbin, & Hsia, 2014). Moreover, experts in a given knowledge domain tend to rely more heavily on gist than novices (Blalock & Reyna, 2016;Reyna & Lloyd, 2006), and adults rely on gist representations more commonly than children (Brainerd, Reyna, & Ceci, 2008).…”