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Theory—understanding mental processes that drive decisions—is important to help patients and providers make decisions that reflect medical advances and personal values. Building on a 2008 review, we summarize current tenets of fuzzy-trace theory (FTT) in light of new evidence that provides insight regarding mental representations of options and how such representations connect to values and evoke emotions. We discuss implications for communicating risks, preventing risky behaviors, discouraging misinformation, and choosing appropriate treatments. Findings suggest that simple, fuzzy but meaningful gist representations of information often determine decisions. Within minutes of conversing with their doctor, reading a health-related web post, or processing other health information, patients rely on gist memories of that information rather than verbatim details. This fuzzy-processing preference explains puzzles and paradoxes in how patients (and sometimes providers) think about probabilities (e.g., “50-50” chance), outcomes of treatment (e.g., with antibiotics), experiences of pain, end-of-life decisions, memories for medication instructions, symptoms of concussion, and transmission of viruses (e.g., in AIDS and COVID-19). As examples, participation in clinical trials or seeking treatments with low probabilities of success (e.g., with antibiotics or at the end of life) may indicate a defensibly different categorical gist perspective on risk as opposed to simply misunderstanding probabilities or failing to make prescribed tradeoffs. Thus, FTT explains why people avoid precise tradeoffs despite computing them. Facilitating gist representations of information offers an alternative approach that goes beyond providing uninterpreted “neutral” facts versus persuading or shifting the balance between fast versus slow thinking (or emotion vs. cognition). In contrast to either taking mental shortcuts or deliberating about details, gist processing facilitates application of advanced knowledge and deeply held values to choices. Highlights Fuzzy-trace theory (FTT) supports practical approaches to improving health and medicine. FTT differs in important respects from other theories of decision making, which has implications for how to help patients, providers, and health communicators. Gist mental representations emphasize categorical distinctions, reflect understanding in context, and help cue values relevant to health and patient care. Understanding the science behind theory is crucial for evidence-based medicine.
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A scientific theory of gist communication and misinformation resistance, with implications for health, education, and policy
A framework is presented for understanding how misinformation shapes decision-making, which has cognitive representations of gist at its core. I discuss how the framework goes beyond prior work, and how it can be implemented so that valid scientific messages are more likely to be effective, remembered, and shared through social media, while misinformation is resisted. The distinction between mental representations of the rote facts of a message—its verbatim representation—and its gist explains several paradoxes, including the frequent disconnect between knowing facts and, yet, making decisions that seem contrary to those facts. Decision makers can falsely remember the gist as seen or heard even when they remember verbatim facts. Indeed, misinformation can be more compelling than information when it provides an interpretation of reality that makes better sense than the facts. Consequently, for many issues, scientific information and misinformation are in a battle for the gist. A fuzzy-processing preference for simple gist explains expectations for antibiotics, the spread of misinformation about vaccination, and responses to messages about global warming, nuclear proliferation, and natural disasters. The gist, which reflects knowledge and experience, induces emotions and brings to mind social values. However, changing mental representations is not sufficient by itself; gist representations must be connected to values. The policy choice is not simply between constraining behavior or persuasion—there is another option. Science communication needs to shift from an emphasis on disseminating rote facts to achieving insight, retaining its integrity but without shying away from emotions and values.
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- Award ID(s):
- 2029420
- PAR ID:
- 10145526
- Publisher / Repository:
- Proceedings of the National Academy of Sciences
- Date Published:
- Journal Name:
- Proceedings of the National Academy of Sciences
- ISSN:
- 0027-8424
- Page Range / eLocation ID:
- Article No. 201912441
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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