This Dead or That Dead: Framing Effects in the Evaluation of Health States.

OBJECTIVES: Current approaches to health state valuation rely on credible classification of states as either "better than dead" or "worse than dead" (WTD). We investigate how such evaluations of health states are affected by the framing in pairwise comparison tasks. METHODS: We conducted an online survey with 361 participants to compare the propensity to evaluate a state as WTD under 6 frames: (A) using a regular time trade-off (TTO) choice task, (B) using a lead-time TTO choice task, (C) excluding the immediacy of death, (D) avoiding reference to the process of dying, (E) focusing on longevity, and (F) focusing on improvements in quality of life. Each participant evaluated 9 EQ-5D-5L health states using 3 frames. The frames were compared using several statistical approaches to confirm robustness to indirect comparisons or respondent heterogeneity and inattentiveness. RESULTS: The odds of a state being evaluated as WTD, compared with frame A, increase 2.7-fold and 1.5-fold in frame B and E, respectively, and decrease >5-fold in frame F. Frames C and D do not differ significantly from frame A. CONCLUSIONS: Different framings for questions about whether a state is WTD or better than dead, even if theoretically equivalent, yield substantially different results. Notably, whether a state is evaluated as WTD differs greatly between the regular TTO and lead-time TTO choice tasks and when either final outcomes or improvements over time are considered.

To risk or not: The impact of socioeconomic status on preschoolers' risky decision-making for gains and losses.

Disparities in socioeconomic status (SES) may affect individuals' risk preferences, which have important developmental consequences across the lifespan. Yet, previous research has shown inconsistent associations between SES and risky decision-making, and little is known about how this link develops from a young age. The current research is among the first to examine how SES influences preschoolers' risky decisions in both gain and loss frames. Across two studies, children aged 5 to 6 years (total N = 309, 154 boys) were asked to choose between certain and risky options. The risky option was more advantageous, equal to, or less advantageous than the certain option. Study 1 revealed that in the loss frame, high-SES children (n = 84, 44 boys) chose more risky options and were more sensitive to the expected value compared to low-SES children (n = 78, 42 boys), especially when the risk was more advantageous. However, this SES difference was not significant in the gain frame. Supporting the potential causal link between SES and risky decision-making, Study 2 further found that experimentally increasing low-SES children's (n = 68, 30 boys) status by providing additional resources increased their risk-seeking behavior in the loss frame. Overall, our findings suggest an interaction between environmental cues (gain vs. loss) and early life circumstances (SES) in shaping children's risk preferences. RESEARCH HIGHLIGHTS: This research is among the first to examine how school backgrounds and experimentally manipulated SES influence preschoolers' risk preferences in gain and loss frames. Children were more risk-seeking for losses than for gains; this framing effect was stronger in higher-SES than lower-SES children. Lower-SES children exhibited fewer risk-seeking behaviors and decreased sensitivity to the expected value of options for losses, but not for gains. A temporary boost in SES increased children's risk-seeking behavior, but not sensitivity to expected values.

Connectome-based individualized prediction of reciprocity propensity and sensitivity to framing: a resting-state functional magnetic resonance imaging study.

BACKGROUND: The social representation theory states that individual differences in reciprocity decisions are composed of a stable central core (i.e., reciprocity propensity, RP) and a contextual-dependent periphery (i.e., sensitivity to the framing effect; SFE, the effect by how the decision is presented). However, the neural underpinnings that explain RP and SFE are still unknown. METHOD: Here, we employed prediction and lesion models to decode resting-state functional connectivity (RSFC) of RP and SFE for reciprocity decisions of healthy volunteers who underwent RS functional magnetic resonance imaging and completed one-shot trust (give frame) and distrust (take frame) games as trustees. RESULTS: Regarding the central core, reciprocity rates were positively associated between the give and take frame. Neuroimaging results showed that inter-network RSFC between the default-mode network (DMN; associated with mentalizing) and cingulo-opercular network (associated with cognitive control) contributed to the prediction of reciprocity under both frames. Regarding the periphery, behavioral results demonstrated a significant framing effect-people reciprocated more in the give than in the take frame. Our neuroimaging results revealed that intra-network RSFC of DMN (associated with mentalizing) contributed dominantly to the prediction of SFE. CONCLUSION: Our findings provide evidence for distinct neural mechanisms of RP and SFE in reciprocity decisions.

I want to be safe: understanding the main drivers behind vaccination choice throughout the pandemic.

BACKGROUND: Despite being a major advancement in modern medicine, vaccines face widespread hesitancy and refusal, posing challenges to immunization campaigns. The COVID-19 pandemic accentuated vaccine hesitancy, emphasizing the pivotal role of beliefs in efficacy and safety on vaccine acceptance rates. This study explores the influence of efficacy and safety perceptions on vaccine uptake in Italy during the pandemic. METHODS: We administered a 70-item questionnaire to a representative sample of 600 Italian speakers. Participants were tasked with assessing the perceived effectiveness and safety of each vaccine dose, along with providing reasons influencing their vaccination choices. Additionally, we conducted an experimental manipulation, exploring the effects of four framing messages that emphasized safety and/or efficacy on participants' willingness to receive a hypothetical fourth vaccine dose. Furthermore, participants were asked about their level of trust in the scientific community and public authorities, as well as their use of different information channels for obtaining COVID-19-related information. RESULTS: Our study reveals a dynamic shift in vaccine efficacy and safety perceptions throughout the COVID-19 pandemic, potentially influencing vaccination compliance. Initially perceived as more effective than safe, this assessment reversed by the time of the third dose. Beliefs regarding safety, rather than efficacy, played a significant role in anticipating future vaccinations (e.g., the booster dose). Safety-focused messages positively affected vaccination intent, while efficacy-focused messages showed limited impact. We also observed a changing trend in reasons for vaccination, with a decline in infection-related reasons and an increase in social related ones. Furthermore, trust dynamics evolved differently for public authorities and the scientific community. CONCLUSIONS: Vaccine perception is a dynamic process shaped by evolving factors like efficacy and safety perceptions, trust levels, and individual motivations. Our study sheds light on the complex dynamics that underlie the perception of vaccine safety and efficacy, and their impact on willingness to vaccinate. We discuss these results in light of bounded rationality, loss aversion and classic utility theory.

Understanding consumer attitude toward the name framings of cultured meat: Evidence from China.

The naming and labeling of products can affect consumer attitudes and subsequent behavior, particularly in the case of new food products in the market. The present study explores the effects of name framing on consumer attitudes towards cultured meat (CM), which is currently in the early stages of development. With a sample of 1532 Chinese consumers, we integrated several pathways to explain the name-framing effect by examining three different terms ("cultured," "artificial," and "cell-based") for CM. Results indicate that "cultured meat" and "cell-based meat" are more appealing than "artificial meat." Name framings of CM affect consumers' perception of benefits more than that of risks. Our comprehensive model identified evoked affect (perceived disgust) and naturalness as two crucial predictors of attitudes. These two predictors also act as substantial mediators of perceived benefits, and they activate the mediation of perceived risks (an insignificant mediator in cognitive processing). In addition, perceived naturalness mediates the name-framing effect mainly through perceived disgust. Our findings have implications for future strategies for communicating about novel foods (like CM) to the public.

Highly logical and non-emotional decisions in both risky and social contexts: understanding decision making in autism spectrum disorder through computational modeling.

In risky contexts, autism spectrum disorder (ASD) individuals exhibit more logical consistency and non-emotional decisions than do typical adults (TAs). This way of deciding could be also prevailing in social contexts, leading to maladaptive decisions. This evidence is scarce and inconsistent, and further research is needed. Recent developments in computational modeling allow analysis of decisional subcomponents that could provide valuable information to understand the decision-making and help address inconsistencies. Twenty-seven individuals with ASD and 25 TAs were submitted to a framing-task and the ultimatum game (UG). The Rescorla-Wagner computational model was used to analyze UG decisions. Results showed that in the UG, the ASD group exhibited a higher utilitarianism, characterized by lower aversion to unfairness and higher acceptance of offers. Moreover, this way of deciding was predicted by the higher economic rationality found in the framing task, where people with ASD did not manifest emotional biases such as framing effect. These results could suggest an atypical decision making, highly logical and non-emotional, as a robust feature of ASD.

COVID-19 stressor reduces risk taking: the role of trait interoception.

The Framing Effect (FE) demonstrated that the way two alternatives are displayed affects people's inclination to make a specific choice, showing a risk aversion when alternatives are displayed on positive frames and risk seeking in negative frames. Risk seeking in negative frames is closely linked to loss aversion. Moreover, classical research and the salience-of-losses hypothesis argues that stress may enhance the FE and loss aversion. Recent studies also suggest that the trait interoception and alexithymia could interact and moderate the framing susceptibility. However, experimental paradigms on stress could ignore variables such as threat perception. In this sense, COVID-19 pandemic has become a powerful real-life stressor in many countries. We aimed to study how real-life stressors influence decision-making under risk. A total of 97 participants were divided into a control (n = 48) and an experimental group (n = 49). The experimental group were exposed to a stressor manipulation, a 5 min COVID-19 lockdown documentary. Our results show that COVID-19-related stressors significantly decreased bet acceptance regardless of the frame, also reducing loss aversion. Moreover, interoception was a significant predictor of loss aversion under stress conditions. Our results do not support classical research on stress and FE.

The influence of gain-loss framing and its interaction with political ideology on social distancing and mask wearing compliance during the COVID-19 pandemic.

The COVID-19 pandemic has caused millions of cases and over half a million deaths in the United States. While health experts urge citizens to adopt preventative measures such as social distancing and wearing a mask, these recommended behaviors are not always followed by the public. To find a way to promote preventative measures, the present study examined the role of gain-loss framing of COVID-19 related messages on social distancing and mask wearing compliance. Moreover, the study also tested potential moderating effects on framing with three individual characteristics: political ideology, subjective numeracy, and risk attitude. A sample of 375 U.S. adult residents were recruited from Amazon Mechanical Turk. Each participant read either a gain or loss-framed message related to practicing protective behaviors during the COVID-19 pandemic. Participants also completed scales of preventative behaviors, risk attitude, subjective numeracy, political ideology, and other demographic variables. It was found that those who were more liberal, risk-averse and had greater subjective numeracy were more likely to wear a mask and/or follow social distancing. Furthermore, in the presence of demographic and psychological factors, the study found participants in the loss-framed condition than in the gain-framed condition were more likely to adopt both preventative measures, supporting the notion of loss aversion. Additionally, the framing effect was also moderated by political ideology on mask-wearing, with the effect being stronger in liberals than in conservatives. Collectively, the study implies message framing may be a useful means to promote preventative measures in the current pandemic.

Time to Pay Attention? Information Search Explains Amplified Framing Effects Under Time Pressure.

Decades of research have established the ubiquity and importance of choice biases, such as the framing effect, yet why these seemingly irrational behaviors occur remains unknown. A prominent dual-system account maintains that alternate framings bias choices because of the unchecked influence of quick, affective processes, and findings that time pressure increases the framing effect have provided compelling support. Here, we present a novel alternative account of magnified framing biases under time pressure that emphasizes shifts in early visual attention and strategic adaptations in the decision-making process. In a preregistered direct replication (N = 40 adult undergraduates), we found that time constraints produced strong shifts in visual attention toward reward-predictive cues that, when combined with truncated information search, amplified the framing effect. Our results suggest that an attention-guided, strategic information-sampling process may be sufficient to explain prior results and raise challenges for using time pressure to support some dual-system accounts.

Metaphors we Lie by: our 'War' against COVID-19.

In this paper we discuss the influence of war as a metaphor in the context of the COVID-19 pandemic. After an introduction on the traditional analysis of the war metaphor, we address the social consequences of using this metaphor, a topic that has been widely debated with regard to public communication in the context of COVID-19. We pay particular attention to a theory that many intellectuals have raised: the possibility that the use of the metaphor in this context is harmful to a democratic society because it may lead citizens to accept limited civil liberties and authoritarian policies. After presenting the extensive literature on the use of the war metaphor before and during the COVID-19 pandemic, in the final section of the paper, we analyse experimental evidence of the effects of this metaphor. In the conclusion, we hint at open questions and suggest that the current evidence does not support claims of direct liberticidal influence.

The Neural Mechanism of the Social Framing Effect: Evidence from fMRI and tDCS Studies.

As an important cognitive bias, the framing effect shows that our decision preferences are sensitive to the verbal description (i.e., frame) of options. This study focuses on the neural underpinnings of the social framing effect, which is based on decision-making regarding other people. A novel paradigm was used in which participants made a trade-off between economic benefits and the feelings of others. This decision was described as either a "harm" to, or "not helping," other persons in two conditions (Harm frame vs Help frame). Both human males and females were recruited. Participants behaved more prosocially for Harm frame compared with Help frame, resulting in a significant social framing effect. Using functional magnetic resonance imaging, Experiment 1 showed that the social framing effect was associated with stronger activation in the temporoparietal junction (TPJ), especially its right part. The functional connectivity between the right TPJ (rTPJ) and medial prefrontal cortex predicted the social framing effect on the group level. In Experiment 2, we used transcranial direct current stimulation to modulate the activity of the rTPJ and found that the social framing effect became more prominent under anodal (excitatory) stimulation, while the nonsocial framing effect elicited by the economic gain/loss gambling frame remained unaffected. The rTPJ results might be associated with moral conflicts modulated by the social consequences of an action or different levels of mentalizing with others under different frame conditions, but alternative interpretations are also worth noting. These findings could help elucidate the psychological mechanisms of the social framing effect.SIGNIFICANCE STATEMENT Previous studies have suggested that the framing effect is generated from an interaction between the amygdala and anterior cingulate cortex. This opinion, however, is based on findings from nonsocial framing tasks. Recent research has highlighted the importance of distinguishing between the social and nonsocial framing effects. The current study focuses on the social framing effect and finds out that the temporoparietal junction and its functional connectivity with the medial prefrontal cortex play a significant role. Additionally, modulating the activity of this region leads to changes in social (but not nonsocial) framing effect. Broadly speaking, these findings help understand the difference in neural mechanisms between social and nonsocial decision-making. Meanwhile, they might be illuminating to promote helping behavior in society.

Arbitration between insula and temporoparietal junction subserves framing-induced boosts in generosity during social discounting.

Generosity toward others declines across the perceived social distance to them. Here, participants chose between selfish and costly generous options in two conditions: in the gain frame, a generous choice yielded a gain to the other; in the loss frame, it entailed preventing the loss of a previous endowment to the other. Social discounting was reduced in the loss compared to the gain frame, implying increased generosity toward strangers. Using neuroimaging tools, we found that while activity in the temporoparietal junction (TPJ) and the ventromedial prefrontal cortex (VMPFC) was associated with generosity in the gain frame, the insular cortex was selectively recruited during generous choices in the loss frame. We provide support for a network-model according to which TPJ and insula differentially subserve generosity by modulating value signals in the VMPFC in a frame-dependent fashion. These results extend our understanding of the insula role in nudging prosocial behavior in humans.

Framing and self-responsibility modulate brain activities in decision escalation.

BACKGROUND: Escalation of commitment is a common bias in human decision making. The present study examined (1) differences in neural recruitment for escalation and de-escalation decisions of prior investments, and (2) how the activations of these brain networks are affected by two factors that can arguably modulate escalation decisions: (i) self-responsibility, and (ii) framing of the success probabilities. RESULTS: Imaging data were obtained from functional magnetic resonance imaging (fMRI) applied to 29 participants. A whole-brain analysis was conducted to compare brain activations between conditions. ROI analysis, then, was used to examine if these significant activations were modulated by two contextual factors. Finally, mediation analysis was applied to explore how the contextual factors affect escalation decisions through brain activations. The findings showed that (1) escalation decisions are faster than de-escalation decisions, (2) the corresponding network of brain regions recruited for escalation (anterior cingulate cortex, insula and precuneus) decisions differs from this recruited for de-escalation decisions (inferior and superior frontal gyri), (3) the switch from escalation to de-escalation is primarily frontal gyri dependent, and (4) activation in the anterior cingulate cortex, insula and precuneus were further increased in escalation decisions, when the outcome probabilities of the follow-up investment were positively framed; and activation in the inferior and superior frontal gyri in de-escalation decisions were increased when the outcome probabilities were negatively framed. CONCLUSIONS: Escalation and de-escalation decisions recruit different brain regions. Framing of possible outcomes as negative leads to escalation decisions through recruitment of the inferior frontal gyrus. Responsibility for decisions affects escalation decisions through recruitment of the superior (inferior) gyrus, when the decision is framed positively (negatively).

The Dark Triad trait of psychopathy and message framing predict risky decision-making during the COVID-19 pandemic.

The effects of framing on risky decision-making have been studied extensively in research using Kahneman and Tversky's (1981) hypothetical scenario about a contagious Asian disease. The COVID-19 pandemic offers a unique opportunity to test how message framing affects risky decision-making when millions of real lives are at stake worldwide. In a sample of US adults (N = 294), we investigated the effects of message framing and personality (Dark Triad traits) in relation to risky decision-making during the COVID-19 crisis. We found that both gain- and loss-framing influenced risk choice in response to COVID-19. People were more risk-averse in the loss condition of the current study compared to the benchmark established by Tversky and Kahneman (1981). Among the Dark Triad traits, psychopathy emerged as the significant predictor of risk taking, suggesting that people who score high in psychopathy are more likely to gamble with other people's lives during the COVID-19 crisis. We suggest that both voters and pandemic-related public awareness campaigns should consider the possibility that decision-makers with psychopathic tendencies may take greater risks with other people's lives during a pandemic. In addition, the framing of public-health messages should be tailored to increase the chances of compliance with government restrictions.

The interplay between the importance of a decision and emotion in decision-making.

Decision-making literature has demonstrated that individuals' preferences are strongly affected by the way in which choices are presented. This cognitive bias, termed the framing effect, is influenced by the importance of the possible outcomes that a decision can have. However, the direction of this influence remains poorly understood. The aim of this paper was to examine the role of the importance of a decision in framing susceptibility and to explore a potential mechanism underlying this influence. Our first study revealed that participants display a framing effect when their decision implies a high importance outcome, but resist framing manipulation when their decision implies a low importance outcome. Our second study confirmed that an increase in the importance of a decision is associated with increasing framing susceptibility. Moreover, a moderated mediation analysis revealed that the more a decision was important, the more the gain and loss frames aroused opposite emotions, and this accounted for the increase in framing susceptibility. The results of these two studies confirmed that an increase in the importance of a decision is associated with increasing framing susceptibility and suggest that this influence on framing susceptibility is underpinned by emotion. Implications and direction for future studies are discussed.

Effect of the Contents in Advance Directives on Individuals' Decision-Making.

Completing an advance directive offers individuals the opportunity to make informed choices about end-of-life care. However, these decisions could be influenced in different ways depending on how the information is presented. We randomly presented 185 participants with four distinct types of advance directive: neutrally framed (as reference), negatively framed, religiously framed, and a combination. Participants were asked which interventions they would like to receive at the end of life. Between 60% and 70% of participants responded "accept the special interventions" on the reference form. However, the majority (70%-90%) chose "refuse the interventions" on the negative form. With respect to the religious form, 70% to 80% chose "not decided yet." Participants who refused special life-sustaining treatments were older, female, and with better prior knowledge about advance directives. Our findings imply that the specific content of advance directives could affect decision-making with regard to various interventions for end-of-life care.

The influence of number line estimation precision and numeracy on risky financial decision making.

This study examined whether different aspects of mathematical proficiency influence one's ability to make adaptive financial decisions. "Numeracy" refers to the ability to process numerical and probabilistic information and is commonly reported as an important factor which contributes to financial decision-making ability. The precision of mental number representation (MNR), measured with the number line estimation (NLE) task has been reported to be another critical factor. This study aimed to examine the contribution of these mathematical proficiencies while controlling for the influence of fluid intelligence, math anxiety and personality factors. In our decision-making task, participants chose between two options offering probabilistic monetary gain or loss. Sensitivity to expected value was measured as an index for the ability to discriminate between optimal versus suboptimal options. Partial correlation and hierarchical regression analyses revealed that NLE precision better explained EV sensitivity compared to numeracy, after controlling for all covariates. These results suggest that individuals with more precise MNR are capable of making more rational financial decisions. We also propose that the measurement of "numeracy," which is commonly used interchangeably with general mathematical proficiency, should include more diverse aspects of mathematical cognition including basic understanding of number magnitude.

Role of Emotion and Cognition on Age Differences in the Framing Effect.

Framing effect studies indicate that individuals are risk averse for decisions framed as gains but risk-seeking for decisions framed as losses. Findings of age-related differences in susceptibility to framing are mixed. In the current study, we examined emotional arousal in two decision tasks (life saving vs. money gambling) to evaluate the effects of emotion on age differences in the framing effect. When cognitive abilities and styles were controlled, there was a framing effect in the younger group in the life-saving task, a high-emotional arousal task, while older adults did not display this classic framing effect pattern. They showed risk aversion in both positive and negative framing. Age differences existed in the framing effect. Conversely, younger and older adults in the money-gambling task both displayed the framing effect; there was no age difference. When the cognitive abilities were not controlled, the pattern of results in the high-emotional arousal task remained unchanged, while greater framing effects were found, from the perspective of effect size, for older than younger adults in the low-emotional arousal task. Limited cognitive resources would not hamper older adults' performances when their emotional arousal was high. However, older adults with low-level emotional arousal were more susceptible than younger adults to framing because of declining cognitive capacities. This implied the importance of emotion in older adults' decision making and supported the selective engagement hypothesis.

COMT Val158Met polymorphism influences the susceptibility to framing in decision-making: OFC-amygdala functional connectivity as a mediator.

Individuals tend to avoid risk in a gain frame, in which options are presented in a positive way, but seek risk in a loss frame, in which the same options are presented negatively. Previous studies suggest that emotional responses play a critical role in this "framing effect." Given that the Met allele of COMT Val158Met polymorphism (rs4680) is associated with the negativity bias during emotional processing, this study investigated whether this polymorphism is associated with individual susceptibility to framing and which brain areas mediate this gene-behavior association. Participants were genotyped, scanned in resting state, and completed a monetary gambling task with options (sure vs risky) presented as potential gains or losses. The Met allele carriers showed a greater framing effect than the Val/Val homozygotes as the former gambled more than the latter in the loss frame. Moreover, the gene-behavior association was mediated by resting-state functional connectivity (RSFC) between orbitofrontal cortex (OFC) and bilateral amygdala. Met allele carriers showed decreased RSFC, thereby demonstrating higher susceptibility to framing than Val allele carriers. These findings demonstrate the involvement of COMT Val158Met polymorphism in the framing effect in decision-making and suggest RSFC between OFC and amygdala as a neural mediator underlying this gene-behavior association. Hum Brain Mapp 37:1880-1892, 2016. © 2016 Wiley Periodicals, Inc.

The moderating role of objective and subjective numeracy in attribute framing.

Previous research has found that objective numeracy moderates framing effects: People who are less numerate were found to be more susceptible to goal-framing and attribute-framing effects than people who are highly numerate. This study examined the possibility that subjective numeracy likewise moderates attribute framing in contexts where participants are presented with percentages of success or failure. The results show that compared with highly numerate participants, less numerate participants were more susceptible to the effect of attribute framing. Interestingly, this moderating effect was revealed only when using objective numeracy measures, and not when subjective numeracy measures were used. Future research is suggested to replicate these findings, to establish the generalizability of numeracy as a moderator of other cognitive biases, and to examine several possible theoretical explanations for the differential moderation of attribute-framing bias.