How Confidence in Prior Attitudes, Social Tag Popularity, and Source Credibility Shape Confirmation Bias Toward Antidepressants and Psychotherapy in a Representative German Sample: Randomized Controlled Web-Based Study.

Stefan Schweiger,Ulrike Cress

doi:10.2196/11081

Abstract

BackgroundIn health-related, Web-based information search, people should select information in line with expert (vs nonexpert) information, independent of their prior attitudes and consequent confirmation bias.ObjectiveThis study aimed to investigate confirmation bias in mental health–related information search, particularly (1) if high confidence worsens confirmation bias, (2) if social tags eliminate the influence of prior attitudes, and (3) if people successfully distinguish high and low source credibility.MethodsIn total, 520 participants of a representative sample of the German Web-based population were recruited via a panel company. Among them, 48.1% (250/520) participants completed the fully automated study. Participants provided prior attitudes about antidepressants and psychotherapy. We manipulated (1) confidence in prior attitudes when participants searched for blog posts about the treatment of depression, (2) tag popularity —either psychotherapy or antidepressant tags were more popular, and (3) source credibility with banners indicating high or low expertise of the tagging community. We measured tag and blog post selection, and treatment efficacy ratings after navigation.ResultsTag popularity predicted the proportion of selected antidepressant tags (beta=.44, SE 0.11; P<.001) and blog posts (beta=.46, SE 0.11; P<.001). When confidence was low (−1 SD), participants selected more blog posts consistent with prior attitudes (beta=−.26, SE 0.05; P<.001). Moreover, when confidence was low (−1 SD) and source credibility was high (+1 SD), the efficacy ratings of attitude-consistent treatments increased (beta=.34, SE 0.13; P=.01).ConclusionsWe found correlational support for defense motivation account underlying confirmation bias in the mental health–related search context. That is, participants tended to select information that supported their prior attitudes, which is not in line with the current scientific evidence. Implications for presenting persuasive Web-based information are also discussed.Trial RegistrationClinicalTrials.gov NCT03899168; https://clinicaltrials.gov/ct2/show/NCT03899168 (Archived by WebCite at http://www.webcitation.org/77Nyot3Do)

Highlights

BackgroundDo people attend to information independent of their prior attitudes, and do they distinguish expert from nonexpert sources on the Web? To address these important questions [1,2,3], we investigate confirmation bias, the tendency to favorably select and evaluate attitude-consistent information [3,4,5,6].A comprehensive meta-analysis identified 2 major motivational factors that moderate confirmation bias [7]
We suggest that social tag clouds are nonintrusive and highly suited to circumvent the influence of prior attitudes as larger tags are visually dominating, and it has been shown that people who primarily attend to large tags [25,27,28] are more likely to click on large tags [20,29,30] even when large tags are inconsistent with activated associations in memory [29,30] or prior attitudes [20]
As expected in H1a, we found that participants’ prior attitudes favor psychotherapy over antidepressants

Summary

Introduction

In health-related, Web-based information search, people should select information in line with expert (vs nonexpert) information, independent of their prior attitudes and consequent confirmation bias. Objective: This study aimed to investigate confirmation bias in mental health–related information search, (1) if high confidence worsens confirmation bias, (2) if social tags eliminate the influence of prior attitudes, and (3) if people successfully distinguish high and low source credibility. We manipulated (1) confidence in prior attitudes when participants searched for blog posts about the treatment of depression, (2) tag popularity —either psychotherapy or antidepressant tags were more popular, and (3) source credibility with banners indicating high or low expertise of the tagging community. Trial Registration: ClinicalTrials.gov NCT03899168; https://clinicaltrials.gov/ct2/show/NCT03899168 (Archived by WebCite at http://www.webcitation.org/77Nyot3Do)

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