BackgroundPrevious research suggests that physicians' inclination to refer patients for suspected cancer is a relatively stable characteristic of their decision making. We aimed to identify its psychological determinants in the presence of a risk-prediction algorithm.MethodsWe presented 200 UK general practitioners with online vignettes describing patients with possible colorectal cancer. Per the vignette, GPs indicated the likelihood of referral (from highly unlikely to highly likely) and level of cancer risk (negligible/low/medium/high), received an algorithmic risk estimate, and could then revise their responses. After completing the vignettes, GPs responded to questions about their values with regard to harms and benefits of cancer referral for different stakeholders, perceived severity of errors, acceptance of false alarms, and attitudes to uncertainty. We tested whether these values and attitudes predicted their earlier referral decisions.ResultsThe algorithm significantly reduced both referral likelihood (b = -0.06 [-0.10, -0.007], P = 0.025) and risk level (b = -0.14 [-0.17, -0.11], P < 0.001). The strongest predictor of referral was the value GPs attached to patient benefits (b = 0.30 [0.23, 0.36], P < 0.001), followed by benefits (b = 0.18 [0.11, 0.24], P < 0.001) and harms (b = -0.14 [-0.21, -0.08], P < 0.001) to the health system/society. The perceived severity of missing a cancer vis-à-vis overreferring also predicted referral (b = 0.004 [0.001, 0.007], P = 0.009). The algorithm did not significantly reduce the impact of these variables on referral decisions.ConclusionsThe decision to refer patients who might have cancer can be influenced by how physicians perceive and value the potential benefits and harms of referral primarily for patients and the moral seriousness of missing a cancer vis-à-vis over-referring. These values contribute to an internal threshold for action and are important even when an algorithm informs risk judgments.HighlightsPhysicians' inclination to refer patients for suspected cancer is determined by their assessment of cancer risk but also their core values; specifically, their values in relation to the perceived benefits and harms of referrals and the seriousness of missing a cancer compared with overreferring.We observed a moral prioritization of referral decision making, in which considerations about benefits to the patient were foremost, considerations about benefits but also harms to the health system or the society were second, while considerations about oneself carried little or no weight.Having an algorithm informing assessments of risk influences referral decisions but does not remove or significantly reduce the influence of physicians' core values.

More gist, better math: Fuzzy-trace theory-based investigation of the relationship between long-term memory and mathematical skills.

Framing effects (risk preferences reverse for gains vs. losses) and the Allais paradox (risk preferences reverse when an option is certain vs. not) are major violations of rational choice theory. In contrast to typical samples, certified public accountants who are competent in working with probabilities and expected values should be an ideal test case for rational choice, especially high scorers on the cognitive reflection test (CRT). Although dual-process theories emphasize numeracy and cognitive reflection, fuzzy-trace theory emphasizes gist-based intuition to explain these effects among cognitively advanced decision-makers. Thus, we recruited a high-numeracy sample of certified public accountants (N = 259) and students (N = 648). We administered classic dread-disease framing, business framing, and Allais paradox problems and the CRT. Each participant received a gain and loss framing problem from different domains (one disease and one business), with presentation order counterbalanced across participants. Order of Allais problems was counterbalanced within participants. Within-participants (cross-domain) framing, between-participants (within-domain) framing, and the Allais paradox were observed for both samples. Accountants did not show domain-specific attenuation (differentially smaller framing) for business problems. Despite large expected-value differences between Allais problem options, accountants' choices resembled students' choices. Contrary to dual-process theories, CRT scores were positively related to framing for students (more framing with higher CRT) and inconsistently related for accountants, but high scorers had robust framing effects; high scorers also showed the Allais paradox. Results are consistent with fuzzy-trace theory's expectation that experts show framing effects because they rely primarily on gist-based intuition, not because they lack numeracy or cognitive reflection. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The majority of research on the effects of emotional stimuli false memory has used the Deese-Roediger-McDermott (DRM) paradigm over long-term delays. Yet, results have been mixed, and studies have not yet considered the effects of emotional content on short-term false memories. The present study examined emotional and neutral false memories at both short and long delays to both compare the results for short- and long-term memory and attempt to clarify previous mixed findings. A secondary purpose was to test the role of attention on false memories across these delays, as this factor has been found to influence emotion effects. In two experiments, participants studied 4-item negative, positive, and neutral DRM lists and completed both immediate, single-item recognition tests (short delay), and a surprise recognition test following all short-term trials (long delay). Attention was manipulated at encoding (Experiment 1) or retrieval (Experiment 2). A novel finding is reported, which replicated across both experiments: only negative lists produced significant false memories at the short delay, whereas all list types produced significant false memories at the long delay. Furthermore, both experiments showed that when attention was divided, negative lists produced higher hit rates than positive lists in short-term tests. However, the attention condition did not affect false memories in either experiment. Results support both the activation-monitoring framework and fuzzy trace theory explanations for false memories, but the finding of negative false memories at short delays is better explained by activation-monitoring views.

This study aims to analyze the influence of framing, time pressure, and uncertainty avoidance on investment evaluation decision-making. This study uses an experimental approach based on fuzzy-trace theory and prospect theory rooted in behavioral finance. The experiment was conducted on final-year accounting students as a proxy for financial decision-makers, using a 2x2x2 factorial design to examine the influence of each variable. The analysis results indicate that information framing significantly influences investment decisions; participants who received information with negative framing tended to be more willing to take risks compared to those with positive framing. Time pressure was also found to affect decision accuracy, while uncertainty avoidance revealed significant differences in risk preferences. These findings reinforce evidence that psychological aspects and situational context play a significant role in financial decision-making, particularly in the evaluation of fixed asset investments. The practical implications of this study highlight the importance of developing information strategies and managerial controls in the long-term investment decision-making process.

Previous research suggests that the MINERVA2 model can capture basic Deese/Roediger/McDermott (DRM) false recognition findings with either randomized representations or distributional semantic representations. In the current article, we extended this line of research by showing that MINERVA2 can accommodate not only basic DRM recognition findings but also the effects of various theory-driven manipulations. Importantly, we incorporated two assumptions of fuzzy-trace theory into MINERVA2: the verbatim-gist distinction and hierarchies of gist. To implement the verbatim-gist distinction, we represented local gist traces with distributional semantic vectors and verbatim traces with holographic word-form vectors. With separate representations incorporated, MINERVA2 successfully simulated a wide range of empirical effects in the DRM illusion, as well as remember/know and source judgments. To incorporate hierarchies of gist into the framework, we added an assumption that an item's storage quality depends on its semantic similarity to the preceding item. This accommodated the effect of global gist beyond that of local gist and solved the problem of storage independence in multitrace models of episodic memory. Our findings provided extensive evidence that MINERVA2 is a viable candidate for scalable modeling of the DRM illusion and strengthened the connection between computational modeling and substantive theories of false memory. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Recent studies using verbal list-learning tasks have examined how language proficiency affects intrusion rates using semantic/associative lists. Typically, false memories decrease as language proficiency decreases; a finding consistent with fuzzy trace theory (gist extraction is less effective when items are less familiar; Brainerd & Reyna, Current Directions in Psychological Science, 11, 164-169, 2002) and with the activation/monitoring framework (semantic networks are less developed; Roediger et al., 2001). Native and non-native speakers (high and low proficiency, determined based on subjective and objective measures) studied phonological, semantic, and hybrid (half semantic, half phonological) lists to determine whether language proficiency affects errors across different types of associates. False recall was observed in all three proficiency groups; however, the patterns of errors differed. High proficiency and native speakers did not differ from one another: Both groups made the most errors with hybrid lists and similar error rates with semantic and phonological lists. In contrast, low proficiency speakers made significantly fewer semantic than hybrid and phonological errors. All groups showed a strong hyper-additive effect for Hybrid lists. Less proficient speakers might rely less on semantic than phonological information compared to more proficient speakers. The present work indicates that language proficiency modulates false memory broadly. (192 words).

How do parents decide on genetic testing in pediatrics? A systematic review.

While generally reliable, human memory is susceptible to distortions such as false memories. This study investigates the relationships among the emotional valence of events, mood states, and the formation of false autobiographical memories, applying the blind implantation method. We examine the impact of positive and negative moods, combined with the emotional valence of events (negative vs. positive), on false belief and recollection ratings. We conducted two preliminary studies to develop an online mood induction and select critical and noncritical autobiographical events. In the main experiment, 715 adults completed a list of 20 autobiographical events. The participants who had not experienced certain critical events were invited to a second phase, resulting in a final sample of 242 participants (130 female, 108 male, and four others), aged 19-81 years (M = 40.35, SD = 12.64). After experiencing the mood induction, they were presented with a survey suggesting that they had previously reported experiencing a critical event. False beliefs and memories were implanted in 6% (n = 15) to 34% (n = 83) of the cases. While mood did not affect false belief and recollection ratings, negative events led to greater false belief and recollection than positive events did, aligning with the associative activation model and fuzzy-trace theory. These findings highlight the need for caution in settings (e.g., therapy), where possible suggestive techniques could inadvertently implant false traumatic memories.

Supplemental Material for True and False Recognition in MINERVA2: Integrating Fuzzy-Trace Theory and Computational Memory Modeling

Health misinformation undermines responses to health crises, with social media amplifying the issue. Although organizations work to correct misinformation, challenges persist due to reasons such as the difficulty of effectively sharing corrections and information being overwhelming. At the same time, social media offers valuable interactive data, enabling researchers to analyze user engagement with health misinformation corrections and refine content design strategies. This study aimed to identify the attributes of correction posts and user engagement and investigate (1) the trend of user engagement with health misinformation correction during 3 years of the COVID-19 pandemic; (2) the relationship between post attributes and user engagement in sharing and reactions; and (3) the content generated by user comments serving as additional information attached to the post, affecting user engagement in sharing and reactions. Data were collected from the Facebook pages of a fact-checking organization and a health agency from January 2020 to December 2022. A total of 1424 posts and 67,378 corresponding comments were analyzed. The posts were manually annotated by developing a research framework based on the fuzzy-trace theory, categorizing information into "gist" and "verbatim" representations. Three types of gist representations were examined: risk (risks associated with misinformation), awareness (awareness of misinformation), and value (value in health promotion). Furthermore, 3 types of verbatim representations were identified: numeric (numeric and statistical bases for correction), authority (authority from experts, scholars, or institutions), and facts (facts with varying levels of detail). The basic metrics of user engagement included shares, reactions, and comments as the primary dependent variables. Moreover, this study examined user comments and classified engagement as cognitive (knowledge-based, critical, and bias-based) or emotional (positive, negative, and neutral). Statistical analyses were performed to explore the impact of post attributes on user engagement. On the basis of the results of the regression analysis, risk (β=.07; P=.001), awareness (β=.09; P<.001), and facts (β=.14; P<.001) predicted higher shares; awareness (β=.07; P=.001) and facts (β=.24; P<.001) increased reactions; and awareness (β=.06; P=.005), numeric representations (β=.06; P=.02), and facts (β=.19; P<.001) increased comments. All 3 gist representations significantly predicted shares (risk: β=.08; P<.001, awareness: β=.08; P<.001, and value: β=.06; P<.001) and reactions (risk: β=.04; P=.007, awareness: β=.06; P<.001, and value: β=.05; P<.001) when considering comment content. In addition, comments with bias-based engagement (β=-.11; P=.001) negatively predicted shares. Generally, posts providing gist attributes, especially awareness of misinformation, were beneficial for user engagement in misinformation correction. This study enriches the theoretical understanding of the relationship between post attributes and user engagement within web-based communication efforts to correct health misinformation. These findings provide a foundation for designing more effective content approaches to combat misinformation and strengthen public health communication.

Ubiquitous misinformation on social media threatens the health and well-being of young people. We review research on susceptibility to misinformation, why it spreads, and how these mechanisms might operate developmentally. Although we identify many research gaps, results suggest that cognitive ability, thinking styles, and metacognitive scrutiny of misinformation are protective, but early adverse experiences can bias information processing and sow seeds of mistrust. We find that content knowledge is not sufficient to protect against misinformation, but that it, along with life experiences, provides a foundation for gist plausibility (true in principle, rather than true at the level of verbatim details) that likely determines whether misinformation is accepted and shared. Thus, we present a theoretical framework based on fuzzy-trace theory that integrates the following: knowledge that distinguishes verbatim facts from gist (knowledge that is amplified by cognitive faculties and derived from trusted sources); personality as an information-processing filter colored by experiences; emotion as a product of interpreting the gist of information; and ideology that changes prior probabilities and gist interpretations of what is plausible. The young and the old may be at greatest risk because of their prioritization of social goals, a need that social media algorithms are designed to meet but at the cost of widespread exposure to misinformation.

Fuzzy-trace theory (FTT) posits that people share misinformation online if it promotes gist mental representations, cuing motivationally relevant values. Most people value the truth. Thus, per FTT, people decide to share messages that they perceive as true. FTT also predicts that messages will be more effective if they communicate a simple gist. We test these predictions by examining the roles of mental representation and epistemic quality in decisions to share misinformative articles on Facebook across two experiments and two correlational studies. In Studies 1 and 2, we use Facebook data to test the hypothesis that gist proxies in text are associated with online sharing. In Study 3, we experimentally manipulate subjects' exposure to a gist-based intervention that explains why a misinformative article is false, a simple debunk stating only that the article is false (but not explaining why) and a verbatim condition providing relevant detailed information but allowing subjects to draw their own conclusions. We found that the gist condition decreased intentions to share misinformation. Finally, in Study 4, we replicated this finding and showed that the gist condition also reduces misinformation endorsement. Results provide support for FTT's predictions regarding reducing sharing and endorsement of misinformation on social media. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Young adult coping and perceived susceptibility early in the COVID-19 pandemic: A fuzzy-trace theory application.

As they become more common, automated systems are also becoming increasingly opaque, challenging their users’ abilities to explain and interpret their outputs. In this study, we test the predictions of fuzzy-trace theory—a leading theory of how people interpret quantitative information—on user decision making after interacting with an online decision aid. We recruited a sample of 205 online crowdworkers and asked them to use a system that was designed to detect URLs that were part of coordinated misinformation campaigns. We examined how user endorsements of system interpretability covaried with performance on this coordinated misinformation detection task and found that subjects who endorsed system interpretability displayed enhanced discernment. This interpretability was, in turn, associated with both objective mathematical ability and mathematical self-confidence. Beyond these individual differences, we evaluated the impact of a theoretically motivated intervention that was designed to promote sensemaking of system output. Participants provided with a “gist” version of system output, expressing the bottom-line meaning of that output, were better able to identify URLs that might have been part of a coordinated misinformation campaign, compared to users given the same information presented as verbatim quantitative metrics. This work highlights the importance of enabling users to grasp the essential, gist meaning of the information they receive from automated systems, which benefits users regardless of individual differences.

ABSTRACTRisk and decision‐making are central to human behavior and have been extensively studied across many disciplines. To better understand the factors that influence an individual's risk‐related choices, this paper investigates the influence of frame valence intensity. It does so by comparing predictions from two prominent theories of decision‐making: Prospect theory (PT) and fuzzy‐trace theory (FTT). PT relies on the numerical transformation of subjective value information suggesting that the intensity of the frame should not affect the decision outcome. In contrast, FTT predicts that the level of frame valence should correspond to the intensity of the extracted memory trace and have predictable effects on risky choice. The results demonstrate that risky choice varies across different levels of the frame's valence. For positive frames, increasing valence intensity is associated with decreased risk preference. For negative frames, the relationship is more complex and context‐dependent. These findings extend our understanding of framing effects, suggesting that both the direction and intensity of frame valence influence risk preferences. While broadly aligning with FTT predictions regarding gist extraction, our results also indicate that PT could be extended to account for valence intensity effects, potentially bridging these theoretical perspectives.

When tasked with recalling a heard conversation, most individuals are unable to remember specific details. In this study, we tested the effect of Verbatim Recall Instruction (VRI) at recall. Drawing on fuzzy-trace theory, we hypothesised that the use of VRI would lead earwitnesses to use their verbatim mnesic trace to produce a more detailed recall. We compared the quantity and the quality of 42 recalls from participants who had received the VRI or the Free Recall Instruction (FRI). We analysed the level of detail of participants’ recall along a fuzzy to verbatim continuum. Results showed that participants having received a VRI recalled information that was more correct and closer to the original phrasing. However, differences in procedure make the VRI difficult to compare with other studies. Methodological differences are accordingly discussed. Findings suggest that VRI encourages the recollection of verbatim traces, in turn benefiting the recall of detailed elements of a conversation. These findings support fuzzy-trace theory.

ABSTRACT During the COVID-19 pandemic, it was important for people to be able to comprehend information about mRNA vaccination. Moderna and Pfizer were two of the largest distributors of mRNA vaccinations, and their websites provided information about how mRNA vaccinations work. Applying the tenets of Fuzzy-trace Theory (FTT), we calculated Gist Inference Scores (GIS) to assess the extent to which texts taken from Moderna and Pfizer websites facilitate gist comprehension. We then rewrote the Moderna and Pfizer texts to increase GIS and tested their ability to facilitate a reader’s understanding of how mRNA vaccinations work. We conducted two experiments in which participants read original Moderna and Pfizer texts, a High GIS-version presenting the same content, or control texts on unrelated topics. Findings indicate that the High GIS-version increased comprehension. We conclude that this theory-driven approach can help subject-matter experts better communicate important information, allowing readers to “get the gist” of it.

Who Makes the Decision, How, and Why: A Fuzzy-Trace Theory Approach.

IntroductionPension participants need appropriate support when making (complex) pension decisions. Grounded in Fuzzy-Trace Theory, we argue that suitable decisions require participants to (accurately) understand meaningful differences between decision alternatives. Based on this, we investigated the effectiveness of different types of decision support for the decision when to retire.MethodsWe conducted two experiments among participants of four Dutch pension funds (Study 1: N = 2,328, Study 2: N = 500) on the effectiveness of three different types of decision support: (a) a traditional pros and cons text, (b) a Value Clarification Method (VCM), and (c) testimonials.ResultsThe studies showed mixed results. In the first study, we found an activating effect of the VCM and the testimonials: participants who received one of these two types of decision support were more likely to visit a web page with additional information. In the second study, we found no differences between the three types of decision support.ConclusionWe discuss possible explanations for the effects found, as well as implications for future (research on) pension decision support.