Understanding the Cognitive and Affective Mechanisms that Underlie Proxy Risk Perceptions among Caregivers of Asthmatic Children

James A. Shepperd, Nikolette P. Lipsey, Thorsten Pachur and Erika A. Waters
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James A. Shepperd: Department of Psychology, University of Florida, Gainesville, GL, USA
Nikolette P. Lipsey: Department of Psychology, University of Florida, Gainesville, GL, USA
Thorsten Pachur: Max Plank Institute for Human Development, Berlin, Germany
Erika A. Waters: Washington University in St. Louis, St. Louis, MO, USA

Medical Decision Making, 2018, vol. 38, issue 5, 562-572

Abstract: Objective. Medical decisions made on behalf of another person—particularly those made by adult caregivers for their minor children—are often informed by the decision maker’s beliefs about the treatment’s risks and benefits. However, we know little about the cognitive and affective mechanisms influencing such “proxy†risk perceptions and about how proxy risk perceptions are related to prominent judgment phenomena. Methods. Adult caregivers of minor children with asthma ( N = 132) completed an online, cross-sectional survey assessing 1) cognitions and affects that form the basis of the availability, representativeness, and affect heuristics; 2) endorsement of the absent-exempt and the better-than-average effect; and 3) proxy perceived risk and unrealistic comparative optimism of an asthma exacerbation. We used the Pediatric Asthma Control and Communication Instrument (PACCI) to assess asthma severity. Results. Respondents with higher scores on availability, representativeness, and negative affect indicated higher proxy risk perceptions and (for representativeness only) lower unrealistic optimism, irrespective of asthma severity. Conversely, respondents who showed a stronger display of the better-than-average effect indicated lower proxy risk perceptions but did not differ in unrealistic optimism. The absent-exempt effect was unrelated to proxy risk perceptions and unrealistic optimism. Conclusion. Heuristic judgment processes appear to contribute to caregivers’ proxy risk perceptions of their child’s asthma exacerbation risk. Moreover, the display of other, possibly erroneous, judgment phenomena is associated with lower caregiver risk perceptions. Designing interventions that target these mechanisms may help caregivers work with their children to reduce exacerbation risk.

Keywords: affect; better-than-average effect; heuristics; perceived risk; unrealistic optimism (search for similar items in EconPapers)
Date: 2018
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:38:y:2018:i:5:p:562-572

DOI: 10.1177/0272989X18759933

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