What is the Cost of Sadness? Age Differences in Risky Medical Decision Making

What is the Cost of Sadness? Age Differences in Risky Medical Decision Making Jenna Wilson It's unknown how a sadness induction affects risky decision making within the medical domain, as well as whether the cognitive appraisal tendencies of uncertainty and situational control, which are theorized to underlie sadness, explain why sadness is related to subsequent decision making. Additionally, although initial work suggests that age differences in risky decision making may not exist within the medical domain, this limited work has only used one measure of risky medical decision making (e.g., Butler et al., 2012; Hanoch et al., 2018; Rosman et al., 2013). The first aim of the current study was to examine the effect of a sadness induction on risky medical decision making, and to explore whether the appraisal tendencies of uncertainty and situational control explained the link between sadness and decision making. The second aim of the current study was to examine the association between age and risky medical decision making utilizing a different measure of medical risk taking than has been used previously. The third aim of the current study was to explore whether age moderated the association between the sad video condition and risky medical decision making, as well as the association between the sad video condition and appraisals of situational control. Younger (aged 18-35) and older (aged 60-89) adults from the U.S. (N = 270; 51.5% female; 77% White) were recruited online via CloudResearch. Participants were randomly assigned to either a sad condition or neutral control condition and watched a short video clip. Participants then read three hypothetical medical decision scenarios that described being diagnosed with either cancer, a stroke, or an ankle fracture. After each scenario, participants were presented with two treatment options – Treatment A was lower risk and Treatment B was higher risk. For each decision scenario, participants rated their likelihood to choose Treatment A relative to Treatment B, as well as answered questions about their appraisals of uncertainty and situational control related to the treatment outcomes. Older adults were less likely to choose the riskier treatment option (Treatment B) than younger adults. However, this finding was no longer significant after accounting for age differences in baseline negative affect, such that older adults reported less negative affect at baseline than younger adults. The sad video induction, compared to the neutral control condition, did not have a significant effect on risky medical decisions, but an exploratory analysis showed that baseline sadness was related to greater risky medical decision making. However, the appraisal tendencies did not statistically account for why baseline sadness was related to risky medical decisions. Additionally, age moderated the association between the sad video condition and appraisals of situational control, such that older adults in the sad condition reported higher appraisals of situational control than older adults in the neutral condition. Together, the findings suggest that baseline sadness is related to greater risk taking, but it’s unclear why since the appraisals tendencies did not explain this association. Moreover, age is not related to risky medical decision making after accounting for age differences in affect. SADNESS, AGE AND RISKY MEDICAL DECISIONS iii ACKNOWLEDGMENTS Throughout the writing of this dissertation I have received a great deal of support and assistance. This research was made possible by the Eberly College of Arts and Sciences and the Department of Psychology. I would like to thank Dr. JoNell Strough, my dissertation chair and advisor, for her mentorship and guidance throughout this project. I would also like to thank my committee members, Drs. Natalie Shook, Amy Gentzler, and Caroline Groth, for their feedback and time. In addition, I would like to thank my colleagues for all of their support. Lastly, I am incredibly grateful for the endless support and encouragement I have received from my family and friends throughout my graduate career. SADNESS, AGE AND RISKY MEDICAL DECISIONS iv