Kathleen M. Kowalski-Trakofler* 

and Charles Vaught 

National Institute for Occupational Safety and Health, 

Pittsburgh Research Laboratory, 626 Cochrans Mill Road, 

Pittsburgh, PA 15236, USA
 

E-mail: kkowalski@cdc.gov E-mail: cvaught@cdc.gov
 

Ted Scharf 

National Institute for Occupational Safety and Health c-24, 

4676 Columbia Parkway, Cincinnati, OH 45226, USA 

E-mail: tscharf@cdc.gov 

*Corresponding author 

Abstract: This paper discusses human judgment and decision making under 

stress. The authors review selected recent literature across various disciplines 

and suggest a definition of stress within the context of decision making during 

the management of emergencies. They also discuss fieldwork by the Pittsburgh 

Research Laboratory, NIOSH, which explores traumatic incident stress, the 

relationship between previous training and performance under stressful 

conditions, and human behaviour in underground mine fires. The authors assert 

that stress is one of the factors that decision makers must contend with in most 

life-or-death situations. They suggest that a better understanding of individual 

judgment and decision making activities whilst under stress would yield a 

better understanding of how people reach the choices they make in 

emergencies. This enhanced understanding would be of enormous value to 

emergency managers, researchers and policymakers. 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1 Introduction 

Clearly, the effect of stressful conditions on human judgment is of importance to 

emergency managers. In natural or human-induced emergencies, the decisions that are 

made in the first minutes, hours, and days are critical to successful mitigation; damage 

control; prevention of death, injury and structural loss; control of financial costs; and, 

ultimately, the overall resolution of the disaster. The impact of stress on professional 

judgment is significant. During an emergency situation, critical judgments are frequently 

made under conditions of acute temporary or prolonged stress. Emergency decision 

makers are required to process massive amounts of information, which is sometimes 

incomplete or faulty, usually under severe time constraints. 

1.1 Definitions 

The use of the term ”stress‘ is rooted deeply in the literature. Lazarus and Lazarus [1, 

p.220] discuss the use and definition of the word ”stress‘ and note that it was used as 

early as the fourteenth century to mean hardship, straits, or adversity of affliction. In the 

seventeenth century, a physicist-biologist, Robert Hooke, tried to help engineers design 

man-made structures such as bridges, which had to carry heavy loads and resist buffeting 

by winds, earthquakes and other natural forces that could destroy them. An important and 

practical engineering task, therefore, was how to design bridges to resist these loads, or 

stresses. Hooke‘s analysis greatly influenced the way stress came to be thought of in 

physiology, psychology and sociology œ as an environmental demand on a biological, 

psychological or social system. 

One popular current definition stipulates that —stress is a process by which certain 

work demands evoke an appraisal process in which perceived demands exceed resources 

and result in undesirable physiological, emotional, cognitive and social changes“ [2, p.6]. 

The authors hold this definition as one of the most appropriate for emergency 

management purposes, because ”demand exceeding resource‘ is a key factor, either in the 

management of an emergency or in the response of an individual. The focus is on the 

demand œ which may come from numerous sources including the emergent hazards, other 

elements of the environment, and social factors œ interacting with the human resource, 

which is dependent upon numerous factors including individual perception, physiological 

constraints, training and experience. 

The relationship of stress to judgment and decision making is an aspect of human 

behaviour that remains inadequately explored [3,4]. The literature in this area is 

extremely complex and not conclusive. Gillis [4, p. 1355] maintains that: 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hammond points out that the notion of stress having an influence on judgment was only 

first broached during a US Congressional hearing in 1988. At issue was compensation for 

the victims of Iran Air Flight 655, which was shot down by the US Navy cruiser 

Vincennes over the Persian Gulf. A second hearing was called —to examine the impact of 

human factors such as stress“ on the crew‘s performance. 

1.2 The Congressional inquiry 

Two questions posed during the second Congressional hearing are of interest to this 

discussion: 

1 Does the performance during the shooting down identify elements of human 

behaviour that are poorly understood? 

2	 What have researchers uncovered to date on human ability to make rapid and even 

complex decisions in high-stress environments? [5]. 

Four behavioural scientists, identified as expert witnesses, testified and wrote reports to 

the Defence Policy Panel of the Armed Services in 1989 concluding that we know almost 

nothing about the extent to which decisions are affected by stressful circumstances, much 

less the manner in which the decisions are influenced by high-stress environments [3]. 

The agreement among these experts was three-fold [3]. Firstly, judgment and decision 

making under stress is an area that has not been adequately studied and we know little 

about severe stress in group situations. Secondly, it is believed that the competence of 

human judgment is decreased by stress (even though the experts could not cite empirical 

data). Finally, the scientists concluded that stress narrows the focus of attention, implying 

a negative impact on judgment. In hindsight, these experts appear to have been correct 

only in their first conclusion œ that decision making under extreme stress is not a 

thoroughly studied area of human behaviour. (Hammond disagrees with this conclusion; 

our divergence with his opinion will be addressed below.) Conclusions two and three are 

discussed further in this paper, and the authors suggest that the 1989 analysis was too 

simplistic. 

One recommendation of the committee to Congress was that stress needed to be 

studied further. Meanwhile, the American Psychological Association and the National 

Institute for Occupational Safety and Health (NIOSH) joined forces in 1990, declaring 

the 1990s to be the ”Decade of Stress‘. During that decade, resources and attention were 

focused on increasing knowledge about human stress response and its relationship to 

numerous variables. 

1.3 Paper overview 

Over a dozen years have passed since the Congressional hearings on Iran Flight 655, and 

although no conclusive data on judgment and decision making under stress have 

emerged, a number of studies have identified topics of interest to those who must make 

decisions under stress. The research is scattered throughout the social, psychological, 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

models and planning responses that require decision making in disaster situations. 

This paper was written prior to September 11, 2001, and has subsequently, been 

revised. The attacks on the World Trade Center and the Pentagon, as well as the anthrax 

investigations in offices and postal facilities, created extremely stressful situations for 

emergency responders. There has been neither time nor opportunity to adequately 

research these recent experiences with respect to judgment and decision making under 

stress. Needless to say, these experiences and the potential for future events weigh 

heavily in the thinking and planning of every emergency manager. Our goal is to 

contribute to this discussion with an analysis that leads to greater insight into the issues 

and better questions for continuing research. 

2 Assumptions and key issues 

2.1 Stress is affected by perception 

It is critical to include the concept of perception when discussing stress in relation to 

performance, including performance in judgment and decision making. The reader should 

note that in Section 1.1, discussing the definition of stress, the key phrase ”perceived 

demands‘ is used. The ability to cope with stress is dependent upon an individual‘s 

perception or interpretation of an event. Gillis [4] suggests that stressful circumstances do 

not automatically lead to problems in judgment; it is the perceived experience of stress. 

An overall review of workplace stress can be found in the International Labour Office 

Encyclopaedia chapter, —Psychosocial and organisational factors“ [6], and in Hurrell and 

Murphy [7]. Evans and Cohen [8] reviewed human interactions with environmental 

stressors in detail. For example, uncontrollable cataclysmic events place greater demands 

on all involved individuals than do minor, albeit emergent, life events. Major disasters 

press heavily on everyone‘s resources, and stress reactions are to be expected. The 

problem is that emergency responders still have a job to do, regardless of the 

environmental demands and consequent stress. Deciding how to get the job done 

effectively when critical information is unavailable, or not yet determined, places 

additional pressure on the individual‘s decision making process. 

2.2 Competence in judgment is always compromised under stress 

This particular conclusion of the experts in the 1989 Congressional hearings deserves 

further evaluation. It is important to note that both improved performance and 

performance degradation have been associated with increased stress [9]. For some 

individuals, heightened stress elevates their performance. Others are vulnerable to the 

negative impacts of stress, which results in diminished performance. A physiological 

example of this positive/negative dynamic of stress is athletic performance. An athlete 

desiring to be at an optimal performance level whilst competing demands an optimal 

stress level. The stress level should be enough to stimulate top performance, but not 

enough to over-stress the body, because performance declines as the body moves toward 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

were placed under conditions of stress (a disturbing noise) and the others were left to 

focus on their task. The exercise involved varying levels of difficulty and lasted five 

hours. The researchers found that subjects under stress performed equally to those not 

stressed, but their problem solving patterns were different. Stressed subjects focused on 

the general outline of the problem, while non-stressed individuals relied on in-depth 

analysis. Consequently, stressed subjects made fewer errors in setting priorities whilst 

non-stressed subjects controlled their fire fighting operations better. 

Two Greek researchers, Kontogiannis and Kossiavelou [11], examined the decision 

making strategies and cooperation patterns used by proven, efficient teams in adapting 

their behaviour to cope with stressful emergencies. The authors conclude that stress 

restricts cue sampling, decreases vigilance, reduces the capacity of working memory, 

causes premature closure in evaluating alternative options, and results in task shedding. A 

study of military commanders [12] found that teams with records of superior 

performance have one common critical characteristic: they are extremely adaptive to 

varying demands. The teams in their study could maintain performance using just onethird of the time usually available to make decisions, but the mode of communication 

changed. Initially, the team responded to explicit requests in communications from 

commanders. As time pressure increased, they stopped waiting for explicit requests and 

instead provided commanders with information they implicitly determined would be 

useful. 

Serfaty and Entin [12] suggest that changes from ”explicit‘ to ”implicit‘ 

communication can help teams maintain performance under time pressure. Implicit 

coordination patterns, anticipatory behaviour, and redirection of the team communication 

strategy are evident under conditions of increased time-pressure. The authors conclude 

that effective changes in communication patterns may involve updating team members, 

regularly anticipating the needs of others by offering unrequested information, 

minimising interruptions, and articulating plans at a high level in order to allow 

flexibility in the role of front-line emergency responders. The authors found support for 

the main hypothesis that team coordination strategies will evolve from explicit 

coordination under low workload conditions to implicit coordination as work load 

increases. 

High reliability organisations exhibit a similar flexibility [13]. Aircraft carriers, 

nuclear power plants, and similar organisations operate under conditions of extreme 

hazard, with little latitude for failure. Organisational structures, functions, and a safety 

climate that promotes rapid and effective communication are critical to maintaining safe 

work practices [14]. 

2.3 Stress is related to information 

In studies of escape from underground mine fires, researchers have identified several 

human behavioural and organisational dimensions relevant to understanding decision 

making under duress. Firstly, initial warnings in dangerous situations are often unclear, 

sometimes due to the way technology behaves and sometimes due to faulty 

communication. This can lead to different interpretations of the problem. Secondly, 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

apparatus (e.g., those used in mine emergencies) may not work as expected or may fail. 

Thus, emergency decision makers under stress not only have the effects of their own 

stress response and its resulting consequences, the information they must base their 

judgments on is often unclear, faulty and incomplete [15]. 

2.4 Stress narrows the focus of attention 

A primary conclusion of the experts at the Congressional hearing was that stress narrows 

one‘s focus. Time pressure studies, where the subject is given a task and a specific, 

usually unreasonable, time to complete it, generally support this conclusion. Other 

studies, however, report contradictory results for this conclusion [3]. Negative 

information gains become important under time pressure because they need to be 

evaluated and discarded. If a situation involves risk (as in response to an emergency), 

time pressure studies show that the subject becomes more cautious and adopts 

risk-avoiding behaviour with importance placed on avoiding losses [16]. These studies 

have shown that, under time pressure, the subject adopts a simpler mode of information 

processing in which alternatives are not explored fully and certain important ”cues‘ are 

used to determine the decision. From these studies, the experts conclude that stress 

narrows the focus of attention. In other words, the focus of attention shrinks, and the 

individual focuses just on critical issues and elements. This focused attention was 

assumed to be bad, but it actually may be good because it can eliminate nonessential 

information and highlight the most important sources. 

Citing two studies reported in 1993, Gillis [4] did not find support for the ”narrowing 

of attention‘ hypothesis. Keinan et al. [17] tested the proposition that deficient decision 

making under stress is due largely to an individual‘s failure to fulfil adequately a most 

elementary requirement of the decision making process, i.e., the systematic consideration 

of all relevant decision alternatives. In their study, which required participants to solve 

problems whilst under stress, one group was put under stress and compared to a 

non-stress control group. Stress was found to induce a tendency to offer solutions before 

all decision alternatives had been considered and to scan such alternatives in a nonsystematic fashion. 

2.5 Dynamic environments impact on decision making 

According to Kerstholt [18], decision making behaviour is considerably affected by the 

dynamics of environment, because most natural dynamic situations contain much 

uncertainty. He notes that a dynamic situation continually changes and, thus, a decision 

maker has to take temporal changes into consideration. He further notes that a decision 

maker can use feedback on the effect of his/her actions on the system. In other words, as 

decisions are made and action is taken, the results of the decision may be taken into 

consideration and the information used in subsequent decisions. Additionally, in dealing 

with the uncertainty of a continually changing environment, the decision maker must 

achieve a trade-off between the cost of action and the risk of non-action. 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

incentive system, and correct treatments were treated as benefits. The decision making 

strategy remained constant. False alarms and ”real‘ changes in system parameters 

represented sources of deterioration in the system. Time pressure in the study was related 

to the development of the situation itself, and the allocation of time had to be correlated 

to the risk of negative consequences and the cost of delaying further information 

requests. The results showed a general speeding up of information processing as time 

pressure increased. Under high levels of time pressure, this strategy led to a significant 

increase in system crashes. 

It is interesting to note that requests for information were not congruent with 

conditions œ subjects tended to wait until an already deteriorating situation had further 

deteriorated before acting. It can be assumed that, if information is expensive in time and 

actions are cheap, subjects will be more inclined to use an action-oriented strategy. To 

the contrary, subjects did not select the most efficient strategy œ they chose further 

information over action. Results indicated that selection of a decision strategy in dynamic 

tasks is less adaptive than is generally concluded from studies with static tasks. 

Kidd et al [19] linked stress and injury in another dynamic environment œ farming. In 

a three-step secondary analysis of focus group data, one of their conclusions stated: the 

dimensions of workload that were particularly important included job and task 

complexity and lack of time. Both of these dimensions are relevant to the emergency 

worker. Further, as a preventative measure, the researchers suggested that a decrease in 

the number of roles performed exclusively by a single farmer during busy seasons could 

improve safe work practices and contribute to successful task performance. 

2.6 Stress affects behaviour in emergencies 

There are limited studies regarding the effects of stress on behaviour in emergencies. 

Researchers working with the US mining industry have explored the issues of traumatic 

incident stress in mine disasters [20], burnout [21] stress levels related to training during 

a simulated escape through smoke [22], and behaviours in underground mine fires [15]. 

In the training study, small groups of miners were required to don self-contained 

self-rescuers (breathing apparatus), enter an area of an underground limestone mine that 

had been filled with non-toxic theatrical smoke, and travel approximately 270 metres to a 

door, through which they exited into fresh air. Individual subjects then provided a selfreport of their experiences on questionnaires administered immediately upon completion 

of their walk through smoke. The general finding was that miners who had more 

experience or training also tended to report less stress during the exercise. 

In the study of worker behaviours in underground mine fires, researchers examined 

eight cases in which groups of miners had escaped their workplaces through smoke. One 

goal was to determine whether it would be possible to model those factors that impact on 

one‘s ability to make good decisions during an emergency. The researchers suggested 

that any person engaged in decision making is actively involved in a process 

characterised by certain elements: 
 

 

 

 

 

 

 

 

 

 

 

 

3 consideration of available options 

4 choice of what is seen to be the best option given the perceived needs 

5 execution of the choice based on what has transpired. 

At any moment in this process, several factors significantly impact one‘s ability to solve 

complex problems in a limited time: 

1 psychomotor skills, knowledge and attitude 

2 information quality and completeness 

3 stress œ generated both by the problem at hand and any existing background problem 

4 the complexity of elements that must be attended to. 

The resulting model posited interactions amongst the major components, so that 

heightened stress, for instance, might interfere with an accurate diagnosis, whilst an 

accurate diagnosis would lead to lowered stress levels. 

2.7 Laboratory studies vs real-world experiences: 

Hammond [13] stated that he believes there is a substantial body of research on decision 

making under stressful circumstances. As noted above, we challenge Hammond‘s 

interpretation, but this disagreement is more likely to be a question of definition: what 

exactly constitutes a study of decision making under stress? Do the laboratory results of 

task performance under severe time constraint, for example with a loud noise, readily 

generalise to emergent conditions where the consequence of failure is that someone is 

injured or killed? The problem for experimenters is that it is dangerous and unethical to 

conduct experiments in truly hazardous or harmful circumstances. The problem for 

external validity is that minor stresses in the laboratory may be fundamentally different 

from life-threatening conditions in the real world. Thus, whilst we recognise that 

laboratory studies often represent the best approximation of stress that can be achieved, 

this research should continue with more comprehensive follow-up assessments of 

experiences of emergency crews in the field (e.g., [15]). 

3 Analytical vs. intuitive judgment under stress 

There is an assumption that the best decisions are rational œ based on logic and factual 

information. This assumption has implications for the discussion of judgment and 

decision making under stress. Researchers have tended to look at reason and emotion 

separately. A value has been placed on decisions made with reason: — . . . it is a careless œ 

but common œ usage to suggest that when we make bad decisions, they are based on 

emotion, but when we arrive at good decisions, they are based solely on reason“ [1, p. 

199]. Hammond posited that different situations demand different forms of cognitive 

activity, some calling for increased analytical cognition, and others calling for increased 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

describes the following: 

Case 1: The USS Samuel B. Roberts, operating in the Persian Gulf, struck a 

mine, caught fire, and began to sink. The Roberts‘ captain, Commander P.X. 

Rinn, drawing upon his training and experience, analysed the situation and 

determined a course of action directly opposed to Navy protocol. From his 

knowledge of how much water the ship could take on and still stay afloat, Rinn 

realised that the Roberts would sink before his crew could extinguish the fire. 

Commander Rinn made the decision to focus on keeping the ship afloat and 

give the fire second priority. He is on record as having arrived at his decision 

analytically, based on available information, training, and operational 

experience. 

Case 2: A United DC-10, on its way from Denver to Chicago, lost its hydraulic 

fluid and, hence, its controllability. Captain Al Hayes and his crew had to 

discover an alternative way to fly the plane by using the throttles œ something 

their training had not prepared them for œ and do it with few of the cues usually 

available to pilots. That they were able to land with minimal loss of life may be 

attributed to intuitive decision making under stress. 

The two cases cited by Hammond portray decision making in life-threatening 

circumstances under two distinct scenarios: one where the knowledge and training of the 

decision maker were readily applicable, and one where the decision makers‘ training had 

not prepared them for the exigency they faced. Yet, both instances involved individuals 

who were highly trained. In many dynamic settings, such as mining, those who are forced 

to make decisions in emergency situations have little training. This is because mines, 

fishing boats, and logging operations, amongst others, are dedicated to production 

activities rather than to emergencies. Thus, their personnel may have had minimal 

exposure to potential crises. Their decisions must, almost of necessity, be based on 

intuition or fragmentary knowledge. 

Considering this issue of analytical vs. intuitive judgment, a NIOSH [15] report 

observed: 

—The point here is that research which focuses on judgment must include 

scrutiny not only of decisions that are made, but also of real-world variables 

that influence them. The quality of any decision may have little or no direct 

relationship to the eventual outcome of its execution in a given situation. This 

is because a decision-maker is constrained not only by the stress of the situation 

or personal knowledge and attitudes, but also because he or she can only weigh 

information that is available.“ 

Acknowledging the complex context of decision making environments and their various 

sources of stress is a first step to understanding the process of decision making and 

learning to evaluate the abilities of decision makers. 

4 Conclusions and observations 

Growing research interest has led to the question of what factors influence a person‘s 

ability to make good decisions during an emergency. There is still little agreement on 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

understand judgment and decision making under stress. The fundamental assumption is 

that, whilst there are untold successes, there are also notable failures resulting from 

decisions that can be ascribed to one or more errors of judgment. What part, then, does 

stress play in the commission of these errors? This is a question for further inquiry. We 

accept that from a cognitive perspective, any person engaged in decision making 

(either alone or in a group) is actively involved in a process characterised by certain 

elements. At any moment in this process, there are factors that have a large impact upon 

one‘s ability to solve complex problems in a limited time. Stress is one of those factors. 

So what is the advice for the emergency manager based on the data? Unfortunately, 

the authors cannot offer a ”list‘ of factors to consider in judgment and decision making 

under stress. The present, limited data do not support such an approach. There are serious 

limitations to generalising from laboratory studies to real-life emergencies. We know that 

there is an interaction: stress affects human decision making. What we do not know is the 

exact nature of this interaction. 

The research suggests that successful teams communicate amongst themselves and, as 

the emergency intensifies, a flatter communication hierarchy develops with more 

(unsolicited) information coming from the field to the command centre. Command centre 

personnel can facilitate and encourage this type of information. 

Stress is affected by perception; it is the perceived experience of stress that an 

individual reacts to. However, extremely hazardous emergent environments will create 

some degree of stress reaction in every worker present. A common approach by 

emergency managers is to minimise stress for the responders through pre-event training. 

The key question is: what is the best form for this training to take? 

Contrary to popular opinion, judgment is not always compromised under stress. 

Although stress may narrow the focus of attention (the data are inconclusive), this is not 

necessarily a negative consequence in decision making. Some studies show that the 

individual adopts a simpler mode of information processing that may help in focusing on 

critical issues. Decisions can only be made based on the information available, and 

studies have shown that, on many occasions, decisions are made with incomplete 

information. In addition, the issue of training plays a part in stress and decision making. 

Regarding the development of decision support systems, the authors offer several 

suggestions. Decision support programs should be tested under conditions of stress 

(time pressure is one option) to evaluate their effectiveness. Simulations should be used 

to replicate stress conditions in the field. New simulations should include a stress 

component, taking into consideration the issues presented in this paper. A simulation 

should also take into account the increased need, as an emergency progresses, for explicit 

and implicit information to be received from the field and integrated into the decision 

making process. Because simulation exercises cannot replicate the hazardous nature of 

emergent events, the simulation studies need to be confirmed through observations of 

emergency personnel and through follow-up discussion. Investigations of actual events 

can begin along several dimensions: 
 

 

 

 

 

 

 

 

 

effectiveness of communications 

3 the resources for bringing the hazard under control, including the likely effectiveness 

of the control efforts 

4	 the timeframe in which decisions have to be implemented and efforts completed 

5 the severity of physical and emotional stressors present in the environment and the 

likely stress reactions that may develop. 

This paper has suggested that a better understanding of the interplay between stress and 

an individual‘s judgment and decision making activities would yield a better 

understanding of how people reach the choices they make in emergencies. As far as 

studies of judgment and decision making are concerned, the limited literature in this area 

suggests a strong need for increased attention to the topic. 

Stress is one of the key factors that underlie the demands on decision makers in most 

life-or-death situations. Whether the individual is a naval commander, an airline pilot, a 

mineworker, or an emergency manager who has access to a decision support system, an 

emergency makes it necessary to deal with an enormous number of variables in a rather 

short time frame. 

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