Factors Affecting Interpretation of Diagnostic Images as a Decision Process:
Authors: Kazmierczak Elzbieta T. 
Published: September 2021

This article presents an empirical investigation into interpreters’ decision-making criteria, personality characteristics, and emotion-laden experiences as factors affecting interpretation of images that were created for diagnostic assessment. Specifically, it seeks to examine (1) heuristic strategies as interpretive tools, which are both cognitive and experience-based, (2) the relationship between the decision criteria and accuracy of the judgments, and (3) the relationship between interpreters’ experiences of abuse as victims and the judgments about the meaning of images. The study used a sample of 196 self-representational drawings created by college students and 60 independent interpreters who were asked to identify drawings that were created by individuals who experienced interpersonal abuse.
This study identified six visual heuristics that were reported independently by 60 percent of the interpreters and were associated with marginally higher accuracy of the interpretive judgments. Thirty-eight percent of participants reported making judgments about the meaning of drawings based on direct or secondhand experiences with interpersonal abuse. The study found that the trauma of interpersonal abuse can profoundly bias interpretive judgments. This result has been particularly robust among female interpreters. Women who self-identified as survivors of abuse saw indicators of abuse up to 90 percent of the time, whereas male interpreters who have been abused saw indicators of abuse up to 65 percent of the time, whether or not those purported indicators were correct. Implications of the findings for design are discussed.
An overarching goal of this article is to address interpretation of images as a decision process. The study situated the factors affecting interpretation of images within the framework of the naturalistic/ ecological psychology (Brunswik, 1952, 1955) and the fast and frugal heuristic model of decision-making (Gigerenzer, 2007) vis-à-vis a model of conscious and nonconscious information processing. This study also recognized that certain personality characteristics and emotion-laden experiences can influence the quality of interpretive judgments. The frameworks, methods, and findings from psychology have been used with an intent to inform future research and practice of image construction and interpretation in visual studies and design.
One limitation of this study is that it relied on participants’ introspection and reflection on the decision process. There is a risk, then, that interpreters’ explanations of how they arrived with judgments were translations rather than representations of the decision process. Even though this study has not cracked the black box of meaning-making inside the mind, it offers an analytical framework for studies of visual interpretation as a decision process that combines cognitive, personality, and experiential factors as influencing the quality of interpretations. The article translates the findings of the study into practical guidelines for applications in visual communication design and human-centered design research and practice.