ISSN 0439-755X
CN 11-1911/B

Acta Psychologica Sinica ›› 2022, Vol. 54 ›› Issue (8): 951-963.doi: 10.3724/SP.J.1041.2022.00951

• Reports of Empirical Studies • Previous Articles     Next Articles

The effect of aging stereotypes on the quality of medical decision-making and the mediating role of attribution bias

ZHANG Baoshan, JIN Dou, MA Mengjia, XU Ran   

  1. School of Psychology, Shaanxi Normal University, Xi’an 710062, China
  • Published:2022-08-25 Online:2022-06-23

Abstract:

The quality of decision-making in older people decreases with age. In medical decision-making, poor medical decisions in older adults can have a range of adverse effects. Therefore, exploring the influencing factors of the quality of medical decision-making is necessary. Aging stereotypes are closely related to the quality of decision-making. Negative aging stereotypes will have a negative impact on the decision-making of older adults. However, the relationship between aging stereotypes and the quality of medical decision-making has not been fully studied, and the mechanism between the two remains unclear.
As an important concept in social cognitive psychology, attribution bias is closely related to aging stereotypes and medical decision-making. When encountering behaviors or phenomena consistent with stereotypes, people are more inclined to attribute such behaviors internally to maintain the stereotypes. Furthermore, attribution bias is an important factor in decision-making, and the attribution bias of the older adults will have a significant impact on their subsequent treatment decisions. Nevertheless, the role of attribution bias in the relationship between aging stereotypes and medical decision-making in older adults remains unknown. Thus, this study attempts to clarify the relationship between aging stereotypes and medical decision-making and reveal the mediating role of attribution bias in the relationship between aging stereotypes and medical decision-making.
This study has two experiments. Experiment 1 attempted to explore the relationship between aging stereotypes, attribution bias, and quality of medical decision-making in older adults. Experiment 2 attempted to further verify the relationship between the three by training attribution bias. Seventy-eight older adults were recruited as participants in Experiment 1 (see Table 1 for participants’ information). All participants were randomly assigned to the stereotypes threat group or the control group (see Table 1 for the results of t-test and Chi-square test of background variables between the two groups). Attribution bias and the quality of medical decisions in both groups were then measured.
Eighty participants were recruited in Experiment 2 (see Table 2 for the detailed information). All participants were randomly assigned to the stereotypes threat group or the attribution bias intervention group (see Table 2 for the results of t-test and Chi-square test of background variables between the two groups). First, the aging stereotypes of all participants were activated. Participants in the stereotype threat group completed the same measurement as Experiment 1. Participants in the attribution bias intervention group completed attribution bias measurement and medical decision-making tasks after attribution bias training.
SPSS 25.0 was used for the statistical analysis of the data. Experiment 1 found that the aging stereotypes negatively predicted the quality of medical decisions and increased the internal attribution bias. The internal attribution bias in the stereotype threat group was significantly higher than that in the control group, and the quality of medical decision-making was substantially lower than that in the control group (see Table 1 for the means and t-test results). The study also found that internal attribution bias was mediating in the relationship between aging stereotypes and medical decision quality. The results of the mediation effect test showed that aging stereotypes positively predicted the internal attribution bias, b = 0.60, SE = 0.09, t = 6.57, p < 0.001, 95% CI = [0.419, 0.784], internal attribution bias negatively predicted medical decision quality, b = −0.25, SE = 0.10, t = −2.43, p = 0.018, 95% CI = [−0.457, −0.045], aging stereotypes negatively predicted the medical decision quality, b = −0.52, SE = 0.10, 95% CI = [−0.725, −0.313]. Internal attribution bias mediated the relationship between aging stereotypes and medical decision quality, indirect effect = −0.15, Boot SE = 0.07, 95% CI = [−0.302, −0.033].
Results of Experiment 2 show that the internal attribution bias of participants in the attribution bias intervention group was significantly lower than that in the stereotypes threat group, and the quality of medical decision-making was significantly higher than that in the stereotypes threat group (see Table 2 for the means and t-test results). That is, aging stereotypes negatively affected the quality of medical decisions, and internal attribution played a mediating role between the two. Furthermore, the control training of attribution bias can effectively alleviate the adverse effects of stereotypes in old age.
This study enriches the previous research on the influence of stereotypes on decision-making. It has certain practical value for alleviating the negative effect of stereotypes in older adults and improving the quality of individual medical decision-making.

Key words: negative stereotypes, attribution bias, quality of medical decision-making, older adults