Risk Assessment: The Consumer as an Intuitive Statistician - Innovation and Marketing in the Pharmaceutical Industry - page 293

of depression and tattoo piercings in the context of Hepatitis-C), on the
other hand, require less interpretation prior to being identified. This implies that
communication aimed at de-biasing risk estimates based on behaviors needs to
increase their accessibility, whereas communication aimed at de-biasing risk
estimates based on symptoms needs to first disambiguate them, that is, define
what the symptom is in terms of specific, concrete examples.
(b) Frequency of occurrence : If a symptom is expected to occur only some of the
time (e.g., an infrequent behavior), rather than all of the time (such as a state or
feeling or a very frequent behavior), then it is a stronger signal. This is because
the symptom's occurrence in the individual is unexpected, and, therefore, it is
more likely to be recalled, that is, accessible.
Behaviors that occur frequently in a population also have lower signal value
than those that are rarer and less normal. Consumers may also simply be
unaware of the symptoms associated with a disease (Feinberg 2012 ). The fre-
quency with which a behavior or symptom occurs affects both the accessibility
of the signal and the diagnosticity of the signal. This is because the greater the
frequency of any behavior, the higher its accessibility (Higgins 1989 ), but the
lower its diagnosticity as per signal detection theory. If the behavior or symp-
tom has low frequency then its accessibility needs to be increased if it is likely
to be identified, but once it is identified it is likely to be incorporated into a risk
estimate due to its higher perceived diagnosticity. On the other hand, if the
behavior or symptom has high frequency, then its diagnosticity for a disease
needs to be established for it to be appropriately incorporated into a risk
assessment.
There are multiple ways of increasing the accessibility of a (low frequency)
behavior or a symptom. Merely asking people to recall a behavior associated
with a disease can serve the purpose, although as the number of behaviors peo-
ple are asked to recall becomes more difficult, this can backfire and lower risk
perceptions as the lack of accessibility is used as information in and of itself
(Raghubir and Menon 1998 in the context of AIDS). Providing a list of symp-
toms can also increase the accessibility of the symptoms in a context-based (vs.
memory-based) task, as the list improves the overall awareness of the symp-
toms associated with a disease (Raghubir and Menon 2005 in the context of
depression), though if the set of behaviors included are performed with a lower
frequency and are unusual, then this too may backfire (Menon et al. 2002 in the
context of Hepatitis-C).
Increasing the perceived diagnosticity of high frequency behaviors or symp-
toms, on the other hand, may require different tactics. A simple solution is to
manipulate the availability of alternate inputs that are available to make the risk
judgment. For example, Raghubir and Menon ( 2005 ) showed that depression
symptoms of “loss of interest or pleasure in activities normally enjoyed” or
“feeling unusually sad or irritable over a 2-week period” that are more diagnostic
of depression as per DSM-IV guidelines than the less frequent symptom of
“thoughts of suicide and death” were more likely to be used to construct a risk esti-
mate when the depression inventory did not include the infrequent symptom.