The Role of the Representativeness Heuristic in Probability Judgments of Heart Attack and Coronary Heart Disease

Background: Diabetes continues to be a major health problem around the globe, and low treatment adherence continues to hinder clinical outcomes. Risk perception has been considered to guide the decision-making processes, and in recent years, the bounded rationality theory and cognitive heuristics have proved to be a useful lens to gain insight into informal and irrational reasoning. In particular, heuristics for the estimation of event frequencies and probabilities are considered to be relevant to the field of health behaviors. It is possible that the risk perceptions that determine patients' adherence could be generated by these heuristics. Aims: The purpose of this study is to analyze the role of the representativeness heuristic in risk perceptions related to heart attacks and coronary heart disease (CHD) in a sample of patients with type 2 diabetes (T2D). Method: Cross-sectional study with 342 patients attending a public hospital in an urban setting to treat their diabetes. Results: The heuristic was correlated through both its mechanisms with CHD and heart attack. Evidence suggests that the representativeness heuristic might play a role in probability judgments related to heart complications in patients with T2D. Limitations: Only CHD and heart attack were included in the study, and the heuristic could correlate with the risk perception of other complications as well as the perceived risks and benefits of the diabetes treatment. Conclusion: We call for researchers to further study these heuristics in the context of treatment adherence of T2D patients.