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Media allegations about malpractice in psychiatry are not uncommon, but little is known about their effects and how clinic management can effectively mitigate reputational damage. This study explored the impact of footage from a TV documentary raising allegations against a psychiatric clinic and assessed the effectiveness of different public response strategies from clinic management. N = 615 adults were randomized to one of four intervention groups watching allegations of malpractice in a psychiatric clinic or unrelated footage (control). Each intervention group further included one specific fictitious public response from clinic management: Denial, attack the accuser, apology, or decline to respond. The primary outcome was attitudes toward psychiatry, assessed before and after the intervention. Secondary outcomes (attitudes toward the staff of the clinic, intentions to recommend the clinic) were measured post-intervention. There was a decrease of favorable attitudes toward psychiatry across intervention groups (F = 14.46, p <.001, η p 2 =.102). Favorable attitudes toward the clinic staff (MD = 0.49, 95% CI = 0.02–0.96, p <.05) and intentions to recommend the clinic to a friend (MD = 0.42, 95% CI = 0.02–0.81, p <.05) were greater when accusations were denied as compared to no response. Media portrayals featuring allegations of psychiatric malpractice cause reputational damage not only to the specific clinic facing allegations, but also to the entire field. Public responses can partially mitigate the reputational damage and are preferable to no response. [ABSTRACT FROM AUTHOR]

The Netflix show 13 Reasons Why (2017) aroused widespread concern regarding potential contagious effects of its graphic depiction of an adolescent girl's suicide and the events that led to her death. To explore the effects of the second season of the show in 2018. We recruited a sample of young adults (ages 18–29; N = 729) with access to Netflix who completed surveys shortly before and one month after the release of the show's second season. Based on theories of narrative empathy, we hypothesized that those who discontinued watching the show would be most vulnerable to its adverse effects on suicide-relevant outcomes. We further identified a higher risk subset of viewers who were more likely to have stopped watching the first season (those currently enrolled in school) in order to observe if the show had more adverse effects on this audience. Finally, we examined effects of the show on all viewers' intentions to help a suicidal person as a prosocial consequence of viewing the entire second season. We used both covariance and "genetic" matching to control for selection effects. In support of predictions, viewers who stopped watching the second season exhibited greater suicide risk and less optimism about the future than those who continued to the end. However, unexpectedly, current students who watched the entire second season reported declines in suicide ideation and self-harm relative to those who did not watch the show at all (ps <.01). Moreover, those who watched the entire second season were also more likely to express interest in helping a suicidal person, especially compared to those who stopped watching. The results suggest that a fictional story with a focus on suicidal content can have both harmful and helpful effects. • Netflix's 13 Reasons Why sparked criticism globally. • Concerns were raised that the series might trigger self-harm and suicides. • We investigated the effects of watching Season 2 using a two-wave panel survey. • We found evidence for both harmful and helpful effects. [ABSTRACT FROM AUTHOR]

Background Although suicide experts recommend using neutral suicide referents in news media reporting, this recommendation has not yet been tested empirically. This recommendation, based on the empirically yet untested assumption that problematic suicide referents carry meaning that is inappropriate from a prevention perspective, may lead to a different perspective on suicide, termed “framing effects.” For example, in German-speaking countries, the neutral term Suizid (suicide) is recommended. Conversely, Freitod (“free death”) and Selbstmord (“self-murder”) convey associative meanings related to problematic concepts such as free will ( Freitod ) and crime/murder ( Selbstmord ), and are therefore not recommended. Method Using a web-based randomized controlled trial focused on German speakers ( N  = 451), we tested whether the news media's use of Suizid , Selbstmord , and Freitod elicits framing effects. Participants read identical news reports about suicide. Only the specific suicide referents varied depending on the experimental condition. Post-reading, participants wrote short summaries of the news reports, completed a word-fragment completion test and a questionnaire targeting suicide-related attitudes. Results We found that the news frame primed some frame-related concepts in the memory and also increased frame-related word choice. Importantly, we found that participants reading the free will-related Freitod frame showed greater attitudinal support for suicide among individuals suffering from incurable diseases. Conclusions This study highlights the importance of how the news media write about suicide and supports the language recommendations put forward by suicide experts. [ABSTRACT FROM AUTHOR]

Suicide has become an increasingly concerning problem among soldiers in recent years. Previous research has hypothesized that media-related social contagion effects, termed "Werther effects," may contribute to military suicide numbers. Unfortunately, there is limited empirical knowledge on such social contagion effects in soldiers. We contribute to the literature by investigating this phenomenon in the context of a specific historical suicide case, allowing us to provide a longitudinal assessment: Crown Prince Rudolf, heir to the Imperial throne of the Austro-Hungarian Empire, who died by suicide in January 1889. His death was a well-known news story that shook the monarchy to its foundations. Notably, soldiers of the late nineteenth century were an especially vulnerable portion of the population, proven by the fact that the Austro-Hungarian military had one of the highest suicide rates at the time compared to other European countries. An interrupted time-series analysis, relying on annual military suicide rates between 1873 and 1910, indicated a significant increase in the suicide rate the year of Rudolf's death, a pattern consistent with a social contagion effect. In fact, time series analysis estimated that there were about 30 excess suicides per 100,000 population within the year of Rudolf's death. Additionally, we identified a substantial change in the trend after Rudolf's death, pointing to a long-term decrease in military suicide rates. The latter was not observed in the general population but appeared to be unique to soldiers. Although we are very careful when interpreting causal effects with our historical data, we discuss the latter finding by questioning whether a change in military culture, that is, the establishment of better conditions for soldiers in the aftermath of Rudolf's suicide, contributed to decreasing suicide numbers. Although tentative, these findings are also highly relevant for the study of military suicide today. • Suicide has become an increasingly concerning problem among soldiers. • Social contagion effects may have contributed to these recent increases. • We investigated social contagion in the context of a historical suicide case. • Evidence indicates a social contagion effect and a long-term decrease in numbers. • A change in military culture may have contributed to the long-term decrease. [ABSTRACT FROM AUTHOR]

Voting is a central aspect of political participation. Although there seems to be a widespread agreement about the beneficial consequences of reading quality newspapers on turnout, there is a lack of causal evidence. We investigated whether the reading of quality newspapers can increase turnout. In order to develop a more comprehensive understanding, we also investigated whether efficacy, interest, knowledge, and distrust mediate newspapers’ impact on turnout. A panel study with two waves was utilized in the run-up to the 2014 EU parliamentary election. Analyses indicate that exposure to quality newspapers increased turnout and that efficacy and knowledge mediated this effect. [ABSTRACT FROM AUTHOR]

• Patients are increasingly turning to physician-rating websites and write reviews. • Negative reviews can elicit reputational damage for physicians. • A web-based experiment was used to test the effectiveness of response strategies. • Physicians can prevent reputational damage by using effective response strategies. • We provide evidence-based action recommendations for physicians. [ABSTRACT FROM AUTHOR]

The coronavirus disease (COVID-19) pandemic is an immense global health threat that has invoked unheard-of containment measures in numerous countries to reduce the number of new infections. The sequential introduction of severe measures, intentionally aiming at reducing the number of new infections, also imposes sharp restrictions on populations with potentially unintended, detrimental effects on public mental health. We used observational data reflecting the number of phone calls made to national crisis hotlines in Austria and Germany during the COVID-19 pandemic (January 2020–April 2020) to investigate the impact of government restrictions as well as their later revocations on public mental health. Importantly, both countries have comparable health care systems, are similar in their political and socio-economic idiosyncrasies, and took similar restrictive government measures in order to contain COVID-19—but implemented them at different points in time. Analysis indicated that the number of crisis hotline calls increased in both countries. This increase seemed to occur at around the same time as the implementation of restrictive governmental responses. Importantly, the revocation of these governmental restrictions (i.e., re-opening the economy, allowing more social contact) seemed to occur at around the same time as the decrease in the number of calls. The present study supports the notion that the implementation of severe measures affects public mental health. However, the negative mental health effects of COVID-19 may be reduced if severe governmental restrictions are kept in place as briefly as possible. • The coronavirus disease (COVID-19) pandemic is a severe global health threat. • Severe government responses may have negatively impacted public mental health. • We used the number of crisis hotline calls as an indicator for public mental health. • The number of calls increased at around the same time as government responses. • Revoking severe measures occurred at around the same time as the decrease in calls. [ABSTRACT FROM AUTHOR]

Rationale. Measles is a highly contagious disease that is responsible for about 110,000 annual deaths worldwide, even though a safe, effective, and inexpensive vaccine is available. Given that full vaccination coverage is below the desired threshold in many countries, increasing the vaccination coverage is an important public health goal, aiming to contribute to a reduction of measles deaths. Objective. This study investigates the dynamics between media and public attention on measles and vaccination coverage during the 2015 measles outbreak in Berlin, Germany. It was hypothesized that the epicentral distance would influence the observed effects of the outbreak on public attention due to a higher perceived threat susceptibility in more proximal states. Method. Using observational macro-level data from German federal states, the study taps into news-stimulated public-attention dynamics around the outbreak. We assessed public attention, media attention, and vaccination coverage among 24-month-old children. Results. Findings indicate that public attention increased exponentially as the epicentral distance lessened. Distance mattered more in states surrounding Berlin—a discovery we termed the "Rubicon effect." Importantly, within a small radius of the epicenter, the decay in public attention was slower, and higher rates of public attention were related to an increase in vaccination coverage among children aged 24 months. Conclusions. Given that full vaccination coverage for measles (after receiving the second dose) is below the desired value in Germany (and many other countries), the observed increase in vaccination coverage, in response to news-stimulated increases in public attention, can be deemed a beneficial public health outcome. The findings, including the Rubicon effect, are discussed in light of optimal resource allocation for vaccination programs. • A German measles outbreak stimulated media and public attention on the issue. • The increase in public attention was exponentially related to epicentral distance. • Proximal states showed higher public attention: the "Rubicon effect.". • Higher public attention in the epicenter predicted increased vaccination coverage. • Measuring public attention may improve resource allocation for vaccination programs. [ABSTRACT FROM AUTHOR]

Google can act as a "gatekeeper" for individuals who seek suicide-related information online (e.g., "how to kill oneself"). The search engine displays a "suicide-prevention result" (SPR) at the very top of some suicide-related search results. This SPR comes as an info box and contains supposedly helpful crisis help information such as references to a telephone counseling service. It remains unknown, however, how Google has implemented the SPR in the especially dangerous context of celebrity suicide for which imitational copycat suicides in vulnerable individuals are most likely. Relying on agent-based testing, a computational social science method, we emulated a total of 137,937 Google searches in April 2019, using both general suicide-related and specific celebrity suicide-related search terms. Given the recently discovered language-based differences in SPR display rates, we held the language constant and focused on German-speaking populations in four European countries. The SPR was never shown in searches for celebrities who died by suicide in all four countries. Furthermore, analyses indicated a digital divide in access to suicide-prevention information with moderately high SPR display rates in Germany and Switzerland, yet with no display in Austria and Belgium. Higher SPR display rates could support global suicide-prevention efforts at virtually no cost by providing preventive information to vulnerable users precisely at the moment when it is apparently needed. • Celebrities who die by suicide can elicit relatively strong copycat effects. • Internet search engines may play an increasingly important role for suicide prevention. • Google's suicide-prevention result (SPR) presents preventive information. • Yet Google never displayed SPRs in celebrity-suicide-related searches. • Higher SPR display rates may contribute to saving the lives of vulnerable users. [ABSTRACT FROM AUTHOR]

In 2018, Alden et al. showed that the desired degree of family involvement in medical decisions is an individual preference that is largely independent from East-West cultural stereotypes. At the same time, individual-level interdependence influenced whether patients preferred more individual or more family involvement in their decision making together with their medical care provider. The present study provides empirical evidence and adds evidence for Europe for which no such data previously existed. The present study is a direct replication and extension of the original Alden et al. (2018) study (N = 2031; Australia, China, Malaysia, India, South Korea, Thailand, United States [U.S.]), however, using survey data from four European countries (Austria, Belgium, Germany, Netherlands) and the United States (U.S.) with a total sample size of N = 2750. Random effects within-between models replicated the original primary finding that those with higher self-involvement in medical decision making preferred less family involvement. Furthermore, patients with lower self-independence, higher relational interdependence, and stronger beliefs in social hierarchy are more likely to want their families involved in medical decisions besides their health care provider. These observed relationships are largely consistent both within and across the four European countries and the U.S. In conclusion, the results point to the importance of avoiding cultural stereotypes and instead, recognizing that patient desires for family involvement in medical decision making vary dramatically within cultures depending on multiple individual differences. Furthermore, a growing body of evidence suggests that these antecedents of family involvement as well as the construct itself may be measurable in diverse cultures with high levels of confidence in their reliability and validity. • Family involvement in shared medical decision making can help improving health outcomes. • Cultural influences have been identified in Asia-Pacific region but not in Europe. • Direct replication of Alden et al. (2017) in four Central European countries and the USA. • Higher self-independence and stronger desire for self-involvement decrease family involvement. • Higher relational interdependence and stronger beliefs in social hierarchy increase family involvement. [ABSTRACT FROM AUTHOR]