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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]

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]