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Politicians often rely on in-group markers of identity, aiming to signal their ideology to specific segments of the electorate. The impact of this practice on the electorate is insufficiently understood. In particular, we know markedly little about the effects of visual cues, a domain of utmost importance on social media. With previous research indicating that some politicians use more visual cues as identity markers than others, we set out to assess whether the effects of visual cues vary based on how much a politician uses them. We used an experiment conducted in Germany (N = 655) to test whether the use of visual cues by a fictitious politician impacted citizens’ attitudes and voting intentions, depending on the interplay between strength of use (i.e. how many liberal or conservative cues a politician uses) and citizens’ political ideology. A balanced sample of participants—one-third each self-categorized as liberal, moderate, or conservative—was randomly allocated to one of 13 conditions denoting various strengths of use, ranging from very liberal to very conservative. Analyses indicated substantial effects of strength of use on attitudes and voting intentions, yet only for liberal participants. Only liberals used the information provided by visual cues when evaluating the politician. [ABSTRACT FROM AUTHOR]

There has been a debate about the suitability of different narratives in educative suicide prevention materials. Whereas some suicide prevention experts recommend raising awareness of suicide by highlighting its prevalence, others argue that this approach may normalize suicide and advocate focusing on help resources instead. Unfortunately, empirical evidence regarding this question is lacking. This randomized controlled trial aimed to test the impact of educative news articles that conveyed different narratives of suicide prevention. One article focused on the prevalence of suicide, one article highlighted professional help resources, and one article emphasized on how everyone can help to prevent suicide. We randomized n = 334 participants to read either one of these three articles or an article unrelated to suicide. Data on suicidal ideation, stigmatizing attitudes toward suicidal individuals, attitudes toward suicide prevention, and help-seeking intentions were collected with questionnaires, and implicit measures were used to assess participants' mental accessibility of concepts related to suicide and suicide prevention. Participants exposed to the article highlighting the high prevalence of suicide tended to show a higher accessibility of potentially detrimental cognitive concepts related to suicide. In contrast, the accessibility of the concept of "helping" and that "suicide is preventable" was higher in participants' memory when exposed to materials focusing on help. It seems that the impact of educative suicide awareness materials on readers' access to suicide- and suicide-prevention-related concepts in memory varied depending on the narrative featured in the article. [ABSTRACT FROM AUTHOR]

The media are assumed to play a key role in democratization. Much of the available evidence on the media's role in democratic transitions is based on a comparative and global perspective, focusing on rather recent key political events. Although democratization is conceptualized as a process that occurs over a long time, there is limited longitudinal evidence. Focusing on Austria, we used a long-term macrolevel perspective ranging from 1816 to 1932, including the transition from authoritarian rule (monarchy) to democracy (republic). Grounded in previous research on the demonstration effect, we investigated whether the press contributed to democratization processes. Contentanalytic data on the Vienna-based press were used to assess the salience of the idea of democracy in the press for each year of the observation period: How much did the press report on democratic ideals, such as freedom or equality? The level of democratization was assessed using three available longitudinal measures of democratization. Using autoregressive integrated moving average (ARIMA) modeling to account for autocorrelation and the trend in the time series, we show that there was a covariation between increases in the salience of the idea of democracy in the press and increases in the level of democratization. Furthermore, we found that a higher salience of the idea of democracy in the press in a given year "Granger-caused" (i.e. prospectively predicted) future increases in the level of democratization. Although we acknowledge the limitations in terms of causal interpretations, these findings are consistent with the idea of a longterm macro-level media effect. [ABSTRACT FROM AUTHOR]

Background: Media guidelines for reporting on suicide recommend that journalists should avoid monocausal explanations of suicide, but it is unclear if media items with monocausal explanations elicit different effects as compared to multicausal portrayals. Method: Using a web‐based randomized controlled trial (n = 969), we tested five versions of a news article about the suicide of a teenage girl with varying portrayals of reasons for the suicide: (1) bullying as the sole (external) factor (i.e., monocausal), (2) several external social factors, (3) a combination of internal and external factors, (4) a combination of internal and external factors along with a focus on suicide prevention, or (5) no reason for the suicide (control group). We measured perceptions about the cause of suicide, attitudes toward suicide and suicide prevention, and identification with the suicidal protagonist with questionnaires. Results: Readers of articles that portrayed suicide as being caused by one specific reason or exclusively social factors tended to adopt these misconceptions. Identification with the suicidal protagonist did not vary between interventions groups, but was lower in the control group. Conclusion: Highlighting the multifactorial etiology of suicide in news articles may help to avoid the misconception that suicide is a monocausal issue. [ABSTRACT FROM AUTHOR]

This study focuses on the changes in the global digital divide produced by language-based, algorithmic information disparities in relation to crisis-prevention resources for suicide available through the Google search engine. We used agent-based testing to emulate Google searches performed in 17 countries and in 16 different languages as a direct replication and extension of previous work. We compare data collected in 2017 with data collected in 2021. Our analyses revealed that Google searches in English from within the United States still have the highest likelihood of triggering the display of additional crisis-prevention information prominently shown in addition to the regular search results (i.e., Google's suicide-prevention result). Searches in Spanish from within the United States are informationally disadvantaged. Display rates are only slightly lower in other English-speaking countries and when searches are performed in English. While information disparities and digital divides narrowed between 2017 and 2021, substantial differences in the display of crisis-prevention resources remain observable within multilingual countries, especially when other languages compete with English. In Bahrain, South Africa, and Sweden, the crisis-prevention information functionality seems unimplemented. Our findings suggest that the use of automated computational methods is both useful to continuously observe the implementation of new algorithmic functionalities and necessary to hold global media institutions accountable for their actions. [ABSTRACT FROM AUTHOR]

Recent theorizing on deliberative democracy has put political listening at the core of meaningful democratic deliberation. In the present experiment (N  =   827), we investigated whether news media can improve diverse political listening in the United States via a reduction in party cue salience. Although Republican (Democratic) participants showed a strong preference for listening to speeches given by Republican (Democratic) politicians when party cues were highly salient, this bias in selective political listening was reduced or even absent when news items provided no or only low-salience cues. Conditional process analysis indicated that (automatically activated) implicit and (overtly expressed) explicit party attitudes mediated this effect. There are important implications: Current journalism practices tend to exacerbate tribal us-vs-them thinking by emphasizing partisan cues, nudging citizens toward not listening to political ideas from the other political camp. A more helpful news-choice architecture tones down partisan language, nudging citizens toward more diverse political listening. [ABSTRACT FROM AUTHOR]

The media portray various social groups stereotypically, and studying the effects of these portrayals on prejudice is paramount. Yet, audience selectivity—inherent within today's high-choice media environments—has largely been disregarded. Relatedly, the predominance of forced-exposure designs is a source of concern. This article proposes the integration of audience selectivity into media stereotype effects research. Study 1 (N  =   1,166) indicated that prejudiced individuals tended to approach prejudice-consistent stereotypical news and avoid prejudice-challenging counter-stereotypical news. Using a forced-exposure experiment, study 2 (N  =   380) showed detrimental effects of prejudice-consistent news and beneficial effects of prejudice-challenging news. Relying on a self-selected exposure paradigm, study 3 (N  =   1,149) provided evidence for preference-based reinforcement. Study 4's "net-effect perspective" (N  =   937) indicated that operationalizing exposure as forced or self-selected can lead to different interpretations of actual societal effects. The findings emphasize the key role played by audience selectivity when studying media effects. [ABSTRACT FROM AUTHOR]

During the nineteenth century, suicide rates rose substantially in many countries, including the geographic region of the present state of Austria. Sensational news reporting about suicides may have contributed to this rise by eliciting so-called copycat suicides, a phenomenon termed the 'Werther effect.' We conducted a large-scale content analysis of nineteenth-century suicide reporting (N = 14,638) to provide a descriptive account of the quality of suicide reporting back then. We found that much of the sensational reporting of the nineteenth century was characterized by presenting vivid details on the suicide method, specific location, and personal details, such as the deceased's name, occupation, and exact address. To put these findings into context, we compared them to twenty-first-century suicide reporting (N = 300 articles). We found that the quality of reporting has improved since then, containing less Werther-effect-facilitative elements, however, the reports still fail to adhere to modern-day guidelines of responsible reporting. [ABSTRACT FROM AUTHOR]

COVID-19 is a news issue that can be covered from many different angles. When reporting, journalists have to select, accentuate, or exclude particular aspects, which, in turn, may evoke a specific, and possibly constricted, perspective in viewers, a phenomenon termed the news-framing effect. Guided by the reinforcing spiral framework, we conducted a multi-study project that investigated the news-framing effect's underlying mechanism by studying the dynamic of self-reinforcing effects. Grounded in a real-life framing environment observed during the pandemic and systematically assessed via a content analysis (study 1) and survey (study 2), we offer supporting evidence for a preference-based reinforcement model by utilizing a combination of the selective exposure (i.e., self-selected exposure) and causal effects (i.e., forced exposure) paradigms within one randomized controlled study (study 3). Self-selection of news content by viewers was a necessary precondition for frame-consistent (reinforcement) effects. Forced exposure did not elicit causal effects in a frame-consistent direction. [ABSTRACT FROM AUTHOR]

Crown Prince Rudolf, heir to the Imperial throne of the Austro-Hungarian Empire, died by suicide in 1889. His death is a prime example of a historical celebrity suicide. Although news coverage about celebrity suicide has been shown to be linked to increases in suicides – a phenomenon known as the Werther effect –, censorship and/or journalists' anticipatory obedience back then may have led to a form of "forced responsible reporting" that may have prevented a Werther effect. A content analysis was conducted, and civil death registers were used to identify suicides before and after Rudolf's suicide. We compared Rudolf's case with another historical celebrity suicide case (Colonel Redl) for which there is already empirical evidence consistent with a Werther effect. As expected, the press heavily reported on Rudolf's death, but did not give undue prominence to suicide and rarely gave details on the method. Importantly, there was no evidence of an increase in suicides. This is in stark contrast to the Redl case in which the press reported irresponsibly. The Rudolf case emphasizes the importance of current media guidelines on responsible reporting. Thus, a high amount of news coverage does not necessarily translate into a Werther effect. [ABSTRACT FROM AUTHOR]

Despite much theorizing on the quality of journalism, there is limited actual empirical evidence for the effects of improved news quality on societal outcomes. This study provides such evidence for suicide reporting. News quality especially matters in this domain, as low-quality reporting can elicit "copycat" suicides (Werther effect). We developed and disseminated a web-based campaign promoting high-quality suicide reporting, targeting newsrooms in Germany. Twenty-two newsrooms participated. A content analysis (N  =   4,015 articles) provided supporting evidence for an increase in high-quality reporting (Study 1). Interrupted time series analyses offered tentative evidence for a reduction in actual suicides (Study 2). Acknowledging limitations in terms of causal interpretations, the findings support the claim that high-quality news can save lives. Similar newsroom interventions run elsewhere may contribute to preventing suicides globally. We discuss the implications, including those of a theoretically meaningful discovery related to the suicide-protective effect's underlying mechanism, termed the dampening-the-spikes hypothesis. [ABSTRACT FROM AUTHOR]

The coronavirus disease (COVID-19) pandemic is a serious threat to public health and the economy. Importantly, there was a stock price crash on Monday, March 9, 2020, followed by a similar crash one week later. Leading global indices substantially dropped. Based on previous research indicating that the news media may elicit effects on stock prices, we hypothesized that the amount of news coverage about COVID-19 within a given country would predict the size of the stock price drop in that country. Using data for N = 58 nations from five continents, we observed average stock price drops of 6.57% (week 1) and 6.43% (week 2). Using a cross-national correlational approach, we found a positive relationship between the amount of news coverage about COVID-19 and the extent of the stock price drop. Actual severity within a given country (indicated by the number of confirmed cases and deaths, based on data provided by the World Health Organization) and public attention (indicated by COVID-19-related Internet search engine volume) did not predict the extent of the stock price drop in multivariate analyses. Correlational evidence is consistent with the idea that intensive media reporting on a threatening pandemic with uncertain negative consequences on health, social life, and the economy may provoke substantial reactions in the market, with as yet unknown indirect effects on public health. However, the causal order of media attention and stock price drops should be assessed with caution. [ABSTRACT FROM AUTHOR]

Opioid abuse is a severe public health threat. Recent evidence points to a disturbing increase in the illicit use of fentanyl, a potent synthetic opioid, with abuse often involving illicitly produced opioids mixed with heroin. Public health experts have emphasized that there is an urgent need for new, effective harm-reduction strategies and technologies. We asked whether Internet search engines could contribute toward this goal. Using state-level data from the USA, we provide evidence for a cross-sectional and longitudinal statistical relationship between opioid-related overdose deaths and the number of Google searches using the term "fentanyl." This finding points to the relevance of Internet search engines: Users – who may be non-addicted vulnerable individuals, addicts, addicts' friends and family members, or physicians – do in fact search for fentanyl online. We argue that during such searches, an info box including a warning (i.e., awareness material to educate users about the risks) and a help message (i.e., references to professional help) can be presented to target users and possibly prevent both unintentional and suicidal overdoses. Even if this info box only helps some users, the high number of daily Google searches renders this a promising public health intervention to supplement other opioid harm-reduction strategies. [ABSTRACT FROM AUTHOR]

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 press may have contributed to suicide as a mass phenomenon during the nineteenth century. There is limited knowledge on how the press reported on suicide. We utilized a content analysis of suicide news during the time period of suicide rate's strong increase in Austria (1855, 1865, 1875, 1885), assessing variables related to the responsible reporting on suicide (RRS). Analyses indicate that the press showed low levels of RRS and the quantity of low-quality reporting increased during the observation period. Although causal claims should be made with caution, the findings are consistent with the idea of a long-term Werther effect. [ABSTRACT FROM AUTHOR]

Politicians' reticence to communicate their views clearly increases the information asymmetry between them and the electorate. This study tested the potential of subtle ideological cues to redress the balance. By spotlighting visual rather than the already much-examined verbal cues, we sought to contribute to building theory on cue effects. Specifically, we aimed to determine whether the effects from the literature on verbal cues could also be shown for visual ones. We used an experiment (N = 361) to test the effects of subtle backdrop cues (SBCs), that is, of visual cues to ideology embedded in the background of political images. We manipulated photos of a fictitious politician to include liberal or conservative SBCs. We embedded these images in Twitter posts and tested whether they influenced perceptions of the politician's ideology and the intention to vote for him. We analyzed the relationship between exposure to SBCs, the politician's perceived political ideology, and voting intention—including the study of conditional effects elicited by cue awareness and ideological consistency between the depicted politician and participant. The conditional process analysis suggested that SBCs mattered, as they influenced citizens' perceptions of a politician's political ideology, and consequently, voting intention. These effects were moderated by cue awareness and ideological consistency. We concluded that SBCs can elicit substantial effects and that their use by politicians is paying off. [ABSTRACT FROM AUTHOR]

Self-injurious behavior is often practiced in secrecy or involves body parts that are easy to hide, making early detection difficult and hampering intervention and treatment. However, cutting, one of the most common intentional forms of nonsuicidal self-injury (NSSI), is relatively often shared publicly via new digital media technologies. We explored NSSI on Instagram through a pioneering combination of two computational methods: First, we developed an automatic image-recognition algorithm that uncovered NSSI (or the absence of NSSI) in digital pictures, and second, we employed web-scraping techniques to obtain all pictures posted on Instagram in a given time frame under four NSSI-related hashtags in English and German. The image-recognition algorithm was then used to explore the relative prevalence of NSSI in these N = 13,132 pictures posted within 48 hr on Instagram under #cutting (n = 4,219), #suicide (n = 7,910), #selbstmord (n = 173), and #ritzen (n = 830) in June 2018. This article not only aims to raise awareness of NSSI on Instagram but also introduces the first automatic image-recognition algorithm that addresses cutting on social media and presents that algorithm's first empirical test run on a large sample of pictures scraped from Instagram. The ultimate goal of this research is to protect vulnerable populations from contact with NSSI-related pictures posted on social media. [ABSTRACT FROM AUTHOR]

During the 19th century, suicide rates increased in many countries. The press may have contributed to this increase, even though empirical evidence is lacking in this regard. We assessed suicide statistics within five territories of the Austro-Hungarian Empire between 1871 and 1910 and combined these data with a content analysis of suicide reporting in five newspapers, each appearing in one of the five territories. The analysis revealed a covariation between the quantity of reporting and the number of suicides within all five regions. Furthermore, the quantity of reporting significantly predicted the following year's suicides. Although the causal order of suicides and the quantity of reporting should be assessed with caution, evidence is consistent with the idea that the press may have contributed to the establishment of suicide as a mass phenomenon. The findings also support contemporary guidelines for journalists, especially the notion of avoiding undue repetition of suicide stories. [ABSTRACT FROM AUTHOR]

Responsible reporting on suicide (RRS) is a cornerstone of suicide prevention. Scholars have developed media guidelines facilitating RRS, but there are barriers to accepting and implementing these suggestions, alongside obstacles for journalists' comprehensive adherence to them. For example, journalists could perceive media guidelines as a threat to their autonomy or to the freedom of the press. However, there is scant evidence on how journalists actually evaluate RRS media guidelines, leaving it unclear as to how journalists perceive them and how willing they are to adhere to them. The present study addresses this research gap and explores potential barriers to guideline adherence using 30 qualitative, semi-structured interviews with journalists in Germany. Journalists expected that their freedom of speech would remain untouched, which mostly referred to the non-restrictive tone of the guidelines, to persuasive, evidence-based explanations, and to clear reporting examples. Practical implications for increasing journalists' adherence to media guidelines are discussed. [ABSTRACT FROM AUTHOR]

Search engines are increasingly used by citizens to seek out political information. Both the high frequency of use and the high credibility attributed to them by their users emphasize the need for research on search engines' role in the democratic process. The present paper reports on a case study on online information seeking (OIS) via search engines during the 2016 US presidential election. Presidential candidate Donald Trump was largely unknown as a politician, was opposed by the vast majority in elite circles, broke the standard niceties of politics, and practiced a style of politics based on riot and conflict. Based on these attention-gaining maneuvers, we predicted that citizens would show an OIS bias toward Trump (compared to Hillary Clinton). Importantly, we hypothesized that key events broadly categorizable as gaffes, scandal, or gossip influenced OIS bias due to a general negativity bias. We used a retrospective database study relying on query share data from the search engine Google to test these assumptions. Consistent with our predictions, we found that there was a substantial OIS bias toward Trump and that negatively-valenced key events influenced the size of the OIS bias meaningfully. Of interest, additional analyses revealed a correlation between OIS bias and election outcome: The higher the OIS bias toward Trump, the less citizens voted for Trump. We offer post hoc theorizing on this explorative finding. [ABSTRACT FROM AUTHOR]

Suicide is a leading cause of death among youth, and media depictions of suicidal behavior can be a contributing risk factor. Of interest, Instagram recently received more scholarly attention due to its large number of publicly available, explicit, and graphic depictions of self-harm. Importantly, researchers have hypothesized that exposure to this content could be a risk for self-harm and suicide in vulnerable audiences. We tested this hypothesis using a two-wave US panel survey among young adults (N = 729). Analyses indicated that exposure to self-harm on Instagram was associated with suicidal ideation, self-harm, and emotional disturbance even controlling for exposure to other sources with similar content. As hypothesized, exposure to self-harm on Instagram at the first wave prospectively predicted self-harm and suicidality-related outcomes at the second wave 1 month later. These findings provide evidence that such exposure can lead to contagion in vulnerable users. Implications are discussed. [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]

Media consumers often lack the motivation, time, or cognitive capacity to select content in a deliberate way; instead, they opt for mental shortcuts. Brands are important in this regard because they simplify decision making. In the present study we investigated whether attitudes toward news media brands predict news choice. It is important that we conceptualized attitudes on two different levels: Although explicit attitudes are defined as overtly expressed, more or less deliberate evaluations, implicit attitudes are defined as automatically activated, gut-level evaluations. The supplementary use of implicit attitudes is consistent with current theorizing highlighting that deeply held and sometimes even unconscious evaluations influence media choice. Using a web-based study, we found that implicit and explicit attitudes toward television brands predicted choice. Each attitude construct predicted variance beyond that predicted by the other. We discuss implications by emphasizing the role of automatic, gut-level decision making in current high-choice media environments. [ABSTRACT FROM AUTHOR]

The present study investigated the chronology of media attention, public attention, and actual vaccinations during a recent measles outbreak in Austria. The analysis indicated that initial news coverage about the measles outbreak (the first wave of media attention) sparked public attention and led to additional heavy news coverage about measles (the second wave of media attention). The observed patterns of public and media attention reflect typical issue-attention cycles, as revealed by previous research. As a supplement to previous studies, the present study links media and public attention with a consecutive increase in the number of vaccinations, thereby supporting the notion of an issue-attention-action cycle. Additional curve-fitting analyses showed that the day-by-day variations in media and public attention resembled sharp, short-term "spotlight effects," whereas consequences on vaccination behavior represented a broader, long-term "echo effect." Above and beyond the theoretical contributions, we discuss practical implications: Surveilling the development of media and public attention in the immediate aftermath of a measles outbreak may be a cost-effective strategy to predict future patient load, thereby helping to effectively allocate resources for vaccination programs. A thorough understanding of the issue-attention-action cycle contributes to this aim. [ABSTRACT FROM AUTHOR]

Recent campaigns try to reduce social stigma associated with persons living with HIV. For example, a German campaign raised awareness that infection is unlikely in low-risk day-to-day interactions. Research has yet to show that there are no harmful side effects. This is essential because such messages promote a less threatening picture of HIV and thus may unintentionally increase complacency. We tested the possible side effects on the willingness to have sex without condoms. An experiment was conducted in which participants were exposed to anti-stigma messages or not. Anti-stigma messages did not elicit an increase in the willingness to have sex without condoms. [ABSTRACT FROM AUTHOR]

Minority group members tend to have more negative health outcomes compared to majority group members. As reducing health inequalities is a global imperative, research testing strategies to improve minority patient health outcomes are important. Evidence exists that ethnic concordance in patient-physician communication is statistically associated with positive outcomes for minority patients. Previous research has exclusively relied on non-experimental observational methods. The present study adds to this literature by presenting supplementary experimental evidence, thus increasing confidence in the causal interpretation of the relationships observed in previous studies. Individuals with Turkish migration backgrounds living in Germany (N = 256) were randomly assigned to a hypothetical medical consultation in which a physician, Dr. Thomas Kirsch ("German majority physician"; ethnic-discordance condition) or Dr. Çağdaş Kılıç ("Turkish minority physician"; ethnic-concordance condition) talked about lifestyle factors associated with chronic non-communicable diseases (tobacco smoking, an unhealthy diet, and physical inactivity). The analysis indicates that ethnic concordance improved belief in the physician, reduced reactance-related outcomes, and improved prevention-related knowledge transfer. Notably, the effect of ethnic concordance on knowledge was especially pronounced in low health-literacy participants. We discuss the implications related to the ongoing calls for a more diverse physician workforce. [ABSTRACT FROM AUTHOR]

The volume of Google searches for suicide-related terms is positively associated with suicide rates, but previous studies used data from specific, restricted geographical contexts, thus, limiting the generalizability of this finding. We investigated the correlation between suicide-related search volume and suicide rates of 50 nations from five continents. We found a positive correlation between suicide rates and search volume, even after controlling for the level of industrialization. Results give credence to the global existence of a correlation. However, the reason why suicide-related search volume is higher in countries with higher suicide rates is still unclear and up to future research. [ABSTRACT FROM AUTHOR]

Health messages can emphasize the benefits of engaging in healthy behavior (gain-framed) or the costs of failing to engage in it (loss-framed). Previous research revealed that gain-framed messages tend to be more effective in motivating smokers to quit. As a supplement to previous studies, we questioned whether the ability to process health messages moderates the size of the gain-frame advantage. There were two competing theoretical ideas. First, some scholars have noted that a high ability to process a health message is a necessary precondition to observe the advantage of gain-framing. Second, risk aversion-a central concept used in previous theorizing to explain the gain-frame advantage-is associated with automatic processing and automatic processing has a stronger influence on decision making under a low ability to process. We utilized a 2 (exposure to gain- or loss-framed quit messages) × 2 (low or high ability to process) randomized controlled trial with a pre-post exposure change in quit intentions as the target outcome (N = 182 smokers). Although the analysis revealed the hypothesized gain-frame advantage, the ability to process did not moderate the effect. We discuss the theoretical implications. [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]

This study investigated how Muslims perceive negative news coverage of Islam and how these perceptions possibly contribute to radicalization processes. Utilizing qualitative interviews with former Islamists, Study 1 indicated that radicalized Muslims perceive a governmental infiltration of the media resulting in negative content. Analyses indicate that perceptual phenomena (hostile media, third person), negation, and anger play an important role in radicalization processes. We built on these findings in Study 2, utilizing a laboratory experiment in which Muslims were exposed to negative news content. Indeed, Muslims engaged in negation, perceived news as hostile, and perceived strong effects on non-Muslim Germans. These effects were stronger among Muslims with religious fundamentalist beliefs. Interestingly, negative news elicited anger, independent of such fundamentalist beliefs. [ABSTRACT FROM AUTHOR]

Search engines are increasingly used to seek suicide-related information online, which can serve both harmful and helpful purposes. Google acknowledges this fact and presents a suicide-prevention result for particular search terms. Unfortunately, the result is only presented to a limited number of visitors. Hence, Google is missing the opportunity to provide help to vulnerable people. We propose a two-step approach to a tailored optimization: First, research will identify the risk factors. Second, search engines will reweight algorithms according to the risk factors. In this study, we show that the query share of the search term "poisoning" on Google shows substantial peaks corresponding to peaks in actual suicidal behavior. Accordingly, thresholds for showing the suicide-prevention result should be set to the lowest levels during the spring, on Sundays and Mondays, on New Year's Day, and on Saturdays following Thanksgiving. Search engines can help to save lives globally by utilizing a more tailored approach to suicide prevention. [ABSTRACT FROM AUTHOR]

Suicide is a global public health problem. Media impact on suicide is well confirmed and there are several recommendations on how media should and should not report on suicide to minimize the risk of copycat behavior. Those media guidelines have been developed to improve responsible reporting on suicide (RRS). Although such guidelines are used in several countries, we lack empirical evidence on their causal effect on actual journalistic news writing. We conducted an experiment with journalism students (N = 78) in Germany in which we tested whether exposure to awareness material promoting RRS influences news writing. As a supplement to the widely used text-based material, we tested the impact of a video in which a suicide expert presents the guidelines. A video was used as a supplement to text partly due to its potential benefit for prevention efforts over the Internet. We chose a low-budget production process allowing easy reproduction in different countries by local suicide experts. In the experiment, participants were either exposed to written, audio-visual, or no awareness material. Afterwards, participants read numerous facts of an ostensible suicide event and were asked to write a factual suicide news story based on these facts. Analyses indicate that awareness material exposure helped to improve RRS with the awareness video showing the strongest effects. We recommend that suicide prevention should use instructive awareness videos about RRS complementary to text-based awareness material. [ABSTRACT FROM AUTHOR]

Tests were performed to learn whether exposure to news about crimes committed by dark-skinned criminals increases impulsive facial-threat perceptions of meeting dark-skinned strangers in a subsequent situation (media-priming hypothesis), but only when the facial displays are ambiguous (ambiguity hypothesis). The assumption is that news stereotypes prime the “dark-skinned criminal” stereotype, which, in turn, influences subsequent face processing. An experiment with two groups was used to test this prediction. Participants allocated to the treatment group (n = 53) read about crimes committed by dark-skinned criminals. In contrast, for the control group (n = 52), cues indicating skin color were not mentioned at all. As predicted, the treatment increased the perceived facial threat of dark-skinned strangers, but only when the facial displays were ambiguous. Given the importance of the face in social interaction, I discuss important, real-world implications for recipients as well as for journalists and media organizations. [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]

Despite evidence that suicide rates can increase after suicides are widely reported in the media, appropriate depictions of suicide in the media can help people to overcome suicidal crises and can thus elicit preventive effects. We argue on the level of individual media users that a similar ambivalence can be postulated for search results on online suicide-related search queries. Importantly, the filter bubble hypothesis (Pariser, 2011) states that search results are biased by algorithms based on a person’s previous search behavior. In this study, we investigated whether suicide-related search queries, including either potentially suicide-preventive or -facilitative terms, influence subsequent search results. This might thus protect or harm suicidal Internet users. We utilized a 3 (search history: suicide-related harmful, suicide-related helpful, and suicide-unrelated) × 2 (reactive: clicking the top-most result link and no clicking) experimental design applying agent-based testing. While findings show no influences either of search histories or of reactivity on search results in a subsequent situation, the presentation of a helpline offer raises concerns about possible detrimental algorithmic decision-making: Algorithms “decided” whether or not to present a helpline, and this automated decision, then, followed the agent throughout the rest of the observation period. Implications for policy-making and search providers are discussed. [ABSTRACT FROM PUBLISHER]

Media-related selection ( MRS) is an umbrella concept for selection processes such as gatekeeping by journalists, selective exposure by audience members, and news sharing by social network site ( SNS) users. Importantly, individual attitudes can influence MRS. Previous research on attitude-based MRS has relied almost exclusively on overtly expressed evaluations (i.e., explicit attitudes) as predictors of selection outcomes. We tested whether automatic affective evaluations (i.e., implicit attitudes) can predict MRS as well. In three studies (gatekeeping, selective exposure, and news sharing), we found that journalists', audience members', and SNS users' implicit and explicit attitudes predicted selection. Thus, attitudes may exert their influence even 'under the radar' of conscious awareness. [ABSTRACT FROM AUTHOR]

In spite of the increasing adoption of suicide awareness campaigns to prevent suicide, little is known about the effective construction of awareness messages used and on their impact on suicidal cognition. We hypothesized that media reporting on an individual overcoming a suicidal crisis increases the automatic association between “life” and self. University students (N = 112) were randomly allocated to one of three groups in a laboratory experiment. Participants allocated to treatment group 1 or group 2 read awareness material about a person coping with suicidal ideation by getting professional help. The only difference between the two groups was the amount of social similarity (low vs. high) between the protagonist and the participants. The control group read an article unrelated to suicide. Awareness material increased implicit cognition in terms of a strengthening of self-life associations. This effect was restricted to participants scoring low on wishful identification with the suicidal protagonist. This finding suggests that only individuals who do not wishfully identify with a protagonist going through difficult life circumstances benefit from the awareness material in terms of suicidal cognition. These findings provide a rich basis for further research and have potentially high relevance to the construction of suicide-awareness messages. [ABSTRACT FROM PUBLISHER]

We present a dose-response (DR) account of media priming. DR concepts describe the relationship between a dose and the elicited response and, thus, allow us to study dose-dependent media priming effects. We report empirical evidence from an experiment (N = 351) for the DR relationship between exposure to stereotypic newspaper content and readers’ stereotypic social reality estimates. We investigated the change in the media priming effect size by utilizing nine experimentally manipulated dose-conditions (i.e., frequency of the media prime). The empirical data appeared in the form of a Gaussian distribution function: We were able to document (1) a threshold dose, which generally allows us to specify the acceptable daily intake of potentially harmful media content. Furthermore, (2) we found a decline in the effect size at very high dose levels. We argue that a DR account as a supplement to contemporary approaches can be beneficial for media priming research. [ABSTRACT FROM AUTHOR]

Current research draws a distinction between stereotype activation and application. Building on this differentiation, we present an implicit social cognition model of media priming: Implicit stereotypes (i.e., automatically activated stereotypes) are the outcome of associative processes, whereas explicit stereotypes (i.e., overtly expressed judgments) represent the outcome of propositional processes. We tested some of the model's basic predictions in an experiment. We found that a Gaussian distribution function explained the explicit media priming effect (i.e., decay in effect size at very high dose levels). However, a monotonic function explained the implicit media priming effect. This indicates that stereotypic content may impact implicit stereotypes even if the mass-mediated content is perceived as invalid. We discuss this finding regarding possible media-based reduction strategies. [ABSTRACT FROM AUTHOR]

Although there is evidence that the media priming effect fades with time, we lack empirical evidence from experimental designs. We investigated the media priming effect of reading crime tabloid articles that overrepresented foreigners as criminals on a subsequent real-world reality judgment (i.e., estimated frequency of criminal foreigners). We utilized a factorial experimental design (N = 465) with the between-subjects factors treatment and temporal delay of the postmeasurement. We found that the media priming effect followed an exponential decay function and that vigilance (i.e., the tendency to intensify the intake and processing of threat-relevant information) moderated the decay. [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]

This study investigates how far repeated releases of recommendations for responsible reporting on suicide (RRS) are associated with changes in the quality of suicide reporting. A content analysis was conducted on suicide news articles (N = 606) by the Korean newspapers Hankyoreh Sinmun and Chosun Ilbo in four six-month periods from 2004 to 2019, which covered the periods before and after the releases of three versions of suicide reporting guidelines. Elements for RRS served as a proxy for the reporting quality, which includes both avoiding negative elements and providing positive ones. Not only the number of suicide news stories reduced by half in the last two observation periods, overall RRS scores and most individual RRS elements increased in the third period, compared to the first or second period. The avoidance RRS for headline, however, was not significantly improved. Korean news media also tended to be sensationalistic in using photos. [ABSTRACT FROM AUTHOR]

There is limited knowledge about why political actors are dissatisfied with journalism. This article attempts to answer this question by pointing to individual-level perceptual processes of politicians. We argue that part of politicians' unease with the media can be explained by the hostile media phenomenon (HMP). Originally developed in audience research, the HMP refers to a process by which highly involved individuals tend to perceive media coverage as biased against their own views. Based on a survey of politicians in three European countries, we demonstrate that the HMP also holds for political actors. More importantly, we show that the HMP makes politicians less likely to contact journalists and more likely to use conflict and drama to gain public attention. Finally, the HMP decreases politicians' trust in democracy by fostering the belief that the public is not adequately informed about political matters. Theoretical and societal consequences are discussed. [ABSTRACT FROM AUTHOR]

Worldwide, people profit from equally accessible online health information via search engines. Therefore, equal access to health information is a global imperative. We studied one specific scenario, in which Google functions as a gatekeeper when people seek suicide-related information using both helpful and harmful suicide-related search terms. To help prevent suicides, Google implemented a "suicide-prevention result" (SPR) at the very top of such search results. While this effort deserves credit, the present investigation compiled evidence that the SPR is not equally displayed to all users. Using a virtual agent-based testing methodology, a set of 3 studies in 11 countries found that the presentation of the SPR varies depending on where people search for suicide-related information. Language is a key factor explaining these differences. Google's algorithms thereby contribute to a global digital divide in online health-information access with possibly lethal consequences. Higher and globally balanced display frequencies are desirable. [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]

Background and Aims: Numbers of drug-overdose deaths, both intentionally and unintentionally, have been increasing in the United States. Of interest, Google spotlights counselling services as helpful resources when users query for suicide-related search terms. However, the search engine does so at varying display rates, depending on terms used. Display rates in the drug-overdose deaths domain are unknown.Methods: We emulated suicide-related potentially harmful searches at large scale across the U.S. to explore Google's response to search queries including or excluding additional drug-related terms. Employing agent-based testing we conducted 215,999 search requests with varying combinations of search terms.Results: Counseling services such as helpline telephone numbers were displayed at high rates after suicide-related potentially harmful search queries (e.g., "how to commit suicide"). While this is a desirable outcome, display rates were substantially lower when drug-related terms, indicative of users' suicidal overdosing tendencies, were added (e.g., "how to commit suicide fentanyl"). Importantly, the addition of any drug-related search term to the suicide-related queries decreased the display frequency of helpful prevention-related resources substantially.Conclusions: Search queries such as "easy way to commit suicide fentanyl" may indicate acute suicidal crises. Helpful resources should be displayed right in such search moments. Search engines should adjust their algorithms to increase these display rates to direct users to such resources. By doing this, search engines may contribute to the prevention of drug-related suicides. [ABSTRACT FROM AUTHOR]