Decision fatigue

Decision fatigue is a phrase popularised by John Tierney, and is the tendency for peoples' decision making to become impaired as a result of having recently taken multiple decisions.{{cite web |last1=Tierney |first1=John |title=Do You Suffer From Decision Fatigue? |url=https://www.nytimes.com/2011/08/21/magazine/do-you-suffer-from-decision-fatigue.html |website=The New York Times |access-date=13 January 2022 |date=17 August 2011}}

Decision fatigue has been hypothesised to be a symptom, or a result of ego depletion. It differs from mental fatigue which describes the psychobiological state that results from a prolonged duration of demanding cognitive tasks, such as multi-tasking or switching between various tasks.{{cite journal |last1=Lorist |first1=MM |last2=Klein |first2=M |last3=Nieuwenhuis |first3=S |last4=De Jong |first4=R |last5=Mulder |first5=G |last6=Meijman |first6=TF |title=Mental fatigue and task control: planning and preparation. |journal=Psychophysiology |date=September 2000 |volume=37 |issue=5 |pages=614–25 |doi=10.1111/1469-8986.3750614 |pmid=11037038}}

Some psychologists and economists use the term to describe impairments in decision making resulting specifically from a long duration of having to make decisions.{{cite journal |last1=Vohs |first1=Kathleen D. |last2=Baumeister |first2=Roy F. |last3=Schmeichel |first3=Brandon J. |last4=Twenge |first4=Jean M. |last5=Nelson |first5=Noelle M. |last6=Tice |first6=Dianne M. |title=Making choices impairs subsequent self-control: A limited-resource account of decision making, self-regulation, and active initiative. |journal=Journal of Personality and Social Psychology |date=May 2008 |volume=94 |issue=5 |pages=883–898 |doi=10.1037/0022-3514.94.5.883|pmid=18444745 }} Others view factors such as complexity of the decisions being made, repeated acts of self regulation,{{cite journal |last1=Baumeister |first1=Roy F. |last2=Bratslavsky |first2=Ellen |last3=Muraven |first3=Mark |last4=Tice |first4=Dianne M. |title=Ego depletion: Is the active self a limited resource? |journal=Journal of Personality and Social Psychology |date=1998 |volume=74 |issue=5 |pages=1252–1265

|doi=10.1037/0022-3514.74.5.1252|pmid=9599441 |s2cid=14627317 }} physiological fatigue, and sleep deprivation{{cite journal |last1=Scott |first1=LD |last2=Arslanian-Engoren |first2=C |last3=Engoren |first3=MC |title=Association of sleep and fatigue with decision regret among critical care nurses. |journal=American Journal of Critical Care |date=January 2014 |volume=23 |issue=1 |pages=13–23 |doi=10.4037/ajcc2014191 |pmid=24382613|doi-access=free }} as implicated in the emergence of decision fatigue.

Decision fatigue is thought to be a result of unconscious, psychobiological processes, and is a reaction to sustained cognitive, emotional and decisional load, as opposed to a trait or deficiency.{{cite journal |last1=Pignatiello |first1=Grant A |last2=Martin |first2=Richard J |last3=Hickman |first3=Ronald L |title=Decision fatigue: A conceptual analysis |journal=Journal of Health Psychology |date=23 March 2018 |volume=25 |issue=1 |pages=123–135 |doi=10.1177/1359105318763510|pmid=29569950 |pmc=6119549 }} Decision fatigue is an emergent construct that has several possible applications in the fields of healthcare psychology,{{Cite journal |last=Grignoli |first=Nicola |last2=Manoni |first2=Greta |last3=Gianini |first3=Jvan |last4=Schulz |first4=Peter |last5=Gabutti |first5=Luca |last6=Petrocchi |first6=Serena |date=2025-02-08 |title=Clinical decision fatigue: a systematic and scoping review with meta-synthesis |url=https://fmch.bmj.com/content/13/1/e003033 |journal=Family Medicine and Community Health |language=en |volume=13 |issue=1 |doi=10.1136/fmch-2024-003033 |issn=2009-8774|pmc=11808891 }} behavioural economics and healthcare policy.

Behavioural attributes of decision fatigue tend to reflect an underlying state of ego depletion and may symbolise an unconscious method whereby individuals adapt their behaviour to prevent further depletion. Individuals experiencing decision fatigue are more prone to avoidant behaviours, such as procrastination; Sjastad and Baumeister demonstrated that decision fatigued individuals are less willing to engage in planning, and were more avoidant, compared to controls.{{cite journal |last1=Sjåstad |first1=Hallgeir |last2=Baumeister |first2=Roy F. |title=The Future and the Will: Planning requires self-control, and ego depletion leads to planning aversion |journal=Journal of Experimental Social Psychology |date=May 2018 |volume=76 |pages=127–141 |doi=10.1016/j.jesp.2018.01.005 |url=https://www.sciencedirect.com/science/article/pii/S0022103117301968#s0115 |language=en |issn=0022-1031|url-access=subscription }} Decision fatigue may also induce passive behaviours, such as inaction and decision avoidance.{{cite journal |last1=Rao |first1=Suchitra |last2=Nyquist |first2=Ann-Christine |title=The Power of the Nudge to Decrease Decision Fatigue and Increase Influenza Vaccination Rates |journal=JAMA Network Open |date=14 September 2018 |volume=1 |issue=5 |pages=e181754 |doi=10.1001/jamanetworkopen.2018.1754 |pmid=30646149 |s2cid=58591946 |url=https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2702208 |access-date=17 January 2022 |issn=2574-3805|doi-access=free }} Furthermore, individuals experiencing decision fatigue may display less persistence when putting effort into decision making, and thus may be prone to choosing the 'default' option.{{cite journal |last1=Linder |first1=Jeffrey A. |last2=Doctor |first2=Jason N. |last3=Friedberg |first3=Mark W. |last4=Reyes Nieva |first4=Harry |last5=Birks |first5=Caroline |last6=Meeker |first6=Daniella |last7=Fox |first7=Craig R. |title=Time of Day and the Decision to Prescribe Antibiotics |journal=JAMA Internal Medicine |date=1 December 2014 |volume=174 |issue=12 |pages=2029–2031 |doi=10.1001/jamainternmed.2014.5225 |pmid=25286067 |pmc=4648561 |url=https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1910546 |access-date=17 January 2022 |issn=2168-6106}} They may also be prone to impulsive, erratic or short-sighted behaviour.{{cite journal |last1=Hickman |first1=Ronald L. |last2=Pignatiello |first2=Grant A. |last3=Tahir |first3=Sadia |title=Evaluation of the Decisional Fatigue Scale Among Surrogate Decision Makers of the Critically Ill |journal=Western Journal of Nursing Research |date=14 August 2017 |volume=40 |issue=2 |pages=191–208 |doi=10.1177/0193945917723828 |pmid=28805132 |pmc=5750078 |issn=0193-9459}}

=== Cognitive ===

Decision fatigue may also alter cognitive functioning. Some studies suggest that decision fatigue impairs cognitive abilities, especially executive functioning and reasoning abilities. For example Kathleen Vohs and Roy Baumeister found that the more that people had made frequent and deliberate choices, the less able they were to persist on a math task, regardless of how tired they were or how long they spent on the task.{{cite web |last1=Vohs |first1=Kathleen |last2=Baumeister |first2=Roy |last3=Twenge |first3=Jean |title=Decision Fatigue Exhausts Self-Regulatory Resources — But So Does Accommodating to Unchosen Alternatives |url=https://www.researchgate.net/publication/237738528 |website=ResearchGate |access-date=17 January 2022}}

=== Physiological ===

There is evidence to suggest that decision fatigue may impact physiological endurance and self control. This was demonstrated in a series of studies which showed that participants who had made a long series of choices were less able to tolerate a bad-tasting drink, and were less able to tolerate pain, compared to controls.{{cite journal |last1=Vohs |first1=Kathleen D. |last2=Baumeister |first2=Roy F. |last3=Schmeichel |first3=Brandon J. |last4=Twenge |first4=Jean M. |last5=Nelson |first5=Noelle M. |last6=Tice |first6=Dianne M. |title=Making choices impairs subsequent self-control: A limited-resource account of decision making, self-regulation, and active initiative. |journal=Journal of Personality and Social Psychology |date=May 2008 |volume=94 |issue=5 |pages=883–898 |doi=10.1037/0022-3514.94.5.883 |pmid=18444745 |url=https://www.apa.org/pubs/journals/releases/psp945883.pdf |access-date=17 January 2022}} This indicates that decision fatigue impairs physiological as well as cognitive self-control.

File:Car Dealer, Eastern Avenue, Gants Hill - geograph.org.uk - 701435.jpg

Trade-offs, where either of two choices have positive and negative elements, are an advanced and energy-consuming form of decision making. A person who is mentally depleted becomes reluctant to make trade-offs, or makes very poor choices. Jonathan Levav at Stanford University designed experiments showing how decision fatigue can leave a person vulnerable to sales and marketing strategies designed to time the sale.{{Cite journal|last1=Levav|first1=Jonathan|last2=Reinholtz|first2=Nicholas|last3=Lin|first3=Claire|date=2012-10-01|title=The Effect of Ordering Decisions by Choice-Set Size on Consumer Search|journal=Journal of Consumer Research|language=en|volume=39|issue=3|pages=585–599|doi=10.1086/664498|issn=0093-5301}} "Decision fatigue helps explain why ordinarily sensible people...can't resist the dealer's offer to rustproof their new car."{{cite magazine|url=https://healthland.time.com/2011/08/23/mind-over-mind-decision-fatigue-may-deplete-our-willpower-but-only-if-we-let-it/#ixzz1WRGB2Bya|title=Decision Fatigue Saps Willpower—if We Let It|last=Szalavitz|first=Maia|date=August 23, 2011|magazine=Time|access-date=24 October 2018}}

Dean Spears of Princeton University has argued that decision fatigue caused by the constant need to make financial trade-offs is a major factor in trapping people in poverty.{{Citation|url=https://riceinstitute.org/wordpress/wp-content/uploads/downloads/2011/12/depletion-published.pdf|title=Economic decision-making in poverty depletes behavioral control|last=Spears|first=Dan|date=9 December 2010|website=Griswold Center for Economic Policy Studies|publisher=Princeton University|issue=CEPS Working Paper No. 213|access-date=24 October 2018}}. Given that financial situations force the poor to make so many trade-offs, they are left with less mental energy for other activities. "If a trip to the supermarket induces more decision fatigue in the poor than in the rich – because each purchase requires more mental trade-offs – by the time they reach the cash register, they'll have less willpower left to resist the Mars bars and Skittles. Not for nothing are these items called impulse purchases."

Decision fatigue can lead people to avoid decisions entirely, a phenomenon called "decision avoidance".{{cite journal | title= The Psychology of Doing Nothing: Forms of Decision Avoidance Result from Reason and Emotion | first = Christopher | last = Anderson | year = 2003 | journal=Psychological Bulletin | volume=129 | issue = 1 | pages=139–167 |ssrn=895727 | doi=10.1037/0033-2909.129.1.139| pmid = 12555797 | s2cid = 9284883 }}{{citation | title = Principles of Management: A Modern Approach | first = PK | last = Saxena | year = 2009 | isbn = 978-81-907941-5-2 | page = 89| publisher = Global India Publications }}. In the formal approach to decision quality management, specific techniques have been devised to help managers cope with decision fatigue.{{citation | title = Decision process quality management | first = William D | last = Mawby | year = 2004 | isbn = 978-0-87389-633-7 | page = 72| publisher = ASQ Quality Press }}. Other forms of decision avoidance used to bypass trade-offs and the emotional costs of decision making can include selecting either the default, or status quo options, where these are available.

Decision fatigue can influence irrational impulse purchases at supermarkets. During a trip to the supermarket, trade-off decisions regarding prices and promotions can produce decision fatigue, hence by the time the shopper reaches the cash register, less willpower remains to resist impulse purchases of candy and sugared items. Sweet snacks are usually featured at the cash register because many shoppers have decision fatigue by the time they get there. Florida State University social psychologist Roy Baumeister has also found that it is directly tied to low glucose levels, and that replenishing them restores the ability to make effective decisions. This has been offered as an explanation for why poor shoppers are more likely to eat during their trips.

The "process of choosing may itself drain some of the self's precious resources, thereby leaving the executive function less capable of carrying out its other activities. Decision fatigue can therefore impair self-regulation". "[S]ome degree of failure at self regulation" is at the root of "[m]ost major personal and social problems", such as debt, "underachievement at work and school" and lack of exercise.{{cite journal | first = Roy | last = Baumeister | title = Ego Depletion and Self-Control Failure: An Energy Model of the Self's Executive Function | year = 2002 | volume = 1 | issue = 2 | pages = 129–136 | journal = Self and Identity | doi = 10.1080/152988602317319302 | s2cid = 12823588 }}

Experiments have shown the interrelationship between decision fatigue and ego depletion, whereby a person's ability for self-control against impulses decreases in the face of decision fatigue.{{Cite book|title=Time and Decision: Economic and Psychological Perspectives of Intertemporal Choice|last1=Baumeister|first1=Roy F.|last2=Vohs|first2=Kathleen D.|publisher=Russell Sage|year=2003|isbn=978-1-61044-366-1|editor-last=Loewenstein|editor-first=George|pages=201–214|chapter=Willpower, Choice, and Self-Control|editor-last2=Read|editor-first2=Daniel|editor-last3=Baumeister|editor-first3=Roy F.}}

Baumeister and Vohs have suggested that the disastrous failure of men in high office to control impulses in their private lives may at times be attributed to decision fatigue stemming from the burden of day-to-day decision making. Similarly, Tierney notes that "C.F.O.s [are] prone to disastrous dalliances late in the evening", after a long day of decision-making.

With regard to self-regulation in legal regulation: One research study found that the decisions judges make are strongly influenced by how long it has been since their last break. "We find that the percentage of favorable rulings drops gradually from ≈65% to nearly zero within each decision session and returns abruptly to ≈65% after a break."{{citation | first1 = Shai | last1 = Danzigera | first2=Jonathan|last2=Levav | first3=Liora|last3=Avnaim-Pesso | title = Extraneous factors in judicial decisions | journal = Proceedings of the National Academy of Sciences | year = 2011 | volume = 108 | issue = 17 | pages = 6889–6892 | doi=10.1073/pnas.1018033108 | pmid=21482790 | pmc=3084045| bibcode = 2011PNAS..108.6889D | doi-access = free }}.

Several studies have indicated that decision fatigue can increase reliance on mental shortcuts and biases.

A study by Shai Danziger, Jonathan Levav, and Liora Avnaim-Pesso from Columbia Business School showed that the percentage of favourable rulings by judges on parole boards in a prison dropped gradually (from around 65% to almost 0%) within each 'decision session' recorded, but would return to around 65% after a break.{{cite journal |last1=Danziger |first1=Shai |last2=Levav |first2=Jonathan |last3=Avnaim-Pesso |first3=Liora |title=Extraneous factors in judicial decisions |journal=Proceedings of the National Academy of Sciences |date=Apr 2011 |volume=108 |issue=17 |pages=6889–6892 |doi=10.1073/pnas.1018033108 |pmid=21482790 |pmc=3084045 |bibcode=2011PNAS..108.6889D |doi-access=free }} This suggests that judicial rulings were increasingly determined by biased assumptions as decision fatigue increased.

Another demonstration of the relationship between decision fatigue and increased susceptibility to biased decision making was that of journal editors reviewing manuscripts. This study found that when the number of manuscripts discussed per meeting increased from 10 - 19 to over 20, the rate of rejection increased from 38% to 44%. When the number of manuscripts an editor had to read a day increased from 1-2 to 3 or more, the number of manuscripts rejected without peer review increased by 6%.{{cite journal |last1=F. Stewart |first1=Adam |last2=M. Ferriero MD |first2=Donna |last3=Andrew Josephson MD |first3=S |last4=H. Lowenstein MD |first4=Daniel |last5=O. Messing MD |first5=Robert |last6=R. Oksenberg PhD |first6=Jorge |last7=Claiborne Johnston MD PhD |first7=S. |last8=L. Hauser MD |first8=Stephen |title=Fighting decision fatigue |journal=Annals of Neurology |date=24 January 2012 |volume=71 |issue=1 |pages=A5–A15 |doi=10.1002/ana.23531 |pmid=22275264 |s2cid=8726068 |doi-access=free }} This indicates that the greater decision fatigue editors experienced (whether alone or working in collaboration), the greater their bias towards rejecting manuscripts emerged.

Decision fatigue increases consumers' reliance on cognitive biases, such as anchoring and framing effects, making them more prone to quick, biased choices under conditions of mental exhaustion.

Individuals experiencing decision fatigue may feel a greater degree of decisional conflict. Decisional conflict is a state wherein an individual is uncertain about which course of action to take when the decision between various options involves regret, risk or challenge to their values.{{cite journal |last1=LeBlanc |first1=Annie |last2=Kenny |first2=David A. |last3=O'Connor |first3=Annette M. |last4=Légaré |first4=France |title=Decisional Conflict in Patients and Their Physicians: A Dyadic Approach to Shared Decision Making |journal=Medical Decision Making |date=January 2009 |volume=29 |issue=1 |pages=61–68 |doi=10.1177/0272989x08327067 |pmid=19196706 |s2cid=30171455 |url=https://journals.sagepub.com/doi/abs/10.1177/0272989X08327067 |access-date=15 January 2022 |issn=0272-989X|url-access=subscription }} Decisional conflict is likely to arise from decision fatigue because decision fatigue impairs one's ability to make decisions efficiently, makes them prone to over-reliance on heuristics and biases, reduces one's ability to make trade-offs, and can even lead to avoiding making decisions.

Decision fatigue might also increase levels of decisional regret.{{cite journal |last1=Pignatiello |first1=Grant A |last2=Martin |first2=Richard J |last3=Hickman |first3=Ronald L |title=Decision fatigue: A conceptual analysis |journal=Journal of Health Psychology |date=23 March 2018 |volume=25 |issue=1 |pages=123–135 |doi=10.1177/1359105318763510 |pmid=29569950 |pmc=6119549 |issn=1359-1053}} If an individual is aware that their decision-making abilities are impaired, or if they are experiencing decisional conflict as a result of decision fatigue, they may anticipate the regret they can experience as a result of post-decisional feedback on the outcomes they didn't choose.{{cite journal |last1=Zeelenberg |first1=Marcel |last2=Beattie |first2=Jane |last3=van der Pligt |first3=Joop |last4=de Vries |first4=Nanne K. |title=Consequences of Regret Aversion: Effects of Expected Feedback on Risky Decision Making |journal=Organizational Behavior and Human Decision Processes |date=1 February 1996 |volume=65 |issue=2 |pages=148–158 |doi=10.1006/obhd.1996.0013 |url=https://www.sciencedirect.com/science/article/pii/S0749597896900138 |language=en |issn=0749-5978}} This anticipation of regret may influence decision making, and can further impair the individual's ability to make rational decisions.

This relationship between decisional fatigue, regret, and conflict was demonstrated in a recent study that aimed to find the impacts of decision fatigue on nurses working during the COVID-19 pandemic. Researchers concluded that decision fatigue could be a determinant of psychological outcomes among nurses, and clinical outcomes among patients and their family members.{{cite journal |last1=Pignatiello |first1=Grant A. |last2=Tsivitse |first2=Emily |last3=O'Brien |first3=Julia |last4=Kraus |first4=Noa |last5=Hickman |first5=Ronald L. |title=Decision fatigue among clinical nurses during the COVID-19 pandemic |journal=Journal of Clinical Nursing |date=21 July 2021 |volume=31 |issue=7–8 |pages=869–877 |doi=10.1111/jocn.15939 |pmid=34291521 |pmc=8447365 |language=en |issn=1365-2702}} Additionally, the decisional conflict and regret that arises from decision fatigue may impact the mental health and the decision making ability of healthcare workers, and those in occupations that demand long decision-making sessions.

Several psychologists have challenged the effects of ego depletion, such as decision fatigue, on multiple grounds.{{Cite journal|last1=Friese|first1=Malte|last2=Loschelder|first2=David D.|last3=Gieseler|first3=Karolin|last4=Frankenbach|first4=Julius|last5=Inzlicht|first5=Michael|date=May 2019|title=Is Ego Depletion Real? An Analysis of Arguments|url=http://journals.sagepub.com/doi/10.1177/1088868318762183|journal=Personality and Social Psychology Review|language=en|volume=23|issue=2|pages=107–131|doi=10.1177/1088868318762183|pmid=29591537|s2cid=4471882|issn=1088-8683|url-access=subscription}} One replication effort including 23 laboratories did not find an ego depletion effect to be significantly different from zero.{{Cite journal|last1=Hagger|first1=M. S.|last2=Chatzisarantis|first2=N. L. D.|last3=Alberts|first3=H.|last4=Anggono|first4=C. O.|last5=Batailler|first5=C.|last6=Birt|first6=A. R.|last7=Brand|first7=R.|last8=Brandt|first8=M. J.|last9=Brewer|first9=G.|last10=Bruyneel|first10=S.|last11=Calvillo|first11=D. P.|date=July 2016|title=A Multilab Preregistered Replication of the Ego-Depletion Effect|journal=Perspectives on Psychological Science|language=en|volume=11|issue=4|pages=546–573|doi=10.1177/1745691616652873|pmid=27474142|s2cid=28540342|issn=1745-6916|doi-access=free|hdl=10072/173861|hdl-access=free}} This indicates that existing evidence may not be sufficient to support the existence of an ego depletion effect. Furthermore, even when an ego depletion effect does replicate, there is substantive heterogeneity in the effect size in the literature and the average effect size is small.{{Cite journal|last1=Dang|first1=Junhua|last2=Barker|first2=Paul|last3=Baumert|first3=Anna|last4=Bentvelzen|first4=Margriet|last5=Berkman|first5=Elliot|last6=Buchholz|first6=Nita|last7=Buczny|first7=Jacek|last8=Chen|first8=Zhansheng|last9=De Cristofaro|first9=Valeria|last10=de Vries|first10=Lianne|last11=Dewitte|first11=Siegfried|date=January 2021|title=A Multilab Replication of the Ego Depletion Effect|journal=Social Psychological and Personality Science|language=en|volume=12|issue=1|pages=14–24|doi=10.1177/1948550619887702|issn=1948-5506|pmc=8186735|pmid=34113424}} As there is little evidence for ego depletion, then the existence of decision fatigue comes into question.

Stanford University Professor of Psychology Carol Dweck found "that while decision fatigue does occur, it primarily affects those who believe that willpower runs out quickly." She states that "people get fatigued or depleted after a taxing task only when they believe that willpower is a limited resource, but not when they believe it's not so limited". She notes that "in some cases, the people who believe that willpower is not so limited actually perform better after a taxing task."

• Analysis paralysis
• Ego depletion
• Fatigue (medical)
• Interruption science
• Somnolence

{{Reflist|33em}}

Category:Decision-making