Cognitive processing and intuitive characteristics of health intertemporal decision-making: Evidence from behavioral...

Health intertemporal decision-making is related to the health and well-being of individuals and the nation. However, its cognitive processing remains poorly understood. From a healthcare perspective, the current study adopts a dual-processing theory framework and employs the food time discount rate as a measurement paradigm to systematically examine the relationship between health behaviors and health intertemporal decision-making, as well as their underlying cognitive processing.

The current study consists of three interconnected sub-studies. Study 1 recruited 397 participants from northwestern and southwestern China, who were asked to rate 21 health behaviors across three dimensions: required effort, duration, and health impact. Cluster analysis was then used to test whether health behaviors could serve as proxy indicators of health intertemporal decision-making. Study 2 recruited 156 participants from northwestern China and explored whether health intertemporal decision-making simultaneously relies on heuristic and analytical processing by manipulating emotional tasks (heuristic processing) and working memory tasks (analytical processing). Study 3 recruited 30 participants from northwestern China and employed event-related potential (ERP) technology to compare intuitive preferences in health intertemporal decision-making under manipulations of time intervals.

The results of Study 1 indicate that, compared to short-term-effortless health behaviors, long-term-effortful health behaviors scored significantly higher on effort investment (t = 22.902∗∗∗) and duration (t = 16.607∗∗∗), but significantly lower on health impact (t = -18.779∗∗∗), suggesting that health behaviors can be categorized into two types: long-term-effortful health behaviors corresponding to delayed large benefits and short-term-effortless health behaviors corresponding to immediate small benefits. This provides a feasible method for indirectly measuring health intertemporal decision-making through health behaviors. The results of Study 2 showed a significant interaction between heuristic and analytical processing in health intertemporal decision-making (F(1, 147) = 4.934, p = 0.028, η_p² = 0.032). Moreover, individuals exhibited higher discount rates and a stronger preference for immediate gratification in unhealthy food contexts (F(1, 147) = 16.886, p < 0.001, η_p² = 0.103), suggesting that health intertemporal decision-making conforms to a dual-process model. The results of Study 3 showed that when presented with unhealthy foods, individuals exhibited a stronger preference for immediate rewards (F(1, 24) = 0.391, p = 0.538, η_p² = 0.016) and relied more on heuristic processing (N1: F(1, 24) = 1.258, p = 0.273, η_p² = 0.050; P2: F(1, 24) = 0.259, p = 0.615, η_p² = 0.011).

Current research indicates that healthy behaviors can serve as indirect measures of health intertemporal decision-making, which follows the dual-process theory, and that unhealthy foods are more susceptible to reliance on heuristic processing. This not only expands the applicability of dual-process theory in health intertemporal decision-making but also provides theoretical support for intervention strategies based on delayed gratification and inhibitory control, thereby offering new insights into promoting individual health outcomes.