We propose conviction narrative theory (CNT) to broaden decision-making theory in order to better understand and analyse how subjectively means–end rational actors cope in contexts in which the traditional assumptions in decision-making models fail to hold. Conviction narratives enable actors to draw on their beliefs, causal models, and rules of thumb to identify opportunities worth acting on, to simulate the future outcome of their actions, and to feel sufficiently convinced to act. The framework focuses on how narrative and emotion combine to allow actors to deliberate and to select actions that they think will produce the outcomes they desire. It specifies connections between particular emotions and deliberative thought, hypothesising that approach and avoidance emotions evoked during narrative simulation play a crucial role. Two mental states, Divided and Integrated, in which narratives can be formed or updated, are introduced and used to explain some familiar problems that traditional models cannot.
Back to the future: the crucial role of clinical registries in the era of randomized controlled trials for identifying the optimal medical therapy of heart failure