Psycholinguistic and metacognition researchers mostly disagree on what constitutes a tip-of-the-tongue (TOT) state. Psycholinguists argue that TOT states occur when there is a transmission of activation failure between the lemma and phonology levels of word production (e.g., Burke, MacKay, Worthley, & Wade, 1991). Metacognition researchers argue that the TOT state is better described as a subjective experience caused by a mechanism that assesses the likelihood of recall from memory. One sub-hypothesis of the metacognitive account of TOT states is the cue familiarity hypothesis, which suggests that a TOT state may occur when cues elicit a feeling of familiarity (Metcalfe, Schwartz, & Joaquim, 1993). We conducted three experiments to evaluate the cue familiarity hypothesis of TOT state etiology. Experiment 1 included a test-retest TOT task with identical definitions (i.e., cues that should elicit familiarity) versus alternative definitions. TOTs were as likely to repeat for alternative definitions across test and retest as identical definitions, which is inconsistent with the cue familiarity hypothesis. Experiment 2 included the same task layout as Experiment 1, but we used very different cues (pictures versus descriptions for famous people). Again, we found that TOTs tended to repeat regardless of whether or not prompts were identical. In Experiment 3, we presented either a picture and description simultaneously or a description only on the first test, followed by a description only on retest. We found that giving participants an extra semantic cue did not change the probability of repeating a TOT state. These findings suggest that repeated TOT states do not occur due to cue familiarity nor is the locus of the TOT state at the semantic level of the word production/word recall system. Therefore, we argue that the results point towards a success of lemma access, but then failure of the lemma-to-phonology mappings.

Objective: The present study examined whether medical terminology impacts self-triage decisions (deciding if and when to seek medical treatment) compared to lay terminology.Methods: Undergraduate psychology student participants read 32 hypothetical health scenarios and reported how urgently they would seek care ["In this situation, when would you seek medical attention?" presented along with a seven-point scale, with anchors at either extreme: "Never (At the next scheduled appointment, if at all)" and "As soon as possible (Within the hour)," reflecting the options coded as 1 and 7, respectively]. Data were collected in person via a paper-based questionnaire. Scenarios included a description of symptoms, which were labeled as consistent with a particular medical disorder using either a lay disease label (e.g. "Heart Attack") or medical terminology (e.g. "Myocardial Infarction"). The 32 health scenarios represented medical disorders that purposefully reflected a spectrum of severity, commonality, and how recently the medical terminology had entered common use. results: For disorders for which medical terminology has been more recently established, participants reported that they would seek care more urgently when the disorder was presented using a medical label [mean (SE) = 4.08 (0.23)] than when they were described using the lay disease labels [3.32 (0.23), t(35) = 5.36, p < 0.001, e.g., "seborrheic dermatitis" versus "chronic dandruff"]. However, this differential response to medical or lay disease labels was not observed for disorders for which medical terminology has been more well established [medical labels = 5.16 (0.18); lay labels = 4.89 (0.18), t(35) = −1.67, p = 0.104, e.g., "heart attack" and "myocardial infarction"].conclusion: These results indicate that self-triage decision-making can be readily influenced by the terminology used to identify a disorder; however, this phenomenon appears to be particularly relevant for disorders in which public opinion may still be in flux.