CSUN Presentation, On-Demand: A Web of Anxiety: Is a Little Tension a Good Thing?

Presenter: David Swallow

Watch the recording of “A Web of Anxiety: Is a Little Tension a Good Thing?”.

Since David’s last foray into accessibility for people with anxiety and panic disorders [1], there has been an interesting development. The high-pressure sales tactics and deceptive dark patterns [2] practiced by online hotel booking websites have caught the attention of the Competition and Markets Authority (CMA) in the UK [3]. Ruling such practices “misleading”, “aggressive”, and “wholly unacceptable”, the CMA brought enforcement action against six leading websites in this sector: Expedia, Booking.com, Agoda, Hotels.com, ebookers and trivago. The six sites have since given firm undertakings not to engage in these practices and the CMA is now seeking to make the rest of the sector follow suit.

Accompanying the CMA’s ruling was a set of principles [4] that clarify the CMA’s position on what online hotel booking companies need to do to ensure that they comply with consumer law. This describes how anxiety-inducing persuasive notifications, such as “Hurry, only 2 tickets left!” or “Book now as 6 other people are viewing this hotel” are permissible under certain conditions. Principle 29 states:
“Statements about popularity and availability must:
(a) be clear;
(b) disclose the assumptions, limitations and qualifications that are relevant to the statement; and
(c) be substantiated by the hotel booking website’s data.”
This raises an interesting possibility: is a little anxiety a good thing, or at least an acceptable side-effect of certain design decisions?

To recap, anxiety disorders comprise a range of mental illnesses that are characterised by excessive feelings of fear, apprehension, and dread. For example, social anxiety disorder [5] is an intense fear of being embarrassed, humiliated, or judged negatively by others in a social or work setting. Claustrophobia [6] is the fear of confined spaces. Agoraphobia [7] is a fear of being in a situation that would be difficult to escape from. People with health anxiety [8] have a preoccupation with the idea that they have (or will have) a physical illness. Panic disorders [9] describe sudden, frequent, and intense feelings of panic or fear, sometimes for no clear reason.

After asking about it on discussion forums, message boards and social media, David talked with several people with anxiety and panic disorders about aspects of user interface (UI) and user experience (UX) design that contribute to feelings of anxiety and panic. Several themes emerged:

  • Urgency – Anything that provokes a sense of urgency or scarcity (such as persuasive notifications, time-limited transactions and countdown timers) was a commonly cited source of anxiety.
  • Unpredictability – the unpredictable nature of certain websites and apps, particularly when it comes to forms, was another commonly cited source of apprehension.
  • Powerlessness – Hiding key information, such as contact details or account-deactivation instructions, in difficult-to-reach corners of websites was another commonly cited source of anxiety left users feeling powerless.
  • Sensationalism – Irresponsible or careless reporting, particularly with regard to medical information, can have serious consequences for anyone with health anxiety and was another commonly cited source of anxiety.

This presentation will continue his investigation of this often-overlooked aspect of web accessibility, exploring aspects of user interface and user experience design where some degree of anxiety may be inevitable, or even desirable.

For example, as the CMA’s ruling suggests, if persuasive notifications are clear, substantiated by actual data, and designed with the purpose of informing, rather than misleading, consumers, might the potential anxiety they cause be acceptable?

There is an inevitable tension between unpredictable user interface innovations and maintaining consistency and familiarity. But will such innovations ever occur if we rely purely on convention?

Creating unnecessary friction, by making account deactivation controls difficult to find, may cause feelings of powerlessness. But equally, such friction might provide the opportunity for people to reflect on their actions and can prevent accidental or unwanted changes.

Delivering accurate and timely medical information without causing unnecessary panic and anxiety is a difficult balancing act. But If such methods lead to more people getting their symptoms checked, then the alarming tone is perhaps justified.

This presentation will expand upon each of these themes to explore the “gray areas” of designing for people with anxiety and panic disorders. It will also present a prototype design support tool for encouraging designers and developers to consider the impact of UI/UX design decisions on people with anxiety and panic disorders. This tool will not only raise awareness of problematic design patterns but also provide practical suggestions and alternatives to avoid or reduce anxiety and panic triggers on the web.


  1. Swallow, D. (2018). A web of anxiety: accessibility for people with anxiety and panic disorders. Retrieved from https://www.tpgi.com/a-web-of-anxiety-accessibility-for-people-with-anxiety-and-panic-disorders-part-1/
  2. What are dark patterns? (2018, September 28). Retrieved from https://darkpatterns.org/
  3. Hotel booking sites to make major changes after CMA probe. (2019, February 6). Retrieved from https://www.gov.uk/government/news/hotel-booking-sites-to-make-major-changes-after-cma-probe
  4. Principles for businesses offering online accommodation booking services. (2019, February 26). Retrieved from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/781624/webteam_online_booking_services_principles.pdf
  5. Social anxiety (social phobia). (2017, March 9). Retrieved from https://www.nhs.uk/conditions/social-anxiety/
  6. Claustrophobia. (2016, June 7). Retrieved from https://www.nhs.uk/conditions/claustrophobia/
  7. Agoraphobia. (2016, February 20). Retrieved from https://www.nhs.uk/conditions/agoraphobia/
  8. Health anxiety. (2017, September 26). Retrieved from https://www.nhs.uk/conditions/health-anxiety/
  9. Panic disorder. (2017, August 15). Retrieved from https://www.nhs.uk/conditions/panic-disorder/
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