Understanding Psychological Reactance: New Developments and Findings

Twelve tips for teaching culturally and socially responsive care to medical students

In recent years, discourse on topics like cultural humility, social determinants of health (SDOH), and health disparities and inequities has greatly increased in medical education as attention to their impact on health has magnified. Unfortunately, traditional medical education models may fail to optimize learning in this area. To address these complex social health issues, we must find innovative ways to engage students in an educational partnership in which they are challenged to critically think and reflect on their attitudes, role, and actions in health equity and culturally responsive care. Through reviews of existing literature coupled with our own experience with iterative implementation of a model that includes interpersonal engagement paired with individual self-directed learning, we assembled 12 tips on how to prepare diverse students to practice lifelong cultural humility and provide culturally and socially responsive care in an ever-changing social landscape.

Spillover of sustainable routines from work to private life: application of the Identity and Practice Interdependence Framework

Introduction

Spillover of sustainable routines and environmentally-responsible behaviors from one setting to another may contribute to achieving essential sustainability goals. Several previous studies on this topic have found few examples of spillover and have focused primarily on individual influences, indicating the need for a better understanding of the factors that have an impact on whether, how, and when spillover occurs. To this end, a novel conceptualization examining the interactions between identity principles and socio-material elements, the Identity and Practice Interdependence Framework, was applied to investigate the occurrence of spillover of sustainable routines from the workplace to home.

Methods

Three focus groups totaling 30 employees of a major Brazilian steel-producing company, interviews in 15 employee homes, and on-site observations of work and private domains provided data that was analyzed qualitatively, using a deductive reflexive thematic approach.

Results

Participants identified 58 changes in home routines related to sustainability as resulting from their experiences at work. With the consistent availability of practice elements (materials, competencies, meanings), learning about, witnessing and performing sustainable routines at work favored satisfactory levels of identity principles (self-efficacy, self-esteem, distinctiveness, continuity). Analysis suggested that seeking the same satisfactions of identity principles outside the workplace led individuals to adapt, change, and/or create more environmentally-responsible routines in their homes.

Discussion

The Identity and Practice Interdependence Framework permitted investigation of the integration of socio-material aspects with the role of individuals in the process of spillover, and indicated some ways they may interact. Both the provision of socio-material components in the first setting and the recognition of more sustainable routines as a feasible path to satisfaction of identity principle needs contribute to individual engagement and persistence in the second setting. Consistent and frequent experiences with more sustainable routines in the first setting or situation may be key to creating this expectation, and therefore to the occurrence of spillover to another setting. The framework complements previous approaches by allowing for a more complex analysis of spillover, which can be used to enrich research on sustainable practices and help promote environmentally-friendly behaviors and sustainable routines, or other desired outcomes, both within organizations and beyond.

How appraisals of an in-group's collective history shape collective identity and action: Evidence in relation to African identity

This research tested the impact of how group members appraise their collective history on in-group identification and group-based action in the African context. Across three experiments (Ns = 950; 270; and 259) with Nigerian participants, we tested whether the effect of historical representations-specifically the valence of the in-group's collective history-on in-group engagement, in turn, depends on whether that history is also appraised as subjectively important. In Study 1, findings from exploratory moderated-mediation analyses indicated that the appraised negative valence of African history was associated with an increase in identification and group-based action when African history was appraised as unimportant (history-as-contrast). Conversely, the appraised positive valence of African history was also associated with an increase in identification and group-based action when African history was also appraised as important (history-as-inspiration). Studies 2a and 2b then orthogonally manipulated the valence and subjective importance of African history. However, findings from Studies 2a and 2b did not replicate those of Study 1. Altogether, our findings suggest that the relationship between historical representations of groups and in-group identification and group-based action in the present is more complex than previously acknowledged.

Exploring the Relationship Between Psychological Constructs and Decision-Making Preferences in Psychiatric Outpatients

Objective

This study aimed to elucidate the relationships among health locus of control, psychological reactance, attitudes toward psychiatric treatment, and patient decision-making preferences within a psychiatric outpatient population.

Methods

A total of 200 consecutive psychiatric outpatients from a community mental health center in Tenerife, Spain, were approached for participation between September 2023 and March 2024. Of these, 151 patients consented to participate in this cross-sectional study. Participants were selected based on their willingness to participate and were provided with informed consent forms. Data were collected using the Patient's Health Belief Questionnaire on Psychiatric Treatment (PHBQPT) and the Control Preferences Scale (CPS). The PHBQPT evaluates health beliefs impacting adherence to psychiatric treatment, while the CPS assesses the preferred level of involvement in medical decision-making. Sociodemographic data were also collected to contextualize the findings.

Results

Significant correlations were found between patients' control preferences and their attitudes towards medication, compliance with psychiatric advice, and perceptions of treatment control. A collaborative control preference was notably associated with positive attitudes toward medication and trust in the psychiatrist. These findings suggest that tailored treatment approaches prioritizing patient involvement could enhance adherence and outcomes.

Conclusion

 The study underscores the importance of considering psychological constructs in psychiatric care to foster a holistic, patient-centered approach. Recognizing and integrating patients' control preferences, attitudes towards medication, and psychological reactance can improve the therapeutic relationship and treatment adherence. Future research should explore longitudinal and interventional studies to further understand the impact of aligning treatment approaches with patient preferences and psychological profiles.

Reconsidering the Effectiveness of Fear Appeals: An Experimental Study of Interactive Fear Messaging to Promote Positive Actions on Climate Change

Masspersonal communication has emerged as a compelling alternative persuasive approach in response to the widespread use of social media. It is crucial to comprehend how observing online interpersonal interactions regarding the fear appeal of climate change can foster pro-environmental behaviors among users. This study examines the effects of vicarious message interactivity in promoting actions against climate change and the underlying mechanisms behind this effect. The results of an online experiment conducted in China (N = 236) revealed that psychological reactance and message elaboration mediated the effects of vicarious message interactivity on behavioral intention in a serial indirect effect. In comparison to static fear appeal, interactive fear appeal proves effective in reducing psychological reactance, promoting message elaboration, and ultimately increasing intention to take actions against climate change. Our findings not only contribute to the literature on interactive communication but also provide insights for environmental-health campaigns on social media.

Local public health under threat: Harassment faced by local health department leaders during the COVID-19 pandemic

Background

Prior to the COVID-19 pandemic, local health departments (LHDs) faced several challenges including underfunding and understaffing. COVID-19 exacerbated these challenges and introduced new ones, including harassment of the agency, staff, and leadership. The objective of this study was to qualitatively understand the experiences and impact of harassment faced by LHDs during the pandemic and provide recommendations to prevent future harassment.

Study design

A qualitative study was conducted utilizing focus groups for data collection.

Methods

LHDs were sampled from the 2022 National Profile of Local Health Departments (Profile) study to ensure diversity in LHD size. Four virtual focus groups were conducted in Fall 2022 with a total of 16 LHD leaders surveyed in Profile, who were still in their positions. Focus group transcripts were then coded by two independent coders and analyzed using thematic analysis.

Findings

Four common domains arose from the data: aggravating factors of harassment, content and formats of harassment, protective factors, and effects on individuals and on the workforce.

Conclusion

Findings suggest that harassment was pervasive with many forms and impacts on the LHD leaders and workforce overall. Recommendations are proposed for the local as well as federal partners because the public health system is threatened without immediate, substantial, and coordinated solutions to address harassment and offer protection.

Trait reactance as psychological motivation to reject vaccination: Two longitudinal studies and one experimental study

Anti-science attitudes can be resilient to scientific evidence if they are rooted in psychological motives. One such motive is trait reactance, which refers to the need to react with opposition when one's freedom of choice has been threatened. In three studies, we investigated trait reactance as a psychological motivation to reject vaccination. In the longitudinal studies (n = 199; 293), we examined if trait reactance measured before the COVID-19 pandemic was related to people's willingness to get vaccinated against COVID-19 up to 2 years later during the pandemic. In the experimental study (n = 398), we tested whether trait reactance makes anti-vaccination attitudes more resistant to information and whether this resistance can be mitigated by framing the information to minimize the risk of triggering state reactance. The longitudinal studies showed that higher trait reactance before the COVID-19 pandemic was related to lower willingness to get vaccinated against COVID-19. Our experimental study indicated that highly reactant individuals' willingness to vaccinate was unaffected by the amount and framing of the information provided. Trait reactance has a strong and durable impact on vaccination willingness. This highlights the importance of considering the role of trait reactance in people's vaccination-related decision-making.

Modelling social norms: an integration of the norm-utility approach with beliefs dynamics

We review theoretical approaches for modelling the origin, persistence and change of social norms. The most comprehensive models describe the coevolution of behaviours, personal, descriptive and injunctive norms while considering influences of various authorities and accounting for cognitive processes and between-individual differences. Models show that social norms can improve individual and group well-being. Under some conditions though, deleterious norms can persist in the population through conformity, preference falsification and pluralistic ignorance. Polarization in behaviour and beliefs can be maintained, even when societal advantages of particular behaviours or belief systems over alternatives are clear. Attempts to change social norms can backfire through cognitive processes including cognitive dissonance and psychological reactance. Under some conditions social norms can change rapidly via tipping point dynamics. Norms can be highly susceptible to manipulation, and network structure influences their propagation. Future models should incorporate network structure more thoroughly, explicitly study online norms, consider cultural variations and be applied to real-world processes. This article is part of the theme issue 'Social norm change: drivers and consequences'.

Testing Psychological Inoculation to Reduce Reactance to Vaccine-Related Communication

Research has found that vaccine-promoting messages can elicit state reactance (i.e., negative emotions in response to a perceived threat to behavioral freedom), especially among individuals with high trait reactance (i.e., proneness to experiencing reactance). This can result in a lower willingness to accept vaccines. We investigated whether inoculation against reactance - that is, forewarning individuals about potentially experiencing reactance - can reduce the effects of trait reactance on vaccination willingness. Participants (N = 710) recruited through Facebook were randomly allocated to be either inoculated or not. They were then shown a message promoting a fictitious vaccine, which included either a low, medium, or high threat to freedom. Contrary to research on other health topics, inoculation was ineffective at reducing state reactance toward the vaccination message. Inoculation also did not mitigate the effects of trait reactance on vaccination willingness, and was even counterproductive in some cases. High-reactant individuals were less willing to get vaccinated than low-reactant ones, especially at high freedom threat. Conversely, high freedom threat resulted in increased vaccination willingness among low-reactant individuals. Further research is needed to understand why inoculation against reactance produces different results with vaccination, and to develop communication strategies that mitigate reactance to vaccination campaigns without compromising the positive effects of vaccine recommendations for low-reactant individuals.

How do hospital providers perceive and experience the information-delivery process? A qualitative exploratory study

Objective

To explore how professionals deal with informing their patients and how they experience the process per se, in order to deepen understanding of the issues involved and to identify areas of focus for improvement.

Methods

Semi-structured qualitative interviews were conducted with 13 hospital professionals at Lausanne University Hospital, Switzerland.

Results

Information includes feedback, practical information, patient condition, treatment/process of care, and educational material. Information-delivery is a process that involves informing the patient then checking patient reception of the information. The main expected outcome is patient action. Providers can feel trapped, guilty, inadequate, powerless, disenchanted when the process fails to achieve its expected purpose.

Conclusions

Informing and checking strategies are not implemented optimally, and providers could benefit from guidance in order to decrease discomfort and become more proficient at delivering information.

Innovation

Addressing the information-delivery process per se provides us with a novel insight into the complexity of the process and contributes to identifying essential ingredients of future innovative training programs for providers at large.

Hotels re-explored: Experience and influence of reciprocity and social normative appeals

In this paper we report two high-powered and pre-registered experiments, testing the robustness and conceptual development of reciprocity and social norm appeals. Both experiments assessed both psychological processes for complying with these appeals and pro-environmental behavioral intention in tourism settings. In Experiment 1 (N = 2004), participants reported lower psychological reactance levels after learning that the hotel engaged in resource conservation (i.e., indirect homeomorphic reciprocity). No statistically significant effect was obtained for either obligatory motivation, prosocial motivation, skepticism, or behavioral intentions to reuse hotel towels. Importantly, high baseline intention of reusing hotel towels might have limited the effect of appeals. Therefore, we targeted meat consumption in Experiment 2 (n = 2540). Results first showed stronger obligatory and prosocial motivation for all three reciprocity appeals, compared to the standard appeal. No statistically significant results were found for either reactance or skepticism. Finally, after learning that the hotel had made a financial contribution to an environmental organization (i.e., indirect heteromorphic reciprocity) participants showed reduced meat consumption intentions compared to the standard appeal. Overall, the results provide initial evidence for conceptually refining the norm of reciprocity to encourage pro-environmental behaviors and for understanding the underlying psychological processes.

Rural adults' perceptions of nutrition recommendations for cancer prevention: Contradictory and conflicting messages

Despite robust evidence linking alcohol, processed meat, and red meat to colorectal cancer (CRC), public awareness of nutrition recommendations for CRC prevention is low. Marginalized populations, including those in rural areas, experience high CRC burden and may benefit from culturally tailored health information technologies. This study explored perceptions of web-based health messages iteratively in focus groups and interviews with 48 adults as part of a CRC prevention intervention. We analyzed transcripts for message perceptions and identified three main themes with subthemes: (1) Contradictory recommendations, between the intervention's nutrition risk messages and recommendations for other health conditions, from other sources, or based on cultural or personal diets; (2) reactions to nutrition risk messages, ranging from aversion (e.g., "avoid alcohol" considered "preachy") to appreciation, with suggestions for improving messages; and (3) information gaps. We discuss these themes, translational impact, and considerations for future research and communication strategies for delivering web-based cancer prevention messages.

Spicing up food interactions: Development of a healthy food education activity targeting fathers and their young children

BACKGROUND

Childhood obesity rates have been rapidly increasing worldwide. Several actions to reduce this trend have addressed maternal feeding practices. However, research reports an unwillingness to taste healthful foods expressed by children and fathers, which represents a major obstacle to a healthy diet in the family household. The present study aims to propose and qualitatively evaluate an intervention to increase fathers' involvement with their families' healthy eating through exposure to new/disliked healthy foods.

METHODS

Fifteen Danish families took part in a 4-week online intervention involving picture book reading, a sensory experience session and the cooking of four recipes with four targeted vegetables (celeriac, Brussels sprouts, spinach and kale) and two spices (turmeric and ginger). Interviews were conducted with the families and the content was analysed through a blended or abductive approach.

RESULTS

Participating in the activities motivated children and fathers to try new vegetables and spices, and increased fathers' sense of self-efficacy toward cooking, tasting new foods and healthy feeding. For the family, the intervention acted as a trigger to consume a higher variety of vegetables and spices and prompted feelings of "food joy". The outcomes observed are of importance considering the relatively low cost and the remote approach of the intervention.

CONCLUSIONS

The results highlight the fact that fathers play an important role in the home food environment. We conclude that fathers should be included to a higher extent in food and nutrition strategies aimed at promoting healthy weight development in their children.

Psychiatric Patients' Perceived Health Control and Reactance: Implications for Medication Adherence

Adherence to prescribed treatment is a major challenge in psychiatry, with non-adherence rates estimated to be as high as 50%. Two factors that have been suggested to influence medication adherence in psychiatric patients are perceived health control and psychological reactance. Perceived health control refers to the belief that one can control their own health outcomes, while psychological reactance refers to the negative response that occurs when individuals perceive their freedom or autonomy to be threatened. The aim of this review is to explore the possible relevance and interaction of perceived health control and psychological reactance in the adherence of psychiatric patients to their treatment. Several studies have suggested that higher levels of perceived health control are associated with better medication adherence, while higher levels of psychological reactance are associated with poorer adherence. Moreover, it has been suggested that patients with high levels of perceived health control may be more likely to experience psychological reactance if they feel that their autonomy is threatened by the treatment regimen. Taken together, these findings suggest that perceived health control and psychological reactance may interact to influence medication adherence in psychiatric patients. Future research could explore ways to enhance patients' perceived health control while minimizing psychological reactance in order to improve treatment adherence in this population.

Discovery of interconnected causal drivers of COVID-19 vaccination intentions in the US using a causal Bayesian network

Holistic interventions to overcome COVID-19 vaccine hesitancy require a system-level understanding of the interconnected causes and mechanisms that give rise to it. However, conventional correlative analyses do not easily provide such nuanced insights. We used an unsupervised, hypothesis-free causal discovery algorithm to learn the interconnected causal pathways to vaccine intention as a causal Bayesian network (BN), using data from a COVID-19 vaccine hesitancy survey in the US in early 2021. We identified social responsibility, vaccine safety and anticipated regret as prime candidates for interventions and revealed a complex network of variables that mediate their influences. Social responsibility's causal effect greatly exceeded that of other variables. The BN revealed that the causal impact of political affiliations was weak compared with more direct causal factors. This approach provides clearer targets for intervention than regression, suggesting it can be an effective way to explore multiple causal pathways of complex behavioural problems to inform interventions.

Mistaking opposition for autonomy: psychophysical studies on detecting choice bias

Do people know when they act freely and autonomously versus when their actions are influenced? While the human aspiration to freedom is widespread, little research has investigated how people perceive whether their choices are biased. Here, we explored how actions congruent or incongruent with suggestions are perceived as influenced or free. Across three experiments, participants saw directional stimuli cueing left or right manual responses. They were instructed to follow the cue's suggestion, oppose it or ignore it entirely to make a 'free' choice. We found that we could bias participants' 'free responses' towards adherence or opposition, by making one instruction more frequent than the other. Strikingly, participants consistently reported feeling less influenced by cues to which they responded incongruently, even when response habits effectively biased them towards such opposition behaviour. This effect was so compelling that cues that were frequently presented with the Oppose instruction became systematically judged as having less influence on behaviour, artificially increasing the sense of freedom of choice. Taken together, these findings demonstrate that acting contrarian distorts the perception of autonomy. Crucially, we demonstrate the existence of a novel illusion of freedom evoked by trained opposition. Our results have important implications for understanding mechanisms of persuasion.

Waiting for a Match: Mitigating Reactance in Prosocial Health Behavior Using Psychological Distance

This study examined how psychological distance, both social and temporal, can be leveraged in prosocial health behavior messages to mitigate perceived psychological reactance. Following the construal level and psychological reactance theories, we conducted a 2 × 2 between-subjects factorial design (N = 245), which manipulated naturalistic messages regarding a prosocial communications campaign. Structural equation modeling showed that far temporal distance combined with far social distance could significantly reduce threat to freedom and therefore positively affect attitudes and behavioral intentions toward prosocial health topics. The effect of social distance was found not significant, differing from past findings. Further, intertwined and parallel psychological reactance models were tested and discussed. We suggest the need for more psychological reactance research, particularly examining prosocial health behavior. Strategies for practical persuasion strategies in prosocial messages are proposed.

[Pathological Demand Avoidance: Current State of Research and Critical Discussion]

Pathological Demand Avoidance: Current State of Research and Critical Discussion Abstract: Pathological demand avoidance (PDA) describes children who obsessively avoid any demand to a clinically relevant extent and is presently the subject of controversial discussion. Their behavior may be interpreted as an attempt to reduce anxiety by establishing security and predictability through rigid control of the environment as well as the demands and expectations of others. The symptoms are described in the context of autism spectrum disorder. This article reviews the current state of research and discusses the questionable validity of pathological demand avoidance as an independent diagnostic entity. It also addresses the impact of the behavior profile on development and treatment. This paper concludes that PDA is not a diagnostic entity nor a subtype of autism; rather, it is a behavior profile that can be associated with adverse illness progression and unfavorable outcomes. PDA is one feature in a complex model. We must consider not only the patient's characteristics but also those of the caregiver and their psychopathology. The reactions of the interaction partners as well as the treatment decisions play a key role play for the affected individuals. Substantial research is needed concerning the occurrence of the behavior profile PDA in diverse disorders, treatment options, and treatment responses.

Not All Effects Are Indispensable: Psychological Science Requires Verifiable Lines of Reasoning for Whether an Effect Matters

To help move researchers away from heuristically dismissing "small" effects as unimportant, recent articles have revisited arguments to defend why seemingly small effect sizes in psychological science matter. One argument is based on the idea that an observed effect size may increase in impact when generalized to a new context because of processes of accumulation over time or application to large populations. However, the field is now in danger of heuristically accepting all effects as potentially important. We aim to encourage researchers to think thoroughly about the various mechanisms that may both amplify and counteract the importance of an observed effect size. Researchers should draw on the multiple amplifying and counteracting mechanisms that are likely to simultaneously apply to the effect when that effect is being generalized to a new and likely more dynamic context. In this way, researchers should aim to transparently provide verifiable lines of reasoning to justify their claims about an effect's importance or unimportance. This transparency can help move psychological science toward a more rigorous assessment of when psychological findings matter for the contexts that researchers want to generalize to.

Dietary Supplements: A Gateway to Doping?

Dietary supplements are widely used among athletes, but many may be unaware of the potential for unintentional doping, especially considering that supplements can often be contaminated with prohibited substances. The reason behind the widespread use of dietary supplements among athletes is often cited as being for the purposes of enhancing health or performance. However, many athletes turn to unreliable sources of information, and often lack knowledge of dietary supplement regulations. The aim of this narrative review is to explore the current research surrounding the psychological constructs (such as norms, attitudes, and beliefs) related to dietary supplement use among athletes that may lead to inadvertent doping. This review also covers possible programme structures that may be effective at preventing inadvertent doping.

„Ein Social-Media-Post ist kein Projektil“ – Konzeptionelle Herausforderungen durch Desinformation

Das sicherheitspolitische Paradigma der „Hybriden Bedrohungen“ zählt Desinformationsaktivitäten zum Arsenal internationaler „Grauzonenkonflikte“ unterhalb der Schwelle des bewaffneten Angriffs. Demokratische Staaten geraten damit in das Paradox, ihre Öffentlichkeit als Plattform der Meinungs- und Willensbildung gegen feindselige Interventionen zu verteidigen, ohne in deren konstitutive Freiheitlichkeit einzugreifen. Dies stellt die staatliche Gefahrenabwehr vor neue konzeptionelle Herausforderungen.

Ecology, Culture, and Behavior: Role in Societal Development

The field of cross-cultural psychology studies the development and display of human behavior as it emerges in various ecological and cultural contexts worldwide. I adopt two perspectives on this field: functionalism and universalism. The first perspective considers that individual behaviors are adaptive to these contexts in variable ways that permit success in life; that is, adaptation involves changing societal institutions and behaviors over time to meet the needs and goals of local cultural populations. The second perspective views these behaviors as being rooted in species-wide shared processes and capacities; that is, all human beings possess a set of common underlying potentials for development. From these two perspectives, I see no contradiction between evidence that behaviors are differentially shaped, developed, and expressed in different cultures, and the evidence that there are shared underlying processes on which these developments take place. Culturally sensitive development, when viewed within this conceptual nexus, is not a “one size fits all” approach, but one that is rooted in, and meets, both local and global needs and concerns.

Field Trial of a Shopworker Robot with Friendly Guidance and Appropriate Admonishments

We developed an admonishing service for a shopworker robot and conducted a field trial to investigate the impressions of a shop’s staff and customers. Applying the admonishing service in a real-world robot is difficult due to the high risk of rejection by society. We wanted to achieve an acceptable admonishing service while simultaneously avoiding the impression of a forceful request from a machine. We proposed a harmonized design that provided friendly and admonishing services. First, we interviewed a shop’s staff to learn their strategies for both friendly and admonishing services. From our evaluation of the interview results, we derived three design principles: friendly impressions, zero erroneous admonishments, and polite requests. Based on the design principles, we implemented our harmonized design on a social robot that guides customers to product locations and admonishes those who are not wearing face masks. We conducted a 13-day field trial in a retail shop and interviewed the customers and shopworkers to learn their impressions of our robot. The results of the field trial imply that our harmonized design approach is successful. Both the customers and the shop staff had overall positive impressions of the robot, its admonishing and friendly services, and expressed an intention to use it in the future. Furthermore, we studied the robot’s autonomous service-providing capability in the field and conducted an evaluation with hired participants to deepen our study of the robot’s mask recognition capability.

Reactance, Decisional Procrastination, and Hesitation: A Latent Class Analysis of Clutter Behavior

During the 2019-2020 global pandemic, mandated time at home suggested engagement in personal projects, such as home decluttering. Clutter (an overabundance of possessions) may impede one's quality of life by interfering with space livability and social connections and prompting negative affect and financial problems. The present study explored action-state orientation, psychological reactance, and decisional procrastination with 227 American adults (M age = 49.9 years old). A latent class analysis tested for differences in cognition across groups. Results supported that persons who struggle with clutter reflect clusters or "classes" given their self-reported cognitive processes, with hesitant and indecisive participants experiencing greater negative impacts of clutter than action-oriented and decisive participants. Our findings suggested improving the decision-making and goal-directed capacities of those struggling with clutter may be effective as preventive and/or interventive strategies. Future research might consider when hesitation to initiate challenging tasks and indecision emerge in the decluttering timeline and how those who are prone to these cognitions may be supported in managing their personal possessions.

[Work-related sedentary behavior]

Background

Sedentary behavior is associated with an increased risk of chronic diseases, such as metabolic syndrome and type 2 diabetes and all-cause mortality. Occupational sitting time contributes to large amounts of daily sedentary behavior, especially in office workers.

Objective

This study investigated the amount of time spent in sedentary behavior during different tasks at work and while commuting of administrative personnel of a university hospital in Germany.

Material and methods

A cross-sectional questionnaire-based study of administrative employees at the University Hospital Regensburg, Germany was carried out to assess work-related sedentary behavior. Descriptive and exploratory statistical analyses were performed.

Results

The study population consisted of 159 participants (54.1% women, 51.6% older than 40 years), which corresponds to a response rate of 26%. The median daily sitting time in the office was 7.0 h (interquartile range, IQR 6.0-7.5 h) and mostly occurred during computer work (57.3%), telephone calls (13.2%) and meetings (11.7%). Median standing time at work was 0.8 h (IQR 0.3-1.4 h). Administrative staff spent a median of 0.7 h (IQR 0.3-1.0 h) per day sedentary while commuting, with 67.3% of respondents commuting by car, motorbike or scooter. The participants were of the opinion that sitting for long uninterrupted periods had negative (69.6%) or relatively negative (29.7%) effects on health.

Conclusion

Administrative staff in hospitals spend large amounts of the daily working time with sedentary behavior. Interventions that enable working both in sitting and standing positions can lead to reduced work-related sitting time and thereby could improve occupational and, in a broader sense, public health.

Examining the effects of psychological reactance on COVID-19 vaccine acceptance: Comparison of two countries

Background

Despite the public acceptance of COVID-19 vaccines being necessary to achieve ample immunization rates and, in turn, put an end to the global pandemic, vaccine hesitancy and refusal are on the rise. To detect and address the concerns of those who are hesitant, it is critical to identify all potential factors behind vaccine decision-making in order to devise strategies to enhance vaccine acceptance and uptake.

Methods

We retrieved a total of 742 and 685 completed questionnaires from Iran and France, respectively; after initial cleaning and data screening, the number of usable questionnaires dropped to 714 and 664. We evaluate the distinct vaccination and lockdown restrictions in Iran and France and used multi-group analysis to evaluate structural path models of French and Iranian people, revealing a significant difference between the two groups in vaccination-related decisions. This empirical study is one of the first to employ the measurement invariance was evaluated using the measurement invariance for composite (MICOM) approach in testing partial least squares-structural equation modelling (PLS-SEM) measurement invariance and one of the first to use both Henseler's MGA and Henseler's permutation method to perform multi-group analysis (MGA).

Results

MGA revealed significant differences in the effects of influential factors on vaccine acceptance across France and Iran. In other words, many determining factors are likely to be context-dependent. The study revealed that reactance (due to restrictions and perceived scarcity) and financial strain significantly influenced COVID-19 vaccine acceptance and uptake among Iranians; however, among the French, confidence, and convenience were far more influential.

Conclusions

These cross-cultural differences point to the importance of conducting additional research in this area that directly compares various effects across countries. Each country's public health authorities and policymakers could use these insights to develop more targeted strategies and, in turn, boost vaccination rates among the public.

The effects of safety certification and nutrition messaging on the demand for nutritionally enhanced food in urban Ethiopia

Micronutrient deficiency is among the most significant public health problems in Ethiopia. In this setting, food fortification has been identified as a cost-effective and sustainable strategy to deliver essential micronutrients. Safety certification and nutrition education messages can be used to nudge people to choose fortified foods. However, there is little evidence as to the effectiveness of such interventions in this context. This paper aims to fill this gap. We focus on cooking oil, as it has been identified as an ideal candidate for vitamin A fortification in Ethiopia. To study consumers’ willingness to pay (WTP) for safety certification and vitamin A fortification, we implemented a stated choice experiment on 996 randomly selected urban consumers to reveal preferences required to calculate WTP. To estimate the causal effect of messages on consumers’ WTP for fortification, a nutrition message on the benefits of vitamin A was provided to 518 randomly selected participants. We found that consumers valued safety certification. This finding holds for certification issued by both government and private parties, with a higher value ascribed to the former. We also found that urban consumers were willing to pay a premium for vitamin A fortification. The nutrition message increased WTP for fortification, albeit only slightly. Finally, we found that the effect of safety certification on consumers’ WTP for fortified cooking oil was higher than its effect on WTP for non-fortified oil, indicating that urban consumers value certification even more when fortification is involved.

Avoiding the Abject and Seeking the Script: Perceived Mind, Morality, and Trust in a Persuasive Social Robot

Social robots are being groomed for human influence, including the implicit and explicit persuasion of humans. Humanlike characteristics are understood to enhance robots’ persuasive impact; however, little is known of how perceptions of two key human capacities—mind and morality—function in robots’ persuasive potential. This experiment tests the possibility that perceived robot mind and morality will correspond with greater persuasive impact, moderated by relational trust for a moral appeal and by capacity trust for a logical appeal. Via online survey, a humanoid robot asks participants to help it learn to overcome CAPTCHA puzzles to access important online spaces—either on grounds that it is logical or moral to do so. Based on three performance indicators and one self-report indicator of compliance, analysis indicates that (a) seeing the robot as able to perceive and act on the world selectively improves compliance and (b) perceiving agentic capacity diminishes compliance, though capacity trust can moderate that reduction. For logical appeals, social-moral mental capacities promote compliance, moderated by capacity trust. Findings suggest that, in this compliance scenario, the accessibility of schemas and scripts for engaging robots as social-moral actors may be central to whether/how perceived mind, morality, and trust function in machine persuasion.

Turning evidence into action using a senior friendly hospital framework and a collaborative network

The Senior Friendly Hospital Accelerating Change Together in Ontario program linked the Collaborative Network Model and the Senior Friendly Hospital Framework in a unique multi-hospital knowledge-to-practice initiative to improve care for hospitalized older adults. The design enabled teams from 78 Ontario hospitals to close a shared skills and knowledge gap while meeting the varied needs of their diverse contexts. Results suggest that this design meant to reduce unnecessary redundancy, while preserving requisite diversity, was successful in achieving its specific objectives: to build a collaborative network and increase the confidence, knowledge, and skills of its members sufficient to lead sustainable improvements in their unique hospital settings. Findings with special relevance to process improvement specialists, health system leaders, and hospital administrators and managers are discussed.

Wildfire imagery reduces risk information-seeking among homeowners as property wildfire risk increases

Negative imagery of destruction may induce or inhibit action to reduce risks from climate-exacerbated hazards, such as wildfires. This has generated conflicting assumptions among experts who communicate with homeowners: half of surveyed wildfire practitioners perceive a lack of expert agreement about the effect of negative imagery (a burning house) on homeowner behavior, yet most believe negative imagery is more engaging. We tested whether this expectation matched homeowner response in the United States. In an online experiment, homeowners who viewed negative imagery reported more negative emotions but the same behavioral intentions compared to those who viewed status-quo landscape photos. In a pre-registered field experiment, homeowners who received a postcard showing negative imagery were equally likely, overall, to visit a wildfire risk webpage as those whose postcard showed a status quo photo. However, the negative imagery decreased webpage visits as homeowners' wildfire risk increased. These results illustrate the importance of testing assumptions to encourage behavioral adaptation to climate change.

Unveiling the effects of consumers' psychological distance on their reactance and related behavioral outcomes: Do lockdown restrictions matter?

This study examined consumers' psychological reactance, which is insufficiently explored in the literature. This research fills the gaps found in the literature reviewed and investigates how the psychological reactance of restaurant consumers developed because of social, temporal, and spatial distancing measures during COVID-19. This study also explored ways in which the restaurant industry can increase its compliance with COVID-19 restrictions in such a situation. We explored the effects of social, temporal, and spatial distancing on psychological reactance. We also identified the moderating effect of lockdown restrictions, which strengthen the psychological reactance developed because of (a) social distancing, (b) temporal distancing, and (c) spatial distancing. We collected data from restaurant consumers in Lahore. This study applied quantitative techniques (i.e., a test of normality, measurement model assessment, structural model assessment, and common method variance). The data were analyzed using IBM SPSS 25 and AMOS 24 and the results were interpreted and presented accordingly. This study added to the literature on psychological reactance, service management, and psychological distance. We could also help the restaurant industry overcome the challenges that occurred during the COVID-19 pandemic and the closures. This study could assist the restaurant industry to understand consumer behavior and attract potential consumers.

Anxiety disorders, COVID-19 fear, and vaccine hesitancy

Development of the COVID-19 vaccines unfolded in real-time, lending a sense that they were developed more rapidly than other vaccines. Long-term data on their safety and effectiveness is not yet available. Thus, people may have greater uncertainty about the COVID-19 vaccines than other vaccines. We know that people high in anxiety have greater intolerance of uncertainty (IUS) and may have greater fears of adverse effects and concerns about the vaccine failing to prevent COVID-19. Ultimately, people with anxiety disorders may have greater COVID-19 vaccine hesitancy (VH). This study examined the degree of VH in people with (n = 96) and without (n = 52) anxiety disorders, whether anxiety status has an additive effect on factors known to predict hesitancy, and whether reasons for VH differed across groups. Groups did not differ in VH, but IUS was associated with greater hesitancy in those without anxiety but with less hesitancy in those with anxiety. Both groups' strongest predictors of hesitancy were influenza vaccine history, conspiracy beliefs, individualism, and trust. The top reasons for VH were concerns about adverse effects and efficacy, and the top reasons to get the vaccine were to protect others and self. Implications for reducing VH are discussed.

Negative vs. Positive Psychology: a Review of Science of Well-Being

Happiness, well-being, human freedom, and life events are interconnected. Nevertheless, the debate about human well-being struggles to find an exact definition. Literature debates on the importance of positive psychology or adverse effects of negative psychology in the well-being context discuss separately. However, both counter each other but have their significance and indisputable fact. Human psychology evolves around determinism and Free Will. One type of determinism is hard, while the other is soft. Individuals who are adamant about and embrace acceptance of chances are driven by their nature and psychology to choose negative behaviors under hard determinism. They give up their free will, whereas soft determinists use it to make choices and behave positively. However, the researchers looked at negative psychology as a useful aspect and positive psychology's dark side. We argued that there are reasons to suppose that chances can develop into options and vice versa. From a well-being perspective, negative and positive psychological strengths and weaknesses can be investigated. From the literature review, useful hypotheses for future research have been derived from our synthesis.

When Are Loss Frames More Effective in Climate Change Communication? An Application of Fear Appeal Theory

This study investigated how goal frames (gain, non-loss, loss) either with or without efficacy statements affect consumers’ support for climate-change policy. Addressing the goal-framing literature’s difficulty in establishing a guiding theory with consistent findings, we (1) propose fear appeal theory as an alternative framework to guide goal-framing research; (2) test five fear appeal variables (fear, perceived threat, hope, perceived efficacy, and message processing) as mediators of goal-framing effects on policy support; and (3) highlight four common goal-framing confounds that may partly underlie the literature’s inconsistent findings. Aligning with fear appeal theory, results from a carefully controlled experiment revealed that a more threatening loss frame paired with an efficacy statement produced the strongest pro-policy attitudes and the greatest willingness-to-pay by successfully balancing fear/threat with hope/efficacy and by producing deeper message processing.

Predicting the role of coping factors on pandemic-related anxiety

The year 2020 saw the emergence of a worldwide pandemic caused by the novel coronavirus COVID-19. Measures against further spread of the virus were taken nearly everywhere in the world. Many countries also imposed social distancing rules and lockdowns on their population. This situation has caused a lot of fear and insecurity, along with reactance and even unrest in some countries. In this study, we measured the psychological concepts of resilience, reactance, positive schemas, social solidarity, and anxiety among psychiatric patients and in how far these factors influence their psychopathological anxiety during the pandemic. The aim was to better understand in what ways these factors influence pandemic anxiety to be able to reduce its negative psychological effects. Findings show a significant effect of positive schemas and social solidarity on the level of pandemic anxiety in a sample of psychiatric patients, but no correlation between resilience or reactance and pandemic anxiety. Based on these insights, the inclusion of positive schemas and social solidarity for therapy should be considered. Looking deeper into the relation between positive schemas and pandemic anxiety could provide insight into the different ways that schemas influence people's anxiety and determine whether some of them are particularly important.

Underlying Motivators for Anti-Vaccination Attitudes Among Regional Sunshine Coast Parents in Australia

BACKGROUND

The Immunisation Register of Australia reports that childhood vaccination rates in some regional areas are below herd immunity levels. This is a concern for the health and well-being of society, as regions with low vaccination rates have an increased risk of disease outbreaks.

OBJECTIVE

This study explored psychological motivators as predictors of anti-vaccination attitudes among parents living on the Sunshine Coast (Queensland), Australia.

METHODS

A cross-sectional survey design explored anti-vaccination attitudes, conspiratorial thinking, psychological reactance, trust in government, and magical beliefs about health in 1,050 parents (968 mothers).

RESULTS

The predictor variables significantly accounted for 42% of the variance in parental anti-vaccination attitudes. The strongest predictor of anti-vaccination attitudes was trust in government.

CONCLUSION

The findings contribute to understanding of psychological factors motivating anti-vaccine attitudes in Australian parents. The findings may help inform health communication campaign effectiveness in their alignment with individual underlying motivations.

"If You Love Me, You Must Do..." Parental Psychological Control and Cyberbullying Perpetration Among Chinese Adolescents

Considering the prevalence of cyberbullying, the current study explores the factors associated with its perpetration. Using self-determination theory, the association of parental psychological control (PPC) with cyberbullying perpetration was examined. To explore this influencing mechanism further, psychological reactance (PRt) and materialism were examined as two mediators in this relationship. Moreover, according to the diathesis-stress model and cognitive model of resilience, psychological resilience (PRl) was examined as a moderator in the direct and indirect link between PPC and cyberbullying perpetration. To test our expectations, 804 adolescents (M = 13.12, SD = 1.16) participated in the current study using a cross-sectional design and multiple questionnaires, namely, the Chinese version of the Parental Control Questionnaire, Revised Cyber Bullying Inventory, Hong Psychological Reactance Scale, Material Values Scale for Children, and Resilience Scale for Chinese Adolescents. Correlation analysis indicated that PPC, PRt, materialism, and cyberbullying perpetration were significantly and positively correlated, and were significantly and negatively related to PRl. Moderated mediation analysis revealed that PRt and materialism played multiple mediating roles in the relationship between PPC and cyberbullying perpetration. Multiple mediation analysis indicated that PRl weakened the direct associations of PPC, PRt, and materialism with cyberbullying perpetration, further alleviating the indirect and direct associations of PPC with cyberbullying perpetration, supporting the moderated mediation model. Specifically, adolescents high in PPC were more likely to have stronger PRt and materialistic values, which further triggered cyberbullying perpetration. PRl can protect adolescents high in PPC from cyberbullying perpetration via weakening the direct and indirect associations of PPC with cyberbullying.

Young Swiss men's risky single-occasion drinking: Identifying those who do not respond to stricter alcohol policy environments

BACKGROUND

Previous research has demonstrated a preventive effect of the alcohol policy environment on alcohol consumption. However, little is known about the heterogeneity of this effect. Our aim was to examine the extent of heterogeneity in the relationship between the strictness of alcohol policy environments and heavy drinking and to identify potential moderators of the relationship.

METHODS

Cross-sectional data from 5986 young Swiss men participating in the cohort study on substance use risk factors (C-SURF) were analysed. The primary outcome was self-reported risky single-occasion drinking in the past 12 months (RSOD, defined as 6 standard drinks or more on a single occasion at least monthly). A previously-used index of alcohol policy environment strictness across Swiss cantons was analysed in conjunction with 21 potential moderator variables. Random forest machine learning captured high-dimensional interaction effects, while individual conditional expectations captured the heterogeneity induced by the interaction effects and identified moderators.

RESULTS

Predicted subject-specific absolute risk reductions in RSOD risk ranged from 16.8% to - 4.2%, indicating considerable heterogeneity. Sensation seeking and antisocial personality disorder (ASPD) were major moderators that reduced the preventive relationship between stricter alcohol policy environments and RSOD risk. They also were associated with the paradoxical observation that some individuals displayed increased RSOD risk in stricter alcohol policy environments.

CONCLUSION

Whereas stricter alcohol policy environments were associated with reduced average RSOD risk, additionally addressing the risk conveyed by sensation seeking and ASPD would deliver an interlocking prevention mix against young Swiss men's RSOD.

Assessment of Attitudes, Main Concerns and Sources of Knowledge Regarding COVID-19 Vaccination in Poland in the Unvaccinated Individuals-A Nationwide Survey

Vaccination is the most effective tool to combat the COVID-19 pandemic. However, it is ineffective without appropriate public acceptance. In Poland, 53% of the country's population is vaccinated, which puts us in the last position among the EU countries. Therefore, this study aims to assess the main concerns regarding vaccination in the unvaccinated population of Poland. The study was based on an original questionnaire that was distributed online. There were three phases of the study: Phase 1-before the preventive vaccination plan, Phase 2-2 months after implementation of the programme, Phase 3-after 4 months when the immunisation rate in Poland was 42%. A total of 4459 individuals participated in the study. As many as 1943 participants were excluded from the analysis due to lack of consent (30 subjects) or COVID-19 vaccination (1913 subjects). Out of the remaining 2516 unvaccinated individuals, 463 were participants in the first phase of the study, 1137 in the second phase of the study, and 916 in the third phase. As the preventive vaccination plan in Poland continued, concerns about vaccine adverse events, safety and efficacy were raised. The only lower concern was that about the vaccine transportation rules. Moreover, as the vaccination programme continued, there was an increase in the percentage of individuals declaring their full reluctance towards vaccination against COVID-19. Conclusions: The Internet is the main source of knowledge about the COVID-19 vaccination, so it should be focused on during vaccination campaigns. The public is primarily concerned about adverse events of vaccines and the lack of appropriate tests of the products used. Therefore, it is advisable to popularise the current state of knowledge and promote reliable information concerning the COVID-19 vaccination.

Can We Do Better Next Time? Italians' Response to the COVID-19 Emergency through a Heuristics and Biases Lens

During the outbreak of COVID-19 in Italy, people often failed to adopt behaviors that could have stopped, or at least slowed down, the spread of this deadly disease. We offer cognitive explanations for these decisions, based on some of the most common heuristics and biases that are known to influence human judgment and decision-making, especially under conditions of high uncertainty. Our analysis concludes with the following recommendations: policymakers can and should take advantage of this established science, in order to communicate more effectively and increase the likelihood that people choose responsible actions in a public health crisis.

Meat Me Halfway: Sydney Meat-Loving Men’s Restaurant Experience with Alternative Plant-Based Proteins

Within the theoretical framework of psychological reactance and impression management, this study conducted in Sydney, Australia, in 2020–2021, explores the acceptance by men of alternatives to animal-based foods. Qualitative in-depth interviews were conducted with 36 men who have visited a vegan restaurant and have eaten a plant-based burger. The findings from the study show that, despite the increasing popularity of these novel food options, men are unlikely to include the plant-based alternatives as a permanent feature of their diets as explained by the theory of psychological reactance. However, the study’s male participants acknowledged the importance of women for their visit to the vegan restaurant which can be explained by impression management theory. Using excerpts from the interviews, men’s experience is highlighted, particularly as it relates to concerns linked to masculinity, dietary identity and social perception by others. The analysis reveals the complexity of transitioning to more sustainable food choices within a gender-constructed social environment. Whether the new plant-based alternatives to meat are going to be a short-lived trend or a more lasting option in the men’s diets is also discussed. Practical implications for social marketing as a tool to influence collective behaviour are drawn. They emphasise the role of women, changing social perceptions and transparency about the new plant-based products.