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Li J, Chen Y, Tang M, Wang S. Do Negative Self-Evaluative Emotions Enhance Healthier Food Choices? Exploring the Moderating Role of Self-Affirmation. Behav Sci (Basel) 2024; 14:538. [PMID: 39062361 PMCID: PMC11274215 DOI: 10.3390/bs14070538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 06/13/2024] [Accepted: 06/17/2024] [Indexed: 07/28/2024] Open
Abstract
Negative self-evaluative emotions arise when an individual engages in behavior that is perceived as inadequate or inconsistent with personal or societal norms and values, leading to feelings of inadequacy, shame, and dissatisfaction with oneself. These emotions are a central motivating force for changing unhealthy behaviors. However, negative evaluative emotions may also direct individuals towards defensive reactions such as reactance and avoidance. This can cause negative self-evaluative emotions to be less effective in reducing unhealthy behavior. More importantly, empirical evidence is needed to explore strategies for enhancing the effectiveness of interventions. In this study, we used an online experiment with 100 student participants to examine if increasing self-affirmation can increase the effectiveness of negative self-evaluative emotions in reducing unhealthy food consumption. We found that negative self-evaluative emotions can significantly increase healthy food consumption. However, our analysis did not reveal a significant moderating impact of self-affirmation on the effectiveness of negative self-evaluative emotions in reducing unhealthy consumption. This is the first study to explore the moderating impact of self-affirmation on the effectiveness of negative self-evaluative emotions on health behavioral change, which opens new avenues for studying how to apply the combination of stimulating negative self-evaluative emotions and increasing self-affirmation to induce behavioral change regarding healthy diets and even a broader range of fields.
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Affiliation(s)
- Jingwen Li
- Faculty of Behavioural and Social Sciences, University of Groningen, 9712 TS Groningen, The Netherlands;
| | - Yu Chen
- Faculty of Economics and Business, University of Groningen, 9747 AT Groningen, The Netherlands;
| | - Mingcong Tang
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA;
| | - Shuangmiao Wang
- Institute of Health Promotion and Medical Communication Science, Guangdong Medical University, Zhanjiang 524023, China
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2
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Travis E, Ashley L, O'Connor DB. Effects of a self-affirmation intervention on responses to bowel cancer screening information. Psychol Health 2024:1-18. [PMID: 38519876 DOI: 10.1080/08870446.2024.2332265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/15/2023] [Indexed: 03/25/2024]
Abstract
OBJECTIVE To investigate the effect of two brief self-affirmation interventions, immediately prior to reading standard information about bowel cancer screening, on state anxiety, message acceptance and behavioural intention to screen for bowel cancer. METHODS 242 adults aged 49 were randomised to one of two self-affirmation interventions (health or values) or one of two control conditions, before reading an NHS England bowel cancer screening leaflet. Participant friend and family history of bowel cancer, state anxiety, message acceptance, behavioural intention to screen, trait self-esteem and spontaneous self-affirmation were measured. Data were analysed using between-participants analysis of variance, planned contrasts and moderated regression. RESULTS No main effects of experimental condition on levels of state anxiety, message acceptance and behavioural intention were found. However, planned contrasts showed participants who self-affirmed about their health or values (conditions-collapsed) were significantly less anxious and reported significantly higher behavioural intentions compared to participants in the controls (conditions-collapsed). Irrespective of condition, higher levels of spontaneous self-affirmation and trait self-esteem were correlated with lower anxiety, higher intentions, and message acceptance. CONCLUSION There was some evidence of the effect of health-based self-affirmation on lowering anxiety; however, further research is needed to explore the effectiveness of different self-affirmation interventions in larger samples.
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Affiliation(s)
| | - Laura Ashley
- School of Humanities & Social Sciences, Leeds Beckett University, Leeds, UK
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3
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Fennell BS, Magnan RE, Hunt RL. Longitudinal comparisons of self-affirmation approaches for sun protection. Br J Health Psychol 2023; 28:793-813. [PMID: 36840397 PMCID: PMC10447630 DOI: 10.1111/bjhp.12654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 02/26/2023]
Abstract
OBJECTIVES Self-affirmation approaches for health behaviour demonstrate consistent small to medium effects on message acceptance, health intentions and behaviour change. There are several forms of self-affirmation (e.g., values affirmations, implementation intentions), but few empirical comparisons to guide selection in empirical work. Further, there has been little emphasis on the putative mechanisms of self-affirmation driving behaviour change. The current investigation compared a control and four self-affirmation approaches: values, social, implementation intention, and perspective taking. METHODS Participants were recruited through CloudResearch (N = 666) and reported baseline sun exposure and protection behaviour at Time 1. One week later (Time 2), returning participants (N = 535) were randomly assigned to condition, viewed a message conveying risks of sun exposure, and reported sun exposure and protection intentions for the next week. Follow-up one week later (Time 3; N = 449) assessed past week sun exposure (i.e., number of days spent outside during peak hours), sun protection behaviour (e.g., sunscreen use), future sun exposure and protection intentions and engagement with resources conveying further health information (i.e., viewing infographics, following links to websites with more information). The association of putative mechanisms with self-affirmation conditions and health outcomes was also examined. RESULTS Unexpectedly, there were few differences between self-affirmation conditions and the control on intentions, information seeking, or behaviour at follow-up. At follow-up, perspective circle participants reported fewer days spent outside, spent longer viewing infographics, and, along with social values participants, followed more weblinks seeking information than control participants. The putative mechanisms were unrelated to health outcomes. CONCLUSIONS The current investigation was a first step in comparing novel online self-affirmation approaches and had largely null findings. Results suggest that the perspective circle performed best at promoting information seeking and, to some extent, behaviour change. Suggestions for future directions are discussed.
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Affiliation(s)
| | - Renee E. Magnan
- Washington State University Vancouver, Vancouver, Washington, USA
| | - Robin L. Hunt
- Washington State University Vancouver, Vancouver, Washington, USA
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4
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Huang S, Zhou C, Yuan Q, Chen G, Shen H. How do online users perceive health risks during public health emergencies? Empirical evidence from China. Front Psychol 2023; 14:1087229. [PMID: 36777227 PMCID: PMC9912773 DOI: 10.3389/fpsyg.2023.1087229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/03/2023] [Indexed: 01/28/2023] Open
Abstract
Background The global COVID-19 pandemic has posed a major threat to human life and health, and new media technologies have intensified the spread of risk perception. Purpose This study aimed to explore the impact of risk information ground on online users' perceived health risks, and further explore the mediating role of psychological distance and the moderating role of self-efficacy. Methods A total of 25 Internet users from different provinces in China were interviewed in-depth, NVIVO.11 was used to qualitatively analyze the interview text data and construct a theoretical model. A total of 492 interviewees were recruited in order to complete a scenario questionnaire, SPSS-27 was used to perform orthogonal experiments, generate eight combinatorial scenarios, analyze demographic data, and clean and prepare data for testing hypotheses. SmartPLS 3.0 was used to test the conceptual model using the structural equation model (SEM) of the partial least squares (PLS). Results The analysis of the SEM model shows that all planned hypotheses (Information fluency → Information diagnosability, Information extensibility → Information diagnosability, Information diagnosability → Psychological distance, Platform interactivity → Scenario embeddedness, Network connectivity → Scenario embeddedness, Scenario embeddedness → Psychological distance, Psychological distance → Risk perception, Psychological distance → Self-efficacy → Risk perception, Information fluency → Information diagnosability → Psychological distance → Risk perception, Information extensibility → Information diagnosability → Psychological distance → Risk perception, Platform interactivity → Scenario embeddedness → Psychological distance → Risk perception, Network connectivity → Scenario embeddedness → Psychological distance → Risk perception) are confirmed. Conclusion This study found that the information ground factors significantly affect online users' perceptions of health risks, psychological distance mediates the effect of information ground factors on risk perception, and self-efficacy negatively moderates the effect of psychological distance on risk perception.
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Affiliation(s)
- Shijing Huang
- High-Quality Development Evaluation Institute, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Cheng Zhou
- School of Public Administration, Nanjing Normal University, Nanjing, China,*Correspondence: Cheng Zhou, ✉
| | - Qinjian Yuan
- School of Information Management, Nanjing University, Nanjing, China
| | - Guohua Chen
- School of Management and Engineering, Nanjing University, Nanjing, China
| | - Hongzhou Shen
- School of Management, Nanjing University of Posts and Telecommunications, Nanjing, China
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5
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Gillman AS, Iles IA, Klein WMP, Ferrer RA. Increasing Receptivity to COVID-19 Public Health Messages with Self-Affirmation and Self vs. Other Framing. HEALTH COMMUNICATION 2022:1-12. [PMID: 35264033 DOI: 10.1080/10410236.2022.2043024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
There remains an urgent need for effective communication about the importance of widespread adherence to behavioral recommendations to control the COVID-19 pandemic that will also reduce resistance to such guidance. We examined two strategies for COVID-19 communication- (1) self-affirmation (reflecting on a personal value in order to boost self-integrity and reduce defensiveness to potentially threatening information); and (2) manipulating self/other message framing - and moderation of these strategies by COVID-19 risk. 600 participants (Mage = 32.55, 51% female) were recruited for an online study and, after assessment of risk factors for severe COVID-19 infection, were exposed to the experimental manipulations. Three classes of defensive responses were considered as outcomes of interest: reactance, attitudinal responses, and behavioral responses. We found that participants derogated the self-focused message more than the other-focused message. Further, other-focused messaging and/or self-affirmation were more likely to elicit positive responses among individuals at higher risk for COVID-19 complications. Our findings suggest having individuals affirm values prior to viewing COVID-19 messages, and framing messages in terms of the importance of protecting others, may be beneficial strategies for encouraging responsiveness - particularly if the targets of such messages are at risk of COVID-19 complications themselves.
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Affiliation(s)
- Arielle S Gillman
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Irina A Iles
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - William M P Klein
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Rebecca A Ferrer
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
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6
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Bartmann N, Rayburn-Reeves R, Lindemans J, Ariely D. Does Real Age Feedback Really Motivate Us to Change our Lifestyle? Results from an Online Experiment. HEALTH COMMUNICATION 2022:1-10. [PMID: 35100916 DOI: 10.1080/10410236.2022.2030078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
We set out to research the causal impact of Real Age feedback, a popular tool on health and lifestyle platforms, on health behaviors. We ran an online experiment where participants were randomly assigned a Real Age that differed in both direction (older or younger) and magnitude (much or slightly) from their passport age, or to a control condition where they received no Real Age feedback. We measured the impact of Real Age feedback on motivation to begin a healthier lifestyle, interest in taking a Real Age test, and percentage click-rate on an optional health link. We found that younger Real Age feedback was associated with higher interest. In addition, participants who received a slightly older Real Age were significantly less motivated to begin a healthier lifestyle compared to not only those who received a much younger or much older Real Age, but also to those in the control condition, suggesting a backfire effect. This effect remained even after accounting for participant health, demographics, and other psychological correlates to motivation. Real Age tests may backfire and demotivate people, and the positive effects they may have on psychological states may not outweigh the negative effects. Though promising, we caution using Real Age tests in their current form as stand-alone interventions to get people motivated.
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Affiliation(s)
| | | | | | - Dan Ariely
- Center for Advanced Hindsight, Duke University
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7
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Psychological Impact of Ambiguous Health Messages about COVID-19. J Behav Med 2021; 45:159-171. [PMID: 34811623 PMCID: PMC8608560 DOI: 10.1007/s10865-021-00266-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 11/04/2021] [Indexed: 12/19/2022]
Abstract
Perceiving ambiguity in health information-that is, uncertainty elicited from believing information lacks credibility, reliability, or adequacy-is typically associated with pessimistic appraisals (e.g., high perceived disease risk) and behavioral avoidance. We examined the effect of ambiguous health information about COVID-19 on health cognitions and vaccination intentions, and tested a "normalized-uncertainty" intervention. Two studies with identical methodology (online adult sample: n = 299, undergraduate sample: n = 150) were conducted in March to April 2020. Participants were randomly assigned to read one of three health messages about COVID-19 that emphasized what was currently unknown (ambiguity condition), what was currently unknown but that scientific uncertainty is expected (intervention condition), or what was currently known (control condition). The ambiguity condition led to greater perceived ambiguity than the control condition and perceived ambiguity in the intervention condition was comparable to the ambiguity condition. There were few differences in health cognitions, and no differences in vaccination intentions, when examining pairwise comparisons across the three conditions. Correlational analyses collapsing across condition indicated evidence of pessimistic appraisal but not behavioral avoidance among individuals who perceived greater ambiguity. Future research should examine longer, more detailed normalized-uncertainty interventions.
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8
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Iles IA, Gillman AS, Ferrer RA, Klein WMP. Self-affirmation inductions to reduce defensive processing of threatening health risk information. Psychol Health 2021; 37:1287-1308. [PMID: 34323138 DOI: 10.1080/08870446.2021.1945060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Self-affirmation reduces defensiveness toward threatening health messages. In this study, we compared several possible self-affirmation inductions in order to identify the most effective strategy. DESIGN Women at increased risk for breast cancer (i.e. who drink 7+ drinks per week) were recruited through Amazon Mechanical Turk (N = 1,056), randomly assigned to one of 11 self-affirmation conditions, and presented with an article about the link between alcohol intake and breast cancer risk. MAIN OUTCOME MEASURES Participants answered questions that measured key indices of message acceptance (risk perception, message endorsement), future alcohol consumption intentions, and action plans to reduce alcohol intake. RESULTS Participants who affirmed health vs. non-health values did not differ in behavioral intentions or action plans to reduce alcohol intake. General values vs. health essay affirmations led to higher odds of reporting some vs. no action plans to reduce alcohol consumption. Essay- vs. questionnaire-based inductions led to higher breast cancer worry and intentions to reduce alcohol consumption. CONCLUSION Overall, self-affirmation inductions that include an explicit focus on values (general or health-related) and self-generation of affirming thoughts through essay writing, are most potent in changing behavioral intentions and action plans to change future health behavior.
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Affiliation(s)
- Irina A Iles
- Office of the Associate Director, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Arielle S Gillman
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rebecca A Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - William M P Klein
- Office of the Associate Director, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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9
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Chen S, Liu J, Hu H. A Norm-Based Conditional Process Model of the Negative Impact of Optimistic Bias on Self-Protection Behaviors During the COVID-19 Pandemic in Three Chinese Cities. Front Psychol 2021; 12:659218. [PMID: 34163404 PMCID: PMC8215150 DOI: 10.3389/fpsyg.2021.659218] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/10/2021] [Indexed: 11/13/2022] Open
Abstract
Data were collected from 896 participants in three Chinese cities affected by the COVID-19 pandemic to varying degrees through an online survey platform. A conditional process model was then proposed for the impact of optimistic bias on self-protection behaviors during the COVID-19 pandemic from the perspective of social norms. Statistical analysis demonstrates that optimistic bias has a negative impact on self-protection behaviors through message acceptance. Perceived social norms moderate this relationship in the following ways: (1) The higher the perceptions of social norms, the smaller the negative impact of optimistic bias on message acceptance, and the smaller the positive impact of message acceptance on self-protection behaviors. (2) Within a certain range, the higher the perceptions of social norms, the smaller the negative impact, both direct and indirect, of optimistic bias on self-protection behaviors. (3) The direct and indirect effects of optimistic bias on self-protection behaviors become insignificant when perceptions of social norms are very strong. Comparing the data of the three cities shows that higher risk is associated with a stronger role of social norms in moderating the relationship between optimistic bias and self-protection behaviors. The above results suggest that there may be both internal (optimistic bias) and external (social norms) reference points in individual decision-making regarding health behaviors. The theoretical and practical significance of the dual reference points are discussed.
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Affiliation(s)
- Sijing Chen
- School of Economics and Management, Zhejiang University of Science and Technology, Hangzhou, China
| | - Jianwei Liu
- School of Economics and Management, Zhejiang University of Science and Technology, Hangzhou, China
| | - Huamin Hu
- School of Economics and Management, Zhejiang University of Science and Technology, Hangzhou, China
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10
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Seaman EL, Robinson CD, Crane D, Taber JM, Ferrer RA, Harris PR, Klein WMP. Association of Spontaneous and Induced Self-Affirmation With Smoking Cessation in Users of a Mobile App: Randomized Controlled Trial. J Med Internet Res 2021; 23:e18433. [PMID: 33666561 PMCID: PMC7980123 DOI: 10.2196/18433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/21/2020] [Accepted: 11/11/2020] [Indexed: 11/19/2022] Open
Abstract
Background Most smokers attempt to stop using cigarettes numerous times before successfully quitting. Cigarette cravings may undermine perceived competence to quit and thus constitute psychological threats to the individual’s self-concept. Self-affirmation may promote smoking cessation by offsetting these threats. Objective This study examines whether self-affirmation is associated with smoking cessation in the context of a cessation app. Two types of self-affirmation are examined: tendency to spontaneously self-affirm, and self-affirmation inductions added to a publicly available smoking cessation app (Smoke-Free Quit Smoking Now). In addition, this study explores whether optimism and emotional states (happiness, anger, anxiousness, hopefulness, sadness) predict smoking cessation. Methods All users who met the inclusion criteria, provided consent to participate, and completed a baseline assessment, including all individual difference measures, were randomized to 1 of 4 conditions. Half of the participants were randomly assigned to complete a self-affirmation induction upon study entry. Orthogonally, half of the participants were randomly assigned to receive self-affirming text notifications during their quit attempt or to receive conventional notifications. The induction and the text notifications were fully automated, and all data were collected through self-assessments in the app. Self-reported smoking cessation was assessed 1 month and 3 months following study entry. Results The study enrolled 7899 participants; 647 completed the 1-month follow-up. Using an intent-to-treat analysis at the 1-month follow-up, 7.2% (569/7899) of participants self-reported not smoking in the previous week and 6.4% (503/7899) self-reported not smoking in the previous month. Greater tendency to spontaneously self-affirm predicted a greater likelihood of cessation (P<.001) at 1 month after controlling for smoking-related variables. Neither self-affirmation induction influenced cessation. In addition, spontaneous self-affirmation did not moderate the relationship between self-affirmation inductions and cessation. Greater baseline sadness was associated with a lower likelihood of reporting successful cessation. Optimism predicted past-week cessation at the 1-month follow-up, and both happiness and anger predicted past-month cessation at the 1-month follow-up; however, none of these potential predictors moderated the relationship between self-affirmation conditions and successful cessation. Conclusions Spontaneous self-affirmation may be an important psychological resource for managing threats to self-concept during the smoking cessation process. Sadness may hinder quit attempts. Future research can explicate how spontaneous versus induced self-affirmation can promote smoking cessation and examine boundary conditions for the effectiveness of disseminated self-affirmation interventions. Trial Registration ISRCTN Registry 56646695; https://www.isrctn.com/ISRCTN56646695
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Affiliation(s)
| | - Cendrine D Robinson
- Behavioral Research Program (BRP), Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, United States
| | | | - Jennifer M Taber
- Department of Psychological Sciences, Kent State University, Kent, OH, United States
| | - Rebecca A Ferrer
- Behavioral Research Program (BRP), Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, United States
| | - Peter R Harris
- School of Psychology, University of Sussex, Falmer, Brighton, United Kingdom
| | - William M P Klein
- Behavioral Research Program (BRP), Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, United States
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11
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A Randomized Study of Values Affirmation to Promote Interest in Diabetes Prevention Among Women With a History of Gestational Diabetes. Med Care 2019; 57:528-535. [PMID: 31107396 DOI: 10.1097/mlr.0000000000001133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to test whether 2 interventions promote interest in diabetes prevention among women with a history of gestational diabetes mellitus, who face high lifetime risk for diabetes. RESEARCH DESIGN AND METHODS We designed an email outreach message promoting an existing preventive lifestyle program. The message incorporated values affirmation, a theory-based intervention that can improve openness to health information but typically relies on a writing exercise less practical in health care settings. In a 3-arm randomized study, 237 women with elevated body mass index and a history of gestational diabetes mellitus were randomized to read an outreach message containing either no affirmation (control) or 1 of 2 affirmations, streamlined to remove the typical writing exercise: either a values affirmation prompting reflection on any personal value, or a parenting affirmation prompting reflection on caregiving-related values. Outcomes included demonstrating interest in the lifestyle program (seeking information about it or intending to join) and seeking publicly-available health information about diabetes prevention. RESULTS Compared with control, participants randomized to the values affirmation more frequently demonstrated interest in the lifestyle program (59.0% vs. 74.4%; adjusted relative risk: 1.31; 95% confidence interval: 1.04-1.66) and sought information about diabetes prevention (59.0% vs. 73.4%; adjusted relative risk: 1.22; 95% confidence interval: 0.97-1.54). The parenting affirmation yielded no significant differences in either outcome. CONCLUSIONS A streamlined values affirmation, designed for feasibility in a health care setting, can promote interest in diabetes prevention among women at high risk. Research is needed to evaluate its effects on diabetes prevention program enrollment and clinical outcomes.
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12
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Turbitt E, Roberts MC, Taber JM, Waters EA, McNeel TS, Biesecker BB, Klein WMP. Genetic counseling, genetic testing, and risk perceptions for breast and colorectal cancer: Results from the 2015 National Health Interview Survey. Prev Med 2019; 123:12-19. [PMID: 30817954 PMCID: PMC7321923 DOI: 10.1016/j.ypmed.2019.02.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 02/16/2019] [Accepted: 02/23/2019] [Indexed: 11/19/2022]
Abstract
We examined what proportion of the U.S. population with no personal cancer history reported receiving either genetic counseling or genetic testing for cancer risk, and also the association of these behaviors with cancer risk perceptions. We used data from the 2015 National Health Interview Survey. Objective relative risk scores for breast (women) and colorectal (men and women) cancer risk were generated for individuals without a personal history of cancer. Participants' risk perceptions were compared with their objective relative risk. Of 12,631 women, 1.2% reported receiving genetic counseling and 0.8% genetic testing for hereditary breast cancer risk. Of 15,085 men and women, 0.8% reported receiving genetic counseling and 0.3% genetic testing for hereditary colorectal cancer risk. Higher breast cancer risk perception was associated with genetic counseling (OR: 4.31, 95%CI: 2.56, 7.26) and testing (OR: 3.56, 95%CI: 1.80, 7.03). Similarly, higher perception of colorectal cancer risk was associated with genetic counseling (OR: 5.04, 95%CI: 2.57, 9.89) and testing (OR: 5.92, 95%CI: 2.40, 14.63). A higher proportion of individuals with colorectal cancer risk perceptions concordant with their objective risk (vs. discordant) had undergone genetic counseling or testing for colorectal cancer risk. Concordant risk perceptions for breast cancer were not associated with breast cancer genetic counseling or testing. Given frequent dialogue about implementing population level programs involving genetic services for cancer risk, policy makers and investigators should consider the role of risk perceptions in the effectiveness and design of such programs and potential strategies for addressing inaccuracies in risk perceptions.
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Affiliation(s)
- Erin Turbitt
- National Human Genome Research Institute, Bethesda, MD, United States of America; University of Technology Sydney, NSW, Australia.
| | - Megan C Roberts
- National Cancer Institute, Rockville, MD, United States of America
| | | | - Erika A Waters
- Washington University School of Medicine in St. Louis, St Louis, MO, United States of America
| | - Timothy S McNeel
- Information Management Services, Inc., Calverton, MD, United States of America
| | - Barbara B Biesecker
- Research Triangle Institute, International, Washington, DC, United States of America
| | - William M P Klein
- National Human Genome Research Institute, Bethesda, MD, United States of America; National Cancer Institute, Rockville, MD, United States of America
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13
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Ferrer RA, Cohen GL. Reconceptualizing Self-Affirmation With the Trigger and Channel Framework: Lessons From the Health Domain. PERSONALITY AND SOCIAL PSYCHOLOGY REVIEW 2018; 23:285-304. [DOI: 10.1177/1088868318797036] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Self-affirmation—a theory-based technique to affirm the adaptive adequacy of the self—can promote positive behavior change and adaptive outcomes, although effects are variable. We extend a novel framework (Trigger and Channel), proposing three conditions that facilitate self-affirmation-induced behavior change: (a) presence of psychological threat, (b) presence of resources to foster change, and (c) timeliness of the self-affirmation with respect to threat and resources. Using health behavior as a focus, we present meta-analytic evidence demonstrating that when these conditions are met, self-affirmation acts as a psychological trigger into a positive channel of resources that facilitate behavior change. The presence of a timely threat and the availability of timely resources independently predicted larger self-affirmation effects on behavior change, and the two interacted synergistically to predict still larger effects. The results illustrate the conditionality of self-affirmation effects and offer guidelines for when, where, and for whom self-affirmation will be most effective.
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Affiliation(s)
- Rebecca A. Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, National Cancer Institute, Bethesda, MD, USA
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14
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Chipperfield JG, Perry RP, Pekrun R, Hamm JM, Lang FR. Paradoxical Effects of Perceived Control on Survival. J Gerontol B Psychol Sci Soc Sci 2018; 73:1166-1174. [PMID: 28204798 PMCID: PMC6146758 DOI: 10.1093/geronb/gbx002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 01/06/2017] [Indexed: 11/13/2022] Open
Abstract
Objectives Appraising health as controllable is typically thought to be adaptive, but recent evidence suggests the paradoxical possibility that perceived control (PC) can be detrimental. We considered the premise that high PC should have a survival benefit when it is part of an adaptive mindset involving high value (importance) for health, but it might be detrimental when it is part of a mindset comprised of low health value (HV). In addition, we examined whether the survival consequences of PC and HV vary with advancing age. Method Interviews were conducted with a heterogeneous sample of community-dwelling adults (n = 341; 72-99 years) to assess appraisals of control and value in the domain of health. Mortality data were obtained over 12 years from a provincial health registry. Results Both age and HV moderated the PC effect on mortality. The predicted beneficial and detrimental PC effects emerged at younger ages: higher PC predicted longer survival times when health was highly valued but shorter survival times when health was less highly valued. Discussion These findings deepen the knowledge regarding the conditions under which PC is or is not adaptive, suggesting the consequences depend on age and the extent to which health is valued.
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Affiliation(s)
| | | | - Reinhard Pekrun
- Department of Psychology, University of Munich, Germany
- Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | | | - Frieder R Lang
- Institute of Psychogerontology, University of Erlangen-Nuremberg, Germany
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15
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Gamp M, Schupp HT, Renner B. Risk Perceptions After Receiving Multiple Risk Feedback. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2018; 44:1350-1363. [PMID: 29716423 DOI: 10.1177/0146167218767877] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
How do people respond to multiple risk feedback in a real-life context? Based on theoretical assumptions, three different predictions for risk perceptions were tested: (a) relative accuracy in risk perceptions, (b) self-defensive responses according to self-affirmation theory, and (c) compensatory responses according to the compensatory health belief model. Participants of a community health screening ( N = 725) received multiple risk indicator feedback for actual blood pressure, blood glucose, and blood lipid levels. Consistent multiple risk feedback profiles encompassed three consistent readings (three normal or three elevated readings). Mixed risk profiles included one elevated and two normal readings. Results indicate relative accuracy in responses: an elevated reading triggered higher risk perception of the respective risk factor. Importantly, the effect was not modulated by the presence of normal readings as assumed by the self-defensive or compensatory response perspective, indicating that people accurately integrate multiple risk indicator feedback as it is often provided in real life.
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16
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Lipkus IM, Johnson CM, Amarasekara S, Pan W, Updegraff JA. Reactions to online colorectal cancer risk estimates among a nationally representative sample of adults who have never been screened. J Behav Med 2017; 41:289-298. [PMID: 29143218 DOI: 10.1007/s10865-017-9902-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 11/07/2017] [Indexed: 12/20/2022]
Abstract
Data on the public's reactions to online tailored colorectal cancer (CRC) risk estimates are sparse. We assessed among 560 men and women aged 50-75 with no CRC screening history reactions to online tailored CRC estimated comparative risk (i.e., self vs. other their age and sex). Assessed were reactions to estimate (i.e., repeating back estimate, match between perceived comparative risk and estimate, accuracy and usefulness of estimate, emotional reactions), risk appraisals and screening intentions. 73% of the sample accurately repeated back their estimate; the match between perceived comparative risk and the estimate was lowest among those informed of being at higher risk. Higher estimates were viewed as less useful and evoked more negative emotions. Viewing the estimate as more useful and experiencing more negative emotions were related with higher risk appraisals and, in turn, screening intentions. These data indicate that adults at higher comparative risk resist accepting a higher risk status.
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Affiliation(s)
- Isaac M Lipkus
- Duke University School of Nursing, 307 Trent Dr., Durham, NC, 27710, USA.
| | - Constance M Johnson
- University of Texas Health Science Center at Houston, School of Nursing and School of Biomedical Informatics, 6901 Bertner Ave., Houston, TX, 77030, USA
| | - Sathya Amarasekara
- Duke University School of Nursing, 307 Trent Dr., Durham, NC, 27710, USA
| | - Wei Pan
- Duke University School of Nursing, 307 Trent Dr., Durham, NC, 27710, USA
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17
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Jessop DC, Sparks P, Jessop L, Dodds L, Lynch S. Morality or competence? The importance of affirming the appropriate dimension of self-integrity. Br J Health Psychol 2016; 21:956-972. [DOI: 10.1111/bjhp.12209] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 05/05/2016] [Indexed: 11/28/2022]
Affiliation(s)
| | - Paul Sparks
- School of Psychology; University of Sussex; UK
| | | | | | - Sarah Lynch
- School of Psychology; University of Sussex; UK
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18
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Chipperfield JG, Perry RP, Pekrun R, Barchfeld P, Lang FR, Hamm JM. The Paradoxical Role of Perceived Control in Late Life Health Behavior. PLoS One 2016; 11:e0148921. [PMID: 26974153 PMCID: PMC4790945 DOI: 10.1371/journal.pone.0148921] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 01/23/2016] [Indexed: 11/25/2022] Open
Abstract
Research has established the health benefits of psychological factors, including the way individuals appraise outcomes. Although many studies confirm that appraising outcomes as controllable is adaptive for health, a paradoxical possibility is largely ignored: Perceived control may be detrimental under some conditions. Our premise was that appraising health as controllable but at the same time ascribing little value to it might signal a dysfunctional psychological mindset that fosters a mistaken sense of invincibility. During face-to-face interviews with a representative sample of older adults (age range = 72–99), we identified individuals with such a potentially maladaptive “invincible” mindset (high perceived control and low health value) and compared them to their counterparts on several outcomes. The findings were consistent with our hypotheses. The invincibles denied future risks, they lacked the activating emotion of fear, and they visited their physicians less often over a subsequent five-year period. Moreover, in contrast to their counterparts, the invincibles did not appear strategic in their approach to seeking care: Even poor health did not prompt them to seek the counsel of a physician. The recognition that psychological appraisals are modifiable highlights the promise of remedial methods to alter maladaptive mindsets, potentially improving quality of life.
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Affiliation(s)
| | - Raymond P. Perry
- Department of Psychology, University of Manitoba, Winnipeg, Canada
| | - Reinhard Pekrun
- Department of Psychology, University of Munich, Munich, Germany
| | - Petra Barchfeld
- Department of Psychology, University of Munich, Munich, Germany
| | - Frieder R. Lang
- Institute of Psychogerontology, University of Erlangen-Nuremberg, Nuremberg, Germany
| | - Jeremy M. Hamm
- Department of Psychology, University of Manitoba, Winnipeg, Canada
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19
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Voisin D, Girandola F, David M, Aim MA. Self-affirmation and an incongruent drinking norm: alcohol abuse prevention messages targeting young people. SELF AND IDENTITY 2016. [DOI: 10.1080/15298868.2015.1121916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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20
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Klein WMP, Hamilton JG, Harris PR, Han PKJ. Health messaging to individuals who perceive ambiguity in health communications: the promise of self-affirmation. JOURNAL OF HEALTH COMMUNICATION 2015; 20:566-72. [PMID: 25806652 DOI: 10.1080/10810730.2014.999892] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The perception that extant health messages about risk factors for a disease are ambiguous can be associated with greater anxiety and reduced interest in taking precautionary action. In this experiment, 247 female alcohol consumers who perceived varying degrees of ambiguity in current cancer prevention messages read an unambiguous article about the documented link between alcohol consumption and breast cancer. Before reading the article, half were given the opportunity to self-affirm by reflecting on an important value-a technique previously shown to enhance receptivity to threatening messages. The authors found that self-affirmation increased message acceptance among those who perceived relatively higher levels of ambiguity in cancer communications. Also, the relation between perceived ambiguity and risk perception became positive among self-affirmed participants, suggesting they had become less defensive. Self-affirmation may be an effective technique to use when delivering health communications to audiences who perceive a lack of consistency in prevention messages.
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Affiliation(s)
- William M P Klein
- a Behavioral Research Program, Division of Cancer Control and Population Sciences , National Cancer Institute, National Institutes of Health , Bethesda , Maryland , USA
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21
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Kingsbury JH, Gibbons FX, Gerrard M. The effects of social and health consequence framing on heavy drinking intentions among college students. Br J Health Psychol 2014; 20:212-20. [DOI: 10.1111/bjhp.12100] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 01/23/2014] [Indexed: 11/28/2022]
Affiliation(s)
- John H. Kingsbury
- Department of Psychological and Brain Sciences; Dartmouth College; Hanover New Hampshire USA
| | - Frederick X. Gibbons
- Department of Psychological and Brain Sciences; Dartmouth College; Hanover New Hampshire USA
| | - Meg Gerrard
- Department of Psychiatry; Dartmouth Medical School; Lebanon New Hampshire USA
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22
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Zell E, Krizan Z. Do People Have Insight Into Their Abilities? A Metasynthesis. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2014; 9:111-25. [DOI: 10.1177/1745691613518075] [Citation(s) in RCA: 229] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Having insight into one’s abilities is essential, yet it remains unclear whether people generally perceive their skills accurately or inaccurately. In the present analysis, we examined the overall correspondence between self-evaluations of ability (e.g., academic ability, intelligence, language competence, medical skills, sports ability, and vocational skills) and objective performance measures (e.g., standardized test scores, grades, and supervisor evaluations) across 22 meta-analyses, in addition to considering factors that moderate this relationship. Although individual meta-analytic effects ranged from .09 to .63, the mean correlation between ability self-evaluations and performance outcomes across meta-analyses was moderate ( M = .29, SD = .11). Further, the relation was stronger when self-evaluations were specific to a given domain rather than broad and when performance tasks were objective, familiar, or low in complexity. Taken together, these findings indicate that people have only moderate insight into their abilities but also underscore the contextual factors that enable accurate self-perception of ability.
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Affiliation(s)
- Ethan Zell
- University of North Carolina at Greensboro
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23
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Abstract
Following Weinstein's (1980) pioneering work many studies established that people have an optimistic bias concerning future life events. At first, the bulk of research was conducted using populations in North America and Northern Europe, the optimistic bias was thought of as universal, and little attention was paid to cultural context. However, construing unrealistic optimism as a form of self-enhancement, some researchers noted that it was far less common in East Asian cultures. The current study extends enquiry to a different non-Western culture. Two hundred and eighty seven middle aged and middle income participants (200 in India, 87 in England) rated 11 positive and 11 negative events in terms of the chances of each event occurring in "their own life," and the chances of each event occurring in the lives of "people like them." Comparative optimism was shown for bad events, with Indian participants showing higher levels of optimism than English participants. The position regarding comparative optimism for good events was more complex. In India those of higher socioeconomic status (SES) were optimistic, while those of lower SES were on average pessimistic. Overall, English participants showed neither optimism nor pessimism for good events. The results, whose clinical relevance is discussed, suggest that the expression of unrealistic optimism is shaped by an interplay of culture and socioeconomic circumstance.
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Affiliation(s)
- Mary Sissons Joshi
- Department of Psychology, Social Work and Public Health, Oxford Brookes UniversityOxford, UK
| | - Wakefield Carter
- Department of Psychology, Social Work and Public Health, Oxford Brookes UniversityOxford, UK
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25
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An affective booster moderates the effect of gain- and loss-framed messages on behavioral intentions for colorectal cancer screening. J Behav Med 2011; 35:452-61. [DOI: 10.1007/s10865-011-9371-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 07/18/2011] [Indexed: 10/17/2022]
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