Defensive reactions to health-promoting information: an overview and implications for future research

Sixty years of fear appeal research: current state of the evidence

Fear arousal is widely used in persuasive campaigns and behavioral change interventions. Yet, experimental evidence argues against the use of threatening health information. The authors reviewed the current state of empirical evidence on the effectiveness of fear appeals. Following a brief overview of the use of fear arousal in health education practice and the structure of effective fear appeals according to two main theoretical frameworks-protection motivation theory and the extended parallel process model-the findings of six meta-analytic studies in the effectiveness of fear appeals are summarized. It is concluded that coping information aimed at increasing perceptions of response effectiveness and especially self-efficacy is more important in promoting protective action than presenting threatening health information aimed at increasing risk perceptions and fear arousal. Alternative behavior change methods than fear appeals should be considered.

Neuroscientific evidence for defensive avoidance of fear appeals

Previous studies indicate that people respond defensively to threatening health information, especially when the information challenges self-relevant goals. The authors investigated whether reduced acceptance of self-relevant health risk information is already visible in early attention allocation processes. In two experimental studies, participants were watching high- and low-threat health commercials, and at the same time had to pay attention to specific odd auditory stimuli in a sequence of frequent auditory stimuli (odd ball paradigm). The amount of attention allocation was measured by recording event-related brain potentials (i.e., P300 ERPs) and reaction times. Smokers showed larger P300 amplitudes in response to the auditory targets while watching high-threat instead of low-threat anti-smoking commercials. In contrast, non-smokers showed smaller P300 amplitudes during watching high as opposed to low threat anti-smoking commercials. In conclusion, the findings provide further neuroscientific support for the hypothesis that threatening health information causes more avoidance responses among those for whom the health threat is self-relevant.

Examining patterns of association with defensive information processing about colorectal cancer screening

To reduce negative psychological affect from information or behavior that is inconsistent with one's positive self-concept, individuals use a variety of defensive strategies. It is unknown whether correlates differ across defenses. We examined correlates of four levels of defensive information processing about colorectal cancer screening. Cross-sectional surveys were completed by a convenience sample of 287 adults aged 50-75 years. Defenses measures were more consistently associated with individual differences (especially avoidant coping styles); however, situational variables involving health-care providers also were important. Future research should examine changes in defenses after risk communication and their relative impact on colorectal cancer screening.

Belief in life-after-death, beliefs about the world, and psychiatric symptoms

Data from the 2010 Baylor Religion Survey were analyzed by structural equation modeling (SEM) to test five hypotheses: (1) that religious commitment is positively related to belief in life-after-death; that belief in life-after-death is (2) positively related to belief in an equitable world, and (3) negatively related to belief in a cynical world; (4) that belief in a cynical world has a pernicious association with psychiatric symptoms; and (5) that belief in an equitable world has a salubrious association with psychiatric symptoms. As hypothesized, religious commitment was positively related to belief in life-after-death (β = .74). In turn, belief in life-after-death was negatively associated with belief in a cynical world (β = -.16) and positively associated with belief in an equitable world (β = .36), as hypothesized. SEM further confirmed that belief in a cynical world had a significant pernicious association with all five classes of psychiatric symptoms (β's = .11 to .30). Belief in an equitable world had a weaker and less consistent salubrious association with psychiatric symptoms. The results are discussed in the context of ETAS theory.

Preaching to the choir? The influence of personal relevance on the effects of gain- and loss-framed health-promoting messages

This article examines the moderating influence of personal relevance on the persuasive effects of gain- and loss-framed messages. We assessed current behaviour as a proxy for personal relevance, provided 169 participants with gain- and loss-framed messages advocating skin self-examination (SSE) and assessed intention to engage in SSE as the outcome measure. The results showed that loss-framed information was more persuasive than gain-framed information, but only for low-relevance participants. This suggests that loss-framed information might be mainly effective for recipients who need little persuading and, in fact, runs the risk of ‘preaching to the choir’.