Effects of reviewing risk-relevant behavior on perceived vulnerability among women marines

"It Won't Happen to Us": Unrealistic Optimism Affects COVID-19 Risk Assessments and Attitudes Regarding Protective Behaviour

People generally believe that their own future will be better than the one of comparable others. Robust evidence documents such unrealistic optimism in many domains of life. Here, we examine how unrealistic optimism may affect people's risk assessments of COVID-19 infection as well as their attitudes regarding behaviours intended to protect against contagion. In two studies conducted in the USA (N = 160) and UK (N = 161), at different times during the pandemic, we show that participants considered the likelihood of contracting and carrying the infection lower for themselves and their close other compared to an acquaintance, while they considered the likelihood of engaging in protective behaviours higher for themselves and their close other than an acquaintance. The findings document unrealistic optimism in relation to COVID-19. Such biases are particularly critical in relation to infectious diseases, where underestimating the risk for both oneself and close others may reduce precautions and increase virus spreading.

Do Moderators of the Optimistic Bias Affect Personal or Target Risk Estimates? A Review of the Literature

The optimistic bias is defined as judging one's own risk as less than the risk of others. Researchers have identified numerous personal and situational factors that moderate the extent to which people display the bias. It is unclear, however, whether these moderators affect the bias by influencing people's personal risk estimates or their risk estimates for a target. A review of moderators of the optimistic bias reveals evidence for both influences. Moderators associated with negative affect (negative mood, dysphoria, trait and state anxiety, event severity, and proximity of feedback) and control related moderators (perceived control and prior experience) appear primarily to affect personal risk estimates. Positive mood affects target risk estimates. Finally, moderators that surround the comparison process appear to have different effects. Specifically, the type of comparison target appears to affect target risk estimates, whereas attention to personal risk-related behaviors affects personal risk estimates.

Constructing Perceptions of Vulnerability: Personal Relevance and the Use of Experiential Information in Health Judgments

The perceived self-relevance of a health issue determined whether participants relied on recalled content or experienced ease of recall in assessing risk. Participants recalled either three or eight behaviors that increase or decrease risk of heart disease. Although recalling three risk factors was relatively easy, people had difficulty recalling eight risk factors. When heart disease was not considered self-relevant, participants used a heuristic judgment strategy and relied on their ease of recall. They reported greater vulnerability after having recalled three rather than eight risk-increasing behaviors and lower vulnerability after having recalled three rather than eight risk-decreasing behaviors. When heart disease was considered self-relevant, people used a systematic processing strategy and relied on the content of the information recalled. They reported greater (lower) vulnerability after having recalled eight rather than three risk-increasing (decreasing) behaviors. Theoretical implications concerning the interplay of recalled content and ease of recall in judgment and applied implications for risk perception are discussed.

Judgments of Vulnerability to Pregnancy: The Role of Risk Factors and Individual Differences

This study explored women's integration of information in making judgments about vulnerability to pregnancy and examined the influence of personality characteristics on these judgments. Female participants made judgments of the likelihood of pregnancy for each of 24 scenarios created by within-subjects factorial manipulation of three variables: frequency of intercourse, method of contraception, and target (self vs. the average woman their age). Their judgments reflected knowledge of the effect of frequency of intercourse and efficacy of birth control on the likelihood of pregnancy and an understanding of the interaction of these two factors. The results also indicate that two personality characteristics, erotophobia and locus of control, moderate judgments of the likelihood of pregnancy.

Pessimistic Bias in Comparative Evaluations: A Case of Perceived Vulnerability to the Effects of Negative Life Events

This study tested the hypothesis that unrealistic pessimism characterizes comparative estimates of coping ability. Participants rated their ability to adjust to a range of negative life events in comparison to the abilities of other same-sex students at their college. Most coping estimates showed signs of unrealistic pessimism, in that students rated their own abilities as worse than those of other same-sex students. Analyses indicated that this effect was due, in part, to the presence of an egocentric bias and, in part, to the absence of a self-enhancement bias. First, pessimism appeared to arise because participants paid more attention to the difficulties that they would have coping with severe misfortunes than they paid to the difficulties that others would have. Second, pessimism appeared to arise because participants were not motivated to enhance their coping appraisals, given that they were optimistic that they would not experience these events in the future.

Motivation Influences the Underestimation of Cumulative Risk

Past research has shown that people typically underestimate the cumulative risk of events. This effect has mainly been interpreted as resulting from the use of cognitive heuristics and judgment strategies, such as availability or anchoring and adjustment. The authors suggest that motivational processes can be an additional force in the generation of cumulative risk estimates. Using an experimental design, Study 1 shows that people underestimate the cumulative risk of infection with sexually transmitted diseases of appealing prospective sexual partners by using risk-irrelevant information for their judgment. Using a correlational design, Study 2 demonstrates that people underestimate the cumulative risk of being infected with a sexually transmitted disease and that commitment to the present partner is directly related to a low cumulative risk estimate as well as indirectly through its effect on the perceived risk of the present partner. Together, the two studies demonstrate that motivation influences the underestimation of cumulative risk.

Running in the Family or Swimming in the Gene Pool

The present study sought to understand how the genetic component of a disease affects individual's risk perceptions. Specifically, participants read three scenarios that asked them to imagine that they had either genetic, ambiguous, of no family history for a hypothetical disease and to imagine that their parents' lifestyles were either healthy or unhealthy. As expected, when participants received an ambiguous family history (rather than a genetic history or no family history), they rated a healthy diet and exercise as more effective at preventing the disease when their parents lifestyles were discribed as unhealthy rather than healthy (N = 97)

Social-Cognitive Processes in Behavioral Health

Social cognitive variables are salient factors in the prevention, development, and maintenance of health-related problems. These variables are of particular interest to counseling psychologists, as they are amenable to a variety of psychological interventions. We review several social-cognitive processes that have been studied in relation to behavioral health and health-related problems. We then discuss implications for assessment and theory-based interventions.

Self-Esteem, Compensatory Self-Enhancement, and the Consideration of Health Risk

Acknowledging that one engages in risk-increasing behavior is a form of self-generated negative feedback that can engender self-protective responses. This experiment examined the use of one of these reactions, compensatory self-enhancement, following a manipulation that made high and low self-esteem participants explicitly consider their sexual risk behaviors. Participants with high (but not low) self-esteem responded to the manipulation by self-enhancing on both personality ratings and ratings of their contraceptive behavior. Positive self-ratings on personality traits were negatively associated with subsequent ratings of perceived vulnerability to sexually transmitted diseases.

Do Assessments of HIV Risk Behaviors Change Behaviors and Prevention Intervention Efficacy? An Experimental Examination of the Influence of Type of Assessment and Risk Perceptions

BACKGROUND

Behavioral assessments may change behaviors and responses to behavioral interventions, depending on assessment type and respondents' motivations.

PURPOSE

We observed effects on sexual behavior and human immunodeficiency virus (HIV) prevention intervention efficacy of interviews assessing recent HIV risk behavior frequency or HIV risk behavior events among respondents with different perceptions of their risk for HIV.

METHODS

Young South African sexually transmitted infection (STI) clinic clients (N=1,728) participated in a 3 (event-based vs. frequency-based vs. no interview) by 2 (evidence-based vs. standard of care risk-reduction session) RCT.

RESULTS

The interviews increased reported safer sexual behavior among youth with higher but not lower risk perceptions. The intervention session was less effective when combined with interviews, particularly among lower risk perception youth. Patterns replicated for both interviews.

CONCLUSIONS

HIV risk behavior assessments may increase resistance to interventions among unmotivated youth and enhance safer sexual behavior among motivated youth. Behavioral assessments may reduce HIV risk among motivated individuals.

Taking Stock of Unrealistic Optimism

Researchers have used terms such as unrealistic optimism and optimistic bias to refer to concepts that are similar but not synonymous. Drawing from three decades of research, we critically discuss how researchers define unrealistic optimism and we identify four types that reflect different measurement approaches: unrealistic absolute optimism at the individual and group level and unrealistic comparative optimism at the individual and group level. In addition, we discuss methodological criticisms leveled against research on unrealistic optimism and note that the criticisms are primarily relevant to only one type-the group form of unrealistic comparative optimism. We further clarify how the criticisms are not nearly as problematic even for unrealistic comparative optimism as they might seem. Finally, we note boundary conditions on the different types of unrealistic optimism and reflect on five broad questions that deserve further attention.

Responses to gestational weight management guidance: a thematic analysis of comments made by women in online parenting forums

Background

The National Institute for Health and Clinical Excellence (NICE) published guidance on weight management in pregnancy in July 2010 (NICE public health guidance 27: 2010), and this received considerable press coverage across a range of media. This offered an opportunity to examine how gestational weight management guidance was received by UK women.

Methods

A thematic analysis was conducted of 400 posts made in UK-based parenting internet forums in the week following the publication of the NICE guidance. This allowed us to examine the naturally occurring comments from 202 women who posted about the guidance on public forums.

Results

Three main themes were identified and explored: i) Perceived control/responsibility ii) Risk perception iii) Confused messages.

Conclusions

Women differed in their perceptions of the level of control that they had over being overweight with some feeling responsible and motivated to maintain a healthy lifestyle. Others felt there were multiple factors influencing their weight issues beyond their control. There were reports of feeling guilty about the impact of weight on the growing baby and experiencing significant obesity stigma from the public and health professionals. Information about the risks of overweight and obesity in pregnancy were difficult messages for women to hear, and for health professionals to deliver. Women reported being confused by the messages that they received. Health messages need to be delivered sensitively to women, and health professionals need support and training to do this. Risk information should always be accompanied with clear advice and support to help women to manage their weight in pregnancy.

Perceived risk for sexually transmitted infections aligns with sexual risk behavior with the exception of condom nonuse: data from a nonclinical sample of sexually active young adult women

BACKGROUND

Research on the relationship between sexual risk behavior and perceived risk for contracting a sexually transmitted infection (STI) has yielded mixed results. The objective of this study is to investigate the extent to which 3 measures of perceived risk accurately reflect 5 sexual risk behaviors in a sample of healthy, sexually active young adult women. A positive monotonic relationship between sexual risk behavior and perceived risk for STIs is hypothesized.

METHODS

A sample of 1192 female U.S. Marine Corps on their first duty assignment 10 to 11 months (on average) after graduation from recruit training answered a self-administered paper-and-pencil questionnaire as part of a larger study evaluating an intervention to prevent STIs and unintended pregnancy that was administered during recruit training.

RESULTS

All but 1 of the 15 bivariate associations between sexual risk behavior and perceived risk for STIs was statistically significant. The expected positive monotonic relationship was observed except for condom use. Women who never used condoms during intercourse reported lower levels of perceived risk than occasional users and, in some subgroups, consistent condom users. Multivariate analyses further explored the relationship between condom use and perceived risk.

CONCLUSIONS

The results suggest that interventions directed at raising awareness of susceptibility to STIs should emphasize how the individual's own behavior puts them at risk, regardless of situation or context.

Improving pilots' risk assessment skills in low-flying operations: the role of feedback and experience

Risk assessment is one of the most important skills that pilots are expected to acquire to ensure the safe and successful management of flight. The traditional approach to the development of these skills requires pilots to directly engage with potentially hazardous events. Using low-flying as a context, the present study sought to test whether engagement with hazards in a simulated environment, together with feedback concerning performance, would improve pilots' risk assessment during a subsequent simulated test flight. The results indicated that engagement with the hazards, rather than the provision of feedback per se, was associated with behavior that reduced the risk to the aircraft, while maintaining operational performance. It was concluded that exposure to hazards within a simulated environment could provide the basis for the development of risk assessment skills amongst less experienced pilots.

Reasons and risk: factors underlying women's perceptions of susceptibility to osteoporosis

OBJECTIVES

To assess women's perceptions of risk for osteoporosis and to identify factors that shape those perceptions.

METHODS

A community sample of 358 women (aged 40-86) rated their perceived risk of osteoporosis and provided detailed information about factors underlying their risk perceptions. Their open-ended responses were content analysed.

RESULTS

On average, participants believed they were less likely to develop osteoporosis than other women their age. In all, 63% perceived their risk as lower than other women their age; only 16% as higher. In explaining their risk, women mentioned more risk-decreasing factors than risk-increasing factors. Women who rated their risk as low attributed their risk primarily to their own preventive behaviors (e.g. taking calcium, exercising), whereas women who rated their risk as high attributed their risk primarily to their family history. Risk-increasing and risk-decreasing personal actions, hereditary factors, and physiological factors accounted for 53% of the variance in perceived risk for osteoporosis. Only one-half and one-third of all women, however, mentioned calcium consumption and exercise, respectively, as protective factors employed to reduce osteoporosis risk. Women also held misconceptions about osteoporosis risk and protective factors.

CONCLUSIONS

The current findings yield a detailed portrait of women's risk perceptions for osteoporosis. Increasing awareness of osteoporosis should be a priority for future osteoporosis prevention campaigns. Interventions should address misconceptions women may hold about their risk for the disease and promote specific behavioral strategies for osteoporosis prevention.

Predictors of Children’s and Adolescents’ Risk Perception

OBJECTIVE

To test cognitive-developmental, social-cognitive, motivational, and cognitive hypotheses about the psychological mechanisms underlying children's risk perception.

METHOD

Youth (N = 1315) ranging from 9 to 17 years of age completed measures assessing adolescent egocentrism, personal experience with four negative health events, how much they worried about the health events, and their perceived skill for event-related activities. The measures were completed twice, 12 months apart.

RESULTS

Lacking personal experience with and worrying less about health threats were significant predictors of more optimistically biased risk perception a year later.

CONCLUSIONS

The lack of experience with and not worrying about serious health consequences may desensitize children to potential health risks. Clinical applications for health education programs are discussed.

Are comparative risk judgements consistent across time and events?

Research reveals pervasive optimism in people's comparative risk judgements such that people believe they are less likely than others to experience negative events. Two studies explored the extent to which people are consistent in their comparative risk judgements across time and events. Both studies found strong evidence for consistency across time and some evidence for consistency across events. The consistency across time and events was moderated by experience. Specifically, when viewed together, the studies suggest that experience produces an initial decrease in the consistency of comparative judgements (Study 2), followed by greater consistency in subsequent judgements (Study 1). The discussion focuses on reconciling evidence demonstrating consistency with evidence demonstrating variability.

Biases in Social Comparative Judgments: The Role of Nonmotivated Factors in Above-Average and Comparative-Optimism Effects

Biases in social comparative judgments, such as those illustrated by above-average and comparative-optimism effects, are often regarded as products of motivated reasoning (e.g., self-enhancement). These effects, however, can also be produced by information-processing limitations or aspects of judgment processes that are not necessarily biased by motivational factors. In this article, the authors briefly review motivational accounts of biased comparative judgments, introduce a 3-stage model for understanding how people make comparative judgments, and then describe how various nonmotivational factors can influence the 3 stages of the comparative judgment process. Finally, the authors discuss several unresolved issues highlighted by their analysis, such as the interrelation between motivated and nonmotivated sources of bias and the influence of nonmotivated sources of bias on behavior.

Health promotion in active-duty military women with children

The purpose of this study was to determine the extent to which selected demographic characteristics, definition of health, perceived health status, perceived self-efficacy, and resources are related to the health promoting behaviors of active-duty women with children and to describe qualitatively the experience of being an active-duty mother. Grounded in Pender's (1996) Health Promotion Model, this study used methodological triangulation to test a hypothesized model. A sample of 141 active-duty women with children using military health services participated. Resource availability and commitment were key components of being successful at balancing home and work demands.

Prediction of psychological reactions to bone density screening for osteoporosis using a cognitive-behavioral model of health anxiety

Pre-screening measures derived from a cognitive-behavioral theory of health anxiety were significant predictors of individual differences in post-screening reactions to a health screening procedure, bone densitometry. Predictors included specific illness beliefs (vulnerability, severity/consequences, coping and treatment) and general health anxiety measures. Three months after a low bone mineral density (BMD) result, women with high levels of pre-existing general health anxiety gave higher ratings of anxiety about osteoporosis and perceived likelihood of developing osteoporosis than women with low levels of preexisting health anxiety, even though the two groups' initial ratings had not differed significantly. Women with a low BMD result generally showed "minimization" of the seriousness of low BMD but women with very high levels of pre-existing health anxiety did not. After a high BMD result, highly health anxious women were only temporarily reassured. The results were consistent with the cognitive-behavioral analysis of health anxiety.

Predictive genetic testing in children and adults: a study of emotional impact

AIM

To determine whether, following predictive genetic testing for familial adenomatous polyposis (FAP), children or adults receiving positive results experience clinically significant levels of anxiety or depression, and whether children receiving positive results experience higher levels of anxiety or depression than adults receiving positive results.

DESIGN

Two studies, one cross sectional and one prospective.

SAMPLE

208 unaffected subjects (148 adults and 60 children) at risk for FAP who have undergone genetic testing since 1990.

MAIN MEASURES

DEPENDENT VARIABLES

anxiety, depression; independent variables: test results, demographic measures, psychological resources (optimism, self-esteem).

RESULTS

Study 1. In children receiving positive results, mean scores for anxiety and depression were within the normal range. There was a trend for children receiving positive results to be more anxious and depressed than those receiving negative results. In adults, mean scores for anxiety were within the normal range for those receiving negative results, but were in the clinical range for those receiving positive results, with 43% (95% CI 23-65) of the latter having scores in this range. Regardless of test result, adults were more likely to be clinically anxious if they were low in optimism or self-esteem. Children receiving positive or negative results did not experience greater anxiety or depression than adults. Study 2. For children receiving a positive test result, mean scores for anxiety, depression, and self-esteem were unchanged over the year following the result, while mean anxiety scores decreased and self-esteem increased after receipt of a negative test result over the same period of time.

CONCLUSION

Children, as a group, did not show clinically significant distress over the first year following predictive genetic testing. Adults were more likely to be clinically anxious if they received a positive result or were low in optimism or self-esteem, with interacting effects. The association between anxiety, self-esteem, and optimism suggests that counselling should be targeted, not only at those with positive test results, but also at those low in psychological resources.

The effect of risk communication on risk perceptions: the significance of individual differences

The purpose of this paper is to address the literature on the relation between risk communication and the initiation of health behavior change. More specifically, we examine the evidence that providing risk information is an effective way to change risk perceptions, as well as the more limited evidence that altering risk perceptions influences risk behavior. The paper discusses significant developments in the research on these issues, describes specific studies that represent trends in this research, and discusses methodologic issues important to the development of the field. Although there are relatively few studies that demonstrate causal links between risk communication and behavior change, recent developments in the field point to the importance of tailoring risk communications to the individual characteristics of targets. Such tailoring has taken a variety of forms, including providing individualized feedback concerning risk status or genetic vulnerability and assessing readiness for behavior change. Future intervention efforts should combine individualized risk status feedback with assessment of individual differences in previous behavior and acceptance of personal vulnerability.

Treating people with information: an analysis and review of approaches to communicating health risk information

The communication of risk information is a fundamental aspect of nearly all health promotion interventions. However, no consensus exists regarding the most effective way to provide people with risk information. We will review and evaluate the relative merits of two approaches to risk communication. One approach relies on the presentation of numerical information regarding the probability of a health problem occurring, whereas the other relies on the presentation of information about the antecedents and consequences of a health problem. Because people have considerable difficulty understanding and using quantitative information, the effectiveness of interventions that rely solely on numerical probability information has been limited. Interventions that provide people with a broader informational context in which to think about a health problem have had greater success systematically influencing perceptions of personal risk but have several important limitations. However, before any final conclusions can be drawn regarding the relative merits of different communication strategies, investigators must agree on the specific criteria that should be used to identify an effective intervention.

Protection and vulnerability processes relevant for early onset of substance use: a test among African American children

This research tested predictions from a self-regulation model of factors relevant for early onset of tobacco and alcohol use with a community sample of 889 African American children (mean age = 10.5 years). Criterion variables were peer substance use, willingness to use substances, and resistance efficacy (intention to refuse substance offers). Structural modeling indicated effects of temperament dimensions were mediated through self-control and risk-taking constructs, which were related to school involvement, life events, and perceived vulnerability to harmful effects of substances. Peer use was predicted by life events, poor self-control, and parent-child conflict; willingness was predicted by life events, risk taking, and (inversely) parental support; and resistance efficacy was predicted by perceived vulnerability and (inversely) poor self-control. Findings are discussed with reference to theoretical models of early protection and vulnerability processes.