More on Inoculating Against Reactance to Persuasive Health Messages: The Paradox of Threat

This research examined the efficacy of inoculation as a strategy to mitigate psychological reactance based on the level of threat communicated in the forewarning and subsequent persuasive health appeal. Two 2 (inoculation) × 2 (freedom-threatening language) experiments were conducted. The first (N = 181) used elaborated inoculation designed to enhance the threat of impending reactance to a message advocating for responsible alcohol consumption. The second (N = 159) used limited inoculation designed to minimize the threat of impending reactance to a message advocating for responsible soft drink consumption. Results showed that elaborated inoculation increased reactance, whereas limited inoculation decreased reactance but only when the subsequent appeal used less freedom-threatening language. These findings suggest that inoculation has the potential to facilitate or buffer reactance depending on the level of threat communicated in inoculation forewarnings and in subsequent persuasive health appeals.     

Inoculating Against Reactance to Persuasive Health Messages

This investigation examined the possibility of decreasing psychological reactance to health campaigns through the use of inoculation messages. It was hypothesized that an inoculation message, which forewarned of the potential of subsequent reactance, would decrease participants’ likelihood of reacting negatively to a freedom-threatening message aimed to reduce excessive alcohol consumption. Participants (N = 275) who were inoculated against potential reactance felt less threatened and experienced less reactance compared to those who did not read an inoculation message. Structural equation modeling showed that inoculation indirectly predicted lower intention to drink alcohol via the theorized mediated reactance process. This research suggests that it is possible to inoculate against self-generated cognitions that might otherwise lead toward negative health behaviors.     

The Role of Narrative and Other-Referencing in Attenuating Psychological Reactance to Diabetes Self-Care Messages

This study charts pathways through message resistance to enhance the persuasiveness of diabetes self-care messages. A 2 (narrative) × 2 (other-referencing) × 2 (message) × 4 (order) experiment with adult diabetics (N = 58) tested whether packaging overt recommendations as a story rather than an informational argument (i.e., narrative structure) and highlighting the impact of health decisions on family and friends rather than the individual (i.e., other-referencing) can effectively attenuate psychological reactance to messages encouraging healthy diet and physical activity. Narrative and other-referencing each led to lower perceived threat to choice, less state anger and counterarguing, less negative cognitive responses, more positive attitudes toward the ad and the behaviors promoted, and greater intended compliance with message recommendations. Findings illustrate two strategies that communicators may employ in order to benefit from clear, direct health messages while avoiding the reactance they may provoke. Moreover, findings inform message design for diabetes self-care education.     

A close examination of trait reactance and issue involvement as moderators of psychological reactance theory

This study used psychological reactance theory (PRT) to investigate (a) the effectiveness of 2 message features (freedom-threatening language and character frame) and (b) the role of trait reactance and issue involvement as moderators of a perceived freedom threat. Within the context of organ donation, the results indicated no differences for character frame among the donor, recipient, or waiting list narratives. However, freedom-threatening language was positively associated with a perceived freedom threat. In turn, a perceived freedom threat was positively associated with state reactance, which was inversely, albeit nonsignificantly, associated with organ donation attitudes. Attitudes predicted intentions to be an organ donor. Results also revealed that trait reactance was positively associated with a perceived freedom threat. Although not associated with a freedom threat, issue involvement was positively associated with organ donation attitudes and intent to be a donor. Additionally, a trait reactance by issue involvement by freedom-threatening language interaction predicted a perceived freedom threat. Results are discussed with an emphasis on these moderators in PRT.     

A Close Examination of Trait Reactance and Issue Involvement as Moderators of Psychological Reactance Theory

This study used psychological reactance theory (PRT) to investigate (a) the effectiveness of 2 message features (freedom-threatening language and character frame) and (b) the role of trait reactance and issue involvement as moderators of a perceived freedom threat. Within the context of organ donation, the results indicated no differences for character frame among the donor, recipient, or waiting list narratives. However, freedom-threatening language was positively associated with a perceived freedom threat. In turn, a perceived freedom threat was positively associated with state reactance, which was inversely, albeit nonsignificantly, associated with organ donation attitudes. Attitudes predicted intentions to be an organ donor. Results also revealed that trait reactance was positively associated with a perceived freedom threat. Although not associated with a freedom threat, issue involvement was positively associated with organ donation attitudes and intent to be a donor. Additionally, a trait reactance by issue involvement by freedom-threatening language interaction predicted a perceived freedom threat. Results are discussed with an emphasis on these moderators in PRT.     

State Psychological Reactance to Depression Public Service Announcements Among People With Varying Levels of Depressive Symptomatology

Campaigns seeking to help people with depression can be effective, but they can also backfire. Psychological reactance is proposed as a partial explanation. Two experimental studies examined the effect of two depression messages (i.e., autonomy-supportive language, controlling language) for participants (n = 2027, n = 777) with varying levels of depressive symptomatology. For Study 1, two versions of a print public service announcement about seeking help for depression served as the experimental stimulus. Study 2 used an existing video public service announcement about seeking help for depression, but the text was altered to create the two conditions. In both studies, increased depressive symptomatology was associated with reduced help-seeking attitudes and intentions, as well as greater state reactance to a public service announcement about depression. Increased state reactance mediated the relationship between increased depressive symptomology and unfavorable help-seeking outcomes. Further, across the two studies, participants with high levels of depressive symptomatology who were exposed to the autonomy-supportive language ad reported either as much, or more, state reactance than participants with high levels of depressive symptomatology who were in the control condition. These results warn that language perceived as autonomy-supportive by people without depression might be perceived as controlling among people with depression.     

Locating Relationship and Communication Issues Among Stressors Associated With Breast Cancer

This investigation examined antecedents associated with support for clean indoor air policies. Participants (N = 550) living in a Midwestern county (population = 62,223) were randomly sampled. Results suggest that beliefs in the health risks associated with secondhand smoke are positively associated with favorable attitudes toward clean indoor air policies, whereas trait reactance is negatively associated with these attitudes. Findings also indicate that risks and trait reactance are indirectly associated with support for clean indoor air policies, mediated through anger arousal toward exposure to secondhand smoke. In addition, regression analyses revealed that health risks, trait reactance, and smoking status explained a significant amount of variance regarding anger toward exposure to secondhand smoke, but only health risks and smoking status accounted for a significant amount of variance toward clean indoor air attitudes. Finally, the Smoking Status × Health Risks interaction was supported for anger toward exposure to secondhand smoke and favorable attitudes toward clean indoor air policies. Our findings suggest the incorporation of anger appeals when promoting clean indoor air policies.     

Utilizing Audiovisual and Gain-Framed Messages to Attenuate Psychological Reactance Toward Weight Management Health Messages

Guided by the psychological reactance theory, this study predicted that gain-framed messages and audiovisual content could counteract state reactance and increase the persuasiveness of weight management health messages. Data from a 2 (message frame: gain/loss) × 2 (modality: audiovisual/text) × 2 (message repetition) within-subjects experiment (N = 82) indicated that in the context of weight management messages for college students, gain-framed messages indeed mitigate psychological reactance. Furthermore, the modality and the frame of the health message interacted in such a way that gain-framed messages in an audiovisual modality generated the highest motivations to comply with the recommendations in the persuasive health messages.     

How Message Fatigue toward Health Messages Leads to Ineffective Persuasive Outcomes: Examining the Mediating Roles of Reactance and Inattention

Message fatigue refers to a state of being exhausted and tired of prolonged exposure to similarly-themed messages (e.g., anti-obesity messages; So, Kim, & Cohen, 2017). This study tests a mediational model that accounts for how one’s preexisting fatigue toward anti-obesity messages may contribute to two different types of resistance—reactance and disengagement—toward an incoming anti-obesity message, which, in turn, reduce intention to adopt weight-management behaviors advocated in the message. The proposed model was tested in an experimental study (N = 312) involving a sample of overweight or obese adults in the United States. In the meditational model, reactance significantly mediated the negative effects of message fatigue on intention to adopt only one of four weight-management behaviors promoted in the message. However, inattention, which was an operationalization of disengagement, significantly mediated the negative effects of message fatigue on behavioral intention to adopt all four weight-management behaviors. This study urges future research on message fatigue and resistance to persuasion to consider disengagement with a message as a significant barrier to effective health communication and to devise ways to increase engagement with messages communicating “overtaught” health issues.     

Anger and children’s health: Differentiating role of inward versus outward expressed anger on sleep,medical service utilization,and mental health

Objective: To examine the differential associations between children’s anger expression styles and selected health constructs. Method: Measures assessed sleep problems, medical service utilization, and mental health in 125 children (M = 9.48 years). Results: Anger expression styles predicted health outcomes in a multivariate model. As hypothesized, anger-out significantly predicted sleep problems, number of medical visits, externalizing problems, and internalizing problems. Anger-in was not significantly related to any health outcome measure. Conclusion: This study demonstrates the importance of anger expression styles for health, as they are differentially related to impairments. Clinicians are urged to recognize anger problems to broadly impact children’s health.     

Examining the Use of Forceful Language When Designing Exercise Persuasive Messages for Adults: A Test of Conceptualizing Reactance Arousal as a Two-Step Process

This investigation tests a conceptualization of reactance as a two-step process. This conceptualization was recently tested with college students, but research testing this conceptualization among primarily adult samples does not currently exist. Psychological reactance theory (PRT) states that individuals exposed to a threat or elimination of a freedom will experience reactance and subsequently be motivated to restore the freedom. Specifically, it is hypothesized that individuals will perceive persuasive messages containing forceful language as a threat to their personal freedom, which will be followed by reactance, manifested in a latent variable composed of anger and negative cognitions. This hypothesis was tested within the context of persuasive messages aimed at encouraging members (N = 247) to participate in weight lifting or group exercise programs at a health and fitness center. Results support conceptualizing reactance as a 2-step process. In addition, results indicate that a primarily adult sample responds unfavorably to forceful persuasive messages advocating the aforementioned exercise activities. In finding support for conceptualizing reactance as a two-step process, we encourage health campaigners and PRT researchers to employ this measure to provide consistency to future PRT studies.     

Child Sexual Abuse and Negative Affect as Shared Risk Factors for Sexual Aggression and Sexual HIV Risk Behavior in Heterosexual Men

Previous research has suggested that sexually aggressive behavior and sexual HIV risk behavior are associated. Childhood sexual abuse (CSA) is a well-established risk factor for both types of problematic sexual behavior. Negative affect (i.e., anxiety, depression, and anger) is a less well-studied risk factor, but it has been theorized to relate to both sexual aggression and HIV risk behavior. Thus, this study sought to (1) confirm the relationship between sexual aggression and HIV risk behavior, (2) establish CSA and negative affect as shared risk factors for sexual aggression and HIV risk behavior, and (3) evaluate whether negative affect mediates the relationship between CSA and sexual aggression and between CSA and HIV sexual risk in a sample of heterosexual men. We recruited 18- to 30-year-old heterosexual men (N = 377) from urban sexually transmitted infection clinics. Men completed measures of sexual HIV risk history (number of partners and condom use), sexual aggression history, CSA history, and trait negative affect (anger, anxiety, and depression). Structural equation modeling was used to examine hypothesized direct and indirect relationships. In the final SEM model, sexual aggression history and sexual HIV risk behavior were correlated. CSA was associated with both types of problematic sexual behavior. Anxiety significantly mediated the relationship between CSA and sexual aggression and between CSA and sexual HIV risk behavior (χ ²[1300] = 2121.79, p < .001; CFI = 0.905; RMSEA [90% CI] = .044 [.041–.047]). Sexual aggression appears to be part of a constellation of sexual risk behaviors; thus, it may be possible to develop prevention programs that target both sexual HIV risk and sexual aggression. CSA is a shared risk factor for sexual aggression and HIV risk behavior through the pathway of anxiety. Thus, anxiety might be one promising target for intervention.     

Using Media Literacy Education for Adolescent Sexual Health Promotion in Middle School: Randomized Control Trial of Media Aware

This study examined the short-term efficacy of Media Aware, a classroom-based media literacy education (MLE) program for improving adolescents’ sexual health outcomes. In a randomized control trial, schools were randomly assigned to the intervention (N = 5 schools) or health promotion control (N = 4 schools) group. Students completed questionnaires at pretest (N = 880 students) and immediate posttest (N = 926 students). The Media Aware program had a significant favorable impact on adolescent outcomes related to sexual health, including increased self-efficacy and intentions to use contraception, if they were to engage in sexual activity; enhanced positive attitudes, self-efficacy, and intentions to communicate about sexual health; decreased acceptance of dating violence and strict gender roles; and increased sexual health knowledge. Program effects were also found for media-related outcomes, including enhanced media deconstruction skills and increased media skepticism. Media deconstruction skills mediated the program’s impact on students’ intentions to communicate with a medical professional about sexual health issues. This study provides support for the use of MLE with adolescents to promote sexual health.     

Examining the use of forceful language when designing exercise persuasive messages for adults: a test of conceptualizing reactance arousal as a two-step process

This investigation tests a conceptualization of reactance as a two-step process. This conceptualization was recently tested with college students, but research testing this conceptualization among primarily adult samples does not currently exist. Psychological reactance theory (PRT) states that individuals exposed to a threat or elimination of a freedom will experience reactance and subsequently be motivated to restore the freedom. Specifically, it is hypothesized that individuals will perceive persuasive messages containing forceful language as a threat to their personal freedom, which will be followed by reactance, manifested in a latent variable composed of anger and negative cognitions. This hypothesis was tested within the context of persuasive messages aimed at encouraging members (N = 247) to participate in weight lifting or group exercise programs at a health and fitness center. Results support conceptualizing reactance as a 2-step process. In addition, results indicate that a primarily adult sample responds unfavorably to forceful persuasive messages advocating the aforementioned exercise activities. In finding support for conceptualizing reactance as a two-step process, we encourage health campaigners and PRT researchers to employ this measure to provide consistency to future PRT studies.     

Dating violence,quality of life and mental health in sexual minority populations: a path analysis

Purpose

Theories explaining the impact of intimate partner violence (IPV) on mental health have focused on heterosexual relationships. It is unclear whether mental health disparities between heterosexual and sexual minority people are due to IPV or factors related to sexual orientation. The present study aimed to investigate pathways of how sexual orientation influenced quality of life and mental health.

Methods

The present cross-sectional study was conducted in 1076 young adults in a university population (934 heterosexual and 142 sexual minority groups). Structural equation modelling was used to examine the pathways of sexual orientation, dating violence, sexual orientation concealment, quality of life and mental health (perceived stress, anxiety and depression).

Results

After adjusting for sociodemographic factors, quality of life in sexual minority people was poorer [estimate ?2.82, 95 % confidence interval (CI) ?4.77 to ?0.86, p = 0.005], and stress (estimate 2.77, 95 % CI 1.64–3.92, p < 0.0001), anxiety (estimate 1.84, 95 % CI 1.13–2.56, p < 0.0001) and depression levels (estimate 0.62, 95 % CI 0.05–1.2, p < 0.0001) were higher than in heterosexual people. Dating violence and sexual orientation concealment were mediators, with the models showing a good fit.

Conclusion

Our study has progressed investigation of the link between sexual orientation and quality of life and mental health in the Chinese context. It has helped identify health disparities between heterosexual and sexual minority people and determined specific factors affecting their quality of life and mental health.

     

Can community consciousness be a bad thing? A moderated mediation analysis of heterosexism,mental health and body appreciation in sexual minority men

This study examined the connections between heterosexism, mental health, body appreciation and community consciousness in sexual minority men (SMM). Participants (n = 89) completed a national online survey. Simultaneous multiple regressions found that heterosexism explained 9.4% of the variance in body appreciation and 25.8% of the variance in mental health; mental health accounted for 28.0% of the variance in body appreciation. Within these models, harassment/rejection heterosexism was a unique positive predictor of mental health problems and a unique negative predictor of body appreciation; depression was a unique negative predictor of body appreciation. A moderated mediational model found that depression mediated the relationship between harassment/rejection heterosexism and body appreciation, but only in men who endorsed high community consciousness. Intervention research might benefit from helping SMM explore the ways in which body image is affected by heterosexism and mental health, as well as the ways that contemporary Western gay communities might contribute to these connections.     

Influences of Self-Efficacy,Response Efficacy,and Reactance on Responses to Cigarette Health Warnings: A Longitudinal Study of Adult Smokers in Australia and Canada

Guided by the extended parallel process model (EPPM) and reactance theory, this study examined the relationship between efficacy beliefs, reactance, and adult smokers’ responses to pictorial health warning labels (HWL) on cigarette packaging, including whether efficacy beliefs or reactance modify the relationship between HWL responses and subsequent smoking cessation behavior. Four waves of data were analyzed from prospective cohorts of smokers in Australia and Canada (n = 7,120 observations) over a period of time after implementation of more prominent, pictorial HWLs. Three types of HWL responses were studied: psychological threat responses (i.e., thinking about risks from smoking), forgoing cigarettes due to HWLs, and avoiding HWLs. The results from Generalized Estimating Equation models indicated that stronger efficacy beliefs and lower trait reactance were significantly associated with greater psychological threat responses to HWLs. Similar results were found for models predicting forgoing behavior, although response efficacy was inversely associated with it. Only response efficacy was significantly associated with avoiding HWLs, showing a positive relationship. Higher self-efficacy and stronger responses to HWLs, no matter the type, were associated with attempting to quit in the follow-up period; reactance was unassociated. No statistically significant interactions were found. These results suggest that stronger efficacy beliefs and lower trait reactance are associated with some stronger responses to fear-arousing HWL responses; however, these HWL responses appear no less likely to lead to cessation attempts among smokers with different levels of self-efficacy to quit, of response efficacy beliefs, or of trait reactance against attempts to control their behavior.     

The cost of being a man: social and health consequences of Igbo masculinity

In the bid to explain reproductive health outcomes in most developing countries, men have often been seen as the cause of the problem. However, no systematic attempt has been made to examine men's perception of their own social and health needs, including how ideologies of masculinity impact men's social and physical health. This study examines the Igbo context and shows how men understand and interpret masculinity and the consequences of this for social and health behaviours. Data from adolescent and adult Igbo men aged 15–75 were collected using both quantitative survey interviews (n = 1372) and qualitative techniques such as focus-group discussion (n = 20), in-depth interviews (n = 10) and key informant interviews (n = 10) in selected areas of south-eastern Nigeria. We collected data on gender role ideologies and sexuality issues and practices. Our analysis shows that there are social and health costs associated with adherence to masculine ideologies and a strong association between masculine ideologies and men's health, risk-taking and health-seeking behaviours in the study population. We conclude that all sexual and reproductive health programmes should include services that address the specific needs of men and those negative aspects of masculinity that tend to expose men to adverse health outcomes.     

Positive and negative perceived consequences of first intercourse among middle and high school students in Puebla,Mexico

Relatively little is known about young people’s interpretations of sexual behaviour in Latin America. In this study, we examine the most commonly perceived consequences of first sexual intercourse among Mexican middle and high school students, how perceived consequences differ by gender, and factors that may predict experiencing more positive or negative consequences. Sexually active Mexican students aged 12–19 years (n = 268) reported whether they had experienced each of 19 consequences following first intercourse. Both positive consequences, such as physical satisfaction and closeness to partner, and negative consequences, such as worry about STDs and pregnancy, were common. Sex with a non-relationship partner was associated with fewer positive and more negative consequences, with the effect for positive consequences being stronger for young women. Pressure to have sex was associated with fewer positive consequences of first intercourse, and pressure to remain a virgin was associated with more positive and negative consequences. These findings suggest that young people often report mixed feelings about their first sexual intercourse and that relationship context and sexual socialisation influence their perceptions of the event.