Self-affirmation moderates effects of unrealistic optimism and pessimism on reactions to tailored risk feedback

Abstract

We examined whether self-affirmation would facilitate intentions to engage in colorectal cancer (CRC) screening among individuals who were off-schedule for CRC screening and who were categorised as unrealistically optimistic, realistic or unrealistically pessimistic about their CRC risk. All participants received tailored risk feedback; in addition, one group received threatening social comparison information regarding their risk factors, a second received this information after a self-affirmation exercise and a third was a no-treatment control. When participants were unrealistically optimistic about their CRC risk (determined by comparing their perceived comparative risk to calculations from a risk algorithm), they expressed greater interest in screening if they were self-affirmed (relative to controls). Non-affirmed unrealistic optimists expressed lower interest relative to controls, suggesting that they were responding defensively. Realistic participants and unrealistically pessimistic participants who were self-affirmed expressed relatively less interest in CRC screening, suggesting that self-affirmation can be helpful or hurtful depending on the accuracy of one's risk perceptions.

Keywords:

• self-affirmation
• risk perception
• unrealistic optimism
• unrealistic pessimism
• social comparison
• cancer screening

Acknowledgements

This research was supported by grants from the National Cancer Institute (1R03CA101529) and the Winters Foundation as well as by a Steven Manners Faculty Development Award to the first author from the University Center for Social and Urban Research at the University of Pittsburgh. We are grateful to Maggie Brukalo, Megan Block and Jason Choorapuzha for assistance with data collection, and to Stephanie Tower for coding of the taped self-affirmations (AM served as the other coder).