Self-affirmation inductions to reduce defensive processing of threatening health risk information

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.

Disclosure statement

The opinions expressed by the authors are their own and the research presented in this paper should not be interpreted as representing the official viewpoint of the U.S. Department of Health and Human Services, the National Institutes of Health or the National Cancer Institute.

Data availability statement

De-identified participant data used for these analyses are available to individual investigators by request from the authors.

Notes

1 We compared our sample to those described in self-affirmation meta-analyses. Our sample is comparable in terms of race (73.5% White versus 74% White in Epton et al., 2015) and age (M = 33.68 versus 34.64 years old for studies including non-student samples in Sweeney and Moyer (2015)).

2 Of note, analyses in which we controlled for participants’ age did not show different results from the ones reported here.

3 For each of the outcomes, we also compared the essay self-affirmation conditions against their respective controls; the questionnaire self-affirmation conditions against their controls; and self-activation condition against its control (see supplementary Table S2).

4 We reviewed participants’ written responses to the essay inductions to confirm they followed study instructions. Across the four essay inductions, we found 19 problematic responses. Overall, results did not change when these cases were eliminated from our sample, with one exception. Specifically, women who self-affirmed versus activated the self expressed lower risk perceptions about breast cancer (mean difference = −0.32, t(1014) = −2.03, p = .043, d = 0.13).