Predicting proximal health responses to reminders of death: The influence of coping style and health optimism

Abstract

Research derived from terror management theory (TMT) suggests that conscious contemplations of mortality instigate efforts to remove such threatening cognitions from focal attention. Though efforts to manage death concerns in focal attention can positively affect one's health (e.g., engaging in health conscious behavior), such efforts can also negatively affect one's health (e.g., denying vulnerability to disease). The current research explores how individual differences in coping style and health optimism relate to the ways in which people respond to death-related cognitions in focal attention. Study 1 found that adaptive coping was associated with increased health behavioral intentions immediately after death thoughts were made salient (i.e., when death thoughts were still in focal attention) but not after a delay. Study 2 found that immediately after death thoughts were made salient, health optimism was associated with increased disease-detecting behavioral intentions relating to breast cancer. Theoretical and practical implications of these findings are discussed.

Keywords:

• Terror management
• coping style
• health optimism

Notes

Notes

[1] Note that while optimism has been found to have a range of beneficial effects, unrealistic optimism can have a number of deleterious consequences in reflecting lower than actual risk for vulnerability (Weinstein, 1982). Although we touch on these distinctions in the General Discussion, they are a bit beyond the scope of this article.

[2] Due to researcher error, participants’ gender was not recorded in this study. However, given the nature of the introductory psychology subject pool at the University of Missouri, there is reason to expect that the sample was about 60% female. It is also relevant to note that in their study of the effects of mortality salience on health intentions, Taubman-Ben-Ari and Findler (2005) found no evidence of gender differences.

[3] Although looking at +/− 2 standard deviations is justified based on their correspondence to 95% confidence intervals, we also note analyses conducted at one standard deviation. Above the mean on adaptive coping, there was a significant interaction between mortality salience and the delay condition, β = 0.80, SE = 3.3, t = 2.8, p < 0.01, such that, without a delay, mortality salience led to increased scores on the health behavior scale compared to the delay condition, β = 0.62, SE = 2.5, t = 2.5, p = 0.02. Within the dental pain condition, though not significant, this pattern was reversed, β = −0.31, SE = 2.1, t = −1.5, p = 0.15. At one standard deviation below the mean on adaptive coping, there was no interaction between mortality salience and the delay condition, t < 1.

[4] Study 1 was designed to explore how general adaptive relative to maladaptive coping strategies interact with death thoughts in and outside of focal attention. As an exploratory exercise, however, we did conduct the specific simple slope tests of interest (i.e., within the mortality salience and no delay condition) for each of the individual coping subscales (Carver et al., 1989). The simple slopes for the following subscales were significant at or below the 0.05 level (active coping, β = 0.45; restraint coping, β = 0.64; acceptance, β = 0.38, and focus on and venting of emotions, β = −1.27). Other subscales demonstrated slope patterns consistent with the hypothesis but did not reach the 0.05 level of significance. Future theoretical and empirical work is needed to explore the complexities of individual coping mechanisms and how these different mechanisms may interact with one another to influence health-related responses to mortality concerns. However, for the purposes of the current research, both the significant and non-significant slopes are directionally consistent with the notion that the more one tends to adopt adaptive coping strategies (e.g., active coping) and the less one tends to adopt maladaptive coping strategies (e.g., focus on venting), the more he or she will actively confront health information when mortality concerns are in focal attention.

[5] The lack of effects involving age can be seen as failing to replicate the work of Taubman Ben-Ari and Findler (2005). However, it is important to keep in mind a number of differences between the present study an the Taubman Ben-Ari and Findler findings. In addition to such factors as the nationality of the samples (Israel vs. The United States), the Taubman Ben-Ari and Findler research intentionally recruited participants of young, middle and old age, and examined a composite measure of hypothetical health reactions. In contrast, in the present study, age was allowed to vary and we examined actual interest in doing a specific health behavior in BSE. Certainly, however, future studies should more explicitly explore the extent to which age may play a role in the proximal effects of MS on different types of health behaviors. Unfortunately, these studies were conducted before we were aware of the Taubman Ben-Ari and Findler findings (and thus, for example, we did not question participants about their age in Study 1).

[6] Follow-up analyses at one standard deviation above and below the mean revealed the same significant pattern of effects, with one exception. At one standard deviation above the mean on health optimism, the effect of mortality salience on BSE intentions, relative to the control condition, was marginal, β = 0.22, SE = 0.48, t = 1.7, p = 0.09. In addition, analyses of the single question assessing interest in participating in a BSE study revealed a significant interaction between salience and health optimism, β = −0.34, SE = 0.67, t = −2.54, p < 0.05. The pattern of this interaction paralleled the findings with BSE intentions, although many of the follow-up tests were marginally significant.