Reactions to Medical Diagnosis: The Role of Illness Stereotypes

Two studies were conducted to explore the role of illness stereotypes in appraisals of health threat. The results of Study 1 indicated that a substantial proportion of questionnaire respondents believed that high blood pressure (BP) is associated with positive personal characteristics (e.g., persistence) whereas a smaller proportion believed that high BP is associated with negative characteristics. In addition, more favorable stereotypes were correlated with lower ratings of the seriousness of high BP. Study 2 examined the effects of experimentally induced illness stereotypes on the health-related judgments of subjects who received false feedback on a test of their BP. The results revealed a significant effect of illness stereotypes on health-threat appraisals of high BP. Subjects who were led to believe that high BP was associated with achievement and competence perceived high BP as a less serious threat to health than did subjects who believed high BP was associated with less desirable traits. In addition, subjects given high BP readings reported fewer symptoms they were told were associated with high BP when the disorder was associated with negative characteristics. The results demonstrate the importance of illness stereotypes in appraisals of health threats, symptom reporting, and reactions to medical diagnosis.     

Recall criterion does not affect recall level or hypermnesia: A puzzle for generate/recognize theories

Subjects studied a mixed list of 70 words that varied in imagery value and then received three successive tests. Also varied were instructions given to subjects prior to list presentation (imagery or semantic rehearsal) and the type of recall test (standard free recall, an uninhibited-recall procedure in which subjects were encouraged to free associate and to guess while recalling the list, and a forced-recall condition in which they were also told to write a large number of responses to fill the allotted spaces). Recall improved across the three tests in all conditions, but the improvement was greater for high-than for low-imagery words. In addition, hypermnesia (the improved recall across tests) was shown to occur following semantic rehearsal instructions as well as imagery instructions and to occur with low-imagery words, contrary to the imagery hypothesis of the effect. Most importantly, the large variation in recall criterion produced by manipulating instructions at test (as measured by intrusions) did not affect the overall level of correct recall or the magnitude of improvements across tests. Apparently, the assumption of generate-recognize theories that people generate much more information in free recall than they produce (due to a stringent criterion for recognition of the generated material) is false.     

Absolut memory distortions: alcohol placebos influence the misinformation effect

Can the simple suggestion that you have consumed alcohol affect your memory for an event? Alcohol placebos affect social behaviors but not nonsocial ones, and have not previously been shown to affect memory. We investigated the effect of alcohol placebos using materials that revealed both the social and the nonsocial influences of memory Subjects drank plain tonic water, but half were told it was a vodka and tonic; then all subjects took part in an eyewitness memory experiment. Subjects who were told they drank alcohol were more swayed by misleading postevent information than were those who were told they drank tonic water, and were also more confident about the accuracy of their responses. Our results show that the mere suggestion of alcohol consumption may make subjects more susceptible to misleading information and inappropriately confident. These results also provide additional confirmation that eyewitness memory is influenced by both nonsocial and social factors.     

Aging and qualitative characteristics of memories for perceived and imagined complex events

Older and younger adults' memory for perceived and imagined events was examined with a procedure in which everyday situations are simulated in the laboratory. Subjects perceived some situations and imagined others. Later, they were asked to rate their memory for various aspects of these situations (e.g., amount of perceptual detail, thoughts and feelings). A recall test followed the ratings. On the rating scale, for both perceived and imagined events, older subjects reported better memory for their thoughts and feelings than did younger subjects. In addition, on the recall test, older subjects produced more thoughts and feelings than did younger subjects, whereas younger subjects produced more perceptual and spatial information. These results suggest that older subjects may not inhibit personal information (e.g., thoughts and feelings), and this information may interfere with memory for other aspects of information, such as perceptual and contextual details (Hasher & Zacks, 1988).     

Utilization of base-rate information during feeling-of-knowing judgments.

We examined whether subjects use base-rate information about item difficulty when making feeling-of-knowing judgments for items they failed to recall. First, the subjects attempted to recall the answers to general-information questions. Then, for those items they recalled incorrectly, half of the subjects received information about the normative probability of recall of each item while judging their feeling of knowing. The other subjects made their feeling-of-knowing judgments without receiving any base-rate information. Finally, all subjects had a forced-choice recognition test on those items to validate the accuracy of their feeling-of-knowing judgments. Relative to the no-base-rate information group, the base-rate group had lower feelings of knowing for normatively difficult items and higher feelings of knowing for normatively easier items. Subjects who had received base-rate information during the judgment state had greater feeling-of-knowing accuracy than subjects who did not receive base-rate information. However, even the predictions from subjects who received base-rate information were not significantly more accurate for predicting subsequent recognition than were the predictions derived from normative information alone.     

Restraint and internal responsiveness: effects of placebo manipulations of hunger state on eating

Restrained and unrestrained subjects were given a "vitamin" (placebo) prior to an ad-lib taste test. Subjects were either told nothing about the placebo or told that previous subjects had reported that the vitamin had made them feel either hungry or full. As predicted, restrained subjects, in two separate studies, behaved in accordance with placebo messages, eating more when given "hungry" messages than when given "full" messages. Unrestrained subjects showed an apparent reverse-placebo effect; they ate less ice cream when given "hungry" information than when given "full" information. Hunger ratings did not parallel eating behavior; possible explanations for this discrepancy are considered. We conclude that unresponsiveness to internal hunger state, and an overreliance on external cognitive cues, characterizes restrained but not unrestrained individuals.     

Nonverbal Mediators of Expectancy Effects in Black and White Children1

Seventy-two white undergraduates of both sexes taught a lesson “What is psychology?” to a 10-year-old male confederate. Four confederates, two white and two black, alternated in the three conditions of induced expectancy: Subjects were told the child was bright, dull, or were given no information. Unknown to subjects, their nonverbal behavior during the lesson was videotape recorded. Results indicated that induced expectancy affected subject nonverbal behavior only when the confederate was white. Subjects smiled more, looked more, and nodded more at the white “bright” confederates than the white control or “dull” confederates. However, expectancy had no effect, positive or negative, when the confederate was black. In addition, white confederates received more positive nonverbal behavior overall than did black confederates.     

Rehearsal strategy as a function of recall expectation

The subjects were divided into three groups with respect to their expectations concerning a recall task given after the final trial of the usual STM distractor procedure. Group 1 were told only that they would have to recall during each trial's recall interval, thus did not expect to have to recall again. Group 2 were told that they would have to recall all the words presented in the experiment at the end of the last trial, in addition to the trial-by-trial recall. Group 3 were told only that they would have to recall after all words had been presented and they sat passively through the presentation trials. In addition to their recall expectations, half of the subjects in each group received a 2-s presentation and half received a 5-s presentation interval. It was found that the length of the presentation interval had an effect on the number of words recalled at the end of all trials, but recall expectancy did not. However, expectancy did determine the rehearsal strategies of subjects and hence the serial positions from which items were recalled.     

Hypnosis and pseudomemories: the effects of prehypnotic expectancies

Contrary to predictions, the pseudomemory rate of subjects who received prehypnotic information that hypnosis increased recall was indistinguishable from the pseudomemory rates of subjects who received information that hypnosis did not increase recall and of subjects who received no specific prehypnotic information. Indeed, by the last recall trial, none of the 47 subjects exhibited pseudomemory. Subjects exhibited faulty memory of events that actually occurred (i.e., pencils spilling), and were as uncertain of events that actually occurred, as they were of suggested events that did not occur during the session (telephone ringing). Subjects were generally consistent in their certainty, or lack of it, across events. Finally, subjects led to believe that hypnosis is an altered state of consciousness were less aware of external events, and had the lowest rate of recall of target suggestions compared with subjects in the comparison groups.     

The Effects of Hindsight Bias and Causal Attribution on Human Response to Environmental Events1

This research examined the influence of hindsight bias and causal attribution on perceptions of a technological disaster. After reading a fictitious account of a toxic substance spill near a populated area, subjects were provided with information that disease rates had either increased or had remained stable (hindsight conditions), or were presented with no outcome information (control condition). Subjects were then asked to predict the likelihood of increases in disease rates and to make causal attributions regarding the target company and residents of the disaster community. When compared to subjects provided with either no outcome information or with information that disease rates remained stable (positive-outcome condition), subjects told that disease rates had increased (negative-outcome condition) showed elevated predictions regarding future disease rates, ascribed greater responsibility for the accident to the target company, and reported more anger toward the company and greater sympathy for the residents. Subjects receiving positive outcome information and no outcome information did not significantly differ on these measures. In addition, results from a path analysis supported the efficacy of attribution theory to account for the cognitive, affective, and behavioral consequences resulting from hindsight bias following a negative environmental event.     

Judging health status: effects of perceived prevalence and personal relevance

In this article, we show that people's evaluations of the seriousness of a health disorder are influenced by the perceived prevalence and personal relevance of that disorder. As part of a study ostensibly concerned with college students' health characteristics, 60 undergraduates were "tested" for the presence of a fictitious enzyme deficiency. The subjects discovered either that they had the deficiency (deficiency-present subjects) or that they did not have it (deficiency-absent subjects), and were led to believe either that 1 of the 5 people in the laboratory had the deficiency (low-prevalence subjects) or that 4 of them had it (high-prevalence subjects). As predicted, the low-prevalence subjects evaluated the deficiency as more serious than did the high-prevalence subjects. In addition, consistent with the view that personal relevance affects perceptions of health disorders, the deficiency-present subjects evaluated the deficiency as less serious than did the deficiency-absent subjects. The deficiency-present subjects also derogated the validity of the test ostensibly used to diagnose the deficiency compared with other subjects. Finally, the deficiency-present subjects requested more information about the deficiency than did the deficiency-absent subjects.     

Negatively biased recall in children with self-reported symptoms of depression

This study investigated differences in depressed and nondepressed children's recall of positively and negatively reinforced behavior. Twenty-six children with self-reported symptoms of depression in the fourth through sixth grades were compared with a matched sample of 26 nondepressed children to determine if there was a negative bias in depressed children's recall. Subjects first generated guesses of the most common associations to each of a series of 40 words. Later, when compared with their nondepressed peers, the children with depressive symptomology were less accurate in recalling which words they had answered correctly and remembered fewer of their own correct responses. They also did more poorly when asked to recall the correct answers that had been provided by the investigator. The two groups did not differ, however, in their recall of which items had been answered incorrectly or in their recall of their previous wrong responses. These results suggest that children with self-reported depressive symptomology do not remember negative experiences more than do nondepressed children; rather, they recall positive experiences less well. Selective forgetting of positively reinforced behavior could be a serious handicap for depressed children in school. It could also play an important role in the maintenance and perhaps even the etiology of depressive symptomatology in children.We wish to thank Bruce Compas for his helpful comments on an earlier draft of this paper.     

The Interactive Effect of Social Comparison and Objective Information on the Decision to See a Doctor

Doctors' schedules are often overcrowded by unnecessary consultations with people complaining of minor or harmless symptoms. Such people typically decide to seek medical attention after hearing the opinions of family and friends. The present study explored some factors that might affect one's readiness to be influenced by nonprofessional opinions. Subjects in a role-playing setting were asked to imagine they were experiencing various symptoms, and then were given social comparison information suggesting they either should or should not see a doctor. As an orthogonal factor, subjects were also given an objective basis, via a simple physical test, for believing the symptoms either did or did not require medical attention. Consistent with Festinger's (1954) propositions, objective information suggesting the need to see a doctor eliminated the influence of social comparison. However, objective information suggesting the symptoms were harmless failed to reduce the impact of social comparison. These results indicate that providing an objective basis for deciding to sec a doctor will not be effective in controlling unnecessary visits, since "don't go" objective information is completely overridden by "go" social comparison information.     

Effects of preparatory information about sensations, threat of pain, and attention on cold pressor distress.

Pain experience is conceptualized as a combination of stimulus sensations (e.g., aching) and emotional distress. In Experiment 1, less distress was reported to cold pressor stimulation by subjects first told about stimulus sensations than by subjects who were uninformed or were told about symptoms of bodily arousal (e.g., tension). Adding a pain warning to sensation information blocked distress reduction, presumably by eliciting an emotional interpretation of the stimulus. In Experiment 2, subjects attending only to hand sensations reported less distress than subjects attending to their bodies. This decrease in the power of the stimulus to provoke emotion is presumably mediated by a schema of hand sensations formed by attention. In Experiment 3, subjects attending to hand sensations early in the immersion and distracting themselves later reported the same low levels of distress as did subjects who attended to hand sensations throughout. Subjects distracted throughout and subjects attending to hand sensations later showed no distress reduction. Therefore, stimulus schematization must precede distress reduction. Implications for distress control are discussed.     

Recollecting events associated with victimization

Subjects first completed social desirability and anxiety personality scales and then read a story about a woman meeting her brother for lunch. Some subjects were then told that the story involved sexual abuse. A week later all subjects took a multiple-choice memory test over the story. The results indicated that subjects categorized as repressors based on the personality scales had a lower proportion of negative than positive errors than did the nonrepressors, but only when they believed the story was about sexual abuse. However, repressors answered correctly as many items as did nonrepressors. The results were consistent with the idea that repressors remember as much about victimization experiences as do nonrepressors but are more likely to fill in the missing details of victimization experiences with positive reconstructions designed to reduce the over-all negative quality associated with victimization.     

Control motivation and attributions for performance

Two experiments examined the relationship between the desire for effective control over performance outcomes and attributions of causality for those outcomes. In Experiment 1, subjects were led to believe that they had either succeeded at or failed a test that was either unimportant or important. As predicted, failure of the important test was attributed more to lack of effort (a controllable cause) and less to lack of ability (an uncontrollable cause) than was failure of the unimportant test. In Experiment 2, all subjects were led to believe that they had failed a test. Once again, subjects were informed that the test was either important or unimportant. In addition, half the subjects were told that they would be undergoing more tests in a later testing session, while half were not informed of any future testing. As in Experiment 1, subjects failing the important test attributed their failure less to lack of ability than did subjects failing the unimportant test. The anticipation of future testing interacted with test importance in its effects on attributions to ability. Subjects performing the unimportant task attributed their failure more to lack of ability when anticipating future performance than when not. Attributions of subjects performing an important task were not affected by the anticipation of future performance. Results were discussed in terms of the need for control over performance outcomes.     

Self-Efficacy Relationships With Affective and Exertion Responses to Exercise1

This study examined the relationship of preexisting efficacy for exercise with perceptions of effort expenditure and in-task affect during exercise testing. Subjects comprised sedentary, middle-aged adults participating in a submaxi-mal cycle ergometer-graded exercise test. Perceptions of efficacy were assessed prior to and following exercise testing while perceptions of effort expenditure and in-task affect were assessed at 70% of predicted maxim heart rate. Highly efficacious subjects had lower perceptions of effort expenditure and reported more positive affect during exercise than did their less efficacious counterparts. Affective responses during exercise were in turn significant predictors of posttest self-efficacy. These results are discussed in regard to the importance of examining the role of personal efficacy in the formation of exercise-related affect and affective responses as sources of efficacy or competence information in exercise.     

The effects of cueing and constraint instructions on children's free recall performance

The performance of nursery school children was investigated in two experiments involving cued and constrained free recall. Under constrained instructions, subjects were required to recall items by category. Under cued instructions subjects could recall items in any order they wished but the organized nature of the lists was identified and subjects were told that they would remember more if they recalled things from the same category together. No effects of cueing instructions were obtained in either Experiment I or Experiment II. Constrained recall instructions led to enhanced recall and category clustering. However, the beneficial effects were not maintained on later trials with the same list or on a transfer list when the constraints on recall were dropped. In addition, the introduction of constrained recall instructions had identical effects whether they were introduced early or late in practice. The results were discussed in terms of the influences of variables which affect the subjects' use of retrieval strategies and the development of memory.