Does message framing affect changes in behavioural intentions in people with psoriasis? A randomized exploratory study examining health risk communication

Message framing is important in health communication research to encourage behaviour change. Psoriasis, a long-term inflammatory skin condition, has additional comorbidities including high levels of anxiety and cardiovascular disease (CVD), making message framing particularly important. This experimental study aimed to: (1) identify whether health messages about psoriasis presented as either gain- or loss-framed were more effective for prompting changes in behavioural intentions (BI), (2) examine whether BI were driven by a desire to improve psoriasis or reduce CVD risk; (3) examine emotional reactions to message frame; and (4) examine predictors of BI. A two by two experiment examined the effects on BI of message frame (loss vs. gain) and message focus (psoriasis symptom reduction vs. CVD risk reduction). Participants with psoriasis (n = 217) were randomly allocated to one of four evidence-based health messages related to either smoking, alcohol, diet or physical activity, using an online questionnaire. BI was the primary outcome. Analysis of variance tests and hierarchical multiple regression analyses were conducted. A significant frame by focus interaction was found for BI to reduce alcohol intake (p = .023); loss-framed messages were more effective for CVD risk reduction information, whilst gain-framed messages were more effective for psoriasis symptom reduction information. Message framing effects were not found for BI for increased physical activity and improving diet. High CVD risk was a significant predictor of increased BI for both alcohol reduction (β = .290, p < .01) and increased physical activity (β = ?.231, p < .001). Message framing may be an important factor to consider depending on the health benefit emphasised (disease symptom reduction or CVD risk reduction) and patient-stated priorities. Condition-specific health messages in psoriasis populations may increase the likelihood of message effectiveness for alcohol reduction.     

Motives and Consequences of Alcohol Use in People With Social Anxiety Disorder: A Daily Diary Study

People with social anxiety disorder (SAD) are at increased risk for alcohol-related problems. Most research exploring social anxiety and alcohol use has examined negative drinking consequences, with less consideration of positive consequences—namely positive social experiences—that may reinforce alcohol use. In this daily diary study, we examined how adults diagnosed with SAD (N = 26) and a psychologically healthy control group (N = 28) experienced positive drinking consequences in naturally occurring drinking episodes during the study period. For 14 consecutive days, participants answered questions about alcohol use, motives for drinking, and positive consequences of drinking. On days when participants drank, those with SAD were more likely than healthy controls to perceive a reduction in anxiety, but the two groups did not differ in their likelihood of experiencing positive social drinking consequences. For both groups, on days when they were more motivated to drink to enhance social experiences (affiliation motives) or cope with distress (coping motives), they were more likely to obtain positive consequences from drinking. Compared to controls, participants with SAD endorsed stronger trait and daily coping motives (anxiety-coping, social anxiety-coping, and depression-coping). Results are discussed in the context of reinforcement mechanisms that may maintain social anxiety and alcohol use.     

Intentions to use hormonal male contraception: The role of message framing,attitudes and stress appraisals

Two studies are reported. Study one (N = 104) explored the extent to which male hormonal contraception is perceived as risky compared to other prevention behaviours. Study two examined the effects of message framing on intentions to use hormonal male contraception and investigated whether attitude moderates message framing effects. Three hundred and four participants read either a loss frame or gain frame message and then completed questionnaires assessing their intentions to use hormonal male contraception, stress appraisals and the theory of planned behaviour (TPB) variables. Exposure to a loss frame influenced intention to use the daily male pill in men with a more postive attitude. This suggests that attitude, but not other TPB variables or stress appraisals have the capacity to moderate framing effects. Stress appraisals, in addition to TPB variables, significantly predicted variance in behavioural intentions in men and women. These findings are discussed within the context of Prospect Theory, perceived risk and prevention/detection behaviours.     

Framing Charity Advertising: Influences of Message Framing,Image Valence,and Temporal Framing on a Charitable Appeal1

This study examined when and how charitable advertisements could be effective in the context of child poverty. An experiment investigated the influences of message framing, image valence, and temporal framing on a charitable appeal. The results indicate that image valence enhances framing effects on advertising effectiveness of a charitable appeal when the image is congruent with the framed message, especially when the image and the message are presented negatively. A short‐term temporal frame facilitates effects of a negatively framed message with a negative pictorial presentation. Alternatively, a long‐term temporal frame increases advertising influences of a positively framed message with a positive pictorial image. Relevance for information processing of charity advertising is discussed.     

Alcohol self‐presentation: the role of impression motivation and impression construction

Two studies examined impression motivation (IM) and impression construction (IC) processes in college freshman alcohol use. In both studies, students completed individual difference measures related to IM and alcohol IC. In Study 1 (n = 232), participants were assigned to IM (low vs. high) and IC (alcohol vs. control) conditions and then created a personal profile. In Study 2 (n = 65), participants reported levels of IM and alcohol IC, and number of drinks during each evening's social interactions for 3 weeks. Situational alcohol IC was positively related to whether participants presented themselves as an alcohol user in their profile (Study 1) and in the amount they drank (Study 2). In Study 2, the association between IC and drinking was moderated by IM.     

The role of message framing in promoting MMR vaccination: evidence of a loss-frame advantage

This study examined the effects of message framing on intentions to obtain the measles, mumps and rubella (MMR) vaccine for one's child and investigated whether Theory of Planned Behaviour (TPB) and perceived outcome efficacy variables mediate and/or moderate message framing effects. One hundred and forty women read either a loss-framed or gain-framed message and then completed measures assessing their intentions to obtain the MMR vaccine for their child, and TPB and outcome efficacy variables. Exposure to the loss frame increased intentions to obtain the MMR vaccine and influenced perceptions of outcome efficacy. This suggests that outcome efficacy, but not other TPB variables may mediate framing effects within the context of MMR vaccination. Message frame, in addition to TPB variables, significantly predicted unique variance in behavioural intentions. These findings are discussed within the context of Prospect Theory, perceived risk and prevention/detection behaviours.     

Pluralistic ignorance and college student perceptions of gender-specific alcohol norms.

Students' perceived norms and personal concern about alcohol use were examined in 4 (N=971) experiments. Men reported that same-sex peers were less concerned about campus alcohol practices than themselves or female students; women believed that they were more concerned about campus alcohol practices than both same- and opposite-sex peers (Experiments 1 and 2). Additional evidence suggested that students were not merely engaging in impression management. Men reported more social pressure to drink and greater embarrassment about expressing drinking-related concerns; women expected more severe consequences if they drank excessively (Experiment 3). A male student (vs female student) expressing concerns about alcohol was believed to experience greater difficulties fitting in (Experiment 4). Implications for peer influence and drug use intervention are discussed.     

Fitting in and feeling fine: conformity and coping motives as mediators of the relationship between social anxiety and problematic drinking.

The present research was conducted to clarify the relationships among social anxiety, alcohol consumption, alcohol-related problems, and negative-reinforcement drinking motives among college students. Heavy drinking students (N = 316, 53.80% female) completed self-report measures of social anxiety, alcohol consumption, alcohol-related problems, and drinking motives. Findings indicated that students higher in social anxiety consumed less alcohol but experienced more negative consequences. Moreover, the relationship between social anxiety and negative consequences was mediated by coping and conformity drinking motives in addition to alcohol consumption. In the context of social anxiety, the current research demonstrates the importance of examining problematic drinking as distinct constructs: alcohol consumption and negative consequences. Findings are also discussed in terms of implications for interventions with socially anxious students.     

Personal and social correlates of alcohol consumption among mid‐adolescents

A prospective, cohort survey of 540 mid‐adolescent students was conducted to identify personal, family and social correlates of alcohol use. A structured questionnaire recorded alcohol involvement, other substance use, perceived parental alcohol use and related factors, alcohol‐related attitudes and beliefs, psychological well‐being, social and peer behaviours, and school conduct problems. Participants drank on 17.5 days in the past 3 months; on a typical drinking day they consumed 4.7 units, with 28.5% reported drinking six or more units. More frequent drinking was independently correlated with being male, perceiving that parents encouraged drinking, drinking without parental knowledge, drinking to alter mood, buying alcoholic beverages, spending more time with friends who drink, perceiving social pressure to drink, and being excluded from school and truanting. Parental discouragement for alcohol was related to more frequent drinking in females and less frequent drinking in males. Drinking more intensively was associated with use of cannabis, parental encouragement to drink, spending more time with friends who drink, school exclusion, and being in trouble with teachers. These results highlight multidimensional correlates of drinking during mid‐adolescence and underline the importance of addressing personal, family, peer, and school conduct factors in school‐based alcohol education programmes.     

The Role of Psychological Reactance in Drinking Following Alcohol Prevention Messages1

Two experiments tested whether a dogmatic alcohol prevention message may, by arousing psychological reactance (the motivation to reassert a threatened freedom) result in more subsequent alcohol consumption, compared to a neutral message. In Study 1, 535 college students received either a high-threat (dogmatic) or low-threat (neutral) message recommending either abstinence or controlled drinking. Results indicated that high-threat messages were rated more negatively and resulted in more drinking intentions compared to low threat. The negative effect of high threat on message ratings was most pronounced for habitually heavy drinkers and an abstinence-espousing message. In Study 2, under the guise of a “memory study,” 74 college students received either a high- or low-threat message recommending abstinence from alcohol. Then, under the guise of a “perception study,” all subjects participated in a taste-rating task in which their beer consumption was unobtrusively measured. Results indicated that the effect of high threat was most negative for male heavy drinkers, who drank significantly more beer compared to low-threat controls. These results suggest that the persuasive ability of alcohol prevention efforts depend to a considerable extent on the reactance-arousing properties of the materials and that dogmatic alcohol prevention materials may have counterproductive effects for some college students.     

Evaluations and expectancies of alcohol and marijuana problems among college students.

Two studies examined the associations between evaluations (good-bad) and expected likelihood (likely-unlikely) of alcohol- and marijuana-related problems and hazardous consumption and problems among college students. Participants provided data on alcohol use, alcohol-related problems, and expectancies and evaluations of alcohol problems; marijuana use indices, marijuana-related problems, marijuana effect expectancies, and likelihood and evaluations of marijuana problems. Evaluations of alcohol problems were positively related to the number of binge drinking occasions and alcohol-related problems. The interaction between evaluations and expectancies was significant in predicting the number of binge drinking occasions. Expectancies demonstrated a curvilinear relationship with binge drinking and alcohol-related problems. Marijuana users evaluated marijuana-related problems as less negative and less likely to occur than did nonusers. Expectancies, but not evaluations, of negative consequences were significantly associated with marijuana use intensity. Expectancies of problems demonstrated a curvilinear relationship with marijuana-use intensity and marijuana problems. Men evaluated alcohol and marijuana problems less negatively than did women. In summary, the expected likelihood of alcohol-marijuana problems and the evaluation of such problems represent a vulnerability factor associated with increased liability for hazardous alcohol and marijuana use.     

College Students With Military Experience Report Greater Alcohol-Related Consequences

This study examined associations among military experience, alcohol use, and alcohol-related consequences among a large national sample of 27,249 students pursuing postsecondary education. Because of the uniqueness of the developmental period of emerging adulthood, we stratified all analyses by age groups of 18–24 and 25 and older. There were no differences between students with and without military service history in terms of 3 indicators of alcohol use: alcohol consumption in the last 30 days, binge drinking in the last 2 weeks, and drinking and driving in the last 30 days. There were, however, several differences in self-reported consequences of drinking. Among individuals ages 18–24, students with military service history had nearly twofold increased odds of police encounters as a consequence of drinking (adjusted odds ratio [aOR] = 1.91, 95% confidence interval [CI] [1.02, 3.57]) and increased odds greater than twofold of experiencing nonconsensual sex (aOR = 2.68, 95% CI [1.17, 6.19]). Among both age groups, students with military service history reported greater odds of having unprotected sex as a consequence of drinking when compared to students without military service history. Research is needed to identify the reasons why alcohol use results in these particular negative consequences for students with military service history, which can inform prevention and intervention efforts.     

Effects of construal level and need for cognition on consumers' responses to temporally framed benefits

Applying construal level (CL) theory as a theoretical framework, this study examined the conditions under which temporally framed messages are effective. A 2(temporal framing: near‐future vs. distant‐future rewards) × 2(CL: high vs. low) × 2(need for cognition: high vs. low) between‐subjects design was employed. Data from two online experiments showed that consumers generated more favorable responses to the ad when the temporal distance matched consumer CL. Low‐construal consumers, either chronic or primed, were found to prefer product information framed with near‐future rewards. This CL temporal match effect appeared for consumers high in need for cognition only. Further, the matched message enhanced consumers' perception of message quality and this perceived message quality mediated the effect of the CL temporal match on consumer responses to the ad. Theoretical and managerial implications were discussed.     

Contrast Effects on Strategic-Issue Framing

We examined determinants of subjective framing other than semantic manipulation. Participants in the first experiment (n= 176) read several business threats or opportunities, prior to describing a strategic issue. Results revealed a contrast effect, where those exposed to unequivocal opportunities framed an equivocal issue as a threat, whereas those exposed to unequivocal threats did not view the same issue as threatening. A second experiment (n= 185) replicated the contrast effect using only one context manipulation (i.e., threat or opportunity business scenario), and alternative modes of presentation (i.e., serial vs simultaneous). A third experiment (n= 72) showed that the contrast effects extended beyond simple perceptions to actual intentions and behaviors. We conclude that the narrowing of one's frame for a strategic issue may result in a restricted range of alternatives considered and suboptimal responses.     

High school drinking and its consequences

The present study surveyed 930 high school students regarding self-reported alcohol use, their perceptions of parents and peers, and the negative consequences of drinking. Two-fifths of males and one-fifth of females reported frequent problem (binge) drinking. Problem drinkers reported more negative consequences associated with drinking. In addition, problem drinkers reported greater susceptibility to peer pressure, perceived their peers as drinking more, and reported less parental monitoring and more use of alcohol by parents. The results demonstrate the importance of both parent and peer variables in adolescent substance use and highlight the negative consequences of drinking reported by high school students.     

Abstractness and Messages Describing Consequences Promote Healthier Behavioral Intentions

Many health-risk behaviors present a self-control conflict in which the short-term outcomes of an action conflict with its long-term consequences. Across three studies, we find that an abstract construal level leads people to focus on long-term rather than short-term consequences when both are described in a message (vs. no message). Studies 1 and 2 explore this hypothesis through a risk behavior (snacking on sugary products), and Study 3 does the same through a health behavior (physical exercise). In Study 1, the Behavioral Identification Form scale is used to measure the construal level as a personal disposition; Studies 2 and 3 use a priming task designed by Freitas, Gollwitzer, and Trope to manipulate the construal level. All these studies show that, under an abstract mindset, people who have read a mixed-outcome message (vs. no message) tend to base their behavioral plans on long-term outcomes. Individually or in small groups (e.g. school class, therapy groups) health messages can be presented along with protocols to change construal level and thus, promote healthier intentions.     

Parental Predictors of Adolescent Alcohol Use and Alcohol‐Related Consequences

This study examined parental predictors of alcohol use and alcohol‐related consequences among 9th‐grade students (N = 296). Parental disapproval of teen drinking and quality of parent–child general communication were significant predictors of drinking behaviors. Implications for counselors are discussed.     

Alcohol consumption,dating relationships,and preliminary sexual outcomes in collegiate natural drinking groups

This study tested the effects of committed relationships and presence of dates on alcohol consumption and preliminary sexual outcomes in natural drinking groups (NDGs). Undergraduate drinkers (N = 302) answered an online questionnaire on their most recent participation in a NDG. The interaction between relationship commitment and presence of a date on alcohol consumption was significant. Among students not in committed relationships, those dating within their NDG reported heavier drinking than those not dating. Students in committed relationships drank less than those who were not committed only when their partners were present. The positive correlation between drinking and sexual contact was significant only for those who were not in committed relationships. Implications for future research and interventions are discussed.     

Intoxicated eyewitnesses: The effect of a fully balanced placebo design on event memory and metacognitive control

Few studies have examined the impact of alcohol on metacognition for witnessed events. We used a 2 × 2 balanced placebo design, where mock witnesses expected and drank alcohol, did not expect but drank alcohol, did not expect nor drank alcohol, or expected but did not drink alcohol. Participants watched a mock crime in a bar‐lab, followed by free recall and a cued‐recall test with or without the option to reply “don't know” (DK). Intoxicated mock witnesses' free recall was less complete but not less accurate. During cued‐recall, alcohol led to lower accuracy, and reverse placebo participants gave more erroneous and fewer correct responses. Permitting and clarifying DK responses was associated with fewer errors and more correct responses for sober individuals; and intoxicated witnesses were less likely to opt out of erroneous responding to unanswerable questions. Our findings highlight the practical and theoretical importance of examining pharmacological effects of alcohol and expectancies in real‐life settings.