Bio-terrorism and the role of perceived control in minimizing automated fears

1
Bio-terrorism and the role of perceived control
in minimizing automated fears

• Len Lecci, Ph.D. Dale Cohen, Ph.D.
• University of North Carolina Wilmington

2
The Threat

• Anthrax
• Will result in death
• Everyone at risk
• Delivered by Postal Service
• But, low probability
• 1 in 14 million (vs. 1 in 5 million risk of being
  struck by lightning)

3
Facilitating Factor Ambiguity

• Forer Effect (1949)
• (a.k.a.Barnum Effect)
• People accept vague and general descriptions as
  uniquely applicable to themselves without
  realizing that the same description could be
  applied to just about anyone.

• Horoscope
• You have a need for other people to like and
  admire you, and yet you tend to be critical of
  yourself. While you have some personality
  weaknesses you are generally able to compensate
  for them. You have considerable unused capacity
  that you have not turned to your advantage.

4
Facilitating Factor Ambiguity
Anthrax (CDC) Initial symptoms may resemble a
common cold. After several days, the symptoms may
progress to severe breathing problems and shock.
Inhalation anthrax is usually fatal.
Common Cold (NIAID) Nasal discharge, obstruction
of nasal breathing, swelling of the sinus
membranes, sneezing, sore throat, cough, and
headache
5
Facilitating Factor Media

• Extensive Media Coverage
• Influences Perception of Risk
• High media Coverage Increased Perception of
  Risk

6
Lichtenstein, et al., 1978
Heart Disease
Diabetes
Small Pox Vaccine
Food Poisoning
7
CNN
8
MSNBC
9
Anthrax

• High Perceived Risk
• Extensive media coverage makes threat salient
• Ambiguous symptoms
• Similar to common cold, yet need for early
  detection
• Low Actual Risk
• Note Reducing anxiety by providing statistical
  information has little influence because people
  dont understand very small numbers (Cohen, et
  al., In Press)

10
Personality and Health Fears
Perceived Invulnerability
Optimal
Perceived Vulnerability
Optimal
11
Clinical Hypochondriasis

• Individuals make extensive use of medical care
  services
• Epidemiological data 4-5 of the general
  population exhibits such symptoms
• Upwards of 50 of adult ambulatory health care
  costs

12
Dangerous Interaction
Perceived Vulnerability Anthrax
13
Health behavior and salient health threats

• This can easily overburden the medical system by
• limiting the availability of resources through
  increased demand (e.g., Cipro by healthy
  individuals)
• making interventions less effective (e.g.,
  individual immune to interventions because they
  are used inappropriately)
• making the health delivery system less efficient
  (higher rate of false positives)

14
How can we minimize hypochondriacal responses to
health threats?

• Perceived Control
• Predicts well-being, health, and mortality
• Has been linked to individual differences in the
  use of medical resources
• Easier to manipulate than real control

15
Exploratory research (NSF grant 0204846)

• Method
• Participants randomly assigned to one of two
  conditions
• High Control condition (152 participants) - List
  3 things that are within your control that could
  result in reducing the likelihood that you will
  contract anthrax.
• Low Control condition (150 participants) - List
  3 things that are outside of your control that
  could result in increasing the probability that
  you will contract anthrax.

16
Method - continued

• Participants were provided with an anthrax fact
  sheet and photos depicting cutaneous anthrax
  exposure (arms hands)
• Importance of re-establishing salience (Lecci
  Cohen 2002), especially given the decrease in
  media coverage as the data was being collected
  (February to April, 2002)
• Provides all participants with similar level of
  knowledge and exposure to anthrax information
• Assessed hypochondriacal tendencies using the
  SAMPI

17
Measured controlled and automatic responses to
health threats

• Controlled Behavior
• Intentional thoughts and actions
• Examples
• Goal I will regularly visit a doctor
• Behavior Seeking out medical attention

18
Automatic Behaviors Habitual, Involuntary,
thoughts and actions

• Physiological responses
• Increased Heart Rate
• Shallow Breathing
• Psychological Responses
• Recall associated memories
• Attention fixates on threat stimuli

19
Three questions

• Can perceptions of control minimize the types of
  automated behaviors we just described?
• Will this occur even though health fears have
  been activated?
• Will this occur even if the individual exhibits
  tendencies to be hypochondriacal (i.e., they
  perceive themselves to be unusually vulnerable to
  health threats)?

20
Preliminary Results

• Manipulation of control beliefs eliminated
  automatic health relevant behaviors
• Even after activating anthrax fears
• Even for those evidencing hypochondriacal
  tendencies.
• Low control condition - those with high
  hypochondriacal tendencies were more likely to
  involuntarily devote attention to Anthrax related
  stimuli
• High control condition - No Effect

21
General Implications

• When threatened with biological warfare, more
  individuals will exhibit hypochondriacal
  tendencies
• This increase in individuals exhibiting health
  vulnerability beliefs will likely strain the
  health care system
• A simple manipulation of control beliefs may
  affect the manner or extent to which individuals
  process health threats.

22
Data to be analyzed

• How does our manipulation affect controlled
  behaviors?
• Can perceived control change peoples health
  goals?
• Can perceived control minimize the overuse of the
  health system?
• Over 600 participants are being tracked for
  their long term use of the university health care
  system

23
Open Questions

• Do these findings generalize to all health
  threats?
• Can unambiguous descriptions of symptoms mitigate
  automated and controlled health related
  behaviors?