Is My Story Better Than His Story? Understanding the Effects and Mechanisms of Narrative Point of View in the Opioid Context.

Sharing the stories of people whose lives are impacted by Opioid Use Disorders (OUDs) can be a promising strategy to reduce stigma and increase support for beneficial public policies. Since a story can be told from a first-person or third-person point of view (POV), this study sought to (1) determine the relative persuasive effects of narrative POV and (2) identify the underlying psychological mechanisms, including character identification and psychological reactance, of such narratives. A one-way between-subjects experiment was conducted among a college student sample (N = 276). Narrative POV was manipulated by describing a college student's OUD experience from either the first- or third-person POV. Findings demonstrated that POV did not influence identification but had a significant effect on reactance. Specifically, the first-person (vs. third-person) POV narrative led to lower reactance, which was associated with participants' decreased desire to socially distance themselves from people with OUDs and stronger support for public health-oriented policies regarding OUDs. This study sheds light on the mixed findings revealed in the literature and has practical importance in health message design in the current opioid epidemic.

Increasing Perceived Risk of Opioid Misuse: The Effects of Concrete Language and Image.

Risk perception is a critical determinant for individuals' health behavior change, especially for behaviors with distal future consequences. Building on construal-level theory, this study investigates if and how thinking concretely about the negative consequences of opioid misuse influences people's risk perception toward opioid misuse. Two message cues - images and concrete (vs. abstract) language - are proposed to influence concrete thinking and perceived temporal distance, which in turn influence risk perception directly and through negative affect. Using a factorial online experiment with Amazon Mechanical Turk workers (N = 220), this study found that messages using concrete language made people think more concretely about the negative consequences of opioid misuse. Perceived concreteness, in turn, increased risk perception and negative affect. Negative affect also increased risk perception. The use of images decreased perceived temporal distance, which in turn, changed risk perception through its influence on negative affect. Theoretical and practical implications are discussed.

The Influence of Stigmatizing Messages on Danger Appraisal: Examining the Model of Stigma Communication for Opioid-Related Stigma, Policy Support, and Related Outcomes.

Drug overdose is a leading cause of injury and death in the United States, and opioids are among the most significant of causes. For people with opioid use disorders (OUDs), opioid stigma can lead to devastating consequences, including anxiety and depression. Still, mass media may stigmatize people with OUDs by ascribing stigmatizing labels (e.g., "opioid addict") and other stigma features to those individuals. However, it is unclear how these stigmatizing messages influence public perceptions of people with OUDs and public support for rehabilitation and Naloxone administration policies. The model of stigma communication (MSC) provides a framework for understanding these relationships. This study used the MSC in two online factorial experiments, the first among college undergraduates (N = 231) and the second among Amazon Mechanical Turk workers (N = 245), to examine how stigmatizing messages about people with OUDs influence stigma-related outcomes. Results reveal that opioid stigma messages influence different outcomes depending on the content of those messages. Classification messages with a stigmatizing mark (e.g., "Alex appears unkempt") and label (e.g., "opioid addict") led to greater perceptions of dangerousness and threat in both studies. High stigma classification messages also led to an increased desire for behavioral regulation and social distance in Study 2. Structural equation modeling in Study 1 also supported the applicability of the MSC in the opioid context. Implications for health communication theory development and practice are discussed.