Disgust and behavioral avoidance in colorectal cancer screening and treatment: a systematic review and research agenda.

BACKGROUND: The emotion of disgust appears to promote psychological and behavioral avoidance, a dynamic that has significant implications in physical and psychological outcomes in colorectal cancer (CRC). Patients, caregivers, and health professionals alike are all potentially susceptible to responding with disgust and the associated avoidance. OBJECTIVE: This article aimed to review the early-stage literature related to disgust and CRC, consider the clinical implications, and suggest an appropriate research agenda. METHODS: Given limited research in this area, a systematic review of the literature was broadened to include disgust and all cancers. MEDLINE, Web of Science, SCOPUS, and ProQuest Dissertations and Theses databases were searched, with additional works sourced by reviewing citation lists and/or by contacting the lead authors. RESULTS: Nine studies were identified relating to disgust and cancer screening, and 6 related to disgust and cancer treatment. Two broad findings emerged: (1) disgust appears to be promoting aversion to (and avoidance of) CRC screening, and (2) several known elicitors of disgust are widely apparent in CRC contexts. CONCLUSIONS: Disgust likely represents a key emotional substrate for avoidance among CRC patients, caregivers, and health professionals. Further research is required to identify disgust's elicitors and effects in CRC contexts, informing interventions that target early identification of persons at risk of maladaptive outcomes. Exposure therapies and mindfulness training may be well suited to treating disgust-generated avoidance. IMPLICATIONS FOR PRACTICE: Disgust has significant implications in CRC contexts. Oncology nurses are uniquely positioned to guide clinical interventions and ultimately improve outcomes in this area.

Paying for someone else's mistake: the effect of bystander negligence on perpetrator blame.

The success of criminal acts can sometimes depend critically on the oversight or negligence of uninvolved bystanders (e.g., someone leaving a first-floor window open). Four studies examined how the contribution of a negligent bystander affects blame for the perpetrator of a crime. Although participants stated that discounting blame for the perpetrator was normatively inappropriate in this context, they expected that others would make this very "error." Instead, across all four studies, bystander negligence amplified ascriptions of perpetrator blame. This amplification occurred because the bad action of the bystander provided an implicit standard of comparison for the perpetrator's act, framing it as more blameworthy. A variety of alternative mechanisms--that bystander negligence altered perceived crime avoidability, prompted spontaneous counterfactualizing, or increased victim empathy--were tested and ruled out. Implications for legal contexts are discussed.

Message framing and pap test utilization among women attending a community health clinic.

In a randomized experiment, women (N = 441) watched either a loss- or gain-framed video emphasizing the prevention or detection functions of the Pap test to test the hypothesis that loss- and gain-framed messages differentially influence health behaviors depending on the risk involved in performing the behavior. As predicted, loss-framed messages emphasizing the costs of not detecting cervical cancer early (a risky behavior) and gain-framed messages emphasizing the benefits of preventing cervical cancer (a less risky behavior) were most persuasive in motivating women to obtain a Pap test.