Persuasive Narratives About Osteoporosis: Effects of Protagonist Competence, Narrator Point of View, and Subjective Risk.

Narratives have been widely acknowledged as a powerful persuasion tool in health promotion and education. Recently, great efforts have been devoted to identifying message components and causal pathways that maximize a narrative's persuasion power. Specifically, we investigated how narrator point of view and readers' subjective relative risk moderate the effects of protagonist competence on intentions to adopt osteoporosis-prevention behaviors, and proposed identification with the protagonist, self-referencing, and fear arousal as three mediators explaining the effect. Women aged 35 to 55, still young enough to reduce osteoporosis risk, read a narrative in which the 60-year-old female character reflects on either taking actions to prevent osteoporosis (competent protagonist) or failing to do so, resulting in osteoporosis (incompetent protagonist) (N = 563). The narratives were told from either the first- or third-person point of view. We found that women who perceived themselves to be at lower risk for developing osteoporosis relative to their peers identified more with the competent protagonist. For women at higher perceived risk, the competent and incompetent protagonists elicited similar levels of identification. Identification was higher when the protagonist's story was told from the first-person perspective, but only for the incompetent protagonist narrative. Identification, self-referencing, and fear arousal played important mediating roles. Implications for theory development and practice are examined.

Incivility in COVID-19 Vaccine Mandate Discourse and Moral Foundations: Natural Language Processing Approach.

BACKGROUND: Vaccine hesitancy poses a substantial threat to efforts to mitigate the harmful effects of the COVID-19 pandemic. To combat vaccine hesitancy, officials in the United States issued vaccine mandates, which were met with strong antivaccine discourse on social media platforms such as Reddit. The politicized and polarized nature of COVID-19 on social media has fueled uncivil discourse related to vaccine mandates, which is known to decrease confidence in COVID-19 vaccines. OBJECTIVE: This study examines the moral foundations underlying uncivil COVID-19 vaccine discourse. Moral foundations theory poses that individuals make decisions to express approval or disapproval (ie, uncivil discourse) based on innate moral values. We examine whether moral foundations are associated with dimensions of incivility. Further, we explore whether there are any differences in the presence of incivility between the r/coronaviruscirclejerk and r/lockdownskepticism subreddits. METHODS: Natural language processing methodologies were leveraged to analyze the moral foundations underlying uncivil discourse in 2 prominent antivaccine subreddits, r/coronaviruscirclejerk and r/lockdownskepticism. All posts and comments from both of the subreddits were collected since their inception in March 2022. This was followed by filtering the data set for key terms associated with the COVID-19 vaccine (eg, "vaccinate" and "Pfizer") and mandates (eg, "forced" and "mandating"). These key terms were selected based on a review of existing literature and because of their salience in both of the subreddits. A 10% sample of the filtered key terms was used for the final analysis. RESULTS: Findings suggested that moral foundations play a role in the psychological processes underlying uncivil vaccine mandate discourse. Specifically, we found substantial associations between all moral foundations (ie, care and harm, fairness and cheating, loyalty and betrayal, authority and subversion, and sanctity and degradation) and dimensions of incivility (ie, toxicity, insults, profanity, threat, and identity attack) except for the authority foundation. We also found statistically significant differences between r/coronaviruscirclejerk and r/lockdownskepticism for the presence of the dimensions of incivility. Specifically, the mean of identity attack, insult, toxicity, profanity, and threat in the r/lockdownskepticism subreddit was significantly lower than that in the r/coronaviruscirclejerk subreddit (P<.001). CONCLUSIONS: This study shows that moral foundations may play a substantial role in the presence of incivility in vaccine discourse. On the basis of the findings of the study, public health practitioners should tailor messaging by addressing the moral values underlying the concerns people may have about vaccines, which could manifest as uncivil discourse. Another way to tailor public health messaging could be to direct it to parts of social media platforms with increased uncivil discourse. By integrating moral foundations, public health messaging may increase compliance and promote civil discourse surrounding COVID-19.

Uncivil Reactions to Sexual Assault Online: Linguistic Features of News Reports Predict Discourse Incivility.

Reports of sexual assault have been found to elicit online discourse incivility. The present study employs a computerized coding tool to examine linguistic characteristics of news media that are likely to influence discourse incivility-specifically, negative emotion, disagreement, and discussion about power relations. Additionally, machine learning was harnessed to measure the levels of comment toxicity, insult, profanity, threat, and identity attack in Reddit and Twitter posts sharing news reports of sexual assault. Findings reveal that linguistic features of news articles interact with platform community norms to predict rape culture as expressed within online responses to reports of sexual assault.

Desensitization to Fear-Inducing COVID-19 Health News on Twitter: Observational Study.

BACKGROUND: As of May 9, 2021, the United States had 32.7 million confirmed cases of COVID-19 (20.7% of confirmed cases worldwide) and 580,000 deaths (17.7% of deaths worldwide). Early on in the pandemic, widespread social, financial, and mental insecurities led to extreme and irrational coping behaviors, such as panic buying. However, despite the consistent spread of COVID-19 transmission, the public began to violate public safety measures as the pandemic got worse. OBJECTIVE: In this work, we examine the effect of fear-inducing news articles on people's expression of anxiety on Twitter. Additionally, we investigate desensitization to fear-inducing health news over time, despite the steadily rising COVID-19 death toll. METHODS: This study examined the anxiety levels in news articles (n=1465) and corresponding user tweets containing "COVID," "COVID-19," "pandemic," and "coronavirus" over 11 months, then correlated that information with the death toll of COVID-19 in the United States. RESULTS: Overall, tweets that shared links to anxious articles were more likely to be anxious (odds ratio [OR] 2.65, 95% CI 1.58-4.43, P<.001). These odds decreased (OR 0.41, 95% CI 0.2-0.83, P=.01) when the death toll reached the third quartile and fourth quartile (OR 0.42, 95% CI 0.21-0.85, P=.01). However, user tweet anxiety rose rapidly with articles when the death toll was low and then decreased in the third quartile of deaths (OR 0.61, 95% CI 0.37-1.01, P=.06). As predicted, in addition to the increasing death toll being matched by a lower level of article anxiety, the extent to which article anxiety elicited user tweet anxiety decreased when the death count reached the second quartile. CONCLUSIONS: The level of anxiety in users' tweets increased sharply in response to article anxiety early on in the COVID-19 pandemic, but as the casualty count climbed, news articles seemingly lost their ability to elicit anxiety among readers. Desensitization offers an explanation for why the increased threat is not eliciting widespread behavioral compliance with guidance from public health officials. This work investigated how individuals' emotional reactions to news of the COVID-19 pandemic manifest as the death toll increases. Findings suggest individuals became desensitized to the increased COVID-19 threat and their emotional responses were blunted over time.

Erratum: Metadata Correction: "Desensitization to Fear-Inducing COVID-19 Health News on Twitter: Observational Study".

[This corrects the article DOI: 10.2196/26876.].

Narratives of Prevention and Affliction in Type 2 Diabetes: Mechanisms of Influence in a Sample of Middle-aged Women.

Research suggests that readers identify more with a competent protagonist who acts to prevent diabetes than with a less competent protagonist whose inaction leads to disease. We sought a better understanding of the mediators of this protagonist competence effect. Middle-aged women (45-55) read a prevention narrative depicting a protagonist at risk for type 2 diabetes (T2D) who prevents diabetes through lifestyle changes or an affliction narrative in which protagonist inaction leads to disease (N = 315). The prevention narrative elicited more identification than the affliction narrative for participants at low risk of T2D, but less identification for higher risk participants. Identification's impact on intentions to adopt self-protective behaviors was partially mediated by self-referencing. Protagonist competence did not affect transportation, but transportation had a direct effect on behavioral intentions and an indirect effect on intentions mediated by self-referencing. Fear arousal predicted behavioral intentions and was highest among those who read the affliction narrative and rated self as at risk for T2D. Protagonist competence had an indirect effect on intentions mediated by attributions of trustworthiness in response to the affliction narrative. This study contributes to our understanding of how narratives work and underscores the importance of tailoring narratives to the risk profile of individuals.

Effects of public versus media responsibility messages on stigmatization of people with schizophrenia in an American adult sample.

PURPOSE: People with mental illness suffer from the consequences of stigma. Interventions to reduce stigma should focus on alternative approaches that target false beliefs toward mental disorders. The effectiveness of two messages to reduce stigma toward schizophrenia was tested: a traditional public responsibility message that attributes stigma to public misunderstandings, and an alternative media responsibility message that attributes stigma to bias in media representations. METHODS: An experiment with Americans (N = 448) randomly assigned to a public responsibility message, a media responsibility message, or a control condition. Participants in the two message conditions completed measures of guilt and reactance toward the media. Perceptions of personal responsibility and dangerousness, and social rejection intentions were assessed for all participants. RESULTS: Both messages lowered perceptions of dangerousness and social rejection intentions, relative to control. The media responsibility generated more reactance toward the media than the public responsibility approach, but not more guilt. Reactance did not mediate message effects. Perceptions of personal responsibility were reduced after exposure to the public responsibility message, but only for participants with no prior contact with mental illness. CONCLUSIONS: Both approaches reduced perceptions of dangerousness and social rejection intentions. Stigma reduction campaigns might segment the audience based on prior contact.

Emotional Self-Disclosure in Online Breast Cancer Support Groups: Examining Theme, Reciprocity, and Linguistic Style Matching.

The present study investigated emotional self-disclosure (ESD) patterns and their effects in online support groups specific to different stages of breast cancer. Linguistic features of messages posted to an online breast cancer support group were analyzed. ESD was common, and was consistent across four stage forums. Emotional talk was linked to a variety of themes, but most prominently in the context of discussions about social connections rather than health or death. Linguistic style matching mediated the relationship between ESD in posts and reciprocal ESD in comments, suggesting a key role for mutual understanding and engagement between posters and commenters. Implications for health communication theory and practice were discussed.

Stigma of HIV Testing on Online HIV Forums: Self-Stigma and the Unspoken.

Most studies examining HIV-related content in web forums have revolved around the most frequently used terms in HIV-related messages and topics, as well as the supportive nature of those messages. The current study explored barriers that prevent individuals from seeking HIV testing (specifically stigma). The current study analyzed a total of 210 threads and 319 posts, yielding 13 threads that revealed how individuals self-stigmatize and expressed how the fear of being diagnosed prevented them from seeking HIV testing. Results suggest that forums or online communities may perpetuate subculture values that deviate from mainstream values. Another important finding is that there is a lack of HIV testing information in forums for adolescents, which may contribute to the trend of young individuals engaging in risky sexual behaviors not getting tested in a timely fashion. [Journal of Psychosocial Nursing and Mental Health Services, 55(12), 34-43.].

Persuasive Effects of Point of View, Protagonist Competence, and Similarity in a Health Narrative About Type 2 Diabetes.

We examined the persuasive effects of three narrative features in a message about type 2 diabetes: narrative point of view (first- vs. third-person perspective), protagonist competence (positive role model who prevents diabetes vs. negative role model who develops diabetes), and protagonist-reader similarity (demographically similar vs. dissimilar). We posited that a first-person point of view would elevate people's identification levels more than a third-person point of view, especially when the protagonist was depicted as a positive role model. We also expected a similar protagonist to foster greater levels of identification than a dissimilar one. In addition, the positive effect of a competent role model on identification was expected to be enhanced under the condition of reader-protagonist similarity. Finally, we hypothesized that the effects of identification on persuasion would be mediated by self-referencing. Participants 30 years of age or younger (N = 489) were randomly assigned to read a story about a person with a family history of type 2 diabetes that was altered with regard to the experimental factors. Thereafter they completed a questionnaire incorporating measures of study variables. Greater levels of identification were found to foster self-referencing, leading to persuasion. Identification was strongest with a first-person point of view and when the narrator was a positive role model. The effect of identification on persuasion was mediated by self-referencing. Contrary to expectations, protagonist-reader demographic similarity did not affect identification or self-referencing. There was no support for the two moderation hypotheses.

Narrator Point of View and Persuasion in Health Narratives: The Role of Protagonist-Reader Similarity, Identification, and Self-Referencing.

Narratives are often used in messages about health threats. We posited that a 1st-person point of view (POV) narrative would have a greater effect than a 3rd-person POV on the mediators identification and self-referencing-an effect moderated by protagonist-reader similarity. Higher levels of identification and self-referencing were expected to elevate susceptibility and severity perceptions, leading to persuasion. Participants ages ≤30 years were recruited from a crowdsource website and randomly assigned to read one version of a faux magazine article about caffeine overdose. Article versions were defined by a 2 (1st- or 3rd-person POV) × 2 (similar or dissimilar protagonist) design. To manipulate similarity, we had respondents read an article in which the protagonist was also young (24 years of age) and of the same sex or much older (54 years of age) and of the opposite sex. Participants then completed a questionnaire measuring study variables. Contrary to expectations, POV did not affect identification or self-referencing. However, similarity directly impacted identification, which in turn influenced severity perceptions. Self-referencing was not affected by the experimental manipulations but had a direct effect on susceptibility and also mediated the identification → susceptibility relationship. Susceptibility and severity perceptions were associated with greater levels of persuasion. Implications for message design are discussed.

Bones, body parts, and sex appeal: An analysis of #thinspiration images on popular social media.

The present study extends research on thinspiration images, visual and/or textual images intended to inspire weight loss, from pro-eating disorder websites to popular photo-sharing social media websites. The article reports on a systematic content analysis of thinspiration images (N=300) on Twitter and Pinterest. Images tended to be sexually suggestive and objectifying with a focus on ultra-thin, bony, scantily-clad women. Results indicated that particular social media channels and labels (i.e., tags) were characterized by more segmented, bony content and greater social endorsement compared to others. In light of theories of media influence, results offer insight into the potentially harmful effects of exposure to sexually suggestive and objectifying content in large online communities on body image, quality of life, and mental health.

The motives for and consequences of viewing television medical dramas.

Although television medical dramas have been popular for a long time and have delivered health- and medical-related information to audiences, few studies have focused on audience's view. This study explores motives for and consequences of viewing medical dramas from the uses and gratifications (U&G) perspective. A survey identified college students' motives toward medical drama viewing and the relationship of the motives with individuals' health information orientation, audience activity (selectivity, attention, involvement), and their use of health information learned from the dramas. Although viewers' primary motive for viewing medical drama was not to gather health information, only health information motive, among all motives, directly predicted use of health information from medical dramas. Viewers' entertainment-related motives toward medical drama viewing indirectly and positively predicted use of information in the dramas via involvement with those dramas, and indirectly and negatively via attention to the story in those dramas. Theoretical and practical implications of these findings are discussed.

Male partner selectivity, romantic confidence, and media depictions of partner scarcity.

An experiment was conducted to explore the effects of exposure to partner scarcity or abundance messages on men's partner selectivity, romantic confidence, and self-assessed attractiveness. Undergraduate male participants watched a soap opera narrative featuring either two men competing over one potential female partner (partner scarcity) or two women competing over one potential male partner (partner abundance). Relative to control subjects, watching either narrative reduced romantic confidence. Experimental condition also affected partner selectivity and self-assessed attractiveness, though both effects were moderated by endorsement of traditional masculine ideology. Viewing the abundance narrative resulted in greater selectivity and self-assessed attractiveness for men high in endorsement of traditional masculinity but diminished selectivity and self-assessed attractiveness for men low in endorsement of traditional masculine identity.

Death and television: terror management theory and themes of law and justice on television.

Based on terror management theory, it was hypothesized that media choices may be affected by the salience of death-related thoughts. Three experiments with samples of undergraduate students were conducted to investigate whether such a process would affect preferences for law and justice television programming. In the first experiment (n = 132), individuals for whom mortality had been made salient through experimental induction preferred more programs with law and justice themes than individuals for whom mortality had not been made salient. In the second experiment (n = 761), this effect was observed regardless of trust in law enforcement and only for participants induced to think about death, not those induced to think about pain. In the third experiment (n = 163), participants for whom mortality was salient who watched a crime drama that showed justice being carried out showed a diminished self-enhancing bias compared to participants who watched a version of the same program in which justice was thwarted. Results indicate that entertainment choices are influenced by thought of death beyond simply seeking distraction and that entertainment programming emphasizing justice can effectively ameliorate existential anxiety that arises from thoughts of death.

Watching Aggressive, Attractive, Female Protagonists Shapes Gender Roles for Women Among Male and Female Undergraduate Viewers.

The impact of exposure to media representations of aggressive, attractive, female protagonists on audiences' gender role expectations for women was explored through a laboratory experiment with 122 undergraduates from a large university on the west coast of the United States. Participants viewed a segment of a major Hollywood motion picture that featured a female protagonist who was either highly attractive or less attractive and either highly aggressive or not aggressive. Viewing clips featuring a female protagonist who was both aggressive and stereotypically attractive led to greater endorsement of stereotypically feminine and stereotypically masculine gender role expectations for women. The effect on endorsement of stereotypically masculine expectations was partially mediated by the perception that the protagonist was a good role model for women. Although women endorsed both feminine and masculine gender role expectations for women more strongly than men, the effects of exposure to aggressive, attractive, female protagonists were similar for both male and female participants. Results are discussed in terms of gender stereotype activation and superwoman expectations for women.

Third-person effects and direct-to-consumer advertisements for antidepressants.

BACKGROUND: This study examines the evidence for a third- person effect (TPE) in the reactions of individuals affected by depression to direct-to-consumer (DTC) advertisements for antidepressants. TPE predicts that people will perceive the self to be less vulnerable to such advertisements than others. Previous research has identified such an effect, but did so in general population surveys. Past Previous research has also found a link between depression and diminished self-serving biases; whether this would be the case for TPE is unknown. METHODS: An online questionnaire was administered to 148 participants in an Internet depression support group to investigate their perceptions of the influence of direct-to-consumer (DTC) advertisements for antidepressants. RESULTS: Consistent with expectations derived from third-person effect TPE research, participants, although relatively neutral in their attitudes toward such advertisements, nevertheless perceived other individuals with depression as more influenced than themselves. Positive attitudes towards DTC advertisements and depressive symptoms at the time of the survey were each negatively associated with this third-person perception (TPE). CONCLUSIONS: Individuals who have been diagnosed with depression and who participated in an online depression support group believe that they are less vulnerable to the influence of DTC advertisements than the typical person with a history of depression. This is moderated by attitudes towards DTC advertisements as well as by depressive symptoms, each of which is associated with a weakened TPE.

Avatars and emotional engagement in asynchronous online communication.

The notion that an avatar can elicit a sense of emotional involvement or connection on the part of a user in asynchronous online communication was explored through a pair of content analyses of a popular online question-and-answer bulletin board. In the first study, questions accompanied by an avatar not only received more answers than questions without an avatar, but the answers were more likely to be characterized by expressions of empathy. In the second study, a preference for answering questions accompanied by an avatar was found to be associated with interpersonal, altruistic motives for answering questions. Results are discussed in terms of presence and alternative explanations, as well as practical implications.

Do antidepressant advertisements educate consumers and promote communication between patients with depression and their physicians?

OBJECTIVE: To examine how online depression support group members respond to direct-to-consumer (DTC) antidepressant advertising. METHODS: Survey of 148 depression forum members, administered via an online questionnaire. RESULTS: Chronicity was high, as 79.1% had received a diagnosis of depression 3 or more years earlier. Respondents reported seeing advertisements for an average of 4.3 of seven brands investigated. A majority rated the information quality of these advertisements as "poor" or "fair." Attitudes toward antidepressant advertisements were neutral (mean: 2.96 on a five-point scale). More than half (52.4%) visited official websites provided in these advertisements, 39.9% had talked with a doctor after seeing an advertisement, 20.3% made an advertisement-induced prescription request, and 25.7% said these advertisements reminded them to take their antidepressants. Amount of attention given to these advertisements correlated positively with belief in the brain chemical imbalance causal model, but belief in this model did not predict prescription requests. CONCLUSION: Awareness of DTC antidepressant advertisements is high among individuals with depression, but so is skepticism. PRACTICE IMPLICATIONS: Among members of an online support group, these advertisements encourage patient-doctor dialogue, prescription requests, and adherence, but might also reduce the acceptability of psychotherapy and encourage doctor switching in a small number of patients.

Self-esteem, academic self-concept, and aggression at school.

The present study explores the relation between academic self-concept, self-esteem, and aggression at school. Longitudinal data from a racially diverse sample of middle-school students were analyzed to explore how academic self-concept influenced the likelihood of aggressing at school and whether high self-concept exerted a different pattern of influence when threatened. Data include self-reported academic self-concept, school-reported academic performance, and parent-reported school discipline. Results suggest that, in general, students with low self-concept in achievement domains are more likely to aggress at school than those with high self-concept. However, there is a small sample of youth who, when they receive contradictory information that threatens their reported self-concept, do aggress. Global self-esteem was not found to be predictive of aggression. These results are discussed in the context of recent debates on whether self-esteem is a predictor of aggression and the use of a more proximal vs. general self-measure in examining the self-esteem and aggression relation.