Preliminary evidence that misalignment between sleep and circadian timing alters risk-taking preferences.

Decision-making has been shown to suffer when circadian preference is misaligned with time of assessment; however, little is known about how misalignment between sleep timing and the central circadian clock impacts decision-making. This study captured naturally occurring variation in circadian alignment (i.e., alignment of sleep-wake timing with the central circadian clock) to examine if greater misalignment predicts worse decision-making. Over the course of 2 weeks, 32 late adolescent drinkers (aged 18-22 years; 61% female; 69% White) continuously wore actigraphs and completed two overnight in-laboratory visits (Thursday and Sunday) in which both dim-light melatonin onset (DLMO) and behavioural decision-making (risk taking, framing, and strategic reasoning tasks) were assessed. Sleep-wake timing was assessed by actigraphic midsleep from the 2 nights prior to each in-laboratory visit. Alignment was operationalised as the phase angle (interval) between average DLMO and average midsleep. Multilevel modelling was used to predict performance on decision-making tasks from circadian alignment during each in-laboratory visit; non-linear associations were also examined. Shorter DLMO-midsleep phase angle predicted greater risk-taking under conditions of potential loss (B = -0.11, p = 0.06), but less risk-taking under conditions of potential reward (B = 0.14, p = 0.03) in a curvilinear fashion. Misalignment did not predict outcomes in the framing and strategic reasoning tasks. Findings suggest that shorter alignment in timing of sleep with the central circadian clock (e.g., phase-delayed misalignment) may impact risky decision-making, further extending accumulating evidence that sleep/circadian factors are tied to risk-taking. Future studies will need to replicate findings and experimentally probe whether manipulating alignment influences decision-making.

The 24-hour rhythm in alcohol craving and individual differences in sleep characteristics and alcohol use frequency.

BACKGROUND: Evidence implicates sleep/circadian factors in alcohol use, suggesting the existence of a 24-h rhythm in alcohol craving, which may vary by individual differences in sleep factors and alcohol use frequency. This study sought to (1) replicate prior findings of a 24-h rhythm in alcohol craving, and (2) examine whether individual differences in sleep timing, sleep duration, or alcohol use frequency are related to differences in the timing of the peak of the craving rhythm (i.e., the acrophase) or magnitude of fluctuation of the rhythm (i.e., amplitude). Finally, whether such associations varied by sex or racial identity was explored. METHODS: Two-hundred fifteen adult drinkers (21 to 35 years of age, 72% male, 66% self-identified as White) completed a baseline assessment of alcohol use frequency and then smartphone reports of alcohol craving intensity six times a day across 10 days. Sleep timing was also recorded each morning of the 10-day period. Multilevel cosinor analysis was used to test the presence of a 24-h rhythm and to estimate acrophase and amplitude. RESULTS: Multilevel cosinor analysis revealed a 24-h rhythm in alcohol craving. Individual differences in sleep timing or sleep duration did not predict rhythm acrophase or amplitude. However, alcohol use frequency moderated this rhythm wherein individuals who used alcohol more frequently in the 30 days prior to beginning the study had higher mean levels of craving and greater rhythm amplitudes (i.e., greater rhythmic fluctuations). Associations did not vary by sex or racial identity. CONCLUSIONS: Results show that alcohol craving exhibits a systematic rhythm over the course of the 24 h and that the frequency of alcohol use may be relevant to the shape of this rhythm. Consideration of daily rhythms in alcohol craving may further our understanding of the mechanisms that drive alcohol use.

Sleepiness and Behavioral Risk-Taking: Do Sleepy People Take More or Less Risk?

BACKGROUND: Although sleep loss has been implicated in risk-taking behavior, it is unclear how individuals' current propensity to fall asleep, known as sleepiness, influences risk-taking. Because sleepiness is not only driven by recent sleep but also by factors such as circadian rhythm and current stimulation, it may be an important contributor to risk-taking as it reflects the more immediate sleep-wake state. PARTICIPANTS: One hundred thirty participants were recruited from a large Midwestern U.S. university. METHODS: Participants completed a short personality survey, reported their current sleepiness on the Stanford Sleepiness Scale, and then completed the Balloon Analog Risk Task, a computerized risk-taking measure in which participants earned real money for their performance. RESULTS: There was little support for a linear relation between sleepiness and risk-taking, but the evidence indicated a robust curvilinear relation. Even after controlling for important individual differences in sleep and risk-taking, participants who were moderately sleepy took longer to complete the risk-taking task, pumped balloons more, and exploded more balloons than those who were either low or high on sleepiness. CONCLUSIONS: The curvilinear relation between sleepiness and risk-taking sheds light on inconsistencies in prior findings linking sleepiness and sleep loss to risk-taking behavior. Moreover, current sleepiness appears to have unique implications for risk-taking.

Individual Differences in Diurnal Preference and Time-of-Exercise Interact to Predict Exercise Frequency.

BACKGROUND: Diurnal preference (and chronotype more generally) has been implicated in exercise behavior, but this relation has not been examined using objective exercise measurements nor have potential psychosocial mediators been examined. Furthermore, time-of-day often moderates diurnal preference's influence on outcomes, and it is unknown whether time-of-exercise may influence the relation between chronotype and exercise frequency. PURPOSE: The current study examined whether individual differences in diurnal preference ("morningness-eveningness") predict unique variance in exercise frequency and if commonly studied psychosocial variables mediate this relation (i.e., behavioral intentions, internal exercise control, external exercise control, and conscientiousness). Moreover, the study sought to test whether individuals' typical time-of-exercise moderated the impact of diurnal preference on exercise frequency. METHODS: One hundred twelve healthy adults (mean age = 25.4; SD = 11.6 years) completed baseline demographics and then wore Fitbit Zips® for 4 weeks to objectively measure exercise frequency and typical time-of-exercise. At the end of the study, participants also self-reported recent exercise. RESULTS: Diurnal preference predicted both self-reported exercise and Fitbit-recorded exercise frequency. When evaluating mediators, only conscientiousness emerged as a partial mediator of the relation between diurnal preference and self-reported exercise. In addition, time-of-exercise moderated diurnal preference's relation to both self-reported exercise and Fitbit-recorded exercise frequency such that diurnal preference predicted higher exercise frequency when exercise occurred at a time that was congruent with one's diurnal preference. CONCLUSION: Based on these findings, diurnal preference is valuable, above and beyond other psychological constructs, in predicting exercise frequency and represents an important variable to incorporate into interventions seeking to increase exercise.

IntEgrating Smoking Cessation treAtment into usual online Psychological care for people with common mEntal illness: Protocol for an online randomised feasibility and pilot study (ESCAPE digital).

BACKGROUND: In the UK, smoking prevalence in people with depression (34%) and anxiety (29%) is more than double that of the general population (13%). People who stop smoking improve their mental health with comparable effect sizes found for antidepressants. In England, online psychological therapy is a standard treatment for depression and anxiety. Online therapy is an acceptable setting for smoking cessation support; however, integrated smoking and mental health support is not available. This novel study aims to assess the acceptability and feasibility of an online smoking cessation intervention, and trial procedures, offered alongside online mental health treatment as it offers increased reach to people with common mental health difficulties who smoke. METHODS: A two-armed; Intervention (Integrated SilverCloud smoking cessation support) and control group (SilverCloud usual care), pragmatic, randomised controlled feasibility trial. We aim to recruit 500 adult smokers eligible for online mental health treatment. Follow-up will be conducted at 3-months and 6-months. We will assess the acceptability and feasibility of the trial procedures (i.e., recruitment, data completeness, self-reported acceptability and satisfaction) and the intervention (i.e., self-reported quit attempt, engagement with the smoking cessation and mental health programs, smoking cessation medicine and e-cigarette use, self-reported acceptability and satisfaction) and pilot clinical outcomes (i.e., biologically validated smoking abstinence, anxiety, depression, quality of health). CONCLUSION: If the Trial is successful, a randomised controlled effectiveness trial will follow to examine whether integrated smoking cessation and mental health treatment increases smoking abstinence and improves depression and anxiety compared to usual care. TRIAL REGISTRATION: ISRCTN10612149 (https://doi.org/10.1186/ISRCTN10612149), 02/02/2023.

Sleep and next-day negative affect and suicidal ideation in borderline personality disorder.

Sleep disturbance is associated with elevated suicidal ideation and negative affect. To date, however, no study has investigated the temporal relationship between sleep and suicidality among those diagnosed with borderline personality disorder (BPD). This preregistered (https://osf.io/4vugk) study tested whether nightly sleep (self-reported sleep duration, sleep onset latency, and subjective sleep quality) represents a (within-person) short-term risk factor for affective dysregulation and increases in suicide risk from day-to-day, as well as whether between-person differences in sleep, negative affect, and suicidality were associated. We used a 21-day ecological momentary assessment protocol in a sample of 153 people diagnosed with BPD, 105 of which had a history of serious suicide attempts, and 52 healthy controls (N = 4076 days). We found a within-person association between worse subjective sleep quality and greater next-day negative affect. At the between-person level, we found positive relationships between sleep latency and suicidal ideation, and a negative association between subjective sleep quality and negative affect. BPD severity did not significantly moderate the strength of any within-person associations, although BPD was positively associated with average levels of suicidal ideation, sleep latency, and negative affect, and negatively related to subjective sleep quality. These findings suggest that the association of sleep with suicidal ideation and BPD exists largely at the between-persons rather than the within-person level. Disturbed sleep, therefore, seems to largely coincide, rather than specifically contribute to, the exacerbation of suicidal crises in BPD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Iowa Resistance to Sleeplessness Test (iREST).

INTRODUCTION: Despite considerable individual differences in the vulnerability vs resistance to effects of sleep loss, there is no practical self-report tool to predict these differences across domains and only limited evidence whether they are general or domain-specific. To address this need, we developed the Iowa Resistance to Sleeplessness Test (iREST). METHODS: A construct-validation approach was employed. During the substantive phase, self-report items were generated to capture vulnerability vs resistance to sleep loss across various psycho-behavioral domains. During the structural phase, analyses identified the underlying factor structure and examined reliability of individual scale scores. Finally, the external phase used convergent and discriminant analyses to evaluate the factors in light of related sleep and personality measures, and tested criterion validity of the scale scores in predicting neurocognitive and affective responses to experimental sleep restriction (Total N = 1018). RESULTS: Analyses yielded discriminant and reliable scale scores that reflected resistance across cognitive, affective, and somatic responses, while also marking a general resistance factor. Convergent and discriminant probes revealed moderate associations of scale scores with daytime sleepiness and sleep-related distress, but small to negligible associations with other measures of sleep behavior, perceptions, and personality. Critically, criterion analyses yielded validity evidence for predicting cognitive and affective impairments in response to experimental sleep loss. CONCLUSION: Scores on the iREST show validity in capturing cognitive and affective resistance to moderate sleep loss among young adults, supporting its further exploration as a practical tool for predicting behavior due to lost sleep.

Sleep characteristics of U.S. adults before and during the COVID-19 pandemic.

RATIONALE: Understanding how health has changed in response to the COVID-19 pandemic is critical to recovering from the pandemic. OBJECTIVE: This study focused on how sleep characteristics in the United States may be different from before to during the COVID-19 pandemic. METHODS: To this end, the sleep characteristics of a nationally representative sample of U.S. adults collected before the COVID-19 outbreak (i.e., 2018 National Health Interview Survey, n = 19,433) were compared to the sleep characteristics of a nationally representative sample of U.S. adults recruited via Luc.id, an online survey sampling company, during the COVID-19 outbreak (i.e., 2020 Luc.id, n = 2059). RESULTS: While average sleep duration did not change between 2018 and 2020, the prevalence of both shorter and longer than recommended sleep duration were greater in 2020. Moreover, the number of days with difficulty falling asleep, difficulty staying asleep, and not feeling rested was greater in 2020 than 2018. Adults younger than 60 had larger differences than those 60 or older. CONCLUSIONS: Sleep health in U.S. adults was worse in 2020 than in 2018, particularly in adults younger than 60. Findings highlight sleep as target in future research and interventions seeking to understand and reduce the effects of the COVID-19 pandemic.

Is there a 24-hour rhythm in alcohol craving and does it vary by sleep/circadian timing?

Increasing evidence implicates sleep/circadian factors in alcohol use; however, the role of such factors in alcohol craving has received scant attention. Prior research suggests a 24-hour rhythm in related processes (e.g., reward motivation), but more research directly investigating a rhythm in craving is needed. Moreover, prior evidence is ambiguous whether such a rhythm in alcohol craving may vary by sleep/circadian timing. To examine these possibilities, 36 late adolescents (18-22 years of age; 61% female) with regular alcohol use but without a current alcohol use disorder were recruited to complete smartphone reports of alcohol craving intensity six times a day for two weeks. During these two weeks, participants wore wrist actigraphs and completed two in-lab assessments (on Thursday and Sunday) of dim light melatonin onset (DLMO). Average actigraphically derived midpoint of sleep on weekends and average DLMO were used as indicators of sleep and circadian timing, respectively. Multilevel cosinor analysis revealed a 24-hour rhythm in alcohol craving. Findings across the sleep and circadian timing variables converged to suggest that sleep/circadian timing moderated the 24-hour rhythm in alcohol craving. Specifically, people with later sleep/circadian timing had later timing of peak alcohol craving. These findings add to the growing evidence of potential circadian influences on reward-related phenomena and suggest that greater consideration of sleep and circadian influences on alcohol craving may be useful for understanding alcohol use patterns and advancing related interventions.

Associations Between Adolescent Depression and Self-Harm Behaviors and Screen Media Use in a Nationally Representative Time-Diary Study.

Screen media use is associated with mental health problems among adolescents. However, few studies have examined screen media use using contemporaneous time diaries (rather than retrospective reports), compared associations across specific screen media activities or by gender, or examined associations with self-harm behaviors. Participants were 13- to 15-year-old adolescents completing time diaries (n = 4,252) for one weekday and one weekend day in the 2015 administration of the Millennium Cohort Study, a nationally representative birth cohort study of UK adolescents. Participants also completed a measure of depressive symptoms and reported whether they had engaged in self-harm in the last year. Girls who spent 2 + hrs/day, compared to < 2 h/day, on digital media were more likely to self-harm (for social media use, adjusted relative risk [ARR] for self-harm = 1.46, 95% CI = 1.17, 1.82; for internet use, ARR = 1.80 [1.20, 2.70]). Girls spending more time on digital media were also more likely to be depressed (for social media, ARR = 1.29 [1.03, 1.63]; for internet use, ARR = 1.75 [1.19, 2.59]). Associations with gaming, texting/e-mailing, and TV/video watching among girls were mostly not significant. Associations for boys were mostly not significant. Girls who use digital media (especially social media and the internet) more hrs/day are more likely to have clinically significant levels of depressive symptoms and prior history of self-harm, though gaming, texting/e-mailing, and TV/video watching showed few associations. Screen media use was mostly not significantly associated with self-harm or depression among boys.

Associations between screen time and short sleep duration among adolescents varies by media type: evidence from a cohort study.

STUDY OBJECTIVES: Different types of electronic screen media have repeatedly been linked to impaired sleep; yet, how different uses of electronic media are linked to sleep has received much less attention. Currently, the role of chronotype in these associations is understudied. To address these gaps, this study examined how different uses of screen media are linked to sleep, and whether these associations were accounted for or differed across chronotype. METHODS: Data were from 11,361 children aged 13 to 15 from the United Kingdom who participated in the 2015 wave of the Millennium Cohort Study. RESULTS: Heavy use of screen media was associated with shorter sleep duration, longer sleep latency, and more mid-sleep awakenings. The strongest associations emerged for using screen media to engage in social media or to use the internet. Overall, these associations were weakened, but remained after controlling for chronotype and tended to be the strongest amongst robins (children with an intermediate chronotype). CONCLUSIONS: Spending too much time on electronic devices is associated with multiple dimensions of impaired sleep, especially if this time on devices is used for social media or surfing the internet. Chronotype does not account for the associations between screen media and sleep and can be used to identify children who may be particularly susceptible to the effects of screen media on sleep.

Screen media use and sleep disturbance symptom severity in children.

OBJECTIVES: Few studies have sought to evaluate how screen media use relates to symptoms of sleep-wake disturbances. To extend these prior studies in a large sample of children, this study examined associations of different types of screen media with symptom severity of different classes of sleep-wake disturbances. This study was preregistered here. DESIGN: This study utilized the baseline cross-sectional survey administered within the Adolescent Brain Cognitive Development Study (ABCD; Release 2.0). PARTICIPANTS: ABCD recruited over 11,000 U.S. children age 9-10 across 21 study sites using an epidemiologically-informed school-based recruitment strategy. MEASUREMENTS: Children reported typical weekend and weekday use of TV, video, video game, social media, texting, and video chat, and parents completed reports of the child's symptom severity of sleep-wake disturbances via the Sleep Disturbance Scale for Children. RESULTS: Greater screen media use, TV, video, and video game use, was associated with decreased sleep duration, increased sleep onset latency as well as greater excessive sleepiness, insomnia, and overall sleep disturbance symptom severity. Use of these screen medias were also associated with clinically relevant sleep problems. Ethnoracial differences emerged in screen use and sleep, but did not moderate the association between screen use and sleep. CONCLUSIONS: Greater use of screen medias was not just associated with longer sleep onset latency and shorter sleep duration, but also increased severity of multiple types of sleep-wake disturbances. Future research should use longitudinal designs to determine the direction of these associations in adolescent populations.

Sleepy anger: Restricted sleep amplifies angry feelings.

Despite extensive ties between sleep disruption, anger, and aggression, it is unclear whether sleep loss plays a causal role in shaping anger. On one hand, negative affect and distress frequently follow curtailed sleep, suggesting increased anger responses. On the other hand, fatigue and withdrawal also follow, potentially muting anger. To examine these competing possibilities, 142 community residents were randomly assigned to either maintain or restrict their sleep over 2 days. Before and after, these participants rated their anger and affect throughout a product-rating task alongside aversive noise. Sleep restriction universally intensified anger, reversing adaptation trends in which anger diminished with repeated exposure to noise. Negative affect followed similar patterns, and subjective sleepiness mediated most of the experimental effects on anger. These findings highlight important consequences of everyday sleep loss on anger and implicate sleepiness in dysregulation of anger and hedonic adaptation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Changes in sleep difficulties among the U.S. population from 2013 to 2017: results from the National Health Interview Survey.

OBJECTIVES: This study sought to evaluate how sleep difficulties have changed over time and to evaluate if these changes relate to changes in sleep duration. DESIGN: National Health Interview Survey administered annually from 2013 to 2017 by the National Center for Health Statistics. SETTING: U.S. national adult population. PARTICIPANTS: 164,696 U.S. adults sampled across the nation using multistage area probability design. MEASUREMENTS: Self-reports of difficulties falling asleep, trouble staying asleep, use of sleep medication, feelings of restorative sleep, and sleep duration collected each year. RESULTS: From 2013 to 2017, the prevalence of reporting any days with difficulty falling asleep (B = .01, p <.01), trouble staying asleep (B = .02, p < .001), increased, yet waking feeling rested also increased (B = .01, p = .004), while average sleep duration decreased (B = -.02, p < .001). Moreover, changes in these sleep difficulties were independent of sleep duration and primarily occurred in healthy sleepers. CONCLUSIONS: Multiple aspects of sleep difficulties show an undesirable trajectory in the U.S. adult population. Moreover, these trends appear to be independent of sleep duration and are primarily occurring in healthy sleepers. Future research should simultaneously consider how multiple aspects of sleep are changing and further examine the sources of these changes.

Does Stress Explain the Effect of Sleep on Self-Control Difficulties? A Month-Long Daily Diary Study.

Insufficient sleep is linked to increased stress and suboptimal self-control; however, no studies have examined stress as a reason for why sleep affects self-control. Moreover, it is unknown if there are individual differences that make people vulnerable to this dynamic. Daily diary entries from 212 university students across 30 days were used in a multilevel path model examining if stress explained how prior night sleep affected next-day self-control difficulties and exploring if individual differences in sleep duration, stress, or self-control qualified this effect. Increased stress partially mediated of the effect of reduced sleep duration on increased next-day self-control difficulty. Moreover, short sleep increased next-day stress more for individuals with higher typical stress. Daytime stress especially amplified self-control difficulty for individuals with shorter typical sleep duration. Findings implicate stress as a substantial factor in how sleep loss undermines self-control and identify individuals particularly susceptible to this effect.

Does sleep partially mediate the effect of everyday discrimination on future mental and physical health?

OBJECTIVE: The current study examined whether sleep mediates the effect of discrimination experiences on mental and physical health over time. Prior research suggests a partially mediated relation; however, these studies used cross-sectional designs which provide insufficient causal evidence. METHOD: The study used longitudinal data available from the Midlife in the United States Study (MIDUS II, Biomarker project, and MIDUS III) applying structural equation modeling to evaluate whether self-reported sleep (N = 866) mediated the impact of discrimination on mental and physical health outcomes. RESULTS: Self-reported sleep quality partially mediated the effect of discrimination on mental and physical health. Analyses also indicated self-reported daytime dysfunction (i.e., difficulties maintaining alertness and motivation during the day) as a key component of sleep that mediates the discrimination and mental and physical health relations. Interestingly, having multiple marginalized identities did not amplify the impact of discrimination on sleep and health. CONCLUSIONS: These findings build upon previous cross-sectional research by better supporting the causal assertion that experiences of discrimination undermine sleep, which in turn worsens both mental and physical health. Altogether, results underscore the harmful impact of discrimination on health indirectly through sleep and offer insight into directions for future research.

Associations between screen time and sleep duration are primarily driven by portable electronic devices: evidence from a population-based study of U.S. children ages 0-17.

STUDY OBJECTIVES: Excessive screen time in child and adolescent populations is associated with short sleep duration, but the unique effects of portable vs. non-portable electronic devices has received little attention. Moreover, it is unknown whether the effects of these devices change across childhood. To address these gaps, the current study compared the association of portable vs. non-portable electronic devices with sleep duration throughout childhood. METHODS: Data were from a 2016 national survey of the caregivers of 43,755 children and adolescents ages 0-17 administered by the U.S. Census Bureau. RESULTS: Children and adolescents who spent more time on screens slept fewer hours and were more likely to get insufficient sleep. In multivariate regressions including time spent on TV and video game consoles and portable electronic devices, associations with sleep duration were primarily due to portable electronic devices. These results remained when demographic variables, diagnoses of anxiety or depression, physical activity, and BMI were included in the model. Moreover, time spent using both portable and non-portable devices was important for sleep duration in children under age 10, but the importance of non-portable devices diminished in children over 10. CONCLUSIONS: Spending multiple hours a day on electronic devices is associated with shorter sleep duration across all ages. However, portable electronic devices have a stronger association with sleep duration than non-portable electronic screens, with non-portable devices less relevant for sleep duration in children over age 10. The findings suggest that future interventions should uniquely target portable electronic devices while also accounting for the age group of children targeted.

Decreases in self-reported sleep duration among U.S. adolescents 2009-2015 and association with new media screen time.

STUDY OBJECTIVES: Insufficient sleep among adolescents carries significant health risks, making it important to determine social factors that change sleep duration. We sought to determine whether the self-reported sleep duration of U.S. adolescents changed between 2009 and 2015 and examine whether new media screen time (relative to other factors) might be responsible for changes in sleep. METHODS: We drew from yearly, nationally representative surveys of sleep duration and time use among adolescents conducted since 1991 (Monitoring the Future) and 2007 (Youth Risk Behavior Surveillance System of the Centers for Disease Control; total N = 369,595). RESULTS: Compared to 2009, adolescents in 2015 were 16%-17% more likely to report sleeping less than 7 h a night on most nights, with an increase in short sleep duration after 2011-2013. New media screen time (electronic device use, social media, and reading news online) increased over this time period and was associated with increased odds of short sleep duration, with a clear exposure-response relationship for electronic devices after 2 or more hours of use per day. Other activities associated with short sleep duration, such as homework time, working for pay, and TV watching, were relatively stable or reduced over this time period, making it unlikely that these activities caused the sudden increase in short sleep duration. CONCLUSIONS: Increased new media screen time may be involved in the recent increases (from 35% to 41% and from 37% to 43%) in short sleep among adolescents. Public health interventions should consider electronic device use as a target of intervention to improve adolescent health.

Enhancing the effects of a narrative message through experiential information processing: An experimental study.

First-person narratives are becoming a popular means to communicate health risk information. Although studies show they can increase risk perception and motivate health behaviours compared to statistical messages, more research on the conditions in which they are particularly likely to have effects is needed. In this study, we tested a moderator related to how information is processed. Specifically, we hypothesised that thinking in terms of emotions and personal experiences - known as experiential information processing - would increase people's responsiveness to a narrative. Female college students (N = 138) who reported indoor tanning were randomly assigned to read a first-person narrative message or a statistical message about the risks of skin cancer. Prior to reading the message, the women received instructions that would activate either experiential or rational information processing. Participants then reported their risk perceptions of skin cancer, worry about skin cancer and behaviour intentions related to skin cancer. Analyses showed that message type and information processing interacted to influence risk perceptions and worry. Consistent with hypotheses, participants reported the highest risk perception and worry when they used an experiential information system prior to reading the narrative message. There were no effects on behaviour intentions. Implications of these findings are discussed.