title: Reactions to threatening health messages.
abstract: BACKGROUND
  Threatening health messages that focus on severity are popular, but frequently have no effect or even a counterproductive effect on behavior change. This paradox (i.e. wide application despite low effectiveness) may be partly explained by the intuitive appeal of threatening communication: it may be hard to predict the defensive reactions occurring in response to fear appeals. We examine this hypothesis by using two studies by Brown and colleagues, which provide evidence that threatening health messages in the form of distressing imagery in anti-smoking and anti-alcohol campaigns cause defensive reactions.
  
  
  METHODS
  We simulated both Brown et al. experiments, asking participants to estimate the reactions of the original study subjects to the threatening health information (n = 93). Afterwards, we presented the actual original study outcomes. One week later, we assessed whether this knowledge of the actual study outcomes helped participants to more successfully estimate the effectiveness of the threatening health information (n = 72).
  
  
  RESULTS
  Results showed that participants were initially convinced of the effectiveness of threatening health messages and were unable to anticipate the defensive reactions that in fact occurred. Furthermore, these estimates did not improve after participants had been explained the dynamics of threatening communication as well as what the effects of the threatening communication had been in reality.
  
  
  CONCLUSIONS
  These findings are consistent with the hypothesis that the effectiveness of threatening health messages is intuitively appealing. What is more, providing empirical evidence against the use of threatening health messages has very little effect on this intuitive appeal.
authors.affiliation: Dept of Work & Social Psychology, Faculty of Psychology & Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. Gill.tenHoor@maastrichtuniversity.nl
authors.forename: Gill A
authors.initials: GA
authors.lastname: Ten Hoor
authors.forename: Gjalt-Jorn Y
authors.initials: GJ
authors.lastname: Peters
authors.forename: Janice
authors.initials: J
authors.lastname: Kalagi
authors.forename: Lianne
authors.initials: L
authors.lastname: de Groot
authors.forename: Karlijne
authors.initials: K
authors.lastname: Grootjans
authors.forename: Alexander
authors.initials: A
authors.lastname: Huschens
authors.forename: Constanze
authors.initials: C
authors.lastname: Köhninger
authors.forename: Lizan
authors.initials: L
authors.lastname: Kölgen
authors.forename: Isabelle
authors.initials: I
authors.lastname: Pelssers
authors.forename: Toby
authors.initials: T
authors.lastname: Schütt
authors.forename: Sophia
authors.initials: S
authors.lastname: Thomas
authors.forename: Robert A C
authors.initials: RA
authors.lastname: Ruiter
authors.forename: Gerjo
authors.initials: G
authors.lastname: Kok
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control* / Q000523:psychology; D001294:Attitude to Health; D005239:Fear; D005260:Female; D058015:Health Communication / Q000379:methods*; D006801:Humans; D008297:Male; D015397:Program Evaluation; D012907:Smoking / Q000523:psychology; D000074606:Smoking Prevention; D055815:Young Adult