title: Individual differences in aversion to ambiguity regarding medical tests and treatments: association with cancer screening cognitions.
abstract: BACKGROUND
  Aversion to "ambiguity"-uncertainty about the reliability, credibility, or adequacy of information-about medical tests and treatments is an important psychological response that varies among individuals, but little is known about its nature and extent. The purpose of this study was to examine how individual-level ambiguity aversion relates to important health cognitions related to different cancer screening tests.
  
  
  METHODS
  A survey of 1,074 adults, ages 40 to 70 years, was conducted in four integrated U.S. healthcare systems. The Ambiguity Aversion in Medicine (AA-Med) scale, a measure of individual differences in aversion to ambiguity (AA) about medical tests and treatments, was administered along with measures of several cancer screening-related cognitions: perceived benefits and harms of colonoscopy, mammography, and PSA screening, and ambivalence and future intentions regarding these tests. Multivariable analyses were conducted to assess the associations between AA-Med scores and cancer screening cognitions.
  
  
  RESULTS
  Individual-level AA as assessed by the AA-Med scale was significantly associated (P < 0.05) with lower perceived benefits, greater perceived harms, and greater ambivalence about all three screening tests, and lower intentions for colonoscopy but not mammography or PSA screening.
  
  
  CONCLUSIONS
  Individual-level AA is broadly and simultaneously associated with various pessimistic cognitive appraisals of multiple cancer screening tests. The breadth of these associations suggests that the influence of individual-level AA is insensitive to the degree and nonspecific with respect to the causes of ambiguity.
  
  
  CONCLUSIONS
  Individual-level AA constitutes a measurable, wide-ranging cognitive bias against medical intervention, and more research is needed to elucidate its mechanisms and effects.
authors.affiliation: Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, Maine. hanp@mmc.org.
authors.forename: Paul K J
authors.initials: PK
authors.lastname: Han
authors.affiliation: Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, Maine.
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Williams
authors.affiliation: Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, Maine.
authors.forename: Amy
authors.initials: A
authors.lastname: Haskins
authors.affiliation: Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, Maine.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Gutheil
authors.affiliation: Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, Maine.
authors.forename: F Lee
authors.initials: FL
authors.lastname: Lucas
authors.affiliation: Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
authors.forename: William M P
authors.initials: WM
authors.lastname: Klein
authors.affiliation: Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Mazor
mesh_terms: D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000517:prevention & control / Q000628:therapy*; D015203:Reproducibility of Results