A fear appeal is a persuasive message that attempts to arouse fear in order to divert behavior through the threat of impending danger or harm. It presents a risk, presents the vulnerability to the risk, and then may, or may not suggest a form of protective action.
It is assumed that through a fear appeal the perception of threatening stimuli creates fear arousal. The state of fear is believed to be an unpleasant emotional state that involves physiological arousal that motivates cognitive, affective, and behavioral responses directed towards alleviating the threat or reducing fear. There are many different theoretical models of fear appeal messages. They include: the extended parallel process model, the drive theory, the subjective expected utility theory, the protection motivation theory, the health belief model, the theory of reasoned action, and the transtheoretical model. These models are widely used in substance abuse campaigns, sexual health programs, and many other general health contexts. The persuasive effect of fear appeals is thought to be influenced by several factors such as individual characteristics, self-efficacy, perception of norms, fear strength, perceived threat, perception of treatment efficacy, and defense mechanisms. Mixed results have been produced from studies that attempt to demonstrate the effectiveness of fear appeals for behavior modification, and a recent meta-analysis recommended extreme caution in the use of fear appeals.
It is assumed that through a fear appeal the perception of threatening stimuli creates fear arousal. The state of fear is believed to be an unpleasant emotional state that involves physiological arousal that motivates cognitive, affective, and behavioral responses directed towards alleviating the threat or reducing fear. There are many different theoretical models of fear appeal messages. They include: the extended parallel process model, the drive theory, the subjective expected utility theory, the protection motivation theory, the health belief model, the theory of reasoned action, and the transtheoretical model. These models are widely used in substance abuse campaigns, sexual health programs, and many other general health contexts. The persuasive effect of fear appeals is thought to be influenced by several factors such as individual characteristics, self-efficacy, perception of norms, fear strength, perceived threat, perception of treatment efficacy, and defense mechanisms. Mixed results have been produced from studies that attempt to demonstrate the effectiveness of fear appeals for behavior modification, and a recent meta-analysis recommended extreme caution in the use of fear appeals.
Models
Over
the last half century, a substantial amount of research has been done
on the influence of fear on persuasion. A multitude of theories and
models of fear appeals, also known as cognitive mediating processes,
have been derived from this research. The goal of each of these has been
to conceptualize the influence of fear on persuasion so as to better
understand how to employ it in addressing the public on a number of
social issues.
Extended parallel process model
The extended parallel process model
(EPPM) is a theory that explains how cognitive and emotional mechanisms
trigger distinct motivational and coping responses such as fear control
and danger control responses. Fear control responses minimize fear
through emotional coping that generates reassurance through denial of
the threat or derogation of the persuasive message. Fear control is a
process of denial that does not involve physically averting behavior to
the perceived threat. Danger control is a cognitive process also
oriented towards reducing the presented threat. However, unlike fear
control response, danger control response may prompt protective action.
Thus according to the extended parallel process model, the experience of
fear is considered an emotional reaction, and the perceptions of threat
are a set of cognitions.
The extended parallel process model differs from many other fear appeal
arguments because it suggests that fear arousal and danger control
processes are distinct processes where fear arousal need not precede the
danger control process that underpin precautionary behaviors.
It is predicted that a fear appeal will initiate a dominant
response of either fear control or danger control processes.
The extended parallel process model concludes that cognition (attitudes, intentions, and behavior changes) result in fear appeal
success via the danger control process. It also concludes that fear
appeals fail when the fear emotion is reduced via the fear control
process.
Defensive avoidance is an example of a fear control response that leads to the failure of fear appeals.
Drive theory
Emotional
tension is a key characteristic of drive theory. According to the
theory, a threat that portrays the negative consequences of
non-compliance to a recommended behavior is expected to create fear. In
order to relieve the emotional tension of the threat, the "drive" state
motivates behavior conduct that reduces the tension. According to the
drive theory, it is expected that the greater the fear, the greater the
compliance to message recommendations.
Research has not produced consistent empirical results supporting
the drive reduction model. For example, a dental hygiene presentation
to a group of high school students reported greater change in attitudes
using mild rather than strong fear appeals. When repeated, the reverse
effect was true: greater attitude and behavior change occurred when a
strong fear appeal was used, versus a moderate or weak fear appeal.
Subjective expected utility theory
The subjective expected utility theory
has been applied to contexts beyond fear appeals. In the context of a
fear appeal, the subjective expected utility theory predicts that a fear
appeal is successful when the individual believes that the benefits in
risk reduction outweigh the expected cost of acting.
To assess the efficacy of a fear appeal respondents would be asked about
the likelihood and severity of harmful outcomes of risk involved. The
proposed severity is considered under the conditions of the current
behavior and then under the alternative behavior. The efficacy is
perceived through the effectiveness of the respondents answer. The
subjective expected utility theory is unlike other theories of fear
appeal because it does not describe the emotional process involved in
fear reduction. It is only used to predict the relative likelihood of
action. As previously stated, the subjective expected utility theory can
be applied to various contexts such as predicting retirement and
child-bearing.
Protection motivation theory
The
protection motivation theory is an attitude-based model. It holds that a
fear appeal argument initiates a cognitive assessment process that
considers the severity of the threatened event, the probability of the
occurrence of the event, and the efficacy of a recommended behavior
response. According to the theory, the cognitive assessment processes
enhance a fear appeal when it provokes protection motivation. Protection
motivation is a variable that arouses, sustains, and directs the
suggested behavior to avoid danger.
In absence of protection motivation, the recommended protective action
is judged to be ineffective in averting the threat or impossible to
undertake then no intention to act will result.
The protection motivation theory predicts that preventative actions
will be preferred in a high threat situation when the self-efficacy and
the efficacy of the recommended action are both high. Conversely, it is
expected that maladaptive actions will be maintained when there is a
high threat but the efficacy perceptions are low.
The protection motivation theory has been applied to analyzing
the efficacy of health campaigns such as those encouraging self-breast
examinations for detecting breast cancer. Studies found that perceptions
of threat concerning breast cancer prompted adaptive actions, such as
performing self-examinations, and maladaptive actions, such as to avoid
thinking about breast cancer.
Health belief model
The health belief model
predicts that perceived susceptibility and severity of a risk motivates
individuals to engage in preventive actions, and the type of
preventative action depends on the perceived benefits and hindrances of
performing the action.
A fear argument based on the health belief model is typically
presented in terms of the likelihood and severity of health consequences
if the current behavior is not changed. With the health belief model,
it is unclear whether self-efficacy is directly considered a cost of
performing a suggested action because occasionally, a fear appeal is
thought to be less effective if a difficulty of acting is considered a
cost of acting.
Theory of reasoned action
According to the theory of reasoned action,
acting on fear appeals begins by consideration of a wider range of
consequences of continuing the current behavior beyond the threat of
health risks. It also considers a wider range of consequences of the
suggested behavior beyond the costs and reduced health risks. The
projected consequences vary depending on the situation. The theory of
reasoned action differs from other theories because it also incorporates
a social influence factor in predicting the efficacy of fear appeals.
The social influence is determined by normative beliefs and the desires
of other relevant people to perform the given behavior.
The theory of reasoned action has been applied to alcohol,
tobacco, and other drug campaigns. For example, it has helped identify
the importance of peer pressure and the normative belief of parents as
variables for improving school-based drug campaigns. Although the theory
of reasoned action has been shown to be a strong predictive utility of
social behavior, it is considered to be deficient in explaining behavior
change.
Transtheoretical model
A transtheoretical model
of fear appeals explains a dynamic process of health behavior change.
Its structure is based on the assumption that behavior change is a
systematic process involving a series of stages referred to as stages of
change. It also holds that the transition between stages involves a
rational coping process referred to as processes of change. The stages
of change are: pre-contemplation, contemplation, preparation, action,
and maintenance.
According to the transtheoretical model, movement through the different
stages involves a process called decision balance. Decision balance
takes into account the potential gains and costs resulting from the new
behavior. It is believed that an individual will not change or continue a
behavior unless they perceive advantages to outweigh the disadvantages.
Pre-contemplation
The
pre-contemplation stage is a period in which individuals have no
intentions to stop a risky behavior or start a healthy behavior. This
may be due to a lack in knowledge of the risk involving their current
behavior, or an unwillingness to acknowledge that their behavior puts
them at risk. The process of change from the pre-contemplation phase to
the contemplation phase includes the response of conscious raising,
dramatic relief, and an environmental reevaluation process to the
argument.
Contemplation
The
second stage is contemplation. It is the stage at which an individual
is actively considering stopping risky behavior or starting a healthy
behavior. It is predicted that individuals will remain at this stage for
a long period of time due to the difficulty in evaluating the
advantages and disadvantages of behavior change.
The process of change to the following stage is expedited by self-reevaluation.
Preparation
This is the third stage at which individuals have been persuaded and commit to change their behavior.
The process of change to the action stage involves a self-liberation
process in which the fear appeal influences a changed behavior.
Action
Action is
the stage at which the individual engages in behavior change. They have
tried to stop their risky behavior. The process of change that helps
facilitate progression includes behavioral processes, such as
reinforcement management, helping relationships, counter-conditioning,
and stimulus control.
Maintenance
Maintenance
is the final stage for changing risky behavior. This is the stage at
which individuals adopt healthy behavior into their lifestyle, and try
to prevent regression into the risk behavior.
Regression is possible at any point of the stages.
The transtheoretical model has been used to structure various
programs for smoking cessation, alcohol abstinence, sunscreen use,
dietary change, and contraceptive use.
Factors that affect its efficacy
"The
ultimate goal of fear appeals is to effectively promote reflective
message processing and to influence individual affect towards the
message".
Individual perceptual differences towards the fear appeal are factors
that govern the efficacy of the fear appeal. Researchers have examined
several variables that have been thought, at one time or another, to
influence the persuasive effect of fear appeals. These factors include:
individual characteristics, risk perception, perception of
self-efficacy, perception of treatment efficacy, perception of norms,
the strength of the fear elicited, perceived threat, and defense
mechanisms. The results of the research have demonstrated that various,
and sometimes multiple factors, affect the efficacy of fear appeals
depending on the method used and the individual.
Individual characteristics
Also of interest in the fear appeals literature has been the contribution of individual characteristics.
The goal has been to understand which individual differences in
personality or psychological traits contribute or detract from the
effectiveness of the fear appeal. Individual moderating variables
studied thus far include trait anxiety, age, ethnicity, gender, coping style, locus of control, self-esteem, perceived vulnerability, need for cognition and uncertainty orientation.
Of these, uncertainty orientation and need for cognition have been
found to interact with the level of threat. Uncertainty orientation is
an individual's characteristic response to uncertainty. That is, whether
one attends to or avoids and ignores the source of the uncertainty.
Those with an uncertainty orientation tend to be more motivated to
deeply process the information presented as the personal relevance
increases, whereas those with a certainty orientation will actively
avoid it.
Some early studies examined other characteristics, such as individual
thresholds for fear arousal, to see if they moderated the effect of fear
on persuasion. A study by Janis and Feshbach (1954)
found that those with lower fear arousal thresholds were the least
compelled to act by the high fear appeals, as they tended to react with
defensive control responses. Lower threshold subjects were also more
easily persuaded by counterarguments following the fear appeal. Trait
anxiety has also been the subject of some of the early research, which
has since been found to have no discernible effect on persuasion.
Perception of self-efficacy
The self-efficacy theory states that all processes of psychological change alter the level and strength of self-efficacy.
Self-efficacy is enhanced by performance accomplishments, vicarious
experience, verbal persuasion, and physiological states. Self-efficacy
can also be enhanced by the perceived dependability of the source. The
level of self-efficacy an individual has is believed to influence their
choice of behavior as well as the amount of time, and the amount of
effort expended on that behavior. If the individual does not believe
that he or she is capable of averting the threat, it is likely that
denial or other defensive responses will be produced in order to lower
the fear. The fear of threatening situations may have an adverse effect
on the efficacy of a fear appeal. An intimidating situation may cause an
individual to believe that he/she is incapable of performing the
suggested preventative behaviors that will lead to avoidance behaviors.
Bandura's
research has demonstrated a positive correlation between changes in
behavior and changes in self-efficacy expectation. He found that
behavioral transformations are caused by changes in self-efficacy.
Research done by others have revealed "a positive, linear effect
of fear on overall intentions and behavior", especially when the
messages endorse people's self-efficacy.
This effect is more positive when behaviors are performed on one-time
basis instead of repeatedly. However, other researchers also pointed out
that in the context of self-efficacy need to be considered carefully in
relation to other strategies. The use of other persuasive techniques
such as behavioral trainings might counteract against the efficacy of
fear appeal in isolation.
Performance accomplishments
According
to the theory of self-efficacy, performance accomplishments are related
to the success of personal experience. When strong efficacy
expectations are established, then the impact of occasional failures are
reduced. If self-efficacy is established, it tends to generalize to
other situations.
Vicarious experience is the observation of others who have performed
threatening activities. If others are observed to successfully perform
threatening activities, then self-efficacy is expected to increase
because the social comparison will reinforce the perception that the
behavior can be achieved through effort.
Verbal persuasion
Verbal
persuasion is widely used because of the potentially persuasive
influence of suggestion. The influence of suggestion is expected to
boost individual self-efficacy. Research has shown that the effects of
verbal persuasion may not prevail through a long history of failure. It
has been shown to create an enduring sense of self-efficacy in
situations where aid is given to facilitate successful action. Failures
have a negative effect because it discredits the persuaders and
undermines the individual's self-efficacy.
Emotional arousal
Depending
on the circumstances, stressful situations can lessen the feeling of
personal competency. Poor performance, for example is usually associated
with a state of high arousal. Fear-provoking thoughts can cause an
individual to overestimate the intensity of a threatening situation.
According to the self-efficacy theory, diminishing emotional arousal can
reduce avoidance behavior. Physiological arousal has been predicted to
have both positive and negative effects on beneficial or negative coping
behaviors. A positive perception of an aroused state may energize,
while a negative perception of an aroused state may inhibit coping
behaviors.
Physiological arousal
Physiological
arousal has been predicted to have both positive and negative effects
on beneficial or negative coping behaviors. A positive perception of an
aroused state may energize, while a negative perception of an aroused
state may inhibit coping behaviors.
Perception of treatment efficacy
Perceived
treatment efficacy is also referred to as response-outcome
expectancies. It is conceptualized as a person's estimate that a given
behavior will lead to certain outcomes. Perception of treatment efficacy
differs from self-efficacy because an individual's belief in their
ability to perform the suggested actions does not influence their
behavior it is the perceived outcome that determines an individual's
actions. The enactment of sustained long-term behaviors intended by the
fear appeal communication is strongly influenced by the individual
perception of treatment efficacy. The extent to which an individual
perceives the protection of the recommended action against the health
risk determines whether they are persuaded to perform the recommended
course of action. A positive perception of treatment efficacy is
internalized by the emphasis of the positive aspects of the recommended
action.
Perceived treatment efficacy is possibly the most integral element of
an effectively persuasive fear appeal, and more predictive of action
than fear arousal, is perceived efficacy. Some research has found that
perceived efficacy is more predictive of intention to change behavior
than other elements of perceived threat.
Perception of norms
Even
if a health behavior is portrayed as harmful, the behavior may not be
altered by fear inducing communication if the individual is convinced
that the behavior is common practice. The behavior is unlikely to be
changed if the individual's social group models or reinforces the
actions. In this case, there may also be a false perception of norms.
Reinforcement of the negative health behavior by the common social group
decreases the effectiveness of the fear appeal.
Example: In a study of alcohol abuse on college campuses,
students demonstrated heavy alcohol use in response to their peer groups
that reinforced the behavior. Students who abused alcohol also believed
that their peers were even heavier users than they actually were. Those
who believed that heavy intoxication was an element of campus culture
may be at a greater risk for personal alcohol abuse due to the desire to
conform to the perceived norm.
Fear strength
The
strength of the fear elicited by the message is also an important
determinant of the subject's intentions to change the target behavior.
Fear strength is distinct from threat severity in that, as mentioned
before, fear strength is related to the emotion of fear, whereas threat
severity is considered to be an entirely cognitive process. Some early
research found that higher levels of fear produced defensive reactions,
compelling the researchers to caution that low or moderate levels were
the most effective.
With rare exception, strength of the fear elicited has been
consistently found to be positively correlated with behavior change.
This positive linear correlation is ubiquitous in fear appeal research
and has laid to rest the curvilinear relationship implied by some of the
earliest research. Strength of fear has been found to be positively
correlated, as expected, with arousal. Early research has found that low fear appeal strength was the most persuasive.
Strength of fear alone is not enough to motivate change in behavior as
strong fear with no recommended action, or a recommended action that is
not easily performed, may result in the exact opposite effect. According
to Sternthal and Craig,
fear strength affects attitude change more than it does intentions.
They argue that although persuasion increases when fear rises from low
to moderate levels, when rising from moderate to high levels, it
actually decreases.
Some have even gone so far as to argue that fear is an entirely
unnecessary component of an effective appeal as perceived efficacy is
more predictive of intention to change behavior than either element of
perceived threat.
The tendency for higher levels of fear to raise defensive control
responses, it is argued, suggests that fear is not useful and that
efficacy may be able to bring about intention and behavior change by
itself. Another argument states that since higher levels of personal
efficacy are necessary, the target of the fear appeal who is most likely
to act is one who is most likely to change his behavior to begin with. The implication is that another tact (other than fear) is necessary.
Perceived threat
Perceived threat is thought to be an important moderator in the process of fear evoked persuasion. It consists of both the perceived severity of the threat and the perceived susceptibility to it.
Perceived susceptibility, sometimes referred to as perceived
vulnerability, is thought to be key in motivating an individual to act
in response to a fear appeal. It is the perception of the probability
and extent to which he/she might experience the threat. Perceived
severity, however, is the degree to which the person believes that they
will be harmed if the threat is experienced. These threat components
form the perceptual trigger for the fear reaction. Higher levels of
perceived susceptibility have been found to increase the degree to which
people are critical of the message. An example of a fear appeal of a
message that emphasizes perceived severity would be the quote "AIDS
leads to death".
These threat components form the perceptual trigger for fear reaction.
Higher levels of perceived susceptibility have been found to increase
the degree to which people are critical of the message. However,
subjects report more positive thoughts about the recommendation and
negative emotions associated with the threat when susceptibility is
high. Higher levels of perceived susceptibility are associated with
greater intention to change behavior in the manner recommended in the
fear appeal message, and are a strong determinant of intentions and
behavior, even in the face of weak arguments.
It is thought that when perceived susceptibility is high, defense
motivations prevent even poor information or weak arguments from
detracting from the message's impact on intention. As influential as it
appears to be, susceptibility has still been found in some cases to have
a much less direct effect on motivation to act on the message than, for
instance, self efficacy beliefs or response efficacy.
Perceived severity, the extent to which the individual believes
he/she will be adversely affected by the threat has a significant effect
on persuasion. A statement that emphasizes the seriousness of a threat
would be a statement directed towards a targeted population. An example
would be, "You're at-risk for AIDS because you share needles while using
intravenous drugs". In some cases, persuasion has been found to be aided by lowering severity,
the majority of the fear appeal research has found just the opposite.
However, it is important to distinguish perceived severity of the threat
from the actual fear elicited. The former is considered to be an
entirely cognitive process, while the latter is an emotional process.
Some have even argued that cognitive processes in the context of fear
appeals are more important than emotional ones. Research has found that
the effect of fear on intentions is mediated by the perceived severity.
That is, fear does not act directly on intentions, but increases the
level of perceived severity, which in turn raises intentions to act on
the message. Indeed, the strength of the fear appeal is believed to be
positively correlated with the perceived severity of the threat.
Severity seems to produce the strongest effects on perceptions.
Defense mechanisms
The
previous components are thought to determine what response an
individual has to the message. One of these potential reactions to the
fear appeal that is of the most negative consequence is that of the
defensive fear control reaction. In response to the fear appeal, an
individual may form the intent to change their behavior. However, when
either self or response efficacy is low, the individual, perceiving that
they are unable to avert the threat, may rely on defensive avoidance to
lower their fear. Some have argued that fear appeals are unnecessary as
defensive avoidance reactions have been found in some studies to be
positively correlated with strength of fear and negatively with
perceived efficacy.
The required balance of fear and efficacy levels has been the subject of
much research, with some finding that moderate to high levels of fear
are unnecessary in changing intentions. In fact, they argue, what is
important is the ratio of these to each other. Gore and Bracken (2005)
found that even with low levels of threat, they were able to take
individuals who had started to exhibit defensive fear control reactions
to move toward danger control (intention change) reactions. Another way
of defending yourself against fear appeals is prior knowledge, according
to one study, individuals are less likely to be influenced by a fear
appeal if they have prior knowledge.
Ethical considerations
A
number of ethical concerns regarding the use of fear appeals have been
raised, leading to widespread debate regarding the acceptability of
their use. For example, it has been questioned whether it is ethical to
expose large numbers of people to potentially distressing messages
without their consent. Hastings, Stead and Webb question whether it is
ethically acceptable to expose an entire population to a distressing
message intended for a specific subset of that population.
For example, a fear appeal message stressing the likelihood of
premature death for individuals who smoke may also reach the children of
people who smoke, leading to avoidable anxiety in such groups.
Further to this, it is evident that anxiety responses may not
even be helpful when elicited in the target group. This is because,
while anxiety can motivate positive health behavior, it can also be
maladaptive, as some individuals form a defensive response to mitigate
the negative feeling arising from the fear appeal.
While there have been mixed results regarding whether fear appeals
elicit a defense response, it is important to note that studies
exploring this relationship are done in a laboratory setting free of
external distractions and where participants are told to focus on the
health messages.
It may be that people may have stronger defense responses in real life
situations where they must navigate a complex range of competing
messages and where they have the option of ignoring the message or
looking for competing explanations.
In addition to this, no studies have followed responses to fear appeals
over the longer term, and it possible that repetition of fear appeals
may lead to habituation and annoyance, therefore cause individuals to
tune out to the messages of the health promotion campaign.
Furthermore, even if they do work, some authors question whether it is
ethical to frighten people in to behaving in a certain way, as this may
compromise their autonomy by manipulating their beliefs.
A concern has also been raised that fear appeals serve to
contribute to the widening of health disparities. This is because
certain individuals are more likely to develop the maladaptive responses
mentioned above. Empirical research suggests that fear appeals work
best for individuals with high levels of self-efficacy, and that maladaptive responses are more likely in those with low self-efficacy.
This means that fear appeals work best for those who are equipped, both
physically and psychologically, to take appropriate action. Individuals
who do not have the resources for health behaviour change are often
those who already have negative health status. For example, people who
regularly engage in behaviours which are damaging to health (e.g.
smoking and other drug use) have been found to typically have lower
self-efficacy than others.
Therefore, it seems that, in addition to having the potential to cause
harm, this harm is more likely to affect groups that would most benefit
from health behavior change, therefore contributing to the widen of
health disparities.
There is also a concern that fear appeals give rise to stigmatization
of those who are seen to be already suffering the negative consequences
of the undesirable behavior. For example, injury prevention campaigns
often rely on emphasizing the negative consequences of potentially
becoming disabled. Wang hypotheses that when becoming disabled is
portrayed as unacceptable, so is being disabled, adding to the
stigmatization of disabled individuals.
For example, in responses to a poster campaign stating that "Last year,
1057 teenagers got so drunk they couldn't stand up. Ever." presented
alongside a picture of a wheelchair, disabled participants in Wang's
study felt that this held them up as an example of how not to be. One
participant said "I feel it's an attack on my self esteem and dignity."
