Skip to main content
Log in

Monitoring styles in women at risk for cervical cancer: Implications for the framing of health-relevant messages

  • Published:
Annals of Behavioral Medicine

Abstract

We explored the interaction effects of individual attentional style (high versus low monitoring) and the framing of informational messages on the responses of women undergoing diagnostic follow-up (colposcopy) for precancerous cervical lesions. Prior to the colposcopic procedure, patients (N=76) were randomly assigned to one of three preparatory conditions: (a) Loss-framed message, which emphasized the cost of nonadherence to screening recommendations; (b) Gain-framed message, which emphasized the benefit of adherence; and (c) Neutrally-framed message. It was hypothesized that low monitors (who are more positively biased about their health) would show a more adaptive pattern of response to loss-framed information than high monitors (who are more negatively biased about their health). The results of a series of hierarchical multiple regression analyses were consistent with this prediction. Low monitoring was associated with greater knowledge retention (β=.61, p<.05) and less canceling/rescheduling of follow-up appointments in the loss condition than in the neutral condition (β=.82, p<.002). High monitoring, however, was associated with greater intrusive ideation when information was presented in the loss-oriented frame as compared to the neutral frame (β=.99, p<.01). Knowledge retention and screening adherence were not affected by the framing manipulation. The differences between high versus low monitors as a function of loss or neutral frame suggest an interaction effect, wherein both the type of framing message and the individual's attentional style lead to distinctive cognitive-affective and behavioral patterns. The findings may have clinical implications for the tailoring of health messages to the individual's signature style.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Boring CC, Squires TS, Tong T: Cancer statistics, 1993.CA-A Cancer Journal for Clinicians. 1993,43: 7–26.

    PubMed  CAS  Google Scholar 

  2. Larsen PM, Vetner M, Hasen K, Fey SJ: Future trends in cervical cancer.Cancer Letters. 1988,41: 123–137.

    Article  PubMed  CAS  Google Scholar 

  3. American Cancer Society:Cancer Facts & Figures, 1998. Atlanta, GA: American Cancer Society, Inc., 1998.

    Google Scholar 

  4. Miller SM, Mischel W, O'Leary A, Mills M: From human papillomavirus (HPV) to cervical cancer: Psychosocial processes in infection, detection, and control.Annals of Behavioral Medicine. 1996.18: 219–228.

    PubMed  CAS  Google Scholar 

  5. Lerman C, Ross E, Boyce A, et al: The impact of mailing psychoeducational materials to women with abnormal mammograms.American Journal of Public Health. 1992,82: 729–730.

    PubMed  CAS  Google Scholar 

  6. Miller SM, Shoda Y, Hurley K: Applying cognitive-social theory to health-protective behavior: Breast self-examination in cancer screening.Psychological Bulletin. 1996,119: 70–94.

    Article  PubMed  CAS  Google Scholar 

  7. Rothman AJ, Salovey P: Shaping perceptions to motivate healthy behavior: The role of message framing.Psychological Bulletin. 1997,121: 3–19.

    Article  PubMed  CAS  Google Scholar 

  8. Miller SM, Mangan CE: Interacting effects of information and coping style in adapting to gynecologic stress: Should the doctor tell all?Journal of Personality and Social Psychology. 1983,45: 223–236.

    Article  PubMed  CAS  Google Scholar 

  9. Watkins LO, Weaver L, Odegaard V: Preparation for cardiac catheterization: Tailoring the content of instruction to coping style.Heart and Lung. 1986,15: 382–389.

    PubMed  CAS  Google Scholar 

  10. Gattuso S, Litt M, Fitzgerald T: Coping with gastrointestinal endoscopy: Self-efficacy enhancement and coping style.Journal of Consulting and Clinical Psychology. 1992,60: 133–139.

    Article  PubMed  CAS  Google Scholar 

  11. Jacob TC, Penn NE, Kulik JA, Spieth LE: Effects of cognitive style and maintenance strategies on breast self-examination (BSE) practice by African-American women.Journal of Behavioral Medicine. 1992,15: 589–609.

    Article  PubMed  CAS  Google Scholar 

  12. Miller SM: Monitoring versus blunting styles of coping with cancer influence the information patients want and need about their disease: Implications for cancer screening and management.Cancer 1995,76: 167–177.

    Article  PubMed  CAS  Google Scholar 

  13. Miller SM: Monitoring and blunting: Validation of a questionnaire to assess styles of information seeking under threat.Journal of Personality and Social Psychology. 1987,52: 345–353.

    Article  PubMed  CAS  Google Scholar 

  14. Rothman AJ, Salovey P, Antone C, Keough K, Martin CD: The influence of message framing on intentions to perform health behaviors.Journal of Experimental Social Psychology. 1993,29: 408–433.

    Article  Google Scholar 

  15. Wilson DK, Purdon SE, Wallston KA: Compliance to health recommendations: A theoretical overview of message framing.Health Education Research. 1988,3: 161–171.

    Article  Google Scholar 

  16. Leventhal H, Diefenbach MA, Leventhal E: Illness cognition: Using common sense to understand treatment adherence and affect cognition interaction.Cognitive Therapy and Research. 1992,16: 143–163.

    Article  Google Scholar 

  17. Miller SM: Monitoring and blunting of threatening information: Cognitive interference and facilitation in the coping process. In Sarason IG, Pierce GR (eds),Cognitive Interference: Theories, Methods, and Findings. Hillsdale, NJ: Erlbaum, 1996, 175–190.

    Google Scholar 

  18. Tversky A, Kahneman D: The framing of decisions and the psychology of choice.Science. 1981211: 453–458.

    Article  PubMed  CAS  Google Scholar 

  19. Kahneman D, Tversky A: Choices, values, and frames.American Psychologist. 1984,39: 341–350.

    Article  Google Scholar 

  20. Meyerowitz BE, Chaiken S: The effect of message framing on breast self-examination attitudes, intentions, and behavior.Journal of Personality and Social Psychology. 1987,52: 500–510.

    Article  PubMed  CAS  Google Scholar 

  21. Maheswaran D, Meyers-Levy: The influence of message framing and issue involvement.Journal of Marketing Research. 1990,27: 361–367.

    Article  Google Scholar 

  22. Block LG, Keller PA: When to accentuate the negative: The effects of perceived efficacy and message framing on intentions to perform a health-related behavior.Journal of Marketing Research. 1995,32: 192–203.

    Article  Google Scholar 

  23. Lauver D, Rubin M: Message framing, dispositional optimism, and follow-up for abnormal Papanicolaou tests.Research, in Nursing and Health. 1990,15: 199–207.

    Article  Google Scholar 

  24. Wegener DT, Petty RE, Klein DJ: Effect of mood on high elaboration change: The mediating role of likelihood judgments.European Journal of Social Psychology. 1994,24: 25–43.

    Article  Google Scholar 

  25. Chaiken S: Heuristic versus systematic information processing and the use of source versus message cues in persuasion.Journal of Personality and Social Psychology. 1980,39: 725–726.

    Article  Google Scholar 

  26. Petty RE, Cacioppo JT: Central and peripheral routes to persuasion: Application to advertising. In Percy L, Woodside A (eds).Advertising and Consumer Psychology. Lexington, MA: Lexington Books, 1983, 3–23.

    Google Scholar 

  27. Miller SM, Green V, Bales CB: What you don't know can hurt you: A cognitive-social framework, for understanding children's responses to stress. In Lewis M, Ramsay D (eds).Stress and Soothing. Hillsdale, NJ: Lawrence Erlbaum (in press, 1999).

    Google Scholar 

  28. Miller SM, Brody DS, Summerton J: Styles of coping with threat: Implications for health.Journal of Personality and Social Psychology. 1988,54: 142–148.

    Article  PubMed  CAS  Google Scholar 

  29. Miller SM, Leinbach A, Brody DS: Coping styles in hypertensive patients: Nature and consequences.Journal of Consulting and Clinical Psychology. 1989,57: 333–337.

    Article  PubMed  CAS  Google Scholar 

  30. Steptoe A, O'Sullivan J: Monitoring blunting coping styles in women prior to surgery.British Journal of Clinical Psychology. 1986,25: 143–144.

    PubMed  Google Scholar 

  31. Steptoe A, Sutcliffe I, Allen B, Coombes C: Satisfaction with communication, medical knowledge, and coping style in patients with metastatic cancer.Social Science and Medicine. 1991,32: 627–632.

    Article  PubMed  CAS  Google Scholar 

  32. Christensen AJ, Moran PJ, Lawton W, Stallman D, Voigts A: Monitoring attentional style and medical regimen adherence in hemodialysis patients.Health Psychology. 1997,16: 256–262.

    Article  PubMed  CAS  Google Scholar 

  33. Muris P, van Zuuren FJ, Kindt M: Monitoring coping style, fear of AIDS, and attitudes towards AIDS prevention.Social Behavior and Personality. 1994,22: 137–144.

    Article  Google Scholar 

  34. Miller SM, Roussi P, Altman D, Helm W, Steinberg A: Effect of coping style on psychological reactions of low-income, minority women to colposcopy.Journal of Reproductive Medicine. 1994,39: 711–718.

    PubMed  CAS  Google Scholar 

  35. Miller SM, Rodoletz M, Schroeder CM, Mangan CE, Sedlacek TV: Applications of the monitoring process model to coping with severe long-term medical threats.Health Psychology. 1996,15: 216–225.

    Article  PubMed  CAS  Google Scholar 

  36. Miller SM, Roussi P, Caputo GC, Kruus L: Patterns of children's coping with an aversive dental tratment.Health Psychology. 1995,14: 236–246.

    Article  PubMed  CAS  Google Scholar 

  37. Lerman C, Rimer B, Blumberg B: et al: Effects of coping style and relaxation on cancer chemotherapy side effects and emotional responses.Cancer Nursing. 1990,13: 308–315

    Article  PubMed  CAS  Google Scholar 

  38. Ludwick-Rosenthal R, Neufeld R: Preparation for undergoing an invasive medical procedure: Interacting effects of information and coping style.Journal of Consulting and Clinical Psychology. 1993,61: 156–164.

    Article  PubMed  CAS  Google Scholar 

  39. van Zuuren FJ: Coping under experimental threat: Observable and cognitive correlates of dispositional monitoring and blunting.European Journal of Personality. 1993,7: 245–253.

    Article  Google Scholar 

  40. Phipps S, Zinn A: Psychological response to amniocentesis: Effects of coping style.American Journal of Medical Genetics. 1986,25: 143–148.

    Article  PubMed  CAS  Google Scholar 

  41. Wardle F, Pernet A, Collins W, Bourne T: False-positive results in ovarian cancer screening: One-year follow-up of psychological status.Psychology and Health. 1994,10: 33–40.

    Article  Google Scholar 

  42. Weinstein ND: Testing four competing theories of health-protective behavior.Health Psychology. 1993,12: 324–333.

    Article  PubMed  CAS  Google Scholar 

  43. Horowitz MJ, Wilner N, Alvarez W: Impact of Events Scale: A measure of subjective stress.Psychosomatic medicine. 1979,41: 209–218.

    PubMed  CAS  Google Scholar 

  44. Wilson DK, Wallston KA, King JE: Effects of contract framing, motivation to quit, and self-efficacy on smoking reduction.Journal of Applied Social Psychology. 1990,20: 531–547.

    Article  Google Scholar 

  45. Miller SM: Monitoring and blunting in the face of threat: Implications for adaptation and health. In Montada L, Filipp S, Lerner M, (eds),Life Crises and Experiences of Loss in Adulthood. Hillsdale, NJ: Lawrence Erlbaum, 1992, 255–273.

    Google Scholar 

  46. Miller SM, Fang C, Diefenbach M, Bales C: Tailring psychosocial interventions to the individual's health information processing style. In Baum A, Anderson B (eds),Psychosocial Interventions and cancer. Washington, DC: APA (inpress, 1999).

    Google Scholar 

  47. King ES, Rimer BK, Trock B, Balshem A, Engstrom P: How valid are mammography self-reports?American Journal of Public Health. 1990,80: 1386–1388.

    Article  PubMed  CAS  Google Scholar 

  48. Aiken LS, West SG:Multiple Regression: Testing and Interpreting Interactions. Newbury Park, CA: Sage, 1991.

    Google Scholar 

  49. Schwartz MD, Lerman C, Miller SM, Daly M, Masny A: Coping disposition, perceived risk, and psychological distress among women at increased risk for ovarian cancer.Health Psychology. 1995,14: 232–235.

    Article  PubMed  CAS  Google Scholar 

  50. Miller SM, Mischel W, Schroeder CM, et al: Intrusive and avoidant ideation among females pursuing infertility treatment.Psychology and Health. 1999,13: 847–858.

    Google Scholar 

  51. Weinstein ND: Effects of personal experience on self-protective behavior.Psychological Bulletin. 1989,105: 31–50.

    Article  PubMed  CAS  Google Scholar 

  52. Wilson DK, Chaiken S, Axsom D: The cognitive mediation of message framing in persuasion. Annual Midwestem Psychological Association Convention. Chicago, IL: 1986.

  53. Purdon SE, Wilson DK, Endom PL: The cognitive mediation of persuasive messages in health psychology. Annual Convention of the American Psychological Association. New York: 1987.

  54. Croyle RT, Lerman C: Interest in genetic testing for colon cancer susceptibility: Cognitive and emotional correlates.Preventive Medicine. 1993,22: 284–292.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Preparation of this manuscript was supported in part by NIH grants CA58999, CA61280, CA06927, HG0166, ACS grant PBP-89318, DOD grants BC971638 and OC970004, and appropriations from the Commonwealth of Pennsylvania.

The authors wish to acknowledge the assistance of Rob Sipps, Leeann Speechley, and Lloyd Ohls.

About this article

Cite this article

Miller, S.M., Buzaglo, J.S., Simms, S.L. et al. Monitoring styles in women at risk for cervical cancer: Implications for the framing of health-relevant messages. ann. behav. med. 21, 27–34 (1999). https://doi.org/10.1007/BF02895030

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02895030

Keywords

Navigation