Psychological impact of predicting individuals' risks of illness: a systematic review
Article Abstract:
Author's Abstract, COPYRIGHT 1999, Elsevier Science Ltd. The aim of this review is to determine the frequency and circumstances under which predicting individuals' risk of illness has adverse psychological effects. Using systematic review methodology, the literature was searched for studies that had assessed the adverse psychological outcomes of risk assessment programmes. The outcomes investigated are emotional (anxiety, depression, distress) cognitive (intrusive thoughts, perceptions of health) and behaviour (work absenteeism). The impact of both positive and negative test results are summarised in terms of the number of studies showing significant effects between and within groups in the short (one month or less) and longer term (more than one month). Where sufficient data were available, a meta-analysis was conducted to assess effect size. Fifty-four studies met the criteria for inclusion. The studies assessed the impact of informing individuals about cardiovascular risk (21), risk of AIDS (eight), risk of cancer (10), risk of Huntington's disease (10), risk of diabetes (two), risk of spinocerebellar ataxia (one) and risk of asteoporosis (two). Overall, the quality of studies assessed was limited, with only two using a randomised design to determine the psychological impact of risk assessment. Receiving a positive test result was associated in the short term in the great majority of studies with depression, anxiety, poorer perceptions of health and psychological distress. Data were available for a quantitative synthesis of results on three outcomes, anxiety, depression and distress. Anxiety and depression were significantly higher in those tested positive compared with those tested negative in the short term but not the longer term. Distress could only be assessed in the longer term: there was no evidence of an increase for those receiving positive test results. The five experimental studies that reported interventions aimed at preventing some of these adverse effects all reported favourable results. There was little evidence of any adverse psychological effects of receiving an unfavourable test result. Adverse psychological effects are a common immediate consequence of positive test results following risk assessment. Results from the few experimental studies reviewed suggest that these adverse outcomes should not be seen as inevitable. Keywords: Risk assessment; Screening; Psychological impact
Publication Name: Social Science & Medicine
Subject: Social sciences
ISSN: 0277-9536
Year: 1999
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Effects of gain and loss decision frames on risky purchase negotiations
Article Abstract:
Tversky and Kahneman (1981) and others have proposed that preference for risky alternatives is influenced by positive and negative decision frames. However, such effects have yet to be examined wherein groups negotiate agreements from a continuum of risky alternatives. A total of 26 teams of Master of Business Administration (MBA) students in Experiment 1, and 12 teams of professional buyers in Experiment 2, were assigned to one of two conditions in a bargaining task. Condition 1 teams, presented with payoff tables showing chances of obtaining net profits, were induced to think of potential gains (a positive frame). Condition 2 teams, presented with chances of incurring expenses, were induced to think of potential reduced losses (a negative frame). The potential profit in both conditions was held constant. Bargaining teams thinking "a gain is at stake" were hypothesized to make less risky bargaining agreements than opposing teams thinking "a loss-reduction is at stake." This hypothesis was supported. Results further support and extend findings on the causal relation between positive and negative decision frames and judgement. (Reprinted by permission of the publisher.)
Publication Name: Journal of Applied Psychology
Subject: Social sciences
ISSN: 0021-9010
Year: 1987
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Job seeking, reemployment, and mental health: a randomized field experiment in coping with job loss
Article Abstract:
Cognitive theories of adherence to difficult courses of action and findings from previous survey research on coping with a major life event - job loss - were used to generate a preventive intervention, tested by a randomized field experiment. The aim was to prevent poor mental health and loss of motivation to seek reemployment among those who continued to be unemployed and to promote high-quality reemployment. Ss were 928 recently unemployed adults from southeastern Michigan, representing a broad range of demographic characteristics; they were randomly assigned to either the experimental or control condition. The experimental intervention included training in job seeking with a problem-solving process emphasizing inoculation against setbacks and positive social reinforcement. A pretest was administered, followed by posttests 1 and 4 months after the experiment. The experimental condition yielded higher quality reemployment in terms of earnings and job satisfaction, and higher motivation among those who continued to be unemployed. (Reprinted by permission of the publisher.)
Publication Name: Journal of Applied Psychology
Subject: Social sciences
ISSN: 0021-9010
Year: 1989
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