Impact of Mortality Concerns on Cancer Risk Behavior

描述（由申请人提供）：尽管在识别不同类型癌症的行为健康风险因素方面取得了重要进展，但在理解是什么导致某些人从事健康促进行为，以及为什么有些人总是继续将自己的健康置于危险之中，仍然存在相当大的差距。当人们有意识或无意识地面对癌症和最终死亡的想法时，可能会产生更深层次的动机和心理过程，通过考虑这些过程，可以获得重要的见解。事实上，越来越多的社会心理学研究表明，各种各样的自我调节过程（包括认知和行为）起着保护个人免受与死亡有关的担忧的作用。然而，这些想法或研究在行为健康方面的应用很少。目前的应用程序通过将死亡恐惧的心理后果与癌症的行为风险因素相结合来解决这一差距。指导这项研究的假设是，对死亡和癌症的担忧会产生两种类型的心理防御，每一种都可能对健康产生适应性或非适应性影响。为了应对对癌症和死亡的有意识恐惧，“直接”心理防御旨在减少感知到的脆弱性。为了应对无意识的与死亡有关的恐惧，“象征性”的心理防御是为了维持一种意义感和自尊：这种努力可能发生在与健康有关的方面（例如，晒黑以改善一个人的外表）。提出了15项实验研究，以解释与每种防御类型相关的条件，以及三种防御策略何时、如何、为什么以及对谁具有适应性（例如，进行自我乳房检查的意图）或不适应（例如，避免健康信息）对风险（例如，吸烟）和预防（例如，使用防晒霜）行为的影响。因此，这项研究项目有可能阐明以前未被认识到的癌症风险预防因素。通过强调人们从意识中消除死亡思想和防范无意识死亡关切的动机的重要性，可以显著改善促进癌症预防的教育和干预措施。

DESCRIPTION (provided by applicant): Despite important progress toward identifying behavioral health risk factors for different forms of cancer there are still considerable gaps in understanding what leads certain individuals to engage in health promotion behavior, and why some individuals all-too-often continue to put their health at risk. Significance insight may be gained by considering the deeper motivational and psychological processes that are elicited when people are confronted with, both consciously and unconsciously, thoughts of cancer and, ultimately, their death. Indeed, an increasing amount of social psychological research indicates a diverse array of self-regulatory processes (both cognitive and behavioral) function to protect individuals from concerns associated with mortality. Yet there have been few applications of these ideas or research to behavioral health. The present application addresses this gap by integrating ideas about psychological consequences of fears of death with behavioral risk factors for cancer. The hypotheses guiding this research are that concerns about death and cancer can engender two types of psychological defense, each of which may have adaptive or maladaptive health implications. In response to conscious fears about cancer and death, "direct" psychological defenses aim to reduce perceived vulnerability. In response to unconscious death-related fears, "symbolic" psychological defenses are directed toward maintaining a sense of meaning and self-esteem: such efforts may occur along health-relevant dimensions (e.g., tanning to improve one's appearance). Fifteen experimental studies are proposed to explicate the conditions associated with each type of defense, and when, how, why, and for whom thee defensive strategies have adaptive (e.g., intentions to conduct self-breast exams) or maladaptive (e.g., avoidance of health information) implications for risky (e.g., smoking) and preventative (e.g., using sun screen) behaviors. This research program thus has the potential to illuminate previously unrecognized factors in cancer risk prevention. By highlighting the importance of peoples' motivation to remove thoughts of death from consciousness and to defend against unconscious mortality concerns, education and interventions fostering cancer prevention can be markedly improved.