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PubMed2002

Selective exposure and dissonance after decisions.

Well-known literature reviews from the 1960s question whether cognitive dissonance underlies experimental participants' selective exposure of themselves to consonant messages and avoidance of dissonant ones. A meta-analytic review of 16 studies published from 1956 to 1996 and involving 1,922 total participants shows that experimental tests consistently support the supposition that dissonance is associated with selective exposure (r = .22, p < .001). Statistical power exceeded .99. Advances in statistical methodology and increased attention to selecting appropriate tests of dissonance theory were essential to finally resolving this question.

Cognition↗
PubMed2004

Is there any "free" choice? Self and dissonance in two cultures.

Four experiments provided support for the hypothesis that upon making a choice, individuals justify their choice in order to eliminate doubts about culturally sanctioned aspects of the self, namely, competence and efficacy in North America and positive appraisal by other people in Japan. Japanese participants justified their choice (by increasing liking for chosen items and decreasing liking for rejected items) in the standard free-choice dissonance paradigm only when self-relevant others were primed, either by questionnaires (Studies 1-3) or by incidental exposure to schematic faces (Study 4). In the absence of these social cues, Japanese participants showed no dissonance effect. In contrast, European Americans justified their choices regardless of the social-cue manipulations. Implications for cognitive dissonance theory are discussed.

Choice Behavior↗
PubMed2002

Thinking and caring about cognitive inconsistency: when and for whom does attitudinal ambivalence feel uncomfortable?

The relation between conflicting evaluations of attitude objects (potential ambivalence) and associated unpleasant feelings (felt ambivalence) was investigated. Participants indicated their potential and felt ambivalence about capital punishment (Studies 1 and 2) and abortion (Studies 1-3). The simultaneous accessibility (J. N. Bassili, 1996) of participants' potential ambivalence (i.e., how quickly and equally quickly conflicting evaluations came to mind) was measured using response latency (Studies 1-3) and manipulated by repeated expression (Study 3). The relation between potential ambivalence and felt ambivalence was strongest when potential ambivalence was high in simultaneous accessibility (Studies 1-3). This pattern was most pronounced for participants who were high in preference for consistency (Study 3; R. B. Cialdini, M. R. Trost, & T. J. Newsom, 1995). Similarities of ambivalence and cognitive dissonance constructs are discussed.

Adult↗
PubMed2001

Dissonant imperatives in nursing: a conceptualization of stress in intensive care in Sweden.

The aim of this study was to explore nurses' experiences of stress within the context of intensive care. The theoretical perspective for the study builds on a cognitive-phenomenological-transactional theory of stress and coping and the theory of cognitive dissonance. Respondents were 36 registered nurses recruited from 10 intensive care units (general, neonatal and thoracic units). Their experience as nurses ranged from one to 32 years. These intensive care units had similar structural characteristics, namely a high working pace, advanced technology, constrained finances, frequent reorganizations, a shortage of registered nurses and all were filled to overcapacity. Data were collected in open-ended interviews that were audio-taped and transcribed. A content analysis identified four contradictory themes: (1) controlled by the work situation--needing to be in control; (2) constrained by prioritization--wanting to do more; (3) lacking the authority to act--knowing that something should be done; and (4) professional distance--interpersonal involvement. These four themes were synthesized at a higher level of abstraction into a main theme: stress induced by dissonant imperatives, which conceptualizes nursing stress in the intensive care unit. In conclusion, dissonant imperatives might lead to stress in intensive care nursing.

Humans↗
PubMed2001

Adoption in the age of reproductive technology.

The choice of adoption over genetic parenthood was investigated in 105 women retrospectively by questionnaire. Participants were divided into four groups: female/male subfertility; female subfertility; male subfertility; and female/male fertility. Half the sample (59/105) answered the question about the importance of a genetic link. Women who failed to adopt thought a genetic link was important, as did those who were less likely to disclose alternative reproductive conceptions to their child. First thoughts following diagnosis were more focused and actions more centered on adoption in the female/male subfertile group compared to the other groups. Communication of the child's origins was least prevalent in the female/male subfertile group, followed by the male subfertile group, although all groups would disclose adoption. The choice of adoption was determined by a number of factors, not all associated with infertility resolution. Although it is unlikely that resolution to infertility can be achieved in any population attempting to overcome infertility, the cognitive dissonance identified in this population is likely to be generalizable to those choosing other options to overcome infertility. Cultural and counselling acknowledgement of postmodern family theory principles is likely to ease cognitive consistency regarding the status of adoptive familyhood, and dispel the importance of reproductive options emphasizing a genetic link.

Adoption↗
PubMed2005

Profiles in patient safety: confirmation bias in emergency medicine.

Confirmation bias is a pitfall in emergency care and may lead to inaccurate diagnoses and inappropriate treatments and care plans. Because of the increasing severity and volume of emergency care, emergency physicians often must rely on heuristics, such as rule-out protocols, as a guide to diagnosing and treating patients. The use of heuristics or protocols can be potentially misleading if the initial diagnostic impression is incorrect. To minimize cognitive dissonance, clinicians may accentuate confirmatory data and ignore nonconfirmatory data. Clinicians should recognize confirmation bias as a potential pitfall in medical decision making in the emergency department. Reliance on the scientific method, Bayesian reasoning, metacognition, and cognitive forcing strategies may serve to improve diagnostic accuracy and improve patient care.

Attitude of Health Personnel↗
PubMed2003

The St-Louis du Parc Heart Health Project: a critical analysis of the reverse effects on smoking.

OBJECTIVES: Although some school based smoking prevention programmes have shown positive impacts, others have had only short term effects, no effects, and in some cases reverse effects. The St-Louis du Parc Heart Health Project was a five year heart health promotion programme targeting children in eight elementary schools aged 9-12 years in disadvantaged multiethnic neighbourhoods in Montreal. In a controlled, longitudinal evaluation, the programme produced reverse effects on smoking--children exposed to the programme were more likely to initiate and to continue smoking than control children. This article explores hypotheses to explain the reverse effects. DESIGN: Following work by an in-house committee, a consensus workshop with international experts was conducted to develop hypotheses to explain the reverse effects. This was complemented by an analysis of the programme's concordance with the standard guidelines on the school based prevention of tobacco use, and discussions with experts at the Centers for Disease Control and Prevention. RESULTS: The programme respected most standard guidelines for smoking prevention programmes with respect to content and mode of delivery. Hypotheses to explain the reverse effects include: an unfavourable environment characterised by strong pro-smoking models and resistance to environmental interventions; heightened sensitivity to smoking among children most exposed to the programme; defence mechanisms among children stimulated by cognitive dissonance or anxiety; unanticipated effects associated with the health educator who delivered the programme; inadequate attention in programme development to the diverse cultural origins of the population targeted; and intervention content inappropriately targeted to children's stages of cognitive development. CONCLUSION: Elementary school based interventions should aim to develop a clear and coherent social norm about the non-use of tobacco, as a precursor to or in close conjunction with having children as their primary target. Programme design should take key student characteristics into consideration and ensure that the modes of communication are adapted to the targeted group's characteristics. Neighbourhood level interventions should be orchestrated to complement regional, provincial, and national programmes.

Child↗
PubMed2004

Cognitive moderators of the longitudinal association between peer rejection and adolescent depressive symptoms.

This longitudinal study examined peer rejection as a predictor of adolescent depressive symptoms during the critical developmental period associated with substantial increases in the prevalence of girls' depression. In a sample of 158 adolescents aged 15-17 years, a peer nomination, sociometric assessment was conducted to examine adolescents' peer status at an initial time point, along with self-report measures of depressive symptoms, depressogenic attributions, and peer importance. Adolescents completed a second measure of depressive symptoms 17 months later. Results were consistent with integrated cognitive vulnerability-stress and cognitive dissonance models, particularly for girls. Specifically, peer rejection was a significant prospective predictor of depressive symptoms when combined with high levels of importance ascribed to peer status and high levels of adolescents' depressogenic attributional styles.

Adolescent↗
PubMed1997

Attitudes and attitude change.

We review empirical and conceptual developments over the past four years (1992-1995) on attitudes and persuasion. A voluminous amount of material was produced concerning attitude structure, attitude change, and the consequences of holding attitudes. In the structure area, particular attention is paid to work on attitude accessibility, ambivalence, and the affective versus cognitive bases of attitudes. In persuasion, our review examines research that has focused on high effort cognitive processes (central route), low effort processes (peripheral route), and the multiple roles by which variables can have an impact on attitudes. Special emphasis is given to work on cognitive dissonance and other biases in message processing, and on the multiple processes by which mood influences evaluations. Work on the consequences of attitudes focuses on the impact of attitudes on behavior and social judgments.

Affect↗
PubMed2002

Motivational versus social cognitive interventions for promoting fruit and vegetable intake and physical activity in African American adolescents.

Strategic self-presentation (motivational intervention [MI]) is a theoretical approach that is distinct from social cognitive theory (SCT). Specifically, strategic self-presentation involves increasing motivation by creating cognitive dissonance and inducing shifts in self-concept by generating positive coping strategies during a videotaped session. Fifty-three healthy African American adolescents were randomized to a SCT+MI, SCT-only, or an education-only group for increasing fruit and vegetable (F&V) intake and physical activity. The SCT+MI and SCT-only groups received a 12-week SCT program. Students in the SCT+MI group also participated in a strategic self-presentation videotape session. Participants completed 3-day food records, completed measures of self-concept and self-efficacy, and wore an activity monitor for 4 days at pre- and posttreatment. Both the SCT+MI (2.6 +/- 1.4 vs. 5.7 +/- 2.2, p < .05) and the SCT-only (2.5 +/- 1.2 vs. 4.8 +/- 2.4, p < .05) groups showed greater increases in F&V intake from pre- to posttreatment as compared with the education-only group (2.3 +/- 1.0, vs. 3.3 +/- 2.1, p > .05). There were no significant time or group effects for any of the physical activity measures. Correlation analyses revealed that only the SCT+MI group showed that dietary self-concept (r = .58, r = .67, p < .05) and dietary self-efficacy (r = .65, r = .85, p < .05) were significantly correlated with posttreatment F&V intake and change in F&V intake, respectively. These findings suggest that the change in F&V intake in the SCT+MI group resulted from strategic self-presentation, which induced positive shifts in self-concept and self-efficacy.

Adolescent↗
PubMed2004

Informed consent and decision making by cataract patients.

OBJECTIVES: To investigate decision making by patients on the day before cataract surgery and to evaluate to what extent the informed consent process influences the patients' decision regarding consent. METHODS: On the day before surgery, 70 patients (mean +/- SD age, 70.3 +/- 10.3 years) underwent a standardized informed consent procedure. They were also invited to answer 15 questions established in interdisciplinary cooperation among clinical psychologists, lawyers, and ophthalmologists. MAIN OUTCOME MEASURES: We assessed presurgical information and personal estimation of risks in cataract surgery; the patient-physician relationship regarding surgery-related decisions; and evaluations of the informed consent procedure and the patients' decision. RESULTS: Questionnaire answers indicated that 28 (40%) of the 70 participating patients arrived for surgery without any information; 16 (23%) believed that there were surgical procedures without risks; and 53 (76%) estimated that there were no risks for their cataract surgery. A physician-dominated decision for surgery was preferred by 31 patients (44%); 16 (26%) wanted to decide together with their ophthalmologist. Possible risks of a sight-threatening complication did not influence 54 patients' (77%) decisions, and 55 patients (78%) said the informed consent process did not influence their decision. The remaining 15 (22%) stated that the informed consent process positively confirmed their decision. CONCLUSIONS: Informed consent 1 day preoperatively does not seem to influence the decision for cataract surgery. Cognitive dissonance as part of a decision-making process makes changes in an already chosen option unlikely. The resulting limited decisive potential is very important for credibility in a trial and has to be considered in ophthalmologic surgery.

Aged↗
PubMed2001

Exhibits facilitate histology laboratory instruction: student evaluation of learning resources.

Some professional schools have replaced microscopes for histology laboratory instruction with printed and electronic media. It is recognized that these media cannot replace experience with the microscope and that there is a cognitive dissonance of completely replacing microscope study. In addition, students believe that their time is not optimally used in the traditional histology laboratory. Therefore, at Loma Linda University, nine weekly microscope exhibits consisting of 10-15 slides each were prepared. For each exhibited slide, a one page "atlas" is provided, consisting of labeled low- and high-power color micrographs taken from that slide and an informative legend. By referring to the atlas, the student can easily identify the exact field and the labeled features with little help from an instructor. A live or taped video demonstration of the microscope exhibit is available on the first day of the exhibit. During the eighth week of the quarter, students were asked to evaluate the various learning resources available to them. No resource was valued significantly more than the microscope exhibits, but the video demonstrations were valued significantly more than the printed black and white atlas or the color atlas on CD. These exhibits have been used for 2 years to instruct a class of 90 dental students. Advantages are (1) students' time is used efficiently, (2) only one slide set and a fourth as many microscopes need be maintained compared with a traditional laboratory, and (3) one-of-a-kind slides derived from research activities provide for high impact learning.

Computer-Assisted Instruction↗
PubMed1984

After aesthetic rhinoplasty: new looks and psychological outlooks on post-surgical satisfaction.

Thirty-four female patients who underwent rhinoplasty were followed through assessment of post-surgical satisfaction (pss), perception of subjective improvement, objective improvement (surgeon's ratings), and objective post-surgical nasal deformity. Assessments of pss and subjective improvement were obtained on 3 occasions: T1, 1 week after surgery, on cast removal; T2, 1 month after cast removal; and T3, 3 months after cast removal. The investigation was aimed at examination of the relationship of patients' subjective post-surgical appraisals of the operation with objective indices of outcome of rhinoplasty. Results indicated that at T1, pss is totally dissociated from objective outcome or its appraisal by the patient. At T2 an association between objective outcome and pss and subjective appraisal of outcome is evident, but seems to reflect the total reliance of the patients' judgment on surgeons' appraisals. At T3 a paradoxical trend is indicated: slim objective favorable outcomes correlate with high pss, while a considerable share of patients with whom a highly favorable outcome has been attained express relatively low pss. This paradoxical trend may be well understood when applying Cognitive Dissonance Theory. The whole pattern of results point again at highly complex and powerful psychological processes, some of them seemingly irrational, operating within patients when relating to rhinoplasty, a simple superficial surgical procedure.

Adult↗
PubMed2005

Perspectives on quality of life of people with intellectual disabilities: the interpretation of discrepancies between clients and caregivers.

Large discrepancies have sometimes been found between the quality of life (QOL) experienced by clients with intellectual disabilities and their QOL as described by their caregivers. Olsen and Schober (Soc Indi Res 1993; 28: 173-193) may have provided a framework useful to conceptualize such discrepancies. They suggested that lack of concordance between objective circumstances (i.e. poverty) and perceived QOL must not be treated as measurement noise, but as a source of information. They speculated on the psychological processes that underly and explain this lack of concordance; particularly processes that try to deal with the stress induced by cognitive dissonance and learned helplessness. In this study low to moderate agreement was found between caregivers judgement of QOL of individual clients and clients' own perception of QOL. In some areas and for some clients the discrepancies indicated dissonance (caregivers are satisfied, clients are not) and in other areas and for other clients adaptation (clients are satisfied, caregivers are not). There were systematic differences between clients falling in these groups with respect to their personal characteristics and with respect to factual conditions of care. These outcomes are interpreted with respect to Olson and Schober's contentions regarding the psychological processes that underly a person's experience of QOL. The Olson and Schober framework appears to be a fruitful way to combine different sources of information regarding QOL.

Caregivers↗
PubMed1986

Expectations and satisfaction of denture patients in a university clinic.

These results indicate that patients' expectations of dentures before treatment were unrealistically high and that informational videotapes did not significantly affect these expectations. Satisfaction with current dentures was surprisingly high before treatment and increased significantly from pretreatment to postreatment for both groups in the study. While it is likely that this increase in satisfaction reflects a change from poor to excellent denture status, this finding may also be attributed to cognitive dissonance theory; that is, high satisfaction may represent the means by which patients justify the expenses of their denture treatment. Although the videotape presentations did not alter the expectations of patients and their satisfaction with dentures, the tapes represent a potential source of accurate, standardized information for both patient and student dentist.

Adult↗
PubMed1994

Attorney attitudes regarding behaviors associated with child sexual abuse.

There appears to be a good deal of disagreement between professionals as to what constitutes child abuse. Attorneys as a group have been found to judge behaviors associated with child abuse more leniently than other abuse professionals. However, no one has discriminated between defense and prosecuting attorneys in these areas. It was hypothesized that because of divergent roles in child sexual abuse cases attitudes toward adult-child behaviors associated with sexual abuse would differ among attorney groups. Two prosecuting and two defense attorneys from every county in the state of Indiana were sent questionnaires. Participants were asked to indicate if a behavior was acceptable, inappropriate, or sexual abuse if it occurred on one or on multiple occasions. Prosecutors had more severe judgements than the defense attorneys on 32 of the 42 behaviors. They were more likely to indicate that a behavior was inappropriate or abuse. Cognitive dissonance theory is proposed as a possible explanation for these findings.

Adolescent↗
PubMed1983

The impact of mass communication campaigns in the health field.

This article analyzes a series of health education projects that used the mass media to change behavior. First, the article describes how persuasion theories are used to maximize impact in mass communication campaigns. Second, this paper discusses theories of social psychology used in such campaigns. One such theory, cognitive dissonance, explains changes at the level of attitudes, beliefs and opinion. Another theory, social learning, defines strategies of behavior changes. A third theory, concerning diffusion of innovations, helps understand the network of interpersonal relationships essential for the adoption of any innovation. McGuire's inoculation theory suggests strategies to aid resistance to harmful environmental influences (e.g. smoking, excessive drinking, etc.). Third, this work reviews public health campaigns that have used one or more of these theories of social psychology. The first project, dealing with smoking behavior cessation and prevention, mainly used strategies of interpersonal communication for inoculating and modeling useful behavior in order to resist social pressures favorable to smoking. The second project, designed to prevent alcoholism, used the mass media primarily. The objective of this campaign was to obtain changes in knowledge, attitude and behavior in the public through modeling desirable behaviors over public service announcements. The third campaign, a heart disease prevention program, used a combination of mass media and interpersonal communication to achieve changes in lifestyle of the population. Finally, this article describes limitations in using mass media in behavior change health programs.

Attitude↗
PubMed1988

Psychological defence, phase of dependence and further prerequisites for the intention of alcoholics to abstain.

One hundred and four alcoholics who had undergone detoxification in two psychiatric hospitals in West Germany were examined regarding psychological defence, attitudes and norms towards abstinence. Results show that along with loss of well-being and the increasing perception of the negative consequences of alcohol abuse, there is a lessening of defence, an advanced stage of dependence and pronounced abstinence intention. One conclusion is that psychological defence mechanisms of alcohol dependent persons can be explained on the basis of threat to the sense of self worth or cognitive dissonance.

Adult↗