The Appeal of Fear Appeals

People scare other people in order to get them to behave accordingly.  Most parents do it: “If you don’t study and get yourself a good education you’ll end up being miserable in life.”  The doctor is even more threatening: “If you don’t quit drinking you’ll have a greater chance of developing liver cancer” (which is scientifically proven, by the way).  The police are also good at it: “Put down the gun or else I’ll shoot you!”  Even our revered teachers: “I am going to report to your parents that you did not take the test!”

Pretty threatening, aren’t they?  They are what we call fear appeals, messages that contain amounts of threat intended to motivate and/or induce people to action.  Fear appeals are everywhere—in the media as well as everyday situations.  For example, TV and radio spots are telling us to “Drive safely: the life you save could be your own.”  Under normal circumstances we may scare our toddlers not to go to the basement because there is “a monster or ghost in there.”  Truth is, parents only wanted their kids to stay away from the basement where all the harmful chemicals like insecticides are stored.

Fear appeals could also take many forms: textual, visual, aural or these three combined.  A good example of a fear appeal laden message in visual form is the anti-smoking poster produced by the National Health Society (NHS) in the United States.  The image of a human hand gripping a human heart (complete with blood and visible veins) is an example of an explicit intent to scare people away from cigarettes.  There is a fear appeal-laden anti-drug message that went on air in US television in the late 1980’s which, at present is the most-cited example of fear appeal in communication classes in American universities.

The TV ad goes:

This is your brain.
This is drugs.
This is your brain on drugs.
Any questions?

But in the US where fear appeals are employed to promote a multitude of social concerns–health, education, social justice, peace, food security, even insurance investments, the effectiveness of fear appeals is widely studied.  The literature is replete of varied arguments on the question “Does fear appeal work or not?”

A great number of researches found that fear does not work, and if they do, the effect is not lasting enough to guarantee long-term behavioral change in target individuals.   The thing with scary images and words is that they turn people away. I have a very simple illustration for this.  When I was eight years old, my whole family went to the movie house to watch a rerun of The Exorcist.  All throughout the movie the sound of creaking floors and doors, of ugly screams by whoever it was that possessed Megan (Linda Blair), her contorted expressions and hideous face scared the hell out of me that I kept screaming and simply hid behind my mother’s sleeves halfway in the movie until the show was over.  My mother was egging me to look or I would miss the story.  But I was confident then that I simply can’t.

Going back to behavior change communication, when what we see and hear scare us, we turn ourselves off instinctively and look away.  This act of turning our attention off the, say, health message and looking away triggers a chain of destructive reactions.  As soon as we look away, we miss the message underpinning that which is frightening or repelling and the purpose of putting the message out there (not to mention the production cost) is lost.  Also, when we deliberately ignore the message, chances are we will continue performing previously risky behaviors.  In a number of cases, when these risky behaviors are associated to addiction and/or compulsion, repetitive performance may make it harder for us to get off the hook.

Drs. Suzanne M. Miller and Michael A. Diefenbach did quite a good job in providing us a picture of the interaction between fear appeal and human behavior through the Cognitive-Social Health Information-Processing (C-SHIP) model, a meta-model based on previous theories/models of human behavior.  My first full-blown paper as a communication student in Michigan State examined the constructs of the model.  In C-SHIP, two types of health information processor/receiver are identified: the high monitors and the low monitors.  The high monitors are the people who are highly given to arousal, they acutely pay attention to messages, to every stimulus in their environment, to every phenomenon around them, sensitive even to every aspect of their biological states.  These people are more likely to do a mental rehearsal of any perceived uncertainty or risk over and over again to the extent that they suffer high levels of anxiety. They are the worriers, as we know them in everyday parlance.  Even before a disease could actually strike them, they already suffer from it.  The low monitors are different.  They simply do not pay attention to anything.  Period.  They are called the blunters because they distract themselves from medical risks, for example, and are less likely to retain important health information.

The high and low monitors are the reasons why you can’t scare people into action.  Because once the highly anxious monitor is exposed to a threatening message the natural response would be to deny the message and ignore any personal condition that needs immediate attention and/or behavioral modification.  What could be a more likely response to scary and intrusive images than avoidance?  When a person actively avoids important information and denies highly risky behavior, any preventive or curative measures are bound to fail.  In a study on a certain group of women in the US, high anxiety levels and high perceptions of vulnerability predicted low adherence to breast cancer screening.  In contrast, breast cancer screening was significantly higher among women with moderate levels of anxiety and perceived susceptibility, ceteris paribus.

Thus, instead of banking on fear appeals, Miller and colleagues recommended “cooling off” what it is that makes a certain issue hot for the high monitors so that they would pay attention to the message at a deeper level.  As for the low monitors, a brief and straightforward information about the issue is recommended.  No scary images or it will only encourage more blunting.  No embellishments of facts or it will also make the low blunter more incredulous or suspicious of the message.

The literature tells us that fear appeal has detrimental effects.  That it is easier to scare people but it is thrice difficult to unscare them.  In fact, a study conducted by Michigan State researchers in an African country flooded with HIV/AIDS fear appeal messages found that at a certain threshold when people are already afraid, fear appeals can do nothing more.  More aptly, their research was titled “Scaring the Already Scared.”  You can’t scare people who are already scared in the first place.  The only aspect of the communication literature that seemed to push for the use of fear appeals is the one which focused on high sensation-seekers.

People who are high-sensation seekers are those who tipped high in the sensation-seeking scale (SSS).  They are the daredevils, the sky jumpers.  They let their motorbikes fly from one mountain peak to another.  They scale rocky mountains while putting their lives under the strength of nylon ropes.  They scuba dive with sharks.  A few of them watch blood with fascination as they spurt from a skin puncture.  You cannot convince them with subtle messages that fall under their sensation threshold.  For their case, fear appeals might work.

End of story, right?

Not quite. In the crowd of people who investigate what fear appeal can do or can’t do in terms of behavior modification, there are scholars who believe that fear appeals work. One of them is a communication scholar who taught in my University at one time and is now working in HIV/AIDS projects in African countries like Kenya and Zambia. She came to my class last semester and talked in detail how fear appeal works in behavioral modification projects. Her name is Dr. Kim Witte (shown in the picture) and she authored the theory which is known in communication and widely examined in health communication today, the Extended Parallel Process Model (EPPM).

Here is the main premise of the EPPM.  When confronted with anxiety-inducing situation, risky images and messages, individuals may react in two possible ways: the danger control process and the fear control process.  An individual’s appraisal of a risk is dependent upon his/her perceived efficacy (beliefs that the recommended action is effective and that you yourself is capable of executing the recommended action), and perceived threat (belief in the severity of the risk and that you are susceptible to it).  When a person’s perceived threat is higher compared to his/her perceived efficacy, the person becomes scared, and thus, lacking the repertoire of responses needed to avert fear, s/he will resort to defensive motivation which eventually leads to message rejection (fear control process).  On the other hand, when an individual’s perceived efficacy exceeds that of his/her perceived threat, the person will resort to protection motivation responses and accepts the message (danger control process).   So, the condition is pretty neat:  fear works but only when you arm individuals with high perceived efficacy.  Perceived threat should be strong enough to convince people of the importance of taking preventive/control measures.  Yet, it shall be emphasized that people must also believe that they are capable of averting the risk and that the recommended steps to control or reduce risk is equally effective.  Otherwise, we will go back to the concept of avoidance that is mentioned above.

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Dr. Kim Witte’s Photo from: https://www.msu.edu/~wittek/eppm.htm