Martin A. Safer

The Impact of Communications on the Self-Regulation of Health Beliefs, Decisions, and Behavior

The models used in the study of communication and health behavior have changed from those describing how to impose health actions on relatively passive respondents to models describing how respondents regulate their own health practices. We have traced the change from the fear-drive model, which described how fear induced change, to the parallel response model, which described how subjects processed information and generated coping responses to solve the problem posed by both the objective health threat and by their subjective fear. The data supporting this change showed that increasing fear led to more favorable attitudes but that fear alone was insufficient to create action: Specific action instructions had to be added to both high and low fear and both combinations produced the same level of health action. Neither the data nor the parallel model specified what subjects learned about the threat that made exposure to a high or low fear message necessary for behavior change. The parallel response model has been elaborated into a more complete systems model and new studies show how health threats are represented. They have found attributes such as IDENTITY (label and symptoms), CAUSES, TIME LINES or duration, and CONSEQUENCES, that set goals and criteria to generate and evaluate problem solving (coping) behavior. Suggestions are made for applying this more complete model to public health practice.

Sources of Bias in Memory for Emotions

How accurately can people remember how they felt in the past? Although some investigators hold that emotional memories are resistant to change, we review evidence that current emotions, appraisals, and coping efforts, as well as personality traits, are all associated with bias in recalling past emotions. Bias occurs as memories of emotional states are updated in light of subsequent experience and goals. Biased memories in turn influence future plans and emotions, and may contribute to the formation of enduring personality traits. Peoples memories for emotions provide highly condensed and accessible summaries of the relevance of past experiences to current goals.

Remembering our past: Emotional events and emotions in autobiographical memories

“And the question which I have for you (Professor Anita Hill) is how reliable is your testimony in October of 1991 on events that occurred 8, 10 years ago, when you are adding new factors, explaining them by saying you have repressed a lot?,” asked Senator Specter. (Republicans and Democrats alternate in questioning, 1991). It is October 11, 1991, and the U.S. Senate Judiciary Committee is considering the controversial nomination to the Supreme Court of Judge Clarence Thomas. Toward the end of the nomination process, there is a surprise witness. An attorney, Anita Hill, who used to work for Thomas, claims he sexually harassed her a decade earlier. Hill, now a University of Oklahoma law professor, reluctantly agrees to testify in front of the Senate Judiciary Committee, and much of the nation watches spellbound as she testifies on television. “My working relationship became even more strained when Judge Thomas began to use work situations to discuss sex. … His conversations were very vivid. He spoke about acts that he had seen in pornographic films involving such matters as women having sex with animals and films showing group sex or rape scenes. … One of the oddest episodes I remember was an occasion in which Thomas was drinking a Coke in his office.

Tunnel memory for traumatic events

In four experiments subjects remembered the critical information in a traumatic slide as either more focused spatially than in its original presentation or more focused spatially than information in a matched neutral slide. Subjects comprehend a neutral scene by automatically extending its boundaries and understanding the visual information in a broader external context. However, when subjects are negatively aroused by a scene, they process more elaborately those critical details that were the source of the emotional arousal, and they maintain or restrict the scenes boundaries. ‘Tunnel memory’ results from this greater elaboration of critical details and more focused boundaries. Tunnel memory may explain the superior recognition and recall of central, emotion-arousing details in a traumatic event, as shown in previous research on emotion and memory.

Effects of present pain level on recall of chronic pain and medication use.

&NA; The present study experimentally manipulated pain intensity in chronic pain patients to evaluate whether the present pain level influenced the recall of past pain and medication use. For 1 week 30 chronic pain patients recorded every change in their pain levels and every use of medication on an electronic diary. At the end of the week, we evaluated recall of pain level and medication use for the previous day and week either before (control group, n = 15) or immediately after a physical therapy (PT) session (PT group, n = 15). As expected, the PT patients reported a significantly lower present pain level than did the control patients. More importantly, the PT patients recalled their usual and their highest levels of pain for the previous day and week to be less severe than did the control patients; furthermore, they significantly underestimated these levels as compared to their diary. In contrast, the control patients significantly overestimated their lowest and highest levels of pain for the previous day and their usual and lowest levels of pain for the previous week. In addition, PT patients recalled taking significantly less medication than they had recorded in their diaries, and less than the control patients. Our results demonstrate clearly that chronic pain patients recall their pain and medication use for the previous day and week in a way that is congruent with their present pain intensity.

Eyewitnesses show hypermnesia for details about a violent event.

A total of 90 undergraduates watched a videotape that portrayed a burglar breaking into a home and shooting three innocent victims. The 2-min tape contained 47 important violent and nonviolent details. Subjects recalled increasingly more details in each of four successive recall trials, including a trial 48 hr after seeing the tape. Instructions to use context or emotion as retrieval cues did not affect recall gains, and the gains were not the result of increased guessing. We conclude that eyewitness accounts may become more accurate with repeated attempts to recall information. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Distortion in Memory for Emotions: The Contributions of Personality and Post-Event Knowledge

Undergraduates (N = 189) rated their test anxiety and emotions immediately before a midterm examination and recalled those feelings 1 week later. Students who learned they had done well on the exam underestimated, and those who learned they had done poorly overestimated, pre-exam test anxiety. Personality traits and emotional states together predicted memory distortion. Specifically, traits predicted the intensity of pre-exam states, such as test anxiety, which in turn predicted later distortion in recalling pre-exam negative and positive emotions. Also, students with positive personality traits were particularly likely to be influenced by current feelings when recalling test anxiety. Overestimating pre-midterm test anxiety predicted intentions to study more as well as feelings of unpleasantness just prior to the final exam.

The meaning of pain: cancer patients' rating and recall of pain intensity and affect

Abstract The present study investigated the influence of an increase in present pain intensity on the rating and recall of the intensity and affective dimensions of clinical pain. Thirty‐two cancer patients who reported that movement caused or exacerbated their pain rated their present pain intensity and affect before and after a session of physical therapy. Subjects also rated their usual, highest and lowest pain intensity and pain affect for the previous 3 days, and were randomly assigned to make these ratings either before or after the physical therapy session. Physical therapy increased the intensity (P<0.01) but not the unpleasantness of the pain (P>0.05), thus demonstrating a dissociation between pain intensity and pain affect. Beliefs about pain etiology also influenced post‐therapy pain ratings. Subjects (N=11) who believed that their pain was due to cancer, rated their post‐therapy pain intensity and pain affect significantly higher than those subjects (N=21) who did not believe their pain was due to cancer (both P<0.05). For all subjects, recall of past pain intensity and affect was positively correlated with present levels of pain intensity and pain affect (P<0.01). Thus, recall was assimilated to present pain levels. The results demonstrate the importance of rating both the intensity and affective dimensions of pain, and suggest that the significance of clinical pain influences pain ratings. These results also suggest that research on the rating and recall of pain, particularly the affective dimension of pain, should use actual patients who are experiencing changes in their naturally occurring pain.

It was never that bad: Biased recall of grief and long-term adjustment to the death of a spouse

At 6 months following the death of their spouse, 37 participants reported their grief-related symptoms and thoughts, and then, approximately 4.5 years later, they attempted to recall how they felt at the time of the 6-month report. Although participants were far less distressed at recall than initially, they recalled their 6-month grief rather accurately. Participants did however overestimate prior grief-related intrusive ideation. Participants current level of grief predicted what they recalled slightly better than the actual initial grief. Conversely, what they recalled predicted current levels of grief across various measures. Participants whose grief diminished relatively little over time tended to overestimate prior grief more. The retrospective reappraisal that ones past grief was not severe may indicate effective coping.

Killing versus witnessing in combat trauma and reports of PTSD symptoms and domestic violence

Active participation in combat trauma increased reports of posttraumatic stress disorder (PTSD) symptoms over passive witnessing of trauma. Using archival data from 376 U.S. soldiers who took part in the family interview component of the 1988 National Vietnam Veteran Readjustment Study (NVVRS), findings are that even after statistically accounting for witnessing combat trauma, U.S. soldiers who likely killed enemy soldiers in combat reported elevated levels of PTSD symptoms. Both inference and direct self-reports were used to measure killing in combat, and both measures accounted equally well for variance in PTSD symptoms. The likelihood of a soldier killing enemy combatants was also weakly related to his spouses report of physical domestic violence in the past year. Diagnosing the mental health symptoms of combat soldiers should specifically assess whether they actively participated in wounding or killing the enemy.