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2008-2010

Striving for good feelings or averting bad ones

Previous research suggests that the emotions people value (“ideal affect”) can help explain cultural differences in health care preferences.  For example, those valuing excitement tend to prefer physicians who promote excitement and medications that induce feelings of excitement. However, the emotions people want to avoid (“avoided affect”) may be just as influential, particularly among older adults and East Asian Americans who tend to be motivated more by avoiding (versus approaching) certain outcomes. Using survey methods, the researchers examined whether the emotions people want to avoid change as we age for two cultural groups, European Americans and East Asian Americans. They then examined the conditions under which avoided affect shapes health care preferences. Participants read several hypothetical health care scenarios (e.g., selecting a long-term care facility) and indicated their preference for two options framed in terms of positive (e.g., induces energy vs. relaxation) or negative (prevents anxiety vs. lethargy) affective states.

The researchers completed data collection of 318 participants (1/3 younger, 1/3, middle-aged, 1/3 older; ½ Chinese American, ½ European American; ½ female) across three conditions (one positive and two negative). For the positive condition, 133 participants evaluated health care options that promote either HAP (high arousal positive) or LAP (low arousal positive) states. For positive states, previous findings were replicated showing that the more people value HAP states, the more they prefer health care options that promote these states over those that promote LAP states. For negative states (n=92), contrary to expectation, avoided affect did not predict choice of health care options when they promised to prevent negative states. When the negative health care options were reframed as "inducing" negative states and presented to 93 additional community participants, the less people wanted to avoid HAN states and the more they wanted to avoid LAN states, the higher likelihood of choosing HAN vs. LAN health care options.

The researchers recently published a manuscript in Emotion, entitled "Choosing a Physician Depends on How You Want to Feel: The Role of Ideal Affect in Health-Related Decision Making". After receiving promising reviews, they also resubmitted an R01 grant application to NCI extending this work to look at physicians perceptions of patients expressing different affective states, "Ethnic Bias in Cancer Screening Recommendations: The Role of Physicians' Emotional Ideals" in November.