Journal of Personality and Social Psychology 1975, Vol. 32, No. 2, 222-230
Effects of Fear Appeals and Physiological Arousal Upon Emotion, Attitudes, and Cigarette Smoking Ronald W. Rogers University of South Carolina
C. William Deckner Department of Biomedical Engineering, Vanderbilt University
Two experiments are reported that attempted to replicate conceptually Schachter's theory of the determinants of emotion and to test the feasibility of extending the theory to attitudes and behavior that may be mediated by the emotion of fear. A total of 279 cigarette smokers were administered either epinephrine or a placebo and then exposed to situational cues suggestive of disparate emotional states (Experiment 1) or different intensities of the same emotion (Experiment 2). Contrary to predictions based upon Schachter's theory, manipulated physiological arousal was not necessary for emotional labeling and under some conditions elicited fear. The situational cues affected emotion and attitudes. Higher levels of fear appeals strengthened intentions to quit smoking, and reassurance of the efficacy of stopping smoking reduced cigarette consumption.
Schachter's (1964) well-known conceptualization of the determinants of emotional state postulates that emotion is a joint product of two factors: general physiological arousal, which is emotionally neutral, and situational cues which indicate appropriate cognitive labels (e.g., fear, anger) to be attached to the feelings of arousal. The presence of only one of these determinants is not sufficient for an emotion to be experienced; an interaction of the two is necessary. Extending Schachter's work, Valins (1966) and Barefoot and Straub (1971) have found that although they did not manipulate physiological arousal, affective feeling toward the source of bogus (not actual) arousal is influenced in a manner consistent with Schachter's theory. Affective feeling is one component, along with cognitive and conative elements, of the tricomponential definition of attitudes (McGuire, 1969). Thus, these studies may be interpreted as suggesting that not only is emotion determined by physiological arousal and situational cues, but the affective component of an attitude is influenced similarly. Mintz and Mills (1971) reasoned, as had Deckner and Rogers (1970), that the stronger the emotion assoThe authors consider their contribution to the article to be equal. Requests for reprints should be sent to Ronald W. Rogers, Department of Psychology, University of South Carolina, Columbia, South Carolina 29208. 222
ciated with specific situational cues, the stronger is the attitude toward the source of emotional arousal. Another line of convergence between research on emotion and attitude may be found in the fear appeal literature. Fear has been characterized as an emotional state that motivates protective behavior (cf. Janis, 1967). Fear is aroused in response to an external danger and is directed toward mobilizing the organism to avoid or escape from that danger. The emotional disturbance of the viscera has been thought to facilitate muscular activity that affords protection; thus, there has traditionally been a close relationship between emotion and instrumental behavior (Cannon, 1915; Darwin, 1965/1872). The initial theoretical formulation of the effects of fear upon attitude change (Hovland, Janis, & Kelley, 1953) and a more recent revision (Janis, 1967) both adopted the fear-as-acquired-drive model. With respect to fear-arousing communications and attitude change, the evidence reviewed by Leventhal (1970) indicates that, in general, fear appeals facilitate persuasion. More specifically, there is evidence that fear appeals strengthen intentions to stop smoking (Rogers & Thistlethwaite, 1970) and tend to have a suppressive effect upon cigarette consumption (Leventhal & Watts, 1966). If an emotional state of fear mediates some types of attitude and behavior change, then
EFFECTS OF FEAR APPEALS AND PHYSIOLOGICAL AROUSAL factors that determine the quality and intensity of an emotion might be expected to play a determinative role in changing those attitudes and behaviors. The purpose of the present investigation was twofold: (a) to conceptually replicate Schachter and Singer's (1962) classic study and (b) to examine the possibility of extending their theory to determine if situational cues and physiological arousal interact to affect not only emotional state but attitudes and behaviors that have been hypothesized to be mediated by the emotion of fear. EXPERIMENT 1 x Few direct manipulations of physiological arousal by injecting epinephrine have been reported since Schachter and Singer's (1962) and Schachter and Wheeler's (1962) studies. Investigations have been focused instead upon nonveridical representations of physiological arousal (e.g., Valins, 1966) and naturally occurring states of arousal (e.g., Nisbett & Schachter, 1966; Ross, Rodin, & Zimbardo, 1969). For the purposes of the present study, a more adequate test might be achieved by directly manipulating physiological arousal. Epinephrine was the drug chosen, rather than caffeine, for the reasons Schachter and Singer mentioned: It closely approximates the discharge of the sympathetic nervous system. Caffeine is classified as a central nervous system stimulant, while epinephrine is an autonomic arousal agent (Levy & Ahlquist, 1971; Truitt, 1971). The shortcomings of using caffeine to produce physiological arousal have been shown by Mintz and Mills (1971), who found that caffeine actually decreased the pulse rate 1.8 beats per minute and that this diminution was not significantly different from the decrease of 3.8 beats per minute in their placebo-control group. In contrast, Schachter and Singer found that the pulse rate increased 6.4 and decreased 4.1 beats per minute in their epinephrine-ignorant and placebo groups, respectively. In the first experiment, a film on the harmful consequences of cigarette smoking was 1 A brief report, based on a portion of this study, was reported at the 78th Annual Convention of the American Psychological Association, Miami Beach, September 1970.
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shown to one group of smokers. A no-film condition provided a situation designed to evoke cognitions quite different from those suggested by the film. Half of each of these groups was administered epinephrine, while the remainder were administered a placebo. Based upon Schachter's theory, an interaction between physiological arousal and situation cues was predicted on a self-report measure of fear. Since both of these components must be present for a state to be labeled as an emotion, the group exposed to the film and given epinephrine should report a higher level of fear than each of the other groups. Specifically, it was predicted that the film would produce more fear in the epinephrine condition than in the placebo condition and that there would be no difference between those two drug groups within the no-film condition. Furthermore, the difference between the film and no-film groups was expected to be much greater in the epinephrine than the placebo condition. Finally, if it is tenable to assume that the determinants of emotion will have similar consequences on the attitudes and behavior that the emotion presumably mediates, then a similar interaction effect would be anticipated on measures of intent to stop smoking and reduction in cigarette consumption. Method Subjects Subjects were 119 cigarette smokers recruited by advertising for volunteers in university and city newspapers. Approximately half of the subjects in each treatment group were from the university community. The advertisement described an exploratory investigation of procedures designed to help people stop smoking; the procedures were not specified. Eligibility was limited to smokers who averaged at least 10 cigarettes a day. As a health precaution, participation was limited to those under 35 years of age who had no previous history of heart trouble. Respondents to the newspaper advertisement telephoned the investigators, who then described the study as one evaluating procedures designed to reduce smoking. Callers were informed of the poss:bility of being shown a film about smoking, of being administered a drug, and a brief medical history was obtained.
Procedure A 2 X 2 factorial design was used with two between-subjects experimental manipulations: film
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versus no film and epinephrine versus placebo. Subjects in both the film and no-film conditions were given identical information about the drug. They were told that an evaluation was being made of the effect of a drug on reducing the desire to smoke and of a possible secondary drug effect: temporarily increasing one's ability to assimilate information. The information was provided by the film in one condition and by written material in the no-film condition. Thus, one purported purpose of the study was to determine whether the drug would enable the smokers to concentrate better on the information to which they were exposed. No other statements were made about side effects of the drug, especially that the injection might produce physiological arousal or any type of emotional state. Therefore, in addition to providing a plausible cover story for the injection, these instructions were designed to dissuade the subjects from attributing their neutral arousal to the drug and to help ensure that any arousal would be interpreted as an emotional reaction to the situational cues. The film sequence, found to be fear arousing in previous experiments (Rogers & Thistlethwaite, 1970), was entitled "One in 20,000." The 18-minute portion of the film used portrays a heavy smoker's discovery that he has lung cancer in an interview with his physician, his discussions with a surgeon, and a dramatized version of this trip to the operating room. To provide situational cues suggestive of an emotional state quite different from that suggested by the film, the no-film group read emotionally neutral material unrelated to smoking or cancer. To support the cover story that the drug might affect learning, the no-film group was instructed that they were to concentrate on the printed communications while being distracted by a humorous record. The record was entitled "Bill Cosby is a very funny fellow—Right?" Thus, the film groups were provided with situational cues suggestive of fear, while the nofilm groups were not; the epinephrine groups were placed in a state of drug-induced neutral physiological arousal, while the placebo groups were not. All experimental sessions lasted approximately 1 hour. Subjects were first given another description of the purpose of the study. They then signed a consent form stating that they were aware of the possible risks and benefits to be expected and that they were participating voluntarily. They next completed a pretest questionnaire which is described subsequently. A subcutaneous injection of either .5 ml of epinephrine, the dosage used by Schachter and his colleagues, or a saline placebo was administered by a physician in an adjoining room.2 To ensure further the well-being of the subjects, the physicians were not blind with respect to the drug being administered. However, they were blind with respect to other treatment variables and were not aware of the specific hypotheses being tested. Departure from random assignment to the experimental conditions was necessary in four cases where, despite the previous telephone medical screening, epinephrine was medically contraindicated. These subjects were as-
signed to the placebo group. Immediately after the injections, subjects either viewed the film or read the material while the record was played and then completed the posttest questionnaire. All subjects were provided with a list of specific suggestions on how to stop smoking. Finally, they were informed that they could obtain a complete explanation of the study including the particular role they played after all the data had been collected. Follow-up questionnaires which assessed average daily cigarette consumption were mailed 1 week, 1 month, and 3 months after participation in the study.
Questionnaires The pretest, posttest, and follow-up questionnaires were based on those used by Leventhal, Watts, and Pagano (1967). 3 The pretest contained items on smoking history (e.g., average daily consumption, how long this average had been smoked) and a set of items which assessed feelings of vulnerability to the diseases associated with smoking, feelings of anxiety about the effects of smoking on one's health, and motivation to stop smoking. The posttest contained mood adjectives that assessed positive and negative emotion and a second set of attitude items that assesed intentions to stop smoking and beliefs that smoking causes lung cancer. All emotion and attitude items were followed by 9-point graphic rating scales anchored with statements such as "Not at All" or "Completely Disagree" at one end and "Very Much" or "Completely Agree" at the other. For all attitude items, statements were varied so that on some, a rating of 9 represented high endorsement and on others, low endorsement. Prior to the analysis of results, the ratings were converted so that a high score always indicated high endorsement. There were also questions on the posttest that assessed learning of the content of the film or of the material read in the no-film Condition,
Results Pretest Measures There were no differences among the experimental groups on the pretest measures of vulnerability, motivation to stop smoking, chronicity, and rate of cigarette consumption. Despite the random assignment, the group administered placebo was found to be slightly more anxious about the effects of smoking upon their health than the group administered epinephrine, £s = 6.81 and 6.11, respectively; 2
The authors would like to express their thanks to the following physicians, John Griffith, Dale Maxwell, and Landon Palmer, for giving the injections in both experiments. 3 Howard Leventhal is gratefully acknowledged for providing the questionnaires.
EFFECTS OF FEAR APPEALS AND PHYSIOLOGICAL AROUSAL P(l, 115) = 5.09, p < .05. All posttest measures were therefore analyzed using pretest anxiety level as a covariate. Although the analysis of covariance is not a remedy for any failures of randomization, it provided a partial demonstration that pretest anxiety did not bias the pattern of results observed in the posttest measures. The more straightforward and readily interpretable analyses of variance yielded the same results and are reported below. Emotional Arousal The six mood adjectives measuring fear were summed to provide an overall index, and an unequal n analysis of variance was performed. There were significant main effects for both the drug and situational cue variables. The film group experienced more fear than the no-film group, F(l,115) = 14.78, p < .001, and the epinephrine group reported more fear than the placebo group, F(l, 115) = 20.43, p < .001. More importantly, there was a significant interaction between the variables, F(l, 115) = 4.19, p < .005. However, the interaction effect did not conform to the previously described expectations. A Duncan multiple-range test revealed that the no-filmplacebo group (# = 2.81) reported less fear (p < .005) than the no-film-epinephrine (#=5.33), film-placebo (#=5.07), and the film-epinephrine groups (# = 6.02); the latter three groups did not differ from each other. A similar analysis of the mood adjectives measuring positive emotion revealed only a main effect for the film variable: The no-film group had higher positive emotion scores than the film group, #s = 8.26 and 4.80, respectively; F(l, 115) = 32.40, p< .001. The main effect for the drug variable approached significance (F = 3.3, /> < .07), with the placebo group exceeding the epinephrine group. Attitudes Contrary to expectation, there were no significant interaction effects on any of the attitude measures. The film condition was superior to the no-film condition in strengthening the belief that smoking causes lung cancer (#s = 7.96 and 7.39, respectively; F(l, 115)
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= 6.45, p < .02. The effect of the film in strengthening intentions to stop smoking approached but did not reach statistical significance (F - 2.55, p< .11). There were no differences among the groups in answering content questions. Reported Smoking Behavior Although failure to respond to the follow-up questionnaires increased with each of the three follow-ups (89% reported at 1 week, 73% at 1 month, and 51% at 3 months), there was no differential dropout rate among the four experimental groups at any of three assessment periods. The latter conclusion was based upon Cohen's (1967) multiple-comparisons technique for proportions. An analysis of the number of cigarettes smoked at each assessment period indicated that the independent variables had no differential effects. Discussion The predicted interactive effect of physiological arousal and situational cues upon emotional state, derived from Schachter's theory, was not obtained. Contrary to expectations, the difference in mean fear scores between the epinephrine and placebo groups was greater in the no-film condition than in the film condition. Furthermore, there was no evidence that the interaction of both variables increased fear over either factor operating alone. The mean fear score of the film-epinephrine group did not exceed that of either the filmplacebo group or the no-film-epinephrine group. Additionally, the epinephrine groups tended to experience less positive emotion than the placebo groups. Thus, within the no-film condition, the epinephrine group reported more fear and less positive emotion than the placebo group. Several reasons for the lack of support for Schachter's position should be considered. Since the same dosage of epinephrine used in his research (Schachter & Singer, 1962; Schachter & Wheeler, 1962) was used in the present study, presumably an appropriate level of physiological arousal was induced. It is possible, however, that the situational cues provided by the no-film condition may not have been completely appropriate for a
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test of the theory. That is, the attempt to read while being distracted by a humorous record may have been slightly unpleasant. This consideration might account for the higher fear scores in the no-film-epinephrine group than in the no-film-placebo group, since the arousal would accentuate any unpleasant conditions. However, the persuasiveness of this interpretation is lessened somewhat by the fact that the no-film-epinephrine group also experienced a moderately high level of positive emotion (X — 7.72). An alternative explanation that would account for the higher level of fear in the nofilm-epinephrine group than in the no-filmplacebo group (and the reverse pattern of differences on the measure of positive emotion) is that epinephrine, apparently one of the most appropriate sympathomimetic agents available, may not induce physiological arousal that is emotionally neutral. Although unequivocal differential physiological indicators of emotions have not been rigorously demonstrated, numerous empirical studies have shown that rather than being emotionally neutral, epinephrine is associated with fear (Ax, 1953; Dimascio, Boyd, & Greenblatt, 1957; Funkenstein, King, & Drolette, 1957; Lewinsohn, 1956). Furthermore, it has been pointed out that the effect of epinephrine on vascular, muscular, and metabolic actions contributes to increased efficiency in states of stress (Brown & Barker, 1966; von Euler, 1967). Finally, although Schachter (1964) has contended that the presence of the bodily symptoms can be dissociated from the emotional experience of fear, these symptoms occur in continguity with fear and thus may become classically conditioned to the emotional state. Therefore, when only the bodily cues are present and there is no compelling external explanation (i.e., an angry stooge or a film), the internal cues may serve as conditioned stimuli and elicit components of the fear response. Either exogenous epinephrine or the film was sufficient to elicit the maximal amounts of fear obtained in the study. The combination of these two variables did not produce the markedly stronger fear responses that had been anticipated. Apparently, the film provided compelling cues sufficiently suggestive
of fear so that the manipulated arousal added little or nothing to the labeling of the emotional state. However, since the self-reports of fear in the film condition were "moderate" (5.55 on a 9-point scale), the situational cues apparently were not so compelling as to create maximal arousal. There were no differential treatment effects upon the measures of intent to stop smoking or self-reports of cigarette consumption. It is likely that the combination of preexperimental motivation to stop smoking, the list of specific instructions, and the expectancy of receiving help were sufficient to obscure any potential treatment effects. The pattern of results obtained on the measures of emotion, attitudes, and behavior suggested several improvements and extensions. EXPERIMENT 2 A second experiment was performed using situational cues indicative of two different levels of intensities of the same emotional state rather than providing cues suggestive of disparate emotional states as in the first study. This design provided slightly different conditions for another attempt to replicate conceptually Schachter's work. Moreover, by manipulating cues designed to evoke cognitions appropriate to only one emotional state, several ambiguities and limitations of the first experiment were overcome. The possibility of arousal accentuating any unpleasant qualities in the no-film condition was eliminated. Furthermore, the addition of a film with higher fear-arousing properties might overcome the restriction on the possibility of differential attitude and behavior change among the selfselected, motivated smokers. The hypotheses being tested were the same as those described for Experiment 1. With respect to the dependent measure of emotional labeling, it was predicted that within a high-fear film condition, more fear would be reported by the epinephrine group than the placebo group but that the two drug conditions would not differ in a low-fear film condition. Furthermore, the difference between the two film groups was anticipated to be greater in the epinephrine condition than in the placebo condition. The plausibility of extending Schachter's conceptualization was
EFFECTS OF FEAR APPEALS AND PHYSIOLOGICAL AROUSAL tested again by predicting a similar interaction upon intentions to stop smoking and upon reduction of cigarette consumption. A secondary purpose of the present experiment was to examine the efficacy of reassuring smokers that stopping smoking is a highly effective method of avoiding lung cancer. Rogers and Thistlethwaite (1970) found that smokers given high reassurance had stronger intentions to stop smoking than those given low reassurance. It might therefore be expected that compared to a no-reassurance condition, a reassurance communication would strengthen intentions to stop smoking and reduce cigarette consumption. Method Subjects were 160 cigarette smokers recruited by advertising for volunteers in a city newspaper. The advertisement was the same as the one described in the previous study. The same procedures for enrollment and restrictions on eligibility were again employed. A 2 X 2 X 2 factorial design was used with three between-subject manipulations: high-fear film versus low-fear film, epinephrine versus placebo, and reassurance versus no reassurance. The low-fear film clip was the same film shown in the first experiment. The high-fear version consisted of the same scenes plus a S-minute operation sequence that is authentic and shows a cancerous lung being cut out of the smoker's chest. The information about the drug, procedure, administration of treatments, and dependent measures were identical to those previously described. Immediately after completing the Mood Adjective Check List, half of each group was given a 250-word reassurance communication, and half was not. The reassurance message, adapted from Rogers and Thistlethwaite (1970), was an unequivocal statement that the harmful consequences of smoking are reversible and that if one would stop smoking, he would greatly reduce his chances of getting lung cancer.
Results Pretest Measures An analysis of reported cigarette consumption and motivation to stop smoking indicated that there were no pretest differences on these two measures among the treatment groups. Although placement in a particular treatment combination was randomly determined, there were highly similar Film X Drug X Reassurance interaction effects on the measures of pretest anxiety, F(\, 152) = 6.36, p < .05, and vulnerability, 77(1,152) = 13.51,p < .01. However, as in the first experiment, these
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pretest differences bore no similarity to the posttest patterns of differences, and, therefore, it is unlikely that the latter could be accounted for by the preexperimental nonequivalence. Additionally, adjusting all posttest dependent measures for the linear effects of these covariates yielded the same results for each dependent measure as the corresponding analyses of variance. Therefore, only the latter are reported. Emotional Arousal The group exposed to the high-fear film reported stronger feelings of fear than the group shown the low-fear film, ^s = 6.11 and 4.65, respectively; F(l, 152) = 23.70, p < .001. There was no main effect associated with the drug variable (F < 1), and, contrary to the prediction based upon Schachter's theory, there was no Film X Drug interaction (F < 1). (Since the reassurance manipulation was introduced after the Mood Adjective Check List, it did not enter into this analysis.) A ttitudes Compared to the low-fear film, the highfear film strengthened smokers' beliefs that smoking causes lung cancer, ^s = 7.79 and 8.26; 77(1,152) =4.25, p < .05, and increased intentions to stop smoking, Xs = 7.21 and 7.85; 77(1, 152) = 7.05, p < .01. There was a nonsignificant tendency for the reassurance manipulation to strengthen intentions to stop smoking, 77=2.28, p < .15. Finally, there were no differences in recall of the film content associated with the experimental treatments. Reported Smoking Behavior The three follow-up questionnaires were returned by 91%, 78%, and 49% of the subjects, respectively; there was no differential dropout rate among the experimental groups. Analyzing the smoking data as a repeatedmeasures factor disclosed a significant Reassurance X Follow-Up Stages interaction effect, F(3,325) = 3.39, p < .02. Although the two treatment groups reported virtually identical levels of pretest consumption, at each of the three posttest periods those in the reassurance condition were smoking less than those
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not given the reassuring message. Since it would be hazardous to interpret an effect when more than 50% of the subjects have dropped out, separate analyses of variance were performed for the 1-week and 1-month follow-up stages. These analyses revealed that the group given reassurance was smoking less than the no-reassurance group 1 week after the experiment, Zs — 14.2 and 20.6, respectively; F( 1,140) =8.74, #
Effects of Fear Appeals and Physiological Arousal Upon Emotion, Attitudes, and Cigarette Smoking Ronald W. Rogers University of South Carolina
C. William Deckner Department of Biomedical Engineering, Vanderbilt University
Two experiments are reported that attempted to replicate conceptually Schachter's theory of the determinants of emotion and to test the feasibility of extending the theory to attitudes and behavior that may be mediated by the emotion of fear. A total of 279 cigarette smokers were administered either epinephrine or a placebo and then exposed to situational cues suggestive of disparate emotional states (Experiment 1) or different intensities of the same emotion (Experiment 2). Contrary to predictions based upon Schachter's theory, manipulated physiological arousal was not necessary for emotional labeling and under some conditions elicited fear. The situational cues affected emotion and attitudes. Higher levels of fear appeals strengthened intentions to quit smoking, and reassurance of the efficacy of stopping smoking reduced cigarette consumption.
Schachter's (1964) well-known conceptualization of the determinants of emotional state postulates that emotion is a joint product of two factors: general physiological arousal, which is emotionally neutral, and situational cues which indicate appropriate cognitive labels (e.g., fear, anger) to be attached to the feelings of arousal. The presence of only one of these determinants is not sufficient for an emotion to be experienced; an interaction of the two is necessary. Extending Schachter's work, Valins (1966) and Barefoot and Straub (1971) have found that although they did not manipulate physiological arousal, affective feeling toward the source of bogus (not actual) arousal is influenced in a manner consistent with Schachter's theory. Affective feeling is one component, along with cognitive and conative elements, of the tricomponential definition of attitudes (McGuire, 1969). Thus, these studies may be interpreted as suggesting that not only is emotion determined by physiological arousal and situational cues, but the affective component of an attitude is influenced similarly. Mintz and Mills (1971) reasoned, as had Deckner and Rogers (1970), that the stronger the emotion assoThe authors consider their contribution to the article to be equal. Requests for reprints should be sent to Ronald W. Rogers, Department of Psychology, University of South Carolina, Columbia, South Carolina 29208. 222
ciated with specific situational cues, the stronger is the attitude toward the source of emotional arousal. Another line of convergence between research on emotion and attitude may be found in the fear appeal literature. Fear has been characterized as an emotional state that motivates protective behavior (cf. Janis, 1967). Fear is aroused in response to an external danger and is directed toward mobilizing the organism to avoid or escape from that danger. The emotional disturbance of the viscera has been thought to facilitate muscular activity that affords protection; thus, there has traditionally been a close relationship between emotion and instrumental behavior (Cannon, 1915; Darwin, 1965/1872). The initial theoretical formulation of the effects of fear upon attitude change (Hovland, Janis, & Kelley, 1953) and a more recent revision (Janis, 1967) both adopted the fear-as-acquired-drive model. With respect to fear-arousing communications and attitude change, the evidence reviewed by Leventhal (1970) indicates that, in general, fear appeals facilitate persuasion. More specifically, there is evidence that fear appeals strengthen intentions to stop smoking (Rogers & Thistlethwaite, 1970) and tend to have a suppressive effect upon cigarette consumption (Leventhal & Watts, 1966). If an emotional state of fear mediates some types of attitude and behavior change, then
EFFECTS OF FEAR APPEALS AND PHYSIOLOGICAL AROUSAL factors that determine the quality and intensity of an emotion might be expected to play a determinative role in changing those attitudes and behaviors. The purpose of the present investigation was twofold: (a) to conceptually replicate Schachter and Singer's (1962) classic study and (b) to examine the possibility of extending their theory to determine if situational cues and physiological arousal interact to affect not only emotional state but attitudes and behaviors that have been hypothesized to be mediated by the emotion of fear. EXPERIMENT 1 x Few direct manipulations of physiological arousal by injecting epinephrine have been reported since Schachter and Singer's (1962) and Schachter and Wheeler's (1962) studies. Investigations have been focused instead upon nonveridical representations of physiological arousal (e.g., Valins, 1966) and naturally occurring states of arousal (e.g., Nisbett & Schachter, 1966; Ross, Rodin, & Zimbardo, 1969). For the purposes of the present study, a more adequate test might be achieved by directly manipulating physiological arousal. Epinephrine was the drug chosen, rather than caffeine, for the reasons Schachter and Singer mentioned: It closely approximates the discharge of the sympathetic nervous system. Caffeine is classified as a central nervous system stimulant, while epinephrine is an autonomic arousal agent (Levy & Ahlquist, 1971; Truitt, 1971). The shortcomings of using caffeine to produce physiological arousal have been shown by Mintz and Mills (1971), who found that caffeine actually decreased the pulse rate 1.8 beats per minute and that this diminution was not significantly different from the decrease of 3.8 beats per minute in their placebo-control group. In contrast, Schachter and Singer found that the pulse rate increased 6.4 and decreased 4.1 beats per minute in their epinephrine-ignorant and placebo groups, respectively. In the first experiment, a film on the harmful consequences of cigarette smoking was 1 A brief report, based on a portion of this study, was reported at the 78th Annual Convention of the American Psychological Association, Miami Beach, September 1970.
223
shown to one group of smokers. A no-film condition provided a situation designed to evoke cognitions quite different from those suggested by the film. Half of each of these groups was administered epinephrine, while the remainder were administered a placebo. Based upon Schachter's theory, an interaction between physiological arousal and situation cues was predicted on a self-report measure of fear. Since both of these components must be present for a state to be labeled as an emotion, the group exposed to the film and given epinephrine should report a higher level of fear than each of the other groups. Specifically, it was predicted that the film would produce more fear in the epinephrine condition than in the placebo condition and that there would be no difference between those two drug groups within the no-film condition. Furthermore, the difference between the film and no-film groups was expected to be much greater in the epinephrine than the placebo condition. Finally, if it is tenable to assume that the determinants of emotion will have similar consequences on the attitudes and behavior that the emotion presumably mediates, then a similar interaction effect would be anticipated on measures of intent to stop smoking and reduction in cigarette consumption. Method Subjects Subjects were 119 cigarette smokers recruited by advertising for volunteers in university and city newspapers. Approximately half of the subjects in each treatment group were from the university community. The advertisement described an exploratory investigation of procedures designed to help people stop smoking; the procedures were not specified. Eligibility was limited to smokers who averaged at least 10 cigarettes a day. As a health precaution, participation was limited to those under 35 years of age who had no previous history of heart trouble. Respondents to the newspaper advertisement telephoned the investigators, who then described the study as one evaluating procedures designed to reduce smoking. Callers were informed of the poss:bility of being shown a film about smoking, of being administered a drug, and a brief medical history was obtained.
Procedure A 2 X 2 factorial design was used with two between-subjects experimental manipulations: film
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versus no film and epinephrine versus placebo. Subjects in both the film and no-film conditions were given identical information about the drug. They were told that an evaluation was being made of the effect of a drug on reducing the desire to smoke and of a possible secondary drug effect: temporarily increasing one's ability to assimilate information. The information was provided by the film in one condition and by written material in the no-film condition. Thus, one purported purpose of the study was to determine whether the drug would enable the smokers to concentrate better on the information to which they were exposed. No other statements were made about side effects of the drug, especially that the injection might produce physiological arousal or any type of emotional state. Therefore, in addition to providing a plausible cover story for the injection, these instructions were designed to dissuade the subjects from attributing their neutral arousal to the drug and to help ensure that any arousal would be interpreted as an emotional reaction to the situational cues. The film sequence, found to be fear arousing in previous experiments (Rogers & Thistlethwaite, 1970), was entitled "One in 20,000." The 18-minute portion of the film used portrays a heavy smoker's discovery that he has lung cancer in an interview with his physician, his discussions with a surgeon, and a dramatized version of this trip to the operating room. To provide situational cues suggestive of an emotional state quite different from that suggested by the film, the no-film group read emotionally neutral material unrelated to smoking or cancer. To support the cover story that the drug might affect learning, the no-film group was instructed that they were to concentrate on the printed communications while being distracted by a humorous record. The record was entitled "Bill Cosby is a very funny fellow—Right?" Thus, the film groups were provided with situational cues suggestive of fear, while the nofilm groups were not; the epinephrine groups were placed in a state of drug-induced neutral physiological arousal, while the placebo groups were not. All experimental sessions lasted approximately 1 hour. Subjects were first given another description of the purpose of the study. They then signed a consent form stating that they were aware of the possible risks and benefits to be expected and that they were participating voluntarily. They next completed a pretest questionnaire which is described subsequently. A subcutaneous injection of either .5 ml of epinephrine, the dosage used by Schachter and his colleagues, or a saline placebo was administered by a physician in an adjoining room.2 To ensure further the well-being of the subjects, the physicians were not blind with respect to the drug being administered. However, they were blind with respect to other treatment variables and were not aware of the specific hypotheses being tested. Departure from random assignment to the experimental conditions was necessary in four cases where, despite the previous telephone medical screening, epinephrine was medically contraindicated. These subjects were as-
signed to the placebo group. Immediately after the injections, subjects either viewed the film or read the material while the record was played and then completed the posttest questionnaire. All subjects were provided with a list of specific suggestions on how to stop smoking. Finally, they were informed that they could obtain a complete explanation of the study including the particular role they played after all the data had been collected. Follow-up questionnaires which assessed average daily cigarette consumption were mailed 1 week, 1 month, and 3 months after participation in the study.
Questionnaires The pretest, posttest, and follow-up questionnaires were based on those used by Leventhal, Watts, and Pagano (1967). 3 The pretest contained items on smoking history (e.g., average daily consumption, how long this average had been smoked) and a set of items which assessed feelings of vulnerability to the diseases associated with smoking, feelings of anxiety about the effects of smoking on one's health, and motivation to stop smoking. The posttest contained mood adjectives that assessed positive and negative emotion and a second set of attitude items that assesed intentions to stop smoking and beliefs that smoking causes lung cancer. All emotion and attitude items were followed by 9-point graphic rating scales anchored with statements such as "Not at All" or "Completely Disagree" at one end and "Very Much" or "Completely Agree" at the other. For all attitude items, statements were varied so that on some, a rating of 9 represented high endorsement and on others, low endorsement. Prior to the analysis of results, the ratings were converted so that a high score always indicated high endorsement. There were also questions on the posttest that assessed learning of the content of the film or of the material read in the no-film Condition,
Results Pretest Measures There were no differences among the experimental groups on the pretest measures of vulnerability, motivation to stop smoking, chronicity, and rate of cigarette consumption. Despite the random assignment, the group administered placebo was found to be slightly more anxious about the effects of smoking upon their health than the group administered epinephrine, £s = 6.81 and 6.11, respectively; 2
The authors would like to express their thanks to the following physicians, John Griffith, Dale Maxwell, and Landon Palmer, for giving the injections in both experiments. 3 Howard Leventhal is gratefully acknowledged for providing the questionnaires.
EFFECTS OF FEAR APPEALS AND PHYSIOLOGICAL AROUSAL P(l, 115) = 5.09, p < .05. All posttest measures were therefore analyzed using pretest anxiety level as a covariate. Although the analysis of covariance is not a remedy for any failures of randomization, it provided a partial demonstration that pretest anxiety did not bias the pattern of results observed in the posttest measures. The more straightforward and readily interpretable analyses of variance yielded the same results and are reported below. Emotional Arousal The six mood adjectives measuring fear were summed to provide an overall index, and an unequal n analysis of variance was performed. There were significant main effects for both the drug and situational cue variables. The film group experienced more fear than the no-film group, F(l,115) = 14.78, p < .001, and the epinephrine group reported more fear than the placebo group, F(l, 115) = 20.43, p < .001. More importantly, there was a significant interaction between the variables, F(l, 115) = 4.19, p < .005. However, the interaction effect did not conform to the previously described expectations. A Duncan multiple-range test revealed that the no-filmplacebo group (# = 2.81) reported less fear (p < .005) than the no-film-epinephrine (#=5.33), film-placebo (#=5.07), and the film-epinephrine groups (# = 6.02); the latter three groups did not differ from each other. A similar analysis of the mood adjectives measuring positive emotion revealed only a main effect for the film variable: The no-film group had higher positive emotion scores than the film group, #s = 8.26 and 4.80, respectively; F(l, 115) = 32.40, p< .001. The main effect for the drug variable approached significance (F = 3.3, /> < .07), with the placebo group exceeding the epinephrine group. Attitudes Contrary to expectation, there were no significant interaction effects on any of the attitude measures. The film condition was superior to the no-film condition in strengthening the belief that smoking causes lung cancer (#s = 7.96 and 7.39, respectively; F(l, 115)
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= 6.45, p < .02. The effect of the film in strengthening intentions to stop smoking approached but did not reach statistical significance (F - 2.55, p< .11). There were no differences among the groups in answering content questions. Reported Smoking Behavior Although failure to respond to the follow-up questionnaires increased with each of the three follow-ups (89% reported at 1 week, 73% at 1 month, and 51% at 3 months), there was no differential dropout rate among the four experimental groups at any of three assessment periods. The latter conclusion was based upon Cohen's (1967) multiple-comparisons technique for proportions. An analysis of the number of cigarettes smoked at each assessment period indicated that the independent variables had no differential effects. Discussion The predicted interactive effect of physiological arousal and situational cues upon emotional state, derived from Schachter's theory, was not obtained. Contrary to expectations, the difference in mean fear scores between the epinephrine and placebo groups was greater in the no-film condition than in the film condition. Furthermore, there was no evidence that the interaction of both variables increased fear over either factor operating alone. The mean fear score of the film-epinephrine group did not exceed that of either the filmplacebo group or the no-film-epinephrine group. Additionally, the epinephrine groups tended to experience less positive emotion than the placebo groups. Thus, within the no-film condition, the epinephrine group reported more fear and less positive emotion than the placebo group. Several reasons for the lack of support for Schachter's position should be considered. Since the same dosage of epinephrine used in his research (Schachter & Singer, 1962; Schachter & Wheeler, 1962) was used in the present study, presumably an appropriate level of physiological arousal was induced. It is possible, however, that the situational cues provided by the no-film condition may not have been completely appropriate for a
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test of the theory. That is, the attempt to read while being distracted by a humorous record may have been slightly unpleasant. This consideration might account for the higher fear scores in the no-film-epinephrine group than in the no-film-placebo group, since the arousal would accentuate any unpleasant conditions. However, the persuasiveness of this interpretation is lessened somewhat by the fact that the no-film-epinephrine group also experienced a moderately high level of positive emotion (X — 7.72). An alternative explanation that would account for the higher level of fear in the nofilm-epinephrine group than in the no-filmplacebo group (and the reverse pattern of differences on the measure of positive emotion) is that epinephrine, apparently one of the most appropriate sympathomimetic agents available, may not induce physiological arousal that is emotionally neutral. Although unequivocal differential physiological indicators of emotions have not been rigorously demonstrated, numerous empirical studies have shown that rather than being emotionally neutral, epinephrine is associated with fear (Ax, 1953; Dimascio, Boyd, & Greenblatt, 1957; Funkenstein, King, & Drolette, 1957; Lewinsohn, 1956). Furthermore, it has been pointed out that the effect of epinephrine on vascular, muscular, and metabolic actions contributes to increased efficiency in states of stress (Brown & Barker, 1966; von Euler, 1967). Finally, although Schachter (1964) has contended that the presence of the bodily symptoms can be dissociated from the emotional experience of fear, these symptoms occur in continguity with fear and thus may become classically conditioned to the emotional state. Therefore, when only the bodily cues are present and there is no compelling external explanation (i.e., an angry stooge or a film), the internal cues may serve as conditioned stimuli and elicit components of the fear response. Either exogenous epinephrine or the film was sufficient to elicit the maximal amounts of fear obtained in the study. The combination of these two variables did not produce the markedly stronger fear responses that had been anticipated. Apparently, the film provided compelling cues sufficiently suggestive
of fear so that the manipulated arousal added little or nothing to the labeling of the emotional state. However, since the self-reports of fear in the film condition were "moderate" (5.55 on a 9-point scale), the situational cues apparently were not so compelling as to create maximal arousal. There were no differential treatment effects upon the measures of intent to stop smoking or self-reports of cigarette consumption. It is likely that the combination of preexperimental motivation to stop smoking, the list of specific instructions, and the expectancy of receiving help were sufficient to obscure any potential treatment effects. The pattern of results obtained on the measures of emotion, attitudes, and behavior suggested several improvements and extensions. EXPERIMENT 2 A second experiment was performed using situational cues indicative of two different levels of intensities of the same emotional state rather than providing cues suggestive of disparate emotional states as in the first study. This design provided slightly different conditions for another attempt to replicate conceptually Schachter's work. Moreover, by manipulating cues designed to evoke cognitions appropriate to only one emotional state, several ambiguities and limitations of the first experiment were overcome. The possibility of arousal accentuating any unpleasant qualities in the no-film condition was eliminated. Furthermore, the addition of a film with higher fear-arousing properties might overcome the restriction on the possibility of differential attitude and behavior change among the selfselected, motivated smokers. The hypotheses being tested were the same as those described for Experiment 1. With respect to the dependent measure of emotional labeling, it was predicted that within a high-fear film condition, more fear would be reported by the epinephrine group than the placebo group but that the two drug conditions would not differ in a low-fear film condition. Furthermore, the difference between the two film groups was anticipated to be greater in the epinephrine condition than in the placebo condition. The plausibility of extending Schachter's conceptualization was
EFFECTS OF FEAR APPEALS AND PHYSIOLOGICAL AROUSAL tested again by predicting a similar interaction upon intentions to stop smoking and upon reduction of cigarette consumption. A secondary purpose of the present experiment was to examine the efficacy of reassuring smokers that stopping smoking is a highly effective method of avoiding lung cancer. Rogers and Thistlethwaite (1970) found that smokers given high reassurance had stronger intentions to stop smoking than those given low reassurance. It might therefore be expected that compared to a no-reassurance condition, a reassurance communication would strengthen intentions to stop smoking and reduce cigarette consumption. Method Subjects were 160 cigarette smokers recruited by advertising for volunteers in a city newspaper. The advertisement was the same as the one described in the previous study. The same procedures for enrollment and restrictions on eligibility were again employed. A 2 X 2 X 2 factorial design was used with three between-subject manipulations: high-fear film versus low-fear film, epinephrine versus placebo, and reassurance versus no reassurance. The low-fear film clip was the same film shown in the first experiment. The high-fear version consisted of the same scenes plus a S-minute operation sequence that is authentic and shows a cancerous lung being cut out of the smoker's chest. The information about the drug, procedure, administration of treatments, and dependent measures were identical to those previously described. Immediately after completing the Mood Adjective Check List, half of each group was given a 250-word reassurance communication, and half was not. The reassurance message, adapted from Rogers and Thistlethwaite (1970), was an unequivocal statement that the harmful consequences of smoking are reversible and that if one would stop smoking, he would greatly reduce his chances of getting lung cancer.
Results Pretest Measures An analysis of reported cigarette consumption and motivation to stop smoking indicated that there were no pretest differences on these two measures among the treatment groups. Although placement in a particular treatment combination was randomly determined, there were highly similar Film X Drug X Reassurance interaction effects on the measures of pretest anxiety, F(\, 152) = 6.36, p < .05, and vulnerability, 77(1,152) = 13.51,p < .01. However, as in the first experiment, these
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pretest differences bore no similarity to the posttest patterns of differences, and, therefore, it is unlikely that the latter could be accounted for by the preexperimental nonequivalence. Additionally, adjusting all posttest dependent measures for the linear effects of these covariates yielded the same results for each dependent measure as the corresponding analyses of variance. Therefore, only the latter are reported. Emotional Arousal The group exposed to the high-fear film reported stronger feelings of fear than the group shown the low-fear film, ^s = 6.11 and 4.65, respectively; F(l, 152) = 23.70, p < .001. There was no main effect associated with the drug variable (F < 1), and, contrary to the prediction based upon Schachter's theory, there was no Film X Drug interaction (F < 1). (Since the reassurance manipulation was introduced after the Mood Adjective Check List, it did not enter into this analysis.) A ttitudes Compared to the low-fear film, the highfear film strengthened smokers' beliefs that smoking causes lung cancer, ^s = 7.79 and 8.26; 77(1,152) =4.25, p < .05, and increased intentions to stop smoking, Xs = 7.21 and 7.85; 77(1, 152) = 7.05, p < .01. There was a nonsignificant tendency for the reassurance manipulation to strengthen intentions to stop smoking, 77=2.28, p < .15. Finally, there were no differences in recall of the film content associated with the experimental treatments. Reported Smoking Behavior The three follow-up questionnaires were returned by 91%, 78%, and 49% of the subjects, respectively; there was no differential dropout rate among the experimental groups. Analyzing the smoking data as a repeatedmeasures factor disclosed a significant Reassurance X Follow-Up Stages interaction effect, F(3,325) = 3.39, p < .02. Although the two treatment groups reported virtually identical levels of pretest consumption, at each of the three posttest periods those in the reassurance condition were smoking less than those
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not given the reassuring message. Since it would be hazardous to interpret an effect when more than 50% of the subjects have dropped out, separate analyses of variance were performed for the 1-week and 1-month follow-up stages. These analyses revealed that the group given reassurance was smoking less than the no-reassurance group 1 week after the experiment, Zs — 14.2 and 20.6, respectively; F( 1,140) =8.74, #
