# Presentation: 067389

## Of Health and Death: Health Behavior Implications of a Dual Defense Model of Terror Management 

**Jamie Arndt**
**University of Missouri-Columbia**

## Some background ideas:

** ****terror management theory (TMT):**
**	****awareness of mortality        potential for anxiety         managed via investment in cultural worldview and self-esteem**
** ****Recent focus on distinctions between managing conscious concerns with death (via proximal defenses) and unconscious concerns (via distal defenses)**
** ****TMT and health psych literatures have not really considered implications of deeply rooted fears about death for understanding health relevant behavior**

## HEALTH APPLICATION OF DUAL DEFENSE TERROR MANAGEMENT MODEL

**Conscious death        thought activation**

**Proximal Defenses:        *****health responses to remove death thoughts from focal attention/ reduce perceived vulnerability***

**Distal Defenses:               *****health responses influenced by motivation to maintain self-esteem and symbolic sense of self***

**Health promoting responses**

**Health risk responses**

**Non-conscious death        thought activation**

##     HEALTH  APPLICATION

- Conscious death        thought activation

- Proximal Defenses:              *health responses that minimize perceived vulnerability*

- Distal Defenses:               *health behaviors influenced    by motivation to maintain     self-esteem and symbolic sense of self*

**Death can be good for your health:                                                       Application of dual defense model to exercise intentions                         ****(Arndt, Schimel, & Goldenberg, 2003)**

**EXERCISE INTENTION APPLICATION**

- Non-conscious death        thought activation

**Conscious death        thought activation**

**Proximal Defenses:          *****increased exercise intentions (regardless of fitness relevance to self-esteem)***

## Note: High Scores indicate greater exercise intentions 

- Note: High Scores indicate greater exercise intentions

**Immediate exercise intentions as a function of mortality salience**

##     HEALTH  APPLICATION

- Conscious death        thought activation

- Proximal Defenses:              *health responses that minimize perceived vulnerability*

- Distal Defenses:               *health behaviors influenced    by motivation to maintain     self-esteem and symbolic sense of self*

**Death can be good for your health:                                                       Application of dual defense model to exercise intentions                         ****(Arndt, Schimel, & Goldenberg, 2003)**

**EXERCISE INTENTION APPLICATION**

- Non-conscious death        thought activation

- Conscious death        thought activation

- Proximal Defenses:            *increased exercise intentions (regardless of fitness relevance to self-esteem)*

**Distal Defenses:               *****increased exercise intentions when fitness is contingency of self-esteem***

**Non-conscious death        thought activation**

## Note: High Scores indicate greater exercise intentions 

- Note: High Scores indicate greater exercise intentions

**Delayed exercise intentions as a function of mortality salience and relevance of fitness to self-esteem**

## HEALTH/CANCER APPLICATION

**A time to tan:                                                                                          Application of dual defense model to safe sun behavior intentions                         ****(Routledge, Arndt, & Goldenberg, 2004)**

**SUN-TAN INTENTION APPLICATION**

- Conscious death        thought activation

- Proximal Defenses:              *health responses that minimize perceived vulnerability*

- Distal Defenses:               *health behaviors influenced    by motivation to maintain     self-esteem and symbolic sense of self*

- Non-conscious death        thought activation

**Conscious death        thought activation**

**Proximal Defenses:          *****increased interest in sun protection (products)***

## Note: High Scores indicate more interest in high SPF sunscreen

**Interest in buying high SPF sunscreen as a function of mortality salience and delay**

## HEALTH/CANCER APPLICATION

**A time to tan:                                                                                          Application of dual defense model to safe sun behavior intentions                         ****(Routledge, Arndt, & Goldenberg, 2004)**

**SUN-TAN INTENTION APPLICATION**

- Conscious death        thought activation

- Proximal Defenses:              *health responses that minimize perceived vulnerability*

- Distal Defenses:               *health behaviors influenced    by motivation to maintain     self-esteem and symbolic sense of self*

- Non-conscious death        thought activation

- Conscious death        thought activation

- Proximal Defenses:            *increased interest in sun protection (products)*

**Distal Defenses:               *****decreased interest in sun productive (products); increased interest in tanning***

**Non-conscious death        thought activation**

## Note: High Scores indicate more interest in high SPF sunscreen

**Interest in buying high SPF sunscreen as a function of mortality salience and delay**

## ADAPTIVE AND MALADATPVIE DEFENSES

**Conscious death        thought activation**

***Suppression of death-thoughts ******(Arndt et al., 1997b)***
***Denial of vulnerability to risk factors ******(Greenberg, Arndt et al., 2000)***
***Exercise intentions ******(Arndt et al. 2003)***
***Safe sun behavior ******(Routledge, Arndt, & Goldenberg., 2004)***

**Unconscious death        thought activation**

**Health Relevant Proximal Defenses **

**Health Relevant Distal Defenses **

***Exercise intentions ******(Arndt et al. 2003)***
***Risky sun behavior ******(Routledge, Arndt, & Goldenberg., 2004)***
***Risky driving behavior ******(Taubman et al., 1999)***
***Dieting and body identification ******(e.g., Goldenberg, Arndt et al., in press)***

**GUIDING QUESTION:**
**What are the personality and situational factors that promote **
**adaptive vs. maladaptive health behaviors as people try to **
**manage conscious and unconscious concerns with death?**

## Effects of salience and perceived vulnerability to cancer on suppression of death-related cognitions         		(Arndt, Cook, & Goldenberg, in prep)

**Effects of salience and perceived vulnerability to cancer on suppression of death-related cognitions****         ****	****	****(Arndt, Cook, & Goldenberg, in prep)**
** ****Study 1&3 : whereas explicit simple cancer salience induction does not increase death thought accessibility (relative to control condition), subliminal cancer primes do.**
** ****Study 2: cognitive load + explicit cancer salience does lead to increased death accessibility**
** ****Study 4: exposure to low vulnerability to cancer information leads to higher death accessibility than exposure to high vulnerability to cancer information.**

## The influence of coping strategies and health optimism on proximal health defenses             (Arndt, Routledge, & Goldenberg, in prep)

** ****Study 1: higher adaptive coping is associated with greater interest in taking active responsibility for health behavior immediately (vs. delay) after MS (vs. control topic). **
**Study 2: women higher in health optimism respond to conscious death thoughts (vs. control topic) with greater interest in FBD screening when learn may be at risk        **
** ****Study 3: middle-aged women higher in health optimism respond to conscious death thoughts (vs. control topic) by increasing intentions to conduct BSEs. **

**The influence of coping strategies and health optimism on proximal health defenses             ****(Arndt, Routledge, & Goldenberg, in prep)**

## Exploring factors that can affect the adoption of healthy vs. unhealthy distal defenses

**self-esteem contingencies (e.g., tanning, fitness)**
**2. Existential concerns with the physicality of the body...aka creatureliness**
**The body is a problem for humans because it reminds us of our sheer physicality and our similarity to other animals, which is threatening because it makes apparent our vulnerability to death**

## +

**Creatureliness and Breast Self Exams (BSEs)**
**Goldenberg, Arndt, Hart, & Turrisi (under review)**

**activation of death-related thought**

**+**

**reminder of creatureliness**

**increased existential discomfort**

**distancing from     physicality of the body**

**Reduced breast exam **
**intentions and behavior**

## Slide 17

## Study 2: Seconds Conducting Exam on Breast Model

## SUMMARY OF TMT DUAL DEFENSE MODEL OF HEALTH DECISIONS

**Conscious death        thought activation**

**Health promoting    Proximal Defenses**

**Health risk                    proximal defenses**

- Health optimism
- & adaptive coping

- High perceived
- vulnerability

**Non-conscious death        thought activation**

- Self-esteem
- contingencies

- creatureliness

**Health risk distal       defenses**

**Health promoting/risky    Distal Defenses**

##   Some contributions :

-  **provide insight into how conscious and unconscious fears about mortality motivate different classes of psychological defense in ways that connect to risk enhancing & reducing health judgments.**
** ****reveal the differential influence of factors affecting proximal health defenses (e.g., optimism) and distal health defenses (e.g., self-esteem contingencies).**
** ****consideration of creatureliness introduces novel mechanism by which existential concerns can influence health relevant domains and implicates the influence of malleable and non-conscious emotional discomfort in health behavior**
** ****Generally: suggest ways of broadening health theory to incorporate motivational sources of non-rational influence **

## The key here, I think, is not to think of death as an end, but rather, as a very effective way of cutting down on your expenses.

***The key here, I think, is not to think of death as an end, but rather, as a very effective way of cutting down on your expenses.***
***	******	******	******	******-*****Woody Allen**

## A special thanks to the contributions of:

** ****Jamie L. Goldenberg,** **Clay Routledge, Alison Cook, Cathy Cox, Jeff Schimel, Josh Hart, Rob Turrisi**
** ****National Cancer Institute (R01 CA96581)**