Everyday discrimination and cancer metaphor preferences: The mediating effects of needs for personal significance and cognitive closure

Abstract

Metaphors are often used to describe cancer experiences (e.g., battle, journey). Few studies explore how social threats (e.g., discrimination) shape metaphor preferences. We examined the relationship between discrimination and preferences for cancer battle metaphors (i.e., concrete, action-based) versus journey metaphors (i.e., open-ended, reflective) and mediating effects of needs for personal significance and cognitive closure. We also stratified the analysis when discrimination was/was not attributed to race and by racial/ethnic group. Four-hundred twenty-seven U.S. participants completed an online survey. Items included everyday discrimination, need for personal significance, need for cognitive closure, and preference for cancer scenarios using battle or journey metaphors. Multigroup structural equation modeling examined: serial mediation (i.e., discrimination predicting metaphor preference via needs for personal significance and cognitive closure) stratified by discrimination attribution; and single mediation (i.e., discrimination predicting need for cognitive closure via need for personal significance) stratified by racial/ethnic group. Discrimination was associated with battle metaphor preferences through serial mediation when discrimination was not attributed to race (β = 0.02, 95% CI [0.01,0.05]). Discrimination was directly associated with journey metaphor preferences (β = −0.20, 95% CI [-0.37,-0.06]) and the serial mediation was nonsignificant when discrimination was attributed to race. The single mediation model varied across racial/ethnic groups and was strongest for Non-Hispanic White participants (β = 0.17, 95% CI [0.07,0.30]). Discrimination may shape cancer metaphor preferences through needs for personal significance and cognitive closure, yet these relationships differ based on whether discrimination is attributed to race and racial/ethnic group. Given that the U.S. health system often focuses on battle metaphors when framing cancer treatment and screenings, individuals who prefer journey metaphors (i.e., those who experienced more frequent racial discrimination in the present study) may experience a systematic disadvantage in cancer communication. A more careful consideration of cultural, racial, and ethnic differences in metaphor use may be a crucial step towards reducing cancer disparities.

The significance quest theory and the 3N model: A systematic review.

“…This could be a temporary solution while waiting for the previously mentioned Significance Quest Scale to undergo peer scrutiny (Molinario et al, unpublished work). This scale has already been employed in a recently published paper examining the mediating role played by the quest for significance in the relationship between experiences of ethnic discrimination and preferences for cancer metaphors (battle vs. journey) (Fernandez et al, 2022).…”

Significance Quest: A Meta-Analysis on the Association Between the Variables of the 3N Model and Violent Extremism

“…Indeed, the items do not focus on an obsessive passion towards one's significance, they focus instead on an ideological obsession (Bélanger, 2021), reflecting more one's commitment to a radical ideology than one's significance quest. What is more, although a Quest for Significance Scale (Molinario et al, unpublished) does exist, it has not yet been published and therefore subjected to peers' scrutiny, and it has been used in a single unpublished study (Hasbrouck, 2020, Study 1) and in another study unrelated to violent extremism (Fernandez et al, 2022). If the scale's validation process meets the peers' approval, it could be tested (and compared against obsessive passion) in future research.…”