Psychological Reactance and Persuasive Health Communication: A Review of the Literature

Abstract

Psychological reactance theory is a commonly relied upon framework for understanding audience members' resistance to persuasive health messages. This review article provides an overview of reactance research in the context of persuasive health communication. The article begins with an overview of psychological reactance theory. The major concepts of the theory are discussed, as well as recent developments by communication researchers in measuring reactance. Following this, contemporary reactance research in the context of persuasive health communication is summarized. An emphasis is placed on research examining message features associated with reactance, as well as the moderating role of trait reactance. The article concludes with a discussion of several promising directions for future research.

Predictors of Staying at Home during the COVID-19 Pandemic and Social Lockdown based on Protection Motivation Theory: A Cross-Sectional Study in Japan

“…Another example is a narrative message from a physician, stating that no treatment is available for COVID-19, that some patients rapidly develop severe symptoms, and that hospitals are overwhelmed [ 36 ]. Although social lockdown presumably evoked psychological reactance in many individuals [ 37 ], studies indicated that narrative messages obfuscate persuasive intent, subsequently reducing the psychological reactance and generating more persuasiveness than expository messages [ 38 , 39 , 40 ].…”

Choosing not to follow rules that will reduce the spread of COVID-19

“…In the context of rule-following during the COVID-19 pandemic, Reynolds-Tylus (2019) is particularly useful. Reynolds-Tylus (2019) presents features of persuasive health communications that are likely to impact reactance. Freedom-threatening language, message sensation, and other-referencing messages are of particular importance in the pandemic context.…”

“…Freedom-threatening language, message sensation, and other-referencing messages are of particular importance in the pandemic context. Regarding freedom-threatening language, while messages with the objective of enacting behavior change must be direct in advocating for specific actions, explicit messages are more likely to incite reactance due to their freedom threatening nature ( Reynolds-Tylus, 2019 ). Regarding message sensation, messages that are high in sensation value (i.e., are dramatic, exciting, and novel), are perceived as more persuasive, with high sensation and low controlling language perceived as most effective ( Xu, 2015 ).…”

<p>Self-Report for Measuring and Predicting Medication Adherence: Experts’ Experience in Predicting Adherence in Stable Psychiatric Outpatients and in Pharmacokinetics</p>

“…82 • Psychological reactance theory is a commonly used framework for understanding health-care service users' resistance to persuasive health messages such as the need for adherence to prescribed treatment. 83 • According to psychological reactance theory, freedom of behavior is an important, beneficial, and pervasive aspect of people's lives; when that freedom is threatened, they become motivated to restore it. 84,85 • The Hong Psychological Reactance Scale 86 is a 14-item self-report questionnaire developed to assess individual differences in reactance proneness, that is, individuals' trait propensity to experience psychological reactance.…”

“…Those psychiatric patients with low internal and external HLOC beliefs described greater adherence to treatment, while patients with high internal and external HLOC beliefs described lower adherence. 81 Psychological reactance is defined precisely in Box 1, [82][83][84][85][86] but a simplified version is an emotional reaction toward rules perceived as a threat; it is typically measured using the Hong Psychological Reactance Scale. 86 In psychiatric outpatients, those who are more prone to reactance tend to show decreased adherence to prescribed treatment.…”