ESSAYS ON STIGMA AND MORALITY IN HEALTH PERSUASION

Abstract

As my doctoral dissertation, I report theoretical development and hypotheses testing in two essays that delve into the psychology of stigma in health messaging and consumption. Across two essays, I examine the nature of stigma and its implications to aspects of self, and I present strategies to enhance the effectiveness of health messaging despite the stigma. In essay 1, titled “Tainted by Stigma: Interplay of Stigma and Morality in Health Persuasion”, I posit that health behaviors (e.g., getting a vaccination, screening for cervical cancer) can become tainted by the stigma associated with health risk factors (e.g., having multiple sexual partners, being overweight) and this undermines the effectiveness of messages aimed at promoting the health behaviors. Specifically, I show that associations with stigma threaten the moral self, and therefore, the presence of stigmatized risk factor in a health message undermines health persuasion for consumers with high (vs. low) moral identity. Five studies demonstrate that when a risk factor in a health message is (not) loaded with stigma, consumers with a high (low) moral identity are defensive about their susceptibility to the health issue. This, in turn, undermines the effectiveness of health messages and reduces participants’ likelihood of engaging in health behaviors. Increasing the salience of an innocuous risk factor and self-affirmation mitigate the effect of stigma and improve health outcomes. These findings highlight the importance of considering stigma in health messages, even when the health issue is not stigmatized, and how moral identity can have downstream consequences in the health domain. In essay 2, titled “Accentuating Stigma: Leveraging Variations in Moral Beliefs to Enhance Mental Health Persuasion”, I demonstrate that accentuating some dimensions of mental health stigma, rather than not addressing the stigma at all enhances the moral acceptability of seeking help and the effectiveness of mental health messaging. Based on past clinical research, I delineate two dimensions of mental health stigma: perceptions about individuals affected with mental health issues as ‘not normal’ (norm-deviating) and as likely to hurt others (harm-causing). Across four experiments, I show that accentuating norm-deviating (vs. harm-causing vs. no stigma) aspects of mental health stigma might enhance the persuasiveness of mental health appeals and that this effect is moderated by whether individuals hold rights- or duty-based moral beliefs. When the norm-deviating (vs. control vs. harm-causing) aspect of stigma about mental health issues is made salient, individuals with rights (vs. duty)-based moral beliefs are not deterred by the stigma to seek healthcare, because according to their beliefs, being different from the norm is not a moral violation. However, when the harm-causing (vs. control vs. norm-deviating) aspect of stigma is made salient, individuals holding both rights-based and duty-based beliefs are less likely to seek help because causing harm to others is a moral violation according to both belief systems. These findings present a moral conceptualization of mental health stigma and suggest that explicitly addressing stigma in messages might have a positive impact on consumers’ likelihood of seeking healthcare.