When dealing with a health threat, health information seeking [HIS] is a prominent way of engagement coping. Yet, there is only limited research as to its motivational and emotion regulatory antecedents. We present a theoretical model integrating approach and avoidance motivation, emotion regulation, HIS self-efficacy, and problem and emotion coping focus as predictors of HIS. We propose that, in the context of HIS, [1] approach and avoidance motivation have a direct effect on emotion regulation ability [positive and negative, respectively], [2] approach and avoidance motivation have indirect effects on intended comprehensiveness of search via emotion regulation, HIS self-efficacy and problem coping focus, [3] avoidance motivation has a direct effect on emotion coping focus. Our model was tested by means of structural equation modeling in a sample of university students [N = 283]. Model fit was good, and all three hypotheses were supported. We show that emotion regulation ability is essential to explain the effects of approach and avoidance motivation on HIS as it fosters self-efficacy and a problem coping focus. The direct effect of avoidance motivation on emotion focus may represent an alternative way of coping with a health threat for those individuals who are highly sensitive to threat-related emotions.
Experiencing a health threat challenges individuals in two ways. Not only do they have to cope with the health problem itself. They are also required to deal with aversive emotions like anxiety and worry. These essential processes in dealing with threatening situations have been referred to as emotion and problem focused coping [e.g., Lazarus 2006]. With regard to these two basic ways of coping, other authors have further distinguished between engagement coping and disengagement coping [Carver and Connor-Smith 2010]. Disengagement coping encompasses a diverse set of strategies to deal with a threat and with resulting aversive emotions by avoiding and denying the threat as a whole [e.g., Derakshan et al. 2007]. Engagement coping, in contrast, is characterized by actively facing up to the threat or the threat-related aversive emotions. When facing a health threat, a prominent engagement coping strategy which can be pursued with a problem or emotion focus, is health information seeking [Shiloh and Orgler-Shoob 2006]. We define health information seeking [HIS] as actively and deliberately searching and retrieving health related information, e.g. about prevention, symptoms and diseases using any kind of information channels. Hence, not only searching the internet for information about recently occurred symptoms, but also visiting the family doctor for a check-up or asking friends and colleagues are possible ways of HIS.
Helping individuals to adequately cope with a [health] threatening situation via information seeking by considering their needs and preferences requires research focusing on motivational and affective dispositions which impact coping behavior [Lazarus 2006]. Past research has identified motivational and affective dispositions as most pertinent in explaining interindividual differences in HIS [Gerend and Shepherd 2007; Hastall and Wagner 2017; Hevey and Dolan 2014; Van't Riet and Ruiter 2013]. For example, in an experimental study, Hastall and Wagner [2017] found that low-anxious individuals who were highly avoidance-motivated selected more loss-framed [compared to gain-framed] health information articles for reading. Furthermore, in a comprehensive literature review, van't Riet and Ruiter [2013] point out that differing levels of emotion regulation ability affect the exposure to health-promoting information. In the present study, we strive for a better understanding of how these dispositions impact HIS via simultaneously identifying relevant mediators and unique modes of effects. This is, on the one hand, fruitful for future research on the relationship between personality and health information behavior. On the other hand, scrutinizing the impact of these dispositions on HIS provides clinical practitioners with professionally relevant insights concerning interindividually differing information needs of their patients.
In past studies, there have been valuable approaches to capture individual differences in engagement and disengagement coping styles with regard to information seeking under a [health] threat [e.g., vigilance vs. cognitive avoidance, Krohne and Hock 2011; monitoring vs. blunting, Miller 1987; sensitizing vs. repressing, Byrne 1961]. These concepts of coping styles essentially capture behavioral tendencies that are mainly attributed to dispositional preferences [Krohne and Hock 2011]. According to these and similar conceptualizations of coping styles, the dispositional preference to cope with a threat via avoiding and neglecting the threat itself, for example, would lead to behavioral avoidance and neglect of threat-relevant information [as is the case with so called “blunters” or “repressors”]. Correspondingly, the main focus of this research was to investigate individual differences in two opposing, dichotomously conceptualized coping styles: [1] in actively seeking [e.g., monitoring] or [2] in avoiding [e.g., blunting] potentially threatening information. If potentially threatening information is not avoided and thus, an active search for information is conducted, it can vary on a wide continuum with regard to its comprehensiveness. Individuals may conduct an exhaustive search, taking into account many perspectives and facets of a topic. They may also, however, conduct a rather shallow or biased search which is mainly driven by the motivation to find reassuring or confirming [rather than accurate] information [Hart et al. 2009]. Thus, research on HIS exclusively focusing on interindividual differences in choosing between all-or-none alternatives [avoiding vs. seeking] neglects possible variations in the realization of an active search. Up to now, only little is known about the personality factors that are responsible for these interindividual differences in actively seeking health information [Litman and Lunsford 2010]. Shedding light on such factors, however, is crucial for future research on interventions to help patients meet their information needs and become more responsible for their own health and wellbeing [Berkman et al. 2011]. Existing research identified motivational and affective dispositions to be particularly relevant for HIS [see above]. If we increase our knowledge with respect to the direct and mediated effects of these factors on HIS, corresponding interventions could be tailored to individuals differing in their motivational and affective dispositions. For example, individuals regularly experiencing difficulties in downregulating threat-related emotions such as anxiety may benefit from interventions that prevent them from confirming their fear through threat-directed searches [e.g., searching for “headache brain tumor” when suffering from a headache; White & Horvitz, 2009]. Furthermore, awareness in how far patients differ with regard to motivational and affective dispositions can aid clinical practitioners in following a need-sensitive and flexible approach when providing health information [see also Kiesler and Auerbach 2006].
In the present study, we aim at developing and testing a theoretical model which for the first time integrates relations between motivational and emotion regulatory processes as well as emotion and problem foci in HIS. In the model, we also consider the differential impact of emotion focused vs. problem focused HIS on the intended comprehensiveness of the search [as a proxy for actual seeking behavior]. Intended comprehensiveness is characterized by exhaustively seeking balanced information which may contradict one’s own opinion [e.g., about vaccination]. In the following section, we develop our final model [see Fig. 1] based on the existing evidence and derive specific hypotheses.
Fig. 1
Model including approach and avoidance motivation, emotion regulation, health information seeking self-efficacy and coping focus in health information seeking, and their effects on intended comprehensiveness of search. *p