COMMUNICATING THE RISKS AND BENEFITS OF PRESCRIPTION OPIOID USE: SELF-CATEGORIZATION AS AN INTRINSIC MESSAGE FEATURE THAT INFLUENCES CONSTRUAL LEVEL

Abstract

The opioid crisis presents a challenge for risk communicators because the judicious short-term use of prescription opioids for noncancer pain may benefit quality of life but also poses risks such as the development of opioid use disorder, thus prompting calls for messaging to reduce the demand for prescription opioids. Communicating the possibility for benefits of short-term prescription opioid use and the risks is therefore ethically required, but message characteristics that simultaneously reduce the demand for opioids while offering complete information about its benefits would be most useful and ethical. Construal level theory posits that altering the level of abstraction of one’s mental representation of a choice meaningfully affects one’s cognitions and behaviors regarding said choice. However, in this theoretical framework changing the mental representation of a choice is usually achieved by methods unsuitable for public health messages that are communicated to a large audience (e.g., priming or changing the characteristics of a choice to be more psychologically distant) or interpersonally. Recognizing the limitations of these approaches, I suggest that self-categorization with its focus on self-construals at increasingly abstract levels may act as a potential intrinsic message feature that can affect construal level without altering the characteristics of the choice being evaluated. A thought-listing pilot study demonstrated that self-categorizing at the relational (i.e., significant other) versus subordinate level (i.e., individual) affects the type of salient behavioral beliefs. Study 1 experimentally demonstrated that altering self-categorization changes the extent to which participants focus on the pros of prescription opioid use (high construal level beliefs) but not their focus on the cons of use or psychological distance. However, psychological distance, pro focus, and con focus all predicted intent to use prescription opioids. Study 2 experimentally demonstrated that altering self-categorization in a message about pros and cons of using prescription opioids significantly indirectly predicted attitudes, subjective norm, and perceived behavioral control over prescription opioid use mediated by identity salience. Attitudes, subjective norm, and perceived behavioral control in turn predicted behavioral intent to use prescription opioids. This dissertation integrates construal level theory and self-categorization theory to provide an intrinsic message feature that alters behavioral intention to use prescription opioids.