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Mood’s Role in Selective Exposure to Health and Risk Information

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In today’s media-saturated environment, individuals may be exposed to hundreds of media messages on a wide variety of topics each day. It is impossible for individuals to attend to every media message, and instead, they engage in the phenomenon of selective exposure, where certain messages are chosen and attended to more often than others. Health communication professionals face challenges in creating messages that can attract the attention of targeted audiences when health messages compete with more entertaining programming. In fact, one of the greatest obstacles for health campaigns is a lack of adequate exposure among targeted recipients. Individuals may avoid health messages completely or counterargue against persuasive attempts to change their health-related attitudes and behaviors. Once individuals have been exposed to a health message, their current mood plays an important role in the processing of health information and decision making. Early research indicated that a positive mood might actually be detrimental to information processing because individuals are more likely to process the information heuristically. However, recent studies countered these results and suggested that individuals in positive moods are more likely to attend to self-relevant health information, with increased recall and greater intent to change their behaviors.

Since mood has the ability to influence exposure to health messages and subsequent message processing, it is important for individuals to be able to manage their mood prior to health information exposure and possibly even during exposure. One way individuals can influence their moods is through media use including TV shows, movies, and music. Mood management theory predicts that individuals choose media content to improve and maintain positive moods and examines the mood-impacting characteristics of stimuli that influence individuals’ media selections. Therefore, an individual’s mood plays an important role in selection of any type of communication (e.g., news, documentaries, comedies, video games, or sports).

How can health message designers influence individuals’ selection and attention to health messages when negative moods may be blocking overtly persuasive attempts to change behaviors and a preference for entertaining media content? The narrative persuasion research paradigm suggests that embedding health information into entertainment messages may be a more effective method to overcome resistance or counterarguing than traditional forms of health messages (e.g., advertisements or articles). It is evident that mood plays a complex role in message selection and subsequent processing. Future research is necessary to examine the nuances between mood and health information processing including how narratives may maintain positive moods through narrative selection, processing, and subsequent attitude and/or behavior change.

Keywords: selective exposure, mood, mood management theory, narrative persuasion, health, health information seeking, health information processing, health and risk message design and processing

Moods’ Importance to Health and Decision Making

Moods can be defined as an individual’s “frame of mind” (Morris, 1990) and determine our outlook on the world including ourselves and other people. Moods are different from emotions, which are associated with a specific event or object, and moods often last longer in duration. Considered to be “free-floating” or “objectless,” it is often difficult to pinpoint the source of a particular mood as we are often unaware of what is influencing our moods. For example, a bad mood may originate from a failing grade on a college exam and subsequently influence the student’s interactions with a boyfriend/girlfriend and their plans for the weekend. The negative mood may increase the likelihood for a conflict or disagreement with a significant other who wants to plan a romantic evening or attend a fraternity party. The student with the failing exam grade may want to stay home and ruminate in negative feelings instead of engaging in weekend festivities, creating conflict with a significant other. On the other hand, the student may also choose to attend a party and engage in questionable decision making such as binge drinking or drug use to eliminate the bad mood, which may also result in upsetting the significant other. As is evident in the example described above, moods have a wide range of influence on individuals’ affective, cognitive, and behavioral responses to a variety of stimuli.

Thus, moods are influential in daily life by affecting information processing, impression formation, decision making, persuasion, and ultimately, our behaviors. For example, moods have a profound influence on social judgments. People in a good mood tend to evaluate others as more attractive, to judge people as more dangerous when they are fearful, and to interpret interactions with others based on their mood (Forgas & Bower, 1987). If an individual is in a good mood when meeting someone for the first time, she will form more positive judgments regarding the individual. Therefore, moods can have a lasting impact on the impressions we form of other people. Think of the implications for individuals interviewing for a new career with an interviewer who is in a bad mood! Moods not only have an influential role in our social interactions, but they also affect how we view ourselves and make decisions regarding our own bodies.

In particular, moods play an important role in an individual’s health. The relationship between an individual’s mood and health is interrelated: physical illness impacts mood and mood also affects an individual’s self-appraisal of his/her own health. For instance, an individual in a chronically negative mood has an increased susceptibility to illness and may experience increased physical discomfort and body pains, ultimately leading to prolonged recovery times (Bruhn, Chandler, & Wolf, 1969). Thus, a negative mood can result in a reinforcing spiral where a bad mood leads to illness and illness reinforces the bad mood. Further, mood congruency evaluations occur not only in social judgments but also in individuals’ self-appraisals of their own health, where individuals in a positive mood report fewer symptoms, have lower estimates that a negative health outcome will result, and greater self-efficacy to manage their health than individuals in a negative mood. Therefore, individuals in a negative mood have a reduced drive to engage in behaviors to improve health, reinforcing the reciprocal relationship between bad mood and poor health.

As we have already alluded to a bit in this chapter, mood plays a significant role in health-related decision making. Individuals in a negative mood are more likely to see risky, unhealthy behaviors as less dangerous than individuals in a positive mood (Abele & Hermer, 1993). Think back to our college student at the beginning of the chapter who failed an exam. This individual is more likely to engage in destructive behaviors (e.g., binge drinking or recreational drug use) to improve his or her mood following the bad news regarding the exam. Obviously, these destructive behaviors have the ability to significantly impair the college student’s decision-making ability, and he or she may be more likely to drive while under the influence or practice unsafe sexual behaviors. Further, individuals in negative moods are less likely to engage in preventative health behaviors (e.g., maintaining a healthy diet, exercising regularly, or demonstrating health-related self-efficacy in general).

For the most part, scholarly research has investigated the role of negative mood in health-related decision making. For example, in one study, participants diagnosed with the common cold or flu who were induced into negative moods reported lower self-efficacy toward health-promoting behaviors or illness-alleviating behaviors than participants induced into happy or neutral moods (Salovey & Birnbaum, 1989). Further, ill participants in negative moods reported negative outcome expectations, or were less likely to believe that health-promoting behaviors would be effective in making them feel better. Individuals in negative moods are actually more likely to seek medical care for symptoms, but unfortunately, they are also less likely to comply with recommended treatments for illnesses. Mood also affects risk perceptions, where individuals in negative moods report greater vulnerability to serious health issues (e.g., cancer) than participants in positive moods (Waters, 2008).

Relevant to health decision making, studies have investigated the role of mood in information processing and demonstrated that positive moods may actually be a hindrance to decision making in general. Positive moods increase the likelihood for peripheral processing (i.e., reliance on simple inferences or heuristics) whereas negative or neutral moods increase systematic processing (i.e., careful consideration of quality of arguments). Positive moods cause individuals to ignore information that may spoil their moods and cause them to pursue more hedonically pleasing information (Wegener & Petty, 1994). Individuals may then process negative information (e.g., a threatening health message) more heuristically and process pleasant messages systematically. For example, an individual in a positive mood may gloss over important, relevant health information in a threatening message so as to not dampen a positive mood. As a result, the message may not have the intended effect of changing healthy attitudes or behaviors. Further, individuals in positive moods are less likely to be able to differentiate between strong and weak arguments and experienced reduced elaboration in recalling information after exposure to a message (Petty & Cacioppo, 1981).

Research has also demonstrated that individuals in positive and negative moods utilize different types of schemes for organizing information. Individuals in positive moods tend to utilize general knowledge structures such as scripts, whereas individuals in negative moods tend to rely on a problem-solving approach. In one study, when individuals had a time limit for exposure to a message, those induced into positive moods engaged in more peripheral processing than individuals in a neutral mood (Mackie & Worth, 1989). Results from this study demonstrated that individuals in a positive mood did not process information as well as individuals in a neutral mood when given the same amount of time. However, when individuals had an unlimited amount of time with the message, mood state did not have a significant influence on processing type and those in a positive mood utilized systematic processing.

For the most part, early psychology research focused on the detrimental influence of positive moods on decision-making. More recently, however, researchers have examined if positive moods actually can have beneficial impacts on decision-making, specifically in the realm of health. It appears that the effects of moods on decision-making are actually more nuanced and depend on multiple factors including context and self-relevant information. In fact, positive moods can promote systematic processing of negative information when that information is relevant to the self. For instance, one study induced participants into positive and negative moods and asked them to read a message about the risks involved in caffeine consumption (Raghunathan & Trope, 2002). High caffeine consuming participants in positive moods recalled more negative information about caffeine than participants who consumed less caffeine. Further, this study demonstrated that positive moods increased high caffeine consumers’ negative attitudes toward caffeine and intentions to consume less caffeine more than low caffeine consumers.

In another study, participants’ risk in developing repetitive strain injury (RSI; high vs. low) was manipulated, and then participants were exposed to a threatening health message about RSI (Das & Fennis, 2008). Only participants induced into a positive mood with a high risk in developing RSI processed the self-relevant information systematically and distinguished between strong and weak arguments. Further, a second study also demonstrated that smokers in a positive mood responded to self-threatening words more quickly than smokers in a neutral mood. Thus, results from both studies indicate that positive moods actually increase attention to and systematic processing of self-relevant threatening health information.

The research previously reviewed in this section utilized forced-exposure experiments where participants had no choice as to which health messages they viewed. In the real world, individuals select the health or media messages they attend to, but fewer studies have investigated if mood influences selective exposure to health information. For instance, one survey examined personal characteristics between online and offline health information seekers (Cotton & Gupta, 2004). Results indicated that happier individuals were more likely to seek health information online. Another study tracked breast cancer patients’ online information seeking for four months and demonstrated that cancer patients in positive moods sought cancer-related information online only when they thought they did not have adequate social support (Kim et al., 2013). Specifically, these women searched for information in a narrative format concerning interpersonal and psychosocial information related to cancer. On the other hand, women in positive moods with adequate social support were less likely to seek health information online.

Since mood has the ability to influence exposure to health information, information processing, and overall health and well-being, it is important for individuals to be able to manage their mood prior to health information exposure and possibly even during exposure. There are many mood-managing techniques available to individuals, although some of them are not healthy ways to cope (e.g., alcohol use, compulsive eating, or cigarette use). A healthier, more constructive way individuals can influence their moods is through media use including TV shows, movies, and music (Westermann, Spies, Stahl, & Hesse, 1996). In fact, the narrative persuasion research paradigm suggests that embedding health messages into entertainment messages may be a more effective method to overcome resistance or counterarguing than traditional forms of health messages (e.g., advertisements or articles). The next section will examine mood management theory to demonstrate how mood influences media choices.

Mood Management Theory and Selective Media Exposure

Originally labeled the theory of affect-dependent stimulus arrangement, the theory gained more prominence as mood management theory (MMT; Zillmann, 1988). In essence, MMT predicts that individuals choose media content to improve and maintain positive moods. MMT comprises three important theoretical components (i.e., arousal level, hedonic valence of mood, and semantic affinity), which will be examined more in depth in the following. This section will link mood and exposure to health messages as MMT applies to the selection of any type of communication (e.g., news, documentaries, comedies, video games, or sports).

First, individuals seek to manage their levels of arousal—specifically they want to avoid unpleasant levels of arousal (e.g., boredom or stress). Boredom and stress represent unpleasant degrees of arousal where boredom is too low and stress is too high. Through selection of media content, individuals can regulate their arousal levels. For instance, after a stressful day at work, an individual may select a relaxing TV show to watch in the evening (e.g., a home improvement show on HGTV or a cooking show on the Food Network) to reduce arousal levels. Further, this individual may ignore any type of programming that would maintain or increase stress levels such as watching the evening news where the focus is often on violent or negative stories. They may also avoid potentially threatening self-relevant health messages as these will likely aggravate or enhance a stressed mood rather than providing the much sought after relief. On the other hand, a bored individual may play a violent video game or watch an action movie in order to increase arousal to the desired level. Perhaps, a bored individual is more willing to attend to a health message, especially if it is embedded into an entertainment message, but research has not yet investigated this prediction. However, the personality trait of sensation seeking may moderate attention paid to health campaigns with high sensation seekers paying attention to health messages if they are embedded in high sensation-value programming (see Donohew, Palmgreen, & Pugzles Lorch, 1994).

Second, regarding hedonic valence of mood, the goal is to select media content that will produce a positively valenced mood—thus, individuals will likely select a comedy or film with a happy ending to achieve the desired results. Cheerful, positive media messages will be sought out to improve mood., A college student may listen to pop songs such as “Can’t Stop the Feeling!” by Justin Timberlake or “Confident” by Demi Lovato after a stressful day of studying to improve her mood. However, individuals do select tragedy movies or sad music and engage with negative news stories on a daily basis. Thus, MMT’s predictions will not apply in all circumstances, and the theory has faced criticisms, which will be discussed in more detail below. Individuals may select these genres for “truth-seeking” or personal growth especially if the topic is self-relevant (Oliver & Raney, 2011). Further, a message’s information utility for an individual may cause him or her to seek out a message dissonant with one’s mood for survival or adaptation purposes, and this could be an explanation for why individuals attend to health messages in negative or stressed moods.

Third, with respect to semantic affinity in MMT, any media selections that may remind the individual of the source of a negative mood (e.g., a failed exam or break-up with a significant other) will be avoided as this media will likely prolong the negative mood state. Therefore, our college student who failed an exam will likely avoid movies featuring college students such as National Lampoon’s Animal House directed by John Landis or Old School directed by Todd Phillips. Further, if a woman who was recently diagnosed with breast cancer is in a bad mood, she may choose a light-hearted romance comedy instead of Stepmom, directed by Chris Columbus, featuring a mother who receives a terminal cancer diagnosis. The negative mood may also cause her to be less likely to seek out online information regarding cancer because recent research has demonstrated that negative feelings can consume cancer patient’s time. Thus, mood management through selective media exposure may aid in lifting cancer patients’ spirits so that they have the ability to seek out and process relevant health information.

Zillmann (2000, p. 104) best summarizes the three basic hypotheses of mood management theory:

The indicated hedonistic objective is best served by selective exposure to material that (a) is excitationally opposite to prevailing states associated with noxiously experienced hypo- or hyperarousal, (b) has positive hedonistic value above that of prevailing states, and (c) in hedonically negative states, has little or no semantic affinity with the prevailing states.

Mood-Impacting Characteristics of Media Stimuli

These hypotheses highlight four dimensions of media stimuli that influence an individual’s selection and can be particularly relevant for creating (narrative) health messages: excitatory potential, absorption potential, semantic affinity, and hedonic valence. The four characteristics of media may be sought out or avoided depending on how they influence one’s mood.

The first mood-impacting media message attribute is excitatory potential and involves how the media influence an individual’s arousal levels. Fast-paced music (e.g., rap or hip hop), action or horror films, and violent video games are more likely to increase arousal than more slow-paced media including country music, romance movies, or home and gardening TV shows. Media format can also induce arousal where fast cuts in audio-visual media will increase arousal, and videos with only a few cuts and smooth transitions will produce more normal levels of arousal. For instance, placing healthy behaviors into an entertaining, interactive video game may be an effective way to target children and teenagers (Lieberman, 1997) through increased attention due to arousal created by the video games that a written health message in a magazine could not provide. Similarly, embedding health information into a medical drama may produce optimal arousal levels necessary for processing the healthy facts.

The second message attribute per MMT is absorption potential. A current mood state is sustained based on rumination of negative or positive thoughts. According to MMT, media selection will interfere with an individual’s current mood. Absorption potential refers to the ability of the media message to interrupt the individual’s rumination of negative thoughts sustaining her current bad mood, thus producing a more positive mood. The higher the absorption potential for media content, the more quickly and effectively the media will change an individual’s mood. Further, based on narrative persuasion literature, the more individuals are absorbed into a message, the less likely they will counterargue or resist a health message placed into the storyline (Moyer-Gusé, 2008). Thus, absorption potential highlights an important connection between mood management and embedding health information into entertainment messages. High absorption potential allows for quicker mood improvement and reduced defenses against persuasive health messages, providing an avenue for future research.

With respect to absorption potential, in a negative mood, an individual may prefer a murder mystery on the Investigation Discovery Channel because involvement in the complex plot disrupts rumination of negative thoughts, allowing for improvement in mood. Individuals in a positive mood may seek less absorbing messages to maintain their currently positive mood as was demonstrated in decision making literature where positive moods cause individuals to ignore information that may spoil their moods and pursue more hedonically pleasing information. More research is necessary, however, to investigate how mood influences selection and processing of health messages including entertainment education messages. Perhaps individuals in a positive mood prefer health information embedded into narratives or TV programming since the entertainment content will bolster positive moods that the threatening health information may influence.

The third dimension is the semantic affinity between the preexisting mood state and media message. If affinity between the mood state and media content is high, an individual will avoid the media content because it will not produce any mood change. In fact, high semantic affinity between the mood state and media message is likely to contribute to rumination of negative thoughts that will prolong a bad mood. For example, an individual who has just lost a parent will likely avoid a movie such as The Last Song, featuring Miley Cyrus (directed by Julie Anne Robinson), where the main character loses her father to a terminal illness. The high semantic affinity between an individual’s current mood and The Last Song may cause the individual to ruminate in sad thoughts instead of mood improvement. This may also cause an individual to be reluctant to interact with health information with high semantic affinity to his current mood, which is a possible reason why cancer patients in negative moods may avoid seeking potentially stressful, worrisome cancer-related health information online as demonstrated in Kim et al.’s (2013) study. However, high affinity might be desirable if an individual is in a good mood in order to maintain positive feelings.

Finally, the hedonic valence of a media message refers to mood impacts resulting from selective media exposure. In essence, positive media content should subsequently produce happy feelings in an individual, whereas sad content should dampen one’s spirits. However, individuals may interpret the same media messages differently where one may view a message as positive, but another individual may interpret a message negatively (Zillmann & Knobloch, 2001). Thus, what may be enjoyable for one individual is not necessarily enjoyable for another. For example, movies featuring non-traditional female heroines may not be appealing to individuals who hold traditional views on gender roles, but it may be very desirable for individuals with more progressive attitudes.

Finally, MMT posits that individuals may not be aware that they are engaging in mood management techniques. In Zillmann and Bryant’s (1985) early work regarding the theory of affect-dependent stimulus arrangement, operant conditioning is posited as the manner in which individuals create mood management processes that are stored for later retrieval and usage. When mood improvement occurs via media selection, the mood-enhancing experience is stored in one’s memory. Thus, when an individual finds herself in the same mood with similar media options to select from, she will likely unconsciously choose the media selection that improved a prior negative mood.

On the other hand, an individual may intentionally choose media content to influence her mood. Sometimes, we are aware of the cause of a bad mood and consciously select a romantic comedy to unwind. If we consciously select a media option for mood management, the same mood management processes still occur (Knobloch, 2003), but the mechanisms of mood management will require different conceptualizations. The uncertainty in conscious awareness of mood management highlights the necessity for methodological designs to test MMT’s predictions. If the mood management processes do occur without conscious awareness, unobtrusive measures of mood management are necessary (e.g., tracking individual’s selection of media content or health messages) and highlight the importance of selective exposure designs. Thus, self-reports in surveys may not be a reliable tool for measuring mood management techniques utilized by individuals. At any rate, whether mood management occurs consciously or unconsciously, research has consistently supported MMT’s predictions. In the next section, we will review how individuals can utilize media content to alleviate noxious moods including boredom, stress, and anger.

Seeking Positive Moods Through Media Selection

Ruminating in a negative mood is detrimental to individuals’ health and well-being, resulting in increased psychological distress and unhappiness (Brown & Mankowski, 1993). Maintaining a positive mood is critical since it is associated with greater life satisfaction in a variety of domains. Mood management through media choices is one way individuals can improve and maintain good moods, which can lead to positive impacts in areas of individuals’ lives, especially with respect to health information seeking and processing. For the most part, mood management research has only focused on the improvement of moods and not how moods regulate exposure to or processing of health information. Further, studies have explored factors that contribute to individuals’ health-information seeking including message design (e.g., source credibility or message type), sociodemographic factors, and emotions (e.g., more short-term affective feelings), but they have not examined mood’s role in health information selection or processing. Therefore, this section will review relevant MMT research and how individuals have utilized media content to make them feel better. We will begin by reviewing research on negative moods in general, then explore specific moods of stress and anger, respectively.

For instance, an early MMT study investigated women’s media preferences at different points in their menstrual cycles since premenstrual syndrome is often associated with lasting negative moods (Meadowcroft & Zillmann, 1987). In a survey, undergraduate women were given a list of popular primetime TV shows, including comedies, dramas, and game shows, and were asked to develop a list of TV shows they would be interested in watching that night. Since women in their premenstrual and menstrual phases of the cycle feel the most depressed, it was expected that these women would need the most mood management via media selection. In fact, women in the premenstrual and menstrual phases of their cycles reported a greater preference for comedies (i.e., uplifting entertainment) than women who were in the middle of their menstrual cycle. This study demonstrates that women attempt to improve their negative moods, brought on by different phases in the menstrual cycle, through preferring comedies, thus providing one way in which media can be used to improved one’s overall current health status.

Another study induced participants into bad, neutral, or positive moods and allowed them to select from several TV programs including an action drama, game show, or sitcom (Zillmann, Hezel, & Medoff, 1980). Participants’ moods influenced their media selection, but MMT’s predictions regarding hedonic valence were not supported. Participants in a bad mood chose comedies least frequently, but the authors interpreted this finding based on excitatory potential and absorption potential of the programs offered. Further, the semantic affinity in the comedies may have aligned with the participants’ negative mood because humor in comedies often involves making fun of another individual and hostile actions. Thus, participants in a bad mood may see the disparaging comedies as high in semantic affinity to what caused their own negative moods. Results from this study demonstrated that the mood-impacting characteristics of media stimuli may present confounds for testing the predictions of MMT.

MMT’s predictions regarding hedonic valence of media content have also been examined using Internet news websites. Participants in one study were induced into positive, mediocre, or negative moods and then were allowed to browse the Internet (Knobloch, 2002). Results indicated that participants in a negative mood spent more time on positive web pages than participants in a mediocre mood. Further, participants in a good mood spent an equal amount of time with both positive and negative content; a result that does not coincide with MMT’s predictions regarding hedonic valence of media. Perhaps hedonic valence of media content is too intertwined with other mood-impacting characteristics, and thus, may not be the most important feature when individuals are in positive moods. When in a positive mood, an individual may not have the ability to select material that is better than her current mood. Thus, she may make media selections based on the other mood-impacting characteristics.

The hedonic valence of media stimuli has also been investigated with music as medium. Friedman, Gordis, and Förster (2012) induced participants into sad or neutral moods with corresponding film excerpts. After mood induction, participants were asked to list three songs they felt liking listening to and to indicate if those songs would be categorized as happy or sad. Participants also indicated if the songs they selected would allow them to think about the film excerpt they had previously watched. Results indicated that participants in a sad mood selected more sad songs than participants in a neutral mood. Participants who selected sad songs reported that they would like to think about the film that had put them in a sad mood. These results do not support MMT’s predictions regarding hedonic valence of media, but they lend support to the idea that individuals may seek the meaning of life when selecting tragedies or other sad media content. In the second study conducted by these authors, participants first listed their three favorite happy and three favorite sad songs. Then, they were induced into a sad mood and asked to select the music they would prefer to listen to right now. Sad participants avoided happy songs, but they also did not prefer to listen to sad songs. Thus, these results indicated that participants may be more likely to avoid happy songs than listen to sad music. Perhaps, individuals do not feel it is appropriate to listen to happy music after viewing sad stimuli. However, if mood management occurs without conscious awareness, these studies would not be able to test MMT’s predictions.

Stress negatively affects an individual’s health and well-being (Cooper, 2009), but media use is one way to overcome these bad feelings. Experimental methods have been utilized to examine mood’s influence on selection of media content when individuals are induced into stressed moods. For instance, one study induced either boredom or stress by having participants complete a tedious task or a difficult exam under a short time limit (Bryant & Zillmann, 1984). Then, individuals were led into a waiting room where they could select from a TV that was programmed to play three exciting or three relaxing programs. Participants’ program selections were recorded, and results indicated that stressed participants watched similar amounts of exciting and relaxing programming, but bored participants watched almost all exciting TV content and very little relaxing content. Results from this study support MMT’s prediction that individuals strive to maintain desired, comfortable levels of arousal through media use.

Individuals can also use other forms of media including the Internet or video games to regulate arousal levels. One study replicated Bryant and Zillmann’s (1984) study with the Internet to examine if MMT’s predictions were supported (Mastro, Easton, & Tamborini, 2002). Once again, participants were induced into bored or stressful moods utilizing the same tasks from the 1984 study. After mood induction, participants were allowed to browse the Internet while waiting for the next task in the study. Their web browsing activity was tracked, and some of MMT’s predictions held up. Bored participants viewed significantly more sites than stressed participants. Therefore, bored participants viewed more sites to increase arousal levels and stressed participants viewed fewer sites. The arousal hypothesis was the only MMT hypothesis supported in the study. The semantic affinity hypothesis was not supported because stressed participants did not choose more soothing websites than bored participants.

MMT’s predictions have also been examined with video games. Since video games have a higher absorption potential than other forms of media, it was expected that video games would have a greater ability to influence moods in a very quick manner. Once again, participants in this study were induced into stressed or bored moods, and then they were allowed to choose a video game to play (Bowman & Tamborini, 2015). The video games were pre-tested and categorized into levels of demand: low, medium, or high. Participants in both bored and stressed moods avoided video games with a low level of demand (i.e., boring video games). Stressed participants chose video games with medium levels of demand more than bored participants. Further, both bored and stressed participants chose the video games with the highest level of demand. Based on the results of this study, the authors concluded that mood repair was occurring, or a shift from a bad mood to a positive mood, when stressed participants chose the video games with medium levels of demand and the bored individuals chose the video games with a high level of demand.

MMT research has also investigated media’s ability to improve angry moods. Anger negatively affects health, leading to increased susceptibility to illness, increased pain, and greater risk for heart disease (Mahon, Yarcheski, & Yarcheski, 2000). One MMT study investigated negative moods more in depth by examining provocation and frustration (Medoff, 1982). Participants were induced into these respective moods and were given the option to select from hostile and non-hostile comedy along with other media content. Women were more likely to select positively valenced comedies with no hostility, but only men induced into neutral moods selected non-hostile comedy. Thus, women’s selections fell in line with MMT predictions but men’s selections did not. Men induced into a frustrated mood spent the most time viewing hostile comedy and provoked men did not choose any type of comedy. The results from this study indicate that men and women demonstrated different mood management processes. For the most part, mood management research has only investigated how mood influences media selection.

It is evident that the theoretical assumptions of MMT have received broad support in the literature, but one challenge to the theory is that it does not address why individuals seek sad media content (Knobloch, 2003). MMT originally considered a hedonic approach to media message selection where individuals seek to avoid discomfort associated with negative moods and prefer pleasure brought on by a positive mood, and Zillmann (2000) addressed this criticism by expanding the time frame for achieving the desired positive mood. Moreover, Knobloch (2003) suggested a mood adjustment approach where individuals seek a specific mood state for certain tasks. For example, college students who are studying for an exam would select soothing music instead of energetic, fast-paced music, which could be too distracting. However, a full investigation of the critiques of MMT and basics of mood adjustment theory are beyond the scope of this chapter (see Knobloch, 2003, for an overview). Further, the research summarized in the next section suggests that positive moods may be optimal in the selection and processing of health information.

Selective Exposure to Health Information and Positive Moods

This section will highlight why positive moods produced through mood management may be especially important for the selection of and processing of health information. Empirical research has not yet investigated how moods influence overall health and exposure to health information, but studies have examined the role of more fleeting emotions. Positive emotions are associated with a reduced likelihood of having or developing diseases such as hypertension and diabetes (Smart Richman et al., 2005). Studies have also examined how emotions affect exposure to health information. In general, positive emotions promote health information seeking, whereas negative emotions evoke both approach and avoidance mechanisms. Positive emotions are also associated with increased attention, information processing, and action (Fredrickson, 1998). For instance, anger, anxiety, and guilt promote information seeking, but fear and sadness may cause individuals to avoid health information altogether (Lee, Hwang, Hawkins, & Pingree, 2008). Further, anxiety promotes information seeking, but it also reduces information retention (Turner, Rimal, Morrison, & Kim, 2006). Since emotions are considered more fleeting and shorter in duration than moods, it is important to consider how positive moods influence individuals’ exposure to health information and subsequent processing of that information.

Since positive moods are known to enhance individuals’ health-related self-efficacy and increase their attention to self-relevant, threatening health information, promotion of positive moods is essential. It is expected that positive moods will influence health information seeking and processing in a similar manner to positive emotions but with longer enduring effects. Thus, a positive mood produced through an individual’s media selection should make her more accepting of health information and increase her likelihood of retaining that information. Perhaps this is why narrative persuasion has been such an effective tool in promoting healthy attitudes and behaviors. The entertaining content of the message positively influences an individual’s mood while the high absorption potential of the content reduces counterarguing and resistance to the embedded healthy message. In fact, Green, Brock, and Kaufman (2004) predict that narrative persuasion occurs via positive moods produced from transportation (i.e., absorption) into a story. One study demonstrated that heightened positive emotions mediated the relationship between transportation and the greatest change in knowledge, attitudes, and behavior in the desired direction (Murphy, Frank, Moran, & Patnoe-Woodley, 2011). It is likely that positive moods would act in a similar manner.

Health narratives have been effective at influencing individuals’ intentions to be screened for breast cancer (Hether, Huang, Beck, Murphy, & Valente, 2008), sexual health self-efficacy (Moyer-Gusé, Chung, & Jain, 2012), dieting behaviors (Lee & Shapiro, 2015), and sleep hygiene self-efficacy (Robinson & Knobloch-Westerwick, 2017), to name a few. Further, studies have also demonstrated that narratives are more effective at impacting health knowledge and behaviors compared to non-narrative (e.g., statistical or base-rate) messages. Recently, narrative persuasion researchers have highlighted the importance of emotions in narrative messages. For instance, Nabi and Green (2014) use the term “emotional shift” to explain how emotional changes in the narrative influence attitude and belief change. The emotional shifts throughout a story (e.g., changes from happiness to sadness and then relief and enjoyment) enhance individuals’ absorption into the story and subsequent attitude and/or behavior change. Thus, it is necessary to measure emotional changes throughout a narrative to understand its persuasive effects. In fact, the authors argue that the experience of emotional shifts may even influence exposure to certain types of narratives for mood regulation purposes.

Suspense is used as an example where individuals experience many different emotions throughout the story including happiness, fear, and finally, relief if the main character experiences a happy ending. Narrative persuasion researchers must investigate how these emotional shifts influence any attitude or behavior change and subsequently create effective health messages. Thus, health messages can be constructed to “maximize success by presenting information within carefully ordered, emotionally evocative sequences” (Nabi, 2015, p. 120). The resulting moods produced by these narrative messages and attitude and/or behavior change must also be empirically examined.

Discussion of the Literature

Mood management research has mostly focused on individuals’ media preferences based on their current moods. Frequently, studies induce positive, neutral, and negative moods and measure individuals’ subsequent media selections. The influence of mood on individuals’ selective exposure to health information remains an untapped area of research. A future selective exposure study could manipulate individuals’ moods (e.g., induce positive, neutral, and negative moods) and then allow them to browse a variety of articles on a news webpage. Health articles on topics such as diet, exercise, or sleep hygiene, could be interspersed with articles covering entertainment, politics, and sports. Software could then unobtrusively track individuals’ article selections. After article selection, a survey could capture any knowledge gain or attitude change if participants selected the health articles and any differences based on type of mood. This study would indicate if individuals are more likely to select health articles in certain moods. A follow-up survey could also measure any subsequent behavior change. This type of selective exposure study could be easily adapted to specific health behaviors. For example, a sample of smokers could be selected, induced into different moods, and then be asked to browse through a variety of articles on a webpage. Smoking articles could be interspersed with other health topics or articles on entertainment or news. The study would track participants’ selection of smoking articles and any subsequent attitude and behavior change.

Future research should also investigate selective exposure to health information embedded in other media formats. For example, participants could be induced into different moods and then led to a waiting room where they will be asked to browse through some magazines until the researcher is ready to begin the second part of the study. A variety of magazines could be available for participants and health-related articles would be interspersed in the magazines. Video cameras could track how long individuals spend on pages containing health information versus those containing other content (e.g., entertainment, sports, or news). Subsequent attitude and behavior change could be measured as well. Future research needs to determine how mood affects selective exposure to health information.

If these studies demonstrate that positive moods, in fact, cause individuals to be more receptive to health information, then future avenues for narrative persuasion research are necessary. A study could induce participants into positive or negative moods and measure if a narrative with health information on a certain topic embedded improved individuals’ moods. If the narrative both improved mood and enhanced participants’ heath knowledge, then narrative persuasion may be the best avenue for making individuals more receptive to health information. Since there are a variety of genres in media entertainment (e.g., mysteries, tragedies, romances, or comedies), it is necessary to examine which genres may be best for narrative persuasion. For example, tragedies may place individuals in a sad or negative mood. A study should investigate how health information placed in a tragedy affects individuals’ subsequent knowledge, attitudes, and behaviors. If the tragedy portrays a mother dying from cancer, as in the film, Stepmom, this may be an effective route for convincing a mother to be screened for breast cancer. The mother may have an increased intention to be screened for cancer after this study, but the effect of mood from the tragedy must be investigated. Does the sad mood motivate or hinder individuals from enacting the healthy behaviors?

Perhaps mood affects individuals differently, highlighting the need for selective exposure studies. A tragedy and resulting sad mood may motivate one mother to be screened for cancer, but it may cause another mother to avoid screening to put off any bad news she might receive. A future study could provide individuals with a variety of genres (e.g., drama, action, mystery, or comedy) to choose from with the same health message embedded in all stories. Individuals would then choose a story that most interests them. Mood could be measured before and after exposure to determine how the narrative shifted an individual’s mood. Then subsequent knowledge gain, attitude, and behavior change could be measured. Mood’s effect on selective exposure to health information remains an understudied area of research in the field of communication. This section provides a starting point for researchers interested in examining mood’s effect on health information selection and processing.

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