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Research Article

Self-affirmation alters the brain’s response to health messages and subsequent behavior change

Emily B. Falk, Matthew Brook O’Donnell, Christopher N. Cascio, Francis Tinney, Yoona Kang, Matthew D. Lieberman, Shelley E. Taylor, Lawrence An, Kenneth Resnicow, and Victor J. Strecher
  1. aAnnenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104;
  2. bResearch Center for Group Dynamics, Institute for Social Research, University of Michigan, Ann Arbor, MI 48106;
  3. cDepartment of Psychology, University of California, Los Angeles, CA 90095;
  4. dCenter for Health Communications Research, University of Michigan, Ann Arbor, MI 48109; and
  5. eDepartment of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI 48109

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PNAS February 17, 2015 112 (7) 1977-1982; first published February 2, 2015; https://doi.org/10.1073/pnas.1500247112
Emily B. Falk
aAnnenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104;
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  • For correspondence: falk@asc.upenn.edu taylors@psych.ucla.edu
Matthew Brook O’Donnell
aAnnenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104;
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Christopher N. Cascio
aAnnenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104;
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Francis Tinney
bResearch Center for Group Dynamics, Institute for Social Research, University of Michigan, Ann Arbor, MI 48106;
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Yoona Kang
aAnnenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104;
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Matthew D. Lieberman
cDepartment of Psychology, University of California, Los Angeles, CA 90095;
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Shelley E. Taylor
cDepartment of Psychology, University of California, Los Angeles, CA 90095;
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  • For correspondence: falk@asc.upenn.edu taylors@psych.ucla.edu
Lawrence An
dCenter for Health Communications Research, University of Michigan, Ann Arbor, MI 48109; and
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Kenneth Resnicow
dCenter for Health Communications Research, University of Michigan, Ann Arbor, MI 48109; and
eDepartment of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI 48109
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Victor J. Strecher
dCenter for Health Communications Research, University of Michigan, Ann Arbor, MI 48109; and
eDepartment of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI 48109
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  1. Contributed by Shelley E. Taylor, January 6, 2015 (sent for review December 8, 2014)

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Significance

Self-affirmation is a psychological technique that is effective in increasing receptivity to interventions across domains from promoting health behaviors in high-risk populations to improving academic performance in underrepresented groups. The neural mechanisms that lead to affirmation’s success, however, are not known. We show that neural responses associated with self-related processing and value in response to an otherwise-threatening health communication intervention can be changed using self-affirmation; furthermore, these neural responses predict objectively measured behavior change in the month following the intervention. These findings suggest that self-affirmation may exert its effects by allowing at-risk individuals to see the self-relevance and value in otherwise-threatening messages and provide a framework for studying neural effects of self-affirmation more broadly.

Abstract

Health communications can be an effective way to increase positive health behaviors and decrease negative health behaviors; however, those at highest risk are often most defensive and least open to such messages. For example, increasing physical activity among sedentary individuals affects a wide range of important mental and physical health outcomes, but has proven a challenging task. Affirming core values (i.e., self-affirmation) before message exposure is a psychological technique that can increase the effectiveness of a wide range of interventions in health and other domains; however, the neural mechanisms of affirmation’s effects have not been studied. We used functional magnetic resonance imaging (fMRI) to examine neural processes associated with affirmation effects during exposure to potentially threatening health messages. We focused on an a priori defined region of interest (ROI) in ventromedial prefrontal cortex (VMPFC), a brain region selected for its association with self-related processing and positive valuation. Consistent with our hypotheses, those in the self-affirmation condition produced more activity in VMPFC during exposure to health messages and went on to increase their objectively measured activity levels more. These findings suggest that affirmation of core values may exert its effects by allowing at-risk individuals to see the self-relevance and value in otherwise-threatening messages.

  • self-affirmation
  • fMRI
  • behavior change
  • VMPFC
  • physical activity

Footnotes

  • ↵1To whom correspondence may be addressed. Email: falk{at}asc.upenn.edu or taylors{at}psych.ucla.edu.
  • Author contributions: E.B.F., M.B.O., C.N.C., F.T., M.D.L., S.E.T., L.A., K.R., and V.J.S. designed research; E.B.F., M.B.O., C.N.C., and F.T. performed research; E.B.F., M.B.O., C.N.C., Y.K., and M.D.L. analyzed data; and E.B.F., M.B.O., Y.K., M.D.L., S.E.T., K.R., and V.J.S. wrote the paper.

  • The authors declare no conflict of interest.

  • This article contains supporting information online at www.pnas.org/lookup/suppl/doi:10.1073/pnas.1500247112/-/DCSupplemental.

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Neural bases of affirmation
Emily B. Falk, Matthew Brook O’Donnell, Christopher N. Cascio, Francis Tinney, Yoona Kang, Matthew D. Lieberman, Shelley E. Taylor, Lawrence An, Kenneth Resnicow, Victor J. Strecher
Proceedings of the National Academy of Sciences Feb 2015, 112 (7) 1977-1982; DOI: 10.1073/pnas.1500247112

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Neural bases of affirmation
Emily B. Falk, Matthew Brook O’Donnell, Christopher N. Cascio, Francis Tinney, Yoona Kang, Matthew D. Lieberman, Shelley E. Taylor, Lawrence An, Kenneth Resnicow, Victor J. Strecher
Proceedings of the National Academy of Sciences Feb 2015, 112 (7) 1977-1982; DOI: 10.1073/pnas.1500247112
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