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The Power of Fear

Another one of Hovland's variables was characteristics of the message. One of the most studied variables is the degree of fear inspired by a message. An early study by Janis and Feshbach (1953) compared high-fear, medium-fear, and low-fear presentations of information about dental hygiene, each presented to a group of 50 high school students.

How did Janis and Feshbach study the effects of fear in messages?

The high-fear group saw a film that contained 71 different references to such topics as tooth decay, gum disease, discolored teeth, dental drills, and cancer. Many of these warnings were illustrated with graphic photographs. The moderate-fear group saw a movie discussing many of the same topics, such as gum disease, but containing only 49 anxiety-arousing references. The low-fear group saw techniques of effective brushing and teeth cleaning, without unpleasant topics. A fourth group, serving as a control, received no lecture at all.

Students in the high-fear group were impressed with the film. 28% said they found the film so disgusting that it really bothered them. By contrast, students receiving the low-fear presentation thought it was boring, and only 2% in that group found anything offensive in the presentation.

Which group actually changed their behavior more, in the Janis and Feshbach "fear" study?

After a week, Janis and Feshbach administered questionnaires asking how tooth-brushing behavior had actually changed. They found 28% of the high-fear group reported that they had changed their habits, but 50% of the low-fear group reported better habits. Evidently the low-fear group learned from their presentation, even if they found it boring. Students in the high-fear group had a quick emotional reaction but less behavior change. Notice a crucial detail in this study, which is that the low-fear group did receive specific, practical instructions. Those instructions may have been lost amidst the the 71 fear-arousing images in the high-fear presentation.

One successful behavior-changing campaign in the 1990s involved a fear message along with specific instructions. It occurred in the African country of Uganda. Early in the 1990s, there was an AIDS epidemic in Uganda. Fully 30% of pregnant women in Uganda tested positive for the AIDS virus. Large numbers of people were dying, both in the cities and in the rural areas. The government started a campaign to change people's behavior and attitudes toward sexuality and AIDS. In this case, the fear condition was created naturally by people's personal experience with friends and relatives dying. To stop the epidemic, fear was not enough. People needed specific information about how to prevent HIV infection. This required breaking some long-standing cultural taboos about discussing sexual behavior.

What techniques were used in the anti-AIDS campaign in Uganda? What were the results?

To spread accurate information about AIDS, highly credible messengers were used. The fact that reputable people were talking calmly about AIDS probably made this analogous to the low-fear condition in the Janis and Feshbach study. The Ugandans did not want to resort to dramatic photos of people dying of AIDS, for example. They wanted to avoid offending people and simply educate them in the steps necessary to prevent AIDS transmission.

For example, a general who was a war hero and also HIV-positive toured the country, talking about how the virus could and could not be transmitted. Condoms were sold at very low cost, or given away, throughout the country. Young couples were encouraged to wait for marriage before having sex and to stay in monogamous relationships. In rural villages where literacy rates might be as low as 2%, traveling nurses talked to groups of young people in graphic and unembarrassed detail about factors promoting the transmission of the HIV virus.

The combination of high credibility communicators, fear of AIDS, and specific problem-solving instructions resulted in a dramatic decline in new HIV infections. The percentage of women testing positive for HIV during pre-childbirth exams went down from 30% to 10% in three years. (ABC Nightline, August 7, 1997). Attitudes changed, and—more importantly—so did behaviors.

The history of anti-AIDS efforts in Uganda over the following years showed the real-world complexities of attitude and behavior change. The rate of AIDS infection in Uganda continued to fall until 2001, when it hit a low of about 5% of the adult population, if you trust the government figures. This was down from a peak of 15% in 1991. The government program emphasized an A-B-C mnemonic: Abstinence, Being Faithful, and Condom use.

What happened next in Uganda?

Starting in 2001, the Bush administration in the United States decided to emphasize abstinence-only programs. Money from the U.S. to fight AIDS was channeled through faith-based organizations (church groups) many of which discouraged condom use. Dozens of billboards sprang up around the country advocating abstinence and recommending against using condoms. Millions of condoms were recalled by the government because of an unpleasant odor and rumors they were defective, although tests showed they were not defective. Many rural people lost faith in condoms because of the confusing and contradictory messages. Many people who wanted condoms could not get them, because the huge recall led to condom shortages in 2004 and 2005.

The rate of AIDS started to climb again. In 2004 a non-governmental organization, the National Guidance and Empowerment Network, said the percentage of infected adults had risen to 17%, more than four times the government estimate. The government denied this. The numbers are still controversial.

In 2006 the Ugandan government obtained a World Bank loan to import 80 million condoms, and government officials denied that they were downplaying the "C" part of the A-B-C strategy. The story is ongoing. Many anti-AIDS researchers are studying the example of Uganda and other African countries to determine which public health strategies work best over the long term.

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