FACTORS IN THE EFFECTIVENESS OF ANTICIPATORY GUILT AND SHAME APPEALS ON HEALTH COMMUNICATIONS: THE ROLE OF SELF-CONSTRUAL, REGULATORY FOCUS AND PERSONAL CULTURAL ORIENTATION by Nguyen Hoang Sinh A thesis submitted to the Victoria University of Wellington in fulfilment of the requirements for the degree of Doctor of Philosophy in Marketing Victoria University of Wellington 2017 Abstract Negative emotional appeals are commonly used in health messages to cut through the clutter and promote health behaviour change. A research gap exists as to how the emotions of guilt and shame and respective arousals to these emotions act to influence compliance with health messages. Research rarely distinguishes between guilt and shame appeals, different emotional and psychological responses to the two types of appeals, and the main moderators that influence the response to these appeals. To address this gap, this empirical study builds and tests a model for better understanding the processes by which guilt and shame appeals lead to compliance with health messages. Drawing on the theoretical frameworks of cognition, emotion, motivation and research focusing on guilt or/and shame messages and behavioural intention, this study develops an extended model that incorporates influential variables. These include the significant mediating variable of the coping response to emotion, and the moderating variables of self-construal, regulatory focus, and personal cultural orientation. Binge drinking among young adults (aged 16 to 30) is the research context for this study. A series of experiments was conducted to test the research model. Data was collected through an online questionnaire survey among university undergraduates in New Zealand. The main survey collected 301 useable responses including the treatment (n = 266) and control (35) groups. The survey data were analysed using a combination of analysis of covariance and covariance-based structural equation modelling. The results broadly support the proposed model for health communications using guilt and shame appeals. Findings revealed that the coping response has a partial mediating effect on the relationship between guilt/shame arousals and message compliance. Both guilt and shame arousals influence not only message compliance (directly) but also the coping response (indirectly). As predicted, regulatory focus and self-construal were found to moderate guilt/shame arousals from respective emotional appeals. Regulatory focus moderated the levels of shame arousals from shame appeals; that is, prevention-focused individuals exhibited higher shame arousals than their promotion-focused counterparts. Self-construal moderated the levels of guilt arousals from guilt appeals; that is, independent self- construals exhibited higher guilt arousals than their interdependent counterparts. However, there were no interactive effects of self-construal with self-referencing or sources of evaluation on guilt/shame arousals. Personal cultural orientation moderated the iii impact of shame arousals, but not those of guilt arousals, on message compliance. That is, shame predicted message compliance in collectivists, but not individualists. Interestingly, there was no main differential effect of guilt versus shame arousals in message compliance, but there was an interactive effect of emotion type with personal cultural orientation as previously mentioned. The contributions of this study include refining understanding of guilt versus shame, developing the coping response construct, and identifying key moderators and illustrating their impacts on self-conscious emotional arousals. These contributions open new lines of inquiry in the health communications and discrete emotions literature. First, previous discrete emotions literature has mentioned the effects of unintentional emotions, but this research controlled for these effects. It examined guilt and shame separately through respective emotional arousals rather than emotional appeals. Second, the study extended the model of the effectiveness of guilt versus shame appeals in health communications where the coping response is an instrumental mediator. This mediator influences whether or not the receivers actually take on compliant behaviour. Third, the present study differentiated the effect of guilt versus shame appeals. It provides conditions where such appeals are effective. These conditions are type of emotion interacting with self-construal, and regulatory focus. In addition, the study identified the condition under which guilt or shame arousals are most effective. Effectiveness depends on emotion type and personal cultural orientation. The findings have important practical implications. By understanding how distinct emotion (i.e., guilt versus shame) works and how coping responses (i.e., adaptive versus maladaptive) to these emotions are triggered, practitioners can better structure emotional messaging. Knowledge of message receiver attributes will help them select media appropriately. These attributes are independent versus interdependent, promotion focused versus prevention focused, and individualist versus collectivist. Thus, insights from this research could help health marketers, policy makers as well as health promotion agencies to effectively develop health communications campaigns with more appealing message content and appropriate media selection. Keywords: Guilt, Shame, Coping response, Self-construal, Regulatory focus, Personal cultural orientation, Binge drinking, Emotional appeal, Health communications. iv To my family, Vuong Le, Kent, and Huda v Acknowledgements I could not have completed this thesis without the assistance and support of many people. I wish to acknowledge and thank them. Firstly, I would like to express my sincere gratitude to my supervisors, Assoc. Prof. Daniel Laufer and Dr Jayne Krisjanous, for their guidance, advice, and dedication throughout my PhD study. Thank you, Dan, for always pushing me like asking for “a justification for every action”. Jayne, thank you so much for your continued interest in my work and family as well. It was truly such a motive to lead me through this research work. I would especially like to thank my grand family for their support and sacrifice throughout the course of my study in New Zealand. Thanks to my parents, especially my mother-in-law, who looked after my family while I was absent from home. Thanks to my wife, Vuong Le, and my sons, Kent and Huda, for love, encouragement, and understanding. Throughout my PhD journey, there are other people who supported me, to those I need to give a special thanks – Dr James Richard (former PhD Programme Director), Helen Barnard, Kathryn Lawrence (both proof-readers), Linsell Richards, Helena Cook (both former Team Leaders, New Zealand Scholarships Programme, Victoria International), among others. A special thanks also to the Faculty of Commerce, the School of Marketing and International Business (SMIB) for the support and assistance offered by the academic and administrative staff over the course of the PhD programme. Especially, my thanks goes to the SMIB Research Committee for the constructive feedback to my PhD proposal and the funding of fieldwork and conference attendance. My sincere thanks goes to the New Zealand ASEAN Scholar Awards for offering me a full scholarship to pursue a PhD in Marketing at Victoria University of Wellington in New Zealand. Thanks to staff and students from Ho Chi Minh City Open University, Ho Chi Minh City University of Social Sciences and Humanities, and Hoa Sen University for assisting me in vi data collection in Vietnam (even though the data was not included in this thesis). Thanks also to all students who were involved in my study both in New Zealand and Vietnam, without your participation the study would not have been possible. I also acknowledge the examiners, reviewers whose comments and suggestions that have been incorporated into the benefit of this thesis. I would like to thank my PhD cohorts, past and present, at the SMIB for their friendship, generosity, and cheerfulness. I am particularly grateful to Heath Johnson for proof reading my PhD proposal. Finally, thanks to my colleagues, friends, and flatmates whom I have worked, played, and shared with over the past few years. In particular, thanks to members of Vietnamese Tennis Club of Wellington. They are too numerous to name, but they have my gratitude. vii List of Publications Sinh, N. H. (2017). Guilt and Shame Appeals in Health Communications. Paper presented at the Australia and New Zealand Marketing Academy 2017 Conference, Melbourne, Australia. Sinh, N. H., Laufer, D., & Krisjanous, J. (2017). The Effectiveness of Guilt and Shame Appeals on Health Communications: The Role of Coping Response, Self- Construal and Personal Cultural Orientation. Paper presented at the American Academy of Advertising 2017 Global Conference, Tokyo, Japan. Sinh, N. H. (2017). Factors in the Effectiveness of Guilt and Shame Appeals on Health Communications: The Role of Coping Response, Self-Construal and Personal Cultural Orientation. Paper presented at the Macromarketing Conference 2017 Doctoral Colloquium, Queenstown, New Zealand. Sinh, N. H. (2015). The Effectiveness of Guilt and Shame Appeals on Health Communications: The Role of Self-Construal, Regulatory Focus and Culture. Proceedings of the International Conference on Business 2015 (pp. 372-388). Ho Chi Minh City: VNU-HCMC Press. viii Table of Contents Abstract ...................................................................................................................................