ObjectiveObservational research suggests that placing graphic images on cigarette warning labels can reduce smoking rates, but field studies lack experimental control. Our primary objective was to determine the psychological processes set in motion by naturalistic exposure to graphic vs. text-only warnings in a randomized clinical trial involving exposure to modified cigarette packs over a 4-week period. Theories of graphic-warning impact were tested by examining affect toward smoking, credibility of warning information, risk perceptions, quit intentions, warning label memory, and smoking risk knowledge.MethodsAdults who smoked between 5 and 40 cigarettes daily (N = 293; mean age = 33.7), did not have a contra-indicated medical condition, and did not intend to quit were recruited from Philadelphia, PA and Columbus, OH. Smokers were randomly assigned to receive their own brand of cigarettes for four weeks in one of three warning conditions: text only, graphic images plus text, or graphic images with elaborated text.ResultsData from 244 participants who completed the trial were analyzed in structural-equation models. The presence of graphic images (compared to text-only) caused more negative affect toward smoking, a process that indirectly influenced risk perceptions and quit intentions (e.g., image->negative affect->risk perception->quit intention). Negative affect from graphic images also enhanced warning credibility including through increased scrutiny of the warnings, a process that also indirectly affected risk perceptions and quit intentions (e.g., image->negative affect->risk scrutiny->warning credibility->risk perception->quit intention). Unexpectedly, elaborated text reduced warning credibility. Finally, graphic warnings increased warning-information recall and indirectly increased smoking-risk knowledge at the end of the trial and one month later.ConclusionsIn the first naturalistic clinical trial conducted, graphic warning labels are more effective than text-only warnings in encouraging smokers to consider quitting and in educating them about smoking’s risks. Negative affective reactions to smoking, thinking about risks, and perceptions of credibility are mediators of their impact.Trial RegistrationClinicaltrials.gov NCT01782053

The findings indicate that (a) many effects of warnings on smokers' beliefs are mediated rather than direct, (b) both cognitive and affective responses are important mediators, and (c) elaborated text can help to increase effects of images through a cognitive pathway. Warning labels should be designed to maximize effects on these mediators in order to influence smoking outcomes.

People often attempt to shape others' perceptions of them, but the role of romantic relationships in this process is unknown. The present set of studies investigates relationship visibility, the centrality of relationships in the self-images that people convey to others. We propose that attachment underlies relationship visibility and test this hypothesis across three studies in the context of Facebook. Avoidant individuals showed low desire for relationship visibility, whereas anxious individuals reported high desired visibility (Studies 1 and 2); however, similar motives drove both groups' actual relationship visibility (Study 1). Moreover, both avoidant individuals and their partners were less likely to make their relationships visible (Studies 1 and 3). On a daily basis, when people felt more insecure about their partner's feelings, they tended to make their relationships visible (Study 3). These studies highlight the role of relationships in how people portray themselves to others.

Attachment shapes people's experiences in their close relationships and their self-views. Although attachment avoidance and anxiety both undermine relationships, past research has primarily emphasized detrimental effects of anxiety on the self-concept. However, as partners can help people maintain stable self-views, avoidant individuals' negative views of others might place them at risk for self-concept confusion. We hypothesized that avoidance would predict lower self-concept clarity and that less self-verification from partners would mediate this association. Attachment avoidance was associated with lower self-concept clarity (Studies 1-5), an effect that was mediated by low self-verification (Studies 2-3). The association between avoidance and self-verification was mediated by less self-disclosure and less trust in partner feedback (Study 4). Longitudinally, avoidance predicted changes in self-verification, which in turn predicted changes in self-concept clarity (Study 5). Thus, avoidant individuals' reluctance to trust or become too close to others may result in hidden costs to the self-concept.