A conflict-theory approach to understanding adolescents' health behaviour

The relationship between adolescents’ health decisions and their coping reactions to threat has been the focus of some empirical research. A relevant theoretical perspective is the Conflict-Theory Model (Janis, 1983) which specifies several modes by which people cope with threat, including vigilance (objective appraisals), defensive avoidance (evasion of anxiety) and hypervigilance (panic). Developed to explain adult decision making, Conflict-Theory postulates were applied to health decisions in adolescents, thus extending the model to a new population. Conflict-Theory proposes that coping styles moderate relations between health beliefs and decisions, such that perceptions of threat and response-efficacy better predict health decisions in persons high on vigilance, or low on defensive avoidance or hypervigilance. These postulates were tested in a large-scale cross-sectional survey (Umeh, in press). The study involved 885 adolescents (aged 13-17 years) and focused on several important health behaviours (substance use, regular exercise, dietary fat consumption, unsafe sex). There was little evidence that dispositional coping styles moderate relations between health beliefs and decisions. Beliefs about the efficacy of using protection during sexual intercourse predicted intentions to have unprotected sex as a function of vigilance. However, the pattern of this moderator effect contradicted Conflict- Theory postulates: efficacy beliefs better predicted intentions in participants low on vigilance. There was no evidence that relations between health beliefs and decision are affected by levels of defensive avoidance or hypervigilance. Each coping style predicted intentions to exercise regularly and (vigilance only) have unprotected sex, independent of health beliefs. Conflict-Theory also proposes that high levels of vigilance relate to low levels of health risk-taking, whereas high levels of defensive avoidance and hypervigilance relate to high levels of health risk-taking. These postulates were tested in a secondary survey focusing on cigarette use (using a subsample of 104 participants from the main study). Coping patterns were associated with health risk-taking in accordance with Conflict-Theory. Overall, there was no evidence that the proposed role of coping styles in belief-decision relations apply to adolescents. However, there was some evidence for vigilance as a moderator, and coping styles as predictors of decisions irrespective of health beliefs. Coping also relates to health risk-taking. Overall, the importance of Conflict-Theory coping styles in adolescents’ health decisions, whether as moderator or predictor variables, varies across coping constructs and health behaviours