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Author ORCID Identifier

https://orcid.org/ 0009-0009-5293-5389

Date Available

7-29-2026

Year of Publication

2026

Document Type

Doctoral Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

Communication and Information

Department/School/Program

Communication

Faculty

Nancy Grant Harrington

Faculty

Xun Zhu

Abstract

Research on fear appeals shows that threat-framed messages promote adaptive outcomes when accompanied by efficacy information. According to the extended parallel process model (EPPM), danger-control responses, including message acceptance, positive attitudes toward recommended behaviors, and help-seeking intentions, are most likely to occur when efficacy appraisals, particularly perceptions of response efficacy, are sufficient to meet perceived threat. When efficacy appraisals fall short of perceived threat, fear-control responses, such as message derogation, denial, or resistance to seeking help, are most likely to emerge. Beyond reducing defensive processing, response efficacy cues may also evoke positive emotions such as hope. Whereas fear is often associated with vulnerability and avoidance, hope reflects motivation and positive expectations that promote engagement with recommended resources. Despite this, research on mental health communication has rarely examined whether adaptive persuasive outcomes arise primarily from fear reduction or hope activation.

Drawing on the EPPM and appraisal theory, this study examined emotional pathways in depression-related messages among college students (N = 367). A pilot study assessed threat and efficacy beliefs and informed message development (a threat message and two versions of an experimental message that varied by presence or absence of response efficacy). In the main study, participants were first exposed to the threat message, then to a second message that varied in the presence or absence of response-efficacy cues, following a 2 (condition: treatment vs. control) × 3 (time: T0, T1, T2) design.

The initial threat message manipulation was effective in increasing threat. After reading a response efficacy-present message, participants in the treatment condition reported significantly higher perceived response efficacy than those in the control condition who read a response efficacy-absent message, confirming the response efficacy manipulation operated as intended. Hope and fear were measured across time and examined as parallel mediators linking message condition to attitudes toward help-seeking, help-seeking intentions, and behavioral engagement, using the PROCESS Model 4. Mixed repeated-measures ANOVAs revealed significant Time × Condition interactions for both hope and fear, indicating that emotional trajectories differed between conditions. Hope, but not fear, significantly mediated the effect of condition on attitudes and intentions; neither emotion mediated behavioral engagement. A formal bootstrap contrast confirmed that the indirect effect through hope was significantly larger than through fear for attitudes and intentions, though not for behavior.

These findings suggest that the persuasive influence of response efficacy on attitudinal and intentional outcomes is mediated more by hope activation than by fear reduction. By examining how messages, emotions, and outcomes relate, this study offers valuable insights for both the EPPM and health message design. These theoretical and practical implications are discussed, along with limitations and potential future research directions.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2026.371

Archival?

Archival

Funding Information

This study was supported by the University of Kentucky UNITE Research Priority Area (RPA) and the College of Communication and Information. 

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