Scale Development and Validation for Psychological Reactance to Health Promotion Messages

According to the psychological reactance theory, psychological reactance is strongly associated with many adverse outcomes of health promotion messages. This is particularly pertinent when health messages are targeting young adults, as they resist freedom-threatening messages compared to other age groups. However, previous reactance measures either relied on the open-ended thought-listing procedure, or incorporated both antecedents as well as consequences of reactance and state reactance. This study aimed to develop and validate a comprehensive scale to measure the state of psychological reactance specifically toward health promotion messages. To this end, this study was situated in the context of an anti-binge drinking intervention targeting college students. A cross-sectional survey was conducted with 203 Singaporean undergraduate students. The dataset was analyzed by exploratory factor analysis, confirmatory factor analysis, and item analysis. The final 27 items were loaded on eight factors (anger, exaggeration, design derogation, authoritative tone, ineffectiveness, know-it-all attitude, jadedness, and source motive) that accounted for 78.53% of the variance. Each factor showed satisfactory reliability and validity (discriminant, convergent, and predictive). This study specified cognitive reactions by multiple dimensions and examined how they are intertwined with the affective dimension, which is represented by anger. The scale proposed herein will help researchers and practitioners develop sustainable health interventions.