Attitude Accessibility
Attitude accessibility (see Fazio, 1986), or how quickly one engages an attitude upon encountering an issue, has been proposed as an alternative explanation for how inoculation works. Scholars speculated that inoculation increases the speed of retrieval for the target attitude, functioning as a resistance mechanism. And indeed, scholars have found inoculation increases attitude accessibility, which then strengthens resistance (Pfau et al., 2004; Pfau et al., 2003). But instead of considering attitude accessibility an alternative explanation, researchers concluded traditional components of inoculation (threat and counterarguing) and attitude accessibility were “somewhat independent … but to an even greater extent overlapping” (Pfau et al., 2004, p. 347) because both paths begin with threat and involvement.
Associative Networks
Inoculation scholars have turned to associative attitude networks (see Anderson, 1983) to explore how cognitive and affective nodes are created and linked to issues during inoculation. Much of the logic explored in associative networks mirrors that of counterarguing. With associative network research, scholars have used concept maps to illustrate changes to attitudinal nodes. Through this research, scholars have determined inoculation adds more nodes and linkages, and these alterations to the network enhance resistance (Pfau et al., 2005). But another study failed to confirm similar effects. They did find, however, affective-negative pretreatments add more cognitive nodes—more than affective-positive or even cognitive pretreatments (Pfau et al., 2009). Scholars are at early stages of understanding these issues, but it appears dramatic inoculation effects may be attributed to subtle shifts in attitude structures.
SEM: Clarity and Mystery
One promising development in better understanding the inoculation process is the use of structural equation modeling (SEM) to identify and link variables of resistance (e.g., Pfau et al., 2004). But while SEM has added conceptual clarity, it has also revealed one of inoculation’s continuing confounding mysteries: a direct path from inoculation pretreatments to resistance—a path independent of conventional mechanisms (threat and counterarguing) and, to date, proposed alternative explanations (e.g., attitude accessibility; see Compton & Pfau, 2005). In one SEM study, this path represented 14% of variance in attitude toward the issue (Pfau et al., 2004). This mystery path suggests we have not identified significant processes of inoculation (Insko, 1967), or our current efforts to measure inoculation are not optimal (Compton & Pfau, 2005). Or, both.
To better account for this and other as-yet-undefined processes at work in inoculation, more research is needed. This chapter concludes with proposed directions for future inoculation scholarship, including some new areas that emerge from a closer scrutiny of the basic analogic of inoculation theory.
New Directions in Inoculation Research
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Pretreatments: Message Variations
Threat
McGuire once noted: “An obvious way of threatening … is by pre-exposure to weakened forms of attacking arguments” (1964, p. 201). In many ways, threat triggers have not ventured too far from this “obvious” way. Weakened counterarguments, in conjunction with an explicit forewarning, are what, purportedly, elicit threat. Fortunately, scholars have begun to consider less obvious ways of inducing threat—and results are promising. Some of this research looks at manipulations of the traditional forewarning (e.g., Ivanov et al., 2011), and we should also continue to think beyond forewarnings as we develop new ways of generating threat (e.g., triggering reactance, Ivanov et al.). Further exploration of narratives and visuals (e.g., video, animation) seems particularly promising (Compton & Pfau, 2005), including vivid dramatizations of pressure to change issue positions, which may enhance perceived vulnerability beyond that of the conventional written message (e.g., Pfau, Van Bockern, & Kang, 1992).
Refutational Preemption
To date, differentiation in pretreatment message content is mostly on the basis of cognitive and affective appeals, including emotion-specific inductions, such as anger and happiness (e.g., Pfau et al., 2009), or affect intensity of counterarguments and refutations (Nabi, 2003). Other research has explored variations in argument strength (e.g., strong counterarguments with weak refutations; Compton & Pfau, 2004). But other manipulations have received less attention. For example, McGuire and his colleagues explored differences between passive and active refutations of counterarguments as part of an inoculation pretreatment (e.g., McGuire, 1961b), but this has received little attention in contemporary inoculation scholarship. In some ways, this is surprising, as the active/passive dichotomy may be useful analogs for medical inoculation variations (i.e., actively vs. passively acquired immunity). Future research should also consider effects of more implicit inoculation message refutations. For example, editorial cartoons and other types of political humor are often dependent on receivers making connections and drawing conclusions. Could subtle argumentation function in an inoculation message, or is inoculation more effective when conclusions are clearly drawn during refutational preemption?
Process: Macro- and Microconsiderations
Affect
The trajectory of affect research in the story of inoculation scholarship is encouraging. First efforts confirmed that affect matters during inoculation (e.g., Pfau et al., 2001), and then, that specific emotions play roles during inoculation (Pfau et al., 2009). Most recently, by turning to other classic theories of persuasion for insight, we are learning with precision not just that affect matters, but how specific emotions mingle with traditional processes of resistance (e.g., threat and counterarguing) to elicit resistance (Ivanov et al., 2011). What we need next is a broader picture of which specific emotions are playing a role in inoculation-conferred resistance and when.
Post-inoculation Talk
New theorizing and research with word-of-mouth communication in general, and post-inoculation talk (PIT) in particular, offer an exciting shift from intrapersonal dynamics to interpersonal ones. Just as some biological inoculations can pass from person to person (see Compton & Pfau, 2009), persuasion inoculations may also be contagious. Compton and Pfau (2009) articulated the theorizing behind inoculation’s effects on talk. More recently, Ivanov and colleagues (in press) confirmed that those inoculated are likely to talk about the issues and that this post-inoculation talk has a strengthening effect on the resistance of those inoculated. Next, innovative research designs are needed to trace and track post-inoculation talk as messages move along interpersonal networks. This type of research could reveal whether PIT serves more of an advocacy function (passing along issue content) or even, as Compton and Pfau (2009) suggested, an inoculative function (eliciting threat by passing along both counterarguments and refutations, and ultimately, spreading inoculation). Inoculation gives people something to talk about—and the motivation to do it.
Umbrella of Protection
Since McGuire’s original model, scholars have touted inoculation’s ability to confer a wide sphere of protection against persuasive attacks (Compton & Pfau, 2005; McGuire, 1964), confirming that inoculation pretreatments protect against same and novel arguments (see Banas & Rains, 2010). But more recently, scholars have found that inoculation’s protection extends beyond specific arguments and into novel issue domains. Parker, Ivanov, and Compton (2012) confirmed inoculating against challenges to college students’ condom use attitudes also protects binge drinking attitudes—even when only one of the issues is mentioned in the pretreatment message. They suggest further exploration of attitude structures and linkages to better understand this cross-protection.
For example, in their empirical test of attitudinal hierarchies and spatial-linkage models (e.g., Galileo model), Dinauer and Fink (2005) found more support for a spatial-linkage model, suggesting that attitudes can affect one another regardless of their position in an attitude hierarchy. Change in one attitude leads to change in related attitudes. Approaching attitudes and their structures may help to explain wider-ranging effects of inocul
ation than previously realized. And, notably, this line of research is consistent with some medical inoculations that have cross-protection effects, whereas inoculating against one threat provides protection against related threats.
Outcomes: Iatrogenic Effects?
Successful medical inoculation is contingent on a body’s defense mechanisms recognizing and then confronting a threatening agent, or antigen. Presumably, successful persuasion inoculation—if consistent with the conventional model—also requires recognition of threat. But what if a side effect of inoculation is that it makes people too responsive to defending a position? This is one of many potential side effects of inoculation that warrant consideration in future scholarship. In medical terms, we might call these iatrogenic effects, or side-effects caused by a pretreatment protocol. Other possibilities include: Does inoculation lead to increased cynicism by inadvertently (or advertently) fostering source derogation? Does inoculation lead to a heuristic that dismisses rather than thoughtfully refutes challenges? If research demonstrates iatrogenic effects, the next step will be to identify ways of alleviating negative side effects—perhaps even inoculating against them.
Of course, with any future inoculation scholarship, manipulations to inoculation should not be atheoretical. Boundary conditions—as initially proposed by McGuire and clarified in the subsequent decades of research—should be considered. Additionally, following in the same vein as scholarship that has explored inoculation and attitude accessibility (e.g., Pfau et al., 2004) and psychological reactance (Ivanov et al., 2011), scholars should turn to additional theoretical processes when doing inoculation research.
Conclusion
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As we have surveyed more than 50 years of inoculation scholarship and looked ahead to future developments of the theory, we have returned to the original medical analogy for comparison and contrast. While several arguments can be made against the analogy, two fundamental challenges include: (1) Some key variables of inoculation—including forewarnings and refutations (e.g., Wood, 2007)—do not have clear analogs with medical inoculation; and (2) the analogy may overemphasize cognitive dimensions, namely, counterarguing, to secure its parallel with antibodies in medical inoculations.
But even with these objections, the analogy is more instructive than restrictive. As to the first objection, the two main processes of inoculation—threat and protective responses to threat—have clear analogs, even if some manifestations of these processes may not. For example: Forewarning in persuasion inoculation may not have a clear analog with the medical analogy, but threat does, and threat, not forewarning, is the requisite component. In hindsight, it appears we may have clouded operationalizations of threat in previous research by not delineating threat from forewarning. Clearer definitions of threat (a process of inoculation) and forewarning (one possible threat trigger) will be helpful as we continue inoculation’s development.
As to the second major concern, inoculation scholarship did focus mostly on cognitive processes at work in resistance during the early years of theory development. But now, with increased attention to affect, this isn’t so much a problem with the analogy as it is an effect of how much we want to nuance the analogy. The analogy does not limit inoculation explanations to counterarguing. As previously mentioned, antibodies triggered during medical inoculations can be likened to the counterarguing process of persuasion inoculation. But the key descriptor is likened, not limited. Counterarguing is a resistance response triggered by the presence of counterattitudinal content, but it is not the only resistance response (see, for example, reactance, Ivanov et al., 2011). Indeed, some of the most current work with medical inoculations examines ways of conferring resistance with vaccines that not only motivate increased production of antibodies, but also other protection components, such as memory cells and protective proteins. Broadening persuasion inoculation’s scope to include new aspects of resistance is not only consistent with medical inoculations, but even encouraged by new developments in immunology.
My current take on the analogy debate is this: The inoculation analogy is both limiting and flexible enough. It is limiting in the sense that it constrains inoculation as a preemptive strategy of resistance. It is also limiting by defining a process of resistance that stems from threat. But the analogy is also flexible enough to account for a wide range of defense-building processes against a wide range of attacks. What is needed next is to continue expanding our conceptualization of inoculation-conferred resistance while respecting its inherent boundary conditions, and the original analogy helps us do that in some ways McGuire first proposed and in new ways he might have never imagined. An observation he and a colleague made at the conclusion of one of the earliest inoculation studies continues to resonate: “Pursuit of the medical analogy suggests many further questions” (McGuire & Papageorgis, 1962, p. 33). I couldn’t agree more.
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