Risk Perception and Decision-Making

What is the role of risk perception in health behavior?

Many theories of health behavior and behavior change focus on the role of risk perception, arguing that individuals rationally evaluate the risks and benefits of a given choice before deciding on a course of action. In contrast, our research contends that : 1) risk perception is only one small influence on decision-making processes; 2) "objective" or epidemiological assessments of risk do not accurately reflect the perceptions of individuals in their daily lives; and 3) understanding the psychology of risk and the meaning of what is considered risky behavior in the lives of the people with whom we work is critical to crafting effective interventions and supporting health and wellness. 


Research Spotlight

HIV-Related Perseverative Cognition

Across multiple different studies with different samples of gay and bisexual men, we have asked the same two questions: How often do you think about HIV day to day?" and "How often do you think about HIV while you are having sex?" The results are displayed in the two figures below.


When we ask people what they are thinking about, the two most common answers are: fear of infection (e.g., "am I getting it now?" "is it coming through the condom?") and partner mistrust (e.g., "is this person really negative?" "is my partner cheating on me and I don't know?"). Dr. Golub has referred to these data as the "psychological tragedy" of the HIV epidemic, in which individuals have been conditioned to think of "risk" and fear during what should be intimate and fulfilling moments. Our lab is currently trying to relate this phenomenon to the psychological concept of perseverative cognition, which refers to the repeated or chronic activation of the cognitive representation of a psychological stressor.   Perseverative cognition has been linked to physiological stress response, poorer affective and physical health outcomes, and negative health behaviors. We are currently developing a model for understanding HIV risk perception and the chronic activation of HIV-related thoughts in gay and bisexual men by applying a perseverative cognition framework to their experiences and the impact that HIV has in their lives. 

Select Publications

Golub, S.A., Thompson, L., & Kowalczyk, W. (2016). Affective differences in Iowa Gambling Task performance associated with sexual risk taking and substance use among HIV-positive and HIV-negative men who have sex with men. Journal of Clinical and Experimental Neuropsychology, 38(2), 141-157.

Golub, S. A., & Gamarel, K. E. (2016). Psychometric evaluation of the Condom Barriers and Motivations Scale (CBMS). Journal of Behavioral Medicine, 1-12.

Golub, S.A. (2014). Tensions between the epidemiology and psychology of HIV risk: Implications for Pre-exposure Prophylaxis. AIDS and Behavior, 18(9):1686-1693.  

Golub, S.A., Starks, T.J., Payton, G., & Parsons, J.T. (2012). The critical role of intimacy in the sexual risk behaviors of gay and bisexual men. AIDS and Behavior, 16(3), 626-632.