Some Problems With Social Cognition Models: A Pragmatic and Conceptual Analysis

Abstract

Empirical articles published between 1997 and 2001 from 4 health psychology journals that tested or applied 1 or more social cognition models (theory of reasoned action, theory of planned behavior, health belief model, and protection motivation theory; N = 47) were scrutinized for their pragmatic and conceptual basis. In terms of their pragmatic basis, these 4 models were useful for guiding research. The analysis of their conceptual basis was less positive. First, these models do not enable the generation of hypotheses because their constructs are unspecific; they therefore cannot be tested. Second, they focus on analytic truths rather than synthetic ones, and the conclusions resulting from their application are often true by definition rather than by observation. Finally, they may create and change both cognitions and behavior rather than describe them.

Full text

BRIEF REPORTS
Some Problems With Social Cognition Models: A Pragmatic and
Conceptual Analysis
Jane Ogden
University of London
Empirical articles published between 1997 and 2001 from 4 health psychology journals that tested or
applied 1 or more social cognition models (theory of reasoned action, theory of planned behavior, health
belief model, and protection motivation theory; N⫽47) were scrutinized for their pragmatic and
conceptual basis. In terms of their pragmatic basis, these 4 models were useful for guiding research. The
analysis of their conceptual basis was less positive. First, these models do not enable the generation of
hypotheses because their constructs are unspecific; they therefore cannot be tested. Second, they focus
on analytic truths rather than synthetic ones, and the conclusions resulting from their application are often
true by definition rather than by observation. Finally, they may create and change both cognitions and
behavior rather than describe them.
Key words: social cognition models, critique, problems, health cognitions
Despite the widespread use in health psychology of social
cognition models, there have been some critiques. Conner and
Norman (1996) described an overlap in the variables between the
different models, Sutton (1998) concluded that although such
models are designed to predict behavior they leave much of the
variance in behavior unexplained, and Smedlund (2000) criticized
them for their logical construction. This article highlights further
problems with the health belief model (HBM; Becker & Rosen-
stock, 1987), the theory of reasoned action (TRA; Fishbein &
Ajzen, 1975), the protection motivation theory (PMT; Rogers,
1975), and the theory of planned behavior (TPB; Ajzen, 1985) in
terms of their pragmatic and conceptual basis and asks whether
they can be considered good theories. Specifically it addresses the
questions: Are the theories useful? Can the theory be tested? Does
the theory use analytic or synthetic truths? and Does the theory
access or create cognitions?
Method
The main journal outlets for health psychology work for researchers in
the United States, the United Kingdom, and across other European coun-
tries are Health Psychology, published by the American Psychological
Association; the British Journal of Health Psychology, published by the
British Psychological Society; Psychology and Health, the official journal
of the European Health Psychology Society and published by Brunner
Routledge; and the Journal of Health Psychology, published by Sage. All
articles published in these journals between 1997 and 2001 (inclusive)
excluding commentaries, introductions to special issues, and letters to the
editor that focused on the most common structured models (HBM, TRA,
TPB, and PMT) were scrutinized for their pragmatic and conceptual basis.
Exemplar articles were noted and illustrative quotes were recorded.
Results
The Articles
During the 5-year period from 1997 to 2001, 923 articles were
published in these four journals. Of these, 727 did not focus on
health-related cognitions. The remaining 196 articles (21%) con-
tained a substantial focus on health-related cognitions. Twenty-two
of these were nonempirical reviews or discussion pieces. A total
of 47 empirical articles focusing on structured models form the
basis of the present article: HBM (n⫽9), PMT (n⫽5), TRA (n⫽
5), and TPB (n⫽33). (Note that 5 articles focused on two models
simultaneously.)
Pragmatic Basis to a Theory: Are the Theories Useful?
In the sample of articles examined, the behaviors covered were
condom use, exercise, sugar restriction, sun cream use, health
screening, exercise, low-fat diet, dental flossing, breast self-
examination, safety helmet use, providing care for parents, donat-
ing bone marrow, hormone replacement therapy use, ecstasy use,
the request for hospital autopsies, smoking, antibiotic prescribing,
and voting. These articles constituted 5.1% of the total number of
articles published in the four journals over the 5-year period. The
journal offering most of its space to research relating to health
cognitions was Psychology and Health (33.2%, n⫽82), then
Health Psychology (19.5%, n⫽63), then the British Journal of
Health Psychology (18.5%, n⫽25), with the Journal of Health
Psychology showing the least commitment to this perspective
(11.9%, n⫽26). Of these articles, the journal publishing the
largest proportion of research relating to the four structured models
Correspondence concerning this article should be addressed to Jane
Ogden, Reader in Health Psychology, Department of General Practice,
Guy’s, King’s and St Thomas’ School of Medicine, King’s College Lon-
don, University of London, 5 Lambeth Walk, London SE11 6SP, United
Kingdom. E-mail: Jane.Ogden@kcl.ac.uk
Health Psychology Copyright 2003 by the American Psychological Association, Inc.
2003, Vol. 22, No. 4, 424– 428 0278-6133/03/$12.00 DOI: 10.1037/0278-6133.22.4.424
424
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.