Scary bioterror warnings may hurt more than help

By Anne Harding

NEWYORK (Reuters Health) - Graphic public alerts about bioterrorism threats may raise anxiety and stress without any providing any real benefit, New York City researchers warn.

A "horrific" message based on a fictional bioterror event increased anxiety levels significantly, but a neutral message underscoring the low risk of such an attack actually decreased levels of anxiety, Dr. Hillel W. Cohen and colleagues from Albert Einstein College of Medicine found.

"We don't know what raised levels of anxiety from this type of message might do in a very large population," Cohen told Reuters Health.

Scary public health messages are appropriate when threats are under people's control -- like cigarette smoking and drunk driving -- he added. However, scares about anthrax-contaminated letters after September 11 or a smallpox epidemic before the invasion of Iraq were problematic, given that there isn't anything people can do about such dangers, real or imaginary.

"Any health intervention has to be evaluated as to its benefit and its risk. We have risks and no clear benefit," Cohen said.

To investigate the impact of potent, graphic bioterror warnings, Cohen and his colleagues had 116 undergrads read a scenario based on Richard Preston's novel "The Cobra Event" about a bioterror attack in New York City, or a "neutral" message focusing on the relatively low risk of such an attack compared to other public health problems. The messages were of roughly the same length, and both were attributed to "scientists."

While readers of the fictional scenario showed a jump in their anxiety levels, the anxiety levels of those who read the neutral message dropped by about the same amount, the researchers found.

"The high level of anxiety reported by participants reading the potent bioterrorism scenario could under certain circumstances interfere with both physical and psychological well-being of some susceptible individuals," the researchers note in the current issue of the International Quarterly of Community Health Education.

"It's not saying that you should withhold information from the public for fear of scaring them," Cohen said. "The idea is how you present and package the message. For some people, depending on their coping skills, added anxiety can have negative effects. That possibility has to be taken into account and right now it's not even being considered."

SOURCE: International Quarterly of Community Health Education, second issue, 2005-2006.