Counterfactual thinking in response to hypothetical breast cancer scenarios: a pilot study

This paper examined womens counterfactualthoughts in response to hypothetical scenarios aboutearly versus late breast cancer diagnoses.Womenaged 50 and over (N=29) read hypotheticalscenarios about the experience of fictitious womenof mammography screening age and completedcounterfactual statements from the protagonistsperspective.In two scenarios, the protagonist failedto attend mammography screening regularly andwas diagnosed with advanced breast cancer; thethird scenario depicted a woman who hadmammograms biennially and received an early-stagebreast cancer diagnosis.Consistent with pastliterature on counterfactual thinking, participantsgenerated exclusively upward counterfactuals fromthe two late-diagnosis scenarios, and predominantlydownward counterfactuals from the early-diagnosisscenario.Furthermore, participants primarilyfocussed on what the protagonist could personallyhave done differently to lead to a differentoutcome.Hence health communication messagesthat prompt women to think counterfactually mayencourage them to adopt greater personalresponsibility toward routine mammographyscreening.