Health Psychology Copyright 1997 by the American PsychologicalAssociation,Inc.

1997, Vol. 16, No. 2, 137-146 0278-6133/97/$3.00

Self-Esteem and the Relation Between Risk Behavior and Perceptions

of Vulnerability to Unplanned Pregnancy in College Women
Gabie E. Smith, Meg Gerrard, and Frederick X. Gibbons
Iowa State University

This article reports 2 studies testing the hypothesis that individuals with high self-esteem are
more likely than those with low self-esteem to interpret information about their personal
vulnerability to health risks in a self-serving manner. Study 1 used an experimental paradigm
to demonstrate that self-esteem moderates the influence of review of sexual and contraceptive
behavior on college women's perceptions of vulnerability to unplanned pregnancy (N = 125).
Study 2 used a longitudinal design to demonstrate that self-esteem also moderates the relation
between naturally occurring changes in college women's sexual behavior and changes in their
risk perception (N = 273). Together, these studies provide evidence that people with high
self-esteem use self-serving cognitive strategies to maintain their risk perceptions.

Key words: perceived vulnerability, risk perceptions, self-esteem

Several comprehensive reviews of the literature on health
behavior have supported the hypothesis that perceptions of
vulnerability motivate precautionary behavior (e.g., Becker,
1974; Harrison, Mullen, & Green, 1992; Janz & Becker,
1984). The effect has been documented for a wide variety of
preventive behaviors including receiving immunizations,
blood pressure screenings, and preventive medical assess-
ments, and returning for follow-up appointments with
physicians. Given this evidence, questions concerning the
determinants and accuracy of these perceptions warrant
examination. At present, however, research on these issues
presents an apparent contradiction (Rothman, Klein, &
Weinstein, in press). On the one hand, there is ample
evidence that people underestimate their risk of negative
events relative to others (Perloff & Fetzer, 1986; Weinstein,
1980, 1982). On the other hand, there is emerging evidence
that people use information to make reasonably accurate risk
estimates of their absolute risk (Gerrard, Gibbons, Benthin,
& Hessling, 1996; Gerrard & Luus, 1995; Rothman et al., in
press).
Determinants and Accuracy of
VulnerabilityEstimates
make judgments about their own likelihood of pregnancy in
a series of hypothetical situations in which both frequency of
sexual intercourse and contraceptive method were manipu-
lated (Gerrard & Luus, 1995). Results indicated that the
women combined information about frequency of inter-
course and contraception correctly (i.e., they recognized that
the two interact to determine risk) and that their risk
estimates were relatively accurate. Rothman et al. (in press)
reported similar evidence of accuracy in a study in which
college students' estimates of their risk for 11 different
health hazards correlated .71 with the actual probability of
occurrences of these events. Additional evidence that risk
perceptions reflect risk has recently been reported in a
longitudinal study of adolescents' initiation of three risk
behaviors (e.g., reckless driving and smoking; Gerrard,
Gibbons, Benthin, et al., 1996). As expected, increases in
adolescents' participation in these risk behaviors were
followed by increases in their perceptions of vulnerability to
the associated negative consequences (e.g., automobile
accidents and lung disease). In short, these studies suggested
that people do understand the relation between risk behav-
iors and vulnerability and can be fairly accurate in estimat-
ing the relative risks of different courses of action.

In a recent study of predictors of perceptions of vulnerabil- Illusion o f Unique Invulnerability

ity to unwanted pregnancy, college women were asked to
Gabie E. Smith, Meg Gerrard, and Frederick X. Gibbons,
Department of Psychology, Iowa State University.
This research was supported by National Institute of Mental
Health Grant 48165-01.
We would like to thank Bret Pelham for comments on a draft of
this article, and Daniel W. Russell for consultation regarding the
data analyses.
Correspondence concerning this article should be addressed to
Gabie E. Smith, who is now at the Department of Psychology, Guild
Center, Frostburg State University, Frostburg, Maryland 21532.
Electronic mail may be sent via Intemet to g_smith@fre.fsu.umd.edu.
Numerous studies have also demonstrated that people
tend to think that they are less vulnerable than others to
negative events (Gerrard, Gibbons, & Warner, 1991; Perloff
& Fetzer, 1986; Quadrel & Fischhoff, 1993; Taylor &
Brown, 1988; Weinstein, 1987). In other words, individuals'
ability to make accurate estimates is tempered by their
efforts to maintain what is commonly called an illusion of
unique invulnerability, or optimistic bias. Optimistic bias
has been demonstrated by using both absolute estimates of
risk and perceptions of risk relative to others (e.g., Wein-
stein, 1980, 1984). Not surprisingly, a variety of factors
appear to contribute to this perception.

137
138 SMITH, GERRARD, AND GIBBONS
First, it appears that when asked to estimate their own and
others' risk, people are more likely to pay attention to the
risk-increasing factors of others (e.g., genetic predisposi-
tions, unhealthy behaviors) than their own risk factors,
leading to the conclusion that others are at greater risk than
they are (Weinstein & Lachendro, 1982). Second, when
asked to consider their personal risk of a specific disorder,
people appear to conjure up an image of someone who is
particularly vulnerable to that disorder and then compare
themselves with that image (Perloff & Fetzer, 1986). In
comparison with this high-risk image, the self is seen as
relatively invulnerable. Such findings may represent unmoti-
vated cognitive errors in judgment caused, for example, by
comparison with salient stereotypic victims (Weinstein,
1980). It has also been suggested, however, that optimistic
bias is the result of a motivated process designed to maintain
subjective well-being (Perloff & Fetzer, 1986; Taylor, Wood,
& Lichtman, 1983; Weinstein, 1987; Wills, 1981). More
specifically, when considering their own risk, individuals
apparently are motivated to attend to information about
themselves in a self-serving manner (Kulik & Mahler, 1987;
Weinstein, 1984), focusing on their own risk-reducing
factors (e.g., diet, exercise, evidence of hereditary longevity)
and others' risk-increasing factors (Weinstein & Klein,
1995).
Gerrard, Gibbons, et al. (1991) provided evidence of the
motivational component of optimistic bias among women
Marines. This is a group with a high frequency of inter-
course, and therefore, a high risk of pregnancy (Gerrard &
Warner, 1994). Consistent with previous research (Wein-
stein, 1983), the process of behavioral review used in this
study resulted in lower perceptions of vulnerability to
pregnancy. However, this effect was significant only among
those women for whom pregnancy was undesirable. In short,
when their risk and preventive behaviors were both made
salient, the women who considered pregnancy particularly
undesirable focused more on their preventive behaviors,
thereby justifying their preexisting optimistic bias (cf.
Weinstein & Klein, 1995).
Self-Esteem
Previous research and theorizing suggests one factor that
may moderate the relation between risk behavior and risk
perceptions (i.e., acknowledgment of risk) is self-esteem.
For example, Campbell and her colleague (Campbell, 1990;
Campbell & Lavallee, 1993) have demonstrated that individu-
als with high self-esteem have more clearly defined and
more stable self-schemas than do individuals with low
self-esteem. As a result, high self-esteem individuals are
more likely to interpret self-relevant information in a
manner that is consistent with their self-schemas, and those
schemas by definition tend to be favorable. Similarly, high
self-esteem individuals have been shown to be more likely
than low self-esteem individuals to reject information that is
inconsistent with their perceptions and opinions (Cohen,
1959; Knight & Nadel, 1986).
More generally, high self-esteem individuals have been
shown to be more likely than low self-esteem individuals to
participate in a variety of self-serving or self-protective
cognitive distortions and illusions that appear to be similar
to those associated with optimistic bias (for reviews, see
Fiske & Taylor, 1991; Taylor & Brown, 1988). For example,
individuals with high self-esteem are more likely than those
with low self-esteem to exhibit enhanced impressions of
their attributes and abilities (Pelham, 1991; Schrauger &
Terbovic, 1976), and they are less likely to accept informa-
tion suggesting that they have performed poorly or have
been negligent (Brockner, 1979; Shrauger & Kelly, 1988).
Thus, it appears that self-enhancing biases are one way that
high self-esteem individuals validate and maintain positive
self-perceptions and expectations.
Research that has specifically assessed health-relevant
cognitions has also demonstrated the use of self-enhancing
strategies among high self-esteem individuals. For example,
Boney-McCoy, Gibbons, and Gerrard (1995) found that in
spite of comparable levels of risk behavior, high self-esteem
women reported lower perceived vulnerability to sexually
transmitted diseases than did low self-esteem women. In
addition, this study documented high self-esteem women's
use of a self-serving strategy. When high self-esteem women
were asked to identify behaviors or factors that increased
their risk of contracting sexually transmitted diseases, they
made more positive ratings of themselves on two additional
dimensions (their personalities and their pregnancy preven-
tion effeorts) than did women with low self-esteem. Another
study relevant to the current research examined the reaction
of smokers who had joined smoking cessation groups (and
therefore made a public commitment to abstain) and then
relapsed (Gibbons, Eggleston, & Benthin, 1997). In this
study, smokers with high self-esteem, but not those with low
self-esteem, lowered their estimation of the health risks
associated with smoking after relapsing. In sum, each of
these findings suggests that people with high self-esteem
react to information that threatens their perception that their
own preventive behaviors are efficacious in a more self-
serving fashion than do people with low self-esteem.
Current Studies
The current studies were designed to examine the effect of
self-esteem on individuals' interpretations of their health
risk behavior. Study 1 was an experimental investigation of
the effect of self-esteem on women's estimates of vulnerabil-
ity to unplanned pregnancy following review of their sexual
and contraceptive behavior. This study used a manipulation
of the salience of sexual and contraceptive risk behaviors by
having half of the participants review the risk behaviors they
had engaged in with each of their sexual partners (cf.
Gerrard, Gibbons, et al., 1991). In this study, we predicted an
interaction between self-esteem and review such that review
would have more impact on the perceived vulnerability of
low self-esteem women than on the perceptions of high
self-esteem women. We also conducted analyses to explore
the relation between review, perceptions of birth control
efficacy, and perceptions of vulnerability. Study 2 was a
longitudinal assessment of the effect of self-esteem on the
 SELF-ESTEEM AND PERCEIVED VULNERABILITY
relation between naturally occurring changes in risk behav-
ior and risk estimates.
Study 1
Method
Participants in Study 1 were 125 sexually active, unmarried
female students at a large public university in the Midwest who
agreed to participate in a study of health behavior. The mean age of
participants was 19 years old at the time of the study. These women
were selected from a pool of undergraduates who completed the
Rosenberg Self-Esteem Scale (Rosenberg, 1965) and responded to
questions about their sexual activity and contraceptive use in large
group screening sessions.
Procedure and Measures
Review. Data were collected from groups of 10 to 15 women,
with participants separated by empty seats to increase privacy. The
order of the questions was manipulated such that half of the women
completed a detailed report of their risk-increasing and risk-
decreasing behaviors prior to estimating their vulnerability to
unplanned pregnancy (review condition; cf. G-errard, Gibbons, et
al., 1991), which gave the following instructions:
Starting with your first sexual partner, indicate ALL the
periods of time you were ~exually active. For each period of
time indicate.., the length of the relationship, the frequency
of intercourse, and the method of contraception used . . . .
Please start with your first sexual partner, and work forward.
The order of the measures for women in the review condition was
perceived efficacy of birth control methods, attitudes toward
pregnancy (e.g., inconvenience and unhappiness if one were to
experience pregnancy), review of sexual and contraceptive behav-
iors for each partner (e.g., level of commitment, sexual activity),
report of specific contraceptives consistency for current method,
and perceived vulnerability estimates. The other half of the women
estimated their vulnerability prior to reporting these behaviors (no
review condition). The order of the questionnaire materials for the
women in the no review condition was perceived vulnerability
estimates, perceived efficacy of birth control methods, attitudes
toward pregnancy, review of sexual and contraceptive behaviors
for each partner, and report of contraceptive consistency for current
method. In Study 1, we used a 7-point Likert-type response scale
with the Rosenberg Self-Esteem Scale (1 = strongly disagree,
7 = strongly agree). Each of the measures is described below.
Perceived vulnerability. Participants responded to a question
concerning their personal vulnerability to experiencing an un-
planned pregnancy (i.e., "What do you think the likelihood is that
you will have an unplanned pregnancy in the next year?") by using
a 1-100 scale, with higher values indicating greater vulnerability.I
Perceived efficacy of birth control methods and attitudes toward
pregnancy. Because perceptions of vulnerability to unplanned
pregnancy are likely to reflect perceptions of the efficacy of
contraception, we also asked the women how effective they thought
their method of birth control was. For example, one question we
asked was "How effective are condoms in preventing pregnancy?"
(1 = extremely effective, 7 = not at all effective). This variable was
used as a covariate in one set of regression analyses and was also
used in correlational analyses. In addition, in order to address the
motivational components of the relation between self-esteem and
perceived vulnerability, motivation to avoid unplanned pregnancy
was also measured with the following question: "How inconve-
139
nient would it be for you to get pregnant in the next year?" (1 = not
at all, 7 = extremely).
Risk behavior. A pregnancy risk index was created, which
consisted of the product of the woman's frequency of intercourse
and the actual failure rate of her usual contraceptive method
(Hatcher et al., 1992). Frequency of sexual intercourse was
measured by using the item "How often do you have sexual
intercourse?" (response scale from 1 = currently, I am not sexually
active to 6 = more than three times a week; see Table 1). The
failure rate for contraceptive methods was 3% for oral contracep-
fives, 12% for condoms, 18% for withdrawai, and 20% for the
rhythm method. Higher values on the pregnancy risk index indicate
ineffective contraceptive behaviors. For example, the pregnancy
risk for a woman who reported having intercourse "at least once a
month, but not as often as once a week" a n d who used oral
contraceptives would be 4 (frequency) × 3 (the actual failure rate
for oral contraceptives), or 12. This index has previously been
demonstrated to be a valid predictor of pregnancy in a high-risk
sample (Gerrard & Warner, 1994).
Results
The mean self-esteem score o f participants was 54.9
(SD = 13.51, range = 10-70). For illustrative purposes,
mean responses for high and low self-esteem women are
presented in Table 1 using a median split. The most
commonly reported birth control methods were oral contra-
ceptives (53.6% o f participants) and condoms (35.2%); the
remaining participants reported using either withdrawal
(9.6%) or rhythm (1.6%). The modal response on reported
frequency o f intercourse was "at least once a week, but not
more than three times a w e e k " (38.4% o f participants). The
mean on the pregnancy risk index was 34.04 (SD = 24.93,
range = 3-108). High self-esteem women tended t o be
slightly riskier on these dimensions, although there were no
significant differences on the variables reported in Table 1
(all ps > . 14). The mean response to the perceived vulnerabil-
ity item was 20.77 (SD = 20.12).
Hierarchical regression analyses were conducted to test
the influence o f actual risk behavior, risk-relevant review,
and self-esteem on perceptions o f risk to unplanned preg-
nancy. The order of variables entered into the regression was
as follows: Step 1 - - p r e g n a n c y risk index, serf-esteem, and
review condition; Step 2---Self-Esteem × Review, Re-
view × Risk, and Self-Esteem × Risk interaction terms; and
1 We used absolute perceptions of vulnerability in Study 1 and
comparative perceptions of vulnerability in Study 2. We have used
the term perceived vulnerability to refer both to the estimation of
risk in absolute terms and to perceived vulnerability compared with
others. Absolute vulnerability is usually assessed with items like
"What is the likelihood that you will experience...?", whereas
comparative vulnerability is operationaiized as "Compared to most
people your age, what is the likelihood that you will experi-
ence...?" Although optimistic bias has been demonstrated by
using both constructs (e.g., Welnstein, 1980, 1984), little is known
about whether people store information regarding their vulnerabil-
ity in absolute or comparative terms (Gladis, Michela, Waiter, &
Vaughan, 1992; Weinstein, 1984). The literature does suggest,
however, that the two constructs are not redundant, for example,
correlations between the two across different negative events have
ranged from .22 to .75 (Weinstein, 1984).
140 SMITH, GERRARD, AND GIBBONS

Table 1
S t u d y 1: C o n t r a c e p t i v e a n d S e x u a l B e h a v i o r a n d A t t i t u d e s a s a F u n c t i o n o f S e l f - E s t e e m
High self-esteem Low self-esteem Whole sample
(n = 61) (n = 64) (N = 125)
Measure M SD M SD M SD
Failure rate of usual birth control method= 8.57 5.74 7.22 5.39 7.88 5.58
Frequency of intercourse b 4.51 1.04 4.42 .89 4.46 .96
Perceived efficacy of usual birth controlc 1.82 1.20 2.08 1.17 1.95 1.19
Number of partners 3.52 4.18 2.58 1.82 3.04 3.23
Pregnancy risk index a 37.34 26.20 30.89 23.43 34.04 24.93
Inconvenience of pregnancye 5.97 1.71 6.21 1.55 6.09 1.62
=Response scale for failure rate was 3% for oral contraceptives, 12% for condoms, 18% for
withdrawal, and 20% for the rhythm method, bResponse scale for frequency of intercourse was 1 =
currently, I am not sexually active; 2 = less than once a semester; 3 = at least once p e r semester, but
not as often as once a month; 4 = at least once a month, but not as often as once a week; 5 = at least
once a week, but not more than three times a week; and 6 = more than three times a week.
eResponse scale for perceived efficacy was 1 = extremely effective in preventing pregnancy to 7 =
not at all effective in preventing pregnancy, aThe pregnancy risk index was the product of the
failure rate of usual birth control method and frequency of intercourse measures, with high scores
indicating higher pregnancy risk. eResponse scale for inconvenience question was 1 = not at all
inconvenient to 7 = extremely inconvenient.

finally, in order to determine if the predicted Self-Esteem ×
Review interaction was moderated by risk, Step 3 included
the Review × Self-Esteem × Risk interaction term. All
three continuous variables (perceived vulnerability, preg-
nancy risk index, and self-esteem) were standardized by
using z scores prior to regression analyses (el. Aiken & West,
1991).
As c a n b e seen in Table 2, self-esteem was a significant
predictor of perceived vulnerability to unplanned pregnancy,
such that low self-esteem women reported higher vulnerabil-
ity estimates than high self-esteem women, (13 = - . 3 3 ,
p = .001). Also as predicted, the Self-Esteem × Review
interaction was significant (13 = - . 2 4 , p = .04), such that
review did not affect the perceived vulnerability of the high
self-esteem women, but it increased the vulnerability esti-
mates of the low self-esteem women (see Figure 1).
Consistent with previous findings that optimistic bias is not a
function of threat (Weinstein, 1980, 1987), the Review ×
Self-Esteem × Risk interaction was not significant
(13 = - . 0 8 , p = .47). Thus, as predicted, self-esteem moder-
ated the influence of the review process, such that low
self-esteem women's perceptions of vulnerability were more
affected by the review process than were high self-esteem
women's perceptions. This relation was not influenced by
the actual risk behavior o f participants, however.
Finally, in order to control for the women's perceptions of
the efficacy of their contraceptive methods in the main
analyses, we again performed the hierarchical regression
analysis described above, this time adjusting for perceived
efficacy of contraceptive method, which was entered in the
first step of the regression. This analysis demonstrated that
perceived efficacy predicted perceived vulnerability, but it
also revealed a pattern of results that was virtually identical
to the primary analyses. Once again, the self-esteem main
Perceived
Vulnerability Low Serf-
0.8 Esteem
0.6

0.4
Table 2
S t u d y 1: E f f e c t s o f R i s k Behavior, S e l f - E s t e e m ,
0.2
and Review on Absolute Perceived Vulnerability
to U n p l a n n e d P r e g n a n c y
i O'
Measure fJ t p<
Step 1 -0.2 "
Pregnancy risk index .16 1.75 .08
Self-esteem -.33 -3.76 .001 -0.4 ........................... ..... • High Serf-
Review condition .11 1.30 .19 Esteem
Step 2
Self-esteem × Review -.24 -2.09 .04 41.6
Review × Risk Index .14 1.24 .22 No Review Review
Self-Esteem × Risk Index - . 14 - 1.49 .14
Step 3 Review Condition
Review × Self-Esteem × Risk Index -.08 -0.72 .48
Figure 1. Perceived vulnerability to unplanned pregnancy as a
Note. F(7, 117) = 3.46,p = .002;R 2 = .17. function of self-esteem and review.
 SELF-ESTEEM AND PERCEIVED VULNERABILITY
effect and the Self-Esteem × Review interaction were the
only significant effects. Thus, adjusting for perceptions of
the effectiveness of contraceptive methods in preventing
pregnancies did not alter the relation between self-esteem
and behavioral review.
It may be that people with high self-esteem respond to
reviewing their risk behavior by selectively focusing on their
risk-reducing behaviors; that is, the high self-esteem wom-
en's reaction to the behavioral review in Study 1 may have
been to focus on their relatively effective contraceptive
methods (Gerrard, Gibbons, et al., 1991; Rothman et al., in
press). In order to explore this possibility, we examined the
effects of self-esteem and review on the relation between
perceived efficacy of birth control and perceived vulnerabil-
ity to pregnancy by computing the correlations between
these variables for the high and low self-esteem women in
the review and no review conditions separately. Because we
believed that the high self-esteem women in the review
condition would be the most likely group to focus on their
contraceptive behavior, we compared the correlation for this
group with the combined correlation for women in the other
three cells. This analysis revealed that perceived efficacy of
contraceptive method was predictive of perceived vulnerabil-
ity only among the high self-esteem women in the review
condition. The correlation for the high self-esteem women in
the review condition was .45 (p < .01), compared with r =
.16 for the other three cells combined; z test for the
comparison between correlations = 1.62, p = .05, one-
tailed; all other rs < .29, ns). 2
Discussion
The findings of Study I reveal a main effect of self-esteem
on perceived vulnerability. However, this effect is primarily
due to the different reactions high and low self-esteem
women had to a review of their risk-relevant behavior.
Specifically, in the no review condition high and low
self-esteem women did not differ in their perceptions of
vulnerability, but after reviewing their sexual and contracep-
tive behaviors low self-esteem women had significantly
higher perceived vulnerability estimates than did high
self-esteem women. This finding is consistent with the
hypothesis that high self-esteem individuals engage in
cognitive adjustments that allow them to buffer the acknowl-
edgment of actual risks. The pattern of these results is also
consistent with past research regarding the mutability of low
self-esteem individuals' self-perceptions and their depen-
dence on information for self-definition (cf. Campbell &
Lavallee, 1993). In addition, Study 1 provides correlational
evidence that high self-esteem women were more likely than
low self-esteem women to respond to the review by focusing
on the efficacy of their contraceptive behavior even though
the two groups did not differ in birth control behavior.
Study 2 was intended to replicate and extend the findings
of Study 1 by determining whether self-esteem also moder-
ates the relation between naturally occurring changes in risk
behavior and subsequent alterations in perceptions of vulner-
ability. Specifically, self-esteem and change in pregnancy
risk behavior were used to predict changes in estimates of
141
comparative vulnerability in a longitudinal design. Consis-
tent with Gerrard, Gibbons, Benthin, et al., (1996), we
hypothesized that increases in pregnancy risk behavior
would be followed by increases in perceived vulnerability to
unplanned pregnancy. As in Study 1, we also hypothesized
that this effect would be moderated by self-esteem. In
particular, high self-esteem should dilute the effect of
increased risk behavior on perceptions of vulnerability.
Thus, high self-esteem women should be less likely than low
self-esteem women to adjust their vulnerability estimates
following increases in their risk behavior.
Study 2
Method
Participants and Procedures
Participants in this study were college students in an ongoing
longitudinal study of health risk behaviors conducted at a large
public university in the Midwest (see Gibbons & Gerrard, 1995, for
more details).3 Study 2 reports the responses of 273 women who
had complete data for the variables of interest in the spring
semester of their freshman year, or Time 1 (T1), and their fall
semester of their sophomore year, or Time 2 (T2). The mean age of
participants at T1 was 19 years old.
Students completed the questionnaires individually in private
rooms in a laboratory on campus. At each administration, a
same-sex interviewer greeted the student, escorted her to a private
testing room, explained any changes in the procedures or questions
since the last administration, reminded her of the confidential
nature of the data, and remained available to answer any questions
that might arise. Each session lasted about 75 rain, for which the
students were paid $20.
2 In order to further explore the motivational component of this
process, we divided the high self-esteem review and no review
groups into those who were highly motivated to avoid a pregnancy
and those who were less motivated. We then examined the same
correlation (i.e., between perceived efficacy of birth control and
perceived vulnerability to unplanned pregnancy) separately for the
high self-esteem, high motivation women in the review condition
and for the high self-esteem, high motivation women in the no
review condition. High motivation to avoid pregnancy was defined
as responding to the inconvenience question with a 7 (61% of the
women); responses of 6 or lower were classified as less motivated.
The correlation for the high self-esteem, high motivation women in
the review condition was .59 (p < .01), compared with .08 for the
high self-esteem, high motivation women in the no review
condition; (z test for the difference between correlations = 1.86,
p = .03, one-tailed). Although the ns in these two cells were small
(only 23 and 22, respectively), this post boc analysis is consistent
with the hypothesis that high self-esteem women focus on risk-
reducing aspects of their behaviors when reviewing their contracep-
tive behavior and that this is particularly true for those high
self-esteem women who are most motivated to avoid pregnancy.
3 A number of other constructs (e.g., prototype perception,
prevalence estimates) and risk behaviors (i.e., alcohol use, smok-
ing, reckless driving) were assessed as part of the larger longitudi-
nal study. Only data relevant to the current hypothesis are reported
here.
142 SMITH, GERRARD, ANDG~BONS
Measures
Self-esteem was again assessed by means of the Rosenberg
Self-Esteem OScale (using a 7-point Likert-type response scale).
Pregnancy risk was an index consisting of the product of the
woman's frequency of intercourse over the last 6 months (an
open-ended item) and the failure rate of her usual contraceptive
method. Perceptions of comparative vulnerability to unplanned
pregnancy was assessed by a single item, "Compared to others
your age, how likely is it that you will have an unplanned
pregnancy at some time in the future?" Responses to this item were
recorded by using a 7-point scale (1 = much less likely than others,
7 = much more likely than others).
Results
The mean self-esteem score of the participants was 55.81
(SD = 8.30). Participants reported high levels of optimistic
bias (i.e., low levels of comparative vulnerability) as re-
fleeted in the mean of the comparative vulnerability item at
T1 (M = 2.2, SD = 1.35). The mean frequency of inter-
course over the previous 6 months increased from 14.92 to
18.36 between T1 and T2 (p < .02), with the high and low
self-esteem women reporting equal increases (p > .28). The
participants had a mean of 81.05 on the pregnancy risk
index. As in Study 1, there were no differences in the
pregnancy risk index or in optimistic bias at T1 or T2 for
high and low seif-esteem women (p > .57). As seen in Table
3, participants in Study 2 had a mean number of 3.75 sexual
partners by T2, a number comparable to that reported by the
participants in Study 1. Participants reported that they
became sexually active around 16 years of age on average.
Correlations between the measures in Study 2 are reported in
Table 4.
A hierarchical regression was performed to examine the
effects of self-esteem and of changes in risk behavior
between T1 and T2 on changes in comparative vulnerability
estimates from T1 to T2. The criteria variable in the
regression were perceived vulnerability estimates at T2,
with perceived vulnerability estimates at T1 entered in Step
1. Thus, the analyses predicted change in perceptions of
Table 3
Study 2: Contraceptive and Sexual Behavior and Attitudes as a Function o f Self-Esteem
Measure
Failure rate of usual birth control method (T1)a
Failure rate of usual birth control method (T2)
Frequency of intercourse over 6-month period
from T1 to T2
Number of partners
Pregnancy risk index (T1)b
Pregnancy risk index (T2)
Note. There were no differences for any of these variables for high and low self-esteem participants
(allps > .07). T1 = Time 1; T2 = Time 2.
aScale for failure rate at T1 and T2 was 3% for oral contraceptives, 12% for condoms, 18% for
withdrawal, and 20% for the rhythm method. ~I'he pregnancy risk index was the product of the
failure rate of usual birth control method and frequency of intercourse measures, with high scores
indicating higher pregnancy risk.
vulnerability (Gerrard, Gibbons, Benthin, et al., 1996).
Change in behavior was assessed in the same manner,
entering risk behavior at T1 in Step 1 and risk behavior at T2
in Step 2. In sum, Step 1 included perceived vulnerability
estimates at T1, pregnancy risk behavior, and serf-esteem;
Step 2 included pregnancy risk behavior at T2; and in Step 3,
the interaction of self-esteem and pregnancy risk behavior at
T2 was entered. Once again, all variables were continuous
and were standardized by using z scores prior to regression
analyses.
As can be seen in Table 5, risk estimates at T1 predicted
risk estimates at T2, (13 = .58, p < .0001). In addition, T1 to
T2 change in risk behavior predicted T1 to T2 change in
vulnerability estimates, such that women who increased
their risk behavior also increased their vulnerability esti-
mates (13 = .26, p < .0001). More important, self-esteem
moderated the effect of changes in risk behavior on changes
in vulnerability estimates as indicated by the significant
interaction between self-esteem and the pregnancy risk
index (13 = - . 1 0 , p = .03). In particular, low self-esteem
women who increased their risk behaviors increased their
vulnerability estimates to a greater degree than did high
self-esteem women who increased their risk behavior (see
Figure 2). The slopes for both groups were significantly
different from zero; for low self-esteem women, 13 = .26,
t(269) = 4.88, p < .001, and for high self-esteem women,
13 = .10, t(269) = 2.04,p = .04.
Discussion
The results of Study 2 indicate that changes in risk
behavior are associated with changes in comparative vulner-
ability estimates and that the strength of this association is
moderated by self-esteem. More specifically, although in-
creases in risk behavior are followed by increases in
comparative vulnerability estimates for both groups, the
effect is significantly stronger for women with low self-
esteem than for those with high self-esteem. These findings
replicate the results of Study 1 and extend those findings in
High self-esteem Low self-esteem Whole sample
(n = 140) (n = 133) (N = 273)
M SD M SD M SD
9.63 1 4 . 7 9 6.82 4.70 8.29 10.99
8.06 9.29 6.91 4.70 7.49 7.41
20.85 28.28 16.48 21.94 18.65 25.33
3.79 4.53 3.00 3.99 3.75 4.26
81.88 130.12 80.19 128.58 81.05 129.14
108.75 170.60 90.09 141.41 99.62 156.99
 SELF-ESTEEM AND PERCEIVED VULNERABILITY 143

Table 4 Time 2
Study 2: Correlations Between Measures Used Perceived
in the Analyses Vu~era~y
0.4
Measure 1 2 3 4 5 Low Self-
0.3 Esteem
1. Seif-esteem (T1)
2. Perceived vulnerability (T1) -.06 -- 0.2
3. Pregnancy risk index (T1) .06 .37*
4. Perceived vulnerability (T2) -.09 .59* .24* -- 0.1
5. Pregnancy risk index (T2) .07 .23* .48* .35* - - High Self-
0
Note. T1 = Time l; T2 = Time 2. Esteem
*p < .001. -0.1
-0.2

two ways. First, whereas Study 1 addresses the impact of -0.3

self-esteem on vulnerability estimates after risk and preven-
tive behaviors had been made salient through review, Study
2 demonstrates that self-esteem also influences vulnerability
estimates as people pass through naturally occurring changes
in their actual risk. It would appear, then, that in general,
people are aware that changes in their risk behavior influ-
ence their vulnerability to negative consequences of these
behaviors but that high self-esteem acts as a buffer that dulls
this awareness. Second, whereas Study 1 demonstrates that
self-esteem moderates the relation between risk behavior
and absolute vulnerability estimates, Study 2 extends this
finding to the relation between risk behaviors and compara-
tive judgments of vulnerability.
Study 2 also provides insight into another issue of
interest--the question of whether high self-esteem women's
(relative) optimism or low self-esteem women's (relative)
pessimism is a more accurate assessment of their actual
vulnerability to unplanned pregnancy. In this study, both the
high and the low self-esteem women thought that they were
far less likely than "other women their age" to experience an
unplanned pregnancy both at T1 and at T2. It is reasonable to
assume, then, that these women's responses to the compara-
tive risk questions at both times reflect an illusion of unique
invulnerability. Thus, although increases in their risk behav-
ior are associated with decreases in their optimism, these
changes were not sufficient to eliminate the women's
perception that they were less vulnerable to unplanned
pregnancy than were other women.
Table 5
Effects of Self-Esteem and Naturally Occurring Changes
in Pregnancy Risk Behavior on Comparative Perceived
Vulnerability (Study 2)
Measure ~ t
Step 1
Pregnancy risk index (T1) .03 0.57 .57
Self-esteem -.06 - 1.26 .21
Risk estimate (T1) .58 1 0 . 8 7 .0001
Step 2
Pregnancy risk index (T2) .26 4.90
Step 3
Serf-Esteem X Pregnancy Risk (T2) -.10 -2.16
Note. F(5, 268) = 38.28, p < .0001; R 2 = .42. T1 = Time 1;
T2 = Time 2.
-0.4
-0.5
Decreased Increased
Change in Contmcept~ Risk Behavior
From Time 1 to "Fwne2
Figure 2. Changes in comparative risk estimates regarding un-
planned pregnancy as a function of self-esteem and naturally
occurring changes in risk behavior.
General Discussion
The current studies add to a growing body of evidence
suggesting that people with high self-esteem use self-serving
strategies to maintain their optimistic biases regarding their
health risks. When given the opportunity, high self-esteem
individuals discount health information that is contrary to
their perceptions that they are engaging in effective precau-
tionary behaviors (Gerrard, Kurylo, & Reis, 1991). When
forced to acknowledge their less-than-perfect precautionary
behaviors, they react by enhancing their self-perceptions on
other unrelated dimensions (Boney-McCoy et al., 1995).
When they fail at an attempt to decrease a specific risk
behavior, they are more likely than those with low self-
esteem to lower their estimates of the risks associated with
that behavior (Gibbons et al., 1997).
In the current studies, we used both an experimental
manipulation and longitudinal data to demonstrate that high
self-esteem can mitigate the acknowledgement of the rela-
tion between risk behavior and vulnerability to negative
consequences of that risk behavior, a self-serving process
that has been shown to be associated with self-esteem
p< maintenance (Tennen & Affleck, 1993). For example, Gib-
bons et al. (1997) reported that those participants who
responded to their failed attempt to quit smoking by
reducing the amount of risk they associated with smoking
maintained their self-esteem, those who did not evidenced a
.0001 decrease in self-esteem. More specifically, Gibbons et al.
found that high self-esteem participants in the smoking
.04 cessation clinics who relapsed later altered their perceptions
of risks associated with smoking, and this alteration was
related to self-esteem maintenance 5 months later.
144 SMITH, GERRARD, AND GIBBONS
Are Optimistic Biases Always Adaptive ?
A number of researchers have suggested that unrealisti-
cally positive self-evaluations and illusions of control and
invulnerability are normal and can he adaptive (Abramson &
Alloy, 1981; Taylor & Brown, 1988). In fact, Taylor and
Brown have argued that mild levels of these positive
illusions are positively correlated with psychological health.
They point to evidence that only people suffering from
depression and those with extremely low self-esteem do not
harbor illusions of control and invulnerability (see also
Alloy & Ahrens, 1987). The general issue of whether these
illusions are adaptive or maladaptive has been the topic of a
fair amount of speculation (cf. Baumeister, 1989; Colvin &
Block, 1994; Colvin, Block, & Funder, 1995; Gollwitzer &
Kinney, 1989; Taylor, 1989; Taylor & Brown, 1994; Taylor,
Collins, Skokan, & Aspinwall, 1989). On this issue, Taylor
and Brown (1988) have suggested that information inherent
in the situation "offsets the effects of illusions and leads
people to amend their behavior" (p. 204). For example, they
argued that the need for mastery and the illusion of control
can lead people to control their risk behaviors in spite of
their illusions of invulnerability, and that mild illusions do
not interfere with the need to monitor reality. Similarly,
Janoff-Bulman (1989) suggested that people can maintain
their broad illusions while accepting concrete evidence of
their limitations. If this is the case, the benefits of high
self-esteem may outweigh the costs, because the cognitive
biases associated with high self-esteem are kept in check by
aspects of the situation or environment.
Recently, however, a number of authors have raised the
question of whether these positive illusions can be maladap-
tive to physical health. Clearly, negative consequences of
optimistic bias regarding health risks (e.g., underestimating
the likelihood of having an accident while driving under the
influence of alcohol, or the likelihood of contracting HIV
from having unprotected sex) are potentially more danger-
ous than thinking that you are more attractive, socially
poised, or witty than others think you are. Thus, the question
becomes do illusions of invulnerability have the potential to
cause people to forego necessary precautionary behaviors
(cf. Flay et al., 1994; Tennen & Affieck, 1993)? More
specifically, does the tendency to interpret behavior in a
self-serving manner lead to maladaptive complacency regard-
ing their precautionary or risk behavior (Haaga & Stewart,
1992)? Does it interfere with motivation to practice preven-
tive measures? What are the implications of high self-esteem
women's risk perceptions for actual health behaviors?
Unfortunately, very little research has addressed the relation
between positive illusions and subsequent risk and precau-
tionary behavior (Gerrard, Gibbons, & Bushman, 1996), and
none of this research has examined the role of self-esteem as
a moderator of this relation. 4
Several researchers have demonstrated that children's
self-esteem is predictive of good health (Mechanic, 1980)
and illness orientations (knowledge of the correct proce-
dures when experiencing an illness; Lau & Klepper, 1988).
Although the current studies do not provide evidence of a
significant difference in actual pregnancy risk behaviors
between high and low self-esteem women, the direction of
the differences is such that high self-esteem women take
more risks than do low self-esteem women. This is consis-
tent with preliminary evidence from two recent studies that
suggested that people with high self-esteem are more likely
than those with low self-esteem to engage in risky behaviors
such as motorcycle riding, drinking, driving under the
influence of alcohol, and speeding (Gerrard, Gibbons,
Smith, & Hessling, 1995; Pelham, 1995; Sharp & Getz,
1995). More to the point, there is indirect evidence that high
self-esteem individuals' self-serving strategies for dealing
with their personal vulnerability may reduce motivation to
engage in precautionary behavior. A secondary analysis of
the Boney-McCoy et at. data (1995) revealed that use of the
strategy of self-enhancing on other dimensions (when forced
to acknowledge sexual risk behavior) was associated with a
decline in perceived vulnerability. In other words, successful
compensatory self-enhancement appears to have facilitated,
or at least to have been accompanied by, a diminution of
perceived vulnerability.
Perhaps more suggestive of negative consequences of
high self-esteem individuals' self-serving interpretations of
their behavior is a finding reported in the Gibbons et at.
(1997) study of members of smoking cessation groups. In
this research, high self-esteem relapsers showed a signifi-
cantly greater drop in commitment to making another
cessation attempt than did low self-esteem relapsers. In fact,
the decline in perceived vulnerability among relapsers was
correlated with a decline in commitment to another attempt
at quitting. Thus, it may be the case that high self-esteem
individuals' facility to interpret their behavior in positive
terms may contribute to future risk behavior either indi-
rectly, by lowering perceptions of vulnerability, or directly,
by lowering willingness to admit and reduce risky behavior.
At any rate, the issue of the relation between perceived
vulnerability and subsequent risk behavior, and the role that
self-esteem plays in this relation, are important and defi-
nitely worthy of future research.
Limitations and Future Directions
Several limitations of the current studies should be
addressed. Most notably, we did not have the variance
available in the behavior of interest to assess whether
differences in high and low self-esteem individuals' risk
perceptions translate into differences in risk taking (see
footnote 2). The self-enhancing strategies of high self-
esteem individuals that lead to altered risk perceptions could
also result in greater risk-taking behaviors. Alternatively,
4 The longitudinal data set reported in Study 2 cannot be used to
address this question directly because the participants' sexual risk
and preventive behaviors had stabilized between T2 and T3 (6
months after T2). Specifically, there was very little change in
contraceptive method and frequency of intercourse between later
time periods (T2 and T3) as evidenced by the correlations between
failure rate of contraceptive methods at T2 and T3, r = .88,
p < .001, and frequency of intercourse at T2 and T3, r = .58,
p < .001.
 SELF-ESTEEM AND PERCEIVED VULNERABILITY
these biases could be held in check by environmental or
situational constraints and not translate into actual risk-
taking actions (cf. Taylor & Brown, 1988). Research involv-
ing participants whose risk behavior is in flux is necessary to
address these issues.
In addition, the results of Study 1 suggest that when asked
to review both risk-increasing and risk-decreasing factors,
high self-esteem individuals focus more on the factors that
reduce their risks (e.g., perceived efficacy of contraceptive
methods). The current studies, however, like much of the
research conducted in this area, were not intended to
examine the underlying processes that mediate the relation
between personality variables, health information, and per-
ceptions of vulnerability. Future research could provide hard
evidence of the mediating processes that influence percep-
tions of vulnerability.
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