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Affectionate communication constitutes verbal behaviors (e.g., saying “I love you”), nonverbal gestures (e.g., hugging, handholding), and socially supportive behaviors (e.g., helping with a project) that humans employ to develop and maintain close relationships with others. In addition to its relational benefits, affectionate communication contributes to health and wellness for both senders and receivers. Affection exchange theory (AET) addresses the questions of why humans engage in affectionate communication and why diverse benefits are associated with such behaviors. A robust empirical literature supports AET’s contention that both expressing and receiving affectionate behavior are associated with physical and mental health benefits. Despite these contributions, however, some compelling questions about affectionate communication remain to be addressed, and AET can provide a useful framework for doing so.

Have you ever wondered why a complete stranger sitting next to you on a plane would tell you about a recent cancer diagnosis? Why your parents never disclosed that you were adopted, feeling shocked when you accidently find out as an adult? These and many other actions reflect decisions individuals make about managing their private information. Being aware of how individuals navigate decisions to disclose or protect their private information provides useful insights that aid in the development and sustainability of relationships with others. Given privacy plays an integral role in everyone’s life, knowing more about privacy management is critical. communication privacy management (CPM) theory was first introduced by Sandra Petronio in 2002. CPM is evidence-based and accordingly provides a dependable understanding of how decisions are made to disclose and protect private information. This theory uses plain language to understand privacy management in everyday life. CPM focuses on the relationship people have with each other in communicative contexts, such as face-to-face interactions, on social media, and in dyads or groups. CPM theory is based on a communicative-social behavioral perspective and not necessarily a legal point of view. CPM theory illustrates that privacy is not paradoxical but is sustainable through the process of a privacy management system used in everyday life. The theory of CPM has been employed in a number of contexts shedding light on antecedents, mechanisms, and outcomes of private information management. In addition, a number of researchers across multiple countries, such as the Netherlands, United Kingdom, Japan, Kenya, South Korea, and the United States, have used CPM theory in their research investigations. Learning more about the system of private information management allows for a better understanding of how people navigate managing their private information when others are involved. Literature illustrates patterns of privacy management and demonstrates the challenges as well as the positive outcomes of the way individuals regulate their private information.

Communication privacy management theory (CPM) argues that disclosure is the process by which we give or receive private information. Private information is what people reveal. Generally, CPM theory argues that individuals believe they own their private information and have the right to control said information. Management of private information is not necessary until others are involved. CPM does not limit an understanding of disclosure by framing it as only about the self. Instead, CPM theory points out that when management is needed, others are given co-ownership status, thereby expanding the notion of disclosing information; the theory uses the metaphor of privacy boundary to illustrate where private information is located and how the boundary expands to accommodate multiple owners of private information. Thus, individuals can disclose not only their own information but also information that belongs to others or is owned by collectives such as families. Making decisions to disclose or protect private information often creates a tension in which individuals vacillate between sharing and concealing their private information. Within the purview of health issues, these decisions have a potential to increase or decrease risk. The choice of disclosing health matters to a friend, for example, can garner social support to cope with health problems. At the same time, the individual may have concerns that his or her friend might tell someone else about the health problem, thus causing more difficulties. Understanding the tension between disclosing and protecting private health information by the owner is only one side of the coin. Because disclosure creates authorized co-owners, these co-owners (e.g., families, friends, and partners) often feel they have right to know about the owner’s health conditions. The privacy boundaries are used metaphorically to indicate where private information is located. Individuals have both personal privacy boundaries around health information that expands to include others referred to as “authorized co-owners.” Once given this status, withholding to protect some part of the private information can risk relationships and interfere with health needs. Within the scheme of health, disclosure risks and privacy predicaments are not experienced exclusively by the individual with an illness. Rather, these risks prevail for a number of individuals connected to a patient such as providers, the patient’s family, and supportive friends. Everyone involved has a dual role. For example, the clinician is both the co-owner of a patient’s private health information and holds information within his or her own privacy boundary, such as worrying whether he or she diagnosed the symptoms correctly. Thus, there are a number of circumstances that can lead to health risks where privacy management and decisions to reveal or conceal health information are concerned. CPM theory has been applied in eleven countries and in numerous contexts where privacy management occurs, such as health, families, organizations, interpersonal relationships, and social media. This theory is unique in offering a comprehensive way to understand the relationship between the notion of disclosure and that of privacy. The landscape of health-related risks where privacy management plays a significant role is both large and complex. The situations of HIV/AIDS, cancer care, and managing patient and provider disclosure of private information help to elucidate the ways decisions of privacy potentially lead to health risks.

Families represent a central relational unit within society and a formative context of interdependence throughout one’s life. How family members individually and collectively navigate communicative decisions therefore illustrates a process offering implications for each member within a family. Although various forms and contexts of decision-making might emerge, decisions guiding how family members communicate remain inevitable. Thus, particular importance emerges in understanding the processes and considerations that guide communicative decisions in families. Some decision-making processes might remain implicit, but several communication theories and models illuminate explicit considerations guiding family members’ communicative decisions. The first set of theoretical perspectives provides insights regarding communicative decisions relevant in contexts of uncertainty. The theory of motivated information management, for example, suggests that family members must make decisions regarding how they wish to manage a lack of information and any resulting uncertainty. However, those decisions likely remain guided by how family members assess their individual (or collective) ability to obtain the desired information, as well as cope with the outcomes of obtaining new information. Relatedly, uncertainty management theory illustrates the ways that family members experiencing uncertainty likely face decisions regarding if, as well as to what extent, they wish to acquire more information related to the source of uncertainty. Communication often serves as an information-seeking behavior family members decide to either enact or avoid, depending on how interested they are in reducing their uncertainty. A second set of theoretical perspectives illustrates the decisions family members face regarding if (and how) they communicate “private” information, as well as secrets. When managing private information, communication privacy management theory outlines decisions family members likely confront related to privacy ownership, privacy control, and privacy turbulence. In terms of secrets, the revelation risk model explicates considerations guiding if (and how) individuals decide to reveal secrets to their family members. These considerations include assessments of potential risk, perceived communication efficacy, and the relational closeness between the family members. The cycle of concealment model also examines decisions to reveal secrets, but this model suggests that these decisions also consider elements such as family interaction histories and, similarly, the quality of the relationship shared between the family members. A final theoretical perspective illuminates how health contexts introduce unique considerations that might dictate if (and how) family members decide to communicate about health-related information. Specifically, the disclosure decision-making model proposes that these types of communicative decisions remain guided by more unique considerations, such as (a) the type of information to be disclosed, (b) the relationships among the family members, (c) how a family member is likely to respond to the disclosure, (d) perceived disclosure efficacy, and (e) available strategies to disclose the information. Collectively, these six theoretical perspectives provide a multifaceted understanding of the central processes and considerations that guide communicative decisions in families.

Embarrassment, according to Fischer and Tangney, is an “aversive state of mortification, abashment, and chagrin that follows public social predicaments.” It is usually related to our perceptions of how others perceive us as well as their judgments of us, and it is associated with a loss of self-esteem when we perceive that others have judged us as inadequate or incompetent. However, even mere exposure or attention publicly placed on someone can elicit embarrassment (think of someone pointing at you and laughing). Embarrassment is considered a self-conscious emotion. Self-conscious emotions include those that are evoked by self-reflection and self-evaluation: embarrassment, shame, guilt, and pride. Shame, an intense form of embarrassment, also has structural and larger social contexts, while embarrassment is more individually experienced. Self-conscious emotions play an important role in regulating behavior; they assist us in behaving according to social standards and guide us in responding when those rules are broken. While these emotions provide feedback in social situations, they also provide feedback for anticipated outcomes. Embarrassment can play an important role in health, both in communication and behavior, and occurs through different forms. Primary embarrassment is the first rush of blood to the face and increased heart rate that usually lasts a few moments. Secondary embarrassment is the after-effect that shapes future behavior. Anticipatory embarrassment is the emotion surrounding the potential for embarrassment in an upcoming situation. Solitary embarrassment is the one that no one actually observes. Three stigmatized areas of health—mental health, healthcare, and sexual health—may be assessed as case studies through which to understand the literature around embarrassment, as both an affect and an emotion.

The degree to which patients are active and communicative in interactions with medical providers has changed in recent decades. The biomedical model, a model that minimizes patient agency in the medical interaction, is being replaced with a model of patient-centered care, an approach that prioritizes the individual patient in their healthcare and treatment decisions. Tenets of patient-centered care support that patients must be understood within their psychosocial and cultural preferences, should have the freedom to ask questions, and are encouraged to disclose health-relevant information. In short, this model promotes patient involvement in medical conversations and treatment decision-making. Research continues to examine approaches to effective patient-centered communication. Two interpersonal processes that promote patient-centered communication are patient question-asking and patient disclosure. Patient question-asking and disclosure serve to inform medical providers of patient preferences, hesitations, and information needs. Individuals, including patients, make decisions to pursue or disclose information. Patients are mindful that the act of asking questions or disclosing information, particularly stigmatized information such as sexual behavior or drug use, could make them vulnerable to perceived negative provider evaluations or responses. Thus, decisions to ask questions or share information, processes essential to the understanding of patient perspectives and concerns, may be challenging for patients. Various theoretical models explain how individuals consider if they will perform actions such as seeking or disclosing information. Research also explains the barriers that patients experience in asking questions or disclosing relevant health information to providers. A review of pertinent research offers suggestions to aid in facilitating improved patient-centered communication and care.

Adolescent substance use and abuse has long been the target of public health prevention messages. These messages have adopted a variety of communication strategies, including fear appeals, information campaigns, and social marketing/branding strategies. A case history of keepin’ it REAL, a narrative-based substance abuse prevention intervention that exemplifies a translational research approach, involves theory development testing, formative and evaluation research, dissemination, and assessment of how the intervention is being used in the field by practitioners. The project, which started as an attempt to test the notion that the performance of personal narratives was an effective intervention strategy, has since produced two theories, an approach to implementation science that focused on communication processes, and, of course, a school-based curriculum that is now the most widely disseminated drug prevention program in the world. At the core of the keepin’ it REAL program are the narratives that tell the story of how young people manage their health successfully through core skills or competencies, such as decision-making, risk assessment, communication, and relationship skills. Narrative forms not only the content of curriculum (e.g., what is taught) but also the pedagogy (e.g., how it is taught). This has enabled the developers to step inside the social worlds of youth from early childhood through young adulthood to describe how young people manage problematic health situations, such as drug offers. This knowledge was motivated by the need to create curricula that recount stories rather than preaching or scaring, that re-story health decisions and behaviors by providing skills that enable people to live healthy, safe, and responsible lives. Spin-offs from the main study have led to investigations of other problematic health situations, such as vaccination decisions and sexual pressure, in order to address crucial public health issues, such as cancer prevention and sex education, through community partnerships with organizations like D.A.R.E. America, 4-H clubs, and Planned Parenthood.

Relational dialectics theory (RDT) is a postmodern critical theory of meaning. Based on the writing of Russian philosopher, RDT attunes researchers to the ways that discourses (i.e., ideologies) compete to make meaning of particular semantic objects (e.g., identities, phenomena, processes, etc.). Of note, not all discourses hold the same amount of power. Some discourses are dominant (i.e., centripetal) whereas others are marginalized (i.e., centrifugal). RDT researchers, then, are primarily interested in exploring how these discourses, with unequal power, compete. This focus on the competition of discourses for power and the ability of RDT to call out the ideological forces that disenfranchise some groups while enfranchising others holds promise for practical applications such as debunking misconceptions and better understanding where privilege comes from and how it is perpetuated. When discourses compete, they might do so within or across a set of utterances. Utterances are turns in talk and serve as the primary unit of analysis in RDT research. Utterances, however, are not standalone entities. Rather, they are connected by different links to form an utterance chain. Some links of the utterance chain pertain to time (what has been said before and what response an utterance can anticipate) whereas the other links of the utterance chain pertain to the relationship level (some pertain to the culture at large whereas other only to an idiosyncratic relationship). Overall, discursive competition takes place across a continuum of interplay. At one end of the continuum is monologue. Monologue represents the absence of meaning. Next are discursive enactments (i.e., closure) that reinforce the dominant discourse and shut down alternatives (see entry for complete list). Diachronic separation occurs when the dominance of a discourse changes across time. Diachronic separation can take two forms: (a) spiraling inversion or (b) segmentation. Synchronic interplay is next and occurs when two discourses compete within a given utterance. When RDT researchers examine a text for synchronic interplay, they often look to see how a marginalized discourse (a) negates, (b) counters, or (c) entertains the dominant discourse. Finally, on the other end of the continuum of interplay, is dialogic transformation. Dialogic transformation occurs through either (a) discursive hybridity or (b) an aesthetic moment whereby discourses suspend their interplay to create new meanings. Conducted using RDT’s corresponding method, contrapuntal analysis, researchers using this theory work to disrupt hegemonic, taken-for-granted assumptions about how things are and call attention to voices overlooked in the past. To date, this theory has been taken up primarily by family, interpersonal, and health communication scholars, although many scholars have used this theory throughout the discipline.

Self-affirmation theory posits that people are motivated to maintain an adequate sense of self-integrity. It further posits that the self-system is highly flexible such that threats to one domain of the self can be better endured if the global sense of self-integrity is protected and reinforced by self-resources in other, unrelated domains. Health and risk communication messages are often threatening to the self because they convey information that highlights inadequacies in one’s health attitudes and behaviors. This tends to lead to defensive response, particularly among high-risk groups to whom the messages are typically targeted and most relevant. However, self-affirmation theory suggests that such defensive reactions can be effectively reduced if people are provided with opportunities to reinforce their sense of self-integrity in unrelated domains. This hypothesis has generated substantial research in the past two decades. Empirical evidence so far has provided relatively consistent support for a positive effect of self-affirmation on message acceptance, intention, and behavior. These findings encourage careful consideration of the theoretical and practical implications of self-affirmation theory in the genesis and reduction of defensive response in health and risk communication. At the same time, important gaps and nuances in the literature should be noted, such as the boundary conditions of the effects of self-affirmation, the lack of clarity in the psychological mechanisms underlying the observed effects, and the fact that self-affirmation can be easily implemented in some health communication contexts, but not in others. Moreover, the research program may also benefit from greater attention to variables and questions of more direct interest to communication researchers, such as the role of varying message attributes and audience characteristics, the potential to integrate self-affirmation theory with health communication theories, and the spontaneous occurrence of positive self-affirmation in natural health communication settings.

Social psychological research on thinking has generally focused on the attitudes, emotions, motivations, and biases that affect thinking and consequent behavior. What has received less attention is the speed of thinking: how quickly thinking occurs and whether thoughts accelerate or slow down. Communication design and processing may take for granted that the structure and reception of messages occur at a certain speed. Recent findings from the psychological study of thought speed shed light on ways that this research may be applied to health communication. Fast and slow rates of thinking are correlated with distinct patterns of affective, cognitive, physiological, and behavioral events. Fast thinking is associated with positive mood, energy, approach motivation, arousal, creativity, and risk-taking. Slow thinking is associated with negative mood and depression, low energy, and cognitive impairment. Potential theories exist for why psychological and physiological experiences are associated with thought speed. Recent experimental research demonstrates that thought speed can be successfully manipulated to elicit psychological effects, and it can be manipulated independent of thought content. Researchers, healthcare practitioners, and communicators should be aware of the psychological correlates and consequences of thought speed and consider harnessing the effects of thought speed to augment communication. Thought acceleration and deceleration can be integrated into the design and processing of health communication.

In social marketing, the use of guilt appeals can be effective for influencing healthy behaviors. Guilt, being a moral, other-based emotion, can spur people to think of others, act honestly, and be empathetic. Likewise, collective guilt, the feeling that arises when people believe their in-group caused illegitimate harm to others, can lead people to feel positively toward the victimized others and desire policies that will help them. We can see then, that guilt, though often considered “negative” can lead to an array of prosocial, constructive, behaviors. In that vein, a number of researchers have assessed the possibility that guilt based persuasive appeals can induce such positive behaviors. Clearly, guilt-appeals can be an effective tool for reducing risk (STI testing), increasing prevention practices (encouraging mammograms), and effecting altruistic health-related behaviors (donating blood). In the correct conditions, guilt appeals can induce guilty feelings, lead people to want to “right the wrong,” generate positive attitudes about the message’s advocacy, and intend to engage in a behavior.