Juliana Breines Ph.D.

In Love and War

What Motivates People to Take Health Risks?

The desire to be seen in a positive light can give rise to dangerous behaviors.

Posted Jun 29, 2017

Given our strong inclination toward self-preservation, it can be hard to understand why people would do things that knowingly put their health and safety at risk. Yet it happens all the time, especially among adolescents and young adults.

One explanation comes from social psychology. Research on self-presentation suggests that people monitor others’ perceptions of them and strive to present self-images that will elicit positive evaluations. In other words, as much as we might profess not to, we care about what other people think of us and want to make a good impression.

To examine how self-presentation motives impact health behavior, researchers conducted a survey of college freshman. At the end of their first semester, participants were asked whether they had engaged in 10 health risk behaviors for the purpose of making an impression on others: alcohol use, drug use, tobacco use, reckless driving, driving while under the influence of drugs or alcohol, riding with a driver who was under the influence, engaging in unprotected sex, physical fighting, dangerous stunts, and lifting excessive weight at the gym. For each behavior, participants indicated which of the following images they were trying to present: cool/laid-back, fun/social, brave/a risk-taker, physically attractive, or mature.

Results showed that three-quarters of participants reported performing at least one of the behaviors in an attempt to make a desired impression on others. The most common behaviors were drinking alcohol, dangerous driving, and smoking (among men, stunts and excessive lifting were also relatively common).

Participants reported wanting primarily to appear cool/laid-back, brave/a risk-taker, and fun/social. Although there were overlaps in which behaviors were associated with which desired images, drinking was most often associated with wanting to seem fun and social, while smoking was most often linked to wanting to seem cool and laid-back.

Were these risky behaviors effective in eliciting desired impressions? On average, participants perceived their efforts to be moderately successful, though it’s unclear whether other people would share these perceptions. In some instances, self-presentation attempts clearly backfired. For example, one participant described a situation where she drank too much and then vomited on herself in front of others.

Self-presentation motives may also backfire when they’re too obvious. People may want to seem cool and fun, but they don’t want to seem like they’re trying to seem cool and fun. Those who go to dangerous extremes to gain social approval might end up seeming desperate for attention instead, the opposite of the image they’re trying to convey.

Of course, there are plenty of other reasons why people engage in unhealthy behaviors, including physical addiction and stress reduction. But to the extent that self-presentation concerns can play a role, health-promoting interventions may be more effective when they take into account these concerns. For example, when drug education programs focus on the health risks of drug use, they might inadvertently make the behavior more appealing to those who want to appear brave and rebellious.

While reckless behaviors might be more common in adolescents, they can also occur in adults—they just tend to take different forms, such as not seeking treatment for a health problem to avoid embarrassment, or attempting to perform a dangerous physical task, like lifting a heavy piece of furniture on one’s own, in order to appear strong and self-reliant.

Self-presentation concerns may also pose an obstacle to healthy eating. It can be awkward to turn down dessert at a birthday party if you’re on a low-glycemic diet, or to order a salad when everyone else is having a burger and fries. In addition, research suggests that women are more likely to undereat in front of men to present a feminine image, while men are more likely to overeat to show off their virility.

It may not be possible (or desirable) to stop caring about what other people think. But sometimes these concerns feel more important in the moment than they will be in the long run. By stepping back and reflecting on our higher-order goals (e.g. avoiding a car accident, preventing serious illness or injury), we might make healthier choices.


Martin, K. A., & Leary, M. R. (2001). Self-presentational determinants of health risk behavior among college freshmen. Psychology and Health, 16, 17-27.

Martin, K. A., Leary, M. R., & Rejeski, W. J. (2000). Self-presentational concerns in older adults: Implications for health and well-being. Basic and Applied Social Psychology, 22(3), 169-179.

About the Author

Juliana Breines, Ph.D., is a postdoctoral fellow at Brandeis University.

More Posts