Blood donor development: Effects of personality, motivational and situational variables

Copyright

BLOOD DONOR DEVELOPMENT: EFFECTS PERSONALITY, MOTIVATIONAL AND SITUATIONAL VARIABLES* PATRICKW. EDWARDS~and Department

of Psychology,

University

AMOS

of Georgia,

(Received 2 December

0191.8869/85S3.00+0.00 X? 1985 Pergamon Press Ltd

OF

ZEICHNER

Athens,

GA 30602,

U.S.A.

1984)

Summary-The present study examined the relative importance of the aversiveness of the donation procedure, donor motives and donor personality characteristics in the blood donors’ decision to donate. One hundred and eighty-six blood donors and 106 nondonors took part in this retrospective study. Participants were asked lo complete a number of personality measures, and two questionnaires assessing their motives for donating and the aversiveness of their most recent donation experience. Results indicated that both the aversiveness of the donation procedure and the donor’s motivation exert considerable influence upon the donors’ decision to return and donate again. Additionally, the donors’ experience of physical discomfort and fearfulness about the donation procedure made the major contributions to the donation’s aversiveness. The results also revealed that significant differences exist among nondonor, ex-donor, irregular and regular donor groups on several personality characteristics, on their motives for donating, and on the components comprising the aversiveness of the donation procedure. A blood donor decision model is presented incorporating the influence of motivational, situational and dispositional factors in the individual’s development into a regular donor.

INTRODUCTION

In an attempt to help blood-procurement agencies to improve their efforts at both recruiting and retaining donors a number of investigators in the social sciences and medical professions have tried to identify the most significant factors in the blood donor’s decision process. Two basic lines of research have developed. The first is primarily concerned with an individual’s motivation to donate blood, and how the blood procurement agencies can best gear their recruitment campaigns to increase these motives (Condie, 1979; Condie, Warner and Gillman, 1976; Oswalt, 1977). The second effort has centered on studying the experiences of nondonors, regular, first-time and ex-donors in an attempt to identify factors differentiating these groups from one another. A review of studies in this area reveals that when nondonors were compared to donors the former were found to be generally more fearful and anxious about donating blood (Miller and Weikel, 1974; Oswalt and Napoliello, 1974). Furthermore, donors were found to be less concerned with the aversive ‘costs’ of donating blood than nondonors (Condie and Maxwell, 1970; London and Hemphill, 1965). Comparisons between regular and first-time donors revealed that the former were less fearful and less reluctant to donate blood, anticipated less difficulty and found the experience to be less aversive (Paulhus, Shaffer and Downing, 1977; Wiesenthal and Emmot, 1979). Additionally, first-time donors were found to experience significantly more severe physical reactions to the donation procedure than their experienced counterparts (Pisicotto, Sataro and Blumburg, 1982). Similarly, comparisons of ex-donors with active donors revealed that the former group found the donation procedure to be more aversive than the latter group (Drake, 1978; Miller and Weikel, 1974) and evidenced enhanced physiological arousal prior to their initial donation (Edwards, 1982). In an attempt to explain the experience difference between specific donor groups, several studies (Paulhus et al., 1977; Wiesenthal and Emmot, 1979) speculated that the observed donor differences may best be explained by a selection process mediating the first-time donor’s decision to return. The pain and/or the implicated aversiveness of the donation procedure has been hypothesized to be the central mechanism of this process (Paulhus ef al., 1977). Other authors, while not attributing *This paper is based on a thesis by the first author supervised by the second author, submitted in partial fulfillment of the requirements for the MS. degree at the University of Georgia. Parts of this paper were presented at the Western Psychological Association’s Convention, San Francisco, Calif., May 1984. tPresent address: Department of Psychology, North Dakota State University, Fargo, ND 58105, U.S.A. PAlD6!6F

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PATRICK W. EDWARDS and AMOS ZEICHNER

major importance to the aversive quality of the experience, see it playing a role in the individual donor’s development from a first-time donor to a regular donor (Caller0 and Piliavin, 1983; Osborne, Bradley and Lloyd-Griffith% 1978; Piliavin, Caller0 and Evans, 1982; Piliavin, Evans and Callero, 1983). These studies underscore the importance of the aversive donation experience in the donor’s decision to become a regular donor. The exact parameters of the donation experience and their relative impact on the donor’s decision-making process have not yet been fully investigated. In addition to the effect of situational components on the donation experience, several studies have suggested that the donor’s personality characteristics may mediate the decision to return and donate. Reutz, Johnson, Callahan, Meade and Smith (1967) reported that donors who scored high on the MMPI Hypochondriasis scale experienced significantly adverse reactions to the donation procedure. Burnett (1982) reported blood donors to have lower self-esteem and evidence less risk-taking behavior than nondonors. Additionally, in a review of pertinent literature, Oswalt (1979) concluded that a donor’s tendency to respond with a socially desirable response set may influence both his/her initial decision to donate blood and his/her decision to return again. Piliavin et al. (1983) noted that regular donors not only tolerate pain more easily than novice donors, but that they also appear to be less influenced by extrinsic factors (e.g. social pressure) and are more strongly motivated by internal altruistic motives. These authors have noted that these differences could be due to either a selection or a socialization process or a result of a combination of both. In one of the first large-scale research projects undertaken to understand the process of commitment to blood donation, Piliavin et al. (1983) suggest that four processes are important in the development of a behavioral commitment to donate blood. These processes include: (I) developing internal motives (free from social pressure) and integrating them into one’s self-concept; (2) neutralizing the perceived negative consequences of the donation (‘costs’); (3) making a conscious decision to continue to donate; and (4) developing a self-sustaining donation habit. The primary purpose of the present study was to assess the relative importance of the donation experience in the donor’s decision to return and donate again. The situational analysis centered on the aversiveness of the donation experience and the donor’s motives for donating. A second goal was to determine whether personality characteristics such as degree of somatization, cognitive/somatic anxiety response pattern and socially desirable response set may mediate the donation decision process. METHOD Participants A total of 292 individuals participated in the study. One hundred and eighty-six participants (68 males, 118 females; 8 age = 19.21 yr, SD = 1.22) who had donated blood at least once formed the donor group. The remaining 106 participants (38 males, 68 females; 2 age = 18.9 yr, SD = 1.14) who had never donated blood formed the nondonor group. All participants were undergraduate students who were asked to take part in a study investigating the subjective experience of blood donation. The students were given research credit for their participation. Group assignment The participant’s assignment to either the donor or nondonor group was made at the time of recruitment. Donor group assignment was based on the length of time elapsed since the donors’ last donation. Donors who had not donated for 2 yr or more were assigned to the ex-donor group (n = 23). Those donors who had donated within the last 2 yr were further subdivided into regular and irregular donor groups. Regular donors (n = 62) were those individuals who reported having donated blood at least once a year while irregular donors (n = 101) were those individuals who reported having donated less frequently. Measures Participants completed the following questionnaires which were administered in a different random order to each participant. Demographic Questionnaire. This questionnaire consists of 16 items relating to both demographic and donor history information (e.g. frequency of blood donations, time elapsed since last donation

Blood donor development

745

Participants were also asked to indicate on a 7-point Likert-type scale the likelihood of donating blood again. Donor Experience Survey (DES). This specially designed survey consists of 17 items. The first 16 items assess the participant’s experience of various aspects of the donation procedure (e.g. the physical discomforts, fears associated with donation and inconveniences). The participants respond on a 7-point Likert-type scale indicating the quality of his/her experience on a scale ranging from ‘not unpleasant’ through ‘mildly aversive’ to ‘very troublesome’. The final question assesses the overall aversiveness of the donation procedure. Donor Motivation Survey (DMS). This specially designed survey was modeled after surveys given by Oswalt and Napoliello (1974) and Osborne et al. (1978). In completing this survey the participant rated a list of 10 possible motivations for donating blood (e.g. in response to a blood drive, at the request of a friend) relative to their importance in motivating one to donate blood. Participants rated the items on a 7-point Likert-type scale from ‘not at all important’ through ‘somewhat important’ to ‘very important’. Cognitive-Somatic Anxiety Questionnaire (CSAQ). This questionnaire assesses the degree to which an individual tends to experience anxiety in either a cognitive (psychic) or somatic mode. The construction and validation of this instrument was first reported by Schwartz, Davidson and Goleman (1978) as a measure of cognitive and somatic components of anxiety. Wahler Physical Symptoms Inventory (WPSI). This inventory provides a standardized quantitative measure of a participant’s level of somatic complaining (Wahler, 1968). Marlowe-Crowne Social Desirability Scale (MCSD). This scale is used to assess the degree to which an individual responded with a socially desirable response set (Crowe and Marlowe, 1964). etc.).

Procedure

Groups were tested in separate sessions with both groups completing all measures with the exception of the nondonor group omitting the donor experience assessment. RESULTS

Matching analyses

In order to test the homogeneity of the four study groups a one-way analysis of variance (ANOVA) was performed on age, and a 2 x 4 X2-analysis was performed on the distribution of the sexes among the four groups. A least-squares solution to unequal ns was employed in the ANOVA. A significant age difference existed between the groups [F(3,390) = 4.38, P < 0.005] and was further tested using the Newman-Keul’s multiple-range test. Post hoc analysis revealed that the ex-donor group was significantly older (8 = 19.82, SD = 1.42) than the nondonor group (R = 18.90, SD = 1.32, P c 0.05), the irregular donor group (8 = 19.04, SD = 1.03, P < 0.05), and the regular donor group (kT = 19.27, SD = 1.42, P < 0.05). The X2-analysis of the group’s sexual makeup revealed no significant differences between the groups x2(3, N = 293) = 5.61, P < 0.1. Donor experience and motivation variables

In order to facilitate the comparison of the donor groups on the 16 DES items, and the 10 DMS items, two separate factor analyses were performed on the surveys using the method of principal-axis factoring. The resulting factors with eigenvalues > I were rotated to simple structure using the Varimax criterion. The initial analyses yielded five unrotated factors on the DES with eigenvalues > 1 which accounted for 74.3% of the variance, and three unrotated factors on the DMS with eigenvalues > 1 which accounted for 52.4% of the variance. To aid in these data’s interpretation, composite factor scores were generated from the major loadings of the two groups of rotated factors. All items with weights >0.40 were included in the factor score.* Scoring on the DES and DMS factors were weighted in the direction of increasing discomfort, and increasing importance, respectively. Thus, high factor scores on the DES are indicative of greater levels of *Copies of the DES and DMS are available from the first author.

PATRICK W. EDWARDS and Asms ZCICHKEK

746

discomfort, blood.

and

on the DMS

of increasing importance

in motivating

the individual

to donate

DES factors

The loading of variables in the first factor indicated a general factor (accounting for 38.1% of the variance) encompassing the pain of the venipuncture (e.g. the pain of the needle, the number of times stuck). The second factor also encompasses items relating to the physical quality of the donation experience, but was made up exclusively of items pertaining to the donor’s feeling physical discomfort during the donation procedure (e.g. feeling faint, feeling sick). This factor accounted for a sizable 14.1% of the variance. The third factor was a specific personal interaction factor based on two items both of which described interactions with the attending nursing staff (e.g. the way the nurse acted towards the donor). The fourth factor also represented a rather specific set of items pertaining to the convenience of the donation procedure (e.g. the incovenience of the wait, the length of the wait). The fifth factor encompassed the largest number and most diverse group of items. These items pertained to the fears typically associated with blood donation (e.g. the though of the needle, the thought of blood). DMS factors

The loading of variables in the first factor accounted for 2 1.5% of the variance and encompassed ‘altruistic’ reasons for donating blood (e.g. as a service to the community, desire to help others, in response to a blood drive). The second factor accounted for 16.3% of the variance and encompassed items pertaining to the donor’s response to ‘social pressure’ to donate (e.g. encouraged by a friend, asked by a friend, acquaintance). The third factor accounted for a sizable 14.6% of the variance and was comprised of items pertaining to a specific need for blood by a family member or friend. Donor experience

and decision to donate again

A multiple-regression analysis was performed in order to examine the relationship between the donors’ reported willingness to return and donate again, their overall experience of the donation procedure, their motivation for donating and the effect of personality variables. The donor’s reported willingness to return and donate again was used as the dependent variable with eight predictor variables. The latter included the following: the three DMS factor scores (Altruism, Social Pressure and Family Need); the four personality variables (WPSI, COGA, SOMA, MCSD); and the donor’s rating of the overall aversiveness of the donation experience. This analysis produced a regression equation with an R2 or 0.516. The three predictor variables making the highest significant contributions to the regression equation were the donor’s experience of the overall aversiveness of the experience (B = -0.633, F = 118.33, P < 0.0001) and the DMS factor scores, Altruism (B = 0.187, F = 10.76, P < 0.0013) and Family Need (B = 0.111, F = 4.10, P < 0.044). Given the highly significant impact of the overall aversiveness rating on the aforementioned regression analysis, a second multiple-regression analysis was performed to examine the impact that specific components of the donation procedure and personality variables had on the overall aversiveness of the procedure. Owing to a high degree of intercorrelation between the DES factor scores, a stepwise multiple-regression analysis was performed to find the best set of predictors from the DES factors with the least degree of multicollinearity. This analysis produced a regression equation with an RZ of 0.538. The variable of Physical Discomfort and Fear were included in this equation. The determinant of the correlation matrix formed by these two variables (0.82) revealed that multicollinearity was not a substantial problem. These two variables, plus the personality variables, were then used to form a new regression equation with an R2 = 0.560. Only the DES factor scores, Physical Discomforts (B = 0.471, F = 71.61, P < 0.0001) and Fear (B = 0.400, F = 51.48, P < 0.0001) made a significant contribution to this equation. These findings underscore the impact of the aversiveness of the donation procedure and the motivation to donate on the donor’s decision to return and donate again. However, it was still unclear how the donor groups differed in their perception of the donation procedure and their motivations for donating. In an effort to explore these donor group differences a multivariate analysis of variance (MANOVA) was performed comparing the three donor groups on the DES

Blood donor Table

I. Group

comparison

development

MANOVA scores

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on DES and DMS factor

DES scores Groups Ex-donors R SD Irregular R SD Regular R SD

DMS scores

Fear

Pain

Alttm

Socpm

8.9’ 9.3

13.2* 6.6

12.1 5.9

18.7’ 3.4

10.9 4.0

8.6’ 8.3

11.8’ 5.4

11.5 4.8

20.8 3.5

12.8’ 4.0

3.8’ 4.1

9.P 4.2

9.9 3.9

21.5b 4.5

10.Sb 4.1

Phydis

Means with difkent superscripts were found to dilk from each other by the Newman-Keul’s multiple-range test at P ~0.05.

and DMS factor scores. A least-squares solution to unequal ns was employed and all significant main effects and interactions were tested by the Newman-Keul’s multiple-range test. The overall MANOVA was significant, Pillai’s Trace [F(10,354) = 2.52, P < O.OOl] with five of the eight dependent measures being significant. The Physical Discomfort score (Phydis) was highly significant [F(2,179) = 10.02, P -CO.OOOl]with both the Fear score [F(2,179) = 4.68, P < 0.011 and the Pain score [F(2,179) = 3.08, P < 0.041 also reaching significance. Post hoc analyses revealed that the irregular and ex-donor groups found the physical discomfort (P < 0.05) and fearful aspects (P < 0.05) of the donation procedure significantly more aversive than did the regular donor group, and that no significant differences existed between the means on the Pain factor. Additionally, both the Altruistic motivation score (Altrm) [F(2,178) = 4.38, P < 0.011 and the Social Pressure motivation score (Socpm) [F(2,178) = 4.18, P c 0.011 were significant. Pod hoc analyses revealed that the regular donors reported more altruistic reasons for donating than the ex-donors (P < 0.05), and that the irregular donors responded to more social pressure than the ex-donors (P < 0.05). The group means and standard deviations for these significant dependent measures are presented in Table 1. Group comparisons on the personality measures

In order to determine the differential effect of personality variables on the nondonor and donor groups a MANOVA was performed on the personality measures. A least-squares solution to unequal ns was employed and all significant main effects and interactions were tested using the Newman-Keul’s multiple-range test. The overall MANOVA was significant, Pillai’s Trace [F(15,858) = 2.33, P < 0.00441. The group means and standard deviations for the dependent measures are presented in Table 2. There was a highly significant group effect on the participants’ level of somatic complaining (WPSI) [F(3,288) = 4.50, P < 0.0044]. Post hoc analyses revealed that the nondonor group had a significantly higher score than any of the donor groups (Ps > 0.05), indicating that the nondonor group tended to evidence more physical complaints than the donor groups. There was a highly significant difference in the participants’ tendency to respond with a socially desirable response set (MCSD) [F(3,288) = 4.04, P < 0.0079]. Post hoc analysis revealed

Table 2. Group

comparison MANOVA on personality variables WPSI

MCSD

SOMA

40.3” 21.4

14.8’ 4.9

16.2” 5.1

17.1 4.8

SD

28.6” 21.3

17.1 5.6

13.6h 4.2

15.4 5.8

lrr;gular SD

34.3b 19.8

15.6 5.5

16.7’ 4.8

17.7

ReY1ar

30.5k 17.7

17.5h 4.8

14.8 4.1

IS.6 5.6

Groups

CCGA

Nondonors

X SD E.r-doncm

X

SD

Means with difkent superscripts other by the Newman-Keul’s

5.8

were found to differ horn each multiple-runge test at P < 0.05.

748

PATKICK

W.

EDWARDS

and AMOS ZEICHNER

that the regular donors tended to respond with a more socially desirable response set than the nondonors (P < 0.05). A third significant difference was found on the degree to which participants experience anxiety in a somatic mode (SOMA) [F(3,288) = 4.00, P < O.OOS].Posr hoc analysis revealed that the ex-donor group responded less in a somatic mode of anxiety than did the nondonor group (P < 0.05) and the irregular donor group (P < 0.01). Finally, the comparison of the degree to which participants experience anxiety in a cognitive mode (COGA) was significant [F(3,288) = 2.75, P < 0.0421, yet the post hoc analysis did not reveal any significant group comparisons. DISCUSSION

The purpose of this study was to investigate the relationship between a blood donor’s perception of the aversiveness of the donation procedure, motivation to donate, and his/her decision to return and donate again. Also, the study attempted to identify personality characteristics differentiating among blood donor groups. The factor analysis of the DES represents the first reported use of this technique in exploring the parameters of the donation experience. This analysis, in agreement with pertinent literature, revealed that the pain associated with the donation accounted for a sizable proportion of the variance, a finding which underscores the importance of this parameter in the donation experience. Concurrently, the analysis identified the parameters of physical discomfort, interaction with the blood-procurement staff, inconvenience of the procedure, and fear of the procedure as significant components of the donation experience. The factor analysis of the DMS identified three motivational factors that resemble previously reported data describing donor motives as either internal ‘altruistic’ motives, external ‘social pressure’ motives, or as a motivation to donate triggered by critical family crises (Oswalt, 1977; Oswalt and Hoff, 1975; Piliavin er al., 1983). The findings of the initial regression analysis indicated that both the overall aversiveness of the donation procedure and the degree to which the individual reports altruistic motives were potent predictors of the donors’ willingness to return. The second regression analysis revealed that physical discomfort and fear of the procedure were the primary predictors of the overall aversive quality of the donation. These findings indicate that the personality variables failed to contribute to either the prediction of the donors’ willingness to return or of their overall perception of the aversiveness associated with the procedure. Additionally, these findings indicate that whereas pain seems to be a significant descriptor of the donation experience, it appears to be a less important component of the overall aversiveness of the donation procedure and consequently may play a less significant part in the donor’s decision to return and donate again. Group comparisons on the personality characteristics, DES and DMS factor scores revealed several interesting findings. Two personality variables differentiated the donors from the nondonors. All donors evidenced a significantly lower level of somatic complaining than did the nondonors. The regular donors evidenced a greater tendency to respond with a socially desirable response set than did nondonors and found the donation experience to involve less physical discomfort than did the ex-donors and the irregular donors. Additionally, the regular donors perceived the procedure as less threatening and evidenced more altruistic motives for donating than did the ex-donors, while the irregular donors responded more to social pressure as a motivation to donate than did the ex-donor or the regular donor group. These donor group differences on both the experience and motivational variables are quite consistent with earlier literature (Oswalt, 1977) and thus provide validity for the present donor group breakdown. Taken together with the four processes hypothesized by Piliavin et al. (1983) to underlie the development of a behavioral commitment to donate blood, these findings appear to support the postulation of a two-stage blood donor decision model. The potential donor must first make an initial decision to either become a donor or to remain a nondonor. Three factors can be hypothesized to have a direct influence on the initial decision (see Fig. 1, Stage A). These are the individual’s motivation to donate blood, his/her perception of the costs (e.g. the pain, inconvenience) and benefits (e.g. help to the community, sensation of wellbeing after donating) associated with the donation, and pertinent cues about the convenience of donating blood (e.g. easy access to the collection station). Accordingly, an individual who is strongly motivated to donate and

donor development

Blood

749

(a) PERCEIVED

SOClOPSVCHOLOGICAL

(HELP

VARIABLES

-

PERSONALITY SOCIAL

GROUP

MINUS PERCEIVED

PRESSURE

(PAIN

PERCEPTION SICKLY,

OF

'DONOR')

1 DECISION

MOTIVATION

SELF

INDIVIDUAL.

-

.

TO

TO DONATE

DONATE 4

A

CUES

1

TO ACTION

DRIVE -

COSTS

INCONVENIENCE)

1

(RESPONSIBLE

BENEFITS

THE C~~UNITY)

TRAUMA

STATE

ANXIOUS

IN FAMILY

ACCESSIBILITY DONATION

EMOTIONAL

POSTER -

-

DEPRESSED

OF

STATION

(b)

-i-l EXPERIENCE

yes

OF

PROCEDURE

I

Fig. 1. Variables and relationships in the blood donor decision model (modeled after Becker and Maiman (1975)].

perceives more benefits than costs would be likely to decide favorably. Sociopsychological variables such as personality traits and peer or family pressure, can be hypothesized to mediate both the individual’s motivation to donate and the perceived costs and benefits of such an act. The differential sensitivity to physical symptoms and social conformity found in the donors and nondonors may be the primary dispositional factors mediating the donor’s initial decision to donate blood. As hypothesized by Oswalt (1979), individuals who respond with a socially desirable response set may be sensitized to social conformity and will, therefore, respond favorably to blood donation drives. In contrast, individuals who habitually focus on physical symptoms are more likely to become sensitized to the potential physical costs of the donation procedure and may consequently decide against donating. The consistent description of nondonors as fearful, nervous, and concerned with the aversiveness of donating blood lends support to this hypothesis (Condie and Maxwell, 1970; Miller and Weikel. 1974; Piliavin et al., 1983). The motivation to donate can be further mediated by both the individual’s perception of his/her self (e.g. as a responsible

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PATRICK W. EDWARDS and

AMOS ZEICHNEK

community member, as frail or weak) and by pertinent cues of the necessity and salience of donating blood (e.g. trauma in the family, community need during a shortage, blood drive posters). Once an individual has donated blood he/she is faced with the decision of whether to return and donate again. The present findings suggest that once the novice donor has experienced the donation procedure, his/her perception of the experience as either aversive, or undisturbing will have a strong impact on that individual’s subsequent evaluation of the costs and benefits of donating blood (See Fig. 1, stage B). At the same time, factors such as the aforementioned differential sensitivity to physical symptoms will become less influential. While the personality variables seem to play a diminished role in the donor’s decision whether to continue donating, one can speculate that the donor’s emotional state at the time of donation holds an even more significant effect. Research has indicated that novice donors evidence higher GSR readings during donation (Tyano, Munitz and Wijsenbeck, 1975), and are more anxious (J. A. Piliavin, personal communication, 1983) than more experienced donors. Additionally, ex-donors evidence significantly higher physiological arousal prior to their initial donation than do regular donors (Edwards, 1982). This arousal has been hypothesized to be both a major cause of the numerous adverse physical reactions suffered by neophyte donors (Pisicotto et al., 1982) and an important component in the development of a behavioral commitment to blood donation (Piliavin et al., 1983; Caller0 and Piliavin, 1983). Consequently, it can be expected that the level of a donor’s affective arousal at the time of the donation may be one of the crucial ‘situational’ determinants in the donor’s decision to return and donate again.

Strong support for the proposed model comes from a recent study by Caller0 and Piliavin (1983) in which the donor’s process of commitment is conceptualized as a string of successive decisions to donate. These authors conducted separate analyses in an attempt to distinguish among donors following each donation decision. Caller0 and Piliavin’s findings indicate that the impact of different variables change across these separate decision points, illustrating the importance of examining each donation decision separately. While the present study’s results expand and support the findings of earlier research, several limitations remain. The two main limitations are the retrospective nature of the design and the unique nature of the study’s sample. Longitudinal studies are needed to discern the degree to which donor group differences found in this and earlier studies are the result of donor--career factors or the precursors to them. Studies in the area of blood donation behavior ought to be conducted outside the college campuses as the student population does not represent the national norm for the average or typical donor. Finally, studies must diminish the use of self-report measures and employ more multiple independent measures (e.g. self-reported intentions to donate and actual donation records). Acknow/edgemenrs-The authors would like to express their sincere appreciation to Dr Jane Piliavin for her valuable review of an earlier draft of this manuscript. Requests for reprints should be addressed to P. W. Edwards.

REFERENCES Becker M. H. and Maiman L. A. (1975) Sociobehavioral determinants of compliance with health and medical care recommendations. Med. Cure 13, 10-20. Burnett J. J. (1982) Examining the profiles of the donor and nondonor through a multiple discriminant approach. Transfusion 22, 138-142. Caller0 P. L. and Piliavin J. A. (1983) Developing a commitment to blood donation: the impact of one’s first experience. J. appl. sot. Psycho/. 13, I-16. Condie S. J. (1979) When altruism fails: the logic of collective action and blood donor behavior. In Research in Psychology and Medicine, Vol. 2 (Edited by Osbom D. J., Gruneburg M. M. and Eiser J. R.), pp. 21-29. Academic Press, New York. Condie S. J. and Maxwell N. (1970) Social psychology of blood donors. Transfusion 10, 79-83. Condie S. J., Warner W. K. and Gillman D. C. (1976) Getting blood from collective turnips: volunteer donation in mass blood drives. J. appl. Psychol. 61, 290-294. Crowne D. P. and Marlowe D. (1964) The Approval Morive: Studies in Evaluation Dependence. Wiley, New York. Drake A. M. 11978) Public attitudes and decision Drocesses with regard to blood donation (Tech. Rep. No. 138). Operation Research ken&, MIT. Cambridge, Mass. ’ Edwards P. W. (1982) The effects of physiological arousal on the neophyte blood donor’s decision to return and donate again. Paper presented at the Annual Southeastern Psychological Association. New Orleans, La. London P. and Hemphill B. M. (1965) The motivations of blood donors. Transjusion 5, 559-568.

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