attending to a light (high monitoring behavior). In both experiments, high monitors and low blunters attended
more to the information about the threat than low monitors and high blunters. In Experiment 1, low monitors
and high blunters attended more to the distracting music than did high monitors and low blunters. The factor
structure of the scale holds up in tests conducted by independent researchers ( Muris & Schouten, 1994 ). In this
study, 583 students completed the 5-point version of the MBSS, and an exploratory factor analysis was con-
ducted. Two factors were extracted; monitoring items loaded on to the first factor, blunting items on to the sec-
ond factor.
Criterion/Predictive
In a variety of contexts, monitors have been found to have higher levels of worry and distress than blunters.
For example, more so than blunters, monitors have been found to be particularly prone to anxiety ( Muris, van
Zuuren, & De Vries, 1994 ), depression ( Shiloh, Koehly, Jenkins, Martin, & Hadley, 2008 ), displays of distress dur-
ing invasive screening examinations ( Wardle et al., 1993 ), and anticipation of discomfort and physical pain dur-
ing medical procedures ( Miller, Roussi, Altman, Helm, & Steinberg, 1994 ). Other researchers ( Rees & Bath, 2000;
Wakefield, Homewood, Mahmut, Taylor, & Meiser, 2007 ) have validated the general tendency of monitors to
attend to threatening information among patients with a family history of cancer. High monitors are more likely
than low monitors to seek out information about cancer ( Rees & Bath, 2000 ), and high blunters are more likely
than low blunters to engage in distraction ( Wakefield et al., 2007 ).
Location
Miller, S.M. (1988). The interacting effects of coping styles and situational variables in gynecologic settings:
Implications for research and treatment. Journal of Psychosomatic Obstetrics and Gynaecology ,9,2 3/C034. doi:
10.3109/01674828809030946.
Results and Comments
The MBSS is a measure of the degree to which people seek out or avoid information about threatening events.
These issues of information search and threat are particularly relevant in the context of health ( Miller, 1992 ), and
the measure has been used extensively in this domain. Among other applications, the MBSS has been used to
investigate the experience of chronic pain ( Litt, Shafer, & Kreutzer, 2010 ), physician visits ( Miller, Brody, &
Summerton, 1988 ), dental fear (Muris et al., 1996), HIV testing ( Delaney & O’Brien, 2009; Miller, Rodoletz,
Schroeder, Mangan, & Sedlacek, 1996 ), gynecological surgery ( Steptoe & O’Sullivan, 1986 ), prenatal diagnosis
(van Zuuren, 1993 ), genetic screening (Miller et al., 2007), and cancer chemotherapy ( Gard, Edwards, Harris, &
McCormach, 1988 ).
In addition to being more reliable than the blunting subscale, the monitoring subscale has been shown to be a
more consistent predictor of health-related coping behaviors (Miller et al., 1987). However, this does not mean
that monitoring is a more effective strategy than blunting in coping with health threats. Although high monitors
are more likely than high blunters to take preventative health care actions, they are also more likely to experience
arousal and anxiety about their health, and are more prone to ruminative thoughts about their illness ( Miller
et al., 1988, 1996 ). In clinical samples, efforts to avoid disturbing thoughts require extreme defensive strategies
including denial as well as mental and behavioral disengagement. This suggests there might be costs to a moni-
toring attentional style for patients with severe long-term medical threats.
Treatment of the monitoring and blunting subscales can be critiqued on the grounds that dichotomizing
reduces the variance unnecessarily and introduces error at the category boundaries. In addition, the response
format of the scale requires a forced-choice yes/no response from participants, further reducing potentially
explainable variance. It should be noted that researchers have successfully adapted the response scale to a 5-
point Likert-type, however (see van Zuuren, De Jongh, Beekers, & Swinkels, 1999 ). It is also the case that the sub-
scales are not always equally reliable, valid, or strongly negatively associated with each other. Thus independent
use of the subscales, or sole use of the monitoring subscale, can be considered.
MILLER BEHAVIORAL STYLE SCALE (SAMPLE ITEMS)
1.Vividly imagine that you are on an airplane, 30
minutes from your destination, when the plane
unexpectedly goes into a deep dive and thensuddenly levels off. After a short time the pilot
announces that nothing is wrong, although the rest of
the ride may be rough. You, however, are not327 TRAIT COPING MEASURES
III. EMOTION REGULATION