{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T06:15:04Z","timestamp":1778652904601,"version":"3.51.4"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Medical imaging examinations play an irreplaceable role in modern medical diagnosis; however, some patients experience decisional difficulties due to fear of radiation, potentially leading to examination delays or refusals that subsequently compromise timely disease diagnosis and treatment. The psychological mechanisms through which fear of medical imaging radiation influences patient decision-making processes remain unclear, and the heterogeneous characteristics of radiation fear manifestations across patient populations lack systematic investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey design was employed, with 468 adult patients scheduled to undergo medical imaging examinations conveniently sampled from two tertiary Grade-A general hospitals in Sichuan Province, China, between July and August 2025. Data were collected using the Fear of Medical Imaging Radiation Scale, Risk Perception Scale, and Decisional Conflict Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mediation analysis using the PROCESS macro showed that fear of medical imaging radiation was significantly and positively associated with decisional conflict. Risk perception showed a significant partial mediating role in the association between fear of radiation and decisional conflict. Latent profile analysis identified three radiation fear subtypes: a low radiation fear group, a moderate radiation fear group, and a high radiation fear group. Analysis of variance demonstrated significant differences among the three groups in both risk perception and decisional conflict, with patients in the high radiation fear group exhibiting significantly elevated levels of risk perception and decisional conflict compared with the other two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Fear of medical imaging radiation indirectly exacerbates decisional conflict by elevating patients\u2019 risk perception levels, and significant heterogeneity exists in radiation fear manifestations across patient populations. These findings provide evidence-based guidance for healthcare institutions to develop targeted patient education programs, risk communication strategies, and psychological support interventions. The results facilitate the identification of high-risk patient populations and implementation of differentiated clinical management strategies, ultimately advancing the realization of patient-centered imaging medicine service models.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1826113","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T05:53:32Z","timestamp":1778651612000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations between fear of medical imaging radiation, risk perception, and patient decisional conflict: evidence from variable-centered and person-centered analyses"],"prefix":"10.3389","volume":"17","author":[{"given":"Lixing","family":"Lei","sequence":"first","affiliation":[{"name":"Department of Radiology, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiongxiong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nanchong Hospital of Traditional Chinese Medicine","place":["Nanchong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"He","sequence":"additional","affiliation":[{"name":"Department of Radiology, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qianqian","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingling","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nian","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-hua","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/5164970","article-title":"Modern diagnostic imaging technique applications and risk factors in the medical field: A review","volume":"2022","author":"Hussain","year":"2022","journal-title":"BioMed Res Int"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s11042-023-17326-1","article-title":"Recent trend in medical imaging modalities and their applications in disease diagnosis: A review","volume":"83","author":"Abhisheka","year":"2024","journal-title":"Multimedia Tools Appl"},{"key":"B3","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1007\/s40258-024-00876-2","article-title":"Cost of low-value imaging worldwide: A systematic review","volume":"22","author":"Kjelle","year":"2024","journal-title":"Appl Health Econ Health Policy"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021211351","article-title":"Increasing access to imaging for addressing the global cancer epidemic","volume":"301","author":"Hricak","year":"2021","journal-title":"Radiology"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-025-07323-x","article-title":"PET imaging utilization and trends in Germany: A comprehensive survey","volume":"52","author":"Holzgreve","year":"2025","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20210389","article-title":"Radiation risk issues in recurrent imaging","volume":"94","author":"Brower","year":"2021","journal-title":"Br J Radiol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1626906","article-title":"Radiation exposure in recurrent medical imaging: Identifying drivers and high-risk populations","volume":"13","author":"Chen","year":"2025","journal-title":"Front Public Health"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1080\/09553002.2022.2009147","article-title":"Educational dialogue on public perception of nuclear radiation","volume":"98","author":"Hande","year":"2022","journal-title":"Int J Radiat Biol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1097\/hp.0000000000001871","article-title":"Radiation communication: Thoughts and considerations","volume":"128","author":"Sugarman","year":"2025","journal-title":"Health Phys"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.radi.2025.103005","article-title":"Examining the role of radiation risk perception in patient decision-making for diagnostic imaging procedures: Insights from a multi-centre study across diverse populations","volume":"31","author":"Memon","year":"2025","journal-title":"Radiograp Lond"},{"key":"B11","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1186\/s13244-025-02018-1","article-title":"Development and psychometric evaluation of the fear of medical imaging radiation scale (FOMIRS): Insights from multimethod analysis","volume":"16","author":"Feng","year":"2025","journal-title":"Insights Imaging"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1381","DOI":"10.3390\/cancers15051381","article-title":"Scanxiety among adults with cancer: A scoping review to guide research and interventions","volume":"15","author":"Derry-Vick","year":"2023","journal-title":"Cancers Bsel"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.41623","article-title":"Radiology's ionising radiation paradox: Weighing the indispensable against the detrimental in medical imaging","volume":"15","author":"Najjar","year":"2023","journal-title":"Cureus"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/s12529-018-9730-3","article-title":"Prevalence and correlates of worry about medical imaging radiation among United States cancer survivors","volume":"25","author":"Hay","year":"2018","journal-title":"Int J Behav Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1080\/10615806.2014.880111","article-title":"Imagining the future in health anxiety: The impact of rumination on the specificity of illness-related memory and future thinking","volume":"27","author":"Sansom-Daly","year":"2014","journal-title":"Anxiety Stress Coping"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0180592","article-title":"Avoiding fears and promoting shared decision-making: How should physicians inform patients about radiation exposure from imaging tests","volume":"12","author":"Lumbreras","year":"2017","journal-title":"PloS One"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1177\/2150131916648917","article-title":"Prevalence and correlates of worry about the health harms of medical imaging radiation in the general population","volume":"7","author":"Hay","year":"2016","journal-title":"J Prim Care Community Health"},{"key":"B18","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1177\/002200275900300102","article-title":"Decisional conflicts: A theoretical analysis","volume":"3","author":"Janis","year":"1959","journal-title":"J Conflict Reso"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1177\/0272989x08327067","article-title":"Decisional conflict in patients and their physicians: A dyadic approach to shared decision making","volume":"29","author":"LeBlanc","year":"2009","journal-title":"Med Decis Making"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1159\/000126073","article-title":"Systematic review of the effects of shared decision-making on patient satisfaction, treatment adherence and health status","volume":"77","author":"Joosten","year":"2008","journal-title":"Psychother Psy"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2020.06.016","article-title":"Association of conflicting information from healthcare providers and poor shared decision making with suboptimal adherence in direct oral anticoagulant treatment: A cross-sectional study in patients with atrial fibrillation","volume":"104","author":"Moudallel","year":"2021","journal-title":"Patient Educ Couns"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1002\/jmrs.668","article-title":"Radiographers' decision\u2010making processes in the movement of pain\u2010afflicted adult trauma patients in planar diagnostic imaging","volume":"70","author":"Talevski","year":"2023","journal-title":"J Med Radiat Sci"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-024-10659-x","article-title":"Recurrent medical imaging exposures for the care of patients: One way forward","volume":"34","author":"Frush","year":"2024","journal-title":"Eur Radiol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1111\/jep.13864","article-title":"What we owe patients when fear undermines autonomy: Concretized emotions and the incapacity to deliberate","volume":"29","author":"Halpern","year":"2023","journal-title":"J Eval Clin Pract"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1080\/10410236.2019.1692489","article-title":"Feel worried, overloaded, or fatalistic? The determinants of cancer uncertainty management preferences","volume":"36","author":"Peng","year":"2021","journal-title":"Health Commun"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1539-6924.1981.tb01409.x","article-title":"Perspectives on risk perceptions","volume":"1","author":"Cole","year":"1981","journal-title":"Risk Anal"},{"key":"B27","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1111\/j.1539-6924.1982.tb01369.x","article-title":"Why study risk perception","volume":"2","author":"Slovic","year":"1982","journal-title":"Risk Anal"},{"key":"B28","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1097\/00004032-200307000-00011","article-title":"Cancer risks from medical radiation","volume":"85","author":"Ron","year":"2003","journal-title":"Health Phys"},{"key":"B29","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/pl00007682","article-title":"Radiation risks in perspective: Radiation-induced cancer among cancer risks","volume":"39","author":"Tubiana","year":"2000","journal-title":"Radiat Environ Biophys"},{"key":"B30","volume-title":"Patient awareness and knowledge of medically induced radiation exposure","author":"Mann","year":"2019"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.57.3.147","article-title":"Cancer risk elicitation and communication: Lessons from the psychology of risk perception","volume":"57","author":"Klein","year":"2007","journal-title":"CA Cancer J Clin"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.114267","article-title":"Exploring the dynamic relationships between risk perception and behavior in response to the Coronavirus Disease 2019 (COVID-19) outbreak","volume":"285","author":"Qin","year":"2021","journal-title":"Soc Sci Med"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1007\/s13753-022-00398-2","article-title":"Effects of risk perception on disaster preparedness toward typhoons: An application of the extended theory of planned behavior","volume":"13","author":"Ng","year":"2022","journal-title":"Int J Disaster Risk Sci"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/109019818401100101","article-title":"The health belief model: A decade later","volume":"11","author":"Janz","year":"1984","journal-title":"Health Educ Q"},{"key":"B35","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1080\/00223980.1975.9915803","article-title":"A protection motivation theory of fear appeals and attitude change1","volume":"91","author":"Rogers","year":"1975","journal-title":"J Psychol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-10464-0_6","article-title":"Ten frequently asked questions about latent class analysis","volume":"4","author":"Nylund-Gibson","year":"2018","journal-title":"Trans Issues psychol Sci"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-016-9790-z","article-title":"The Tripartite Model of Risk Perception (TRIRISK): Distinguishing deliberative, affective, and experiential components of perceived risk","volume":"50","author":"Ferrer","year":"2016","journal-title":"Ann Behav Med"},{"key":"B38","first-page":"12","article-title":"To translate the three-dimensional disease risk perception scale into Chinese and test its reliability and validity","volume":"39","author":"Zhou","year":"2025","journal-title":"Chin Nurs Res"},{"key":"B39","doi-asserted-by":"publisher","first-page":"876","DOI":"10.1186\/s12877-024-05487-z","article-title":"Development and validation of the sarcopenia disease risk perception scale for older adults","volume":"24","author":"Zhang","year":"2024","journal-title":"BMC Geriatr"},{"key":"B40","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1186\/s12904-024-01467-7","article-title":"Development and psychometric evaluation of the death risk perception scale for advanced cancer patients","volume":"23","author":"Chen","year":"2024","journal-title":"BMC Palliat Care"},{"key":"B41","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1186\/s12913-019-4717-6","article-title":"Cross-cultural adaptation and psychometric assessment of the statement format decisional conflict scale for Mandarin version","volume":"19","author":"Lu","year":"2019","journal-title":"BMC Health Serv Res"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2025.109344","article-title":"Reproductive concerns and fertility intentions in cancer survivors: A longitudinal study of decision-making conflict as mediator","volume":"141","author":"Geng","year":"2025","journal-title":"Patient Educ Couns"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.2147\/ppa.S536024","article-title":"The effect of a patient decision aid developed for Chinese primary angle closure patients: A randomized control trial","volume":"19","author":"Chen","year":"2025","journal-title":"Patient Prefer Adherence"},{"key":"B44","volume-title":"Principles and practice of structural equation modeling","author":"Kline","year":"2023"},{"key":"B45","article-title":"The feeling of risk","volume-title":"New perspectives on risk perception","author":"Slovic","year":"2010"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1037\/1089-2680.11.3.258","article-title":"The impact of vulnerability to and severity of a health risk on processing and acceptance of fear-arousing communications: A meta-analysis","volume":"11","author":"De Hoog","year":"2007","journal-title":"Rev Gen Psychol"},{"key":"B47","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1080\/16506070600874281","article-title":"The role of fear of emotion in distress, arousal, and cognitive interference following an emotional stimulus","volume":"36","author":"Salters\u2010Pedneault","year":"2007","journal-title":"Cogn Behav Ther"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1037\/1528-3542.7.2.336","article-title":"Anxiety and cognitive performance: Attentional control theory","volume":"7","author":"Eysenck","year":"2007","journal-title":"Emotion"},{"key":"B49","doi-asserted-by":"publisher","first-page":"61","DOI":"10.17645\/pag.v6i2.1279","article-title":"Fear, uncertainty, and dread: Cognitive heuristics and cyber threats","volume":"6","author":"Gomez","year":"2018","journal-title":"Politics Gov"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1826113\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T05:53:37Z","timestamp":1778651617000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1826113\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":49,"alternative-id":["10.3389\/fpsyt.2026.1826113"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2026.1826113","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,13]]},"article-number":"1826113"}}