Objectives. The affective dimension of illness representation plays an important role in asthma self-management. However, little is known about the stability of this affective representation across contexts. We explored the role of social comparison in this affective evaluation.

Design and methods. Participants included 20 individuals reporting an asthma diagnosis and 33 healthy controls. To measure asthma attitudes, we used three different versions of the Implicit Association Test (IAT), a single target IAT (ST-IAT) and two IATs with different social comparison standards for asthma evaluation (1) HIV and (2) diabetes. Reaction times to pair asthma with positive or negative word stimuli in the three IATs were compared in a repeated measure ANOVA. Furthermore, the relationship between affective evaluation, self-reported asthma-specific coping, and negative affect was explored.

Results. Individuals reporting an asthma diagnosis showed a stronger negative evaluation of asthma than healthy individuals in the ST-IAT. This negative evaluation was positively related to the self-report of dysfunctional coping strategies. However, in the IAT introducing a downward social comparison with HIV, evaluation of asthma was less negative and no longer positively related to the report of dysfunctional coping.

Conclusion. Downward social comparison can buffer against negative affective evaluation of asthma. The context dependency of illness-related attitudes requires attention in future research and asthma management practice.