Sensitizing the Behavioral-Immune System: The Power of Social Pain

People who believe they are invulnerable to infectious diseases often fail to protect themselves against the disease threats that others pose to them. The current paper hypothesizes that social pain-the experience of feeling interpersonally hurt or rejected-can sensitize the behavioral-immune system by giving people added reason to see others as worthy of protecting themselves against. We obtained four daily diary samples involving 2,794 participants who reported how hurt/rejected they felt by those they knew, how personally concerned they were about the spread of illness/COVID-19, and how vigilantly they engaged in self-protective behaviors to safeguard their health each day. An integrative data analysis revealed robust evidence that people who believed they were invulnerable to infectious disease engaged in more concerted efforts to protect themselves against the greater daily risk of contracting COVID-19 when being in acute social pain gave them added reason to see others as harmful to them.

Pandemic and Attitudes towards Immigrants: Evidence from South Korea during the COVID-19 Crisis

This article investigates the changes in South Koreans' acceptance towards multiculturalism and acceptance towards North Korean defectors during the early months of the COVID-19 pandemic in South Korea and potential factors affecting the changes. Individual-level survey data conducted in 2018-2020 were used to compare pre- and post-COVID-19 period. The results demonstrate that the regions with severe local outbreaks during the early COVID-19 pandemic experienced increased hostile attitudes towards multiculturalism and increased discriminatory preference. On the other hand, the pandemic did not affect attitudes towards North Korean defectors. The change may be associated with fear of infection as interaction effects between vulnerability and affected regions after the pandemic were statistically significant. This finding suggests that efforts to disassociate infectious diseases and foreign migrants can mitigate increased hostility towards multiculturalism and foreigners.

The Influence of Disease Avoidance Motive on the Economic Behavior Ethics under the Impact of Pandemic: A Moderated Mediation Model

Objective: As one of the basic social motives, Disease Avoidance Motive is the deep psychological factor behind many social behaviors. Since the emergence of the COVID-19 and its continuous spread across the world at the end of 2019, the ever-changing and recurring COVID-19 pandemic has increased people's fear and rejection of the threat of infectious diseases, and activated people's Disease Avoidance Motive, which has remained at a high level for a long time. This study takes Disease Avoidance Motive as the starting point, introduces COVID Control Regulations as the intermediary, and disease vulnerability as the regulator, to explore the influence of Disease Avoidance Motive on Economic Behavior Ethics. Methods: Regression analysis, SPSS Statistics and Moderated Mediation Model were applied and 524 random respondents were surveyed through Basic Social Motivation Scale, Pandemic Norm Compliance Questionnaire, Economic Behavior Ethics Questionnaire and Scale of Perceived Vulnerability to Disease. Results: (1) Disease Avoidance Motive positively predicts Economic Behavior Ethics;(2) COVID Control Regulations play a mediating role between Disease Avoidance Motive and Economic Behavior Ethics (3) Perceived Vulnerability to Disease positively moderates the direct effect of Disease Avoidance Motive on Economic Behavior Ethics. Conclusion: Under the moderation of Perceived Vulnerability to Disease, Disease Avoidance Motive exerts an influence on the Economic Behavior Ethics through COVID Control Regulations. © 2022 ACM.

Perceived Vulnerability to Disease Questionnaire: psychometric validation with a Portuguese sample.

BACKGROUND: Individual differences in one's perceived vulnerability to infectious diseases are implicated in psychological distress, social and behavioral disease avoidance phenomena. The Perceived Vulnerability to Disease Questionnaire (PVD) is the most extensively used measure when it comes to assessing subjective vulnerability to infectious diseases. However, this measure is not yet accessible to the Portuguese population. The present study aimed to adapt and validate the PVD with 136 Portuguese participants. METHODS: Factorial, convergent and discriminant validity (of both the scale and between each factor), and reliability analysis were assessed. RESULTS: A modified bifactorial model, comprised of Perceived Infectability and Germ Aversion factors, was obtained, with acceptable goodness-of-fit indices, adequate convergent and discriminant validity, and good internal consistencies. CONCLUSIONS: Overall, the 10-items European-Portuguese PVD appears to be a reliable and valid measure of one's perceived vulnerability to disease, with potential relevance for application in both research and clinical practice pertaining to disease-avoidance processes.

The effect of the COVID-19 pandemic on disgust sensitivity in a sample of UK adults.

The COVID-19 pandemic led to the introduction of a range of infection prevention and control (IPC) measures that resulted in dramatic changes in people's lives however these IPC measures are not practiced consistently across the population. One predictor of an individual's responses to the pandemic is disgust sensitivity. Understanding how disgust sensitivity varies within the population could help to inform design of public health messages to promote more uniform behavioral change during future pandemics. To understand the effect of the current COVID-19 pandemic on an individual's pathogen disgust sensitivity we have compared pathogen disgust sensitivity during the current COVID-19 pandemic to baseline pathogen disgust sensitivity, determined prior to the COVID-19 pandemic, in the same sample of UK adults. We find that the COVID-19 pandemic did not alter overall pathogen disgust sensitivity suggesting that disgust sensitivity is stable despite IPC measures, public health messaging, media coverage and other factors associated with the COVID-19 pandemic.

Fear of being near: Fear supersedes sociability when interacting amid a pandemic.

In the COVID-19 era, physical interactions ubiquitously pose a disease threat. Using a novel online paradigm, this study tested whether under such unique circumstances, the fundamental motivation to avoid disease-related threats interacts with individual differences in sociability, such that: (i) responses to others are slowed down, particularly among sociable individuals, reflecting motivational tension; (ii) the role of sociability in predicting interaction likelihood is diminished. Participants (Israeli young adults, N = 207) listened to auditory descriptions of everyday social situations, taking place in either the physical or virtual space, and decided quickly whether to interact. Participants also completed the Sociability Scale (Cheek & Buss, 1981). Responses were slower in the physical compared to virtual space, regardless of sociability. The association between interaction likelihood and sociability was stronger in the virtual space, with sociability mirrored by self-reported fear of COVID-19 in predicting interaction likelihood. We propose that when physical contact with others poses a threat to safety, fear supersedes sociability in guiding behavior in physical interactions.

Ventromedial prefrontal cortex activity differentiates sick from healthy faces: Associations with inflammatory responses and disease avoidance motivation.

BACKGROUND: Humans are able to discern the health status of others using olfactory and visual cues, and subsequently shift behavior to make infection less likely. However, little is known about how this process occurs. The present study examined the neural regions involved in differentiating healthy from sick individuals using visual cues. METHODS: While undergoing a functional magnetic resonance imaging scan, participants (N = 42) viewed facial photos of 30 individuals (targets) who had been injected with an inflammatory challenge--low-dose endotoxin (i.e., sick) or placebo (i.e., healthy), and rated how much they liked each face. We examined regions implicated in processing either threat (amygdala, anterior insula) or cues that signal safety (ventromedial prefrontal cortex [VMPFC]), and how this activity related to their liking of targets and cytokine levels (interleukin-6, tumor necrosis factor-α) exhibited by the targets. RESULTS: Photos of sick faces were rated as less likeable compared to healthy faces, and the least liked faces were those individuals with the greatest inflammatory response. While threat-related regions were not significantly active in response to viewing sick faces, the VMPFC was more active in response to viewing healthy (vs. sick) faces. Follow-up analyses revealed that participants tended to have lower VMPFC activity when viewing the least liked faces and the faces of those with the greatest inflammatory response. CONCLUSIONS: This work builds on prior work implicating the VMPFC in signaling the presence of safe, non-threatening visual stimuli, and suggests the VMPFC may be sensitive to cues signaling relative safety in the context of pathogen threats.

Perceived Risk of Infection Linked to Changes in Comfort in Social Situations From Before to During the COVID-19 Pandemic.

Background: Social lives have significantly changed since social distancing measures have been implemented to prevent the spread of the coronavirus disease 2019 (COVID-19). This study aimed to investigate how our appraisal of social situations changed during the pandemic. Methods: In two online surveys, conducted in October 2019 and April 2020, 58 participants rated their personal level of comfort for sketches depicting social situations. Situations were separately categorized according to the risk of a possible COVID-19 infection and changes in ratings were analyzed by using a repeated measures ANOVA. Moreover, potential influencing factors on the change in ratings such as perceived infection risk and social factors like regular frequency and liking of social interactions were examined. Results: There was a significant interaction (p < 0.001) between time of measurement and risk category. Comfort ratings of depicted situations with low and medium infection risk were higher during the second compared to the first survey period. Ratings of high-risk situations did not change significantly, although there was a tendency toward lower ratings during the pandemic. Multiple regression analyses showed that perceived probability of short-term infection could explain variance in the change of ratings of social situations with low- and medium risk, but not perceived probability of long-term infection or social factors. Conclusion: The results suggest that the change of participant's appraisal of the social situations during the COVID-19 pandemic relates to perceived infection risk. Both, the risk associated with the specific scenario as well as the general belief of short-term infection risk were associated with change. This change predominantly manifested in greater thought of comfort during low and medium risk situations, which might give a sense of safety during the pandemic. The finding that high-risk social situations were not rated as uncomfortable as expected must be considered with regard to the young sample and may not be generalizable to other individuals. Further research is necessary to evaluate long-term effects on social interactions caused by global pandemics such as the COVID-19 pandemic.

Disease Avoidance Model Explains the Acceptance of Cohabitation With Bats During the COVID-19 Pandemic.

Bats and humans have a close relationship based on cohabitation, with bats taking roost in buildings. It has been suggested that bats function as a reservoir of the SARS-CoV-2 virus that causes the COVID-19 disease in humans. A misconception that bats can spread SARS-CoV-2 to humans may have increased negative emotions toward bats and reduced individuals' acceptance of cohabitation with bats during the COVID-19 pandemic. By applying the disease avoidance model, we tested whether knowledge about bats would be associated with reduced negative emotions toward bats, which in turn would be associated with increased acceptance of cohabitation with bats. Moreover, we tested whether previous experiences of bats, perceived COVID-19 risk, age, gender and level of education would be associated with negative emotions and acceptance of bats. A quantitative survey (N = 577) collected during the COVID-19 pandemic in Finland was analyzed with multiple linear regression. The results supported the disease avoidance model. Negative emotions toward bats reduced the acceptance of cohabitation with bats. However, knowledge about bats was associated with increased acceptance of bats both directly, as well as indirectly, via reduced negative emotions. Moreover, perceived COVID-19 risk was associated with increased negative emotions toward bats, and reduced acceptance of bats. Females were more likely than other respondents to report negative emotions, and reduced acceptance of cohabitation with bats. Prior experience of bats was associated with increased acceptance of bats as neighbors. These findings suggest that COVID-19 pandemic may threaten the existence of bats if no action is taken. The findings highlight the importance of correcting misunderstandings about non-human species as transmitters of diseases to humans.

Pandemic and hospital avoidance: Evidence from the 2015 Middle East respiratory syndrome outbreak in South Korea.

Existing literature shows that people exhibit disease avoidance behaviors in response to contagious disease outbreaks. We examine hospital avoidance behaviors during the 2015 Middle East respiratory syndrome (MERS) outbreak in South Korea. The outbreak provides an excellent setting for the analysis because unlike the coronavirus disease-19 (COVID-19) situation, no mandatory lockdown was imposed during the outbreak, and the economic impact was also not large. Hence, reduced hospital visits are likely to reflect the public's intention to avoid hospitals to protect themselves from getting infected with MERS. Moreover, the outbreak did not spread to the entire country and vanished after a short period of time, allowing us to consider the affected regions as the treatment group and the other regions as the control group without much concern of confounding by other factors. The data come from a government agency, which assesses (national) health insurance claims made by hospitals, and hence cover all outpatient visits in the country. We find that people reduced outpatient visits by about 17% in response to the MERS outbreak, and the response was the most intense when new cases were reported most frequently.

Fear of COVID-19 in Madrid. Will patients avoid dental care?

INTRODUCTION: The objective of this research is to describe how perceived infectability, germ aversion, and fear of COVID-19 in adults in Madrid have changed from the beginning of the pandemic until the lockdown exit phase and their influence on dental care behaviour. MATERIALS AND METHODS: Some 961 participants were monitored in a study in Madrid at 2 time points: before lockdown (T0) and after completion of the total lockdown (T1). A questionnaire that included basic sociodemographic variables, the perceived vulnerability to disease scale (including perceived infectability and germ aversion), the fear of COVID-19 scale, and dental visiting behaviour after confinement for fear of COVID was administered. RESULTS: The participants had higher scores for infectability and germ aversion at T1 than at T0 (P < 0.01). Of those studied, 24.5% (235) of the participants would not go to the dentist for fear of COVID-19. Those who had a high perceived infectability scale score were at least 5 times more likely to not visit the dentist. Those with high COVID-19 fear were at least 6 times more likely to not visit the dentist, and those older than 60 years were 8 times more likely to not visit. CONCLUSIONS: The population's high levels of vulnerability to infectability and perceived germ aversion associated with fear of COVID-19 and the resultant avoidance behaviour to dental care will remain until an effective drug or vaccine for SARS-CoV2 is found.

Clean and Contain: Initial Development of a Measure of Infection Prevention Behaviors During the COVID-19 Pandemic.

BACKGROUND: The Centers for Disease Control and Prevention (CDC) offer behavioral guidance to prevent the spread of infectious diseases like COVID-19. Cleaning (e.g., cleaning surfaces, washing and sanitizing hands) and containing (e.g., covering coughs, keeping distance from others, especially sick people) behaviors are recommended. PURPOSE: To develop the Clean and Contain Measure, a brief measure of compliance with CDC recommendations for prevention of infectious disease, and validate the measure in individuals experiencing the COVID-19 pandemic. METHODS: Participants were recruited from Amazon Mechanical Turk and social media. RESULTS: In Study 1 (N = 97), exploratory factor analysis revealed two scales: (a) five items assessing cleaning behaviors and (b) four items assessing containing behaviors. Simple structure was obtained and alpha coefficients for both scales were >.83. In Studies 2 (N = 204) and 3 (N = 527), confirmatory factor analysis verified the identical factor structure found in Study 1. All loadings were statistically significant at p < .001. Alpha coefficients for both scales were >.84 for Studies 2 and 3. CONCLUSIONS: Our measure is a reliable and valid indicator of compliance with cleaning and containing health behaviors that help to prevent the spread of diseases like COVID-19. Future research should replicate construct validity in more diverse samples and continue to refine items, examine construct validity, including predictive and discriminant validity, and improve the measure for future use. With continued use and refinement, this measure could allow health officials and researchers to accurately assess compliance with important infection prevention behavior guidelines.