Disgust Sensitivity Among Women During the COVID-19 Outbreak

Pathogen disgust is associated with interpersonal bias among healthcare professionals

Background and objectives

Pathogen avoidance is a fundamental motive that shapes many aspects of human behavior including bias against groups stereotypically linked to disease (e.g. immigrants, outgroup members). This link has only been examined in convenience samples and it is unknown how pathogen avoidance processes operate in populations experiencing prolonged and heightened pathogen threat such as healthcare professionals. We examined whether healthcare professionals demonstrate the same link between pathogen disgust and intergroup bias as has been documented among the general population.

Methodology

Participants (N = 317; 210 healthcare professionals) were recruited using snowball sampling to take an online survey. Participants completed the Three Domain Disgust Scale to assess pathogen, sexual and moral disgust. Participants then rated their perceptions of a fictitious immigrant group ('Krasneeans') and the degree to which they endorsed group-binding moral values.

Results

Compared to control participants, healthcare professionals reported lower levels of pathogen disgust, but not sexual or moral disgust. However, regardless of profession, higher pathogen disgust was associated with viewing Krasneeans as less likeable and more unclean. Additionally, regardless of profession, higher pathogen disgust was associated with greater endorsement of group-binding moral values, although healthcare professionals reported greater overall endorsement of group-binding moral values than did control participants.

Conclusions and implications

Although healthcare professionals demonstrated lower levels of pathogen disgust, they nevertheless exhibited largely the same relationship between pathogen disgust and interpersonal biases as did control participants. One practical implication of this association is that pathogen avoidance motives may contribute to inequitable patient treatment in healthcare settings.

A mini-review on how the COVID-19 pandemic affected intertemporal choice

The coronavirus disease (COVID-19) has extremely harmful effects on individual lifestyles, and at present, people must make financial or survival decisions under the profound changes frequently. Although it has been reported that COVID-19 changed decision-making patterns, the underlying mechanisms remained unclear. This mini-review focuses on the impact of the COVID-19 pandemic on intertemporal choice, and potential psychological, biological, and social factors that mediate this relationship. A search of the Web of Science electronic database yielded 23 studies. The results showed that under the COVID-19 pandemic, people tended to choose immediate and smaller rewards, and became less patient. In particular, people with negative emotions, in a worse condition of physical health, or who did not comply with their government restriction rules tended to become more "short-sighted" in behavioral terms. Future studies should examine more longitudinal and cross-cultural research to give a broad view about the decision-making change under the COVID-19 pandemic.

I Got it. Perceived Infectability and Germ Aversion after Covid-19 Infection

Objective

The COVID-19 pandemic has offered a unique opportunity to test evolutionary hypotheses on the functionality of the behavioral immune system. The aim of the present study was to ascertain if a previous infection with COVID-19 was associated with increased levels of perceived infectability and germ aversion. Based on the calibration hypothesis, we predicted that the activation of the behavioral immune system was greater in those participants who had been infected compared to those who reported no previous COVID-19 infection.

Method

The sample included 2072 participants who completed an online survey between March 1 and April 10, 2022 when the Italian population was facing the third wave of the COVID-19 pandemic. To measure the activation of the behavioral immune system, we used the Perceived Vulnerability to Disease (PVD) scale.

Results

Perceived infectability was significantly greater in those participants who had been infected compared to those who reported no previous COVID-19 infection but there was no significant difference between the two groups in terms of germ aversion.Conclusions Overall, our findings suggest that individual differences in the activation of the behavioral immune system were marginally affected by a personal history of COVID-19 infection. A possible explanation is that the environmental sensitivity of the behavioral immune system is tuned more on chronic disease threat (i.e., ecologies with higher pathogen load) than on situational disease threat (e.g., a pandemic or disease outbreak like the COVID-19 pandemic).

Pandemic elevates sensitivity to moral disgust but not pathogen disgust

The behavioral immune system, with disgust as its motivational part, serves as the first line of defense in organisms' protection against pathogens. Laboratory studies indicate that disgust sensitivity adaptively adjusts to simulated environmental threat, but whether disgust levels similarly change in response to real-life threats, such as a pandemic, remains largely unknown. In a preregistered within-subject study, we tested whether the threat posed by the Covid-19 pandemic would lead to increased perceived disgust. The perception of threat was induced by testing during two phases of the Covid-19 pandemic (periods of high vs. low pathogen threat). We found heightened levels of moral disgust during a "wave" of the pandemic, but the effect was not observed in the domain of pathogen or sexual disgust. Moreover, the age of respondents and levels of trait anxiety were positively associated with pathogen and moral disgust, suggesting that variation in disgust sensitivity may be based chiefly on stable characteristics.

Associations between nausea and vomiting in pregnancy, disgust sensitivity, and first-trimester maternal serum free β-hCG and PAPP-A

Elevated levels of nausea and vomiting in pregnancy (NVP) and disgust sensitivity have been observed in the first trimester and both are thought to have a protective function for the mother and her fetus. Their aetiology is not clear, however, with previous studies attributing elevated NVP and disgust to various factors including endocrine changes, immunological changes, and psychological variables. To date, no study has directly assessed the relationship between disgust and NVP. Here, we prospectively collected two independent samples (S1 and S2; n₁ = 201, n₂ = 391) of women in the first trimester of pregnancy, who completed the Index of Nausea, Vomiting, and Retching and the Disgust Scale-Revised. We also measured free β-human chorionic gonadotropin (hCG) and pregnancy-associated plasma protein A (PAPP-A) in maternal serum. Our results did not confirm any association between NVP and disgust; in addition, they indicate that NVP and disgust may have different proximate causes. Disgust sensitivity was significantly negatively correlated with free β-hCG and (only in S1) with PAPP-A. In contrast, NVP was significantly positively associated with free β-hCG levels and (only in S1) with PAPP-A. While low hCG levels seem to be an important indicator for activation of the behavioral immune system in the first trimester, increased hCG levels play a role in stronger symptoms of NVP, a result consistent with previous studies. Levels of PAPP-A are likely part of a larger network of immunological and endocrine responses and do not appear to provide sufficient information for predicting women's NVP and disgust sensitivity.

Disgust sensitivity in early pregnancy as a response to high pathogen risk

Introduction

Considered a part of the behavioral immune system (BIS), disgust sensitivity is expected to be adjusting as a response to the actual level of the environmental health risks.

Methods

In this preregistered study, we tested the hypothesis that disgust sensitivity would be higher during the COVID-19 pandemic compared to the pre-pandemic period in pregnant women. In this between-subject study with a longitudinal trend design, we administered the Disgust Scale-Revised to 200 pregnant women before the pandemic and to 350 pregnant women during the pandemic.

Results

We found a small but significant effect of the pandemic on disgust sensitivity, such that higher disgust sensitivity was found in women pregnant during the pandemic. This effect was stronger in primiparae, however, the interaction between parity and the pandemic period was not significant. Disgust sensitivity decreased with age. No differences in terms of nausea and vomiting were found between the women pregnant before and during the pandemic.

Discussion

Our findings indicate that although BIS is presumed to function as a complex mechanism to prevent health-threatening behaviors, its activation in pregnant women during the COVID-19 pandemic is rather weak.

The psychometric properties and gender invariance of the Italian version of the Perceived Vulnerability to Disease Questionnaire (I-PVDQ) during the COVID-19 pandemic

BACKGROUND

The Perceived Vulnerability to Disease Questionnaire (PVDQ) measures beliefs associated with personal susceptibility to infectious diseases and behaviors or perceptions in the presence of potential risk of pathogen transmission. Given the onset of the Severe Acute Respiratory Syndrome Coronavirus 2 global pandemic, otherwise known as the COVID-19 pandemic, the construct being measured may function differently based on affective, behavioral, and cognitive changes along with the need to change norms and lifestyles in a global context. The present study aims to test the psychometric properties and the gender invariance of the Italian adaptation of the PVDQ to confirm that the scale can be used with Italian-speaking people, and that it functions effectively during a pandemic.

METHODS

A total of 509 participants filled out an online questionnaire including the Italian version of the I-PVDQ (I-PVDQ) and several measures of psychological constructs. Reliability and factor analyses (single and multigroup) were conducted. Bayesian correlation tests and Bayesian independent sample t-tests were used to assess the validity of I-PVDQ.

RESULTS

Exploratory factor analysis supported the two-factor structure of the I-PVDQ, and factor loadings loaded appropriately onto perceived infectability (PI) and germ aversion (GA). In terms of invariance, the scale showed configural, metric, scalar, and strict invariance across genders. Decisive evidence in favor of correlation with the measure of COVID-19 related fears for both PI and GA was found. There was strong evidence for observed correlations with COVID-19 related constructs such as intolerance to uncertainty, psychological inflexibility, resilience, stress, and anxiety. Women showed higher GA than men, while there were no gender differences in PI.

CONCLUSIONS

Taken together, these results suggest that the I-PVDQ confirms the psychometric properties of the original version and that can be used to detect PVD when it is affected by environmental circumstances since its functioning is preserved during a pandemic.

Threats of COVID-19 arouse public awareness of climate change risks

Public climate change awareness is indispensable to dealing with climate change threats. Understanding whether and how the COVID-19 pandemic impacts on individuals’ climate change risk perception would thus be critical to green economic recovery. We conducted a longitudinal survey study in China when the pandemic was at its height and when it was mitigated. The cross-lagged analysis confirmed our assumed “arousal” effect of perceived COVID-19 risks on climate change risk awareness. We further tested and verified the proposed “dual-pathway” mechanisms of affective generalization (i.e., negative affective states aroused by COVID-19 “spillover” to the assessment of climate change risk) and cognitive association (i.e., the outbreak of COVID-19 awakens people’s recognition of the human-nature-climate issues) via multiple mediation analyses. Our results implied that climate policies could be integrated into pandemic control, and that the public should be more awakened to confront multiple crises with proper guidance.

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Public COVID-19 risk perception arouses their climate change awareness

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A longitudinal survey in China was conducted to verify this arousal effect

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Generalized negative affect states explain the effect

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Cognitive association also explains the effect

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.

Health-Promoting Quality of Life at Work during the COVID-19 Pandemic: A 12-Month Longitudinal Study on the Work-Related Sense of Coherence in Acute Care Healthcare Professionals

(1) Background: During a pandemic, the wellbeing of healthcare professionals is crucial. We investigated the long-term association of the Work-related Sense of Coherence (Work-SoC) and the evolution of psychological health symptoms of acute care healthcare professionals during the first year of the COVID-19 pandemic. (2) Methods: This longitudinal observational study enrolled 520 multinational healthcare professionals, who completed an online survey every three months from April 2020 to April 2021. Mixed linear models examined the associations between Work-SOC and COVID-19-related anxiety, perceived vulnerability, depressiveness, and psychological trauma symptomatology. (3) Results: Healthcare professionals with a higher Work-SoC reported lower levels of COVID-19-related anxiety, perceived vulnerability, depressiveness, and psychological trauma symptomatology in April 2020 than healthcare professionals with an average or lower Work-SoC, but the levels increased to higher values in April 2021. Healthcare professionals with a lower Work-SoC reported higher levels of depressiveness and psychological trauma symptomatology in April 2020 but lower levels in April 2021. (4) Conclusions: Healthcare professionals with higher levels of Work-related Sense of Coherence might be protected against variations in psychological symptoms for about three months, but this protection seems to decrease as the pandemic continues, resulting in mental health deterioration. In contrast, healthcare professionals with a lower Work-SoC might be protected at later stages of the pandemic.

Social distancing from foreign individuals as a disease-avoidance mechanism: Testing the assumptions of the behavioral immune system theory during the COVID-19 pandemic

Topics of prejudice, discrimination, and negative attitudes toward outgroups have attracted much attention of social scientists during the COVID-19 pandemic, as the preference for social distancing can originate from the perception of threat. One of the theoretical approaches that offers an explanation for avoidance tendencies is the behavioral immune system theory. As a motivational system that aims to identify and avoid pathogens, the behavioral immune system has been shown to be triggered by various cues of a potential disease threat (e.g., the risk of contracting a virus), which further leads to negative social consequences such as xenophobia, negative attitudes toward various social groups, and distancing tendencies. We present a correlational study (N = 588; Polish sample) that was designed to test mediational models derived from the behavioral immune system theory, using the COVID-19 pandemic as a source of natural disease threat. In serial mediation analyses we show that the perceived threat of COVID-19 translates into greater preferred social distance from foreign individuals, and that this occurs in two ways: 1) via pathogen disgust (but not sexual or moral disgust), and 2) via germ aversion (but not perceived infectability). Both pathogen disgust and germ aversion further predict general feelings toward foreign individuals, which finally determine the preferred social distance from these individuals. The results support the behavioral immune system theory as an important concept for understanding social distancing tendencies.

Women Suffered More Emotional and Life Distress than Men during the COVID-19 Pandemic: The Role of Pathogen Disgust Sensitivity

The outbreak of the COVID-19 has brought upon unprecedented challenges to nearly all people around the globe. Yet, people may differ in their risks of social, economic, and health well-being. In this research, we take a gender-difference approach to examine whether and why women suffered greater emotional and life distress than men at the early stage of the COVID-19 outbreak in China. Using a large nationwide Chinese sample, we found that compared to men, women reported higher levels of anxiety and fear, as well as greater life disturbance during the COVID-19 pandemic. Importantly, that women suffered more was partly explained by their higher level of pathogen disgust sensitivity. Our findings highlight the important consequences of gender differences in response to the threat of the COVID-19 pandemic and suggest that policymakers pay more attention to gender inequalities regarding COVID-19 responses.

Testing the Disgust-Based Mechanism of Homonegative Attitudes in the Context of the COVID-19 Pandemic

Negative attitudes and stigmatization can originate from the perception of a disease-related threat. Following the spread of the COVID-19 pandemic, it is often suggested that incidents of discriminatory behavior are the result of defense mechanisms aimed at avoiding pathogens. According to the behavioral immune system theory, people are motivated to distance themselves from individuals who show signs of infection, or who are only heuristically associated with a disease, primarily because of the disgust they evoke. In this paper we focus on negative attitudes toward gay men and lesbians who are among social groups that have been persistently framed as "unclean." In our correlational study (N = 500 heterosexual participants; Polish sample data collected during the first COVID-19 lockdown in Poland, in March/April 2020) we tested moderation models derived from the behavioral immune system theory. Specifically, we investigated whether perceived vulnerability to disease and perceived threat of contracting COVID-19 moderate the relation between disgust and homonegativity. We found that sexual disgust (but not pathogen nor moral disgust) predicted homonegative attitudes. This effect was stronger for participants expressing higher levels of perceived vulnerability to disease but was not dependent on the perception of the COVID-19 threat. The results reaffirm previous evidence indicating a pivotal role of disgust in disease-avoidance mechanisms. They also point to functional flexibility of the behavioral immune system by demonstrating the moderating role of perceived vulnerability to disease in shaping homonegative attitudes. Finally, they show that the threat of COVID-19 does not strengthen the relationship between disgust and homonegativity.

Trust in Science, Perceived Vulnerability to Disease, and Adherence to Pharmacological and Non-pharmacological COVID-19 Recommendations

Protection motivation theory (PMT) is a theoretical framework informative for understanding behavioral intentions and choices during exceptional and uncommon circumstances, such as a pandemic of respiratory infectious disease. PMT postulates both the threat appraisal and the coping appraisal as predictors of health behaviors. Recent advances in the field of behavioral immune system (BIS) research suggest that humans are equipped with a set of psychological adaptations enabling them to detect the disease-threat and activate behavioral avoidance of pathogens. The present study, set within PMT framework and informed by the BIS research, aimed to explain and predict voluntary adherence to COVID-19 guidelines by perceived personal risk and vulnerability to disease as threat appraisal variables, and trust in science as the response efficacy element of coping appraisal. Gender, age, belief in the second wave, perceived personal risk, germ aversion, and trust in science were all found to be significant positive predictors of the intent to adhere to non-pharmacological COVID-19 recommendations, with the belief in the second wave, germ aversion, and trust in science being the most important ones. On the other hand, only the belief in the second wave and trust in science were significant positive predictors of the intent to adhere to pharmacological COVID-19 recommendations (i.e., to vaccinate). Interventions aimed at enhancing preventative measures adherence should take into account that the psychological mechanisms underlying adherence to these two types of recommendations are not identical.

Do Islanders Have a More Reactive Behavioral Immune System? Social Cognitions and Preferred Interpersonal Distances During the COVID-19 Pandemic

Insular populations have traditionally drawn a lot of attention from epidemiologists as they provide important insights regarding transmission of infectious diseases and propagation of epidemics. There are numerous historical instances where isolated populations showed high morbidity once a new virus entered the population. Building upon that and recent findings that the activation of the behavioral immune system (BIS) depends both upon one's vulnerability and environmental context, we predicted that, during the COVID-19 pandemic, place of residence (island vs. mainland) explains a significant proportion of variance in preferred interpersonal distances, animosity toward strangers, and willingness to punish those who do not adhere to COVID-19 preventive measures. With 48 populated islands, Croatia provides a fruitful testing ground for this prediction. We also opted to explore relations among BIS-related variables (pathogen disgust, germ aversion, and perceived infectability) and social cognitions in a more natural context than has previously been done. The study was conducted online, on Croatian residents, during April and May 2020. As expected, the BIS variables contributed significantly to preferred interpersonal distances, negative emotions toward strangers, and willingness to punish those who do not adhere to COVID-19 preventive measures. Furthermore, our results showed that geographical location explained a significant amount of variance in preferred social (but not personal and intimate) distances and negative emotions toward foreigners. As Croatian islands are extremely frequent travel destinations, these differences between mainlanders and islanders cannot be explained by the lack of exposure to foreigners. Additionally, we found that scores on preferred interpersonal distances, pathogen disgust, and germ aversion were significantly higher compared to those obtained in Croatian samples before the COVID-19 pandemic. Furthermore, men scored higher in perceived infectability than before the COVID-19 pandemic, and women did not, which reflects the objectively higher risk of SARS-CoV-2 for men than for women. Taken together, our results support the notion that BIS is a highly adaptive and context-dependent response system, likely more reactive in more susceptible individuals.