To Help or Not to Help? Prosocial Behavior, Its Association With Well-Being, and Predictors of Prosocial Behavior During the Coronavirus Disease Pandemic

The beneficial effects of social support and prosocial behavior on immunity and health: A psychoneuroimmunology perspective

The COVID-19 pandemic emphasized the pivotal role of the social environment, prompting a surge in research on its impact on well-being and health. This article aims to examine the link between the social environment, the immune system, and health outcomes, with a particular focus on positive aspects like social support and prosocial behaviors that are under-explored. Different aspects of the social environment are examined: the negative effects of loneliness and adverse social conditions, contrasted with the benefits of social support and prosocial behaviors. While the mechanisms behind negative effects are partially studied, those driving the positive effects remain elusive. Understanding the mechanisms of lack of social connection and their effects will allow us to explore the benefits of social connections and whether they can reverse the adverse outcomes. Potential psychoneuroimmunology mechanisms are proposed, highlighting the promotion of a 'safe' state by the vagus nerve, oxytocin circuits, and the additional contribution of the reward pathways. This article reviews the need to bridge knowledge gaps, urging further research to study the causal effects of positive social interactions on immune response and health outcomes to raise clinical awareness and interventions. Such interventions may include integrating lonely individuals with prosocial activities, thereby improving their physical and mental health. There is growing potential to harness the power of social connections for the betterment of individual health and society as a whole.

The effect of a prosocial environment on health and well-being during the first COVID-19 lockdown and a year later

The outset of the COVID-19 pandemic was characterized by prolonged periods of chronic stress and social isolation. While studies have investigated the changes to well-being (WB) during this period, the impact of the social environment on long-term physical and mental health requires further study. This study aimed to assess the factors influencing WB and health outcomes, with the hypothesis that a positive social environment would play a significant immediate and long-term role in improving WB and preventing the effects of anxiety associated with the pandemic. At time point 1 (April 2020), an Israeli sample of 206 participants (84% female, mean age 31.5) responded to traditional questionnaires assessing mental health and social support. Factors affecting WB were assessed within subjects during the first COVID-19 lockdown for 6 weeks using a daily survey (Beiwe phone application). A year later, in May 2021, at time point 2, the initial questionnaires were readministered to a subset of the same participants (N = 94). We found that anxiety during the first lockdown adversely affected WB and predicted health and WB deterioration a year later. In contrast, a high quality of social relationships was associated with better short- and long-term WB, and mitigated the adverse effects of anxiety. Daily activities, including physical activity, meditation, and romantic relations, were also positively associated with WB during the first lockdown but did not have long-term effects. In summary, our study underscores the enduring health advantages of a positive social environment, particularly during stressful periods. These results have implications for health policymakers: programs which support individuals with high anxiety and low support, by integrating them into community-based interventions, promise to enhance well-being (WB) and health, as well as to fortify the community as a whole.

Prosociality predicts changes in leisure activities during the COVID-19 pandemic

Several studies suggest that leisure activities enhance well-being. In line with this perspective, a recent study indicates that augmenting indoor leisure activities to compensate for diminished outdoor pursuits could sustain or enhance well-being during the COVID-19 pandemic. The present study was designed to identify personality traits that predict such behavioral shifts in indoor versus outdoor leisure activities during the pandemic. The present study included 657 participants (Mage = 41.08) and measured 12 personality traits that a previous study reported were associated with health-protective behaviors during COVID-19. Our findings indicate that the rise in indoor leisure activities correlated with prosocial tendencies toward family and friends/acquaintances (but not strangers), self-centered interest, resilience, and Big Five personality traits. Conversely, the decline in outdoor activities was linked solely to prosociality toward family and friends/acquaintances. Further interaction analysis uncovered that prosocial tendencies toward close relations predicted increased indoor activities as an alternative to outdoor engagements. We concluded that prosociality promoted behavioral changes that significantly prevented infections in intimate others, and it could maintain personal well-being during the COVID-19 pandemic by facilitating behavior change.

Prosocial Interventions and Health Outcomes: A Systematic Review and Meta-Analysis

Importance

Prosocial interventions encourage voluntary actions that benefit others. Community solidarity in response to the COVID-19 pandemic, expanding mutual aid programs, and health workforce issues have accelerated prosocial health interventions.

Objective

To investigate the association of prosocial interventions with health outcomes in clinical trials and observational studies.

Data Sources

In this systematic review and meta-analysis informed by the Cochrane Handbook for Systematic Reviews of Interventions, 5 databases (MEDLINE [via PubMed], Embase, CINAHL, PsycInfo, and Scopus) were searched from database inception through February 23, 2023. The search included terms for altruism and prosocial behaviors, health outcomes, and study type.

Study Selection

Included studies, determined by multiple reviewers, compared health outcomes in a prosocial intervention group with a nonintervention group.

Data Extraction and Synthesis

Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline, data extraction and synthesis captured quantitative and qualitative data. To pool data from quantitative studies, random-effects meta-analyses were used to estimate the impact of prosocial interventions. To combine data from quantitative and qualitive studies, data were transformed into qualitative narratives using meta-aggregation.

Main Outcomes and Measures

The main outcome was whether prosocial interventions were associated with improved health outcomes. Barriers to and facilitators of implementation of these interventions were assessed.

Results

The search identified 5229 citations; 30 studies were included in the synthesis. Studies indicated that prosocial interventions were associated with positive health outcomes for givers (17 studies [56.7]) and recipients (8 [26.7%]). Prosocial interventions included acts of kindness (12 studies [40.0%]), cash gifts (7 [23.3%]), pay-it-forward approaches (6 [20.0%]), and expressions of kindness (5 [16.7%]). Improvements were reported in depression, testing for sexually transmitted diseases, vaccine uptake, physical activity, and individual biomarkers. Data from 6 studies (20.0%) demonstrated that pay-it-forward approaches were associated with increased uptake of diagnostic tests or vaccines among vulnerable groups (moderate certainty of evidence). Data from 14 studies (46.7%) suggested that community connectedness facilitated prosocial interventions. Shared vulnerabilities among groups (eg, sexual minority individuals, older adults) may provide a context for collective mobilization to improve health in local communities.

Conclusions and Relevance

This systematic review and meta-analysis found that prosocial interventions were associated with improved health outcomes among vulnerable groups and have been useful for addressing health disparities. Further research is needed to develop and evaluate prosocial interventions.

The Mental Health Impacts of a Pandemic: A Multiaxial Conceptual Model for COVID-19

The COVID-19 pandemic substantially impacted the mental health of the general population and particularly vulnerable individuals and groups. A wealth of research allows for estimating this impact and identifying relevant factors contributing to or mitigating it. The current paper presents and synthesizes this evidence into a multiaxial model of COVID-19 mental health impacts. Based on existing research, we propose four axes: (1) Exposure to COVID-related events; (2) Personal and social vulnerability, such as previous mental health problems or belonging to a vulnerable group; (3) Time, which accounts for the differential impacts throughout the development of the pandemic; and (4) Context, including healthcare and public policies, and social representations of the illness influencing individual emotional reactions and relevant behaviors. These axes help acknowledge the complexity of communities' reactions and are pragmatic in identifying and prioritizing factors. The axes can provide individual information (i.e., more exposure is harmful) and account for interactions (e.g., exposure in an early phase of the pandemic differs from a later stage). This model contributes to the reflections of the evidence and informs the mental health response to the next pandemic.

Volunteering as prosocial behaviour by medical students following a flooding disaster and impacts on their mental health: A mixed-methods study

BACKGROUND

Volunteering is a form of prosocial behaviour that has a been recognised as having positive benefits for medical students. However, there is a lack of research on what influences students to volunteer during and after weather-related disasters. Our study (1) explores factors related to medical students' willingness and readiness to volunteer, and (2) describes mental health impacts of the flood events on students.

METHODS

We conducted a mixed-methods study of medical students on rural clinical placements in a regional area of Australia, 2 to 6 weeks after two major flooding events in 2022. Data were collected through survey and focus groups. Summary statistics were generated from the survey data, and Fisher's exact test was used to determine associations between student experience of the flood and self-rated well-being. Qualitative data were deductively analysed using Byrne and colleagues' theory of prosocial behaviour during an emergency.

RESULTS

The 36 students who participated in focus groups (including the 34 who completed the survey) (response rates 84% and 79%, respectively) demonstrated high levels of prosocial behaviours and were willing to volunteer. A sense of moral obligation was the primary reason for volunteering, whereas concerns for their physical and psychological safety, and missing key aspects of their training, were the strongest reasons for not continuing to volunteer. Students reported personal stress, anxiety and trauma during this period, with significant associations between self-rated impacts on their well-being and feelings of being terrified, helpless and hopeless during the flooding events and of still being distressed weeks later (p < .05).

CONCLUSIONS

This study expands on prosocial behaviour theory by applying Byrne and colleagues elaborated model in the context of medical student volunteering during the 2022 major flooding events in Australia. Modifiable barriers to prosocial behaviour are identified along with proposed strategies to address these barriers.

Preexisting social ties among Auschwitz prisoners support Holocaust survival

Survivor testimonies link survival in deadly POW camps, Gulags, and Nazi concentration camps to the formation of close friendships with other prisoners. To provide evidence free of survival bias on the importance of social ties for surviving the Holocaust, we study individual histories of 30 thousand Jewish prisoners who entered the Auschwitz-Birkenau concentration camp on transports from the Theresienstadt ghetto. We ask whether the availability of potential friends among fellow prisoners on a transport influenced the chances of surviving the Holocaust. Relying on multiple proxies of preexisting social networks and varying social-linkage composition of transports, we uncover a significant survival advantage to entering Auschwitz with a larger group of potential friends.

Predictors of changing patterns of adherence to containment measures during the early stage of COVID-19 pandemic: an international longitudinal study

BACKGROUND

Identifying common factors that affect public adherence to COVID-19 containment measures can directly inform the development of official public health communication strategies. The present international longitudinal study aimed to examine whether prosociality, together with other theoretically derived motivating factors (self-efficacy, perceived susceptibility and severity of COVID-19, perceived social support) predict the change in adherence to COVID-19 containment strategies.

METHOD

In wave 1 of data collection, adults from eight geographical regions completed online surveys beginning in April 2020, and wave 2 began in June and ended in September 2020. Hypothesized predictors included prosociality, self-efficacy in following COVID-19 containment measures, perceived susceptibility to COVID-19, perceived severity of COVID-19 and perceived social support. Baseline covariates included age, sex, history of COVID-19 infection and geographical regions. Participants who reported adhering to specific containment measures, including physical distancing, avoidance of non-essential travel and hand hygiene, were classified as adherence. The dependent variable was the category of adherence, which was constructed based on changes in adherence across the survey period and included four categories: non-adherence, less adherence, greater adherence and sustained adherence (which was designated as the reference category).

RESULTS

In total, 2189 adult participants (82% female, 57.2% aged 31-59 years) from East Asia (217 [9.7%]), West Asia (246 [11.2%]), North and South America (131 [6.0%]), Northern Europe (600 [27.4%]), Western Europe (322 [14.7%]), Southern Europe (433 [19.8%]), Eastern Europe (148 [6.8%]) and other regions (96 [4.4%]) were analyzed. Adjusted multinomial logistic regression analyses showed that prosociality, self-efficacy, perceived susceptibility and severity of COVID-19 were significant factors affecting adherence. Participants with greater self-efficacy at wave 1 were less likely to become non-adherence at wave 2 by 26% (adjusted odds ratio [aOR], 0.74; 95% CI, 0.71 to 0.77; P < .001), while those with greater prosociality at wave 1 were less likely to become less adherence at wave 2 by 23% (aOR, 0.77; 95% CI, 0.75 to 0.79; P = .04).

CONCLUSIONS

This study provides evidence that in addition to emphasizing the potential severity of COVID-19 and the potential susceptibility to contact with the virus, fostering self-efficacy in following containment strategies and prosociality appears to be a viable public health education or communication strategy to combat COVID-19.

Prosocial behavior predicts meaning in life during the COVID-19 pandemic: The longitudinal mediating role of perceived social support

The COVID-19 pandemic was an unexpected, long-term negative event. Meaning in life has been linked to better psychological adjustment to such events. The current study uses longitudinal data collected during the COVID-19 pandemic to discover whether perceived social support mediates the relationship between six dimensions of prosocial behavior (Altruistic, Anonymous, Public, Compliant, Emotional, and Dire) and meaning in life. A sample of Chinese college students (N = 514) was tracked at three time points (T1, T2, and T3) during the COVID-19 outbreak. A cross-lagged panel model (CLPM) was used for mediation analysis. The mediation effect was found in all the dimensions of prosocial behavior except for Public prosocial behavior. We also found a longitudinal, bidirectional association between perceived social support and meaning in life. The current study contributes to the growing literature on the significance of prosocial behavior in predicting meaning in life.

The parental COVID-19 anxiety and emotional exhaustion in healthcare workers: exploring the roles of resilience, prosocialness, and optimism

Healthcare workers (HCWs) also became the main protagonist of the tragic pandemic story. They have had a markedly higher risk of becoming infected with COVID-19. Outside work, healthcare workers with children have experienced mental health challenges, including the worry that they may carry COVID-19 home and infect their children. Based on these, the current study aimed to examine the effect of parental COVID-19 anxiety on emotional exhaustion and identify the roles of resilience, prosocialness, and optimism in this relationship. The findings demonstrated that prosocialness moderated the relationship between personal COVID-19 anxiety and emotional exhaustion by alleviating the depleting effects of personal COVID-19 anxiety. At the same time, prosocialness reinforced the negative effect of resilience on emotional exhaustion. On the other side, optimism moderated the relationship between parental COVID-19 anxiety and resilience by alleviating the adverse effect of parental COVID-19 anxiety. Moreover, it buffered the exacerbating effect of parental anxiety on personal anxiety. In conclusion, promoting personal resources (i.e., resilience, prosocialness, and optimism) seems an excellent way to mitigate the adverse consequences of the pandemic on mental health. Furthermore, the increment in parental mental health problems during COVID-19 pandemic may have long-term effects on children. Considering this perspective, we need to develop a proactive approach for parents' now and children's futures.

Prosocial behavior in emergencies: Evidence from blood donors recruitment and retention during the COVID-19 pandemic

The impact of COVID-19 represents a specific challenge for voluntary transfusional systems sustained by the intrinsic motivations of blood donors. In general, health emergencies can stimulate altruistic behaviors. However, in this context, the same prosocial motivations, besides the personal health risks, could foster the adherence to social distancing rules to preserve collective health and, therefore, discourage blood donation activities. In this work, we investigate the consequences of the pandemic shock on the dynamics of new donors exploiting the individual-level longitudinal information contained in administrative data on the Italian region of Tuscany. We compare the change in new donors' recruitment and retention during 2020 with respect to the 2017-2019 period (we observe 9511 individuals), considering donors' and their municipalities of residence characteristics. Our results show an increment of new donors, with higher proportional growth for older donors. Moreover, we demonstrate that the quality of new donors, as proxied by the frequency of subsequent donations, increased with respect to previous years. Finally, we show that changes in extrinsic motivations, such as the possibility of obtaining a free antibody test or overcoming movement restrictions, cannot explain the documented increase in the number of new donors and in their performance. Therefore, our analyses indicate that the Tuscan voluntary blood donation system was effective in dealing with the challenges posed by the COVID-19 pandemic.

Should I Help? Prosocial Behaviour during the COVID-19 Pandemic

The Movement Control Order (MCO) enacted during the COVID-19 pandemic has profoundly altered the social life and behaviour of the Malaysian population. Because the society is facing huge social and economic challenges that need individuals to work together to solve, prosocial behaviour is regarded as one of the most important social determinants. Because it is related with individual and societal benefits, participating in prosocial activities may be a major protective factor during times of global crisis. Rather than focusing only on medical and psychiatric paradigms, perhaps all that is necessary to overcome the COVID-19 risks is for individuals to make personal sacrifices for the sake of others. In reality, a large number of initiatives proven to be beneficial in decreasing viral transmission include a trade-off between individual and collective interests. Given its crucial importance, the purpose of this concept paper is to provide some insight into prosocial behaviour during the COVID-19 period. Understanding prosocial behaviour during the COVID-19 pandemic is crucial because it may assist in the establishment of a post-COVID society and provide useful strategies for coping with future crises.

The influence of students' sense of social connectedness on prosocial behavior in higher education institutions in Guangxi, China: A perspective of perceived teachers' character teaching behavior and social support

The objective of this study is to examine the sense of social connectedness (SSC) and prosocial behavior (PB) of students in Guangxi higher education institutions in China and to further understand the factors influencing PB of higher education students. In this study, a total of 1,007 students were sampled from 8 Guangxi higher vocational schools through purposive sampling using questionnaires, of which 676 (67.1%) were male students and 331 (32.9%) were female students. This study further enriches self-determination theory by exploring the effects of teachers' character teaching behaviors and social support on PB, using the SSC as an intrinsic motivation. In addition, the results of the study revealed that SSC, perceived teacher character teaching behaviors and perceived social support (PSS) were positively related to students' PB. SSC affects PB not only directly, but also indirectly through the mediating role of perceived teacher character teaching behavior and perceived teacher support. Teacher character teaching behaviors and PSS also play a chain mediating role in the relationship between SSC and PB. Finally, this study provides strategies to optimize school character management for higher education students in order to meet their basic psychological needs and thus promote the production of PB.

Is helping you helping me? The assessment of helping others using event sampling methodology in a clinical and a non‐clinical sample

Individuals diagnosed with major depressive disorder (MDD) and social phobia (SP) have difficulties in social interactions. It is unknown, however, whether such difficulties prevent them from helping others, thereby depriving them of the natural benefits of helping, such as receiving gratitude. Using event sampling methodology (ESM), individuals (MDD, n = 118; SP, n = 47; and control group, n = 119) responded to questions about the frequency of helping, in total at 5333 time points, and their well-being. Contrary to our hypothesis, individuals in the MDD, SP and control group did not differ in their helping frequency. Results did show an association between helping and well-being, such that helping is related to well-being and well-being to helping. Understanding the complex relation of helping others and well-being and how this might be used during therapy and prevention programmes are discussed.

More Relaxed but Less Helpful: The Relationship between Stress, Age, and Self-Reported Prosocial Behavior during the COVID-19 Pandemic

(1) Background: The COVID-19 pandemic has collectively increased stress levels, with individuals making difficult choices between protecting themselves and helping others. Previous research has shown that people engage in more prosocial, or helping, behavior as they age and in moments of acute stress, but it is unclear how c stress has influenced perceived changes in prosocial behavior in the later stages of the pandemic and whether this varies across the lifespan. (2) Methods: The current study explored how perceived stress, age, and gender impact participants’ reports of perceived changes in their prosocial behavior due to the pandemic using survey questions administered through an online subject pool (n = 201). (3) Results: Hierarchical linear regression results revealed results indicated a significant main effect of perceived stress (β = −0.166, p = 0.021) and age (β = −0.217, p = 0.003) but not gender (β = −0.062, p = 0.370) on perceptions of how one’s prosocial behavior was affected by the COVID-19 pandemic. (4) Conclusions: Study findings showed that older adults and individuals with higher levels of perceived stress reported a decrease in their prosocial behavior, which supported our hypotheses. These findings provide unique insight into the influence of a long-term health crisis on different groups of people’s participation in prosocial behavior, with implications for mental health and community engagement during a pandemic.

Stronger association of perceived health with socio-economic inequality during COVID-19 pandemic than pre-pandemic era

Objective

The COVID-19 pandemic has changed peoples’ routine of daily living and posed major risks to global health and economy. Few studies have examined differential impacts of economic factors on health during pandemic compared to pre-pandemic. We aimed to compare the strength of associations between perceived health and socioeconomic position (household income, educational attainment, and employment) estimated before and during the pandemic.

Methods

Two waves of nationwide survey [on 2018(T1;n = 1200) and 2021(T2;n = 1000)] were done for 2200 community adults. A balanced distribution of confounders (demographics and socioeconomic position) were achieved across the T2 and T1 by use of the inverse probability of treatment weighting. Distributions of perceived health [= (excellent or very good)/(bad, fair, or good)] for physical-mental-social-spiritual subdomains were compared between T1 and T2. Odds of bad/fair/good health for demographics and socioeconomic position were obtained by univariate logistic regression. Adjusted odds (aOR) of bad/fair/good health in lower household income(< 3000 U.S. dollars/month) were retrieved using the multiple hierarchical logistic regression models of T1 and T2.

Results

Perceived health of excellent/very good at T2 was higher than T1 for physical(T1 = 36.05%, T2 = 39.13%; P = 0.04), but were lower for mental(T1 = 38.71%, T2 = 35.17%; P = 0.01) and social(T1 = 42.48%, T2 = 35.17%; P < 0.001) subdomains. Odds of bad/fair/good health were significantly increased at T2 than T1 for household income (physical-mental-social; all Ps < 0.001) and educational attainment (social; P = 0.04) but not for employment (all Ps > 0.05). AORs of bad/fair/good health in lower household income were stronger in T2 than T1, for mental [aOR (95% CI) = 2.15(1.68–2.77) in T2, 1.33(1.06–1.68) in T1; aOR difference = 0.82(P < 0.001)], physical [aOR (95% CI) = 2.64(2.05–3.41) in T2, 1.50(1.18–1.90) in T1; aOR difference = 1.14(P < 0.001)] and social [aOR (95% CI) = 2.15(1.68–2.77) in T2, 1.33(1.06–1.68) in T1; aOR difference = 0.35(P = 0.049)] subdomains.

Conclusions

Risks of perceived health worsening for mental and social subdomains in people with lower monthly household income or lower educational attainment became stronger during the COVID-19 pandemic compared to pre-pandemic era. In consideration of the prolonged pandemic as of mid-2022, policies aiming not only to sustain the monthly household income and compulsory education but also to actively enhance the perceived mental-social health status have to be executed and maintained.

Re-examining the relationship between interpersonal reactivity index sub-scales and mental well-being: Implications of the pandemic

The pandemic has severely impacted people's Mental Well-being (MWB) globally. Pre-pandemic studies have widely linked MWB with empathy. Against the backdrop of pandemic, we intend to re-examine this association between empathy, as widely measured by the Interpersonal Reactivity Index (IRI) sub-scales: perspective taking, empathic concerns, and personal distress with MWB. For this, a survey using a non-experimental research design was carried out during the 2020 lockdown. We used the Structural Equation Modeling approach to analyse the data. All the standardized scales have been tested for unidimensionality, reliability, and validity. We also resort to a self-administered questionnaire consisting of questions related to day-to-day activities to support the empirical findings. Results demonstrate a positive relationship between perspective taking and empathic concern with MWB and a negative relationship between personal distress and MWB. The response to the self-administered questionnaire corroborates with our model results and presents the scope of interpreting the findings. In continuation, limitations, contributions, and future scope conclude this essay.