When endocrinology and democracy collide: emotions, cortisol and voting at national elections

County-level political group density, partisan polarization, and individual-level mortality among adults in the United States: A lagged multilevel study

Objective

To investigate the associations between county-level political group density, partisan polarization, and individual-level mortality from all causes and from coronary heart disease (CHD) in the United States.

Methods

Using data from five survey waves (1998-2006) of the General Social Survey-National Death Index dataset and the County Presidential Election Return 2000 dataset, we fit weighted Cox proportional hazards models to estimate the associations between (1) political group density and (2) partisan polarization measured at the county level in 2000 (n = 313 counties) categorized into quartiles with individual-level mortality (n = 14,983 participants) from all causes and CHD, controlling for individual- and county-level factors. Maximum follow-up was from one year after the survey up until 2014. We conducted these analyses using two separate measures based on county-level vote share differences and party affiliation ideological extremes.

Results

In the overall sample, we found no evidence of associations between county-level political group density and individual-level mortality from all causes. There was evidence of a 13% higher risk of dying from heart disease in the highest quartile of county-level polarization (hazards ratio, HR = 1.13; 95% CI = 0.74-1.71). We observed heterogeneity of effects based on individual-level political affiliation. Among those identifying as Democrats, residing in counties with high (vs. low) levels of polarization appeared to be protective against mortality, with an associated 18% lower risk of dying from all causes (HR = 0.82, 95% CI = 0.71-0.94). This association was strongest in areas with the highest concentrations of Democrats.

Conclusions

Among all study participants, political group density and polarization at the county level in 2000 were not linked to individual-level mortality. At the same time, we found that Democratic party affiliation may be protective against the adverse effects of high polarization, particularly in counties with high concentrations of Democrats. Future research should further explore these associations to potentially identify new structural interventions to address political determinants of population health.

Conspiracy beliefs and perceptual inference in times of political uncertainty

Sociopolitical crises causing uncertainty have accumulated in recent years, providing fertile ground for the emergence of conspiracy ideations. Computational models constitute valuable tools for understanding the mechanisms at play in the formation and rigidification of these unshakeable beliefs. Here, the Circular Inference model was used to capture associations between changes in perceptual inference and the dynamics of conspiracy ideations in times of uncertainty. A bistable perception task and conspiracy belief assessment focused on major sociopolitical events were administered to large populations from three polarized countries. We show that when uncertainty peaks, an overweighting of sensory information is associated with conspiracy ideations. Progressively, this exploration strategy gives way to an exploitation strategy in which increased adherence to conspiracy theories is associated with the amplification of prior information. Overall, the Circular Inference model sheds new light on the possible mechanisms underlying the progressive strengthening of conspiracy theories when individuals face highly uncertain situations.

Trajectories of sociopolitical stress during the 2020 United States presidential election season: Associations with psychological well-being, civic action, and social identities

Sociopolitical stress arises in reaction to awareness of, exposure to, and/or involvement in political events. Among a longitudinal cohort of 628 college students from 10 universities across the U.S., we explored trajectories of sociopolitical stress during the 2020 United States presidential election season and examined relationships to psychological well-being. Growth mixture modeling classified our sample into four subgroups each with distinct trajectories of sociopolitical stress: High and Decreasing, Moderate and Increasing, Consistently Low, and High-to-Low. Participants with lower levels of sociopolitical stress expressed higher psychological well-being (high flourishing, high optimism, low anxiety symptoms, low depressive symptoms). The High and Decreasing subgroup was associated with the highest levels of civic action. Participants in the High and Decreasing trajectory were 20 times more likely to identify as LGBQ+, and 4 times more likely to be a woman or a transgender/gender diverse student, compared to participants in the Consistently Low subgroup.

Election-Related Post-Traumatic Stress: Evidence from the 2020 U.S. Presidential Election

The 2020 U.S. presidential election saw rising political tensions among ordinary voters and political elites, with fears of election violence culminating in the January 6 riot. We hypothesized that the 2020 election might have been traumatic for some voters, producing measurable symptoms of post-traumatic stress disorder (PTSD). We also hypothesized that negative sentiment toward the opposing party correlates with PTSD. We measured PTSD using a modified version of the PCL-5, a validated PTSD screener, for 573 individuals from a nationally representative YouGov sample. We modeled the association between affective polarization and PTSD, controlling for political, demographic, and psychological traits. We estimate that 12.5% of American adults (95% CI: 9.2% to 15.9%) experienced election-related PTSD, far higher than the annual PTSD prevalence of 3.5%. Additionally, negativity toward opposing partisans correlated with PTSD symptoms. These findings highlight a potential need to support Americans affected by election-related trauma.

Do elections make you sick? Evidence from first-time voters

Elections permit the continuance of democracy and enable economic development, but may have unintended effects on health. By applying a two-part model with regression discontinuity design to administrative health care claims, we determine that elections increased health care use during legally specified campaign periods by as much as 19% for first-time voters. Contrary to earlier studies focusing on mental health, we find higher spending on the treatment of physical health conditions, such as acute respiratory infections, gastrointestinal conditions and injuries. Levels of medical spending during campaign periods were highest in rural areas and among low-to-middle-income men. Using data on campaign spending from local elections, we identify campaign rallies as one important mechanism for the transmission of disease. Our findings provide additional rationale for policies that limit campaign spending on the grounds that it is socially wasteful.

ADHD and political participation: An observational study

BACKGROUND AND OBJECTIVE

Over the past decade, researchers have been seeking to understand the consequences of adult attention-deficit/hyperactivity disorder (ADHD) for different types of everyday behaviors. In this study, we investigated the associations between ADHD and political participation and attitudes, as ADHD may impede their active participation in the polity.

METHODS

This observational study used data from an online panel studying the adult Jewish population in Israel, collected prior the national elections of April 2019 (N = 1369). ADHD symptoms were assessed using the 6-item Adult ADHD Self-Report (ASRS-6). Political participation (traditional and digital), news consumption habits, and attitudinal measures were assessed using structured questionnaires. Multivariate linear regression analyses were conducted to analyze the association between ADHD symptoms (ASRS score <17) and reported political participation and attitudes.

RESULTS

200 respondents (14.6%) screened positive for ADHD based on the ASRS-6. Our findings show that individuals with ADHD are more likely to participate in politics than individuals without ADHD symptoms (B = 0.303, SE = 0.10, p = .003). However, participants with ADHD are more likely to be passive consumers of news, waiting for current political news to reach them instead of actively searching for it (B = 0.172, SE = 0.60, p = .004). They are also more prone to support the idea of silencing other opinions (B = 0.226, SE = 0.10, p = .029). The findings hold when controlling for age, sex, level of education, income, political orientation, religiosity, and stimulant therapy for ADHD symptoms.

CONCLUSIONS

Overall, we find evidence that individuals with ADHD display a unique pattern of political activity, including greater participation and less tolerance of others' views, but not necessarily showing greater active interest in politics. Our findings add to a growing body of literature that examines the impact of ADHD on different types of everyday behaviors.

Elections have (health) consequences: Depression, anxiety, and the 2020 presidential election

In this paper, we examine the effect of the 2020 presidential election on anxiety and depression among Americans. We use data from the 2020 Household Pulse Survey (HPS), a nationally representative rapid response survey conducted weekly from April to July of 2020 and then bi-weekly until December of 2021. The high-frequency nature of the survey implies that we can identify week-to-week changes in mental health outcomes. We find that self-reported symptoms of moderate to severe anxiety and depression increased steadily up to the presidential election and declined after the election. The anxiety and depression levels are significantly higher around the 2020 election than in April 2020, when most of the U.S. was under mandatory or advisory stay-at-home orders due to the COVID-19 pandemic. Furthermore, anxiety and depression-specific office visits and usage of mental-health-specific prescription drugs show similar patterns. Robustness checks rule out alternative explanations such as a COVID-19 surge or vaccine development.

Age, education, and political involvement differences in daily election-related stress

Stress in daily life is rather common, but elections can present unique challenges. Evaluating the impact of individual characteristics, behaviors, and political beliefs on stress processes is imperative to understanding how elections influence psychological well-being. Exploring how these individual and behavioral characteristics interacted to predict exposure to election-related stressors, we hypothesized that age, education, and past socio-political involvement would be associated with exposure to election-related stressors. In the 2018 U.S. Midterm Election Stress Coping and Prevention Every Day (ESCAPED) study, 140 participants in the United States and territories aged 19-86 were recruited through Amazon's Mechanical Turk for a 30-day daily diary study. Collectively, participants completed a total of 1196 reports between October 15, 2018 and November 13, 2018. The midterm election was November 6, 2018. Each day, participants reported on past political participation, election stress anticipation, and exposure to election-related stressors. Confirming our hypothesis, on days when people were more politically active and on days when stress anticipation increased, exposure to election-related stressors increased. Age differences in exposure depended on political activity in the last 24 h, with older adults exhibiting a steeper increase in exposure following political activity, especially if they were highly educated. However, higher education was protective against election-related stressors among younger adults even with increases in political activity. Individuals' experiences, characteristics, and daily decisions influence the likelihood of exposure to election-related stressors. Additionally, for younger adults, education may function as a protective factor when they engage in political activities.

Anticipatory stress during an election: A daily diary study

Previous research on election stress has focused on reacting to stressors that already occurred, whereas the forecasting of future stressors and associated responses have been underexamined. Leveraging the 2018 U.S. mid-term election, we examined anticipatory stress response, operationalised as the within-person association between daily stressors forecasting and negative affect (NA). We also explore whether such responses might be related to time, partisanship and political orientation. Participants were 125 adults in the U.S. who provided 1056 daily reports in a 29-day daily diary study surrounding the election. Results indicated that daily forecasts of election stressors contributed to increased NA independent of election stressor exposure. Election stressor forecasting was more pronounced during pre-election days and the election day than post-election days, as well as greater in conservatives than liberals. Coping with anticipatory stress may be important for managing election stress.

Core Beliefs Disruption in the Context of an Election: Implications for Subjective Well-Being

Major life events often challenge the core beliefs people hold about the world, which is a crucial cognitive process predictive of adjustment outcomes. Elections have been associated with physical and socioemotional responses, but what is unclear is whether core beliefs can be disrupted and what implication this disruption might have for well-being. In two studies, we examined the association between core beliefs disruption and well-being in the context of the 2018 U.S. midterm election. In both studies, participants reported a small degree of disruption of core beliefs due to the election. In Study 1, a 14-day daily diary study spanning the weeks before and after the election, multilevel modeling on 529 daily reports revealed that greater disruption of core beliefs was associated with lower mean levels of life satisfaction and greater changes in positive and negative affect. In Study 2, a cross-sectional study conducted 40 days following the election, linear regression analyses on 767 adults aged 18-77 from all 50 states revealed that the disruption of core beliefs due to the midterm election was positively associated with current life satisfaction. The effect held when controlling for multiple confounding factors. These findings suggest that elections can trigger disruption of core beliefs, and this disruption may spill over to subjective well-being in the short term but may positively contribute to post-election adjustment.

Elections have Consequences: Partisan Politics may be Literally Killing Us

BACKGROUND

Presidential campaigns and election outcomes have significant health implications for voters and communities. The theoretical underpinning of this relationship is multifaceted, but a new and growing field of empirical literature strongly suggests communities that voted for the losing presidential candidate may experience decreased physical and mental health under the leadership of the winning candidate.

OBJECTIVE

Our objective was to estimate the relationship between mortality rates and community support for the losing presidential candidate (partisan loss).

METHODS

Mortality data compiled by the US Centers for Disease Control and election results at the county level were used across a suite of county-year fixed-effects models to estimate the effect of election outcomes on mortality rates for the years 1999-2017.

RESULTS

Mortality rates were positively associated with partisan loss. Results suggest mortality rates increase by as much as 3% in extremely partisan counties following presidential election losses.

CONCLUSIONS

We suggest two mechanisms-social disintegration and/or partisan theory-by which mortality rates are likely to increase for counties that voted for the losing presidential candidate.

Political events and mood among young physicians: a prospective cohort study

OBJECTIVE

To study the effects of recent political events on mood among young physicians.

DESIGN

Prospective cohort study.

SETTING

United States medical centres.

PARTICIPANTS

2345 medical interns provided longitudinal mood data as part of the Intern Health Study between 2016 and 2018.

MAIN OUTCOME MEASURES

Mean mood score during the week following influential political and non-political events as compared with mean mood during the preceding four week control period.

RESULTS

We identified nine political events and eight non-political events for analysis. With the start of internship duties in July, the mean decline in mood for interns was -0.30 (95% confidence interval -0.33 to -0.27, t=-17.45, P<0.001). The decline in mood was of similar magnitude following the 2016 presidential election (mean mood change -0.32, 95% confidence interval -0.45 to -0.19, t=-4.73, P<0.001) and subsequent inauguration (mean mood change -0.25, 95% confidence interval -0.37 to -0.12, t=-3.93, P<0.001). Further, compared with men, women reported greater mood declines after both the 2016 election (mean gender difference 0.31, 95% confidence interval 0.05 to 0.58, t=2.33, P=0.02) and the inauguration (mean gender difference 0.25, 95% confidence interval 0.01 to 0.49, t=2.05, P=0.04). Overall, there were statistically significant changes in mood following 66.7% (6/9) of political events assessed. In contrast, none of the non-political events included in the analysis were statistically significantly associated with a change in mood.

CONCLUSIONS

Macro level factors such as politics may be correlated with the mood of young doctors. This finding signals the need for further evaluation of the consequences of increasing entanglement between politics and medicine moving forward for young physicians and their patients.

Factors associated with post-election psychological distress: The case of the 2016 U.S. presidential election

This study, through the lens of Social Cognitive Theory, examined potential risk factors that may intensify election-related psychological distress. Six weeks after the 2016 U.S. election, 772 U.S. adult citizens filled out an online survey that assessed psychological distress along with sociodemographic characteristics, and a set of variables tapping various dimensions of political self-efficacy (i.e., importance of politics in one's life, preferences for different media outlets, political directness, and voting choices). The findings showed that election-related psychological distress was positively associated with young age, greater reliance on new media, greater importance of politics in one's life, higher political directness, and voting for the candidate who did not win the election. Findings should be valuable for health-care providers informing them about potential risk factors intensifying psychological distress in the context of significant political events.

Young adults' psychological and physiological reactions to the 2016 U.S. presidential election

Elections present unique opportunities to study how sociopolitical events influence individual processes. The current study examined 286 young adults' mood and diurnal cortisol responses to the 2016 U.S. presidential election in real-time: two days before the election, election night, and two days after the election of Donald Trump, with the goal of understanding whether (and the extent to which) the election influenced young adults' affective and biological states. Utilizing piecewise trajectory analyses, we observed high, and increasing, negative affect leading up to the election across all participants. Young adults who had negative perceptions of Trump's ability to fulfill the role of president and/or were part of a non-dominant social group (i.e., women, ethnic/racial minority young adults) reported increased signs of stress before the election and on election night. After the election, we observed a general "recovery" in self-reported mood; however, diurnal cortisol indicators suggested that there was an increase in biological stress among some groups. Overall, findings underscore the role of macro-level factors in individuals' health and well-being via more proximal attitudes and physiological functioning.

Impacts of Adolescent and Young Adult Civic Engagement on Health and Socioeconomic Status in Adulthood

The present study examines links between civic engagement (voting, volunteering, and activism) during late adolescence and early adulthood, and socioeconomic status and mental and physical health in adulthood. Using nationally representative data from the National Longitudinal Study of Adolescent to Adult Health, a propensity score matching approach is used to rigorously estimate how civic engagement is associated with outcomes among 9,471 adolescents and young adults (baseline M_age  = 15.9). All forms of civic engagement are positively associated with subsequent income and education level. Volunteering and voting are favorably associated with subsequent mental health and health behaviors, and activism is associated with more health-risk behaviors and not associated with mental health. Civic engagement is not associated with physical health.

Public Fears in Ukrainian Society

Numerous experimental studies have revealed that two statistical measures of biological populations—(a) the correlation between certain parameters of their members and (b) the dispersion of theses parameters—simultaneously increase under stress conditions. Later on, this effect was confirmed also for financial systems. In our study we tested the applicability of these two stress-indicating statistical measures to Ukrainian society. We examined the prolonged stress period preceding the 2014 Ukrainian economic and political crisis. We considered the dynamics of 19 major public fears which got spread in the Ukrainian society during this period: of economic regress, of breakdown of the state, of losing sovereignty, etc. The study revealed that there was a simultaneous increase in the total correlation between the fears (by about 64 per cent) and also in their statistical dispersion (by 29 per cent) during the pre-crisis years. It is suggested that these measures may be a useful tool for monitoring stress onset and for possible steps that can be taken to prevent societal crises.

How Cyberattacks Terrorize: Cortisol and Personal Insecurity Jump in the Wake of Cyberattacks

Do cyberattacks fuel the politics of threat? By what mechanism does it do so? To address these questions, we employ a technological and physiological experiment (2 × 2) involving a simulated cyberattack. Participants were randomly assigned to "cyberattack" (treatment) or "no attack" (control) conditions. We find that cyber-attacks make people more likely to express threat perceptions; we suggest salivary cortisol, a measure of stress, as the mechanism bridging cyber and the politics of threat. Contrary to existing evidence, salivary cortisol is the mechanism that translates simulated exposure to cyberattacks into political threat perceptions.

Gender Atypicality and Anxiety Response to Social Interaction Stress in Homosexual and Heterosexual Men

Gender non-conforming behavior and a homosexual sexual orientation have both been linked to higher levels of anxiety. This study examined the independent and interactive effects of gender atypicality and sexual orientation on levels of state anxiety immediately following a stressful social interaction task among a sample of homosexual and heterosexual Israeli men (n = 36). Gender atypicality was measured via both self-report and observer ratings. State anxiety was measured via both self-report immediately subsequent to the stressful social interaction task and pre- to post task changes in salivary cortisol. Results showed that self-reported gender atypicality and heterosexual sexual orientation predicted higher levels of self-reported social interaction anxiety, but not changes in cortisol. There were no sexual orientation by gender behavior interactions and there were no significant effects for observer rated gender atypicality. These findings suggest that gender atypicality, not homosexuality, place individuals at risk for increased anxiety.

Voting at Home Is Associated with Lower Cortisol than Voting at the Polls

Previous research finds that voting is a socially stressful activity associated with increases in cortisol levels. Here we extend this research by investigating whether different voting modalities have differential effects on the stress response to voting. Results from a field experiment conducted during the 2012 presidential elections strongly suggest that traditional "at the polls" voting is more stressful, as measured by increases in cortisol levels, than voting at home by mail-in ballot or engaging in comparable non-political social activities. These findings imply that increased low-stress voting options such as mail-in ballots may increase political participation among individuals who are sensitive to social stressors.

Differences in negativity bias underlie variations in political ideology

Disputes between those holding differing political views are ubiquitous and deep-seated, and they often follow common, recognizable lines. The supporters of tradition and stability, sometimes referred to as conservatives, do battle with the supporters of innovation and reform, sometimes referred to as liberals. Understanding the correlates of those distinct political orientations is probably a prerequisite for managing political disputes, which are a source of social conflict that can lead to frustration and even bloodshed. A rapidly growing body of empirical evidence documents a multitude of ways in which liberals and conservatives differ from each other in purviews of life with little direct connection to politics, from tastes in art to desire for closure and from disgust sensitivity to the tendency to pursue new information, but the central theme of the differences is a matter of debate. In this article, we argue that one organizing element of the many differences between liberals and conservatives is the nature of their physiological and psychological responses to features of the environment that are negative. Compared with liberals, conservatives tend to register greater physiological responses to such stimuli and also to devote more psychological resources to them. Operating from this point of departure, we suggest approaches for refining understanding of the broad relationship between political views and response to the negative. We conclude with a discussion of normative implications, stressing that identifying differences across ideological groups is not tantamount to declaring one ideology superior to another.

Cortisol and politics: variance in voting behavior is predicted by baseline cortisol levels

Participation in electoral politics is affected by a host of social and demographics variables, but there is growing evidence that biological predispositions may also play a role in behavior related to political involvement. We examined the role of individual variation in hypothalamic-pituitary-adrenal (HPA) stress axis parameters in explaining differences in self-reported and actual participation in political activities. Self-reported political activity, religious participation, and verified voting activity in U.S. national elections were collected from 105 participants, who were subsequently exposed to a standardized (nonpolitical) psychosocial stressor. We demonstrated that lower baseline salivary cortisol in the late afternoon was significantly associated with increased actual voting frequency in six national elections, but not with self-reported non-voting political activity. Baseline cortisol predicted significant variation in voting behavior above and beyond variation accounted for by traditional demographic variables (particularly age of participant in our sample). Participation in religious activity was weakly (and negatively) associated with baseline cortisol. Our results suggest that HPA-mediated characteristics of social, cognitive, and emotional processes may exert an influence on a trait as complex as voting behavior, and that cortisol is a better predictor of actual voting behavior, as opposed to self-reported political activity.