Disease-avoidant behaviour and its consequences

Visual attention is not attuned to non-human animal targets' pathogenicity: an evolutionary mismatch perspective

A considerable amount of research has revealed that there exists an evolutionary mismatch between ancestral environments and conditions following the rise of agriculture regarding the contact between humans and animal reservoirs of infectious diseases. Based on this evolutionary mismatch framework, we examined whether visual attention exhibits adaptive attunement toward animal targets' pathogenicity. Consistent with our predictions, faces bearing heuristic infection cues held attention to a greater extent than did animal vectors of zoonotic infectious diseases. Moreover, the results indicated that attention showed a specialized vigilance toward processing facial cues connoting the presence of infectious diseases, whereas it was allocated comparably between animal disease vectors and disease-irrelevant animals. On the other hand, the pathogen salience manipulation employed to amplify the participants' contextual-level anti-pathogen motives did not moderate the selective allocation of attentional resources. The fact that visual attention seems poorly equipped to detect and encode animals' zoonotic transmission risk supports the idea that our evolved disease avoidance mechanisms might have limited effectiveness in combating global outbreaks originating from zoonotic emerging infectious diseases.

Think positive! Resolving human motion ambiguity in the presence of disease threat

Recently, approach-avoidance tendencies and visual perception biases have been increasingly studied using bistable point-light walkers (PLWs). Prior studies have found a facing-the-viewer bias when one is primed with general threat stimuli (e.g. angry faces), explained by the "error management theory", as failing to detect a threat as approaching is riskier than the opposite. Importantly, no study has explored how disease threat - linked to the behavioural immune system - might affect this bias. This study aimed to explore whether disease-signalling cues can alter how we perceive the motion direction of ambiguous PLWs. Throughout 3 experiments, participants indicated the motion direction of a bistable PLW previously primed with a control or disease-signalling stimuli - that is, face with a surgical mask (Experiment 1), sickness sound (Experiment 2), or face with a disease cue (Experiment 3). Results showed that sickness cues do not significantly modulate the perception of approach-avoidance behaviours. However, a pattern emerged in Experiments 2 and 3, suggesting that sickness stimuli led to more facing away percepts. Unlike other types of threat, this implies that disease-related threat stimuli might trigger a distinct perceptual bias, indicating a preference to avoid a possible infection source. Nonetheless, this finding warrants future investigations.

The impact of COVID-19 concerns on perceiving others' faces

Unlike most infectious diseases, COVID-19 is characterised by an absence of facial disease-signalling cues. Yet, it is still unclear whether it has influenced face perception. Understanding this may help clarify if and how our motivation toward social interactions is conditional on situational pathogen threats. The present study investigated if priming disease concerns about COVID-19 would change people's perception of neutral faces on perceived disease, social discomfort and arousal elicited by such faces; this condition was compared with other infectious/non-infectious diseases and a non-disease priming condition. One-hundred sixty-six participants recruited nationally performed the online task. When compared with the non-disease condition, participants primed for COVID-19 perceived faces as sicker and tended to view them as eliciting more social discomfort; no difference occurred in arousal. No other difference was found between conditions. These findings suggest that the pandemic context can shape how we perceive others' apparent sickness. Overall, these might reflect adaptations intertwined with the behavioural immune system's defence mechanisms.

First impressions of a new face are shaped by infection concerns

Along with a classical immune system, we have evolved a behavioral one that directs us away from potentially contagious individuals. Here I show, using publicly available cross-cultural data, that this adaptation is so fundamental that our first impressions of a male stranger are largely driven by the perceived health of his face. Positive (likeable, capable, intelligent, trustworthy) and negative (unfriendly, ignorant, lazy) first impressions are affected by facial health in adaptively different ways, inconsistent with a mere halo effect; they are also modulated by one's current state of health and inclination to feel disgusted by pathogens. These findings, which replicated across two countries as different as the USA and India, suggest that instinctive perceptions of badness and goodness from faces are not two sides of the same coin but reflect the (nonsymmetrical) expected costs and benefits of interaction. Apparently, pathogens run the show-and first impressions come second. Lay Summary: Our first impressions of strangers (whether they seem trustworthy, intelligent, unfriendly, or aggressive) are shaped by how healthy their faces look and by our unconscious motivation to avoid infections. Bad and good impressions turn out to reflect the concrete, potentially vital, expected costs and benefits of interacting with our fellow humans. Apparently, pathogens run the show-and first impressions come second.

Pseudo-Contamination and Memory: Is There a Memory Advantage for Objects Touched by "Morphologically Deviant People"?

Memory plays an important role in the behavioral immune system (BIS; Schaller in Psychological Inquiry, 17(2), 96-101, 2016a), a proactive immune system whose ultimate function is to make organisms avoid sources of contamination. Indeed, it has been found that objects presented next to sick people are remembered better than objects shown next to healthy people-representing a contamination effect in memory. In the present studies, we investigated this memory effect in relation to "pseudo-contaminated" sources, that is to say, people exhibiting cues ultimately evoking the threat of contamination but objectively posing no such threat in terms of disease transmission. Common objects were shown next to photographs of people having three kinds of morphological deviations-obesity (study 1), scars and burns (study 2), strange eyes (study 3)-or no morphological deviation. Contrary to our expectations, we found that "pseudo-contaminated objects" were not remembered better than "non-contaminated objects," whereas discomfort ratings of the idea of touching the same objects were clearly higher with morphologically deviant people. Memory mechanisms do not seem to be mobilized by "pseudo-contamination" sources which are not directly related to infection risk.

Behavioral avoidance of contagious and non-contagious adults

Evolutionary theories of disease avoidance propose that humans have a set of universal psychological processes to detect environmental cues indicative of infectious disease. These processes then initiate cognitive, emotional, and behavioral responses that function to limit contact with harmful pathogens. Here, we study the conditions under which people exhibit behavioral avoidance of others with a contagious illness or a physical injury (i.e., a broken leg), and the potential mechanisms that underlie this behavior. Across three studies, participants were given the option of sitting at one of two workstations previously occupied by two confederates, one of whom either showed visible symptoms of a cold (contagion condition), wore a lower-leg orthopedic boot and used crutches (broken leg condition), or showed no signs of illness or physical injury (control). We found strong evidence that adults explicitly avoid contact with individuals who show symptoms of a contagious illness. Further, we provide some evidence that adults also avoid individuals with a physical injury, but that this behavior might be driven by implicit, unconscious processes. The findings are discussed in terms of implications for the healthy avoidance of contagion, and the risk for potential stigmatization of non-contagious groups.

The Factorial Structure of Stigma and Its Targets

Abstract. We aimed to determine (1) the attributes of multiple stigmatized populations, (2) whether Kurzban and Leary’s (2001) functional typology of stigma emerges and identifies the dimensions upon which each stigma type differs, and (3) the emotional responses toward emergent stigma types. Participants ( N = 2,674) were assigned to 1/52 stigma target conditions and their attitudes surveyed. Data were analyzed by multilevel factor analysis with stigma targets at Level 2. There were five within-factors at Level 1 (social competence, interpersonal access, social inclusion, immorality, perceived permanence) and three between-factors at Level 2 (interpersonal stigmatization, morality-based stigmatization, chronic stigmatization). Interpersonal stigmatization was predicted by disgust and pity, and morality-based stigmatization was predicted by disgust and [-]happiness, with no predictors for chronic stigmatization. These results support a functional typology of stigma.

Why Are Dying Individuals Stigmatized and Socially Avoided? Psychological Explanations

Extant research on the topic of death and dying in modern society frequently includes the observation that death is now rendered invisible, and dying individuals are stigmatized and socially avoided. The current research speculated that lack of contact with a dying individual may promote negative perceptions of the dying, and this may in turn lead to further avoidance of them. Three studies were conducted: The first study examined how frequently the current U.S. participants had social contact with a dying individual; the second study investigated what perceptions they have of the dying, and the third study tested for potential causal links between negative perceptions of the dying and social avoidance of them. The results indicated: Only a small number of the U.S. participants ever had frequent social contact with a dying individual outside their family; they, nevertheless, shared several common negative perceptions of the dying; and those negative perceptions exerted different effects on one's avoidant attitude toward a dying individual-only making males more avoidant, especially in a physically close social relationship. Two concepts, medicalization and masculinism, were suggested as possible explanations for why dying individuals are stigmatized and avoided in modern society.

Tactile disgust: Post-contact can be more disgusting than contact

Several studies have examined if disgust can be evoked by contacting an object-yet none have examined if reported disgust changes when the hand leaves the object. This is surprising given that post-contact tactile disgust is probably a driver of hand hygiene. We examined contact and post-contact tactile disgust and its sensory origins. Participants were asked to touch several objects, making sensory, disgust, and desire-to-handwash evaluations. These ratings were made at three stages-of-contact: object-contact (just touch), post-contact (just touch), and visual post-contact (touch, vision). Disgust was typically highest at post-contact (when the hand left the object). Stickiness and wetness were uniquely predictive of object-contact disgust. Only stickiness drove post-contact disgust, and only wetness visual post-contact disgust. Hand-washing desire was primarily driven by quantity of residue perceived on the hand. These findings suggest that tactile disgust is a multisensory and iterative process relating to object- and residue-adhesiveness.

Validation of Fear of COVID-19 Scale in India: Classical Test Theory and Item Response Theory Approach

COVID-19 has become one of the significant sources of stress, fear, and anxiety throughout the world. Though the global effect on the psychological health of university settings is still unclear, the effect is highly significant (Lima et al., 2020). Therefore, assessing students’ anxiety regarding this pandemic is the need of the hour. The Fear of COVID-19 scale developed by Ahorsu et al. (2020) is a unidimensional scale with seven items that assess the intensity of fear of COVID-19. Given the rapid increase of COVID-19 cases and fear of uncertainty among college students in India, we aim to analyze the psychometric properties and validate this scale in the Indian context. A cross-sectional survey was conducted among college students (n= 572). In confirmatory factor analysis, the loadings ranged between .54 and .78. To further validate this, we have performed item response theory analysis. The unidimensional IRT estimates shown in Table 5 reveals that item difficulties ranged between −.33 and 1.28. The item characteristics curve for the COVID-19 scale is given at the end of the results section.

Stigma and Discrimination (SAD) at the Time of the SARS-CoV-2 Pandemic

Infectious disease control is a crucial public health issue. Although it is important to urgently perform public health measures in order to reduce the risk of spread, it could end up stigmatizing entire groups of people rather than offering control measures based on sound scientific principles. This “us” versus “them” dynamic is common in stigmatization, in general, and indicates a way in which disease stigma can be viewed as a proxy for other types of fears, especially xenophobia and general fear of outsiders. The pandemic risk associated with SARS-CoV-2 infection led us to consider, among other related issues, how stigma and discrimination remain serious barriers to care for people suspected of being infected, even more if they are assisting professions, such as health workers, employed in emergency response. The purpose of this review is to evaluate and promote the importance of psychological aspects of the stigma and social discrimination (SAD) in pandemic realities and, more specifically, nowadays, in the context of SARS-CoV-2/COVID-19. Just as it happened with HIV, HCV, tuberculosis, and Zika, stigma and discrimination undermine the social fabric compromising the ethics and principles of civilization to which each individual in entitled. Recognizing disease stigma history can give us insight into how, exactly, stigmatizing attitudes are formed, and how they are disbanded. Instead of simply blaming the ignorance of people espousing stigmatizing attitudes about certain diseases, we should try to understand precisely how these attitudes are formed so that we can intervene in their dissemination. We should also look at history to see what sorts of interventions against stigma may have worked in the past. Ongoing research into stigma should evaluate what has worked in the past, as above-mentioned, providing us with some clues as to what might work in the current pandemic emergency, to reduce devastating discrimination that keeps people from getting the care they need. We propose a systematic and historical review, in order to create a scientific and solid base for the following SAD analysis. The aim is to propose a coping strategy to face stigma and discrimination (SAD) related to SARS-CoV-2/COVID-19 pandemic outbreak, borrowing coping strategy tools and solutions from other common contagious diseases. Furthermore, our study observes how knowledge, education level, and socioeconomic status (SES) can influence perception of SARS-CoV-2/ COVID-19 risk in a digital world, based on previous research, best practices, and evidence-based research.

Perceptions of IBD within patient and community samples: a systematic review

Objective: Inflammatory bowel disease (IBD) is a chronic, gastrointestinal condition that involves a range of debilitating bowel symptoms. Adjustment to living with IBD can be negatively impacted by maladaptive cognitive and behavioural factors (e.g. negative illness representations and repressing emotions). Patient samples also report negative reactions from the general public and such perceptions can further negatively impact people living with IBD. Therefore, we aimed to systematically review literature investigating the illness perceptions, perceived stigmatisation, and negative emotional reactions toward IBD within patient and community samples. We also aimed to review how these factors impact those living with IBD (i.e. adjustment, psychological health). Design: A range of databases (e.g. Psych INFO, PubMed) were searched over two years. One reviewer individually screened titles and abstracts using the specified inclusion criteria, and this process was repeated by a second reviewer. Subsequently, the full text articles were screened and data were extracted for the 82 articles that satisfied the inclusion criteria. Following data extraction, a narrative synthesis was conducted.Results: The review of 82 studies suggested that negative illness perceptions are linked to poorer psychosocial outcomes, that patient samples frequently anticipate stigmatisation, fear relating to bowel accidents was the most common emotion reported, and that the general public direct little enacted stigma towards IBD.Conclusion: For people living with IBD: (i) poorer psychological adjustment was reported by those who held more negative perceptions and reactions toward their illness; and (ii) their concerns regarding public perceptions of IBD warrants further empirical attention. Results emphasise the importance of targeting perceptions, and facilitating education and adaptive responding during treatment.

Implicit Attitudes About Agricultural and Aquatic Products From Fukushima Depend on Where Consumers Reside

Japanese consumers are still hesitant to purchase products from Fukushima, although 7 years have passed since the Fukushima nuclear disaster, and these products are officially considered safe. In this study, we examined whether Japanese consumers have negative implicit attitudes toward agricultural and aquatic products from the Fukushima region and whether these attitudes are independent of their explicit attitudes. Japanese students completed an implicit association test and a questionnaire to assess their implicit and explicit attitudes toward products from Fukushima relative to another region. The results of two experiments reliably demonstrated that the public has negative implicit attitudes toward Fukushima products, whereas their explicit attitudes are consistently positive. These observations predominantly held for participants living close to Fukushima (Tokyo) as opposed to participants living far away (Hiroshima): Experiment 1 (n = 40). Furthermore, individual differences in aversion to germs contributed to the implicit attitudes; the implicit negative attitudes were attenuated among the participants with a relatively low aversion to germs: Experiment 2 (n = 60). These results suggest that the implicit attitudes associated with the behavioral immune system, which is conceptualized as a suite of psychological mechanisms designed to proactively resist pathogenic threats, may underlie the hesitation to purchase products from Fukushima.

Exogenous attention and memory for faces following contextual behavioral immune system activation

The behavioral immune system (BIS) is characterized by affective, cognitive and behavioral processes that work in an articulated manner to prevent the occurrence of infections. Attention and memory evolved to enhance the organism's chances of survival and have been proposed to play an important role in the BIS. The present study investigated the effects of attention and memory for neutral faces after a contextual activation of the BIS. Participants were primed, by the use of film clips, either with infectious disease concerns or non-infectious disease concerns. They performed an exogenous attentional task involving the discrimination of target letters, with face stimuli presented as distractors, which was then followed by a surprise recognition task for the faces. The results showed that participants in the infectious disease condition were more accurate in the attentional task than participants in the control condition. No significant difference between groups was found in the response times during the attention task nor in memory performance. Overall, these results suggest that the BIS might be associated with a hypervigilant state towards cues in general and that BIS activation through this type of priming may not be sufficient to clearly activate mnemonic mechanisms.

Effect of Partners' Disgust Responses on Psychological Wellbeing in Cancer Patients

The aim of this study was to explore quantitatively the relationship between disgust responses in cancer patients and their partners, and in turn their relationship to patients' psychological well-being. We recruited 50 participants with heterogeneous cancer diagnoses and their partners from cancer-related groups (e.g., charities). Patients completed questionnaires to determine levels of disgust propensity, disgust sensitivity, self-disgust, and symptoms of anxiety and depression. Disgust propensity and sensitivity were also assessed in their partners. Partners' disgust sensitivity was significantly positively correlated with cancer patients' self-disgust, disgust propensity, and depression. Path analyses suggested that patients' self-disgust plays a role in mediating the effect of partners' disgust sensitivity on patients' psychological well-being. This study provides the first quantitative evidence that psychological well-being in cancer patients is contingent on their partners' sensitivity to disgust, and that patients' self-disgust plays a mediating role. Focusing therapeutically on disgust responses could well be beneficial to people with cancer.

Disease avoidance as a functional basis for stigmatization

Stigmatization is characterized by chronic social and physical avoidance of a person(s) by other people. Infectious disease may produce an apparently similar form of isolation-disease avoidance-but on symptom remission this often abates. We propose that many forms of stigmatization reflect the activation of this disease-avoidance system, which is prone to respond to visible signs and labels that connote disease, irrespective of their accuracy. A model of this system is presented, which includes an emotional component, whereby visible disease cues directly activate disgust and contamination, motivating avoidance, and a cognitive component, whereby disease labels bring to mind disease cues, indirectly activating disgust and contamination. The unique predictions of this model are then examined, notably that people who are stigmatized evoke disgust and are contaminating. That animals too show avoidance of diseased conspecifics, and that disease-related stigma targets are avoided in most cultures, also supports this evolutionary account. The more general implications of this approach are then examined, notably how it can be used to good (e.g. improving hygiene) or bad (e.g. racial vilification) ends, by yoking particular labels with cues that connote disease and disgust. This broadening of the model allows for stigmatization of groups with little apparent connection to disease.