Disease avoidance as a functional basis for stigmatization

Challenges and possible improvements for healthcare teams at outreach clinics in Nepal - a qualitative study

BACKGROUND

All Nepalese citizens have the right to high-quality healthcare services free of charge. To achieve this, healthcare services for the rural population in Nepal need to be improved in terms of personnel, medicines, and medical equipment.

OBJECTIVES

To explore challenges and possible improvements healthcare personnel experience when travelling to rural parts of Nepal to provide healthcare.

METHOD

Data was collected from various health professionals using focus group discussions at Dhulikhel Hospital in Nepal. The data were transcribed and analysed using Systematic text condensation.

RESULTS

Twenty-two professional healthcare personnel participated in five group discussions. Four categories emerged from the collected material: Finding ORC services being underutilised, Wanting to fulfil tasks and do a good job, Facing inadequate resources, and Seeing the need for improved organisation and cooperation. There was consensus that rural clinics are important to maintaining health for the rural population of Nepal. However, there was frustration that the rural population was not benefitting from all available healthcare services due to underutilisation.

CONCLUSION

Rural healthcare clinics are not utilised appropriately, according to healthcare workers at the rural outreach clinics. Potential ways of overcoming the perceived challenges of underutilising available healthcare services include financial and human resources. The rural population´s health awareness needs to be increased, and the work environment for rural healthcare workers needs to be improved. These issues need to be prioritised by the government and policymakers.

How Does Disgust Affect Mpox Prevention? Examining the Underlying Mechanisms of Perceived Severity and Perceived Susceptibility Moderated by Stigma

The study aims to examine the influencing mechanism of incidental exposure to Disgusting Graphics Information (DGI) about Monkeypox (Mpox) on the intention of prevention behavior. This study first investigates the components of disgust and then examines the mechanism of disgust's influence. The study uses a cross-sectional survey design among respondents who have been incidentally exposed to DGI about Mpox (N = 368). The results showed that disgust toward Mpox is the most effective component among other proposed ones (disgust toward graphics, information sources, and patients). Disgust not only positively influences prevention intention, but also indirectly influences prevention intention through perceived severity rather than perceived susceptibility. Moreover, moderated mediation was found, indicating that stigma toward patients prevents people from adopting preventive behaviors. Both theoretical and practical implications are discussed.

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.

Age-related disgust responses to signs of disease

Previous studies found similarities in adults' disgust responses to benign (e.g. obesity) and actual disease signs (e.g. influenza). However, limited research has compared visual (i.e. benign and actual) to cognitive (i.e. disease label) disease cues in different age groups. The current study investigated disgust responses across middle childhood (7-9 years), late childhood (10-12 years), adolescence (13-17 years), and adulthood (18+ years). Participants viewed individuals representing a benign visual disease (obese), sick-looking (staphylococcus), sick-label (cold/flu), and healthy condition. Disgust-related outcomes were: (1) avoidance, or contact level with apparel the individual was said to have worn, (2) disgust facial reactions, and (3) a combination of (1) and (2). Avoidance was greater for the sick-looking and sick-label than the healthy and obese conditions. For facial reaction and combination outcomes, middle childhood participants responded with greater disgust to the sick-looking than the healthy condition, while late childhood participants expressed stronger disgust towards the sick-looking and obese conditions than the healthy condition. Adolescents and adults exhibited stronger disgust towards sick-label and sick-looking than obese and healthy conditions. Results suggest visual cues are central to children's disgust responses whereas adolescents and adult responses considered cognitive cues.

When and Why People Conceal Infectious Disease

People sick with infectious illnesses face negative social outcomes, like exclusion, and may take steps to conceal their illnesses from others. In 10 studies of past, current, and projected illness, we examined the prevalence and predictors of infection concealment in adult samples of U.S. university students, health-care employees, and online crowdsourced workers (total N = 4,110). About 75% reported concealing illness in interpersonal interactions, possibly placing others in harm's way. Concealment motives were largely social (e.g., wanting to attend events like parties) and achievement oriented (e.g., completing work objectives). Disease characteristics, including potential harm and illness immediacy, also influenced concealment decisions. People imagining harmful (vs. mild) infections concealed illness less frequently, whereas participants who were actually sick concealed frequently regardless of illness harm, suggesting state-specific biases underlying concealment decisions. Disease concealment appears to be a widely prevalent behavior by which concealers trade off risks to others in favor of their own goals, creating potentially important public-health consequences.

The Potential Role of Undetectable = Untransmittable (U = U) in Reducing HIV Stigma among Sexual Minority Men in the US

The Undetectable = Untransmittable (U = U) message and its scientific underpinnings have been widely suggested to reduce HIV stigma. However, misunderstanding and skepticism about U = U may prevent this destigmatizing potential from being fully realized. This cross-sectional study examined associations between U = U belief (belief that someone with a sustained undetectable viral load has zero risk of sexually transmitting HIV) and HIV stigma among US sexual minority men. Differences by serostatus and effects of brief informational messaging were also explored. The survey was completed online by 106 men living with HIV and 351 HIV-negative/status-unknown men (2019-2020). Participants were 18-83 years old (M[SD] = 41[13.0]). Most were non-Hispanic White (70.0%) and gay (82.9%). Although nearly all participants (95.6%) were aware of U = U, only 41.1% believed U = U. A greater percentage of participants living with HIV (66.0%) believed U = U compared with HIV-negative/status-unknown participants (33.6%). Among participants living with HIV, U = U belief was not significantly associated with perceived, internalized, or experienced HIV stigma or with viral load prejudice (prejudice against people who have a detectable HIV viral load). Among HIV-negative/status-unknown participants, U = U belief was associated with less frequently enacted HIV discrimination, more positive feelings toward people with an undetectable viral load, and lower personal endorsement of stigmatizing beliefs. Brief informational messaging about U = U did not affect most stigma dimensions and did not favorably affect any. Interventions are needed to correct commonly held, outdated misconceptions about HIV transmission risk. Such initiatives must not only engage people living with HIV but also engage HIV-negative/status-unknown people to maximize the destigmatizing potential of U = U.

Stigmatising and Racialising COVID-19: Asian People's Experience in New Zealand

The Asian community - the second largest non-European ethnic community in New Zealand - plays an important role in combatting the COVID-19 pandemic, evidenced by their active advocation for border control and mass masking. Despite the long history of racial discrimination against the Asian population, the Asian community has experienced certain degrees of racial discrimination associated with the stigmatisation as the cause of the COVID-19 outbreak in New Zealand. Based on data from a quantitative online survey with 402 valid responses within the Asian communities across New Zealand and the in-depth interviews with 19 Asian people in Auckland, New Zealand, this paper will illustrate Asian people's experience of racial discrimination and stigmatisation during the pandemic in the country. The survey shows that since the outbreak of COVID-19, under a quarter of the participants reported experiencing discrimination, and a third reported knowing an immediate contact who had experienced discrimination. However, when looking beyond their immediate social circle, an even higher proportion reported noticing racism and stigmatisation through the traditional or social media due to COVID-19. Major variations of the degree of racial discrimination experienced are determined by three demographic variables: ethnicity, age, and region. The in-depth interviews largely echoed the survey findings and highlighted a strong correlation between the perceived racial discrimination among the local Asian community and the stigmatisation associated with COVID-19. These findings are important for improving the way we manage future pandemics and other disasters within the context of the UN Sendai Framework for Disaster Risk Reduction.

Resting parasympathetic activity is associated with malodor-induced change in perceived foreignness of speakers

INTRODUCTION

To protect against infection, individuals have evolved context-dependent pathogen-avoidant strategies, including selective social behaviors aimed at avoiding foreign individuals who may possess greater risk of infection. Parasympathetic nervous system (PNS) activity is associated with social engagement and regulation of the classical immune system but has not been widely investigated in relation to changes in intergroup perception and the behavioral immune system.

METHOD

The current research investigated the relationship between parasympathetic activity and perceived foreignness of in and outgroup speakers during exposure to a pathogen-relevant odor (butyric acid). High-frequency heart rate variability was measured at rest and while participants rated foreignness of speakers with and without the odor present.

RESULTS

Findings show that exposure to the odor was associated with higher foreignness perceptions of outgroup speakers and lower foreignness perceptions of ingroup speakers. This effect was especially evident among individuals with higher resting parasympathetic activity.

CONCLUSION

These results suggest that the PNS may play a role in changes in social perceptions during a behavioral immune response.

Disease-Related Stigma, Stigmatizers, Causes, and Consequences: A Systematic Review

Background

Stigma is a sociological concept that is important in medicine and health because it threatens health as much as the disease itself. We aimed to explore the causes, stigmatizers, consequences and coping strategies related to the stigma of diseases by systematically analyzing relevant literature.

Methods

This systematic review examined 65 articles on Disease-Related Stigma by searching Noormags, Magiran, SID, Google Scholar, and PubMed databases. The articles were published in Persian and English between 2001 and 2022 and conducted in Iran. We used a three-step systematic review process to select articles that met the research criteria.

Results

Conflict in society, lack of knowledge, specific characteristics of the disease, and the contagious nature of disease are the main causes of stigma, leading to stigmatization by different groups such as significant others, generalized others, institutional others, and macro others. Patients experiencing stigma face various psychological, physical, and social complications, and they may use concealment as a coping strategy, which can pose a potential threat to society's general health.

Conclusion

By knowing the causes and stigmatizers of disease-related, it is possible to reduce stigma with less cost and time.

Disgusted snails, oxytocin, and the avoidance of infection threat

Disgust is considered to be a fundamental affective state associated with triggering the behavioral avoidance of infection and parasite/pathogen threat. In humans, and other vertebrates, disgust affects how individuals interact with, and respond to, parasites, pathogens and potentially infected conspecifics and their sensory cues. Here we show that the land snail, Cepaea nemoralis, displays a similar "disgust-like" state eliciting behavioral avoidance responses to the mucus associated cues of infected and potentially infected snails. Brief exposure to the mucus of snails treated with the Gram-negative bacterial endotoxin, lipopolysaccharide (LPS), elicited dose-related behavioral avoidance, including acute antinociceptive responses, similar to those expressed by mammals. In addition, exposure to the mucus cues of LPS treated snails led to a subsequent avoidance of unfamiliar individuals, paralleling the recognition of and avoidance responses exhibited by vertebrates exposed to potential pathogen risk. Further, the avoidance of, and antinociceptive responses to, the mucus of LPS treated snails were attenuated in a dose-related manner by the oxytocin (OT) receptor antagonist, L-368,899. This supports the involvement of OT and OT receptor homologs in the expression of infection avoidance, and consistent with the roles of OT in the modulation of responses to salient social and infection threats by rodents and other vertebrates. These findings with land snails are indicative of evolutionarily conserved disgust-like states associated with OT/OT receptor homolog modulated behavioral avoidance responses to infection and pathogen threat.

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.

Acceptability and feasibility of home and hospital follow-up in Burkina Faso and Guinea: A mixed-method study among patients of the COVID-19 Coverage-Africa clinical trial

Patient experiences and perspectives on trial participation and follow-up may influence their compliance with research procedures or negatively impact their well-being. We aimed to explore the acceptability and feasibility of home-based and hospital-based follow-up modalities among COVID-19 patients enrolled in the ANTICOV ANRS COV33 Coverage-Africa trial in Burkina Faso and Guinea. The trial (2021-2022) evaluated the efficacy of treatments to prevent clinical worsening among COVID-19 patients with mild to moderate symptoms. Patients were either based at home or hospitalized, as per national recommendations, and followed-up through face-to-face visits and phone calls. We conducted a mixed-methods sub-study administering a questionnaire to all consenting participants and individually interviewing purposively selected participants. We performed descriptive analyses of Likert scale questions for the questionnaires and thematic analysis for the interviews. We conducted framework analysis and interpretation. Of the 400 trial patients, 220 completed the questionnaire (n = 182 in Burkina Faso, n = 38 in Guinea) and 24 were interviewed (n = 16 and n = 8, respectively). Participants were mostly followed-up at home in Burkina Faso; all patients from Guinea were first hospitalized, then followed-up at home. Over 90% of participants were satisfied with follow-up. Home follow-up was considered acceptable if (i) participants perceived they were not severely ill, (ii) it was combined with telemedicine, and (iii) the risk of stigma could be avoided. Hospital-based follow-up was viewed as a way to prevent contamination of family members, but could be badly experienced when mandatory and conflicting with family responsibilities and commitments. Phone calls were seen as reassuring and as a way to ensure continuity of care. These overall positive findings support the development of home-based follow-up for mildly ill patients in West-Africa, provided that both emotional and cognitive factors at individual, familial/inter-relational, healthcare and national levels be addressed when planning the implementation of a trial, or developing any public health strategy.

How does disgust regulate social rejection? a mini-review

The need to belong is a fundamental aspect of human nature. Over the past two decades, researchers have uncovered many harmful effects of social rejection. However, less work has examined the emotional antecedents to rejection. The purpose of the present article was to explore how disgust--an emotion linked to avoidance and social withdrawal--serves as an important antecedent to social rejection. We argue that disgust affects social rejection through three routes. First, disgust encourages stigmatization, especially of those who exhibit cues of infectious disease. Second, disgust and disease-avoidance give rise to cultural variants (e.g., socially conservative values and assortative sociality), which mitigate social interaction. Third, when the self is perceived as a source of contamination, it promotes shame, which, subsequently, encourages withdrawal from social interaction. Directions for future research are also discussed.

Understanding of Stigmatization and Death Amid COVID-19 in India: A Sociological Exploration

The unanticipated outbreak of Coronavirus had proven detrimental to human existence. It had created waves of panic, anxiety, and fear among people hence facilitating stigmatization toward an infected person. This stigmatization further influences patients health-seeking behaviour due to the trust deficit in the public health system. The virus had placed the world in an impotent situation as people helplessly watched their loved ones pass away in the absence of effective treatment. Dead bodies are denied a dignified death due to mandatory guidelines prescribed by countries to control the pandemic. This article attempts to understand the process of stigmatization of Coronavirus and its mechanism of influencing the health-seeking behaviour of people. Moreover, the way this stigmatization, accompanied by fear and anxiety, led to the denial of having a dignified death in India.

Disgusting Democrats and Repulsive Republicans: Members of Political Outgroups Are Considered Physically Gross

The status of disgust as a sociomoral emotion is debated. We conducted a stringent test of whether social stimuli (specifically, political outgroup members) can elicit physical disgust, as distinct from moral or metaphorical disgust. We employed stimuli (male faces) matched on baseline disgustingness, provided other ways for participants to express negativity toward outgroup members, and used concrete self-report measures of disgust, as well as a nonverbal measure (participants' facial expressions). Across three preregistered studies (total N = 915), we found that political outgroup members are judged to be "disgusting," although this effect is generally weaker for concrete self-report measures and absent for the nonverbal measure. This suggests that social stimuli are capable of eliciting genuine physical disgust, although it is not always outwardly expressed, and the strength of this result depends on the measures employed. We discuss implications of these results for research on sociomoral emotions and American politics.

How Children Develop Healthy Behavioral Choices to Promote Illness Prevention

Children’s understanding of contagion has been a fruitful area for studying children’s learning. However, despite a large literature on children’s conceptual understanding of illness, there is very little research on the impact of children’s knowledge about illness transmission on adaptive behavior. This is important because how children behave when faced with a sick individual or a contaminated object is what is most relevant to whether children get sick and pass along that illness to other people. Here, we will bring together various theories of how children learn to behave adaptively when faced with the possibility of getting sick (a) to better illuminate the different ways by which children might acquire health-related behaviors and (b) to help develop recommendations for designing interventions aimed at teaching children about contagion and illness prevention in a way that produces the most adaptive health behaviors.

Stigmatization profiles and psychological distress in people at high risk of infection with COVID-19 -A study conducted in Germany from March to August 2021

COVID-19-related stigmatization of affected people or people at risk of infection has been shown to enhance the reluctance of affected individuals to use health services and reduce their mental health. It is thus highly important to gain a thorough understanding of COVID-19-related stigmatization. The present study's first aim was to explore stigmatization profiles of experienced stigmatization (anticipated stigmatization, internalized stigmatization, enacted stigmatization, disclosure concerns) and stigmatization practices in 371 German people at high risk of infection using latent class analyses. The second aim was to investigate the relationship between stigmatization profiles and psychological distress via multiple regression analysis taking into account other possible negative and positive risk factors. Our results showed two stigmatization profiles: "high stigmatization group" and "low stigmatization group". Belonging to the "high stigmatization group" was significantly correlated with higher levels of psychological distress. Other risk factors significantly related to psychological distress were mental health disorders in the past, exposure to COVID-19, fear related to COVID-19, perceived risk of being infected, lower perceived self-efficacy, and lower subjective knowledge about COVID-19.

'Scars: How Our Wounds Make Us Who We Are': Improving appearance-based stigma, conceptualisation of beauty and body esteem through a documentary

Introduction

Those with an altered appearance as a result of injury, health condition or treatment can face stigma, which may contribute to adverse psychosocial outcomes. However, current research tends to focus on supporting individuals themselves to cope, rather than targeting societal stigma. This study aimed to reduce societal stigma towards this group, through the use of a documentary about people with scars.

Methods

146 adults completed questionnaires before and after viewing the documentary.

Results

After viewing, participants had reduced self-reported intentions to behave in a stigmatising way towards those with visible differences, broader conceptualisation of beauty, and more positive body-esteem. Qualitative data also suggested further positive impacts.

Conclusion

Those with visible differences (for example scars) are subject to societal stigmatisation which perpetuates psychological and social problems. Therefore, alleviating social stigma through the media, as demonstrated through the documentary in this study, may improve the lives of those living with visible differences.

Lay Summary

People with an altered appearance or scars as a result of injury, health condition or treatment can face stigma, which may contribute to harmful psychological and social outcomes. However, current research tends to focus on supporting affected individuals themselves to cope, rather than targeting societal stigma. This study aimed to find out whether a documentary about people with scars was successful at reducing viewers' stigma towards this group. A group of 146 adults completed questionnaires before and after viewing the documentary. After viewing, questionnaires indicated that participants had reduced intentions to behave in a stigmatising way towards those with visible differences. Furthermore, they also viewed a broader range of appearances as beautiful and felt more positive about their own bodies. Comments and feedback from participants also suggested further positive impacts. Those with visible differences (for example scars) are subject to societal stigmatisation which can cause and worsen mental health problems. Therefore, alleviating social stigma through the media, as demonstrated through the documentary in this study, may improve the lives of those living with visible differences.

Perceptions of COVID-19 among communities of Conakry (Guinea): a qualitative study exploring the context of the ANRS COV33 Coverage-Africa therapeutic trial

OBJECTIVES

To explore communities' perceptions about COVID-19 in the context of the ANRS COV33 Coverage-Africa clinical trial evaluating the efficacy of treatments in preventing clinical worsening of COVID-19.

DESIGN

Descriptive qualitative study using semistructured in-depth individual interviews conducted by telephone in French and Soussou between May and September 2021. Data were transcribed, translated in French when applicable and analysed with the thematic analysis method.

SETTING

The eight neighbourhoods most affected by COVID-19 in Conakry's urban context, capital of Guinea.

PARTICIPANTS

4 community leaders acting as key informants-providing insights regarding population's opinions-and six community members, who were exposed to an information session conducted as part of Coverage-Africa.

RESULTS

According to participants, community members have heterogeneous viewpoints about COVID-19: it exists and is dangerous; it is benign ('bad cold'); or it is fictitious (eg, government conspiracy). The fear of stigmatisation and social isolation of those sick or cured of COVID-19 was largely reported by participants, with illustrations of distressing situations for the victims. To avoid stigma, many patients seem to adopt strategies of discretion (eg, lying/hiding about the disease). Although community attitudes were reported to have evolved since the beginning of the epidemic, stigma remained a pervasive concern for many people.

CONCLUSIONS

Community perceptions about COVID-19 in Conakry may be partly explained by the Guinean context of Ebola history and of sociopolitical tensions. Stigmatisation of COVID+ people seems to be aimed at protecting others against contamination. However, social avoidance can greatly affect the morale of stigmatised people, especially in collectivist cultures like Guinea. Further investigating stigma, including its role on seeking COVID-19 screening and treatment services, and its consequences on mental health among affected/exposed people, would contribute to identifying improved prevention and care interventions in preparation for future health threats, and to promoting participation in health research.

TRIAL REGISTRATION NUMBER

NCT04920838 (Pre-results stage).

The moderating role of sexual minority status in the associations of the experience and tolerance of shame-related emotions to suicide risk

OBJECTIVE

This study examined the associations of the experience and tolerance of shame-related emotions to suicide risk, as well as the moderating role of sexual minority status.

METHODS

Community adults (N = 360) were recruited via MTurk and completed self-report questionnaires. Hierarchical regression analyses examined the main and interactive associations of sexual minority status and shame-related variables to suicide risk.

RESULTS

Results revealed significant positive associations between self-disgust and suicide risk for sexual minority and heterosexual participants, although the magnitude was greater for sexual minority participants. Additionally, tolerance of shame was significantly negatively related to suicide risk only among sexual minority participants. Finally, exploratory analyses examining the three-way interaction of self-disgust, shame tolerance, and sexual minority status revealed a significant negative association between shame tolerance and suicide risk only among sexual minority participants with high levels of self-disgust.

CONCLUSION

Results highlight the relevance of shame-related experiences to suicide risk among sexual minorities.

A post-outbreak assessment of exposure proximity and Ebola virus disease-related stigma among community members in Kono District, Sierra Leone: A cross-sectional study

Background

Based on findings from other contexts, informed by intergroup contact theory, that more contact is associated with less stigma, we hypothesized that community members with greater exposure to cases of Ebola virus disease (EVD) were less likely to report EVD-related stigma towards EVD survivors. We assessed personal stigmatizing attitudes towards Ebola survivors, which reflects personal fear and judgement, as well as perceived stigma towards EVD survivors, which reflects an individual's perception of the attitudes of the community towards a stigmatized group.

Methods

From September 2016 to July 2017, we conducted a cross-sectional, community-based study of EVD-related stigma among individuals who did not contract Ebola in four EVD-affected rural communities of Kono District, Sierra Leone. We identified individuals from all quarantined households and obtained a random sample of those who were unexposed. Exposed individuals either lived in a quarantined household or were reported to have been in contact with an EVD case. Our explanatory variable was proximity to an EVD case during the outbreak. Our primary outcome was stigma towards EVD survivors, measured by a 6-item adapted HIV-related stigma index validated in Zambia and South Africa, with 1 item reflecting personal stigmatizing attitudes and 5 items reflecting perceived community stigma. The 6-item EVD stigma index had good internal consistency (Cronbach's alpha=0.82). We used modified Poisson and negative binomial regression models, adjusting for potential confounders, to estimate the association between exposure proximity and EVD stigma.

Results

We interviewed 538 participants aged 12 to 85 years. Most (57%) had been quarantined. Over one-third (39%) reported personal stigmatizing attitudes or perceived community stigma; the most frequently endorsed item was fear and judgment towards EVD survivors. Having contact with someone with EVD was significantly associated with a lower likelihood of perceived community stigma (prevalence ratio [PR], 0.26; 95% CI, 0.13-0.54) and personal stigmatizing attitudes (PR, 0.44; 95% CI, 0.29-0.65). In contrast, being quarantined was significantly associated with a higher likelihood of perceived community stigma (PR, 3.9; 95% CI, 1.5-10.1).

Conclusions

In this cross-sectional study, we found evidence of an inverse relationship between EVD-related stigma and contact with an EVD case. This finding substantiates intergroup contact theory and may form the basis for anti-stigma interventions.

"Bed bugs live in dirty places"-How Using Live Animals in Teaching Contributes to Reducing Stigma, Disgust, Psychological Stigma, and Misinformation in Students

Bed bugs are on the rise and are increasingly perceived as harmful parasites. Because individuals affected by bed bugs often feel disgust and shame and are stigmatized, bed bugs are an important public health and environmental justice concern and therefore a health education issue as well. In this quasi-experimental study, we examine how different constructs, namely, forms of stigma, disgust, psychological distance, and myths about bed bugs (dependent variables), change over time (pre/posttest) in response to two forms of teaching intervention (independent variables) in upper secondary-level high school. The content of the interventions was the same, but in class, we showed live bed bugs to one group of students, assuming this would lead to a more realistic, less imaginative response to bed bugs than in the group presented with only pictures of bed bugs. Together with previous studies, we assumed that live bed bugs would be perceived as less disgusting and with a lower degree of stigmatization. Our results show that stigma, psychological distance, and myths can be reduced through intervention (regardless of live animal or picture). Disgust was more strongly reduced by live animals than by pictures. We present implications for biology education and contemporary health education.

Social distancing, community stigma, and implications for psychological distress in the aftermath of Ebola virus disease

Background

The 2013–2016 Ebola virus disease (EVD) epidemic resulted in more infections and deaths than all prior outbreaks in the 40-year history of this virus combined. This study examines how experiences of EVD infection, and preventive measures such as social distancing, were linked to experiences of stigma and social exclusion among those reintegrating into their communities.

Methods

Key informant interviews (n = 42) and focus group discussions (n = 27) were conducted in districts with a high prevalence of EVD and representing geographical and ethnic diversity (n = 228 participants). The final sample was composed of adults (52%) and children (48%) who were EVD-infected (46%) and -affected (42%) individuals, and community leaders (12%). Data were coded using a Grounded Theory approach informed by Thematic Content Analysis, and analyzed using NVivo. Interrater reliability was high, with Cohen’s κ = 0.80 or higher.

Findings

Participants described two main sources of EVD-related stress: isolation from the community because of social distancing and other prevention measures such as quarantine, and stigma related to infected or affected status. Participants linked experiences of social isolation and stigma to significant distress and feelings of ostracization. These experiences were particularly pronounced among children. Sources of support included community reintegration over time, and formal community efforts to provide education and establish protection bylaws.

Interpretation

This study found that social distancing and EVD-related stigma were each prominent sources of distress among participants. These results suggest that isolation because of infection, and the enduring stigmatization of infected individuals and their families, demand coordinated responses to prevent and mitigate additional psychosocial harm. Such responses should include close engagement with community leaders to combat misinformation and promote community reintegration.

Does disgust-eliciting propaganda shape children's attitudes toward novel immigrant groups?

Propaganda frequently leverages themes of dirtiness and disease to foster negative attitudes toward marginalized social groups. Although history suggests that this tactic is highly successful, empirical evidence is required to evaluate propaganda's potential efficacy. Inspired by previous evidence that children rapidly form attitudes about social groups, we conducted an exploratory investigation into whether 5- to 9-year-olds' (N = 48) judgments of novel foreign groups could be swayed by visually depicting one of these groups as disgusting in poster-sized illustrations. Across a wide battery of tasks, there was no clear indication that children readily internalize messages from propaganda in evaluating members of novel social groups. This finding held regardless of the type of disgustingness that was depicted in the propaganda, and generalized across the age range we investigated. Overall, our results are encouraging in a practical sense, suggesting that children are not easily swayed by negative misrepresentations of immigrants in propaganda.

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.

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

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Trait Empathy Modulates Patterns of Personal and Social Emotions During the COVID-19 Pandemic

The COVID-19 pandemic has caused profound consequences on people's personal and social feelings worldwide. However, little is known about whether individual differences in empathy, a prosocial trait, may affect the emotional feelings under such threat. To address this, we measured 345 Chinese participants' personal emotions (e.g., active, nervous), social emotions (i.e., fearful and empathetic feelings about various social groups), and their empathy traits during the COVID-19 pandemic. Using the representational similarity analysis (RSA), we calculated the pattern similarity of personal emotions and found the similarity between the positive and negative emotions was less in the high vs. low empathy groups. In addition, people with high (vs. low) empathy traits were more likely to have fearful and sympathetic feelings about the disease-related people (i.e., depression patients, suspected COVID-19 patients, COVID-19 patients, flu patients, SARS patients, AIDS patients, schizophrenic patients) and showed more pattern dissimilarity in the two social feelings toward the disease-related people. These findings suggest a prominent role of trait empathy in modulating emotions across different domains, strengthening the polarization of personal emotions as well as enlarging social feelings toward a set of stigmatized groups when facing a pandemic threat.

Comparisons Between COVID-19 Stigma and Other Stigmas: Distinct in Explicit Attitudes and Similar in Implicit Process

Since the outbreak of COVID-19, the public stigma associated with COVID-19 has emerged. To better understand the COVID-19 stigma, the present research conducted three studies on 1,493 Chinese participants from the outbreak to the recovery period of the COVID-19 pandemic to examine the psychological mechanisms of COVID-19 stigma by comparing it with other disease-related stigmas in terms of their explicit and implicit processes. Study 1 and Study 2 jointly demonstrated that the public endorsed more stigma toward the COVID-19 related people (i.e., the COVID-19 patients) relative to the other disease-related people (i.e., the SARS patients, people with flu) in multiple explicit aspects, including emotional, motivational, cognitive, and social processing. Using the implicit association test (IAT), Study 3 found no significant difference in the implicit measures of the COVID-19 vs. the SARS groups, which further revealed that the pandemic stigmas (i.e., COVID-19 and SARS) were similar at the implicit level. These findings suggest common (implicit level) but distinct (explicit level) psychological processes of the pandemic-related stigmas, which provide reference to policymakers in formulating suitable interventions to deal with COVID-19 stigma and a newly generated potential stigma and provide psychological support for the public in the future.

Generic model for biological regulation

A substantial portion of molecules in an organism are involved in regulation of a wide spectrum of biological processes. Several models have been presented for various forms of biological regulation, including gene expression regulation and physiological regulation; however, a generic model is missing. Recently a new unifying theory in biology, poikilosis, was presented.  Poikilosis indicates that all systems display intrinsic heterogeneity, which is a normal state. The concept of poikilosis allowed development of a model for biological regulation applicable to all types of regulated systems. The perturbation-lagom-TATAR countermeasures-regulator (PLTR) model combines the effects of perturbation and lagom (allowed and sufficient extent of heterogeneity) in a system with tolerance, avoidance, repair, attenuation and resistance (TARAR) countermeasures, and possible regulators. There are three modes of regulation, two of which are lagom-related. In the first scenario, lagom is maintained, both intrinsic (passive) and active TARAR countermeasures can be involved. In the second mode, there is a shift from one lagom to another. In the third mode, reguland regulation, the regulated entity is the target of a regulatory shift, which is often irreversible or requires action of another regulator to return to original state. After the shift, the system enters to lagom maintenance mode, but at new lagom extent. The model is described and elaborated with examples and applications, including medicine and systems biology. Consequences of non-lagom extent of heterogeneity are introduced, along with a novel idea for therapy by reconstituting biological processes to lagom extent, even when the primary effect cannot be treated.

Generic model for biological regulation

A substantial portion of molecules in an organism are involved in regulation of a wide spectrum of biological processes. Several models have been presented for various forms of biological regulation, including gene expression regulation and physiological regulation; however, a generic model is missing. Recently a new unifying theory in biology, poikilosis, was presented.  Poikilosis indicates that all systems display intrinsic heterogeneity. The concept of poikilosis allowed development of a model for biological regulation applicable to all types of regulated systems. The perturbation-lagom-TATAR countermeasures-regulator (PLTR) model combines the effects of perturbation and lagom (allowed and sufficient extent of heterogeneity) in a system with tolerance, avoidance, repair, attenuation and resistance (TARAR) countermeasures, and possible regulators. There are three modes of regulation, two of which are lagom-related. In the first scenario, lagom is maintained, both intrinsic (passive) and active TARAR countermeasures can be involved. In the second mode, there is a shift from one lagom to another. In the third mode, reguland regulation, the regulated entity is the target of a regulatory shift, which is often irreversible or requires action of another regulator to return to original state. After the shift, the system enters to lagom maintenance mode, but at new lagom extent. The model is described and elaborated with examples and applications, including medicine and systems biology. Consequences of non-lagom extent of heterogeneity are introduced, along with a novel idea for therapy by reconstituting biological processes to lagom extent, even when the primary effect cannot be treated.

Reductions in perceived COVID-19 threat amid UK's mass public vaccination programme coincide with reductions in outgroup avoidance (but not prejudice)

It has long been proposed that perceptions of threat contribute to greater outgroup negativity. Much of the existing evidence on the threat–prejudice association in the real world, however, is cross‐sectional in nature. Such designs do not adequately capture individual‐level changes in constructs, and how changes in constructs relate to changes in other theoretically relevant constructs. The current research exploited the unique opportunity afforded by the mass COVID‐19 vaccination programme in the United Kingdom to explore whether reductions in pathogen threat coincide with reductions in outgroup prejudice and avoidance. A two‐wave longitudinal study (N₁ = 912, N₂ = 738) measured British adult's perceptions of COVID‐19 threat and anti‐immigrant bias before and during mass vaccine rollout in the United Kingdom. Tests of latent change models demonstrated that perceived COVID‐19 threat significantly declined as the vaccine programme progressed, as did measures of outgroup avoidance tendencies, but not prejudiced attitudes. Critically, change in threat was systematically correlated with change in outgroup avoidance: those with greater reductions in perceived COVID‐19 threat were, on average, those with greater reductions in outgroup avoidance. Findings provide important and novel insights into the implications of disease protection strategies for intergroup relations during an actual pandemic context, as it unfolds over time.

Selectivity and Sociality: Aggression and Affiliation Shape Vole Social Relationships

The formation of selective social relationships is not a requirement of group living; sociality can be supported by motivation for social interaction in the absence of preferences for specific individuals, and by tolerance in place of social motivation. For species that form selective social relationships, these can be maintained by preference for familiar partners, as well as by avoidance of or aggression toward individuals outside of the social bond. In this review, we explore the roles that aggression, motivation, and tolerance play in the maintenance of selective affiliation. We focus on prairie voles (Microtus ochrogaster) and meadow voles (Microtus pennsylvanicus) as rodent species that both exhibit the unusual tendency to form selective social relationships, but differ with regard to mating system. These species provide an opportunity to investigate the mechanisms that underlie social relationships, and to compare mechanisms supporting pair bonds with mates and same-sex peer relationships. We then relate this to the role of aggression in group composition in a comparative context.

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.

Perceived vulnerability to immigration policies among postpartum Hispanic/Latina women in the MADRES pregnancy cohort before and during the COVID-19 pandemic

INTRODUCTION AND OBJECTIVES

Research suggests that perceived immigration policy vulnerability has important health implications. Coupled with the mental and physical stressors accompanying the postpartum period and a growing awareness of the discrimination and structural racism experienced by marginalized communities globally, the coronavirus disease 2019 period may have exacerbated stress among vulnerable populations, specifically postpartum Hispanic/Latina women. This study evaluated perceived immigration policy vulnerability (i.e. discrimination, social isolation, and family threats) in early postpartum Hispanic/Latina women in Los Angeles before and during the coronavirus disease 2019 pandemic.

METHODS

The Perceived Immigration Policy Effects Scale (PIPES) was administered cross-sectionally at 1 month postpartum to 187 Hispanic/Latina women in the MADRES cohort. Respondents between September 2018 and March 2020 were classified as "pre-pandemic" (N = 128), between March 2020 and July 2020 as "early pandemic" (N = 38), and between August 2020 and November 2021 as "later pandemic" (N = 21). Average PIPES subscale scores were dichotomized into "higher" and "lower" groups (⩽median, >median) and logistic regression models were performed.

RESULTS

Approximately half of participants had incomes of <$50,000 (50.3%) and were Latin American born (54.6%). After adjusting for age, nativity, education, income, postpartum distress, and employment status, early pandemic respondents had 5.05 times the odds of a higher score on the perceived discrimination subscale (95% CI: 1.81, 14.11), 6.47 times the odds of a higher score on the social isolation subscale (95% CI: 2.23, 18.74), 2.66 times the odds of a higher score on the family threats subscale (95% CI: 0.97, 7.32), and 3.36 times the odds of a higher total score (95% CI: 1.19, 9.51) when compared to pre-pandemic respondents. There were no significant subscale score differences between later pandemic and pre-pandemic periods.

CONCLUSION

Higher perceived immigration policy vulnerability was reported among postpartum women during the early coronavirus disease 2019 pandemic versus pre-pandemic periods. This suggests greater social inequities during the early pandemic period.

Behavioral Responses to Familiar Versus Unfamiliar Older People as a Source of Disgust

Disgust, as a part of the behavioral immune system, leads people to avoid behaviors of pathogens so as to reduce the probability of infection. Disgust also shows the source effects based on familiarity. However, these source effects have not been tested on the older population. Thus, we tested the source effects of emotional and behavioral reactions from the disgust toward older adults and the possible moderating effects of filial piety on disgust. In the first study, we employed the self-report method to test the source effects of emotional feelings of disgust amongst undergraduates. In the second study, we measured whether filial piety among community adults produced moderating effects of the disgust toward older adults. In the third study, we employed the shape discrimination task to test the source effects of behavioral avoidance to older adults among undergraduates. The first and third studies show stronger negative emotional/avoidance reactions towards unfamiliar older adults than familiar older adults, affirming the source effects of disgust towards older adults that we expected. However, we did not find moderating effects of filial piety associated with disgust. These findings can help us understand the evolutionary origin of disgust toward older adults, which is likely activated more intensely and quickly in response to unfamiliar individuals as compared with familiar individuals.

Helping While Social Distancing: Pathogen Avoidance Motives Influence People's Helping Intentions during the COVID-19 Pandemic

The behavioral immune system (BIS) theory suggests that pathogen avoidance motives relate to greater behavioral avoidance against social interactions that pose potential risks of pathogen transmission. Based on the BIS theory, pathogen avoidance motives would decrease people’s helping behavior towards others. However, would pathogen avoidance motives decrease all types of helping behavior towards others during the Coronavirus disease 2019 (i.e., COVID-19) pandemic indiscriminately? In the present study, we conducted a within-subjects design to compare people’s helping intentions toward voluntary work with and without social contact. Specifically, participants (N = 1562) completed an online survey at the early stage of the COVID-19 pandemic in China measuring pathogen disgust sensitivity, state anxiety, and intentions to perform volunteer work with and without social contact. Results revealed that pathogen disgust sensitivity negatively predicted intentions to perform voluntary work with social contact yet had no influence on intentions to perform socially distanced voluntary work. Moreover, the effect of pathogen disgust sensitivity on socially distanced volunteering preference was mediated by the state anxiety people experienced during the pandemic. The findings have implications for understanding people’s helping behavior during the pandemic.

Race, Ethnicity, Nativity and Perceptions of Health Risk during the COVID-19 Pandemic in the US

Previous research demonstrates that pandemics, including COVID-19, have disproportionate effects on communities of color, further exacerbating existing healthcare inequities. While increasing evidence points to the greater threat posed by COVID-19 to Latinx communities, less remains known about how identification as Latinx and migration status influence their perception of risk and harm. In this article, we use cross-sectional data from a large national probability sample to demonstrate a large positive association between ethnic identity and migration status and perceptions of harm from COVID-19 in the US. We find that individuals identifying as Hispanic/Latinx and first-generation immigrants report significantly greater risks of becoming infected by COVID-19 in the next three months, and dying from the virus if they do contract it. Further, subgroup analysis reveals that health risks are especially felt by individuals of Mexican descent, who represent the largest share of US Latinxs. Collectively, our results provide evidence about how the pandemic places increased stress on people from Latinx and immigrant communities relative to White non-Hispanic individuals in the US.

Sinophobia during the Covid-19 Pandemic: Identity, Belonging, and International Politics

In many countries, Sinophobia or discrimination against Chinese has taken place amid the Covid-19 pandemic. While this wave of Sinophobia is popularly understood to be based on a stereotypical association of Chinese with coronavirus, I argue that at a time of international tensions surrounding China, political antipathy toward China and Chinese matters as well. Thus, there is a phenomenon of "triple conflation" in which the health, racial, and political/national statuses of Chinese people become intermingled. In this study, I examine this triple conflation based on dozens of select cases covering Sinophobic actions of governments, politicians, media, businesses and lay persons in North America, Australia, New Zealand, and Western Europe. My study consists of three parts using three respective interdisciplinary approaches. First, using a sociological approach, I argue that the racial and national statuses of Chinese are both, and sometimes interchangeably, used as identity markers for implementing containment, a public health measure that easily leads to stigmatization. Second, using a discursive approach, I examine how political claims unfavorable to China/Chinese are constructed in discussions of the pandemic. Third, using an interpretive approach, I analyze how Covid bio-political metaphors present certain imaginaries depicting Chinese as suspicious bio-political subjects. These three parts are unified in my analysis of the geopolitics of belonging, in which Chinese people's rights to certain social and physical spaces are contested sometimes thorough administrative means (such as travel restriction) and sometimes through mental representations (such as the imagination of Chinese as alien).

Filthy Animals: Integrating the Behavioral Immune System and Disgust into a Model of Prophylactic Dehumanization

The behavioral immune system (BIS) is an evolved psychological mechanism that motivates prophylactic avoidance of disease vectors by eliciting disgust. When felt toward social groups, disgust can dampen empathy and promote dehumanization. Therefore, we investigated whether the BIS facilitates the dehumanization of groups associated with disease by inspiring disgust toward them. An initial content analysis found that Nazi propaganda predominantly dehumanized Jews by portraying them as disease vectors or contaminants. This inspired three correlational studies supporting a Prophylactic Dehumanization Model in which the BIS predicted disgust toward disease-relevant outgroups, and this disgust in turn accounted for the dehumanization of these groups. In a final study, we found this process of prophylactic dehumanization had a downstream effect on increasing anti-immigrant attitudes during the COVID-19 pandemic. However, consistent with the evolutionary logic of a functionally flexible BIS, this effect only occurred when the threat of COVID-19 was salient. The implications of these results for the study of dehumanization and evolutionary theories of xenophobia are discussed.

Do facially disfiguring features influence attention and perception of faces? Evidence from an antisaccade task

Facial disfigurements can influence how observers attend to and interact with the person, leading to disease-avoidance behaviour and emotions (disgust, threat, fear for contagion). However, it is unclear whether this behaviour is reflected in the effect of the facial stigma on attention and perceptual encoding of facial information. We addressed this question by measuring, in a mixed antisaccade task, observers' speed and accuracy of orienting of visual attention towards or away from peripherally presented upright and inverted unfamiliar faces that had either a realistic looking disease-signalling feature (a skin discolouration), a non-disease-signalling control feature, or no added feature. The presence of a disfiguring or control feature did not influence the orienting of attention (in terms of saccadic latency) towards upright faces, suggesting that avoidance responses towards facial stigma do not occur during covert attention. However, disfiguring and control features significantly reduced the effect of face inversion on saccadic latency, thus suggesting an impact on the holistic processing of facial information. The implications of these findings for the encoding and appraisal of facial disfigurements are discussed.

Coronavirus Disease 2019-Related Stigma in China: A Descriptive Study

Coronavirus disease 2019 (COVID-19) tremendously impacts the physical and mental health of humans worldwide. Consequently, studies on COVID-19 remain extensive. However, most of them were mainly focused on the pathological mechanisms and treatment methods from medical perspectives. Various reports have indicated that COVID-19 is closely related to stigma and discrimination, but little statistical information has been integrated quantitatively to describe the situation in China. Thus, this study investigated the COVID-19-related stigma of individuals. We collected the online survey data from 1,920 Chinese participants from October to December 2020. Findings showed that 306 (15.94%), 285 (14.84%), 265 (13.80%), and 100 (5.21%) participants endorsed stigma toward individuals in high-risk areas, recovered patients with COVID-19, families of recovered patients with COVID-19, and frontline healthcare providers, respectively. To understand the possible factors that could impact the COVID-19-related stigma, knowledge about COVID-19 was investigated. Generally, knowledge about COVID-19 was negatively associated with COVID-19-related stigma in general, while no significant relationship existed between the knowledge about COVID-19 and the COVID-19-related stigma in the groups who had held COVID-19-related stigma. Ultimately, individuals showed COVID-19-related stigma toward recovered patients and their families, individuals in high-risk areas, and frontline healthcare providers to some extent. The results of this study can provide reference to nations, governments, and organizations in addressing the stigma issues raised by the COVID-19 pandemic.

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

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

Human sickness detection is not dependent on cultural experience

Animals across phyla can detect early cues of infection in conspecifics, thereby reducing the risk of contamination. It is unknown, however, if humans can detect cues of sickness in people belonging to communities with whom they have limited or no experience. To test this, we presented Western faces photographed 2 h after the experimental induction of an acute immune response to one Western and five non-Western communities, including small-scale hunter-gatherer and large urban-dwelling communities. All communities could detect sick individuals. There were group differences in performance but Western participants, who observed faces from their own community, were not systematically better than all non-Western participants. At odds with the common belief that sickness detection of an out-group member should be biased to err on the side of caution, the majority of non-Western communities were unbiased. Our results show that subtle cues of a general immune response are recognized across cultures and may aid in detecting infectious threats.

The psychological distress and mental health disorders from COVID-19 stigmatization in Ghana

The emergence of the COVID-19 global pandemic in Ghana has resulted in various degrees of stigmatization. Previous studies have stressed the need for developing policies to curb the stigma towards COVID-19 survivors and healthcare workers. Some have investigated the knowledge and willingness of people to accept COVID-19 survivors. Others have also explored the experiences of health workers who have been victims of stigma from COVID-19. There is a need for further studies to understand COVID-19 related stigma and related psychological distress. The purpose of this study was to investigate the cases of COVID-19 related stigma and discrimination against healthcare workers, COVID-19 recovered patients, suspected persons of COVID-19, Asians, and persons with travel history from COVID-19 hotspot countries. The study was undertaken using the phenomenology approach to qualitative research. Purposive and snowball sampling techniques were used in recruiting the twenty-eight study participants. Data were garnered using interviews and focus group discussions. Data were analyzed using interpretative phenomenological analysis. The findings revealed that COVID-19 victims have faced various forms of stigma such as stereotyping, social exclusion, mockery, finger-pointing, and insults. The study recommends that the COVID-19 National Response Team in Ghana must put in place a robust psychosocial intervention plan for stigmatized persons to help them cope with the stigma and help in its prevention.

Stigmatization of Chinese and Asian-looking people during the COVID-19 pandemic in Germany

BACKGROUND

The outbreak and global spread of COVID-19 was accompanied by an increase in reports of stigmatization of Chinese and Asian-looking people. The behavioral immune system provides a framework for stigmatization in response to infectious disease threats. Specifically, stigmatization might increase with rising levels of infectious disease threat. The present study aimed to examine this hypothesis during the early phase of the COVID-19 pandemic.

METHODS

As part of the "EUCLID" project ( https://euclid.dbvis.de ), a total of 5011 persons from Germany were surveyed via an online-questionnaire between February 2^nd and April 3^rd, 2020, covering the progression of the COVID-19 pandemic over three time periods which were defined by critical events.

RESULTS

There was no evidence for an increase in the stigmatization of Chinese and Asian-looking people across three topics, that is personal proximity, air travel, and medical measures upon arrival from China.

CONCLUSIONS

The present findings provide good news in that participants showed an adaptive response to the infectious disease threat rather than displaying increased stigmatization. Further research is necessary to specify the conditions that increase the risk of stigmatization in response to infectious disease threats.