Implications of the behavioural immune system for social behaviour and human health in the modern world

The vaccination divide: Exploring moral reasoning associated with intergroup antipathy between vaccinated and unvaccinated people

OBJECTIVES

There is growing evidence of intergroup hostility between vaccinated and unvaccinated individuals, a process of polarization that threatens to derail population health efforts. This study explores the moral underpinnings of intergroup antipathy between vaccinated and unvaccinated individuals.

DESIGN

A cross-sectional design was employed to investigate the associations between the view of vaccination as a social contract or individual choice, perceived vulnerability to disease, perceptions of outgroup morality, feelings of warmth, and experiences of schadenfreude.

METHODS

Data were extracted from an online, quantitative survey of 233 vaccinated and 237 unvaccinated participants collected between June and July 2022.

RESULTS

Results revealed that vaccinated people had stronger negative attitudes towards unvaccinated people than vice versa. In line with hypotheses, the extent to which vaccinated people saw vaccination as a social contract was significantly associated with perceiving unvaccinated people as immoral. For unvaccinated people, seeing vaccination as an individual choice (the opposite of a social contract) was significantly associated with perceiving vaccinated people as immoral. Among both groups, viewing the other as immoral was associated with feeling significantly less warmth towards the opposing vaccination group, and more schadenfreude in the face of an outgroup member's suffering. Participants' perceived vulnerability to disease played a relatively small role in explaining polarization between vaccinated and unvaccinated people.

CONCLUSIONS

This research builds on previous studies by identifying moral mechanisms associated with intergroup antipathy in the vaccine debate.

Self-reported condom use among Washington State residents prior to and during the COVID-19 pandemic: a cross-sectional analysis of BRFSS data

OBJECTIVES

COVID-19 significantly impacted healthcare access and sexual behaviour, but little is known about how COVID-19 affected condom use. This study aimed to investigate whether self-reported condom use and sex in Washington State changed during pandemic restrictions compared with prepandemic.

DESIGN

Cross-sectional survey data from the Behavioral Risk Factor Surveillance System.

SETTING

Washington State.

PARTICIPANTS

11 684 participants aged 18-65.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was changes in the prevalence of condom use by time of interview pre-COVID-19, before the Washington State lockdown (1 January 2019 to 23 March 2020, n=7708) and during COVID-19, after the first state lockdown (24 March 2020 to 31 December 2020, n=3976). The secondary outcome was changes in the prevalence of reported sex during the same periods. We assessed whether associations differed by rurality and HIV risk behaviour.

RESULTS

Condom use was similar during COVID-19 (37.3%) compared with pre-COVID-19 (37.8%) (adjusted prevalence ratio (PR): 0.98, 95% CI 0.89, 1.01). Associations did not differ by rurality or HIV risk behaviour. Compared with pre-COVID-19 (83.0%), a smaller proportion of respondents reported having sex in the last 12 months during COVID-19 (80.5%), a relative decrease of 3% (PR: 0.97, 95% CI 0.96, 0.99; p<0.001).

CONCLUSIONS

The prevalence of reported sex declined during COVID-19, but condom use remained steady in Washington. As our reproductive health system faces increased challenges, these results may inform future sexual health services.

The role of the behavioural immune system on covid-19 lockdown attitudes: The relationship with authoritarianism and collectivism

Background and objectives

The behavioural immune system (BIS) is a motivational system that facilitates the avoidance of pathogens and is thought to have evolved as a less costly mechanism to combat infectious diseases compared to the physiological immune system. The Parasite Stress Theory of Social Values predicts that authoritarianism and collectivist attitudes may impact the BIS by predisposing people to support disease control measures, including severe restrictions like lockdowns or stay-at-home orders. This study investigates the relationship between authoritarianism, collectivism and Covid-19 worry on support for lockdown measures during the Covid-19 pandemic.

Methodology

A total of 187 UK participants were recruited to complete an online survey, which was administered between 22 June and 7 July 2020. The survey included measures of authoritarianism, collectivism, Covid-19 worry and support for lockdown measures. The data were analysed using moderated parallel mediation analysis.

Results

Covid-19 worry had a direct effect on support for and enforcement of lockdown measures, but not on the idea that adherence to lockdown rules should be an individual choice. The relationship between Covid Worry and Support for and Enforcement of lockdown measures was not mediated by authoritarianism, nor was it moderated by Collectivism. Collectivism and Authoritarianism were related to increased levels of support for lockdown independently from Covid Worry but were not related to enforcement.

Conclusions and implications

Support for lockdown restrictions and enforcement was mainly associated with covid worry. Our findings do not support the parasite stress theory of social values and indicate that the BIS manifested in a more direct way, and not through social values.

The walking sick: Perception of experimental sickness from biological motion

Identification of sick conspecifics allows for avoidance of infectious threats, and is therefore an important behavioral defense against diseases. Here, we investigated if humans can identify sick individuals solely from biological motion and posture (using point-light displays). Additionally, we sought to determine which movements and sickness parameters would predict such detection. We collected video clips and derived point-light displays (one stride presented in a loop) of sick walkers (injected with lipopolysaccharide at 2.0 ng/kg body weight) and the same walkers when healthy (injected with saline). We then presented these displays to two groups, one group classified each walker as sick or healthy (study 1, n = 106), and the other group scored the walkers' health on a visual analogue scale (study 2, n = 106). The raters were able to identify sick individuals above chance, and rated sick walkers as having worse health, both from observing video clips and point-light displays. Furthermore, both sickness detection and worse apparent health were predicted by inflammation-induced increase in rigidity and slower walking, but not other cues. Altogether, these findings indicate that biological motion can serve as a sickness cue, possibly allowing humans to identify sick conspecifics from a distance, and thereby allowing for disease avoidance.

The COVID-19 pandemic and seeking information about condoms online: an infodemiology approach

Objectives: As condoms are effective tools for pathogen-avoidance in sexual intercourse, seeking information about condoms online may be a reactive response to the COVID-19 according to the behavioral immune system theory.Design: Taking an infodemiology perspective, this research employed multilevel analyses to examine how COVID-19 online query data (i.e., Google topic search terms Coronavirus and COVID-19) and coronavirus epidemiological data (i.e., COVID-19 cases per million and case fatality rate) would predict condom information seeking behavior online (i.e., Google topic search term Condom) throughout the pandemic across American states (Study 1) and 102 countries/territories (Study 2), after accounting for death-thought accessibility (i.e., illness-related searches), interest in birth control (i.e., birth-control-related searches), COVID-19 control policy, stay at home behavior, season, religious holidays, yearly trends, autocorrelation, and contextual variables such as HIV prevalence rate and socioeconomic development indicators (GINI index, urbanization, etc.).Results: When there were high levels of COVID-19 concerns in cyberspace in a given week, search volume for condoms increased from the previous week across American states and different countries/territories. By contrast, the effect of actual coronavirus threat was non-significant.Conclusion: Seeking information about condoms online could be a reactive response to high levels of COVID-19 concerns across different populations.

Beyond the surface: accounting for confounders in understanding the link between collectivism and COVID-19 pandemic in the United States

According to the parasite-stress theory, collectivism serves as a trait of ingroup assortative sociality, providing defense against infectious diseases. This study investigated the association between cultural collectivism and COVID-19 severity at the state (Study 1: N = 51), county (Study 2: N = 3,133), and daily (Study 3: N = 52,806) levels from the beginning of 2020 to the end of 2022. State-level collectivism was assessed using two distinct measures: the U.S. collectivism index, focusing on social interconnectedness and interdependence, and the subjective-culture individualism-collectivism index (reversed), capturing attitudes and beliefs related to religion, abortion, and same-sex marriage. By employing random-intercept multilevel models, the results demonstrated significant and negative effects of state-level collectivism, as measured by the U.S collectivism index, on COVID-19 cases per million, COVID-19 deaths per million, and composite COVID-19 severity index, after controlling for confounding factors, such as socioeconomic development, ecological threats, disease protective behaviors, cultural norms, and political influences. A mini meta-analysis (Study 4: N = 9) confirmed the significance of these effects across studies. These findings supported the proactive role of collectivism in defending against the novel coronavirus in the United States, aligning with the parasite-stress theory of sociality. However, the subjective-culture individualism-collectivism index (reversed) did not exhibit a significant relationship with COVID-19 severity when confounding factors were considered. The high correlation between the subjective-culture individualism-collectivism index (reversed) and the controlled variables suggested shared variance that could diminish its impact on COVID-19 outcomes. Accordingly, the present findings underscore the significance of accounting for confounding factors when examining the association between collectivism and COVID-19 severity at population level. By considering relevant confounding factors, researchers could gain a comprehensive understanding of the complex interplay between cultural collectivism and its influence on COVID-19 severity. Overall, this research contributes to our understanding of how cultural collectivism shapes the COVID-19 pandemic in the United States, emphasizing the importance of adjusting for confounding effects in population level studies.

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

Objective

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

Method

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

Results

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

Political Attitudes and Disease Threat: Regional Pathogen Stress Is Associated With Conservative Ideology Only for Older Individuals

What environmental factors are associated with individual differences in political ideology, and do such associations change over time? We examine whether reductions in pathogen prevalence in U.S. states over the past 60 years are associated with reduced associations between parasite stress and conservatism. We report a positive association between infection levels and conservative ideology in the United States during the 1960s and 1970s. However, this correlation reduces from the 1980s onwards. These results suggest that the ecological influence of infectious diseases may be larger for older people who grew up (or whose parents grew up) during earlier time periods. We test this hypothesis by analyzing the political affiliation of 45,000 Facebook users, and find a positive association between self-reported political affiliation and regional pathogen stress for older (>40 years) but not younger individuals. It is concluded that the influence of environmental pathogen stress on ideology may have reduced over time.

COVID-19 vaccination and the behavioral immune system: The newcomer and the old friend get along in preventing infection

Despite its old evolutionary history and emotional relevance, the behavioral immune system is one of the less studied individual predictors of vaccine uptake. To fill the gap, we conducted a large online study (2072 participants) during the spring 2022 when the great majority of the Italian population had already received at least one dose of the COVID-19 vaccine. Hierarchical binary logistic regression showed that, after controlling for the confounding effects of demographic and personality factors, there was a significant and positive association between pathogen disgust sensitivity and COVID-19 vaccine uptake (OR, 1.68; 95% CI, 1.42-1.99). The likelihood of being vaccinated for a participant with the highest possible score on the PVD Germ Aversion scale was approximately 12 times higher than the likelihood for a participant with the lowest possible score. Public health messaging could leverage the activation of the behavioral immune system as an emotional driver of vaccine uptake.

Antenatal depression is associated with perceived stress, family relations, educational and professional status among women in South of China: a multicenter cross-sectional survey

Background

Antenatal depression is a commonly seen mental health concern for women. This study introduced a multicenter cross-sectional survey with a large sample to provide new insights into pregnant women's depression, its socio-demographic and obstetric characteristics correlates, and its perceived stress among Chinese pregnant women.

Methods

This study conducted an observational survey according to the STROBE checklist. The multicenter cross-sectional survey was performed from August 2020 to January 2021 by distributing paper questionnaires among pregnant women from five tertiary hospitals in South China. The questionnaire included socio-demographic and obstetrics information, the Edinburgh Postnatal Depression Scale, and the 10-item Perceived Stress Scale. For the analyses, the Chi-square test and Multivariate logistic regression were utilized.

Results

Among 2014 pregnant women in their second/third trimester, the prevalence of antenatal depression was 36.3%. 34.4% of pregnant women reported AD in their second trimester of pregnancy, and 36.9% suffered from AD in third trimester of pregnancy. A multivariate logistic regression model indicated that unemployed women, lower levels of education, poor marital relationships, poor parents-in-law relationships, concerns about contracting COVID-19, and higher perceived stress could aggravate antenatal depression among participants (p<0.05).

Conclusion

There is a high proportion of antenatal depression among pregnant women in South China, so integrating depression screening into antenatal care services is worthwhile. Maternal and child health care providers need to evaluate pregnancy-related risk factors (perceived stress), socio-demographic factors (educational and professional status), and interpersonal risk factors (marital relations and relationship with Parents-in-law). In future research, the study also emphasized the importance of providing action and practical support to reduce the experience of antenatal depression among disadvantaged sub-groups of pregnant women.

Coronavirus-Related Searches on the Internet Predict COVID-19 Vaccination Rates in the Real World: A Behavioral Immune System Perspective

According to the smoke detector and functional flexibility principles of human behavioral immune system (BIS), the exposure to COVID-19 cues could motivate vaccine uptake. Using the tool of Google Trends, we tested that coronavirus-related searches-which assessed natural exposure to COVID-19 cues-would positively predict actual vaccination rates. As expected, coronavirus-related searches positively and significantly predicted vaccination rates in the United States (Study 1a) and across the globe (Study 2a) after accounting for a range of covariates. The stationary time series analyses with covariates and autocorrelation structure of the dependent variable confirmed that more coronavirus-related searches compared with last week indicated increases in vaccination rates compared with last week in the United States (Study 1b) and across the globe (Study 2b). With real-time web search data, psychological scientists could test their research questions in real-life settings and at a large scale to expand the ecological validity and generalizability of the findings.

The Role of Perceived Risk in the Relationship Between Disgust Sensitivity and COVID-19 Vaccine Hesitancy

Background

Despite widespread availability of COVID vaccines and evidence of their efficacy, vaccine hesitancy remains prevalent. Several studies have examined the relationship between disgust sensitivity and vaccine hesitancy. Although results from studies using data collected prior to the COVID pandemic indicate that higher disgust sensitivity is related to greater vaccine hesitancy, results from studies using data collected during the COVID pandemic are equivocal. The present study examined whether perceived risk of contracting COVID moderated the relationship between disgust sensitivity and vaccine hesitancy.

Methods

Participants (n = 152) completed self-report measures of disgust sensitivity, perceived risk of contracting COVID, and COVID vaccine hesitancy (defined as both vaccine confidence and vaccine complacency).

Results

Perceived risk of contracting COVID significantly moderated the relationship between disgust sensitivity and vaccine complacency, with the association strengthened at low levels of perceived risk. Perceived risk of contracting COVID also marginally moderated the relationship between disgust sensitivity and vaccine confidence, with the association strengthened at low and average levels of perceived risk.

Conclusions

Results suggest that individuals with elevated disgust sensitivity who also report low levels of perceived risk of contracting COVID are more likely to express vaccine hesitancy. Implications of these findings are discussed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10608-023-10391-8.

Quantified multidimensional public sentiment characteristics on social media for public opinion management: Evidence from the COVID-19 pandemic

Background

Public sentiments arising from public opinion communication pose a serious psychological risk to public and interfere the communication of nonpharmacological intervention information during the COVID-19 pandemic. Problems caused by public sentiments need to be timely addressed and resolved to support public opinion management.

Objective

This study aims to investigate the quantified multidimensional public sentiments characteristics for helping solve the public sentiments issues and strengthen public opinion management.

Methods

This study collected the user interaction data from the Weibo platform, including 73,604 Weibo posts and 1,811,703 Weibo comments. Deep learning based on pretraining model, topics clustering and correlation analysis were used to conduct quantitative analysis on time series characteristics, content-based characteristics and audience response characteristics of public sentiments in public opinion during the pandemic.

Results

The research findings were as follows: first, public sentiments erupted after priming, and the time series of public sentiments had window periods. Second, public sentiments were related to public discussion topics. The more negative the audience sentiments were, the more deeply the public participated in public discussions. Third, audience sentiments were independent of Weibo posts and user attributes, the steering role of opinion leaders was invalid in changing audience sentiments.

Discussion

Since the COVID-19 pandemic, there has been an increasing demand for public opinion management on social media. Our study on the quantified multidimensional public sentiments characteristics is one of the methodological contributions to reinforce public opinion management from a practical perspective.

Behavioral and physiological sensitivity to natural sick faces

The capacity to rapidly detect and avoid sick people may be adaptive. Given that faces are reliably available, as well as rapidly detected and processed, they may provide health information that influences social interaction. Prior studies used faces that were manipulated to appear sick (e.g., editing photos, inducing inflammatory response); however, responses to naturally sick faces remain largely unexplored. We tested whether adults detected subtle cues of genuine, acute, potentially contagious illness in face photos compared to the same individuals when healthy. We tracked illness symptoms and severity with the Sickness Questionnaire and Common Cold Questionnaire. We also checked that sick and healthy photos were matched on low-level features. We found that participants (N = 109) rated sick faces, compared to healthy faces, as sicker, more dangerous, and eliciting more unpleasant feelings. Participants (N = 90) rated sick faces as more likely to be avoided, more tired, and more negative in expression than healthy faces. In a passive-viewing eye-tracking task, participants (N = 50) looked longer at healthy than sick faces, especially the eye region, suggesting people may be more drawn to healthy conspecifics. When making approach-avoidance decisions, participants (N = 112) had greater pupil dilation to sick than healthy faces, and more pupil dilation was associated with greater avoidance, suggesting elevated arousal to threat. Across all experiments, participants' behaviors correlated with the degree of sickness, as reported by the face donors, suggesting a nuanced, fine-tuned sensitivity. Together, these findings suggest that humans may detect subtle threats of contagion from sick faces, which may facilitate illness avoidance. By better understanding how humans naturally avoid illness in conspecifics, we may identify what information is used and ultimately improve public health.

Mental Health Challenges during the COVID-19 Pandemic

The impact of the COVID-19 pandemic on mental health has unveiled the complexity of the relationship between psychiatry and the rest of medicine, as clearly shown by the collection of studies published in this Special Issue entitled "Mental Health Challenges during the COVID-19 Pandemic" [...].

Racial and ethnic minority disparities in COVID-19 related health, health beliefs and behaviors, and well-being among students

Objective: The purpose of this study was to examine undergraduate racial/ethnic disparities in physical, mental, behavioral, and psychosocial COVID-19 impacts. Participants: In May 2020, 403 undergraduates (74% women; Mage = 20.4; 65% White, 19% Asian, 10% Latinx, 6% Black) were recruited. Methods: Participants completed a survey 2 months after their university switched to remote instruction due to COVID-19. Results: 15.2% reported either COVID-19 diagnosis or perceived symptoms, but there were no racial/ethnic disparities in this health outcome. Latinx and Asian students experienced higher COVID-19 related threat and negative beliefs than White students. Asian students experienced more discrimination and Latinx students experienced greater economic impacts. There were no differences in mental health or health behaviors. Conclusion: Results suggest that psychosocial impacts of a pandemic on undergraduate students vary by race/ethnicity, although mental health responses may be more universal. Implications for how colleges and universities can best serve student needs are discussed.

How and when institutional trust helps deal with group crisis like COVID-19 pandemic for Chinese employees? A social perspective of motivation

Social factors cannot be neglected in predicting individual psychological health during a group crisis. Grounded in Vroom's expectancy theory of motivation, the present research explores how and when institutional trust influences crisis related worries and griefs. Both the survey study (N = 234) and the experimental study (N = 111) were conducted to examine our hypothesized moderated mediation model. Multiple waves of surveys were delivered in Study 1 and participants were requested to rate their experiences and responses during the COVID-19 pandemic. In Study 2, participants from both the collectivism manipulation group and the control group were requested to rate their psychological responses in an imagined group crisis. Regression analyses showed that institutional trust reduced worries and griefs by improving personal resilience, which is more significant for individuals with high levels of collectivism. These findings point to the importance of understanding individual psychological health in a social perspective of motivation.

Disgust-Eliciting Pathogen Threats and Salivary Immune Responses

Abstract. This study aimed to examine the effects of different sensory modality presentations of disgusting stimuli on aspects of immunity (behavioral and physiological) and affect in men and women. Sixty-four college students participated, and all participants were randomly assigned to one of four groups based on sensory modality stimuli type (visual or olfactory) and manipulation (experimental or control). Results indicated that olfactory stimuli were rated as more disgusting than visual stimuli. When collapsed across sensory modality, females tended to self-report greater disgust sensitivity than males. Overall, there was a significant negative association between disgust ratings and changes in resting heart rate (HR). Baseline salivary immunoglobulin A (SIgA) concentration was significantly positively correlated with disgust ratings in men. Our findings suggest that the behavioral and physiological immune systems are indeed coordinated, but future studies are needed to examine the extent to which multisensory disgusting cues influence immune system responses as a function of gender.

Is a disease leader attractive? Six tests of whether the COVID-19 pandemic affected follower preferences for attractiveness, health and other traits in political and non-political leaders

Attractive political candidates receive more votes on Election Day compared to their less attractive competitors. One well-cited theoretical account for this attractiveness effect (White et al., 2013) holds that it reflects an adaptive psychological response to disease threats. Voters are predicted to upregulate preferences for attractiveness because it constitutes a cue to health. The global COVID-19 pandemic constitutes an ecologically relevant and realistic setting for further testing this prediction. Here, we report the results from six tests of the prediction based on two large and nationally representative surveys conducted in Denmark (n = 3297) at the outbreak of the pandemic and one year later. Utilizing experimental techniques, validated individual difference measures of perceived disease threat and geographic data on COVID-19 severity, we do not find that disease threats like the COVID-19 pandemic upregulate preferences for attractive and healthy political or non-political leaders. Instead, respondents display heightened preferences for health in socially proximate relations (i.e. colleagues). Moreover, individuals who react aversively to situations involving risks of pathogen transmission (scoring high in Germ Aversion) report higher importance of a wide range of leadership traits, rather than for health and attractiveness in particular. Results are discussed in relation to evolutionary accounts of leadership and followership.

Further Understanding of Neuro-Immune Interactions in Allergy: Implications in Pathophysiology and Role in Disease Progression

The complicated interaction between the central and the autonomic (sympathetic, parasympathetic, and enteric) nervous systems on the one hand and the immune system and its components, on the other hand, seems to substantially contribute to allergy pathophysiology, uncovering an under-recognized association that could have diagnostic and therapeutic potentials. Neurons connect directly with and regulate the function of many immune cells, including mast cells, the cells that have a leading role in allergic disorders. Proinflammatory mediators such as cytokines, neurotrophins, chemokines, and neuropeptides are released by immune cells, which stimulate sensory neurons. The release of neurotransmitters and neuropeptides caused by the activation of these neurons directly impacts the functional activity of immune cells and vice versa, playing a decisive role in this communication. Successful application of Pavlovian conditioning in allergic disorders supports the existence of a psychoneuroimmunological interplay in classical allergic hypersensitivity reactions. Activation of neuronal homeostatic reflexes, like sneezing in allergic rhinitis, coughing in allergic asthma, and vomiting in food allergy, offers additional evidence of a neuroimmunological interaction that aims to maintain homeostasis. Dysregulation of this interaction may cause overstimulation of the immune system that will produce profound symptoms and exaggerated hemodynamic responses that will lead to severe allergic pathophysiological events, including anaphylaxis. In this article, we have systematically reviewed and discussed the evidence regarding the role of the neuro-immune interactions in common allergic clinical modalities like allergic rhinitis, chronic rhinosinusitis, allergic asthma, food allergy, atopic dermatitis, and urticaria. It is essential to understand unknown – to most of the immunology and allergy experts – neurological networks that not only physiologically cooperate with the immune system to regulate homeostasis but also pathogenetically interact with more or less known immunological pathways, contribute to what is known as neuroimmunological inflammation, and shift homeostasis to instability and disease clinical expression. This understanding will provide recognition of new allergic phenotypes/endotypes and directions to focus on specialized treatments, as the era of personalized patient-centered medicine, is hastening apace.

Configurations for positive public behaviors in response to the COVID-19 pandemic: a fuzzy set qualitative comparative analysis

BACKGROUND

The COVID-19 crisis poses considerable threats to public health, and exploring the key configuration conditions of the public behavior response is very important for emergency risk management.

OBJECTIVE

This study attempts to reveal differences in the conditional configuration and mechanism of public behavior based on the proposed framework, further make up for the deficiencies of existing research in explaining such issues as "How to promote the public's protective behavior or reduce the public's excessive behavior?" and finally provide new evidence and ideas for the government to improve the emergency management system.

METHODS

A total of 735 valid cases were obtained using an online survey and revealed the conditional configuration and mechanism of public behavior differences through a fuzzy set qualitative comparative analysis based on the proposed public behavioral framework.

RESULTS

The results show that critical factors including risk communication, trust, risk perception, and negative emotions alone did not constitute a necessary condition for public protective or excessive behavior. The different configurations of influencing factors reveal the complexity of public behavioral risk management, and taking adequate measures to increase public trust and reduce negative public emotions constitute the core path of risk management to enhance positive public behavior.

CONCLUSIONS

The configurations of various influencing factors reveal the complexity of public behavioral risk management. For behavioral risk management, governments should focus on adapting to multiple conditions according to their situations and, under the "overall perspective," formulate policies based on local conditions and further form a differentiated risk management path. Practically speaking, for the government, taking adequate measures to increase public trust and reduce negative public emotions is the core path of risk management to enhance positive public behavior.

Heightened religiosity proactively and reactively responds to the COVID-19 pandemic across the globe: Novel insights from the parasite-stress theory of sociality and the behavioral immune system theory

According to the parasite-stress theory of sociality and the behavioral immune system theory, heightened religiosity serves an anti-pathogen function by promoting in-group assortative sociality. Thus, highly religious countries/territories could have better control of the COVID-19 (proactively avoids disease-threat), and heightened COVID-19 threat could increase religiosity (reactively responds to disease-threat). As expected, country-level religiosity (religion-related online searches (Allah, Buddhism, Jesus, etc.) and number of total religions/ethnoreligions) negatively and significantly predicted COVID-19 severity (a composite index of COVID-19 susceptibility, reproductive rate, morbidity, and mortality rates) (Study 1a), after accounting for covariates (e.g., socioeconomic factors, ecological factors, collectivism index, cultural tightness-looseness index, COVID-19 policy response, test-to-case ratio). Moreover, multilevel analysis accounting for daily- (e.g., time-trend effect, season) and macro-level (same as in Study 1a) covariates showed that country-level religious searches, compared with the number of total religions/ethnoreligions, were more robust in negatively and significantly predicting daily-level COVID-19 severity during early pandemic stages (Study 1b). At weekly level, perceived coronavirus threat measured with coronavirus-related searches (corona, covid, covid-19, etc.), compared with actual COVID-19 threat measured with epidemiological data, showed larger effects in positively predicting religious searches (Study 2), after accounting for weekly- (e.g., autocorrelation, time-trend effect, season, religious holidays, major-illness-related searches) and macro-level (e.g., Christian-majority country/territory and all country-level variables in Study 1) covariates. Accordingly, heightened religiosity could proactively and reactively respond to the COVID-19 pandemic across the globe.

The Identification With All Humanity (IWAH) scale: its psychometric properties and associations with help-seeking during COVID-19

The Identification With All Humanity (IWAH) scale was designed to measure the extent to which an individual identifies oneself with all human beings. The current research aimed to conduct the validation of IWAH in a Chinese population and its convergent validity, as well as test the implications of IWAH in associations with help-seeking behaviour during COVID-19. A serial of three studies was conducted from September 1st 2020 to the end of October 2020. The series of studies included Study 1- Exploring the dimensions of the IWAH scale with a sample of 2,881 participants, Study 2- Confirmatory Factor Analysis for the Chinese IWAH dimensions with a separate sample of 6,667 participants, and Study 3- Role of the IWAH in the COVID-19 pandemic with a sample of 9,046 participants. Study 1 found the Chinese version of the IWAH scale to be a two-dimensional construct, with factor 1 - Bond with Humanity and factor 2 - Human Kinship. Study 2 confirmed the two-factor construct as found in Study 1. It also showed positive relations between IWAH and moral judgement, collectivism, nature connectedness, and negative relations with callousness, and having anxiety and depressive symptoms. Study 3 found that IWAH was negatively related to fear of COVID-19 and positively related to the likeliness of help-seeking. This is the first research to test the factorial structure of the IWAH scale in a Chinese population, with the adaptation showing good psychometric properties. The implication of IWAH on fear of COVID-19 and help-seeking provided further understanding of the possible practical value of IWAH during times of global stressful life events. Furthermore, study 3 is the first to explore how IWAH relates to anxiety, depression, and callousness.

Action-Shapers and Their Neuro-Immunological Foundations

Not all our intentions translate into actions, as our capacity to act may be influenced by a variety of mental and biochemical factors. In this article, we present a comprehensive account of how neuro-immunological processes affect our intentional abilities and our capacity to act. We do so by extending the theory of thought-shapers (TTS) through the notion of action-shapers and combining this theory with the essential embodiment thesis (EE). This thesis about the mind-body relation says that human minds are necessarily and completely embodied. Action-shapers dynamically constitute the action-space of individuals, affecting their capacity to take action or to select one course of action over another. We highlight the effects and interactions of neuro-immunological effective processes in the body to demonstrate how they shape the action-space. In this article, we consider neuro-immunological effective processes that influence the gut-brain axis, chronic stress, high levels of sugar intake, the amygdala and the effects of prolonged stress. We investigate the effects of these processes on the perception and on the capacity to form intentions and act on them. We conclude the paper by providing a concise account of action-shapers, in which we attempt to summarize the line of argumentation and provide suggestions for further research.

The behavioral immune system in action: Psychological correlates of pathogen disgust sensitivity in healthcare professionals working in a COVID-19 hospital

The behavioral immune system includes a set of proactive mechanisms that inhibit contact with pathogens in the first place. These mechanisms offer a sort of psychological and behavioral prophylaxis against infection. The aim of this study was to assess the functionality of the behavioral immune system under conditions of strong ecological validity. Our hypothesis was that the emotional and more primitive component of the behavioral immune system (i.e. pathogen disgust sensitivity) acts as a powerful predictor of fear of infection. The sample was made up of 101 healthcare professionals working in a COVID-19 hospital when vaccination was not yet available. We conducted a hierarchical regression analysis to assess the role of germ-related disgust in modulating levels of fear. After controlling for the significant effects of depressive symptoms and exposure to people with a confirmed diagnosis of COVID-19, we found that fear of infection was more intense in those healthcare workers who reported higher levels of germ-related disgust. Fear of infection was not related to perceived infectability, an individual variable informed by more rational cognitive appraisals. These findings show that, even in healthcare workers who can take advantage of their professional knowledge and acquired skills for rational appraisals, the most primitive component of the behavioral immune system still plays a major role in eliciting fear of COVID-19. It is likely that the psychological reactions elicited by the behavioral immune system promote preventive health behaviors in modern environments as well.

Opinions and options about COVID-19: Personality correlates and sex differences in two European countries

In the initial months of the COVID-19 pandemic in 2020, we collected data (N = 1,420) from Portugal and Spain in relation to personality (i.e., Dark Triad traits, Big Five traits, religiousness, and negative affect) and attitudes related to COVID-19 about its origins, opinions on how to deal with it, and fear of it. The most pervasive patterns we found were: (1) neurotic-type dispositions were associated with stronger opinions about the origins of the virus and leave people to have more fear of the virus but also more trust in tested establishments to provide help. (2): religious people were less trusting of science, thought prayer was answer, and attributed the existence of the virus to an act of God. We also found that sex differences and country differences in attitudes towards COVID-19 were mediate by sex/country differences in personality traits like emotional stability, religiousness, and negative affect. For instance, women reported more fear of COVID-19 than men did, and this was verified by women’s greater tendency to have negative affect and low emotional stability relative to men. Results point to the central role of neuroticism in accounting for variance in broad-spectrum attitudes towards COVID-19.

COVID-19 Pandemisi Sırasında Türk Toplumunun Ruh Sağlığı

Giriş: Yeni koronavirüs hastalığı (COVID-1 tüm dünyaya hızla yayılarak tüm dünyada olduğu gibi Türkiye'de de çok sayıda ölüme neden olmuştur. COVID-19 potansiyel olarak öldürücüdür ve insanların ruh sağlığını etkiler. Potansiyel psikolojik sorunları tespit etmek önemlidir. Türkiye'de COVID-19 sürecinde toplumun kaygı düzeylerini ve ilişkili risk faktörlerini belirlemeyi amaçladık. Yöntemler: Bu, pandemi sırasında Türkiye genelinde gerçekleştirilen kesitsel bir çalışmadır. Anketler katılımcılara Google Formlar aracılığıyla ulaştırılmıştır. Anket ilk olarak 15 Nisan 2020 tarihinde yayınlanmış ve 30 günlük bir süre boyunca veriler toplanmıştır. Bulgular: Türk toplumu tarafından doldurulan 8.917 anket formu çalışmaya dahil edildi. Yaşlılarda, kadınlarda, anne-babalarda, sigara içenlerde, ek hastalığı olanlarda, sosyal medya kullananlarda ve eğitim düzeyi yüksek olanlarda kaygı düzeyi ve ölüm korkusu daha yüksekti. Sonuç: Bu çalışma, katılımcı sayısı açısından Türkiye'de yapılmış en kapsamlı çalışma olup, Türk toplumunun pandemi sürecindeki ruhsal durumuna ışık tutmaktadır. Türkiye'de COVID-19'un nüfusun ruh sağlığını olumsuz yönde etkilediği, kaygı düzeylerini ve ölüm korkusunu artırdığı belirlendi. Kaygı düzeyi ve ölüm korkusu yüksek olan kişiler belirlenmeli ve bu kişilere psikolojik destek sağlanmalıdır.

The Impact of COVID-19 Incidence on Motivation to Participate in a Triathlon

The COVID-19 pandemic has caused many changes that have influenced the lives of people around the world and have left their mark in the world of sports, as well. Numerous restrictions resulted in the cancellation of the organization of many sports events, and the players themselves had restricted access to training. The main goal of the study was to identify the motivation to participate in a triathlon between athletes who have undergone COVID-19, those who have never been infected and those who do not know if they have ever caught the virus and to evaluate the differences between them. The assessment of the motives for participating in a sports event was conducted according to four types of orientation: social, experience, factual and results to check what benefits for well-being and self-improvement are brought about by participation in a triathlon as a mass sports event. The desire to feel unity, to develop passion, to integrate with other people and to get away from everyday life were the most important motives for those who have never been infected. It turns out that 100% of the respondents who had a history of COVID-19 disease indicated the desire to prove themselves. The desire to maintain good physical condition and health was reported by the majority of researched people, but again, all respondents (100%) who had been infected with COVID-19 indicated these motives as the most important.

Impact of infectious disease epidemics on xenophobia: a systematic review

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Xenophobia has a significant impact on the health of international migrants.

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During an infectious disease outbreak, stigma and prejudice are highly pronounced.

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Migrants, often seen as disease carriers, are socially rejected during epidemics.

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Ensure an equal treatment and healthcare assistance for migrants is imperative.

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Educational interventions are urgently needed to prevent xenophobic tendencies.

Background Globally, xenophobia towards out-groups is frequently increased in times of economic and political instability, such as in infectious disease outbreaks. This systematic review aims to: (1) assess the xenophobic attitudes and behaviors towards migrants during disease outbreaks; and (2) identify adverse health outcomes linked to xenophobia. Methods We searched nine scientific databases to identify studies measuring xenophobic tendencies towards international migrants during disease outbreaks and evaluated the resulting adverse health effects. Results Eighteen articles were included in the review. The findings were grouped into: (1) xenophobia-related outcomes, including social exclusion, out-group avoidance, support for exclusionary health policies, othering, and germ aversion; and (2) mental health problems, such as anxiety and fear. Depending on the disease outbreak, different migrant populations were negatively affected, particularly Asians, Africans, and Latino people. Factors such as perceived vulnerability to disease, disgust sensitivity, medical mistrust individualism, collectivism, disease salience, social representation of disease and beliefs in different origins of disease were associated with xenophobia. Conclusions Overall, migrants can be a vulnerable population frequently blamed for spreading disease, promoting irrational fear, worry and stigma in various forms, thus leading to health inequities worldwide. It is urgent that societies adopt effective support strategies to combat xenophobia and structural forms of discrimination against migrants.

How Did Awareness, Emotion, and Motivation Shape Behavior Toward COVID-19 in Tunisians?

This study was conducted to assess the psychological distress in the general population of Tunisia during the pandemic of COVID-19 and examines how awareness of the disease, emotional experience, and motivation shaped the behavior toward this outbreak. The study covers 1492 Tunisian participants. Gender effects and age limits were studied in relation with the seriousness of the disease and lockdown impacts. The data were analyzed and interpreted using the chi-square test, ANOVA, path analysis (PA), and confirmatory factor analysis (CFA). We found a significant effect of gender and age on the awareness of the pandemic dangerousness, the attitude, and the commitment to respect the preventive measures. Women are significantly more aware and committed than men to respect preventive health measures. The 35-45 age group showed more awareness and dedication than the other age groups, while the 20-35 age group showed the most less promise. PA and CFA results showed how awareness, emotion, and motivation shaped behavior toward COVID-19. This study provides practical and relevant information on behavior change during a pandemic crisis, which can orient communication campaigns and help policymakers.

The role of behavioural immune system and belief in COVID-19 misinformation on COVID-19 protective behaviours in Indonesia

This study (N = 1306) investigated the role behavioural immune system and specific beliefs in COVID-19 misinformation in predicting COVID-19 protective behaviours. By analysing the data from an online survey, we found that germ avoidance significantly predicted social distancing and was negatively correlated to transportation use. Belief in conspiracy theories and non-psychological cures and prevention methods were negatively associated to social distancing, while the latter also predicted lower preventive commodities purchasing. These findings suggested that germ aversion should be incorporated in the promotion of COVID-19 prevention behaviours and that any misinformation related to COVID-19 should be minimized to improve people's protective behaviours.

Step In, Step Out from the First Lockdown: An Exploration of COVID-19 Perceptions in France and Quebec

OBJECTIVE

The objective of this research was to describe and analyze the role of psychological and behavioral factors on perceptions of COVID-19 in France and Quebec at three different times during the pandemic.

DESIGN

We conducted three qualitative and quantitative studies (Study 1 N = 255, Study 2 N = 230, Study 3 N = 143). Participants were asked to evaluate psychological and behavioral measures: at the beginning of lockdown (Study 1), during lockdown (Study 2), and during lockdown exit (Study 3).

RESULTS

Results of Study 1 show that perceptions of COVID-19 are organized around fear and a sense of threat. During the lockdown, participants mentioned for the first time the health practices to prevent the spread of COVID-19 (Study 2). Psychological and social impacts constitute a central theme in participants' discourse (Study 2 and 3).

CONCLUSIONS

The results show that perceptions of risk during a pandemic are socially constructed. Perceptions seem to be influenced by the political and health management of a territory and by the evolution of behavioral and psychological responses.

The behavioral immune system and vaccination intentions during the coronavirus pandemic

The behavioral immune system is considered to be a psychological adaptation that decreases the risk of infection. Research suggests that, in the current environment, this system can produce attitudes with negative health consequences, such as increased vaccine hesitancy. In three studies, we investigated whether two facets of the behavioral immune system-germ aversion (i.e., aversion to potential pathogen transmission) and perceived infectability (i.e., perceived susceptibility to disease)-predicted intentions to accept COVID-19 and influenza vaccination during the pandemic. The behavioral immune system mechanisms were measured before the COVID-19 pandemic in one study, and during the pandemic in two. In contrast to previous research, those with higher germ aversion during the pandemic perceived vaccines to be safer and had higher intentions to accept vaccination. Germ aversion before the pandemic was not associated with vaccination intentions. Individuals who perceived themselves as more susceptible to disease were slightly more willing to accept vaccination. We conjecture that high disease threat reverses the relationship between the behavioral immune system response and vaccination. As the associations were weak, individual differences in germ aversion and perceived infectability are of little practical relevance for vaccine uptake.

Fear of COVID-19 among Healthcare Workers: The Role of Neuroticism and Fearful Attachment

Fear of becoming infected is an important factor of the complex suite of emotional reactions triggered by the COVID-19 pandemic. Among healthcare workers (HWs), fear of infection can put at risk their psychological well-being and occupational efficiency. The aim of this study was to analyze the role of personality (i.e., the big five traits) and adult attachment in predicting levels of fear (as measured by the FCV-19S) in 101 HWs employed in a COVID-19 university hospital. The three significant predictors retained by the stepwise regression model were age (beta = 0.26, t = 2.89, p < 0.01), emotional stability (i.e., the inverse of neuroticism) (beta = -0.26, t = -2.89, p < 0.01), and fearful attachment (beta = 0.25, t = 2.75, p < 0.01). Older HWs with higher levels of neuroticism and fearful attachment reported more intense fear of COVID-19. Our results can be useful to identify vulnerable subgroups of HWs and to implement selective programs of prevention based on counseling and psychological support.

The relationship between measures of individualism and collectivism and the impact of COVID-19 across nations

Background

The global COVID-19 pandemic has been characterized by marked variations in prevalence, mortality and case fatality across nations. The available evidence to date suggests that social factors significantly influence these variations. The sociological concepts of individualism and collectivism provide a broad explanatory framework for the study of these factors. There is evidence to suggest that cross-cultural variations in collectivism may have emerged via a process of natural selection, as a protective mechanism against infectious diseases. As a test of this hypothesis, this paper examined the association between indices of individualism and collectivism and the prevalence, mortality and case fatality rates of COVID-19 across nations.

Study design

This study was a population-level association study based on data in the public domain and from prior publications.

Methods

Data on four standard measures of individualism/collectivism were obtained from the original publications. These were correlated with estimates of the nation-wide prevalence, mortality and fatality rates for COVID-19 in 94 countries, obtained from the Johns Hopkins Medical University real-time dashboard.

Results

Individualism was positively correlated with COVID-19 prevalence, mortality and case fatality rates; conversely, measures of collectivism were negatively correlated with these parameters. The strongest association was between scores for individualism and mortality rate, and remained significant after correcting for several potential confounders.

Conclusions

These findings are consistent with the prior hypothesis of a relationship between individualism-collectivism and the impact of infectious disease across populations, and have implications in terms of social strategies aimed at minimizing the impact of COVID-19.

The effectiveness of contact tracing in mitigating COVID-19 outbreak: A model-based analysis in the context of India

The ongoing pandemic situation due to COVID-19 originated from the Wuhan city, China affects the world in an unprecedented scale. Unavailability of totally effective vaccination and proper treatment regimen forces to employ a non-pharmaceutical way of disease mitigation. The world is in desperate demand of useful control intervention to combat the deadly virus. This manuscript introduces a new mathematical model that addresses two different diagnosis efforts and isolation of confirmed cases. The basic reproductive number, R 0 , is inspected, and the model's dynamical characteristics are also studied. We found that with the condition R 0 < 1 , the disease can be eliminated from the system. Further, we fit our proposed model system with cumulative confirmed cases of six Indian states, namely, Maharashtra, Tamil Nadu, Andhra Pradesh, Karnataka, Delhi and West Bengal. Sensitivity analysis carried out to scale the impact of different parameters in determining the size of the epidemic threshold of R 0 . It reveals that unidentified symptomatic cases result in an underestimation of R 0 whereas, diagnosis based on new contact made by confirmed cases can gradually reduce the size of R 0 and hence helps to mitigate the ongoing disease. An optimal control problem is framed using a control variable u ( t ) , projecting the effectiveness of diagnosis based on traced contacts made by a confirmed COVID patient. It is noticed that optimal contact tracing effort reduces R 0 effectively over time.

Impact of the COVID-19 outbreak on tourists’ real-time on-site emotional experience in reopened tourism destinations

The COVID-19 pandemic that caused unprecedented havoc on global tourism industry will all blow over, however whether the tourists' real-time on-site emotional experience in the reopened tourism destinations is higher or lower than that of the period before the pandemic outbreak has not been studied. Since this is an important basis for managers to design tourist win-back strategies, this study empirically examines the impact of the COVID-19 outbreak on tourists' real-time on-site emotional experience using geo-tagged check-in user-generated content data in China's National 5A scenic spots from November 7, 2019 to April 8, 2020. Results show that although the COVID-19 pandemic doesn't destroy the tourist attractions, tourists' real-time on-site emotional experience after the outbreak of COVID-19 is significantly lower than that of the period before the COVID-19 outbreak, suggesting that tourism destinations should not only focus on the recovery of tourist arrivals, but also pay attention to the tourist experience recovery during the tourism recovery stage. Results also provide empirical evidence and practical implications for destinations in tourist experience management during and after the COVID-19 pandemic.

Intergroup biologization and outgroup prejudice in the time of COVID-19

Through two studies (N = 602) conducted in Italy between February and March 2020, we examined the impact of the COVID-19 emergency on biologization-a form of dehumanization that involves the perception of others as contagious entities-and outgroup prejudice. Overall, results showed that higher emergency perception was associated with greater biologization toward the groups most affected by the virus, namely the Chinese outgroup and the Italian ingroup. In turn, biologization toward the outgroup increased prejudice against that group. We also found that when the pandemic hit Italy, the greater emergency perception was associated with increased emotional closeness with Chinese people, resulting in reduced biologization and prejudice toward them. However, these results held true only for Italian respondents who reported higher levels of ingroup biologization. Taken together, our findings contribute to the knowledge gaps of biologization and prejudice by also providing relevant insights into the ongoing health emergency.

Empirical evidence to understand the human factor for effective rapid testing against SARS-CoV-2

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapid antigen point-of-care and home tests are available to laypeople. In four cross-sectional mixed-methods data collections conducted between December 2020 and March 2021 (n = 4,026), we showed that a majority of subjects were willing to test despite mistrust and ignorance regarding rapid tests' validity. Experimental evidence shows that low costs and access to events could increase testing intentions. Mandatory reporting and isolation after positive results were not identified as major barriers. Instead, assuming that testing and isolation can slow down the pandemic and the possibility to protect others were related to greater willingness to get tested. While we did not find evidence for risk compensation for past tests, experimental evidence suggests that there is a tendency to show less mask wearing and physical distancing in a group of tested individuals. A short communication intervention reduced complacent behavior. The derived recommendations could make rapid testing a successful pillar of pandemic management.

The skin crawls, the stomach turns: ectoparasites and pathogens elicit distinct defensive responses in humans

Disgust has long been viewed as a primary motivator of defensive responses to threats posed by both microscopic pathogens and macroscopic ectoparasites. Although disgust can defend effectively against pathogens encountered through ingestion or incidental contact, it offers limited protection against ectoparasites, which actively pursue a host and attach to its surface. Humans might, therefore, possess a distinct ectoparasite defence system-including cutaneous sensory mechanisms and grooming behaviours-functionally suited to guard the body's surface. In two US studies and one in China, participants (N = 1079) viewed a range of ectoparasite- and pathogen-relevant video stimuli and reported their feelings, physiological sensations, and behavioural motivations. Participants reported more surface-guarding responses towards ectoparasite stimuli than towards pathogen stimuli, and more ingestion/contamination-reduction responses towards pathogen stimuli than towards ectoparasite stimuli. Like other species, humans appear to possess evolved psychobehavioural ectoparasite defence mechanisms that are distinct from pathogen defence mechanisms.

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.

Community Mitigation of COVID-19 and Portrayal of Testing on TikTok: Descriptive Study

BACKGROUND

COVID-19 testing remains an essential element of a comprehensive strategy for community mitigation. Social media is a popular source of information about health, including COVID-19 and testing information. One of the most popular communication channels used by adolescents and young adults who search for health information is TikTok-an emerging social media platform.

OBJECTIVE

The purpose of this study was to describe TikTok videos related to COVID-19 testing.

METHODS

The hashtag #covidtesting was searched, and the first 100 videos were included in the study sample. At the time the sample was drawn, these 100 videos garnered more than 50% of the views for all videos cataloged under the hashtag #covidtesting. The content characteristics that were coded included mentions, displays, or suggestions of anxiety, COVID-19 symptoms, quarantine, types of tests, results of test, and disgust/unpleasantness. Additional data that were coded included the number and percentage of views, likes, and comments and the use of music, dance, and humor.

RESULTS

The 100 videos garnered more than 103 million views; 111,000 comments; and over 12.8 million likes. Even though only 44 videos mentioned or suggested disgust/unpleasantness and 44 mentioned or suggested anxiety, those that portrayed tests as disgusting/unpleasant garnered over 70% of the total cumulative number of views (73,479,400/103,071,900, 71.29%) and likes (9,354,691/12,872,505, 72.67%), and those that mentioned or suggested anxiety attracted about 60% of the total cumulative number of views (61,423,500/103,071,900, 59.59%) and more than 8 million likes (8,339,598/12,872,505, 64.79%). Independent one-tailed t tests (α=.05) revealed that videos that mentioned or suggested that COVID-19 testing was disgusting/unpleasant were associated with receiving a higher number of views and likes.

CONCLUSIONS

Our finding of an association between TikTok videos that mentioned or suggested that COVID-19 tests were disgusting/unpleasant and these videos' propensity to garner views and likes is of concern. There is a need for public health agencies to recognize and address connotations of COVID-19 testing on social media.

The Impact of Individual Behaviors and Governmental Guidance Measures on Pandemic-Triggered Public Sentiment Based on System Dynamics and Cross-Validation

Negative online public sentiment generated by government mishandling of pandemics and other disasters can easily trigger widespread panic and distrust, causing great harm. It is important to understand the law of public sentiment dissemination and use it in a timely and appropriate way. Using the big data of online public sentiment during the COVID-19 period, this paper analyzes and establishes a cross-validation based public sentiment system dynamics model which can simulate the evolution processes of public sentiment under the effects of individual behaviors and governmental guidance measures. A concrete case of a violation of relevant regulations during COVID-19 epidemic that sparked public sentiment in China is introduced as a study sample to test the effectiveness of the proposed method. By running the model, the results show that an increase in government responsiveness contributes to the spread of positive social sentiment but also promotes negative sentiment. Positive individual behavior suppresses negative emotions while promoting the spread of positive emotions. Changes in the disaster context (epidemic) have an impact on the spread of sentiment, but the effect is mediocre.

Condom use during COVID-19: Findings from an Australian sample of heterosexual young adults

Condoms are a valuable tool in combating the continued spread of sexually transmitted infections (STIs). Despite the fact that condoms are effective and easily accessible, young adults report inconsistent condom use and young adults represent a disproportionately large amount of new STI cases annually. The Behavioural Immune System theory suggests that health behaviours, such as condom use, are impacted by cognitive activation of perceived threat of disease. The advent of the COVID-19 pandemic may then have unforeseen impacts on condom use and the spread of STIs. The present study investigated changes in condom use during the pandemic, and any associations these changes may have had with perceived vulnerability to COVID-19. An Australian sample of 269 students completed a survey asking them to recall their condom use prior to COVID-19, and then their current condom use. Final analyses included a sample of 149 sexually active heterosexual participants. Results revealed a general decline in condom use. Single and coupled participants both reported less frequent condom use, but this decrease was more pronounced among single people. Gender did not moderate these effects. Surprisingly, diminished condom use was not significantly related to perceived threat of COVID-19. Findings of the present study have concerning implications for sexual health and sexual messaging during pandemics.

Pandemic-related behaviours and psychological outcomes; A rapid literature review to explain COVID-19 behaviours

COVID-19 spread rapidly causing widescale loss of life and economic devastation. Efforts to contain it have resulted in measures such as closing of borders and restrictions around travel, social activities and attending places of worship. We conducted this rapid review to systematically examine, synthesize, and critically appraise the available evidence on the relationship between pandemic-related behaviours and psychological outcomes. The methods were compliant with the PRISMA guidelines. The review was preregistered with PROSPERO (Registration #: CRD42020181576). A literature search was conducted from January 2010 to April 2020 using ProQuest, Web of Science, PsycINFO, PsycARTICLES, Scopus, SAGE Journals, and CINAHL. Of 3844 articles identified, we included 11 quantitative articles in the final synthesis, representing data from 32, 049 individual respondents from eight countries. We identified three pandemics (COVID-19, MERS-CoV, Influenza A(H1N1) pdm09) as well as several psychological outcomes including anxiety, mental distress, post-traumatic stress disorder, and anger. We also identified several behaviours during pandemics and categorized them into protective, preparedness, and perverse behaviours. The review showed that even though there is limited evidence regarding pandemic-related behaviours and psychological outcomes, the current findings showed that the psychological outcomes significantly impacted on the adoption of the pandemic-related behaviours. Given the negative effects of psychological outcomes on behaviours, we recommend that mental health professionals should promote mental health support to people exhibiting psychological distress resulting from similar events in the future. Also, we recommend that future research should test the hypothesized effects of pandemics and psychological outcomes on behaviour change.

Prevalence and factors associated with postpartum depression during the COVID-19 pandemic among women in Guangzhou, China: a cross-sectional study

BACKGROUND

The 2019 coronavirus disease (COVID-19) is a public health emergency of international concern. To date, there are limited studies that have investigated the impact of COVID-19 pandemic on mental health among female population. Therefore, the study aims to investigate the prevalence of postpartum depression (PPD) and it's related factors among women in Guangzhou, China, during the COVID-19 pandemic.

METHODS

A cross-sectional study was performed from 30th March 2020 to 13th April 2020 using anonymous online questionnaire among 864 women at 6-12 weeks postpartum. The Chinese version of Edinburgh Postnatal Depression Scale and a questionnaire regarding associated factors were administered to all participants. Multivariate logistic regression was used to determine factors that were significantly associated with PPD.

RESULTS

The prevalence of PPD among women at 6-12 weeks postpartum was 30.0%. A multivariate logistic regression model identified significant factors as: immigrant women, persistent fever, poor social support, concerns about contracting COVID-19 and certain precautionary measures.

CONCLUSIONS

The findings suggest the need for policies and interventions to not only mitigate the psychological impacts but also target disadvantaged sub-groups of women following childbirth during the COVID-19 pandemic.