Moral Judgments of COVID-19 Social Distancing Violations: The Roles of Perceived Harm and Impurity

Cross-cultural differences in prefrontal cortex activity in moral judgment: A functional near-infrared spectroscopy (fNIRS) study based on the CNI model

BACKGROUND

In the past, comparative cultural neurological studies of moral judgments have mainly focused on Eastern and Western groups. We initially examined Japanese and Chinese groups, both East Asian cultures. We utilized a recently proposed polynomial model known as the "consequences, norms, and generalized inaction" (CNI) model to investigate the variations in the overall prefrontal cortex activity between these two groups during moral judgment.

METHODS

We employed functional near-infrared spectroscopy (fNIRS) to analyze the prefrontal cortex (PFC) activity within a CNI model of moral judgment among 23 healthy Japanese and 26 healthy Chinese adults.

RESULTS AND CONCLUSIONS

Our study revealed significant differences in the PFC activation between Japanese and Chinese individuals in the CNI moral judgment task context. Specifically, during the CNI task, Chinese men exhibited higher right dorsolateral prefrontal cortex (R-DLPFC) activity than Chinese women. In contrast, Japanese women showed greater left dorsolateral prefrontal cortex (L-DLPFC) activity than Japanese men. In an international comparison, R-DLPFC activity was higher in Chinese men than in Japanese men. Conversely, the left ventrolateral prefrontal cortex activity was higher in Japanese men compared to Chinese men. Additionally, among women, the right ventromedial prefrontal cortex activity was higher in Japanese women than in Chinese women. In conclusion, our findings support the perspective of cultural psychology and identify cultural and sex differences in PFC activity between Japanese and Chinese individuals.

Blaming the unvaccinated during the COVID-19 pandemic: the roles of political ideology and risk perceptions in the USA

Individuals unvaccinated against COVID-19 (C19) experienced prejudice and blame for the pandemic. Because people vastly overestimate C19 risks, we examined whether these negative judgements could be partially understood as a form of scapegoating (ie, blaming a group unfairly for an undesirable outcome) and whether political ideology (previously shown to shape risk perceptions in the USA) moderates scapegoating of the unvaccinated. We grounded our analyses in scapegoating literature and risk perception during C19. We obtained support for our speculations through two vignette-based studies conducted in the USA in early 2022. We varied the risk profiles (age, prior infection, comorbidities) and vaccination statuses of vignette characters (eg, vaccinated, vaccinated without recent boosters, unvaccinated, unvaccinated-recovered), while keeping all other information constant. We observed that people hold the unvaccinated (vs vaccinated) more responsible for negative pandemic outcomes and that political ideology moderated these effects: liberals (vs conservatives) were more likely to scapegoat the unvaccinated (vs vaccinated), even when presented with information challenging the culpability of the unvaccinated known at the time of data collection (eg, natural immunity, availability of vaccines, time since last vaccination). These findings support a scapegoating explanation for a specific group-based prejudice that emerged during the C19 pandemic. We encourage medical ethicists to examine the negative consequences of significant C19 risk overestimation among the public. The public needs accurate information about health issues. That may involve combating misinformation that overestimates and underestimates disease risk with similar vigilance to error.

Psychological and psychosocial determinants of COVID Health Related Behaviours (COHeRe): An evidence and gap map

Background

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has resulted in illness, deaths and societal disruption on a global scale. Societies have implemented various control measures to reduce transmission of the virus and mitigate its impact. Individual behavioural changes are crucial to the successful implementation of these measures. Common recommended measures to limit risk of infection include frequent handwashing, reducing the frequency of social interactions and the use of face coverings. It is important to identify those factors that can predict the uptake and maintenance of these protective behaviours.

Objectives

We aimed to identify and map the existing evidence (published and unpublished) on psychological and psychosocial factors that determine uptake and adherence to behaviours aimed at reducing the risk of infection or transmission of COVID-19.

Search Methods

Our extensive search included electronic databases (n = 12), web searches, conference proceedings, government reports, other repositories including both published peer reviewed, pre-prints and grey literature. The search strategy was built around three concepts of interest including (1) context (terms relating to COVID-19), (2) behaviours of interest and (3) terms related to psychological and psychosocial determinants of COVID Health-Related Behaviours and adherence or compliance with recommended behaviours, to capture both malleable and non-malleable determinants (i.e. determinants that could be changed and those that could not).

Selection Criteria

This Evidence and Gap Map (EGM) includes all types of studies examining determinants of common recommended behaviours aimed at mitigating human-to-human spread of COVID-19. All potential malleable and non-malleable determinants of one or more behaviours are included in the map. As part of the mapping process, categories are used to group determinants. The mapping categories were based on a previous rapid review by Hanratty 2021. These include: 'behaviour', 'cognition', 'demographics', 'disease', 'emotions', 'health status', 'information', 'intervention', and 'knowledge'. Those not suitable for categorisation in any of these groups are included in the map as 'other' determinants.

Data Collection and Analysis

Results were imported to a bibliographic reference manager where duplications of identical studies gathered from multiple sources were removed. Data extraction procedures were managed in EPPI-Reviewer software. Information on study type, population, behaviours measured and determinants measured were extracted. We appraised the methodological quality of systematic reviews with AMSTAR-2. We did not appraise the quality of primary studies in this map.

Main Results

As of 1 June 2022 the EGM includes 1034 records reporting on 860 cross-sectional, 68 longitudinal, 78 qualitative, 25 reviews, 62 interventional, and 39 other studies (e.g., mixed-methods approaches). The map includes studies that measured social distancing (n = 487), masks and face coverings (n = 382), handwashing (n = 308), physical distancing (n = 177), isolation/quarantine (n = 157), respiratory hygiene/etiquette (n = 75), cleaning surfaces (n = 59), and avoiding touching the T-zone (n = 48). There were 333 studies that assessed composite measures of two or more behaviours. The largest cluster of determinants was 'demographics' (n = 730 studies), followed by 'cognition' (n = 496 studies) and determinants categorised as 'other' (n = 447). These included factors such as 'beliefs', 'culture' and 'access to resources'. Less evidence is available for some determinants such as 'interventions' (n = 99 studies), 'information' (n = 101 studies), and 'behaviour' (149 studies).

Authors' Conclusions

This EGM provides a valuable resource for researchers, policy-makers and the public to access the available evidence on the determinants of various COVID-19 health-related behaviours. The map can also be used to help guide research commissioning, by evidence synthesis teams and evidence intermediaries to inform policy during the ongoing pandemic and potential future outbreaks of COVID-19 or other respiratory infections. Evidence included in the map will be explored further through a series of systematic reviews examining the strength of the associations between malleable determinants and the uptake and maintenance of individual protective behaviours.

Understanding the Link between COVID-19 and HIV/AIDS Stigmas

While the HIV/AIDS epidemic has informed the responses to the COVID-19 pandemic, there is a lack of understanding of the empirical links between stigmas associated with COVID-19 and HIV/AIDS. Surveying 247 adults in the United States online, this study aims to examine the relationships between COVID-19 and HIV/AIDS stigmas in order to understand how they are similar and different from each other, taking into consideration the context relevant to the COVID-19 pandemic. Four scales of stigmas conveying different attitudes (i.e., rejection, despise, accusation, and caution) were used to examine the relationships between the stigmas of these two infectious diseases. Findings based on the mean comparisons from paired t tests showed the mean difference in scores between respondents who supported the exclusion of COVID-19-infected individuals versus HIV-infected individuals was statistically significant. In addition, the mean difference in scores between respondents who were wary of their need to protect their rights around COVID-19-infected persons versus HIV-infected persons was statistically significant. Controlling for the respondents' sociodemographics and factors that were relevant to the COVID-19 pandemic, multiple regression analyses showed that all four types of COVID-19 stigmas were positively associated with their corresponding types of HIV/AIDS stigmas. The preliminary findings between COVID-19 and HIV/AIDS stigmas suggested that HIV/AIDS stigma mitigation strategies may present a fruitful approach to inform stigma mitigation of COVID-19.

Using Moralization as a Persuasion Strategy in Public Health Messages: A Cross-Sectional, Experimental Study on Vaping

Using moralization in anti-vaping public health messages as a persuasion strategy was recently recommended to address the current vaping epidemic. However, previous findings indicated this could lead to moralized attitudes in the general population, which can be very difficult to change and could severely affect social cohesion and distort risk perception. Since the safety and efficiency of using electronic cigarettes as smoking cessation devices are still being investigated, we conducted a cross-sectional, experimental study on a convenience sample of 612 Romanian never vapers, never smokers to assess how exposure to moralizing public health messages about vaping might influence their trust in future scientific results about this topic. Participants were randomized into six groups according to the type of message ("moral," "immoral," "neutral") and the type of effects of vaping on smokers' health, documented in a future fictitious study ("health benefits," "health risks"). Results showed that the type of message moderated trust in future scientific results after controlling for participants' general trust in science. When vaping was framed as immoral, trust in future scientific results showing health benefits was decreased, and vice versa. Implications are discussed for using moralization strategically in public health messaging to curtail or promote certain health behaviors.

Face mask use as a categorical dimension in social perception

Prevention measures aimed at combating COVID-19 pandemic strongly impact several aspects of social life. In particular, interpersonal perception is affected as a function of whether the persons perceived wear or not face masks. In two experimental studies, we here explored whether people rely on the presence vs. absence of face masks when encoding information in memory about other individuals. In a memory confusion paradigm, participants were initially presented with individuals either wearing a face mask or not, each conveying a series of sentences. Next, participants were probed about the identity of the speaker of each sentence. Results showed that it was more likely to erroneously attribute a sentence to a speaker who also was wearing a face mask (or not) as the original speaker, demonstrating that the cue about wearing or not a face mask was spontaneously used to encode information. Study 2 ruled out an alternative explanation based on perceptual processes, suggesting that face masks represent meaningful social objects. Overall, it emerged that participants spontaneously categorize others as a function of whether they wear a mask or not. Findings also confirmed previous research evidence about the more positive evaluation of mask wearers as compared to non-wearers, and the overall detrimental impact that face masks may have on the correct identification of social targets.

Differences in moral judgment predict behavior in a Covid triage game scenario

Moral beliefs influence decisions across many contexts, but researchers typically test how these beliefs translate into moral judgments in hypothetical dilemmas. While this is important, in this study (N = 248), we sought to extend these findings by exploring whether moral judgment (specifically utilitarian or deontological processing) predicted behavior in a commons dilemma game against other players (programmed bots) across multiple rounds in the context of the Covid-19 pandemic. Importantly, participants had to weigh short-term needs against long-term dangers of exhausting the community pool (i.e., a tragedy of the commons). As hypothesized, increased utilitarian processing predicted reduced resource extraction from the community pool. In addition to showing that differences in moral judgment predict behavior in a game situation that simulates a somewhat ecologically valid dilemma, these results also replicate previous research connecting morality to opinions about Covid-19 vaccine requirements.