Germ Aversion Research Articles

Germ aversion is a risk factor for chronic low back pain and shoulder pain under the COVID-19 pandemic: an internet-based panel study

The COVID-19 pandemic has increased germ aversion, an aversive affective response to a high likelihood of pathogen transmission. While psychological factors are associated with chronic pain, the relationship between germ aversion and chronic pain remains unexplored. This study aimed to examine the relationship between germ aversion and new-onset and prognosis of chronic pain using longitudinal data collected during the COVID-19 pandemic. We conducted web-based surveys of full-time workers at baseline and after three months. Data were collected on demographic characteristics, psychological factors, and chronic pain. Germ aversion was assessed using a modified Perceived Vulnerability to Disease scale. We analyzed responses from 1265 panelists who completed the survey twice. The prevalence of chronic low back pain (CLBP) and chronic neck and shoulder pain (CNSP) was associated with sex, short sleep duration, psychological distress, loneliness, and germ aversion. Stratified analyses showed that germ aversion was a risk factor for CLBP at three months in both individuals with and without CLBP at baseline, and for CNSP at three months in those with CNSP at baseline, even after adjustment for confounders. In conclusion, this preliminary study suggests that high germ aversion is a risk factor for CLBP and CNSP in young and middle-aged workers.

The association between consumers' chronic concerns about infectious disease and anthropomorphism

AbstractAssigning human characteristics to products and brands (i.e., anthropomorphism) is a tactic commonly adopted by marketers. However, researchers have recently highlighted the importance of better understanding which consumers will be more (or less) responsive to these cues. Drawing on the behavioral immune system and anthropomorphism literatures, we hypothesize that consumers who are chronically concerned about their susceptibility to infectious disease will have a greater tendency to anthropomorphize nonhuman entities (e.g., nature, technology, and consumer products) because doing so creates relatively pathogen‐free sources of social connection. Importantly, we also predict that this tendency will be muted when consumers are highly germ averse. To test these predictions, we examined the relationships between perceived infectability and germ aversion, the two subscales of the established Perceived Vulnerability to Disease scale, and three different measures of consumers' tendency to anthropomorphize nonhuman entities. The results of four studies, including a preregistered, high‐powered replication, support our hypotheses and offer the first evidence of a context wherein perceived infectability and germ aversion interact.

Crowding at the ballot box: Germ aversion and voting methods in the 2020 U.S. general election

AbstractIn 2020, the growing COVID‐19 pandemic threatened engagement with the U.S. presidential election. Did this threat affect how people perceived the voting process and the means by which they voted? Four months before the election, 564 participants in several states viewed slideshows framing the pandemic primarily as a health or economic threat, then rated their impressions of voting environments and their attitudes about various voting methods. Following the general election, these data were matched to records indicating if and how participants voted. Exposure to the health consequences of COVID‐19 led people to judge socially dense polling places more negatively but had few effects on other voter outcomes. Instead, chronic aversion to germs predicted more negative responses to dense polling places as well as support for, and use of, socially distanced voting methods, even when accounting for other relevant factors such as partisanship and local COVID‐19 rates.

The perceived vulnerability to disease scale: Cross‐cultural measurement invariance and associations with fear of COVID‐19 across 16 countries

AbstractUsing cross‐sectional data from N = 4274 young adults across 16 countries during the COVID‐19 pandemic, we examined the cross‐cultural measurement invariance of the perceived vulnerability to disease (PVD) scale and tested the hypothesis that the association between PVD and fear of COVID‐19 is stronger under high disease threat [that is, absence of COVID‐19 vaccination, living in a country with lower Human Development Index (HDI) or higher COVID‐19 mortality]. Results supported a bi‐factor Exploratory Structural Equation Modeling model where items loaded on a global PVD factor, and on the sub‐factors of Perceived Infectability and Germ Aversion. However, cross‐national invariance could only be obtained on the configural level with a reduced version of the PVD scale (PVD‐r), suggesting that the concept of PVD may vary across nations. Moreover, higher PVD‐r was consistently associated with greater fear of COVID‐19 across all levels of disease threat, but this association was especially pronounced among individuals with a COVID‐19 vaccine, and in contexts where COVID‐19 mortality was high. The present research brought clarity into the dimensionality of the PVD measure, discussed its suitability and limitations for cross‐cultural research, and highlighted the pandemic‐related conditions under which higher PVD is most likely to go along with psychologically maladaptive outcomes, such as fear of COVID‐19.

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

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. 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. 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).

Evolution of preferences for COVID-19 vaccine throughout the pandemic – The choice experiment approach

In this study, we employ a choice experiment to study individual preferences for COVID-19 vaccines in the US. A unique characteristic of the microdata (N = 5671) is that the survey was conducted in five distinct waves from October 2020 to October 2021. Because of this dynamic feature, it is possible to control for evolving pandemic conditions such as the number of COVID-19 active cases, vaccination uptake, and the frequency of Google searches related to the vaccines. Furthermore, we employ a hybrid choice model to incorporate respondents' attitudes related to their perceived vulnerability to diseases, as well as their perceived health status. The hybrid choice model was extended to incorporate latent classes as well as random effects. We find that the rate of vaccinated individuals in the population actually increases the probability of vaccine hesitancy, and therefore may discourage people to get vaccinated. This may be evidence of free-riding behavior. On the other hand, the number of COVID-19 cases has a positive effect on the probability of getting vaccinated, suggesting that individuals react to the pandemic conditions by taking some protective measures. Google trend data do not seem to have a straightforward effect on the vaccination demand, but it increases consumers’ willingness to pay for several vaccine characteristics. With respect to the analyzed attitudes, we find that perceived uninfectability is a significant driver of vaccine hesitancy, probably related to the frequent “natural immunity” argument. In turn, germ aversion has a positive effect on the probability of getting vaccinated as well as on the marginal willingness to pay. Finally, health status has a limited effect on whether the individual will decide to vaccinate or not.

Predictors and motives for mask-wearing behavior and vaccination intention

Containing a pandemic requires that individuals adhere to measures such as wearing face-masks and getting vaccinated. Therefore, identifying predictors and motives for both behaviors is of importance. Here, we study the decisions made by a cross-national sample in randomized hypothetical scenarios during the COVID-19 pandemic. Our results show that mask-wearing was predicted by empathic tendencies, germ aversion, and higher age, whilst belief in misinformation and presentation of an interaction partner as a family member lowered the safety standards. The main motives associated with taking the mask off included: rationalization, facilitating interaction, and comfort. Vaccination intention was positively predicted by empathy, and negatively predicted by belief in misinformation and higher costs of the vaccine. We found no effect of immunization status of the surrounding social group. The most common motive for vaccination was protection of oneself and others, whereas undecided and anti-vaccine groups reported doubts about the effectiveness and fear of side effects. Together, we identify social and psychological predictors and motives of mask-wearing behavior and vaccination intention. The results highlight the importance of social context for mask-wearing, easy access to vaccines, empathy, and trust in publicly distributed information.

Older adults are healthier than many people expect: reducing anti-old attitudes

ABSTRACT There are widespread anti-old attitudes held by younger people. Older adults are generally perceived as closely associated with illnesses. Thus, younger people with a higher degree of germ aversion (i.e. aversion to disease transmission) are thought to view the older population more negatively. In Study 1, we conducted an online survey (N = 981) and found that, even after controlling for the related variables such as fear of death, those with higher germ aversion had more anti-old attitudes. In Study 2, we conducted an online experiment (N = 689). Participants in the experimental group read an explanatory text which showed that older adults in general are healthier than people perceive and those in the control group read an irrelevant explanatory text. Results showed that anti-old attitudes were weaker in the experimental group than in the control group; this effect lasted at least one week. In Study 3, we conducted an online experiment similar to Study 2 (N = 997). In the experimental group, anti-old attitudes toward both the young-old (aged 65–74 years) and old-old (aged 75 years and over) were reduced. Further, advocates for policies to support older adults increased in the experimental group. The experimental manipulation in this study has the advantage that it can be conducted with a large number of participants in a simple procedure. Our findings would be useful in gerontological research aimed at improving anti-old attitudes and creating a society, in which older adults can live comfortably.

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.

Affective and Motivational Accounts of Moralizing COVID-19-Preventive Behaviors

Abstract The purpose of this study was to investigate the role of perceived vulnerability to disease, emotions (disgust, anger), and perceived norms in predicting moral judgments of anti-COVID-19-preventive behaviors in US and Japan. A total of 442 Japanese and 365 American participants completed an online survey. Disgust and anger mediated the link between perceived vulnerability to disease (germ aversion) and moral judgments of preventive behaviors across both cultures. Perceived social norms among friends and family were associated with harsh judgments of anti-preventive behaviors for Japanese but not for American participants. Overall, our results suggest that effective strategies for promoting preventive behaviors may be culturally valid if they focus on the fear for infectious disease and related aversive affect. We also discussed the possibility that some strategies could be characteristic of collectivistic cultures, warranting further cross-cultural comparisons.

A longitudinal perspective on perceived vulnerability to disease during the COVID-19 pandemic in Belgium

During the coronavirus disease 2019 pandemic, individuals relied heavily on media sources to stay informed about the disease and public health measures. However, differences exist in the type and frequency of news media consumption, which can be linked to their perceived vulnerability to disease. In this longitudinal study, 1000 Flemish (Belgium) individuals were followed from March 2020 until September 2020, focussing on the evolution in perceived vulnerability to disease (i.e. perceived infectability and germ aversion). Media consumption significantly impacts perceived germ aversion; heavy consumers of commercial media reported greater germ aversion than light consumers of these media. The evolution of germ aversion among individuals from March to August depends on their gender, living environment, age and possibility to work from home. Furthermore, the evolution of perceived infectability depends on the age and living environment of the respondent. These findings may interest policy makers and media professionals to anticipate how anxieties regarding contracting an infectious disease evolve over time and how individual characteristics affect this evolution.

The Mediating Role of Germ Aversion in the Relationship between Fear of COVID-19 and Intention to Vaccinate

Objective: In the study, it was aimed to determine the fear level of COVID-19 and to demonstrate the relationship between fear of COVID-19 and intention to vaccinate. Materials and Methods: The study population consisted of young, middle, and elderly patients and their relatives who applied to a family medicine unit operating in the city center of Düzce. Data were collected from 530 people using the face-to-face survey technique. The researchers used IBM SPSS Statistic Base 23 V and AMOS package programs for statistical analysis. Results: The empirical result of the study revealed that as the fear level of COVID-19 increased, the intention to get vaccinated for COVID-19 increased positively. In addition, it has been determined that germ aversion behavior has a significant indirect effect and fully mediates the relationship between fear of COVID-19 and intention to get vaccinated. Conclusions: This research revealed that increasing COVID-19 fear level positively increases the intention to be vaccinated through high germ aversion behavior.

The Resilience of South African School Teachers in the Time of COVID-19: Coping with Risk of Infection, Loneliness, and Anxiety.

The COVID-19 pandemic precipitated an overall increase in the global prevalence of mental health disorders and psychological distress. However, against this backdrop, there was also evidence of adaptation and coping, which suggested the influence of protective factors. The current study aims to extend previous research on the role of protective factors by investigating the health-sustaining and mediating roles of resilience in the relationship between perceived vulnerability to disease, loneliness, and anxiety. Participants consisted of a convenience sample of schoolteachers (N = 355) who completed the Perceived Vulnerability to Disease Questionnaire, the short form of the Connor-Davidson Resilience Scale, the University of California, Los Angeles Loneliness Scale, and the trait scale of the Spielberger State-Trait Anxiety Scale, through an online link created with Google Forms. The results of path analysis indicated significant negative associations between resilience and both loneliness and anxiety. These results indicate the health-sustaining role of resilience. In addition, resilience mediated the relationships between germ aversion and perceived infectability, on the one hand, and loneliness and anxiety, on the other hand. The findings confirm that resilience can play a substantial role in counteracting the negative impact of the pandemic on mental health.

A longitudinal assessment of variability in COVID-19 vaccine hesitancy and psychosocial correlates in a national United States sample

Recent evidence suggests that COVID-19 vaccine hesitancy is not static. In order to develop effective vaccine uptake interventions, we need to understand the extent to which vaccine hesitancy fluctuates and identify factors associated with both between- and within-person differences in vaccine hesitancy. The goals of the current study were to assess the extent to which COVID-19 vaccine hesitancy varied at an individual level across time and to determine whether disgust sensitivity and germ aversion were associated with between- and within-person differences in COVID-19 vaccine hesitancy. A national sample of U.S. adults (N = 1025; 516 woman; Mage = 46.34 years, SDage = 16.56, range: 18 to 85 years; 72.6 % White) completed six weekly online surveys (March 20 – May 3, 2020). Between-person mean COVID-19 vaccine hesitancy rates were relatively stable across the six-week period (range: 38–42 %). However, there was considerable within-person variability in COVID-19 vaccine hesitancy. Approximately, 40 % of the sample changed their vaccine hesitancy at least once during the six weeks. There was a significant between-person effect for disgust sensitivity, such that greater disgust sensitivity was associated with a lower likelihood of COVID-19 vaccine hesitance. There was also a significant within-person effect for germ aversion. Participants who experienced greater germ aversion for a given week relative to their own six week average were less likely to be COVID-19 vaccine hesitant that week relative to their own six-week average. This study provides important information on rapidly changing individual variability in COVID-19 vaccine hesitancy on a weekly basis, which should be taken into consideration with any efforts to decrease vaccine hesitancy and increase vaccine uptake. Further, these findings identify-two psychological factors (disgust sensitivity and germ aversion) with malleable components that could be leveraged in developing vaccine uptake interventions.

The germ aversion paradox: When germ aversion predicts reduced alpha power suppression to norm violations

Prior work shows that germ-averse individuals are more norm-abiding than their less germ-averse counterparts in the absence of any germ threat. However, it is unclear if germ aversion has similar effects in the presence of a germ threat. Here, we explored the hypothesis that germ-averse people would show less sensitivity to social norms because their perceived success in avoiding germs could make them feel protected from this threat. As an index of the sensitivity to norms, we assessed electrocortical reactions to another person's norm-violating behaviors. 59 young American adults were either primed with a germ threat or not. They subsequently saw either norm-violating or normal behaviors. In the control-priming condition, a reduction in upper-alpha band power in response to norm-violating (vs. normal) behaviors (signifiying vigilance to norm violations) was significantly greater for those high in germ aversion, thereby conceptually replicating the prior evidence linking germ aversion to conformity. This effect, however, was significantly reversed in the threat-priming condition. The elevated level of neural reactivity to norm violations in the threat-priming condition, present for those low in germ aversion, disappeared for those high in germ aversion. Our findings suggest that although germ aversion predicts greater norm-abidance in the absence of any germ threat, this effect paradoxically reverses itself in the presence of it.

The psychometric properties and gender invariance of the Italian version of the Perceived Vulnerability to Disease Questionnaire (I-PVDQ) during the COVID-19 pandemic

BackgroundThe Perceived Vulnerability to Disease Questionnaire (PVDQ) measures beliefs associated with personal susceptibility to infectious diseases and behaviors or perceptions in the presence of potential risk of pathogen transmission. Given the onset of the Severe Acute Respiratory Syndrome Coronavirus 2 global pandemic, otherwise known as the COVID-19 pandemic, the construct being measured may function differently based on affective, behavioral, and cognitive changes along with the need to change norms and lifestyles in a global context. The present study aims to test the psychometric properties and the gender invariance of the Italian adaptation of the PVDQ to confirm that the scale can be used with Italian-speaking people, and that it functions effectively during a pandemic.MethodsA total of 509 participants filled out an online questionnaire including the Italian version of the I-PVDQ (I-PVDQ) and several measures of psychological constructs. Reliability and factor analyses (single and multigroup) were conducted. Bayesian correlation tests and Bayesian independent sample t-tests were used to assess the validity of I-PVDQ.ResultsExploratory factor analysis supported the two-factor structure of the I-PVDQ, and factor loadings loaded appropriately onto perceived infectability (PI) and germ aversion (GA). In terms of invariance, the scale showed configural, metric, scalar, and strict invariance across genders. Decisive evidence in favor of correlation with the measure of COVID-19 related fears for both PI and GA was found. There was strong evidence for observed correlations with COVID-19 related constructs such as intolerance to uncertainty, psychological inflexibility, resilience, stress, and anxiety. Women showed higher GA than men, while there were no gender differences in PI.ConclusionsTaken together, these results suggest that the I-PVDQ confirms the psychometric properties of the original version and that can be used to detect PVD when it is affected by environmental circumstances since its functioning is preserved during a pandemic.

The Association of Perceived Vulnerability to Disease with Cognitive Restraint and Compensatory Behaviors

Individual differences exist in perceived vulnerability to disease (PVD). PVD is associated with negative responses (e.g., disgust) towards individuals with obesity and heightened sensitivity regarding personal appearance. Through increasing fear of fat (FOF), PVD may be associated with cognitive restraint and compensatory behaviors. We utilized an adult sample (n = 247; 53.3% male sex assigned at birth) recruited through Amazon's MTurk prior to the COVID-19 pandemic to investigate associations between PVD, cognitive restraint and compensatory behaviors. Participants completed the Perceived Vulnerability to Disease Scale, Eating Disorder Diagnostic Scale, Dutch Eating Behaviors Questionnaire, and Goldfarb's Fear of Fat Scale. Mediation analyses were used to test our hypotheses. Perceived infectability (PVD-Infection) was associated with cognitive restraint and compensatory behaviors through increased FOF. Perceived germ aversion (PVD-Germ) was associated with cognitive restraint, but FOF did not mediate this association. Sex-stratified analyses revealed no significant sex differences. PVD may be an overlooked factor associated with cognitive restraint and compensatory behaviors in males and females. FOF was an important mediating factor in these associations. Increased engagement in cognitive restraint and compensatory behaviors may reflect attempts to reduce FOF. Future longitudinal research should explore whether PVD is a risk factor for cognitive restraint and compensatory behaviors.

Influence of Psychological Factors on Vaccination Acceptance among Health Care Workers in Slovenia in Three Different Phases of the COVID-19 Pandemic.

COVID-19 vaccination acceptance among healthcare workers (HCWs) is very important to control the pandemic and to ensure the safety of HCWs and patients. As psychological factors may affect the decision to be vaccinated, the aim of this study was to investigate the influence of psychological factors on vaccination acceptance in different phases of the COVID-19 pandemic. A cross-sectional study using a web-based survey was conducted among HCWs in Slovenia at the beginning of the pandemic (N = 851), one month later (N = 86), and one year later (N = 145) when vaccines were already available. The results showed that the influence of psychological factors (anxiety, psychological burden, perceived infectability, and germ aversion) was specific for each survey period. At the beginning of the pandemic, vaccination intention was positively associated with anxiety. In the third survey period, anxiety was not exposed as a predictive factor for vaccination intention. However, comparison of vaccination status among groups with different levels of anxiety revealed an interesting distinction within those in favour of vaccination; in the group with minimal levels of anxiety, there was a relatively high share of respondents that were already vaccinated, whereas in the group with severe anxiety, most individuals intended to be vaccinated but hesitated to take action.

Preferred distance from camera for online interactions and its relation with individual differences in pathogen sensitivity

Humans maintain distance from others in their interpersonal interactions and this has been documented in previous research in real-world scenarios. However, thanks to telecommunication technologies, humans are also interacting online with each other. While individuals are competent in adjusting their interpersonal distance based on their own preferences and others' considerations in a real-world situation, they might not be as competent in their online interactions. The aim of the current study is twofold: a) to investigate individuals’ preferred distance from a camera both for themselves and others while in an online interaction, and b) to test whether individual differences in pathogen sensitivity influence their preferred distances in an online interaction. Participants (N = 159) were asked to indicate their comfort distance from a camera for themselves and others while interacting in an online scenario. The distance from the camera varied systematically from 50 cm to 200 cm. Results showed that participants preferred to stand 80 cm–120 cm from a camera. As for the avatars that the participants viewed online, men and women preferred female avatars to stand between 80 cm and 130 cm from a camera, and male avatars to stand between 80 cm and 150 cm from a camera. And although the chances of contracting a disease online is zero, we found that germ aversion and concern about contracting COVID-19 were associated with the preferred distances from the camera. We attribute this result to a false positive error in social cognition.

The influence of face mask on social spaces depends on the behavioral immune system.

Interacting with objects and people requires specifying localized spaces where these interactions can take place. Previous studies suggest that the space for interacting with objects (i.e., the peripersonal space) contributes to defining the space for interacting with people (i.e., personal and interpersonal spaces). Furthermore, situational factors, such as wearing a face mask, have been shown to influence social spaces, but how they influence the relation between action and social spaces and are modulated by individual factors is still not well understood. In this context, the present study investigated the relationship between action peripersonal and social personal and interpersonal spaces in participants approached by male and female virtual characters wearing or not wearing a face mask. We also measured individual factors related to the behavioral immune system, namely willingness to take risks, perceived infectability and germ aversion. The results showed that compared to peripersonal space, personal space was smaller and interpersonal space was larger, but the three spaces were positively correlated. All spaces were altered by gender, being shorter when participants faced female characters. Personal and interpersonal spaces were reduced with virtual characters wearing a face mask, especially in participants highly aversive to risks and germs. Altogether, these findings suggest that the regulation of the social spaces depends on the representation of action peripersonal space, but with an extra margin that is modulated by situational and personal factors in relation to the behavioral immune system.