key: cord-0954795-l52u7a64 authors: Kempthorne, JohnMark C.; Terrizzi, John A. title: The Behavioral Immune System and Conservatism as Predictors of Disease-Avoidant Attitudes During the COVID-19 Pandemic date: 2021-03-19 journal: Pers Individ Dif DOI: 10.1016/j.paid.2021.110857 sha: 8b00d487cc30bcba28444b87d14ce5bf6b161782 doc_id: 954795 cord_uid: l52u7a64 The COVID-19 pandemic presents a unique opportunity to explore the relationships between the behavioral immune system (BIS), Political Ideology, and disease avoidant attitudes (e.g., attitudes toward vaccination and attitudes about COVID-19). The BIS (e.g., disgust) is believed to be the first line of defense against pathogens and has been linked to socially conservative values. Ironically, however, the BIS has also been associated with anti-vaccination attitudes. In the current study, American participants (N = 139) completed an online survey with self-report measures of the BIS (e.g., disgust sensitivity and perceived infectability), political ideology, COVID-19 attitudes, and anti-vaccination attitudes. Disgust sensitivity was positively correlated with anti-vaccination attitudes but not significantly correlated with attitudes toward COVID-19. Perceived infectability, however, was negatively correlated with anti-vaccination attitudes and positively correlated with anxiety and knowledge about COVID-19. Right-wing authoritarianism and support for Trump were negatively correlated with knowledge and anxiety about COVID-19 and positively correlated with anti-vaccination attitudes. infected person spreads the disease to about 2.5 people (Center for Disease Control [CDC], 2020a) . Globally, as of December 14th, 2020, there have been over 65 million confirmed cases and 1.5 million deaths (World Health Organization [WHO] , 2020a). The symptomatic fatality ratio is approximately 0.4% (CDC, 2020a) . A severe seasonal influenza has a case fatality rate of approximately 0.1% (Fauci et al., 2020) . Behavioral immune strength (i.e., disgust sensitivity and germ aversion; Haidt et al., 1994; Duncan et al., 2009) varies from individual to individual. Some people are more sensitive to disgust and more germ averse than others. Likewise, individuals vary in the perceived infectability to infectious disease. As different components of the BIS (e.g., disgust, perceived vulnerability to disease) function in different ways, they may diverge in their connections to attitudes about the COVID-19 pandemic. Some evidence has begun to illustrate how these measures are associated with attitudes and behaviors during the COVID-19 pandemic. However, these preliminary findings have been nuanced and inconsistent. Pathogen disgust and perceived infectability have been positively associated with anxiety and concern about COVID-19 as well as engagement in prophylactic behaviors (Makhanova & Shepherd, 2020; Shook et al, 2020; Stangier et al., 2021) . However, in another study, though perceived infectability significantly predicted opinions about the government's response to the pandemic, germ aversion more consistently predicted attitudes towards public health measures (De Coninck et al., 2020) . Some have suggested that disease-threat encourages people to adopt socially conservative values that promote avoidance of out-group members (Terrizzi & Shook, 2016) . From this perspective, prejudicial attitudes (e.g., anti-immigration and prejudice toward sexual minorities) J o u r n a l P r e -p r o o f Journal Pre-proof and the socially conservative values (e.g., right-wing authoritarianism; RWA) that promote them could operate, in part, as a crude means of mitigating the spread of infectious disease by discouraging contact with outgroup members. The BIS has been associated with a wide range of prejudicial attitudes and socially conservative values including anti-immigration, prejudice against gay men and lesbian women, RWA, and in-group favorability and out-group derogation (Hodson, & Costello, 2007 , Navarrete & Fessler, 2006 , Patev et al. 2019 , Terrizzi et al., 2010 . Furthermore, Trump supporters' vaccination concerns increased after being exposed to Trump tweets that depicted his anti-vaccination beliefs (Hornsey et al., 2020) . Given that the BIS has been consistently associated with socially conservative values, some have suggested that such values may operate as culturally constructed disease avoidance strategies (Terrizzi et al, 2013) . On the contrary, the COVID-19 pandemic has presented a different picture of how conservative values relate to disease avoidant attitudes and behavior. Conservatives report wearing masks less frequently; only 49% of conservative Republicans report wearing a mask all the time or most of the time in the past month, while liberal Democrats report 83% (Igielnik, 2020) . In a Pew poll released in June 2020, 63% of Democrats and democratic-leaning independents say that masks should be worn always versus 29% of Republicans and Republican-leaning (Pew Research, 2020). In a survey conducted between March 20-23, 2020, Republicans were less likely than Democrats to comply with CDC-recommended behavior, such as social distancing, and were less concerned about the pandemic (Gadarian et al., 2020) . Political ideology correlated with social distancing compliance, mask-waring compliance, and mask-wearing attitudes, with those more J o u r n a l P r e -p r o o f Journal Pre-proof liberal having more positive attitudes towards masks and wore masks more often compared to conservatives (Xu & Cheng, 2020) . The BIS has also exhibited an inconsistent relationship with disease-avoidant attitudes. Though the BIS is believed to be an evolved solution to the adaptive challenge of infectious disease, people with higher sensitivity to disgust tend to have more negative attitudes about vaccines (Clay, 2017) . Additionally, anti-vaccination attitudes are higher in those that report higher levels of disgust towards needles and blood (Hornsey et al., 2018) . Some data, however, suggest that although disgust sensitivity and germ aversion have an indirect negative effect on vaccine attitudes, they have a direct positive effect on vaccine uptake (Luz et al., 2019) . Pathogen disgust sensitivity is associated with greater belief that vaccines cause autism (Clifford & Wendell, 2016) . Pathogen disgust sensitivity also predicts skepticism of the safety and efficacy of vaccines (Clifford & Wendell, 2016) . Parents that are vaccine hesitant have less trust in physicians and greater sensitivity to both pathogen and sexual disgust (Reuben et al., 2020) . The present aim is to explore how disgust and political ideology relate to disease avoidant attitudes in the time of COVID-19. It is expected that the BIS will be positively associated with COVID-19 relevant disease-avoidant attitudes (e.g., anxiety and knowledge about COVID-19). However, given the previous research linking disgust with negative attitudes toward vaccination, it is believed that the BIS will be positively associated with anti-vaccination attitudes. Though conservative values have been previously thought of as a strategy of disease avoidance, it is J o u r n a l P r e -p r o o f Journal Pre-proof hypothesized that conservative ideology will be ironically inversely related to disease avoidant attitudes. G*Power (Version 3.1; Faul et al., 2007) was used to calculate minimum sample size. To detect a medium effect size using multiple regression with a power of 0.95 and 3 tested predictors, G*Power recommends a sample size of at least n = 119. Participants were recruited through internet flyers. An online survey was sent out between September 2 and October 28, 2020 to students and faculty at three college campuses and posted on various social media websites such as Facebook, Reddit, Tumblr, and Gab. Participants followed the link, read the consent form, and consented to participate. J o u r n a l P r e -p r o o f Journal Pre-proof 8 The Disgust Scale (DS; Haidt et al., 1994) asks how much participants agree with questions on a scale of 1 to 4, 1 being strongly disagree (or not disgusting at all) and 4 being strongly agree (or very disgusting). Sample items from the scale include "I might be willing to try eating monkey meat, under some circumstances." and "You see a man with his intestines exposed after an accident." The Three Domain Disgust Scale (TDDS; Tybur et al., 2009) sample question from the former subscale is "If an illness is 'going around', I will get it;" from the latter, "I prefer to wash my hands pretty soon after shaking someone's hand." The Very Short Authoritarianism Scale (Bizumic & Duckitt, 2018) consists of 6 questions. Participants responded to the items on a scale of 1 (strongly disagree) to 7 (strongly agree). One item is "It's great that many young people today are prepared to defy authority" (reverse scored). The LWA Scale (Costello et al., 2020 ) has participants answer 39 items from 1 (Strongly disagree) to 7 (Strongly agree). The scale consists of three subscales: Anti-hierarchical Aggression, Conventionalism, and Top-down Censorship. An example of an Anti-hierarchical Aggression item is "The rich should be stripped of their belongings and status." An example of a Conventionalism item is "Anyone who opposes gay marriage must be homophobic." Lastly, an example of an item from the Top-down Censorship subscale is "University authorities are right to ban hateful speech from campus." Participants answered three questions on how supportive they are of Donald Trump on a scale of 1 (not at all) to 7 (very much). Sample items include "How supportive are you of Donald Trump?" and "How likely are you to vote for Donald Trump?" Participants answered three questions on how supportive they are of Joe Biden on a scale of 1 (not at all) to 7 (very much). Sample items include "How supportive are you of Joe Biden?" and "How likely are you to vote for Joe Biden?" Anxiety about the coronavirus was measured using the Coronavirus Anxiety Scale (CAS; Lee, 2020) . Participants were asked five questions to indicate how often they have experienced the scale item activities over the last 2 weeks from 0 (Not at all ), to 4 (Nearly every day over the last 2 weeks). An example item is "I felt nauseous or had stomach problems when I thought about or was exposed to information about the coronavirus." J o u r n a l P r e -p r o o f Journal Pre-proof Opinions of pandemic response by public health officials and the CDC were measured with four statements on a scale from 1 (strongly disagree) to 7 (strongly agree). Example items include "The Center for Disease Control (CDC) is doing a good job managing the pandemic," and "I am satisfied with how U.S. public health officials are handling the pandemic." Participants answered 10 questions rating the U.S government's response to the pandemic on a 7-point Likert scale (1 being strongly disagree and 7 being strongly agree). An example item is "overall, the U.S. has done a great job responding to the coronavirus pandemic." Participants were asked how much they agree with four statements on the Trump administration's pandemic response on a scale from 1 to 7; 1 being strongly disagree and 7 being strongly agree. Example items include "I am satisfied with how the Trump administration has responded to the pandemic" and "President Trump has taken appropriate actions to keep Americans safe." Conceivably, participants might have different opinions on how the Trump administration, the government in general, and the CDC and public health officials have handled the pandemic. However, the data shows that opinions on how the government and how the Trump administration have handled the pandemic are very similar and highly correlated (r = .77), so they were combined into a single Government Perception Scale (GPS). Participants were asked four questions on their coronavirus knowledge on a scale of 1 (strongly disagree) and 7 being (strongly agree). A sample of an item is "the coronavirus is more contagious than the flu." J o u r n a l P r e -p r o o f Journal Pre-proof Vaccination attitudes were measured with the VAX scale (Martin & Petrie, 2017) . Participants indicated their agreement of 11 items on a scale of 1 (strongly disagree) to 7 (strongly agree). An example item is "Natural immunity lasts longer than a vaccination." Demographic information collected includes age, region, education, political party affiliation, age, ethnicity, race, gender, religious affiliation, political orientation, and personal experience with the coronavirus. Data and measures can be found at doi.org/10.17605/OSF.IO/KZ3XE. Zero-order correlations between all measures are presented in Table 2 . Disgust measures were not consistently related to COVID-19 attitudes. PVD-PI was the only measure of the BIS that was consistently associated with disease avoidant attitudes. It was negatively correlated with Antivax and positively correlated with CAS and knowledge of the pandemic. Conservative measures (e.g., RWA and Trump support) were consistently negatively associated with disease-avoidant attitudes. Furthermore, they were consistently negatively associated with CAS and COVID-19 knowledge. Likewise, the measures of conservatism were positively correlated with GPS and Antivax. Journal Pre-proof Conservatism significantly predicted less knowledge of the pandemic, greater GPS, greater Antivax, and moderately predicted lower CAS (p = .05). While disgust was shown to be inconsistently related with disease avoidance, when controlling for political ideology and PVD-PI, disgust trends toward significance with knowledge of the pandemic (p = .24). Conservatism significantly predicts most disease avoidance measures, while both disgust and conservatism significantly predicted Antivax. The aim of the present research was to better understand how the BIS and political ideology are related to disease avoidant attitudes during the COVID-19 pandemic. The measures of disgust sensitivity (e.g., DS, TDDS-Pathogen, and TDDS-Sexual) were not consistently correlated with COVID-19 relevant disease avoidant attitudes (e.g., CAS, knowledge and GPS). Likewise, consistent with previous research (e.g., Clay, 2017; Hornsey et al., 2018; Luz et al., 2019) , disgust measures were ironically and consistently, positively related to antivaccination attitudes. PVD-PI was the most consistent BIS measure at predicting disease-avoidant attitudes. PVD-PI correlated positively with coronavirus anxiety, knowledge of the pandemic, and J o u r n a l P r e -p r o o f Journal Pre-proof negatively with antivaccination attitudes and attitudes towards the U.S government's pandemic response. Other BIS measures such as disgust sensitivity were less consistent at predicting pandemic attitudes. A striking divergence for these two variables is that disgust sensitivity positively correlated with anti-vaccination attitudes, while PVD-PI negatively correlated with anti-vaccination attitudes. Measures of conservatism were associated with disease avoidant traits; they correlated positively with some disgust sensitivity measures. However, they were negatively associated with disease avoidant attitudes, such as attitudes towards vaccines, knowledge of the coronavirus, and coronavirus anxiety. In past research, disgust sensitivity has been connected to social conservatism . Additionally, sexual disgust sensitivity (Patev et al. 2019 ) and pathogen disgust sensitivity (Shook, Oosterhoof et al., 2017) have been connected to RWA. The present study was able to replicate the findings that RWA was significantly correlated to sexual disgust sensitivity, but the correlation with pathogen disgust sensitivity did not reach statistical significance (p = .20). Past findings have suggested that conservative ideology may operate as strategy of disease avoidance. However, the present study shows conservatism predicts less knowledge of the pandemic, more favorable opinions of the U.S government's response to the pandemic (despite leading the world in total number of infections and deaths at the time), more negative attitudes toward vaccines, and moderately predicts less coronavirus anxiety. This suggests conservative ideology may not function as a disease-avoidance strategy. Nineteen out of 139 (13.7%) respondents identified as male. The gender composition of the study could influence the results as past research has shown that women typically report higher sensitivity to disgust than men (Druschel & Sherman, 1999) . The present results may be more exaggerated than would be expected from a more gender balanced sample. Males were similarly represented among Republicans (12%). Furthermore, there are inherit limitations associated with research conducted online. Individuals without internet access could not complete the study. Additionally, response fatigue could have influenced the data as there were 169 questions. Lastly, potential participants who are more skeptical of the pandemic and of research in general are less likely to fill out questionnaires about the pandemic, so they would be underrepresented in the sample. The COVID-19 pandemic has presented a valuable opportunity to study how the BIS and political ideology are related to disease avoidant attitudes. The BIS should operate as a reliable disease avoidance mechanism, but attitudes towards disease avoidance were not consistently connected with disgust sensitivity in context of the pandemic. Ironically, disgust sensitivity was connected to antivaccination attitudes. The only BIS measure that was consistently associated J o u r n a l P r e -p r o o f Journal Pre-proof with disease avoidant attitudes was PVD-PI. Pandemic attitudes were clustered along partisan lines, possibly due to politicization. Those who identified more left-wing politically were more anxious about COVID-19, knew more about COVID-19, and lower opinions on the government's pandemic response. In contrast, those who identified as more conservative were less anxious about COVID-19, knew less about COVID-19, and had more favorable opinions on the government's pandemic response. Furthermore, conservatism was consistently correlated with antivaccination attitudes. These results suggest that conservatism does not operate as a disease avoidant strategy. 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