Associations between vaccination and protective behaviors against COVID-19: transfer and redundancy effects as potential psychological mechanisms.

This study aimed to investigate mechanisms explaining associations between vaccination and protective health behaviors during the COVID-19 pandemic. The study used a secondary analysis of data from a longitudinal online study at four time points between April 2020 and March 2021. Two hundred and forty participants responded to questionnaires assessing adherence to multiple COVID-19 protection behaviors, COVID-19 vaccination, behavioral specific outcome expectancies and general healthy lifestyle. Statistical analyses included z statistic for differences between correlations and moderation analysis by the SPSS PROCESS macro. The correlation between initial adherence to protective behaviors prior to availability of vaccination and actual vaccination was positive, but when vaccination was available, the concurrent correlation between these behaviors was null. Healthy lifestyle and outcome expectancies moderated the association between vaccination and adherence to protection behaviors. These results were explained by a 'redundancy effect', conceptualized as beliefs that engagement in specific health behaviors justifies evading other health behaviors. The 'redundancy effect' cancelled the initial positive correlation between vaccination and protective health behaviors, produced by a 'transfer effect', based on similarities between the perceived purposes of those behaviors. Theoretical and practical implications of the findings were discussed.

Is shyness related to depression and suicide risk?

INTRODUCTION: Suicidal behavior is an important health issue, representing a leading cause of mortality, particularly among young adults. Depression was found to be predictive of suicide risk and predicted by shyness. Consequently, we tested a model wherein shyness leads to depression, which in turn leads to suicide risk. Moreover, we expected gender to moderate the effect of shyness on depression and suicide risk. METHODS: A convenience sample of 478 first-year college students (51% women, Age: M = 25.42, SD = 3.61) completed online self-report questionnaires assessing suicide risk, depression, shyness, and demographic variables. RESULTS: As expected, shyness was significantly correlated with depression (r = 0.40) and suicide risk (r = 0.24), and depression and suicide risk were also correlated with each other (r = 0.57). Depression statistically mediated the relationship between shyness and suicide risk (indirect effect for women = 0.92, SE = 0.16; for men = 0.72, SE = 0.17). Gender did not moderate the mediation effect. However, a direct link between shyness and suicide risk was found only among men (direct effect = 0.52, SE = 0.21). CONCLUSIONS: The results suggest that shyness may be a significant factor in the development of depression and suicide risk, potentially serving as a valuable marker for identifying at-risk individuals. Moreover, clinicians should be aware of these associations, particularly among men, in order to maintain and support mental health as well as reduce suicidality.

Belief in a just world and organisational loyalty: Trust as an underlying mechanism.

This research examined whether employees' personal belief in a just world (BJW) is associated with their organisational loyalty and whether this relationship is statistically mediated by organisational trust. To test these hypotheses, we conducted two studies with employees from China (study 1, N = 314) and Germany (study 2, N = 189). The results from both studies supported the proposed model. In addition, study 2 revealed that the relationship between BJW and organisational loyalty persisted when controlling for global personality traits. These suggest that managers and organisations may increase employees' loyalty by providing an environment that fosters their sense of justice and trust.

Using Protection Motivation Theory to Predict Adherence to COVID-19 Behavioral Guidelines.

COVID-19 has become a global pandemic. Throughout most of the pandemic, mitigating its spread has relied on human behavior, namely on adherence to protective behaviors (e.g., wearing a face mask). This research proposes that Protection Motivation Theory (PMT) can contribute to understanding differences in individual adherence to COVID-19 behavioral guidelines. PMT identifies four fundamental cognitive components that drive responses to fear appeals: perceptions of susceptibility (to the disease), severity (of the disease), self-efficacy (to protect oneself), and response efficacy (i.e., recommended behaviors' effectiveness). Two online self-report studies assessed PMT components' capacity to predict adherence to protective behaviors concurrently and across culturally different countries (Israel, Germany, India; Study 1), and again at six-week follow-up (Israeli participants; Study 2). Study 1's findings indicate excellent fit of the PMT model, with about half of the variance in adherence explained. No significant differences were found between participants from Israel (n = 917), Germany (n = 222) and India (n = 160). Study 2 (n = 711) confirmed that PMT components continue to predict adherence after six weeks. In both studies, response efficacy was the PMT component most strongly associated with adherence levels. This study demonstrates that PMT can serve as a theoretical framework to better understand differences in adherence to COVID-19 protective behaviors. The findings may further inform the design of adherence-promoting communications, suggesting that it may be beneficial to highlight response efficacy in such messages.

Core self-evaluations as resilience and risk factors of psychological distress during the COVID-19 pandemic.

In view of the grave consequences of distress reactions to the COVID-19 pandemic, this study investigated CSE (Core Self-evaluations) - internal/external health locus of control, generalized self-efficacy and trait optimism - and intolerance of uncertainty as potential correlates of distress reactions. We conducted an online questionnaire-based cross-sectional study with 422 Israeli respondents. Pandemic-related distress was defined by perceived stress, negative and positive affect, and worries. Predictors were: health locus of control, generalized self-efficacy, trait optimism, and intolerance of uncertainty. The findings show that CSEs and intolerance of uncertainty added between 11% (to perceived stress) and 22% (to negative affect) of explained variance beyond the background variables. Specifically, higher trait optimism and generalized self-efficacy were associated with less distress, and greater intolerance of uncertainty was correlated with higher distress. In conclusion, the CSE framework is useful for explaining psychological distress during the COVID-19 pandemic. Beyond their theoretical contribution, the findings may have practical implications for increasing resilience and ameliorating distress during a pandemic.

Vaccination Against COVID-19: A Longitudinal Trans-Theoretical Study to Determine Factors that Predict Intentions and Behavior.

BACKGROUND: Despite the clear benefits of vaccination, their uptake against common infectious diseases is suboptimal. In December 2020, vaccines against COVID-19 became available. PURPOSE: To determine factors that predict who will take the COVID-19 vaccine based on a conceptual model. METHODS: An online survey was administered twice: prior to public vaccination, and after vaccinations were available. Participants were 309 Israelis with initial data and 240 at follow-up. Baseline questionnaires measured intentions to be vaccinated and hypothesized predictors clustered in four categories: background, COVID-19, vaccination, and social factors. Self-reported vaccination uptake was measured at follow-up. RESULTS: Sixty-two percent of the sample reported having been vaccinated. Intentions were strongly associated with vaccination uptake and mediated the effects of other predictors on behavior. Eighty-six percent of the variance in vaccination intentions was explained by attitudes toward COVID-19 vaccination, regret for having declined vaccination, trust in vaccination, vaccination barriers, past flu vaccination, perceived social norms, and COVID-19 representations. CONCLUSIONS: Beliefs related directly to the COVID-19 vaccine explained most of the variance in intentions to vaccinate, which in turn predicted vaccination uptake.

Patterns of health lifestyle behaviours: findings from a representative sample of Israel.

BACKGROUND: Researchers are increasingly acknowledging the importance of understanding patterns of engagement in multiple, as opposed to isolated, health behaviours. Accordingly, several studies, targeting various geographical regions, have begun to identify and characterize unique classes of individuals in terms of their engagement in health behaviours, towards gaining insights that might guide tailored health interventions. Our study extends this stream of research to the Israeli context, as well as examines whether certain sociodemographic characteristics tend to be associated with affiliation to a specific group of individuals, i.e., class membership. METHODS: Two large representative samples were obtained from the 2010 and 2017 National Social Surveys of the Israel Central Bureau of Statistics. Latent Class Analysis was used to identify different classes, based on levels of engagement in five health behaviours: fruit-and-vegetable consumption, physical activity, smoking avoidance, sleep, and influenza vaccination. Multinomial logistic regression was applied to test the associations between sociodemographic characteristics (age, gender, religion, education level) and class membership. RESULTS: We identified three distinct classes (denoted "healthy", "unhealthy", and "mixed"). Overall, the "healthy" class was characterized by healthy levels of fruit-and-vegetable consumption and physical activity, a low rate of currently-smoking individuals, and a high proportion of influenza vaccination. The "mixed" class was characterized by healthy levels of fruit-and-vegetable consumption and sleep duration, moderate levels of physical exercise, a high proportion of currently light smokers, and a low rate of vaccination. The "unhealthy" class was marked by relatively low levels of engagement in health behaviours. Generally, older, Jewish, and more-educated individuals were more likely to belong to the "healthy" class, while young, non-Jewish, and less-educated individuals were more likely to belong to the "unhealthy" class. We further identified differences between the 2010 and 2017 samples (e.g., differences in men's likelihood of being in the "unhealthy" class), suggesting that some behavioural patterns might have changed over time. CONCLUSION: This research identified three classes of engagement in health behaviours across two large and representative samples. Moreover, the classes were associated with unique sociodemographic characteristics. Consequently, our findings can highlight health-behavioural patterns relevant to different sub-populations that should be considered in public health interventions.

The Association Between Healthy Lifestyle Behaviours and Coronavirus Protective Behaviours.

BACKGROUND: Based on models of cross-behavioural associations and the role of past behaviour in predicting behaviour, an association was hypothesized between healthy lifestyle behaviours prior to the COVID-19 pandemic and adherence to coronavirus protective behaviours. Self-assessed health was also examined as a potential moderator. METHODS: A cross-sectional sample (N = 463) completed online questionnaires during a COVID-19-related lockdown that measured engagement in healthy lifestyle behaviours (e.g., exercising and eating fruits and vegetables), adherence to coronavirus protective behaviours (e.g., wearing a face mask and practicing social distancing), and self-assessed health (subjective evaluation of overall health). RESULTS: As predicted, higher engagement in healthy lifestyle behaviours prior to the pandemic was significantly correlated with higher adherence to coronavirus protective behaviours (Pearson r(459) = .308, p < .001). Adherence levels were higher than engagement in healthy lifestyle behaviours, and self-assessed health was related to the latter but not to the former. Moderation was examined using model 1 in PROCESS for SPSS; as expected, the association was stronger among individuals with higher levels of self-assessed health (coefficient 95% CI [.04, .20]). CONCLUSIONS: The findings highlight cross-behavioural facilitating processes, specifically between lifestyle behaviours and adherence to recommended protective behaviours during the pandemic. They also draw attention to the need to address individuals whose poorer evaluations of their general health might prevent them from implementing their behavioural intentions.

Connectionism and Behavioral Clusters: Differential Patterns in Predicting Expectations to Engage in Health Behaviors.

Background: The traditional approach to health behavior research uses a single model to explain one behavior at a time. However, health behaviors are interrelated and different factors predict certain behaviors better than others. Purpose: To conceptualize groups of health behaviors as memory events that elicit various beliefs. A connectionist approach was used to examine patterns of construct activation related to expectations to engage in health behavior clusters. Methods: A sample of lay people (N = 1,709) indicated their expectations to perform behaviors representing four clusters (Risk Avoidance, Nutrition & Exercise, Health Maintenance, and General Well-Being) and rated them on 14 constructs obtained from health behavior literature. Results: Expectations to engage in all behavioral clusters were significantly and positively associated with "frequency of performance," "perceived behavioral control," and "anticipated regret," and negatively associated with "effort." However, each behavioral cluster was also predicted by activation of a unique pattern of predictors. Conclusions: A connectionist approach can be useful for understanding how different patterns of constructs relate to specific outcomes. The findings provide a rationale for lay people's cognitive schema of health behaviors, with each behavioral cluster possessing characteristics associated with distinct predictors of expectations to engage in it. These unique activation patterns point to factors that may be particularly significant for health interventions targeting different clusters of health behaviors.

Can Belief in a Just World Buffer Mood and Career Prospects of People in Need of Risk Protection? First Experimental Evidence.

Research indicates that individuals high in belief in a just world (BJW) are confident that they will not fall victim to unforeseeable disasters. The current study tested the hypothesis that BJW acts as buffer that serves to sustain mood and career prospects of those in need of risk protection. Threat was manipulated by confronting participants with risks regarding their career outlook, and individual differences in threat perception were measured by degree of uncertainty tolerance. As hypothesized, BJW helped protect the mood of participants threatened by serious career-related risks who were unable to tolerate uncertainty. The finding supported the buffer hypothesis regarding mood, but not career prospects, possibly due to a more conscious mindset or variability in self-efficacy. However, BJW was overall positively associated with career prospects. Moreover, it was suggested that BJW can also serve as a personal resource, not only protecting from risk, but also enhancing mood among those with high uncertainty tolerance.

Justice perceptions and well-being: Belief in a just world is a personal resource and a coping resource.

Although the perception of justice is a core need of all individuals, the adaptive value of belief in a just world (BJW)-in everyday life and when facing severe distress-has been typically investigated in separate studies. In this article, we tested, in only one study, the possibility that BJW can be a personal resource and a coping resource. We analysed data from the European Social Survey comprised of random representative samples of 27 European countries (N = 24,776 participants). We considered distressing circumstances both at an individual level (health impairment and financial difficulty) and at a macroeconomic contextual level. The results showed that for people both facing and not facing financial or health-related distress, BJW was positively associated with well-being, supporting BJW as a personal resource. Furthermore, we found that the decrease of well-being of people facing distress, both at an individual level and at a contextual level, compared to people not facing distress, was lower for individuals with higher BJW than for individuals with lower BJW, supporting BJW as a coping resource.

Predicting adherence to COVID-19 behavioural guidelines: a comparison of Protection Motivation Theory and the Theory of Planned Behaviour.

OBJECTIVE: To compare the utility of Protection Motivation Theory (PMT) and the Theory of Planned Behaviour (TPB) for understanding diversity in adherence to COVID-19 behavioural guidelines. METHODS AND MEASURES: A representative sample (N = 600) completed two online questionnaires: One that included measurements of PMT and TPB components that predict behaviour, and another (after one week) consisting of adherence to COVID-19 behavioural guidelines. TPB was represented by a single model, while PMT was represented by three models: Model 1, which did not include a measure of protection motivation; Model 2, which included protection motivation - represented by behavioural intentions; and Model 3, which was similar to Model 2 and included a direct link from self-efficacy to behaviour. RESULTS: The TPB model displayed the best fit-to-complexity ratio (i.e. information criterion), and its capacity to explain adherence was similar to PMT Models 1 and 2, but lower than Model 3. CONCLUSION: The findings highlight the need to reach a consensus regarding the definition and measurement of protection motivation. While the TPB model exhibited superior fit-to-complexity ratio, variance was better explained when self-efficacy was included, and interventions may benefit from targeting different constructs depending on the context.

Making sense of COVID-19: a longitudinal investigation of the initial stages of developing illness representations.

OBJECTIVES: To describe and explain peoples' developing threat appraisal and representations of the novel illness COVID-19 over the first months of the pandemic. The Common-Sense Model of illness perceptions provided the theoretical framework. DESIGN: A cross-sectional study with 511 respondents and a follow-up study 4 months later on 422 respondents completing an online survey measuring demographic factors, media consumption, self-assessed health, experience with the disease, health anxiety, COVID-19 threat, worries and cognitive and emotional illness representations. RESULTS: Health anxiety, media consumption, female gender, lower self-assessed health, knowing a deceased COVID-19 patient and being infected explained variance in threat appraisal. Worries represented 2 factors: psychosocial and existential. Threat appraisal and worries explained variance in illness representations. Representations of the disease worsened and started stabilizing over time. Emotional representations were exceptionally stable and explainable by threat appraisals. CONCLUSIONS: These studies revealed the initial stages of developing representations of a new disease in the context of the COVID-19 pandemic. Gaining insights into those representations is key to understanding, predicting and modifying behavioral and mental responses to the pandemic.

COVID-19 state anxiety of older adults: effects of defensive information processes.

BACKGROUND AND OBJECTIVES: To explore coping processes used by adults aged 60 and above (defined as high age-related risk group) in reaction to the COVID-19 threat, and the associations between these processes and state anxiety. DESIGN AND METHODS: A cross-sectional study with 498 respondents of an online survey, 72 (15%) in the high age-related risk group. Questionnaires measured: background variables, state anxiety, and COVID-19 related perceptions. RESULTS: The high age-related risk group perceived the coronavirus as more severe, their belongingness to a risk group as higher, and the behavioral recommendations as more effective compared to the low age-related risk group. The part of perceived vulnerability that is not explained by belonging to an age-related risk group (defined as residual perceived vulnerability) was lower in the high age-related risk group. Mediation analysis indicated that the high (compared to the low) age-related risk group had lower anxiety levels, and that this effect was mediated by lower residual perceived vulnerability and higher perceived disease severity levels. CONCLUSIONS: The higher age-related risk group maintains a relatively moderate level of anxiety without denying their belonging to a high risk group. This can be explained by defensive processing of COVID-19 related information and by developmental processes.

The Effect of Pre-operative Psychological Interventions on Psychological, Physiological, and Immunological Indices in Oncology Patients: A Scoping Review.

Introduction: The stressful pre-operative period exerts a profound impact on psychological, physiological and immunological outcomes. Oncological surgeries, in particular, elicit significantly higher stress responses than most other surgeries. Managing these responses through psychological interventions may improve long-term outcomes. The purpose of the current research was to review studies that have explored pre-operative psychological interventions in cancer patients in order to map the types of current interventions and provide an initial assessment of whether these interventions improved psychological, physiological, and/or immunological indices as well as long-term cancer outcomes. Methods: A systematic literature search for studies that included pre-operative psychological interventions in oncology patients was conducted, using the databases PubMed and Web of Science. Inclusion criteria included studies pertaining to oncological surgery in adults, study designs that included a clearly defined pre-operative psychological intervention and control group. Results: We found 44 studies, each using one of the following interventions: psychoeducation, cognitive interventions, relaxation techniques, integrated approaches. All the studies reported improved immediate post-operative psychological, physiological, and/or immunological outcomes. Only a few studies addressed long-term cancer outcomes, and only one reported improved survival. Conclusions: Research on pre-operative interventions with cancer patients is missing systematic methods. Studies provide varying results, which makes it difficult to compare them and reach reliable conclusions. There is considerable heterogeneity in the literature regarding the specific intervention used, the timing of intervention, the characteristics of the patients studied and the outcome measures. In order to improve research in this field, including the measurement of long-term outcomes, we suggest some steps that should be taken in further research.

Who deserves to be sick? An exploration of the relationships between belief in a just world, illness causal attributions and their fairness judgements.

This research explored relationships between beliefs about justice, illness causal attributions and fairness judgements of those causes. Participants (n = 200) completed questionnaires assessing their belief in a just world (BJW) and measuring causal attributions and fairness judgements for 42 illness causes classified into behavioural, environmental and hidden (genetic, mystic, psychosocial) categories. As predicted, BJW was correlated positively with all fairness judgements, but with none of the illness causal attributions. Behavioural causes of illness were judged to be fairer than environmental causes, which were judged fairer than hidden causes. Finally, for environmental and hidden causes (uncontrollable illness attributions), positive correlations between causal attributions and their corresponding fairness judgements were found only among participants with high BJW. Implications of these findings for decision makers and health professionals are discussed, with emphasis on the need to consider the combined effect of causal attributions and BJW on illness fairness judgements.

Associations between self-rated health and depressive symptoms among older adults: Does age matter?

OBJECTIVE: It has been suggested that self-rated health (SRH), a construct of overall subjective health, is predicted by depressive symptoms. However, depressive symptoms were also found to predict SRH. The present study aimed to simultaneously examine these alternatives as well as test the potential moderating role of age. METHODS: Data concerning self-reported measures from two consecutive waves of the Survey of Health, Aging and Retirement in Europe (SHARE) were examined by using a longitudinal cross-lagged panel analysis. RESULTS: The model that included the effects of both paths, i.e. from SRH to depressive symptoms and from depressive symptoms to SRH, demonstrated better fit than models including one or no cross-lagged paths. However, the longitudinal effect of SRH on depressive symptoms was stronger than the longitudinal effect of depressive symptoms on SRH, particularly among adults aged 65-79. The longitudinal effect of depressive symptoms on SRH was stronger among individuals aged 80 and older, compared with younger ages. CONCLUSIONS: Bidirectional effects may exist between SRH and depressive symptoms among adults aged 50 and older. Special attention should be paid to the unique effects of SRH on depressive symptoms in the years following retirement and also to depressive symptoms on SRH among the old-old.

Personal Belief in a Just World and Conscientiousness: A meta-analysis, facet-level examination, and mediation model.

Extensive research efforts have been devoted to understanding the nature of Conscientiousness, the only Big Five personality trait that has been robustly linked to professional achievement and longevity. We proposed that Conscientiousness is associated with Personal Belief in a Just World (PBJW), that is, the extent to which an individual believes that her or his efforts will be rewarded. To investigate this proposition, we undertook a meta-analysis synthesizing past findings regarding the relationship between PBJW and Conscientiousness; we confirmed a positive relationship between the two constructs (r = .16) based on 17 samples and 5,810 individuals. We further proposed a theoretical framework linking PBJW to specific facets of Conscientiousness. A survey of a representative sample of the US population (n = 311) confirmed that PBJW is positively correlated with the specific facets of Self-efficacy, Achievement-striving, and Self-discipline. Internal Locus of Control mediated these associations, elucidating the underlying processes linking PBJW and Conscientiousness.

Can Personality Traits Predict Depression during the COVID-19 Pandemic?

The emotional costs of the COVID-19 pandemic have raised concerns among clinicians and scholars. The goal of the current study was to test whether or not neuroticism, conscientiousness, and personal belief in a just world are associated with depression during the COVID-19 pandemic. Moreover, the contribution of neuroticism and conscientiousness was assessed over and above demographic variables and COVID-19 perceptions, and the unique contribution of personal belief in a just world was evaluated beyond all the other study variables. Samples were collected in three different countries-Israel (N = 917), Germany (N = 213), and India (N = 160). Online self-report questionnaires were utilized to measure age, gender, COVID-19 perceptions (probability, severity, and self-efficacy), neuroticism, conscientiousness, personal belief in a just world, and depression. The findings indicated that, across the three countries, neuroticism was positively associated with depression (correlations ranging from .24 to .44), and conscientiousness and personal belief in a just world were negatively associated with depression (correlations ranging from - .31 to - .21, and from - .35 to - .23, respectively). Moreover, neuroticism and conscientiousness explained unique variance over and above demographic variables and COVID-19 perceptions (except conscientiousness in India), and the effect of personal belief in a just world on depression was significant beyond the effects of all other study variables. These findings support the role of personality in explaining depression regardless of situational characteristics and stress the role of just world beliefs as protective factors against negative emotions.

Adherence to COVID-19 protective behaviors: A matter of cognition or emotion?

OBJECTIVES: To compare the relative strengths of cognitive and emotional factors in explaining variance in adherence to recommendations for protective health behaviors against the coronavirus disease 2019 (COVID-19). DESIGN: A longitudinal (4-month) study with 422 participants who completed an online survey assessing cognitive factors: perceptions of the severity of the disease, vulnerability to it, and the effectiveness of the protective behavior recommendations against it. The emotional factors investigated were: trait health anxiety, worries, and anxiety related to COVID-19. RESULTS: Adherence and perceived behavior efficacy decreased over time, while perceived vulnerability and worries increased. Regression analyses showed a clear predictive advantage of beliefs about the efficacy of adherence to protective behaviors. CONCLUSIONS: The findings support the "cognitive approach" to explaining pandemic-related behaviors, particularly the key role of perceived efficacy of behavior recommendations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).