Predicting health behaviors during the COVID-19 pandemic: A longitudinal study.

We investigated the social, emotional, and cognitive predictors of adherence to four health behaviors (handwashing, mask wearing, social contact limitations, and physical distancing) during one critical phase of the COVID-19 pandemic. We collected data (N = 5803, mean age = 53; 57% women) in Belgium at five time points between April and July 2021, a time during which infections evolved from high (third wave of the pandemic) to low numbers of COVID-19 cases. The results show that the social, emotional, and cognitive predictors achieved high levels of explained variance (R2 > .60). In particular, the central components of behavioral change (attitudes, intentions, control, habits, norms, and risk) were the strongest and most consistent predictors of health behaviors over time. Likewise, autonomous motivation and empathetic emotions (e.g., attentive, compassionate) had a positive impact on health behavior adherence, whereas it was the opposite for lively emotions (e.g., active, enthusiastic). These results offer policymakers actionable insights into the most potent and stable factors associated with health behaviors, equipping them with effective strategies to curtail the spread of future infectious diseases.

Risk perception as a motivational resource during the COVID-19 pandemic: the role of vaccination status and emerging variants.

BACKGROUND: People's perceived risk of being infected and having severe illness was conceived as a motivational source of adherence to behavioral measures during the COVID-19 crisis. METHODS: We used online self-reported data, spanning 20 months of the COVID-19 crisis in Belgium (n = 221,791; 34.4% vaccinated; July 2020 - March 2022) to study the association between risk perception and motivation. RESULTS: Both perceived infection probability and severity fluctuated across time as a function of the characteristics of emerging variants, with unvaccinated persons perceiving decreasingly less risk compared to vaccinated ones. Perceived severity (and not perceived probability) was the most critical predictor of autonomous motivation for adherence to health-protective measures, a pattern observed at both the between-day and between-person level among both vaccinated and unvaccinated individuals. An integrated process model further indicated that on days with higher hospitalization load, participants reported being more adherent because risk severity and autonomous motivation for adherence were more elevated on these days. CONCLUSIONS: These findings suggest that risk severity served as a critical and dynamic resource for adherence to behavioral measures because it fostered greater autonomous regulation.

The role of self-compassion in loneliness during the COVID-19 pandemic: a group-based trajectory modelling approach.

Research has suggested an increase in loneliness during the COVID-19 pandemic, but much of this work has been cross-sectional, making causal inferences difficult. In the present research, we employed a longitudinal design to identify loneliness trajectories within a period of twelve months during the COVID-19 pandemic in Belgium (N = 2106). We were particularly interested in the potential protective role of self-compassion in these temporal dynamics. Using a group-based trajectory modelling approach, we identified trajectory groups of individuals following low (11.0%), moderate-low (22.4%), moderate (25.7%), moderate-high (31.3%), and high (9.6%) levels of loneliness. Findings indicated that younger people, women, and individuals with poor quality relationships, high levels of health anxiety, and stress related to COVID-19, all had a higher probability of belonging to the highest loneliness trajectory groups. Importantly, we also found that people high in two of the three facets of self-compassion (self-kindness and common humanity) had a lower probability of belonging to the highest loneliness trajectory groups. Ultimately, we demonstrated that trajectory groups reflecting higher levels of loneliness were associated with lower life satisfaction and greater depressive symptoms. We discuss the possibility that increasing self-compassion may be used to promote better mental health in similarly challenging situations.

Psychological need fulfillment as a source of resilience: Its protective role in concerns and symptoms of anxiety and depression during the COVID-19 pandemic.

The essential role of the psychological needs for autonomy, competence, and relatedness in well-being has been demonstrated convincingly. Yet whether their fulfillment also serves as a source of resilience in the face of adversity has received limited attention. A longitudinal sample of Belgian citizens (N = 1869; Mage = 56.23, 68% female) completed an online questionnaire on 13 occasions between April 2020 and April 2022 during the COVID-19 crisis. Multilevel analyses showed that need fulfillment, both at the between- and within-person level, related negatively to concerns, even after controlling for exposure to personal risks. Further, the association between concerns and changes in symptoms of depression and anxiety was dampened when people reported higher need fulfillment compared with others (i.e. between-person level) or when they reported periodically more need fulfillment than usual (i.e. within-person level). This moderation effect occurred on top of the systematic negative main effect of need fulfillment on symptoms of anxiety and depression. Psychological need fulfillment serves as a resilience factor (a) by reducing concerns in the face of adverse events (i.e. an appraisal effect) and (b) by mobilizing resources that help individuals to deal better with concerns (i.e. a coping effect). Theoretical and practical implications of the resilience effect of need fulfillment are discussed.

Trajectories of health behaviors during the COVID-19 pandemic: a longitudinal analysis of handwashing, mask wearing, social contact limitations, and physical distancing.

AIM: This study aimed to investigate the associations between health behavior adherence and psychological factors during the COVID-19 pandemic, with a particular focus on identifying trajectories of handwashing, mask wearing, social contact limitations, and physical distancing. METHODS: We employed a multi-trajectory group-based approach to analyze data from 6026 Belgian residents, including 60% women, with an average age of 52.65. Data were collected over six waves spanning from April 2021 to December 2021. RESULTS: Participants were categorized into trajectory groups based on persistently low (11.9%), moderate-low (20.9%), moderate-high (39.1%), and high (28.1%) levels of adherence to the specified health behaviors. Our findings indicate a declining trend in health behavior adherence over the study period. Additionally, we observed that females, older individuals, and those with prior COVID-19 infection had a higher likelihood of belonging to trajectory groups characterized by the highest levels of health behavior adherence. Similarly, individuals with positive vaccination intentions, a heightened perception of consequences, and increased health anxiety demonstrated greater adherence to health behaviors over time. Furthermore, our investigation into the relationship between health behaviors and mental health revealed that participants in trajectory groups with higher levels of adherence to social contact limitations and physical distancing reported increased feelings of loneliness and decreased life satisfaction. CONCLUSIONS: The COVID-19 pandemic has reshaped our lives, and while vaccines have marked progress, maintaining health behaviors is crucial for virus prevention. To address potential mental health challenges from sanitary measures, policies and communication should promote health behaviors while acknowledging their psychological impact.

The new measures of interoceptive accuracy: A systematic review and assessment.

Conscious interoception, the perception of internal bodily states, is thought to contribute to fundamental human abilities (e.g., decision-making and emotional regulation). One of its most studied dimensions is interoceptive accuracy: the objective capacity to detect internal bodily signals. In the past few years, several labs across the world have started developing new tasks aimed at overcoming limitations inherent in classical measures of interoceptive accuracy. In this systematic review, we identified these tasks (since 2015) for the cardiac, respiratory, and gastrointestinal domains. For each identified task, we discuss their strengths and weaknesses, and make constructive suggestions for further improvement. In the general discussion, we discuss the (potentially elusive) possibility of reaching high validity in the measurement of interoceptive accuracy. We also point out that interoceptive accuracy may not be the most critical dimension for informing current theories, and we encourage researchers to investigate other dimensions of conscious interoception.

Discrepancies in the Definition and Measurement of Human Interoception: A Comprehensive Discussion and Suggested Ways Forward.

Interoception has been the subject of renewed interest over the past 2 decades. The involvement of interoception in a variety of fundamental human abilities (e.g., decision-making and emotional regulation) has led to the hypothesis that interoception is a central transdiagnostic process that causes and maintains mental disorders and physical diseases. However, interoception has been inconsistently defined and conceptualized. In the first part of this article, we argue that the widespread practice of defining interoception as the processing of signals originating from within the body and limiting it to specific physiological pathways (lamina I spinothalamic afferents) is problematic. This is because, in humans, the processing of internal states is underpinned by other physiological pathways generally assigned to the somatosensory system. In the second part, we explain that the consensual dimensions of interoception are empirically detached from existing measures, the latter of which capture loosely related phenomena. This is detrimental to the replicability of findings across measures and the validity of interpretations. In the general discussion, we discuss the main insights of the current analysis and suggest a more refined way to define interoception in humans and conceptualize its underlying dimensions.

Individual and collective factors influencing consumer attitudes and behaviour towards edible insects in Kinshasa: a pilot study.

Background: More than 300 peoples in the world consume edible insects either as a component of the traditional diet, or in the event of famine. Despite the benefits of insects, their acceptance by some consumers as a source of human food remains the main obstacle to their consumption. The present study focuses on the consumption of edible insects in the Kinshasa city (DRCongo) in a context of food crisis and shortage. Methods: The study examined individual (attitudes, perceived control, intent); collective factors (subjective norms); context of consumption and emotional factors that influence insect consumption. A semi-directive interview study based on the theory of planned behaviour was conducted among 60 participants. Results: The results showed that the consumption is a common practice in the study area, but that its frequency is influenced by factors related to the individual, such as participants' positive attitudes towards insect consumption and ease of obtaining edible insects. The consumption of insects is also influenced by collective factors, such as family, friends, etc. The taste of insects, contextual factors such as family consumption, nutritional intake, habit and belonging to some specific tribes were related to greater consumption. Negative emotions, such as fear, insect characteristics or lack of knowledge about edible species were related to reduced consumption. Conclusions: The results suggest that there is a need to implement interventions that focus specifically on changing certain attitudes.

Who is motivated to accept a booster and annual dose? A dimensional and person-centered approach.

The transmissibility of new COVID-19 variants and decreasing efficacy of vaccines led authorities to recommend a booster and even an annual dose. However, people's willingness to accept new doses varied considerably. Using two independent longitudinal samples of 4596 (Mean age = 53.6) and 514 (Mean age = 55.9) vaccinated participants, we examined how people's (lack of) vaccination motivation for their first dose was associated with their intention to get a booster (Sample 1) and an annual dose (Sample 2) several months later (Aim 1). We also aimed to capture the impact of the motivational heterogeneity on these intentions by capitalizing on participants' different motivational profiles collected at baseline (Aim 2). Across both samples, autonomous motivation, controlled motivation, and distrust-based amotivation were uniquely related to, respectively, higher, lower, and even lower booster and annual dose intentions. Further, a two-step clustering procedure revealed five profiles, with the profiles characterized by higher autonomous motivation (i.e. Good Quality and High Quantity profiles) reporting the highest vaccination intentions and the profile characterized by the highest number of obstacles (i.e. Global Amotivated profile) yielding the lowest vaccination intentions. These results stress the critical need to support citizens' volitional endorsement of vaccination to harvest long-term benefits with respect to COVID-19.

Predicting Compliance with Sanitary Behaviors among Students in Higher Education During the Second COVID-19 Wave: The Role of Health Anxiety and Risk Perception.

To limit the spread of COVID-19, public authorities have recommended sanitary behaviors such as handwashing, mask-wearing, physical distancing, and social distancing. We recruited a large sample of higher education students in Belgium (N = 3201-3441) to investigate the role of sociodemographic variables, mental health, previous COVID-19 infections, academic involvement, and risk perception on adherence to these sanitary behaviors. This cross-sectional study took place during the second COVID-19 wave in Belgium, between February and March 2021. Analyses showed that living alone, being female, later in the academic curriculum, having higher general and health anxiety, higher academic involvement, and higher risk perception were positively associated with adherence to the four aforementioned sanitary behaviors. Conversely, previous infection with COVID-19 and having been quarantined were negative predictors. Our results show a set of predictors highly similar for the four sanitary behaviors. We discuss potential initiatives to increase adherence to sanitary behaviors in this group of highly educated youngsters.

A novel self-report scale of interoception: the three-domain interoceptive sensations questionnaire (THISQ).

OBJECTIVES: The self-reported perception of bodily sensations is assumed predictive for health and disease. Existing questionnaires mostly focus on aversive sensations, and associated emotions and cognitions, which potentially confounds associations between interoception and illness. Therefore, we developed the Three-domain Interoceptive Sensations Questionnaire (THISQ), assessing self-reported perception of neutral respiratory, cardiac, and gastroesophageal sensations. DESIGN: Using cross-sectional surveys, we developed and validated the THISQ. MAIN OUTCOME MEASURES: In Sample 1 (n = 357), a pool of 28 Dutch items was subjected to exploratory factor analysis. Eighteen items with a primary factor loading >.40 were retained for confirmatory factor analysis in Sample 2 (n = 374) and Sample 3 (n = 484) for the validation of the Dutch and English questionnaire, respectively. RESULTS: Analyses supported the 3-factor solution: cardiorespiratory activation, cardiorespiratory deactivation, and gastroesophageal sensations. Scales showed acceptable to good internal consistency. Convergent validity was confirmed by significant medium associations between THISQ scores and other self-report measures of interoception. Divergent validity was supported by non-significant or small associations with measures of negative affectivity and symptom-related anxiety. CONCLUSION: Our findings suggest that the Dutch and English THISQs are valid and reliable self-report measures of interoception, which could advance our understanding of interoceptive processes in health and disease.Supplemental data for this article is available online at https://doi.org/10.1080/08870446.2021.2009479 .

How do vaccination intentions change over time? The role of motivational growth.

OBJECTIVE: Across nationwide rollout of COVID-19 vaccination, people in Belgium differed widely in their vaccination intention. In the present study, we examined (a) how people's vaccination intentions changed during the vaccination rollout and (b) whether changes in motivation (i.e., autonomous, controlled, and distrust-based (a)motivation) predicted changes in vaccination intention, thereby taking into account people's vaccination intention at baseline. METHOD: Using 4 subsamples of participants who were vaccinated at different time points (ntotal = 10,799) between December 2020 and June 2021; we used latent change modeling and latent growth curve modeling to examine the associations among initial levels and changes in vaccination motivation and vaccination intention. RESULTS: Across subsamples, changes in vaccination intention were found to be qualified by changes in motivation. An increase in autonomous motivation was related to a positive shift in vaccination intention, while an increase in both controlled motivation and distrust-based amotivation was related to a negative shift in vaccination intention. Moreover, autonomous motivation predicted especially an increase in vaccination intention among those initially low in vaccination intention, whereas an increase in either controlled motivation or distrust-based amotivation especially predicted a decrease in vaccination intention among those initially high in vaccination intention. CONCLUSIONS: Findings suggest that a growing sense of ownership and a reduction in distrust is critical for individuals to develop a stronger intention to get vaccinated, particularly when people had initially low vaccination intentions. We discuss conceptual, methodological, and practical implications. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Role of Communication Style and External Motivators in Predicting Vaccination Experiences and Intentions: An Experimental Vignette Study.

This vignette-based study examined in a sample of unvaccinated Belgian citizens (N = 1918; Mage = 45.99) how health care workers could foster reflection about and intentions to get vaccinated against COVID-19 by experimentally varying their communication style (i.e., autonomy-supportive vs. controlling) and the reference to external motivators (i.e., use of a monetary voucher or corona pass vs. the lack thereof). Each participant was randomly assigned to one of six conditions and rated a vignette in terms of anticipated autonomy satisfaction, perceived effectiveness, reflection, and vaccination intention. An autonomy-supportive, relative to a controlling, communication style predicted greater autonomy need satisfaction, which in turn related positively to perceived effectiveness, reflection, and vaccination intention. External motivators failed to generate positive effects compared to the control condition. The findings highlight the critical role of autonomy support in promoting a self-endorsed decision to get vaccinated.

How the Stringency of the COVID-19 Restrictions Influences Motivation for Adherence and Well-Being: The Critical Role of Proportionality.

BACKGROUND: The stringency of the measures taken by governments to combat the COVID-19 pandemic varied considerably across countries and time. In the present study, we examined how the proportionality to the epidemiological situation is related to citizens'behavior, motivation and mental health. METHODS: Across 421 days between March 2020 and March 2022, 273,722 Belgian participants (Mage = 49.47; 63.9% female; 33% single) completed an online questionnaire. Multiple linear mixed regression modeling was used to examine the interaction between the epidemiological situation, as indicated by the actual hospitalization numbers, and the stringency index to predict day-to-day variation in the variables of interest. RESULTS: Systematic evidence emerged showing that disproportional situations, as opposed to proportional situations, were associated with a clear pattern of maladaptive outcomes. Specifically, when either strict or lenient measures were disproportional in relation to the epidemiological situation, people reported lower autonomous motivation, more controlled motivation and amotivation, less adherence to sanitary rules, higher perceived risk of infection, lower need satisfaction, and higher anxiety and depressive symptoms. Perceived risk severity especially covaried with the stringency of the measures. At the absolute level, citizens reported the highest need satisfaction and mental health during days with proportional lenient measures. CONCLUSION: Stringent measures are not per se demotivating or compromising of people's well-being, nor are lenient measures as such motivating or enhancing well-being. Only proportional measures, that is, measures with a level of stringency that is aligned with the actual epidemiological situation, are associated with the greatest motivational, behavioral, and mental health benefits.

A cross-national and longitudinal analysis of handwashing and its predictors during the COVID-19 pandemic in France and Belgium.

BACKGROUND: Using a longitudinal design, we investigate how the adherence to handwashing and its underlying socio-psychological predictors evolved over time during the COVID-19 pandemic and under distinct circumstances (e.g. when the crisis was more acute or chronic). METHOD: We collected data (N = 753) in Belgium and France at the onset of the COVID-19 pandemic when the crisis was at its peak (April 2020), and almost a year later (February 2021), when the outbreak was more manageable. RESULTS: Regression models suggest that the compliance with handwashing and its pattern of underlying predictors remained remarkably stable over time despite the variations in contextual factors such as the severity of the health crisis and the stringency of health measures. As such, the findings also highlight the robustness of the models that predict it, namely the Theory of Planned Behavior. The intentions to perform the behavior, the perceived control over it, and being part of the (para)medical field were among the strongest predictors. CONCLUSIONS: In practice, the stability of the underlying factors suggests a set of action levers that can be used in communication campaigns aimed at fostering its adherence throughout the pandemic.

An empirical investigation of the Pathways Model of problem gambling through the conjoint use of self-reports and behavioural tasks.

Background and aims: Blaszczynski and Nower (2002) conceptualized their Pathways Model by postulating the existence of three subtypes of problem gamblers who share common characteristics, but also present specific ones. Methods: This study investigated how the psychological mechanisms postulated in the Pathways Model predict clinical status in a sample that combined treatment-seeking gamblers (n = 59) and non-problematic community gamblers (n = 107). To test the Pathways Model, we computed a hierarchic logistic regression in which variables associated with each postulated pathway were entered sequentially to predict the status of the treatment-seeking gambler. Self-report questionnaires measured gambling-related cognitions, alexithymia, emotional reactivity, emotion regulation strategies and impulsivity. Behavioural tasks measured gambling persistence (slot machine task), decision-making under uncertainty (Iowa Gambling Task) and decision-making under risk (Game of Dice Task). Results: We showed that specific factors theorized as underlying mechanisms for each pathway predicted the status of clinical gambler. For each pathway, significant predictors included gambling-related cognitive distortions and behaviourally measured gambling persistence (behaviourally conditioned pathway), emotional reactivity and emotion regulation strategies (emotionally vulnerable pathway), and lack of premeditation impulsivity facet (impulsivist-antisocial pathway). Discussion and conclusions: Our study adds to the body of literature confirming the validity of the Pathways Model and hold important implications in terms of assessment and treatment of problem gambling. In particular, a standardized assessment based on the Pathways Model should promote individualized treatment strategies to allow clinicians to take into account the high heterogeneity that characterizes gambling disorder.

Personal and contextual determinants of COVID-19 vaccination intention: a vignette study.

BACKGROUND: This vignette study explores which factors contribute to higher COVID-19 vaccination intentions. METHODS: Between the 4th-11 January 2021, we recruited 15,901 Belgian citizens (Mage = 50.11 years, range 18-100) through convenience sampling to participate in a vignette study. In each vignette, we manipulated contextual determinants consisting of different factors. Each participant rated six vignettes in terms of the outcomes 'vaccination intention' and 'recommendation to others.' Finally, we explored the benefits of tailored communication by examining whether these ratings depended upon citizens' initial motives for vaccination. RESULTS: Participants are most likely to accept a vaccine when they expect no or only small side effects, when the vaccine offers a 95% protection, and when people can no longer infect others (p < 0.001). The possibility to receive the vaccine at home or at the GP's office, highlighting that most citizens are willing to get vaccinated, and emphasizing the protective benefits for others yielded additional positive effects (p < 0.001). Results showed that tailored communication has a small but significant effect, especially for individuals high on distrust-based amotivation (p < 0.01). CONCLUSION: In addition to vaccine characteristics, there is room for policymakers to respond to those determinants that fall under their control and can thus be highlighted within communication campaigns.

When History Seems to Repeat Itself: Exposure to Perceived Lessons of the Past Influences Predictions About Current Political Events.

The idea that the past holds lessons for the present, under the guise of historical analogies, is prevalent in political and public discourse. Those analogies are often accompanied by dire warnings befalling those who "forget" or otherwise neglect the powerful lessons of History-and would then be "doomed to repeat it", as the saying goes. So, Would remembering history make it seem more OR LESS likely to repeat itself in the future? In other words, does exposure to specific lessons about past events, especially ones involving causal claims, affect how people expect real-life events to turn out? Four studies (three preregistered) tested this experimentally. In Studies 1 and 2, participants expected the same behavior (the US adopting a harsh stance against Iran in the Nuclear Treaty) to result in a more negative outcome when this current stance seemed to match a "lesson" they had read about the break-out of World War II (European leaders adopting a harsh approach against Germany in the 1919 Versailles Treaty vs. a conciliatory approach in the 1938 Munich Agreement). Studies 3 and 4 attempted to eliminate some confounds present in the first two studies and to generalize the effect to different events. While results varied across studies, an internal meta-analysis indicated that the analogical effect on predictions (d = -.08) tended to become stronger as participants' knowledge about the target situation decreased (d-1SD = -.24). These findings support the possibility of analogical-based predictive effects for real-life political events, and are discussed in light of their research and political implications.