Political ideology shapes risk and benefit judgments of COVID-19 vaccines.

In April 2021, the use of the Johnson & Johnson COVID-19 vaccine was paused to investigate whether it had caused serious blood clots to a small number of women (six out of 6.8 million Americans who had been administered that vaccine). As these events were unfolding, we surveyed a sample of Americans (N = 625) to assess their reactions to this news, whether they supported the pausing of the vaccine, and potential psychological factors underlying their decision. In addition, we employed automated text analyses as a supporting method to more classical quantitative measures. Results showed that political ideology influenced the support for the pausing of the vaccine; liberals were more likely to oppose it than conservatives. In addition, the effect of political ideology was mediated by the difference between perceived benefit and risk and the language style used to produce reasons in support (or against) the decision to pause the vaccine. Liberals perceived the benefit of vaccines higher than the risk, used a more analytic language style when stating their reasons, and had a more positive attitude toward the vaccine. We discuss the implications of our findings considering vaccine hesitancy and risk perception during the COVID-19 pandemic.

To vaccinate or not to vaccinate? The interplay between pro- and against- vaccination reasons.

BACKGROUND: By mid 2023, European countries reached 75% of vaccine coverage for COVID-19 and although vaccination rates are quite high, many people are still hesitant. A plethora of studies have investigated factors associated with COVID-19 vaccine hesitancy, however, insufficient attention has been paid to the reasons why people get vaccinated against COVID-19. Our work aims to investigate the role of reasons in the decision to get vaccinated against COVID-19 in a representative sample of 1,689 adult Italians (March-April 2021) balanced in terms of age, gender, educational level and area of residence. METHODS: Through an online questionnaire, we asked participants to freely report up to three reasons for and against COVID-19 vaccination, and the weight each had in the decision to get vaccinated. We first investigated the role of emotional competence and COVID-19 risk perception in the generation of both reasons using regression models. Next, we studied the role that the different reasons had in the vaccination decision, considering both the intention to vaccinate (using a beta regression model) and the decision made by the participants who already had the opportunity to get vaccinated (using a logistic regression model). Finally, two different classification tree analyses were carried out to characterize profiles with a low or high willingness to get vaccinated or with a low or high probability to accept/book the vaccine. RESULTS: High emotional competence positively influences the generation of both reasons (ORs > 1.5), whereas high risk perception increases the generation of positive reasons (ORs > 1.4) while decreasing reasons against vaccination (OR = 0.64). As pro-reasons increase, vaccination acceptance increases, while the opposite happens as against-reasons increase (all p < 0.001). One strong reason in favor of vaccines is enough to unbalance the decision toward acceptance of vaccination, even when reasons against it are also present (p < 0.001). Protection and absence of distrust are the reasons that mostly drive willingness to be vaccinated and acceptance of an offered vaccine. CONCLUSIONS: Knowing the reasons that drive people's decision about such an important choice can suggest new communication insights to reduce possible negative reactions toward vaccination and people's hesitancy. Results are discussed considering results of other national and international studies.

The Interplay of Perceived Risks and Benefits in Deciding to Become Vaccinated against COVID-19 While Pregnant or Breastfeeding: A Cross-Sectional Study in Italy.

The present study examined the role of the perception of risks and benefits for the mother and her babies in deciding about the COVID-19 vaccination. In this cross-sectional study, five hypotheses were tested using data from a convenience sample of Italian pregnant and/or breastfeeding women (N = 1104, July-September 2021). A logistic regression model estimated the influence of the predictors on the reported behavior, and a beta regression model was used to evaluate which factors influenced the willingness to become vaccinated among unvaccinated women. The COVID-19 vaccination overall risks/benefits tradeoff was highly predictive of both behavior and intention. Ceteris paribus, an increase in the perception of risks for the baby weighed more against vaccination than a similar increase in the perception of risks for the mother. Additionally, pregnant women resulted in being less likely (or willing) to be vaccinated in their status than breastfeeding women, but they were equally accepting of vaccination if they were not pregnant. COVID-19 risk perception predicted intention to become vaccinated, but not behavior. In conclusion, the overall risks/benefits tradeoff is key in predicting vaccination behavior and intention, but the concerns for the baby weigh more than those for the mother in the decision, shedding light on this previously neglected aspect.

How perceived scarcity predicted cooperation during early pandemic lockdown.

Both material resources (jobs, healthcare), and socio-psychological resources (social contact) decreased during the COVID-19 pandemic. We investigated whether individual differences in perceived material and socio-psychological scarcity experienced during the pandemic predicted preference for cooperation, measured using two Public Good Games (PGGs), where participants contributed money or time (i.e., hours indoors contributed to shorten the lockdown). Material scarcity had no relationship with cooperation. Increased perceived scarcity of socio-psychological wellbeing (e.g., connecting with family) predicted increased preference for cooperation, suggesting that missing social contact fosters prosociality, whilst perceived scarcity of freedom (e.g., limited movement) predicted decreased willingness to spend time indoors to shorten the lockdown. The importance of considering individual differences in scarcity perception to best promote norm compliance is discussed.

People's perspectives about COVID-19 vaccination certificate: Findings from a representative Italian sample.

In Italy, like in other countries, issues still exist regarding how to reach high vaccine coverage and several countries have considered policies to increase vaccine uptake. In the present study, we focused on people who have a favorable attitude towards vaccination. In March-April 2021, we asked a representative sample of Italian participants (N = 1,530) to assess to what extent they would support the adoption of a COVID-19 vaccination certificate, excluding unvaccinated people from participating in public and cultural events. Furthermore, as the vaccination coverage increases, severe forms of COVID-19 requiring hospitalization more likely involve unvaccinated individuals, who might be perceived as those who don't contribute to ending the pandemic and who constitute a significant health cost for society. We then asked participants to assess to what extent they would favor the idea of requiring people who refuse the vaccine to pay for their own medical expenses in case of hospitalization. We hypothesized that support for the adoption of the vaccination certificate would be predicted by the COVID-19 vaccination status (received, booked, high-, medium-, low-willingness to be vaccinated, or refused) and by the same factors that are known to affect the willingness to get vaccinated. These factors were also tested in a model aimed at investigating if a vaccinated person would favor a measure requiring the unvaccinated individuals to pay for medical expenses. Results confirmed that the support towards the vaccination certificate policy was strongly predicted by the vaccination status and by factors known to affect the willingness to get vaccinated. Interestingly (and surprisingly), a similar pattern was observed for the support of the policy about medical expenses. In conclusion, support for a COVID-19 vaccination certificate was high among the Italian population in the early phases of the vaccination rollout. The findings are discussed considering potential policies to tackle the pandemic.

Effects of Socioeconomic Status, Parental Stress, and Family Support on Children's Physical and Emotional Health During the COVID-19 Pandemic.

In the current study, we conduct an exploratory study on children's emotional and physical health in response to the COVID-19 pandemic. The direct and interactive effects of parental stress, family socioeconomic status (SES), and family support on child adjustment were investigated. A total of 116 children of varied socioeconomic and their parents were interviewed. Parents with low household income perceived greater distress related to uncertainty and health worries compared to those with higher household income. However, it was among high-SES families that parental distress was associated with child difficulties. At a multivariate level, children's health was associated with SES, family support, and parental COVID-19 stress. Among families with low household income, when parents perceived low/average COVID-19 stress, family support worked as a protective factor for children's adjustment. Understanding how COVID-19 relates with children's emotional and physical health within families with low and high household income may help to inform recommendations for best practices, for example through family support interventions.

Stress and Emotional Intelligence Shape Giving Behavior: Are There Different Effects of Social, Cognitive, and Emotional Stress?

Acute stress has been linked with prosocial behavior, yet it is entirely unexplored how different types of stressors may affect individuals' willingness to help: This is particularly relevant while people is experiencing multiple sources of stress due to the COVID-19 pandemic. Here we explore whether different types of stress influence peoples' giving behavior and the moderating role of emotional intelligence (EI). Undergraduate students were exposed to experimentally induced social, cognitive, or emotional stress and were asked to self-report on their willingness to help and donate to a charity raising funds for COVID-19 and flu patients. Results showed that when compared to a control condition, after being exposed to a social stress, participants were more willing to help a person in need. Our results also provide evidence that, after experiencing a social stress, participants with high (vs low) trait EI were more willing to help, and, as a result, donated more. Findings indicate that moderate levels of distress are associated with increased donations. Interestingly, when stress is not too threatening, high EI can regulate it and promote prosocial behaviors.

Joint analysis of the intention to vaccinate and to use contact tracing app during the COVID-19 pandemic.

Pharmacological and non-pharmacological measures will overlap for a period after the onset of the pandemic, playing a strong role in virus containment. We explored which factors influence the likelihood to adopt two different preventive measures against the COVID-19 pandemic. An online snowball sampling (May-June 2020) collected a total of 448 questionnaires in Italy. A Bayesian bivariate Gaussian regression model jointly investigated the willingness to get vaccinated against COVID-19 and to download the national contact tracing app. A mixed-effects cumulative logistic model explored which factors affected the motivation to adopt one of the two preventive measures. Despite both COVID-19 vaccines and tracing apps being indispensable tools to contain the spread of SARS-CoV-2, our results suggest that adherence to the vaccine or to the national contact tracing app is not predicted by the same factors. Therefore, public communication on these measures needs to take in consideration not only the perceived risk associated with COVID-19, but also the trust people place in politics and science, their concerns and doubts about vaccinations, and their employment status. Further, the results suggest that the motivation to comply with these measurements was predominantly to protect others rather than self-protection.

Politicians polarize and experts depolarize public support for COVID-19 management policies across countries.

Political polarization impeded public support for policies to reduce the spread of COVID-19, much as polarization hinders responses to other contemporary challenges. Unlike previous theory and research that focused on the United States, the present research examined the effects of political elite cues and affective polarization on support for policies to manage the COVID-19 pandemic in seven countries (n = 12,955): Brazil, Israel, Italy, South Korea, Sweden, the United Kingdom, and the United States. Across countries, cues from political elites polarized public attitudes toward COVID-19 policies. Liberal and conservative respondents supported policies proposed by ingroup politicians and parties more than the same policies from outgroup politicians and parties. Respondents disliked, distrusted, and felt cold toward outgroup political elites, whereas they liked, trusted, and felt warm toward both ingroup political elites and nonpartisan experts. This affective polarization was correlated with policy support. These findings imply that policies from bipartisan coalitions and nonpartisan experts would be less polarizing, enjoying broader public support. Indeed, across countries, policies from bipartisan coalitions and experts were more widely supported. A follow-up experiment replicated these findings among US respondents considering international vaccine distribution policies. The polarizing effects of partisan elites and affective polarization emerged across nations that vary in cultures, ideologies, and political systems. Contrary to some propositions, the United States was not exceptionally polarized. Rather, these results suggest that polarizing processes emerged simply from categorizing people into political ingroups and outgroups. Political elites drive polarization globally, but nonpartisan experts can help resolve the conflicts that arise from it.

Structured reflection increases intentions to reduce other people's health risks during COVID-19.

People believe they should consider how their behavior might negatively impact other people, Yet their behavior often increases others' health risks. This creates challenges for managing public health crises like the COVID-19 pandemic. We examined a procedure wherein people reflect on their personal criteria regarding how their behavior impacts others' health risks. We expected structured reflection to increase people's intentions and decisions to reduce others' health risks. Structured reflection increases attention to others' health risks and the correspondence between people's personal criteria and behavioral intentions. In four experiments during COVID-19, people (N  = 12,995) reported their personal criteria about how much specific attributes, including the impact on others' health risks, should influence their behavior. Compared with control conditions, people who engaged in structured reflection reported greater intentions to reduce business capacity (experiment 1) and avoid large social gatherings (experiments 2 and 3). They also donated more to provide vaccines to refugees (experiment 4). These effects emerged across seven countries that varied in collectivism and COVID-19 case rates (experiments 1 and 2). Structured reflection was distinct from instructions to carefully deliberate (experiment 3). Structured reflection increased the correlation between personal criteria and behavioral intentions (experiments 1 and 3). And structured reflection increased donations more among people who scored lower in cognitive reflection compared with those who scored higher in cognitive reflection (experiment 4). These findings suggest that structured reflection can effectively increase behaviors to reduce public health risks.

Cognitive dysfunction in central disorders of hypersomnolence: A systematic review.

Central disorders of hypersomnolence (CDH) are characterized by excessive daytime sleepiness not related to comorbid sleep or medical disturbances. We systematically examined scientific literature on cognitive functions in patients suffering from CDH. Forty-eight studies proved eligible and were analyzed separately for Narcolepsy Type 1 (NT1), Narcolepsy Type 2 (NT2), Idiopathic hypersomnia (IH) and Kleine-Levin syndrome (KLS). Results were grouped into the cognitive domains of attention, memory, executive functions and higher order cognition. Consistent attention impairments emerged in NT1, NT2 and IH patients, with NT1 patients showing the most compromised profile. Memory functions are largely unimpaired in CDH patients except for KLS patients who display memory deficit. Executive functions and higher-order cognition have been assessed in NT1 while they received little-to-no attention in the other CDH. NT1 patients display high performance in executive functions but exhibit a complex pattern of impairment in higher-order cognition, showing poor decision-making and impaired emotional processing. Moreover, NT1 patients show increased creative abilities. Assessing and monitoring cognitive impairments experienced by CDH patients will allow the design of personalized interventions, parallel to pharmacological treatment, aimed at improving daytime functioning and quality of life of these patients.

The Role of Emotional Competences in Parents' Vaccine Hesitancy.

The role of parents' emotional competencies on vaccine hesitancy and decision making has been seldom examined. Two studies investigated the relationship between parents' attitudes towards childhood vaccines and self-reported behavior (Study 1) and between parents' emotional competence and attitudes towards vaccines (Study 2). In Study 1, predictors of temporal, partial, or complete vaccine refusal (having voluntarily postponed/forgone some/all vaccines) were examined in 2778 parents. In Study 2, psychological predictors of the attitude towards vaccines were examined in 593 parents, using the Profile of Emotional Competence and the valence of mental images spontaneously associated with the term "vaccine". In Study 1, attitudes were aggregated in three independent factors (concerns about vaccine safety; diseases prevented by vaccines; and naturalistic views) that independently predicted vaccine refusal. In Study 2, a significant mediational analysis showed a positive indirect effect of intrapersonal emotional competences on attitudes towards vaccines, through mental images associated with the word "vaccine". Parents' intrapersonal emotional competences affected all dimensions of attitudes towards vaccines, suggesting that being able to manage, identify, and recognize one's own emotions is central to vaccine acceptance. These findings suggest that intervention strategies, rather than stressing the pro-social benefits of vaccinating, should focus on aspects related to one's own emotions.

Associations of COVID-19 risk perception with vaccine hesitancy over time for Italian residents.

RATIONALE: Many countries were and are still struggling with the COVID-19 emergency. Despite efforts to limit the viral transmission, the vaccine is the only solution to ending the pandemic. However, vaccine hesitancy could reduce coverage and hinder herd immunity. OBJECTIVE: People's intention to get vaccinated can be shaped by several factors, including risk perception which, in turn, is influenced by affect. The present work aimed at investigating how risk perception and some factors associated with the decision to comply with vaccination modulated vaccine acceptance for COVID-19 as compared to seasonal influenza, and how these have varied during the lockdown phases. METHOD: The study followed the main phases of the emergency in Italy, investigating the intention to get vaccinated against flu and against SARS-CoV-2 (if a vaccine was available) before, during and after the first national lockdown, covering the period from the end of February to the end of June 2020. We investigated the effect of risk perception and other predictors on the decision of getting vaccinated. RESULTS: Compared to the pre-lockdown phase, during the lockdown more people were willing to get vaccinated for COVID-19, regardless of their beliefs about vaccines, and as risk perception increased, so did the intention to accept the vaccine. The acceptance of the flu vaccine increased after the re-opening phase. In addition, the intention to get vaccinated against COVID-19 and against flu increased if there was previous flu vaccination behavior but decreased with increasing doubts about the vaccines in general. CONCLUSIONS: The observation of vaccination intentions across the three main phases of the emergency allows important considerations regarding psychological, affect, and demographic determinants useful to tailor public health communication to improve public response to future epidemics.

Environmental and psychological variables influencing reactions to the COVID-19 outbreak.

OBJECTIVE: The COVID-19 outbreak in Italy caused a major health emergency and high uncertainty. We studied how media outlets, risk perception, state anxiety, and emotion regulation impacted peoples' reactions and undertaking of protective behaviours aimed at reducing the spread of the virus. DESIGN: Data were collected in two cross-sectional waves (N = 992 at T1; N = 1031 at T2): at the beginning of the outbreak and once the national lockdown was imposed. METHODS: Participants completed online surveys on their perception of the COVID-19 outbreak. Moreover, they were asked to self-report on their emotion regulation, state anxiety, and protective behaviours. RESULTS: Media exposure and wave predicted risk perception. An interaction between wave, risk perception, and emotion regulation predicted the number of protective behaviours people undertook. Specifically, in the second wave, the number of protective behaviours was predicted by risk perception only among those who were ineffective at regulating emotions. Instead, effective regulators undertook the same number of behaviours regardless of their level of risk perception. In the second wave, we also found that the risk perception by emotion interaction predicting protective behaviours was mediated by state anxiety. CONCLUSIONS: The present study provides important insights on how people experienced the early stages of the outbreak. This information could prove valuable in the coming months to understand who might have been more impacted by the stress caused by the COVID-19 pandemic and the consequent restrictive measures.

Media Exposure to Terrorism and Perception of Immigrants as a Threat: The Role of Emotional Intelligence and Psychophysiological Self-Regulation.

To better understand how media exposure to terrorism-related images can lead to perceiving immigrants as more threatening, in the present study we manipulated participants' exposure to media coverage of terrorist attacks and investigated how this may influence people's perception of Arab immigrants. Considering the important role of regulatory abilities when facing stressful events like terrorist attacks, we measured individual differences in both trait emotional intelligence and resting heart rate variability (HRV). Results showed that participants perceived Arab immigrants as more threatening in the media exposure condition than in the control condition. Importantly, there were moderating effects of both trait emotional intelligence and HRV. People with lower trait emotional intelligence or lower HRV at rest felt more threatened in the media exposure condition compared to the control condition, whereas this effect was not observed among participants with higher trait emotional intelligence or higher resting HRV. The present study highlights some of the complexities related to how media exposure to terrorism-related images influences people's reactions to, and evaluations of, an outgroup that is related to the perpetrators of the attacks.

Replicating patterns of prospect theory for decision under risk.

Prospect theory is among the most influential frameworks in behavioural science, specifically in research on decision-making under risk. Kahneman and Tversky's 1979 study tested financial choices under risk, concluding that such judgements deviate significantly from the assumptions of expected utility theory, which had remarkable impacts on science, policy and industry. Though substantial evidence supports prospect theory, many presumed canonical theories have drawn scrutiny for recent replication failures. In response, we directly test the original methods in a multinational study (n = 4,098 participants, 19 countries, 13 languages), adjusting only for current and local currencies while requiring all participants to respond to all items. The results replicated for 94% of items, with some attenuation. Twelve of 13 theoretical contrasts replicated, with 100% replication in some countries. Heterogeneity between countries and intra-individual variation highlight meaningful avenues for future theorizing and applications. We conclude that the empirical foundations for prospect theory replicate beyond any reasonable thresholds.

'Three is better than two': Increasing donations with the attraction effect.

Five experiments (Ntotal  = 2,503) tested the attraction effect and its boundary conditions in the context of helping behaviour. Participants could choose one donation appeal in a set of either two or three alternatives. The three alternatives set included a decoy - an alternative that resembled but was clearly inferior to a target (i.e., the most beneficial) alternative. A clear and consistent pattern emerged: Participants chose the target alternative more frequently and perceived it as more beneficial (and somewhat less costly) when the decoy was present compared to when it was absent. This finding was robust when the attribute ratings of the alternatives were unclear, when the target alternative offered a bundle of unrelated products, and when participants could refrain from donating altogether, or contribute any amount they wished. Our findings offer concrete and simple strategies that charities can implement at zero cost to increase giving and the perceived benefits that people's good deed bring about to those in need.

Media exposure to terrorism and people's risk perception: The role of environmental sensitivity and psychophysiological response to stress.

Terrorist attacks have a destabilizing impact on the general population, causing distress and fear. However, not all individuals are equally susceptible to the effects of terror threat. This study aimed to examine whether exposure to terrorism-related pictures interacted with individual differences in environmental sensitivity and psychophysiological response to stress to explain people's risk perception, operationalized as perceived likelihood of a terrorist attack and willingness to trade off one's privacy to increase national security. Ninety-five university students were randomly assigned to one of two conditions (terrorism-related vs. neutral pictures). After watching the pictures, they answered questions concerning risk perception and completed questionnaires. Stress was induced by the Mannheim Multicomponent Stress Test, during which heart rate was recorded. Results showed that the perceived likelihood of future attacks was affected by the interaction between exposure to terrorism pictures and psychophysiological reactivity to stress, whereas willingness to trade off one's privacy to improve national security was influenced by the interaction between exposure to terrorism pictures and environmental sensitivity. The study suggests that individuals high in sensitivity and psychophysiological stress reactivity are particularly affected by terrorism-related pictures. Psychologists should direct their efforts to raise general awareness of the negative effects, especially for some people, of such media coverage.

Emotional intelligence buffers the effect of physiological arousal on dishonesty.

We studied the emotional processes that allow people to balance two competing desires: benefitting from dishonesty and keeping a positive self-image. We recorded physiological arousal (skin conductance and heart rate) during a computer card game in which participants could cheat and fail to report a certain card when presented on the screen to avoid losing their money. We found that higher skin conductance corresponded to lower cheating rates. Importantly, emotional intelligence regulated this effect; participants with high emotional intelligence were less affected by their physiological reactions than those with low emotional intelligence. As a result, they were more likely to profit from dishonesty. However, no interaction emerged between heart rate and emotional intelligence. We suggest that the ability to manage and control emotions can allow people to overcome the tension between doing right or wrong and license them to bend the rules.

Impulsivity influences betting under stress in laboratory gambling.

Although recent research suggests that acute stress influences subsequent decision-making under ambiguity, less is known about the role of personality variables in this relationship. This study tested whether impulsivity traits and acute stress differentially influence the way in which a prior feedback is incorporated into further decisions involving ambiguity. Sixty college students (50% male; aged 18-25 years) were randomly assigned to a stress versus a non-stress condition before completing a laboratory gambling task. The results revealed that independently of the stress condition, subjects behaved as if the odds of winning increase after a single loss. Additionally, stress effects varied as a function of impulsivity traits. Individuals who lacked perseverance (i.e., had difficulty focusing on a difficult or boring task) gambled more after experiencing a loss in the stress condition than did those in the control condition. The present study supports that impulsivity traits can explain the differential effect of stress on the relationship between prior feedback and choices made under ambiguity.