A synthesis of evidence for policy from behavioural science during COVID-19.

Scientific evidence regularly guides policy decisions1, with behavioural science increasingly part of this process2. In April 2020, an influential paper3 proposed 19 policy recommendations ('claims') detailing how evidence from behavioural science could contribute to efforts to reduce impacts and end the COVID-19 pandemic. Here we assess 747 pandemic-related research articles that empirically investigated those claims. We report the scale of evidence and whether evidence supports them to indicate applicability for policymaking. Two independent teams, involving 72 reviewers, found evidence for 18 of 19 claims, with both teams finding evidence supporting 16 (89%) of those 18 claims. The strongest evidence supported claims that anticipated culture, polarization and misinformation would be associated with policy effectiveness. Claims suggesting trusted leaders and positive social norms increased adherence to behavioural interventions also had strong empirical support, as did appealing to social consensus or bipartisan agreement. Targeted language in messaging yielded mixed effects and there were no effects for highlighting individual benefits or protecting others. No available evidence existed to assess any distinct differences in effects between using the terms 'physical distancing' and 'social distancing'. Analysis of 463 papers containing data showed generally large samples; 418 involved human participants with a mean of 16,848 (median of 1,699). That statistical power underscored improved suitability of behavioural science research for informing policy decisions. Furthermore, by implementing a standardized approach to evidence selection and synthesis, we amplify broader implications for advancing scientific evidence in policy formulation and prioritization.

Double trouble: How sectarian and national narcissism relate differently to collective violence beliefs in Lebanon.

Collective narcissism is a belief in ingroup greatness which is contingent on external validation. A lack of research on collective narcissism amongst non-Western contexts and minority groups remains a challenge for the field. However, here we test two types of collective narcissism (sectarian and national) as differential predictors of two dimensions of collective violence beliefs (against outgroup members and leaders) in a large, diverse, community sample from Lebanon (N = 778). We found that sectarian narcissism (narcissism related to smaller political and religious ingroup identity) predicted support for collective violence against members of different sects, while national narcissism predicted opposition to such collective violence. Neither form of collective narcissism had any significant relationship with collective violence against outgroup leaders. We controlled for both sectarian and national identification and found no significant effects in predicting either one of the two dimensions of collective violence beliefs. In this non-Western context, in which a coherent national identity is undermined by sectarianism, national narcissism seems to be a progressive motivator for unity and social change, while sectarian narcissism is rather associated with extreme attitudes, such as support for collective violence.

Social and moral psychology of COVID-19 across 69 countries.

The COVID-19 pandemic has affected all domains of human life, including the economic and social fabric of societies. One of the central strategies for managing public health throughout the pandemic has been through persuasive messaging and collective behaviour change. To help scholars better understand the social and moral psychology behind public health behaviour, we present a dataset comprising of 51,404 individuals from 69 countries. This dataset was collected for the International Collaboration on Social & Moral Psychology of COVID-19 project (ICSMP COVID-19). This social science survey invited participants around the world to complete a series of moral and psychological measures and public health attitudes about COVID-19 during an early phase of the COVID-19 pandemic (between April and June 2020). The survey included seven broad categories of questions: COVID-19 beliefs and compliance behaviours; identity and social attitudes; ideology; health and well-being; moral beliefs and motivation; personality traits; and demographic variables. We report both raw and cleaned data, along with all survey materials, data visualisations, and psychometric evaluations of key variables.

Efficacy of the Simeox® Airway Clearance Technology in the Homecare Treatment of Children with Clinically Stable Cystic Fibrosis: A Randomized Controlled Trial.

BACKGROUND: Cystic fibrosis (CF) patients require regular airway clearance therapy (ACT). The aim of this study was to evaluate homecare therapeutic effects of a new ACT (Simeox®) added to the optimal standard of care, including home chest physiotherapy, in the treatment of clinically stable children. METHODS: Forty pediatric CF patients (8-17 years old) with stable disease were randomized 1:1 in a single-center, prospective, open-label, cross-over trial into two groups: with or without Simeox®. Lung function (impulse oscillometry, spirometry, body plethysmography, multi-breath nitrogen washout) results, health-related quality of life, and safety were assessed during the study after 1 month of therapy at home. RESULTS: A significant decrease in proximal airway obstruction (as supported by improvement in airway resistance at 20 Hz (R20Hz) and maximum expiratory flow at 75% of FVC (MEF75)) compared to the control group was observed after 1 month of therapy with the device. Lung-clearance index was stable in the study group, while it worsened in the control group. In addition, the device group demonstrated a significant increase in the Cystic Fibrosis Questionnaire-Revised (CFQ-R) physical score. No side effects were identified during the study. CONCLUSIONS: Simeox® may improve drainage of the airways in children with clinically stable CF and could be an option in chronic treatment of the disease.

A Small Price to Pay: National Narcissism Predicts Readiness to Sacrifice In-Group Members to Defend the In-Group's Image.

Collective narcissism is a belief in one's in-group greatness that is underappreciated by others. Across three studies conducted in the context of the coronavirus disease 2019 (COVID-19) pandemic, we found that collective narcissism, measured with respect to the national group, was related to support of policies that protect the national image at the expense of in-group members' health. In Study 1, British national narcissism was related to opposing cooperation with the European Union (EU) on medical equipment. In Study 2, American national narcissism predicted opposition to COVID-19 testing to downplay the number of cases. In Study 3, American national narcissism was related to support for releasing an untested COVID-19 vaccine, to beat other countries to the punch. These relationships were mediated by concern about the country's reputation. Our studies shed light on collective narcissism as a group-based ego-enhancement strategy in which a strong image of the group is prioritized over members' well-being.

National Narcissism predicts the Belief in and the Dissemination of Conspiracy Theories During the COVID-19 Pandemic: Evidence From 56 Countries.

Conspiracy theories related to coronavirus disease 2019 (COVID-19) have propagated around the globe, leading the World Health Organization to declare the spread of misinformation an "Infodemic." We tested the hypothesis that national narcissism-a belief in the greatness of one's nation that requires external recognition-is associated with the spread of conspiracy theories during the COVID-19 pandemic. In two large-scale national surveys (NTotal = 950) conducted in the United States and the United Kingdom, and secondary analysis of data from 56 countries (N = 50,757), we found a robust, positive relationship between national narcissism and proneness to believe and disseminate conspiracy theories related to COVID-19. Furthermore, belief in COVID-19 conspiracy theories was related to less engagement in health behaviors and less support for public-health policies to combat COVID-19. Our findings illustrate the importance of social identity factors in the spread of conspiracy theories and provide insights into the psychological processes underlying the COVID-19 pandemic.

Predicting attitudinal and behavioral responses to COVID-19 pandemic using machine learning.

At the beginning of 2020, COVID-19 became a global problem. Despite all the efforts to emphasize the relevance of preventive measures, not everyone adhered to them. Thus, learning more about the characteristics determining attitudinal and behavioral responses to the pandemic is crucial to improving future interventions. In this study, we applied machine learning on the multinational data collected by the International Collaboration on the Social and Moral Psychology of COVID-19 (N = 51,404) to test the predictive efficacy of constructs from social, moral, cognitive, and personality psychology, as well as socio-demographic factors, in the attitudinal and behavioral responses to the pandemic. The results point to several valuable insights. Internalized moral identity provided the most consistent predictive contribution-individuals perceiving moral traits as central to their self-concept reported higher adherence to preventive measures. Similar results were found for morality as cooperation, symbolized moral identity, self-control, open-mindedness, and collective narcissism, while the inverse relationship was evident for the endorsement of conspiracy theories. However, we also found a non-neglible variability in the explained variance and predictive contributions with respect to macro-level factors such as the pandemic stage or cultural region. Overall, the results underscore the importance of morality-related and contextual factors in understanding adherence to public health recommendations during the pandemic.

Why do narcissists find conspiracy theories so appealing?

Narcissism-a conviction about one's superiority and entitlement to special treatment-is a robust predictor of belief in conspiracy theories. Recent developments in the study of narcissism suggest that it has three components: antagonism, agentic extraversion, and neuroticism. We argue that each of these components of narcissism might predispose people to endorse conspiracy theories due to different psychological processes. Specifically, we discuss the role of paranoia, gullibility, and the needs for dominance, control, and uniqueness. We also review parallel findings for narcissistic beliefs about one's social groups. We consider the wider implications this research might have, especially for political leadership. We conclude by discussing outstanding questions about sharing conspiracy theories and other forms of misinformation.

Their own worst enemy? Collective narcissists are willing to conspire against their in-group.

Collective narcissism - a belief in in-group greatness that is not appreciated by others - is associated with using one's group for personal benefits. Across one pilot and four studies, we demonstrated that collective narcissism predicts readiness to conspire against in-group members (rmeta-analysis  = .24). In Study 1, conducted in Poland (N = 361), collective narcissism measured in the context of national identity predicted readiness to engage in secret surveillance against one's own country's citizens. In Study 2 (N = 174; pre-registered), collective narcissism in UK workplace teams predicted intentions to engage in conspiracies against co-workers. In Study 3 (N = 471; pre-registered), US national narcissism predicted intentions to conspire against fellow citizens. Furthermore, conspiracy intentions accounted for the relationship between collective narcissism and beliefs in conspiracy theories about the in-group. Finally, in Study 4 (N = 1064; pre-registered), we corroborated the link between Polish national narcissism and conspiracy intentions against fellow citizens, further showing that these intentions were only directed towards group members that were perceived as moderately or strongly typical of the national in-group (but not when perceived in-group typicality was low). In-group identification was either negatively related (Studies 1 and 2) or unrelated (Studies 3 and 4) to conspiracy intentions (rmeta-analysis  = .04). We discuss implications for research on conspiracy theories and populism.

Conspiracy mentality and political orientation across 26 countries.

People differ in their general tendency to endorse conspiracy theories (that is, conspiracy mentality). Previous research yielded inconsistent findings on the relationship between conspiracy mentality and political orientation, showing a greater conspiracy mentality either among the political right (a linear relation) or amongst both the left and right extremes (a curvilinear relation). We revisited this relationship across two studies spanning 26 countries (combined N = 104,253) and found overall evidence for both linear and quadratic relations, albeit small and heterogeneous across countries. We also observed stronger support for conspiracy mentality among voters of opposition parties (that is, those deprived of political control). Nonetheless, the quadratic effect of political orientation remained significant when adjusting for political control deprivation. We conclude that conspiracy mentality is associated with extreme left- and especially extreme right-wing beliefs, and that this non-linear relation may be strengthened by, but is not reducible to, deprivation of political control.

National identity predicts public health support during a global pandemic.

Changing collective behaviour and supporting non-pharmaceutical interventions is an important component in mitigating virus transmission during a pandemic. In a large international collaboration (Study 1, N = 49,968 across 67 countries), we investigated self-reported factors associated with public health behaviours (e.g., spatial distancing and stricter hygiene) and endorsed public policy interventions (e.g., closing bars and restaurants) during the early stage of the COVID-19 pandemic (April-May 2020). Respondents who reported identifying more strongly with their nation consistently reported greater engagement in public health behaviours and support for public health policies. Results were similar for representative and non-representative national samples. Study 2 (N = 42 countries) conceptually replicated the central finding using aggregate indices of national identity (obtained using the World Values Survey) and a measure of actual behaviour change during the pandemic (obtained from Google mobility reports). Higher levels of national identification prior to the pandemic predicted lower mobility during the early stage of the pandemic (r = -0.40). We discuss the potential implications of links between national identity, leadership, and public health for managing COVID-19 and future pandemics.

From bad to worse: Avoidance coping with stress increases conspiracy beliefs.

The present research empirically examines how different types of coping strategies are associated with belief in conspiracy theories. Conspiracy beliefs have been linked to the frustration of basic needs and seem to increase during major world events that evoke stress. Thus, we hypothesized that they may serve as a psychological response to maladaptive coping strategies. This hypothesis was tested among British participants and conceptually replicated across three studies. Cross-sectionally, we examined coping strategies (i.e., self-sufficient, social-support, avoidance, and religious) and belief in a specific conspiracy theory (Study 1, n = 199) and belief in general notions of conspiracy (Study 2, n = 411). In Study 3 (n = 398), we experimentally primed different coping styles via a mnemonic recollection procedure and measured belief in notions of conspiracy. Avoidance coping (recognized as being maladaptive and leading to at least temporary disengagement and abandonment of goal-related behaviours) positively predicted belief in conspiracy theories (Studies 1 and 2). In Study 3, priming avoidance coping (vs. self-sufficient coping or no coping strategy) significantly increased belief in conspiracy theories. These findings suggest that using maladaptive coping strategies (either dispositional or situationally induced) may foster conspiracy beliefs.

Who respects the will of the people? Support for democracy is linked to high secure national identity but low national narcissism.

Support for democracy is based on warmth, inclusiveness, and a general belief that others are well-intentioned. It is also related to a willingness to respect the rights of outgroups which do not necessarily share the views of one's ingroup. In this research, we analysed the relationships between different types of national identity and support for democracy. In two surveys (Study 1; American participants, n = 407 and Study 2; Polish participants; n = 570), we found that support for democracy was negatively linked to collective narcissism, measured in relation to the national group, previously associated with negative intra- and inter-group outcomes. The effect of national narcissism on democracy support was present even when accounting for national identification. In Study 2, we also found that this effect was mediated by social cynicism - a negative view of human nature. In both studies, support for democracy was positively linked to a secure national identity, that is national identification without the narcissistic component, which tends to be associated with positive attitudes towards others. We discuss implications for understanding the role of national identity in support for (il)liberal politics.

The effects of the addition of a new airway clearance device to chest physiotherapy in children with cystic fibrosis pulmonary exacerbations.

BACKGROUND: Chest physiotherapy plays a crucial role in managing cystic fibrosis, especially during pulmonary exacerbations. This study evaluated the effects of adding a new airway clearance device to chest physiotherapy in subjects with cystic fibrosis hospitalised due to pulmonary exacerbations. METHODS: This prospective open-label study was carried out at the Pediatric Cystic Fibrosis Centre in Poland between October 2017 and August 2018. Cystic fibrosis patients aged 10 to 18 years who were admitted to the hospital and required intravenous antibiotic therapy due to pulmonary exacerbations were consecutively allocated (1:1) to either chest physiotherapy alone or chest physiotherapy with a new airway clearance device (Simeox; PhysioAssist). Patients performed spirometry and multiple-breath nitrogen washout for lung clearance index assessment upon admission and prior to discharge. RESULTS: Forty-eight cystic fibrosis patients were included (24 in each group). Spirometry parameters in both groups improved significantly after intravenous antibiotic therapy. A significant improvement in the maximum expiratory flow at 25% of forced vital capacity was observed only in the group with a new airway clearance device (p < 0.01 vs. baseline). Trends towards a lower lung clearance index ratio were similar in both groups. No adverse events were observed in either group. CONCLUSIONS: Spirometry parameters increased significantly in cystic fibrosis patients treated for pulmonary exacerbations with intravenous antibiotic therapy and intensive chest physiotherapy. The new airway clearance device was safe and well tolerated when added to chest physiotherapy and may be another option for the treatment of pulmonary exacerbation in cystic fibrosis.

Using social and behavioural science to support COVID-19 pandemic response.

The COVID-19 pandemic represents a massive global health crisis. Because the crisis requires large-scale behaviour change and places significant psychological burdens on individuals, insights from the social and behavioural sciences can be used to help align human behaviour with the recommendations of epidemiologists and public health experts. Here we discuss evidence from a selection of research topics relevant to pandemics, including work on navigating threats, social and cultural influences on behaviour, science communication, moral decision-making, leadership, and stress and coping. In each section, we note the nature and quality of prior research, including uncertainty and unsettled issues. We identify several insights for effective response to the COVID-19 pandemic and highlight important gaps researchers should move quickly to fill in the coming weeks and months.

The dark side of social movements: social identity, non-conformity, and the lure of conspiracy theories.

Social change does not always equal social progress-there is a dark side of social movements. We discuss conspiracy theory beliefs - beliefs that a powerful group of people are secretly working towards a malicious goal - as one contributor to destructive social movements. Research has linked conspiracy theory beliefs to anti-democratic attitudes, prejudice and non-normative political behavior. We propose a framework to understand the motivational processes behind conspiracy theories and associated social identities and collective action. We argue that conspiracy theories comprise at least two components - content and qualities-that appeal to people differently based on their motivations. Social identity motives draw people foremost to contents of conspiracy theories while uniqueness motives draw people to qualities of conspiracy theories.

Superficial ingroup love? Collective narcissism predicts ingroup image defense, outgroup prejudice, and lower ingroup loyalty.

We examined the associations between the need for personal control, different types of ingroup commitment, and group-related outcomes: (1) defensive responses to ingroup criticism, (2) ingroup disloyalty, and (3) outgroup attitudes. We assumed that collective narcissism (i.e., a belief in ingroup's greatness which is contingent on external validation and stems from frustrated individual needs) should be concerned with defending the ingroup image and derogating outgroups, but not necessarily with being loyal to the ingroup. Secure ingroup identification (i.e., a confidently held ingroup evaluation, which stems from satisfied needs), in contrast, should predict greater ingroup loyalty and positive outgroup attitudes. We expected these effects to be especially strong once we account for the overlap between collective narcissism and group-level self-investment - a key component of ingroup identification. In a nationally representative sample of Polish adults (n = 1,007), collective narcissism (net of group-level self-investment) mediated between low personal control and ingroup image defense, lower group loyalty, and less positive outgroup attitudes. Secure ingroup identification (group-level self-investment net of collective narcissism) mediated between high personal control and ingroup loyalty and positive outgroup attitudes. It was not associated with ingroup image defense. Implications for understanding the role of identification in inter- and intra-group relations are discussed.

In search of an imaginary enemy: Catholic collective narcissism and the endorsement of gender conspiracy beliefs.

Gender studies have often been criticized for undermining family and religious values. In this paper, we argue that these criticisms exhibit the characteristics of conspiracy theories. We define gender conspiracy beliefs as convictions that gender studies and gender-equality activists represent an ideology secretly designed to harm traditional values and social arrangements. In two studies conducted among Catholics in Poland (Study 1 N= 1019; Study 2 N= 223), we examined the prevalence of gender conspiracy beliefs and their psychological concomitants. We hypothesized that gender conspiracy beliefs should be associated with a defensive identification with one's religious group, captured by religious collective narcissism. In both studies, Catholic collective narcissism was demonstrated to be a robust predictor of gender conspiracy beliefs. We additionally demonstrated that Catholic collective narcissism predicted outgroup hostility, and this effect was mediated by gender conspiracy beliefs. We discuss the implications for gender-based prejudice.