Facing the Emotional Barriers to Colorectal Cancer Screening. The Roles of Reappraisal and Situation Selection.

BACKGROUND: Disgust, embarrassment, and fear can hinder the attendance of colorectal cancer (CRC) screening. However, individuals can respond to these emotions differently. The present study tested whether reappraising a negative stimulus versus avoiding a negative stimulus is associated with age; whether these two emotion regulation strategies (reappraisal and situation selection) moderate the effects of disgust, embarrassment and fear on CRC screening intention; and the efficacy of a message based on participants' preferred emotion regulation strategy. METHODS: We recruited 483 Italian participants (aged 40-84 years) through snowball sampling. Participants were randomly assigned to one of four conditions differing for a message promoting CRC screening with an affective lever, a cognitive lever, both levers or none. Key variables included emotion regulation strategies, emotional barriers and intention to get screened. RESULTS: The preference for reappraisal over situation selection increased with age. Reappraisal neutralized the effect of disgust on CRC screening intention. The combined message with both affective and cognitive levers increased CRC screening intention (b = 0.27, ß = 0.11, SE = 0.13 p = .049), whereas reading the message based only on the affective (b = 0.16, ß = 0.06, SE = 0.14 p = .258) or the cognitive (b = 0.22, ß = 0.09, SE = 0.14 p = .107) lever was not effective. CONCLUSIONS: Communication campaigns should support the activation of a reappraisal strategy of emotion control, and messages promoting CRC screening should highlight both the instrumental (i.e., early detection) and affective (i.e., peace of mind) benefits of attendance.

Psychosocial Predictors of Colorectal Cancer Screening Intention: An Experiment on the Invitation Letter.

BACKGROUND: In Italy, attendance rates for colorectal cancer (CRC) screening are suboptimal. The present work analysed cognitive and emotional predictors of CRC screening intention and tested an intervention on a real invitation letter to improve CRC screening intention, both directly and in interaction with the predictors of our model. METHODS: Our model included variables from the theory of planned behaviour and the emotional barriers to bowel screening scale. We applied six changes to an invitation letter used in Italy to avoid the repetition of words like 'faeces', 'blood', or 'occult' and reduce the prompting of disgust. The 228 participants were randomly assigned to a between-participants design (original letter vs. manipulated letter). RESULTS: Disgust hindered CRC screening intention, while embarrassment, fear, and subjective norms (i.e., perception of the social pressures to attend CRC screening) were not associated with intention to screen. More positive attitudes towards CRC screening were associated with a higher intention to screen. The positive association between perceived behavioural control and CRC screening intention was stronger for participants who read the letter with fewer (vs. more) references to bodily waste. Letter manipulation did not affect intention to screen. CONCLUSIONS: The disgust associated with faecal matter is a critical factor in determining CRC screening attendance, and it should be acknowledged as such in public policies. Until new screening tests avoiding the activation of this emotional reaction are concretely available, public campaigns should improve CRC screening participation by boosting both positive attitudes towards screening and patients' perceived behavioural control.

Emotional Barriers to Bowel Screening in Italy: Scale psychometric properties and effects on screening attendance.

OBJECTIVE: To assess a three-factor version of the Emotional Barriers to Bowel Screening (EBBS) scale; analyze the scale's psychometric properties; and investigate the associations of fecal disgust, embarrassment, and fear with colorectal cancer (CRC) screening avoidance. METHODS: Retrospective design: We asked participants to rate negative emotions associated with CRC screenings as well as whether they had ever attended a fecal occult blood test. SAMPLE: 268 Italian adults aged 45-74 years. MEASURES: negative emotions, screening knowledge, CRC risk perception, demographic and background data, and hypothetical medical help-seeking. ANALYSES: Confirmatory factor analyses, correlations, logistic regressions. RESULTS: The EBBS scale is a multidimensional instrument and, at least where fecal tests are of interest, can be used without the insertion disgust subscale. The analyzed negative emotions were negatively correlated with screening attendance and positively correlated with intention to delay seeking medical help. However, logistic regression models showed that, of the three analyzed emotions, fear about outcome was the only significant predictor of screening behavior and delaying medical care. CONCLUSIONS: Further studies can adopt the version of the EBBS scale that is most suitable for their research contexts. Interventions must be designed to reassure patients.

Finally, the chance to eat healthily: Longitudinal study about food consumption during and after the first COVID-19 lockdown in Italy.

With the COVID-19 outbreak, structural constraints and social psychological factors changed the dietary habits of many people. This two-wave longitudinal study performed in Italy aimed to explore people's perceptions of changes in healthy and unhealthy food consumption before and during the first lockdown and the possible persistence of such changes after its official end, as a function of the number of people cohabiting, negative emotion activation, and individual eating styles. A total of 728 Italian adults completed self-reported food consumption measures and related psychological variables at both time points. In the lockdown period, participants reported an increase in healthy food consumption and involvement in cooking and a decrease in the consumption of junk food. This general pattern was stronger for both young and restrained eaters. The intensity of negative emotions and the number of cohabitants were not associated with the examined behaviour. In the post-lockdown period, the new consumption pattern acquired during the confinement was partially discontinued: participants cut down their healthy food consumption as well as their involvement in food preparation, but they continued to reduce their junk food intake. These results suggest that people's food consumption patterns can easily improve when the situation is favourable (e.g., more time and opportunities for cooking healthy meals) and offer an interesting theoretical contribution to understanding the factors useful in promoting healthy eating, in the event of a future outbreak.

Impression formation via #foodporn: Effects of posting gender-stereotyped food pictures on instagram profiles.

Previous studies suggested that food may have gender connotations and plays an important role in impression formation. Since sharing food images through social networks is becoming more and more common, the aim of the present study was to examine whether such images influence observers' judgements of a target. Specifically, we hypothesised that posting images of gender-stereotyped dishes would affect impression formation as a function of their congruence with the sex of the profile owner. In a 2 × 3 study, we varied the sex of the owner of a fictitious Instagram profile, and the image-set composition (masculine dishes vs feminine dishes vs neutral images). Subsequently, we measured the perceived femininity/masculinity, gender-stereotyped traits, and the desire to interact with the profile owner. Results confirmed that food pictures can communicate a profile owner's characteristics, showing that posting masculine dishes dampened women's femininity and the attribution of feminine traits to the target, irrespective of gender, and indirectly reduced participants' intention to meet both targets through the lower attribution of feminine traits (i.e., communion). Moreover, posting gender-congruent food images promoted the congruent gendered impression in observers (i.e., femininity for the woman and masculinity for the man) and in turn increased the desire to interact with him/her. These findings contribute to the understanding of the socio-psychological functions at the basis of sharing one's own eating/cooking experiences on social networks, showing that this behavior has an informational role for observers.

Validation of the revised Food Neophobia Scale (FNS-R) in the Italian context.

Measuring individuals' level of food neophobia, i.e., the reluctance to eat novel food, is a critical task since it negatively affects diet variety and quality. Using structural equations models, the revised Food Neophobia Scale (FNS-R) was validated with a sample of 711 Italian adults. After deleting 4 items characterized by both low face validity and a suboptimal association with the other items, and after correcting statistically for the acquiescent response-set, the resulting 6-item, fully balanced FNS-R showed a good construct validity. Moreover, it showed the expected positive correlations with General Neophobia and with Disgust Sensitivity. Finally, it resulted invariant across participants' genders, age classes, and levels of education, and across methods of administration (paper-and-pencil and on-line). Strong points and possible developments of the study are discussed.

Portion size tells who I am, food type tells who you are: Specific functions of amount and type of food in same- and opposite-sex dyadic eating contexts.

Previous research has shown that women eating small portions of food (vs. eating big portions) are perceived as more feminine, whereas men eating large portions are perceived as more masculine. The specific type of food items have also been shown to carry connotations for gender stereotyping. In addition, matching the co-eater's food quantity is also a means to ingratiate him or her. Thus, a potential motivational conflict between gender identity expression and ingratiation arises when people eat in opposite-sex dyads. Scholars have, thus far, focused their attention on one of these two dimensions at a time, and rarely in relation to the co-eaters' sex. The present study investigated, through a restaurant scenario, the way in which women and men, when asked to imagine having lunch in dyads, combine food choice and quantity regulation as a function of the co-eater's sex. Results showed that participants use the quantity dimension to communicate gender identity, and the food type dimension to ingratiate the co-eater's preferences by matching her/his presumed choice, following gender-based stereotypes about food. In opposite-sex dyads, dishes that incorporate the two dimensions were chosen above the expected frequency.

Ingredients of gender-based stereotypes about food. Indirect influence of food type, portion size and presentation on gendered intentions to eat.

The association between certain foods and masculinity or femininity has been widely discussed in different disciplines. However, extant research has yet to clarify which are the critical dimensions lending these gender connotations to food and thus impacting on the willingness to eat it. We present a study on the role of food type, portion size, and dish presentation as potential factors constituting the gender-based stereotype about food, and their indirect or mediated effect on the intention of men and women to eat certain feminine/masculine stereotyped foods. We manipulated the three features cited above in a 2 (food type: Caprese vs. hamburger) × 2 (portion size: small vs. big) × 2 (presentation: elegant vs. rough) full factorial design. Results confirmed a model of moderated mediation: the Caprese salad, the small portion and the elegantly presented dish (in respect to the hamburger, the big portion and the roughly presented dish) tend to be considered "feminine food", and thus women expressed a more pronounced intention to eat it than men. The implications of the findings for both theory and practice are discussed.

The role of disgust as an emotional barrier to colorectal cancer screening participation: a systematic review and meta-analysis.

OBJECTIVE: Worldwide colorectal cancer (CRC) screening rates are suboptimal. This systematic review and meta-analysis examine the role of disgust in CRC screening avoidance. DESIGN: A systematic literature search was conducted. In all, 46 studies were included in the review. Among these, 16 studies were compared with a meta-analytical approach in order to 1) estimate the effect size of state disgust on screening intention and attendance; 2) examine whether methodological characteristics moderate the effect of state disgust on screening behaviour; 3) estimate the effect sizes of trait disgust and type of exam kit on state disgust. RESULTS: In the reviewed studies, state disgust was often associated with CRC screening and especially with CRC screening avoidance. The meta-analysis confirmed low-to-moderate negative effects of state disgust on screening intention and attendance. Population sampling strategy was the only significant moderator of the effect of state disgust on screening attendance, i.e. studies that used convenience (versus random/representative) samples found a significantly lower effect size. Trait disgust and type of exam kit exerted a large and a moderate-to-large positive effect, respectively, on state disgust. CONCLUSIONS: Disgust can boost CRC screening avoidance. Further studies and interventions must be designed to help patients in overcoming this emotional barrier.

Didactic and narrative persuasion: An experiment to promote colorectal cancer screening.

We tested whether a didactic and a narrative video (i.e. educational content and personal stories versus irrelevant information) could boost colorectal cancer (CRC) screening intention directly and through cognitive predictors of CRC screening behavior. We also tested whether exposure to a story changed participants' affective forecasting, reducing the perception of negative emotions associated with CRC screening (disgust, embarrassment, and fear). The study was conducted online with a between-participants design and recruiting a convenience sample (N = 375). We found that, compared with watching the control video, being exposed to the narrative video about CRC screening was indirectly associated with greater screening intention via vicarious experience and positive attitudes, whereas watching the didactic video was positively associated with CRC screening intention only among participants who had received an invitation letter but did not get screened, and among those yet to receive an invitation to screen. In the latter group, screening intention was boosted through positive attitudes. Our findings do not confirm that stories change affective forecasting, but narration likely fosters messages acceptance through vicarious experience. We also found support for the effectiveness of physicians' recommendations in promoting CRC screening, an intervention that might be effectively administered through a generalized, cost-effective video.

Household crowding during the COVID-19 lockdown fosters anti-democracy even after 17 months: A 5-wave latent growth curve study.

In an earlier cross-sectional study, Roccato et al. (2021) showed that household crowding during the COVID-19 lockdown was positively related to support for anti-democratic political systems. However, little is known about the persistence of these effect over time. In this study, we examined its duration in a longitudinal study structured in five waves, the first in May-June 2019 (before the COVID-19 outbreak, N = 1504) and the others during the pandemic, in April 2020 (during the lockdown, N = 1199), October 2020 (N = 1156), April 2021 (N = 1148), and October 2021 (N = 1151). The increase in support for anti-democratic systems associated with household overcrowding in the initial phase of the lockdown (Wave 2) did not change over the subsequent 17 months. Moreover, the effect was stronger among those who had high (compared with low) trust in democratic political institutions before the pandemic. Strengths, limitations, and potential developments of the study are discussed.

Dining with liberals and conservatives: The social underpinnings of food neophobia.

Although food and politics seem to be distant domains, socio-political ideology and food neophobia (i.e., reluctance to eat unfamiliar food) may be related. Conservatives' high threat sensitivity and the inherently threatening nature of novel foods (the existential explanation), along with conservatives' negative attitudes toward minority outgroups (e.g., foreigners) and the role of the latter in introducing novel foods to a culture (the social explanation), led us to expect that socio-political ideology would predict food neophobia over and above their common roots. Across two correlational and two experimental studies (N = 627), socio-political ideology emerged as a strong predictor of food neophobia. In addition, the findings did not support the existential explanation, while confirming the social explanation of the ideology-food neophobia link: Conservatives seem more neophobic than liberals not because of their higher threat sensitivity but rather because they hold more negative attitudes toward foreigners who are associated with those foods.

Adding Insult to Injury: The Effects of Intimate Partner Violence Spillover on the Victim's Reputation.

This article examined indirect consequences for the victims of intimate partner violence (IPV) in terms of ostracism and reputational threats. Through an experimental vignette survey, we compared bystanders' reactions to either an intimate partner violence episode or a generic violence episode. A victim of IPV (vs. generic violence) received a more negative moral evaluation and was considered as more responsible for the violence perpetrated on her. This made participants not only anticipate a less positive reputation attributed to the victim but also report less willingness to approach and defend the victim and include her in relevant ingroups 1 year after the episode.

More guilty if woman: The role of gender and causal attribution in political scandals' impact.

Political scandals can have a great impact for the perpetrator, but negative consequences may vary considerably depending on such factors as personal characteristics of the involved political actors or citizens' expectations. The present study investigated the effect of the gender of the politician involved in different kinds of scandals deriving from the transgression of gender role-based expectations and the role of participants' attribution of responsibility (internal vs. external) on their evaluation of the perpetrator. Results showed that participants did not express different evaluations of the female versus male politician when their behavior testified to a lack of qualities stereotypically associated to men and women. But when participants attributed the responsibility of the scandal to the perpetrator, women were punished more severely than their male colleagues. Theoretical and practical implications of the findings are discussed.

Household crowding can have political effects: An empirical study on support for anti-democratic political systems during the COVID-19 lockdown in Italy.

We analysed some political consequences of household crowding during the 2020 COVID-19 lockdown across a wide quota sample of the Italian adult population, stratified as concerns gender, age, level of education, geographical area of residence, and size of area of residence, interviewed before (May-June 2019) and during (April 2020) the lockdown (N = 1,047, 51.2% women, M age = 50.44, SD = 14.36). Path analysis showed that household crowding during the lockdown was positively associated with support for anti-democratic political systems, through the partial mediation of the perceived relative impact of COVID-19 on one's family and of expectations of future lifestyle restrictions due to the pandemic. These associations did not depend on participants' pre-pandemic socio-economic status and predisposition to strong political leaders. Strengths, limitations, and possible developments of the study are discussed.

The Lasting Effects of the COVID-19 Pandemic on Support for Anti-Democratic Political Systems: A Six-Month Longitudinal Study.

Objectives: We aimed to analyze the enduring effects exerted by COVID-19 exposure and subjective economic threats on support for anti-democratic political systems. Method: We performed a two-wave longitudinal study on a quota panel of the Italian adult population (N  =  1,073), surveyed first in April 2020, during the first peak of the pandemic (T 1) and the first lockdown, and second in October 2020, at the onset of the second peak of the pandemic and of the second lockdown (T 2). Results: A mediation model showed that COVID-19 exposure and subjective economic threats, measured at T 1, fostered a negative evaluation of how the government managed the pandemic, which, in turn, had a positive association with support for anti-democratic political systems, both measured at T 2. Conclusion: The existential threats related to the COVID-19 pandemic have enduring political consequences, undermining people's support for democracy, even six months after their onset.

Coping with the COVID-19 pandemic through institutional trust: Rally effects, compensatory control, and emotions.

Objective: Exogenous shocks trigger rally effects, leading the public opinion toward increased trust in institutions. Rally effects have an important social function because they help society react to shocks rapidly and efficiently as a single unit and cohesively face the threat. However, little is known about the individual functions that these effects fulfil. In this study, we aimed to analyze the individual functions of the rally effect. Method: In a three-wave longitudinal study on a quota sample of the Italian adult population (N = 1070), we analyzed the individual consequences of the increase in institutional trust triggered by the COVID-19 pandemic. Results: A path analysis showed that increased trust in political, super partes and international institutions fostered well-being, reducing anxiety, collective angst, and anger via the mediation of participants' perceived control over their lives. Conclusion: Beyond their well-known social functions, rally effects fulfil the individual function of favoring people's psychological well-being.

A Democratic Emergency After a Health Emergency? Exposure to COVID-19, Perceived Economic Threat and Support for Anti-Democratic Political Systems.

Objectives: The urgency of the COVID-19 pandemic has led governments to impose restrictions on individual freedom and required citizens to comply with these restrictions. In addition, lockdowns related to COVID-19 have led to a significant economic crisis. We aimed to study how the pandemic and related economic threats have impacted support for anti-democratic political systems. Method: We analyzed data from a quota panel of the Italian adult population (N = 1,195), surveyed once before and once during the pandemic. Results: A hierarchical regression model showed that exposure to COVID-19 and perceived economic insecurity were associated with support for anti-democratic political systems, independent of participants' predispositions toward a strong leader. Conclusion: An authoritarian personality is not a necessary precondition for individual anti-democracy: when facing severe personal threats, anyone could restore a subjective sense of control over the social world by becoming anti-democratic, independent of their initial predisposition to support anti-democratic political systems.

Me, us, or them: who is more conformist? Perception of conformity and political orientation.

Research has shown that people perceive others as more vulnerable than themselves to media communication, and their political out-group as more vulnerable than their political in-group. In the present study, the authors predicted that the same two biases would appear with respect to another kind of influence--conformity--but that participants' judgments would display a different pattern according to their political orientations. Right-wing and left-wing university students were asked to evaluate conformity and to estimate how conformist they, their political in-group, their political out-group, and other groups are. As hypothesized, right-wingers expressed more ambivalence toward conformity and viewed it less negatively than did left-wingers. Political orientation had no impact on the discrepancy between self and others, but it did moderate the in-group-out-group discrepancy.