Psychological Disease Avoidance Linked to Preventative Behavior

Summary: Those who have a psychological aversion to germs are more likely to engage in preventative behaviors to protect their health, like wearing a mask and frequently sanitizing their hands.

Source: University of Connecticut

Creeped out by cooties? Grossed out by germs? Squeamish about sickness?

If so, then you might also find yourself engaging in more preventative health behaviors, like frequent handwashing and disinfecting your living environment, during the ongoing coronavirus pandemic.

More than other factors, strong feelings of germ aversion and pathogen disgust are significantly associated with concern about COVID-19 and preventative behavior, according to findings from UConn School of Nursing researchers published in the journal PLOS ONE.

The findings are part of a year-long examination of how behavior and social attitudes change, and what factors influence those changes, when people in the United States are faced with the threat of widespread disease. Supported by a National Science Foundation grant, the study is tracking the well-being, feelings, and behavioral practices of about 1,000 individuals across the country, and more than 18 surveys of the participants have already been conducted since kicking off in March.

“When we feel disgust toward something, our behavioral response is to avoid it and get away from it, but people vary in their experience of disgust,” says Natalie J. Shook, a social psychologist, associate professor, and principal investigator for the study. “In thinking about these psychological processes, what we’re interested in is whether people who are already more sensitive to potential disease threats are then more inclined to follow prescribed preventative health behaviors.”

Shook and her team asked study participants about their overall concerns about COVID-19 and about how often they engaged in preventative health behaviors like physical distancing, frequent hand washing, avoiding touching their face, wearing a facemask, and cleaning and disinfecting.

Participants also answered a series of demographic and social questions, including their age, political and religious values, and socioeconomic status, as well as questions designed to gauge risk factors for the disease – whether they had an underlying health condition that might predispose them to severe illness, whether a family member might be at greater perceived risk, or whether they recently had or believed that they had been ill with COVID-19.

“What we found in our data set was that the most consistent predictors of concern about COVID and then engagement in preventative health behaviors are actually those psychological disease avoidance factors,” says Shook.

More than factors like age, perceived risk, or political stance, individuals who indicated strong feelings of germ aversion and pathogen disgust also reported greater concern for COVID-19 and increased participation in preventative behaviors. The researchers also found that the people most likely to be impacted by the virus are not necessarily those most likely to be engaging in preventative behaviors.

“Older participants reported more concern about COVID, which makes sense – they’re at higher risk,” Shook says. “But when we looked at preventative health behaviors, we weren’t necessarily seeing that older adults were engaging more in preventative health behaviors. So, where there was the concern, that wasn’t necessarily translating into the behaviors that could protect them.”

Individuals with higher incomes were associated with more engagement in physical distancing and cleaning behaviors, but they would also have greater access to resources – like cleaning supplies – and the potential to work from home because of their socioeconomic status, Shook says. Recent illness and general perceived health were also linked with many preventative health behaviors, though the individual reasons could vary, from motivations to prevent others from becoming ill to greater awareness due to recent illness.

This shows a woman in a facemask sanitizing her hands
People already worried about germs and pathogens are more likely to engage in preventative health behaviors during the pandemic Image is credited to University of Connecticut.

Shook and her team say their findings identify a variety of characteristics that may place individuals at risk for contracting and spreading disease during a pandemic.

“We took a really broad approach to looking at the different factors that are related to different preventative health behaviors,” says Shook. “The fact we are seeing psychological disease avoidance variables as coming out more consistently – which conceptually was not surprising, that’s what they should be doing, but that we’re seeing those above and beyond traditional personality traits and demographics – I think might speak to something we could potentially tap into.”

Shook and her team hope to release additional findings related to initial survey data – including findings on mental health, job security and financial concerns, and vaccination related to COVID-19 – to be released in the coming weeks and months as their year-long examination continues.

Funding: This study is supported by NSF Award No. 2027027. UConn’s Institute for Collaboration on Health, Intervention, and Policy (InCHIP) is the managing institute for the grant. Please visit for more information, and visit to learn more about InCHIP and its Rapid Response Proposals to Address COVID-19.

About this health psychology research article

University of Connecticut
Jaclyn M. Severance – University of Connecticut
Image Source:
The image is credited to University of Connecticut.

Original Research: Open access
“Disease avoidance in the time of COVID-19: The behavioral immune system is associated with concern and preventative health behaviors” by Natalie J. Shook, Barış Sevi, Jerin Lee, Benjamin Oosterhoff, Holly N. Fitzgerald. PLOS ONE.


Disease avoidance in the time of COVID-19: The behavioral immune system is associated with concern and preventative health behaviors

The coronavirus disease 2019 (COVID-19) poses a serious global health threat. Without a vaccine, behavior change is the most effective means of reducing disease transmission. Identifying psychological factors that may encourage engagement in preventative health behaviors is crucial. The behavioral immune system (BIS) represents a set of psychological processes thought to promote health by encouraging disease avoidance behaviors. This study examined whether individual differences in BIS reactivity (germ aversion, pathogen disgust sensitivity) were associated with concern about COVID-19 and engagement in recommended preventative health behaviors (social distancing, handwashing, cleaning/disinfecting, avoiding touching face, wearing facemasks). From March 20 to 23, 2020, a US national sample (N = 1019) completed an online survey. Germ aversion and pathogen disgust sensitivity were the two variables most consistently associated with COVID-19 concern and preventative health behaviors, while accounting for demographic, health, and psychosocial covariates. Findings have implications for the development of interventions intended to increase preventative health behaviors.

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