Concealing Infectious Disease

生病是一种常见的经历，但人们并不总是告诉别人，当他们生病的传染病。不披露或主动隐瞒疾病对个人、公众甚至组织的健康都构成了明显的风险。例如，大流行前的调查显示，高达90%的美国员工在生病时仍然去工作，仅普通感冒一项的生产力损失估计每年接近250亿美元。为了帮助更好地理解隐瞒传染病的决定，本项目涉及两个主题：（1）什么个人和社会因素与隐瞒疾病有关？例如，隐瞒疾病在特定类型的关系中更常见，还是具有某些人格特征的人更常见？是否要看病情是否特别危险？(2)做这个决定的心理后果是什么？例如，隐瞒疾病所涉及的心理努力是否会干扰人们的思考和解决问题的能力，是否会损害他们的社会关系，是否会引发可能导致反社会倾向的内疚和羞耻感？为了测试这些问题，一组描述性研究测量了人们隐瞒疾病的频率以及根据谁被隐瞒（朋友，同事，陌生人）和疾病的特征（传播风险，伤害严重程度，疾病寿命）来激发这些决定的动机。在第二组实验中，当研究参与者报告实际上患有传染病时，他们被招募。这里的重点是隐藏自己的疾病是否会导致认知功能（侵入性想法，压力下的表现），社会关系（感觉与他人联系并重视他人）和道德判断（不诚实，内疚/羞耻的自我认同）的变化。最后，将与感染隐瞒相关的心理过程与与非感染性疾病隐瞒相关的过程（如污名化的身份和秘密）进行比较，以帮助确定隐瞒疾病是否是一种独特的行为，需要独特的解决方案。该项目为今后努力减轻与疾病传播相关的公共卫生挑战和相关的工作场所挑战提供了信息。它还提供了一个基础，通过提高有关的认知障碍，揭示一个人的病情和由此产生的认知和情感的影响，当一个不透露的知识，以改善受感染的个人的福利。这个奖项反映了NSF的法定使命，并已被认为是值得通过使用基金会的智力价值和更广泛的影响审查标准进行评估的支持。

Sickness is a common experience, yet people do not always tell others when they are sick with an infectious illness. Failing to disclose, or actively hiding, illness presents clear risks to individual, public, and even organizational health. For instance, pre-pandemic surveys indicate that up to 90% of U.S. employees still go to the workplace when sick, and productivity losses from the common cold alone are estimated at close to $25 billion annually. To help better understand decisions to conceal infectious disease, this project addresses two main themes: (1) What individual and social factors are associated with the concealment of sickness? For example, is concealing illness more common in specific types of relationships or by people with certain personality traits? Does it depend on whether the illness is particularly dangerous or not? (2) What are the psychological consequences of making this decision? For example, does the mental effort involved in concealing sickness interfere with people’s thinking and problem-solving abilities, does it impair their social relationships, and does it trigger feelings of guilt and shame that might contribute to antisocial tendencies?To test these questions, one set of descriptive studies measures how often people hide sickness and what motivates those decisions depending on who is being concealed from (friends, coworkers, strangers) and features of the illness being concealed (transmission risk, harm severity, illness longevity). In a second set of experiments, study participants are enrolled when they report actually becoming sick with an infectious illness. The focus here is whether concealing one’s illness causes changes in cognitive functioning (intrusive thoughts, performance under stress), social relationships (feeling connected to and valuing others), and moral judgment (self-identification of dishonesty, guilt/shame). Finally, psychological processes associated with infection concealment are compared against processes associated with concealment of non-infectious conditions, such as stigmatized identities and secrets, to help determine whether concealing sickness is a unique behavior requiring unique solutions. The project informs future efforts to mitigate public health challenges associated with the spread of disease and associated workplace challenges. It also provides a basis for improving the welfare of infected individuals by advancing knowledge about perceived barriers to revealing one’s condition and the resulting cognitive and affective impact when one does not reveal.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.