Differences in adherence to COVID-19 pandemic containment measures: psychopathy traits, empathy, and sex

Lucas de Francisco Carvalho Gisele Magarotto Machado About the authors

The coronavirus disease 2019 (COVID-19) pandemic required the implementation of containment measures to slow the spread of the virus.11. Wilder-Smith A, Chiew CJ, Lee VJ. Can we contain the COVID-19 outbreak with the same measures as for SARS? Lancet Infect Dis. 2020;20:102-7. , 22. Wilder-Smith A, Freedman DO. Isolation. quarantine. social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak. J Travel Med. 2020;27:3-13. The main measures are social distance, personal hygiene, and the use of face masks.33. World Health Organization. Coronavirus disease (COVID-19) advice for the public [internet]. 2020 [cited 2020 May 5]. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
https://www.who.int/emergencies/diseases...
Adherence to containment measures depends on individual factors,44. Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD. How will country-based mitigation measures influence the course of the COVID-19 epidemic? Lancet. 2020;395:931-6. including personality traits.55. Bogg T, Milad E. Slowing the spread of COVID-19: demographic, personality, and social cognition predictors of guideline adherence in a representative U.S. sample. PsyArXiv [Preprint]. 2020 [cited 2020 May 15]. https://psyarxiv.com/yc2gq/
https://psyarxiv.com/yc2gq/...
, 66. Carvalho LF, Pianowski G, Gonçalves AP. Personality differences and COVID-19: are extroversion and conscientiousness personality traits associated with engagement with containment measures? Trends Psychiatry Psychother. 2020;42:179-84. Previous evidence indicates that people with high levels of empathy tend to adhere more to containment measures.77. Pfattheicher S, Nockur L, Böhm R, Sassenrath C, Petersen M. The emotional path to action: empathy promotes physical distancing during the COVID-19 pandemic. PsyArXiv [Preprint]. 2020 [cited 2020 May 15]. https://psyarxiv.com/y2cg5/
https://psyarxiv.com/y2cg5/...
In contrast, people presenting high scores on the dark triad traits tend to adhere less to these measures.88. Blagov PS. Adaptive and dark personality traits in the Covid-19 pandemic: predicting health-behavior endorsement and the appeal of public-health messages. PsyArXiv [Preprint]. 2020 [cited 2020 May 16]. https://psyarxiv.com/chgkn/
https://psyarxiv.com/chgkn/...
, 99. Stadler M, Niepel C, Botes E, Dörendahl J, Krieger F, Greiff S. Individual psychological responses to the SARS-CoV-2 pandemic: different clusters and their relation to risk-reducing behavior. PsyArXiv [Preprint]. 2020 [cited 2020 May 16]. https://psyarxiv.com/k8unc/
https://psyarxiv.com/k8unc/...
The expression dark triad refers to the set of three constellations of subclinical socially aversive traits: machiavellianism, narcissism, and psychopathy.1010. Paulhus DL, Williams KM. The dark triad of personality: narcissism, Machiavellianism, and psychopathy. J Res Pers. 2002;36:556-63. Each component of the dark triad has specific characteristics, although they overlap in terms of manipulation and insensitivity traits.1111. Furnham A, Richards SC, Paulhus DL. The dark triad of personality: a 10 year review. Soc Personal Psychol Compass. 2013;7:199-216. In this study, our focus was on one of the components of the dark triad, namely, psychopathy.

Psychopathy is characterized mainly by callousness and lack of empathy,1212. Verschuere B, van Ghesel GS, Waldorp L, Watts AL, Lilienfeld SO, Edens JF, et al. What features of psychopathy might be central? A network analysis of the Psychopathy Checklist-Revised (PCL-R) in three large samples. J Abnorm Psychol. 2018;127:51-65. including traits of irresponsibility, a tendency to behave in a socially deviant manner, tendency to deceive, grandiosity, recklessness, and impulsiveness.1313. Hare RD. Psychopathy: a clinical construct whose time has come. Crim Justice Behav. 1996;23:25-54. , 1414. Patrick CJ, Fowles DC, Krueger RF. Triarchic conceptualization of psychopathy: developmental origins of disinhibition, boldness, and meanness. Dev Psychopathol. 2009;21:913-38. Moreover, psychopathy is associated with antisocial and criminal behaviors.1515. Hare RD. Manual for the Psychopathy Checklist-Revised. 2th ed. Canada: Multi-Health Systems; 2003. , 1616. Hare RD, Neumann CS. Psychopathy: assessment and forensic implications. Can J Psychiatry. 2009;54:791-802. Studies indicate that men score higher than women in psychopathy traits.1717. Cale EM, Lilienfeld SO. Sex differences in psychopathy and antisocial personality disorder: a review and integration. Clin Psychol Rev. 2002;22:1179-207. , 1818. Rogstad J, Rogers R. Gender differences in contributions of emotion to psychopathy and antisocial personality disorder. Clin Psychol Rev. 2008;28:1472-84.

Taking into consideration the association between individual differences and adherence to COVID-19 containment measures,44. Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD. How will country-based mitigation measures influence the course of the COVID-19 epidemic? Lancet. 2020;395:931-6. as well as previous evidence indicating that typical psychopathic traits are associated with transgressive behaviors, this study aimed to investigate relationships between psychopathy traits and adherence to containment measures of the COVID-19 pandemic, also observing differences between men and women.

A total of 893 adult participants were included in the study. Age ranged from 18 to 79 years (mean [M] = 34.77; standard deviation [SD] = 11.98), they were mostly women (80%) and Caucasian (71.2%), and most reported having a graduate degree (39%).

Participants answered a web-based questionnaire released on online social networks containing questions about adherence to COVID-19 pandemic containment measures, facets of the Personality Inventory for DSM-5 (PID-5),1919. Krueger RF, Derringer J, Markon KE, Watson D, Skodol AE. Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychol Med. 2011;42:1879-90. which assesses pathological personality traits, and the Affective and Cognitive Measure of Empathy (ACME),2020. Vachon DD, Lynam DR. Fixing the problem with empathy. Assessment. 2005,23:135-49. which evaluates the empathy trait through the affective resonance indicator. Regarding adherence indicators, the items focused on four dimensions: social distancing (engagement to social distance measure; three items), hygiene (engagement in hygienic recommendations; three items), face mask (using face mask; two items), and staying home (never leaving home; one item).

After approval by the Universidade São Francisco research ethics committee, data collection was performed online using Google Forms. We shared the survey link on the social media website Facebook and also via the WhatsApp application, inviting individuals to participate and relying on the snowball strategy to reach a larger number of participants.

We used latent profile analysis to empirically discriminate groups according to the scores obtained on the personality measures. Latent profile analysis is recommended to the investigation of different subpopulations, according to distinct answer patterns to a group of variables.2121. Goodman LA. Exploratory latent structure analysis using both identifiable and unidentifiable models. Biometrika. 1974;61:215-31. , 2222. Muthén BO. Latent variable modeling in heterogeneous populations. Psychometrika. 1989;54:557-85. For this analysis, we used the following indicators: scores on affective resonance (ACME), callousness, deceitfulness, grandiosity, impulsivity, irresponsibility, and risk-taking (PID-5). Previously to this analysis, we standardized the scores in z (M = 0; SD = 1). Comparisons between means were conducted using analysis of variance (ANOVA) to assess differences in adherence to the containment measures, including the groups identified by the latent profile analysis and the sex variable. For ANOVA, we used 0.05 as significance level, and the partial eta squared was used as an effect size indicator. The partial eta squared was interpreted as 0.01 (small), 0.09 (medium) and 0.25 (large).2323. Cohen J, Miles J, Shevlin M. Applying regression and correlation: a guide for students and researchers. London: Sage; 2001. Latent profile analyses were performed in the software Mplus version 7, and ANOVA in the Statistical Package for the Social Sciences (SPSS) version 23.

For the latent profile analysis, we tested solutions with two, three, and four profiles. Although the two-profile solution did not demonstrate the best-fit indices, it did have acceptable fit indices,2424. Lo Y, Mendell N, Rubin DB. Testing the number of components in a normal mixture. Biometrika. 2001;88:767-78.

25. McLachlan G, Peel D. Finite mixture models. New York: Wiley; 2000.
- 2626. Nylund K, Asparouhov T, Muthén B. Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Struct Equ Modeling. 2007;14:535-69. and better interpretability for the observed profiles. The adjustment indices were adjusted Bayesian information criteria (aBIC) = 16883.167; entropy = 0.978; Lo-Mendell-Rubin adjusted likelihood ratio test (LMRT) = 0.0001. Figure 1A shows the two profiles observed.

Figure 1
A) Composition of profiles obtained via latent profile analysis; B) means obtained according to profile and sex.

The tendency to psychopathy traits group (profile 1) comprised 77 participants who showed higher means in psychopathy traits and lower affective resonance; 7.4% of the all the participating women and 12.8% of all the men were in this group. The tendency to empathy group (profile 2) comprised 816 people, and had a higher level of affective resonance and lower scores on psychopathy traits; 92.6% of women and 87.2% of men were in this group.

The groups found in the latent profile analysis were compared in terms of adherence to containment measures against the COVID-19 pandemic. The sex variable was also considered in the analysis. Profiles differed significantly regarding adherence to containment measures, except in the hygiene dimension. There were no significant differences regarding sex. The results are shown in Table 1 .

Table 1
Profile and gender comparison regarding adherence to containment measures.

This study aimed to investigate relationships between indicators of adherence to COVID-19 containment measures and indicators of psychopathy. In addition, we assessed the impact of the sex variable on that relationship. The results indicated that people with increased psychopathy traits and low levels of empathy tend to adhere less to containment measures in comparison to people not showing these characteristics, which is in line with previous findings suggesting personality traits as associated with adherence to containment measures in the COVID-19 pandemic.55. Bogg T, Milad E. Slowing the spread of COVID-19: demographic, personality, and social cognition predictors of guideline adherence in a representative U.S. sample. PsyArXiv [Preprint]. 2020 [cited 2020 May 15]. https://psyarxiv.com/yc2gq/
https://psyarxiv.com/yc2gq/...
- 66. Carvalho LF, Pianowski G, Gonçalves AP. Personality differences and COVID-19: are extroversion and conscientiousness personality traits associated with engagement with containment measures? Trends Psychiatry Psychother. 2020;42:179-84. , 88. Blagov PS. Adaptive and dark personality traits in the Covid-19 pandemic: predicting health-behavior endorsement and the appeal of public-health messages. PsyArXiv [Preprint]. 2020 [cited 2020 May 16]. https://psyarxiv.com/chgkn/
https://psyarxiv.com/chgkn/...
- 99. Stadler M, Niepel C, Botes E, Dörendahl J, Krieger F, Greiff S. Individual psychological responses to the SARS-CoV-2 pandemic: different clusters and their relation to risk-reducing behavior. PsyArXiv [Preprint]. 2020 [cited 2020 May 16]. https://psyarxiv.com/k8unc/
https://psyarxiv.com/k8unc/...
Furthermore, our findings add to the existing literature77. Pfattheicher S, Nockur L, Böhm R, Sassenrath C, Petersen M. The emotional path to action: empathy promotes physical distancing during the COVID-19 pandemic. PsyArXiv [Preprint]. 2020 [cited 2020 May 15]. https://psyarxiv.com/y2cg5/
https://psyarxiv.com/y2cg5/...
, 1515. Hare RD. Manual for the Psychopathy Checklist-Revised. 2th ed. Canada: Multi-Health Systems; 2003. - 1616. Hare RD, Neumann CS. Psychopathy: assessment and forensic implications. Can J Psychiatry. 2009;54:791-802. by indicating traits of psychopathy as associated with transgressive behaviors, and empathy traits as associated with cooperation. Conversely, even though there is evidence suggesting that men are more likely to exhibit behaviors typical of psychopathy than women,1717. Cale EM, Lilienfeld SO. Sex differences in psychopathy and antisocial personality disorder: a review and integration. Clin Psychol Rev. 2002;22:1179-207. , 1818. Rogstad J, Rogers R. Gender differences in contributions of emotion to psychopathy and antisocial personality disorder. Clin Psychol Rev. 2008;28:1472-84. no significant differences were found regarding adherence to containment measures and sex. These findings may be related to the manifestation of psychopathy traits in men and women. For instance, male psychopaths often manifest impulsivity and conduct problems such as violent behavior, whereas female psychopaths usually engage in running away, self-harming behaviors, manipulation, and property crimes such as theft or fraud.2727. Wynn R, Høiseth MH, Pettersen G. Psychopathy in women: theoretical and clinical perspectives. Int J Womens Health. 2012;1:257-63.

Our findings indicate that psychopathy traits should be accounted for as relevant while establishing public policies to increase and maintain adherence to COVID-19 containment measures. These findings should be considered for both men and women, as we did not observe differences regarding sex.

The present findings should be considered in light of the methodological limitations of our study. First, the data were collected online, which may imply a bias regarding the demographic characteristics of the sample. Second, the sample consisted of a larger number of women (80%), which may have skewed the findings. Given these limitations, we recommend that this study be replicated using representative samples. We also suggest that other studies investigate the interaction between psychopathic traits and other variables and their influence on adherence to containment measures.

References

  • 1
    Wilder-Smith A, Chiew CJ, Lee VJ. Can we contain the COVID-19 outbreak with the same measures as for SARS? Lancet Infect Dis. 2020;20:102-7.
  • 2
    Wilder-Smith A, Freedman DO. Isolation. quarantine. social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak. J Travel Med. 2020;27:3-13.
  • 3
    World Health Organization. Coronavirus disease (COVID-19) advice for the public [internet]. 2020 [cited 2020 May 5]. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
    » https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
  • 4
    Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD. How will country-based mitigation measures influence the course of the COVID-19 epidemic? Lancet. 2020;395:931-6.
  • 5
    Bogg T, Milad E. Slowing the spread of COVID-19: demographic, personality, and social cognition predictors of guideline adherence in a representative U.S. sample. PsyArXiv [Preprint]. 2020 [cited 2020 May 15]. https://psyarxiv.com/yc2gq/
    » https://psyarxiv.com/yc2gq/
  • 6
    Carvalho LF, Pianowski G, Gonçalves AP. Personality differences and COVID-19: are extroversion and conscientiousness personality traits associated with engagement with containment measures? Trends Psychiatry Psychother. 2020;42:179-84.
  • 7
    Pfattheicher S, Nockur L, Böhm R, Sassenrath C, Petersen M. The emotional path to action: empathy promotes physical distancing during the COVID-19 pandemic. PsyArXiv [Preprint]. 2020 [cited 2020 May 15]. https://psyarxiv.com/y2cg5/
    » https://psyarxiv.com/y2cg5/
  • 8
    Blagov PS. Adaptive and dark personality traits in the Covid-19 pandemic: predicting health-behavior endorsement and the appeal of public-health messages. PsyArXiv [Preprint]. 2020 [cited 2020 May 16]. https://psyarxiv.com/chgkn/
    » https://psyarxiv.com/chgkn/
  • 9
    Stadler M, Niepel C, Botes E, Dörendahl J, Krieger F, Greiff S. Individual psychological responses to the SARS-CoV-2 pandemic: different clusters and their relation to risk-reducing behavior. PsyArXiv [Preprint]. 2020 [cited 2020 May 16]. https://psyarxiv.com/k8unc/
    » https://psyarxiv.com/k8unc/
  • 10
    Paulhus DL, Williams KM. The dark triad of personality: narcissism, Machiavellianism, and psychopathy. J Res Pers. 2002;36:556-63.
  • 11
    Furnham A, Richards SC, Paulhus DL. The dark triad of personality: a 10 year review. Soc Personal Psychol Compass. 2013;7:199-216.
  • 12
    Verschuere B, van Ghesel GS, Waldorp L, Watts AL, Lilienfeld SO, Edens JF, et al. What features of psychopathy might be central? A network analysis of the Psychopathy Checklist-Revised (PCL-R) in three large samples. J Abnorm Psychol. 2018;127:51-65.
  • 13
    Hare RD. Psychopathy: a clinical construct whose time has come. Crim Justice Behav. 1996;23:25-54.
  • 14
    Patrick CJ, Fowles DC, Krueger RF. Triarchic conceptualization of psychopathy: developmental origins of disinhibition, boldness, and meanness. Dev Psychopathol. 2009;21:913-38.
  • 15
    Hare RD. Manual for the Psychopathy Checklist-Revised. 2th ed. Canada: Multi-Health Systems; 2003.
  • 16
    Hare RD, Neumann CS. Psychopathy: assessment and forensic implications. Can J Psychiatry. 2009;54:791-802.
  • 17
    Cale EM, Lilienfeld SO. Sex differences in psychopathy and antisocial personality disorder: a review and integration. Clin Psychol Rev. 2002;22:1179-207.
  • 18
    Rogstad J, Rogers R. Gender differences in contributions of emotion to psychopathy and antisocial personality disorder. Clin Psychol Rev. 2008;28:1472-84.
  • 19
    Krueger RF, Derringer J, Markon KE, Watson D, Skodol AE. Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychol Med. 2011;42:1879-90.
  • 20
    Vachon DD, Lynam DR. Fixing the problem with empathy. Assessment. 2005,23:135-49.
  • 21
    Goodman LA. Exploratory latent structure analysis using both identifiable and unidentifiable models. Biometrika. 1974;61:215-31.
  • 22
    Muthén BO. Latent variable modeling in heterogeneous populations. Psychometrika. 1989;54:557-85.
  • 23
    Cohen J, Miles J, Shevlin M. Applying regression and correlation: a guide for students and researchers. London: Sage; 2001.
  • 24
    Lo Y, Mendell N, Rubin DB. Testing the number of components in a normal mixture. Biometrika. 2001;88:767-78.
  • 25
    McLachlan G, Peel D. Finite mixture models. New York: Wiley; 2000.
  • 26
    Nylund K, Asparouhov T, Muthén B. Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Struct Equ Modeling. 2007;14:535-69.
  • 27
    Wynn R, Høiseth MH, Pettersen G. Psychopathy in women: theoretical and clinical perspectives. Int J Womens Health. 2012;1:257-63.

Publication Dates

  • Publication in this collection
    25 Sept 2020
  • Date of issue
    Oct-Dec 2020

History

  • Received
    18 May 2020
  • Accepted
    07 Aug 2020
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