Concealing Infectious Disease

Regents Of The University Of Michigan - Ann Arbor, Ann Arbor MI

Investigators

Abstract

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.