Newswise — Wearing a face covering in public is now widely recommended, if not required, to slow the spread of COVID-19, but many people are refusing to do so.

Although discomfort, confusion and even political affiliation are often cited as reasons that make people less likely to wear a mask in public, the psychological traits that shape a person’s behavioral choices may also factor into the decision.

“Research published during previous pandemics such as SARS and Ebola have identified certain traits as playing a role in this decision (Taylor, 2019), including people who tend to think that everything's going to work out in the end,” said Emanuel Maidenberg, PhD, clinical professor of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA.

“There isn’t enough data to know how the decision is actually made and what it looks like once it is made,” he continued. “But people who have a low sensitivity to health-related concerns may fall into this category. “

People who are unwilling to take preventive measures to stop the spread of disease generally fall into two categories:

Low Health Anxiety: People with health anxiety obsessively fear and worry about their health, whereas people with low health anxiety tend to do the opposite. Those with low health anxiety may underestimate the threat of disease during a pandemic.

Unrealistic Optimism Bias: People who are overly optimistic about their health may pose a serious societal threat during a pandemic, research has shown. People with this trait are unlikely to participate in proper preventive health behaviors, such as wearing masks, proper handwashing and vaccination when it becomes available.

Research also has shown that people who are unwilling to vaccinate pose a particular threat to public health since even a minority of refusals may have sizeable repercussions and compromise efforts to eradicate COVID-19 through vaccine distribution.

“The other extreme would be people who are very pessimistic or negative about things,” Maidenberg said. “It’s easy to define the two extremes. It's much more challenging to describe how it looks like in the middle, particularly because of these times that are so unusual.”

Maidenberg added that having extreme health anxiety may prevent some people from returning to a normal routine once social distancing is no longer needed.

“This is what sort of constitutes the Japanese term of hikikomori, which is this form of social anxiety that leads people to start isolating,” he said. “At the present time, isolation is the call, so it's not a choice. But those who have that tendency, or predisposition of some kind, are more likely to do exactly that and then have a hard time returning to a more normative routine.”