Mark Ashby is an independent researcher interested in upland and farmland ecology, and evidence synthesis.
A couple of weeks ago, you may have noticed the stream of headlines suggesting that the refusal to wear a face mask is linked to sociopathy or sociopathic tendencies1-8. These headlines were written in response to the findings of a study published in Personality and Individual Differences suggesting that non-compliance with COVID-19 containment measures is associated with sociopathic traits, such as lower levels of empathy and higher levels of callousness, deceitfulness and risk-taking9. If correct, such a finding would be extremely convenient for the pro-lockdown zealots. Indeed, it is much easier to punish those who are non-compliant if you think they are in some way less human. But are the findings of this study correct? Are those of us who shun the muzzle really more likely to be bare-faced sociopaths? The short answer is no. However, rather than take my word for it, let’s cast a critical eye over the study in question.
A brief description of the study methods
In the preamble, the authors hypothesise that “people with higher levels of antisocial traits and lower levels of empathy would tend to show more difficulty in adhering to the containment measures”. Low levels of empathy and antisocial traits, such as callousness, deceitfulness, and risk-taking, are associated with antisocial personality disorder – sociopathy in common parlance. Empathy levels were evaluated using the Affective and Cognitive Measure of Empathy (ACME) self-report scale10, whereas antisocial traits were assessed using the Personality Inventory for DSM-5 (PID-5) self-report test11. Adherence to COVID-19 containment measures was determined using yet another self-report questionnaire:
- Do you think it is necessary to avoid approaching people as much as possible until the coronavirus situation is controlled? (Social distancing).
- Do you think it is necessary to wash your hands and/or use alcohol gel as many times a day until the coronavirus situation is controlled? (Hygiene).
- Do you think it is necessary to use a facemask (that protects nose and mouth) in Brazil? (Facemask).
Non-adherence to each COVID-19 containment measure was assumed if a respondent answered “no”. I presume that all three self-report questionnaires are anonymous as this is standard practice, but this is never stated by the study authors.
Participants were recruited using a Facebook invitation, and data collection took place on weekends between March 21st to June 29th, 2020. Overall, 1,578 Brazilians between 18 and 73 years of age took part in the study (mean age of 30.97), with just under 70% of the participants being from southern Brazil. During data analysis, the authors organised participants into four groups based on their opinions about COVID-19 containment measures: All = participants who believe that all three containment measures are important (1202 participants); Two = people who believe that two of the containment measures are important (266 participants); One = people who believe that one of the containment measures is important (81 participants); None = people who believe that containment measures are not important (29 participants).
The study isn’t set up to explore the relationship between mask-wearing and sociopathy
The most obvious problem with this study is that it does not actually assess if the participants wear a face mask. Instead, it examines whether participants agree or disagree that face masks, social distancing or increased hygiene are necessary for preventing the spread of COVID-19. It is one thing to agree that such measures are necessary on a questionnaire, but another thing entirely to actually adhere to the measures in your everyday life. There are probably many people who disagree that face masks are necessary but wear one due to social pressure.
Another obvious problem with this study is that, during data analysis, the authors grouped respondents based on how many of the COVID-19 measures they agree with: All, Two, One or None. But, apart from the ‘None’ group, we don’t know which specific COVID-19 measures the respondents agreed or disagreed with. So, at no point do the authors test the relationship between a participant’s personality traits and whether or not they think face masks are necessary.
In short, this study is not set up to explore whether the refusal to wear a facemask is linked to sociopathy or sociopathic tendencies. It’s a pity that none of the journalists reporting on this study noticed these glaringly obvious failings before putting pen to paper.
Methodological bias as far as the eye can see
The keener-eyed among you will have also noticed that this study is plagued with methodological bias (again, missed by the journalists). Firstly, there are the self-report questionnaires, which are known to have multiple flaws. For example, rather than give an honest answer, respondents may provide the answer that they deem to be the most socially acceptable, which is known as social desirability bias12. Thus, many of the respondents in the present study may not agree with social distancing, face masks or increased hygiene, but state that they do because to do so is more socially acceptable (and in everyday life, they do not adhere to these measures). Unfortunately for the study authors, anonymity reduces but does not remove social desirability bias13.
Self-report respondents may also be unable to accurately assess their own personality or interpret the questions being asked. Then there is the issue of subjectivity: questions may have different meanings to different people. The authors provide evidence to suggest that most respondents understood the ACME and PID-5 questionnaires (indicated by relatively high Cronbach’s Alpha internal consistency scores14, 15), but the extent to which the other self-report biases impacted upon the results remains unknown.
Secondly, the use of volunteers recruited by Facebook invitation has resulted in a study sample that “is systematically different from the target population” (a problem known as ascertainment bias16). So, rather than being a representative sample of Brazilian adults, the study sample represents Brazilian adults predominantly from the southern regions of Brazil, who are on Facebook, and are interested in taking part in online surveys. As such, the results of this study cannot be generalised to the Brazilian population or to populations in other countries, and certainly not to people in general.
Thirdly and finally, I question whether the ACME and PID-5 self-report tests are accurate measures of what they purport to measure. The authors state that both tests are valid psychometric tools for measuring empathy and antisocial traits, and provide supportive citations to bolster this claim10, 11. However, when one examines the supporting citations, it becomes clear that the psychometric validity of both tools was tested using a small and biased sample. Moreover, the authors of the study investigating the validity of the PID-5 self-report test openly state that: “additional validity research would be needed before these scales could be deemed appropriate for application in clinical settings”11. Even more damning is the fact that a recent meta-analysis has found that the results of self-report empathy tests are not even close to being comparable to performance-based tests17.
I can personally see an additional problem with these tests in that my responses are likely to vary depending on my mood. If I was in a bad mood, my capacity for empathy would be at its lowest ebb, and, I would probably be more callous than usual. I don’t think I’m unique in this respect, which means that to remove this ‘mood’ effect, the study authors should’ve asked the respondents to complete the ACME and PID-5 self-report tests on two separate occasions: once when they were in a good mood and again when they are in a bad mood. Then, you would average the scores of the two tests for each respondent. But, given that these tests aren’t even valid psychometric tools, this would be a massive waste of time.
I’ve known for some time that the majority of journalists, even so-called ‘science correspondents’, are utterly incapable of distinguishing between good and bad science. The Brazilian sociopath study is yet another depressing example of this. Perhaps they do this on purpose because sensationalism sells but cold and critical examination doesn’t. Or maybe the journalists reporting on this study are all lockdown zealots who cannot tolerate non-compliance. Who knows? What I do know is that the Brazilian sociopath study is bunkum and cannot be used to prove a link between the refusal to wear a facemask and sociopathy or sociopathic traits.