Tulane’s Dr. Damian Murray co-authored the Association for Psychological Science
lead article, Psychological Science in the Wake of COVID-19 Social, Methodological, and  Metascientific Considerations.

The premier article was published in Perspectives on Psychological Science in March 2022.

Dr. Murray explained the importance of the behavioral immune system and along with national and international contributors, noted that the COVID-19 pandemic has extensively changed the landscape of psychological science, and it is continuing to raise important questions about the conduct of research.

How did Dr. Murray become involved as a resource for the article?

“I was simply approached by the lead author, as he was familiar with my work and my being among a (formerly much smaller) group of researchers studying the implications of disease threat for cognition, behavior, and culture,” explained Dr. Murray.

The article considers how the psychology of pathogen threat may elucidate many social
phenomena in the wake of COVID-19. One question of concern brought up about this was, “Why should psychological scientists care about COVID-19 and the day-to-day research?”

Dr. Murray explains that, complementary to our immune systems, people focus on avoiding disease-causing objects, including other people whenever possible, which is referred to as a type of “behavioral immune system.” This concept is explained by Murray & Schaller in their 2016 chapter for Advances in Experimental Social Psychology, titled, “The Behavioral Immune System: Implications for Social Cognition, Social Interaction, and Social Influence.”

“Broadly, the behavioral immune system,” said Dr. Murray, “is a set of cognitive, motivational, and behavioral mechanisms that help to minimize the possibility of getting sick in the face of recurrent infectious disease threats.” As an historical note he added, “This may have been more aptly termed the Psychological Immune System, but that had already been claimed.”

Dr. Murray and co-authors explain that a fundamental goal of any organism is to protect itself from threat, and humans must navigate both realistic such as biological threats to health and symbolic threats such as those to group identity, moral values, and worldviews. Because they pose both realistic and symbolic threats, pandemics have high potential to influence many cognitions and behaviors, explained Dr. Murray.

Until recently psychologists have mostly dismissed the implications of pathogen threat for social cognition and behavior. In general, disease avoidance does not involve a great deal of deliberative thought, given that it is motivated by disgust or embedded cultural norms, reported Dr. Murray and co-authors in a 2017 research article.

However, viewed from the functional perspective, most social phenomena have disease-related causes and/or consequences which include relationships, motivations, moral cognition, and even cultural systems and political institutions, explain Murray & Schaller.

What are some of the most interesting research findings in this area?

“I used to answer this question by saying that disease influences the fundamental ways in which we socialize,” said Dr. Murray, “but now that we’ve all been through a world-altering pandemic that seems like common knowledge. I guess now I would say that I consider the most interesting findings to be those outcomes in the areas that people don’t intuitively link to disease, like conformity or moral judgment,” he said. “Are you more likely to condemn someone who morally transgresses when you’re worried about disease? Are you more likely to conform to even the tritest of social norms when you’re more concerned about disease? The research says ‘yes’ to both of these questions,” said Dr. Murray.

When it detects threat, the behavioral immune system activates anti-infection behavior, such as by eliciting disgust and promoting social avoidance, according to Murray & Schaller. The authors state that when this happens, COVID-19 alerts psychologists to uncertain conditions of infection risk that, to date, have been underappreciated and understudied.

What are some of the most practical applications, or main takeaways, regarding the behavioral system that readers might need to know?

“It’s hard to overstate just how important a factor disease has been in how and why we are the humans we are today,” said Dr. Murray. “With access to remarkable modern medicine, it’s easy to forget that throughout human history, infectious disease has been the biggest
threat to our well-being and thriving…it’s been the source of more deaths than all famines, wars, and natural disasters combined,” he said.

“So, in the lab our work is showing that yes—when people are temporarily made aware of a disease threat, they are more likely to vote with the majority, are more likely to condemn those that violate moral norms, and more likely to say that they would prefer fewer sexual partners in the next 5 years (and/or in their lifetimes),” said Dr. Murray.

“I think the bigger takeaways are that we see these effects play out at the societal level as well,” he said. “People living in countries or regions that have had historically higher levels of disease are (on average, of course) more likely to conform to the majority, more likely to
condemn moral-violators, and prefer fewer sexual partners. And even most importantly we see these psychological effects manifest in how countries and societies operate: more disease is associated with less trust of your neighbors, more authoritarian governance, and more restrictions on personal freedoms,” said Dr. Murray.

“We’ve found this when looking at both samples of contemporary nation states and samples of more traditional societies. Another huge downstream effect of disease threat (via its effects on less creative thinking) is less cultural innovation. You see this manifest in pretty much any innovation metric available…Nobel prizes, patents, global innovation scores, whatever.”

What are some of the other interesting findings in Dr. Murray’s publications?

“We’ve been doing a bunch of work over the past few years looking at how becoming a parent influences our political attitudes,” said Dr. Murray. “Most of this work has been led by Nick Kerry, a fantastic former grad student of the lab. As we know, motivations shift when one becomes a parent…as a parent you’re all of a sudden responsible for a very vulnerable other human, and you will be for many years.

“When we started this work,” said Dr. Murray, “we reckoned that maybe you’d see that motivational shift reflected in political attitudes, specifically in attitudes in the domain of social conservatism. Given that socially conservative attitudes emphasize group cohesion, familial stability, and more punitive punishments for people who might pose threats, we
predicted that parenthood is associated with higher political conservatism. This is exactly the pattern we find study after study—not just in America but all around the world. And this pattern is exclusive to social (and not economic) conservatism,” Dr. Murray said. “I think that this is fascinating work because so much work on parenting focuses on the other causal
arrow of how parents influence their children’s attitudes and behaviors. Our work shows how effects work in the opposite direction too; children influence their parents’ psychology simply by virtue of being children.”

How did he become involved in evolutionary psychology?

“I find ‘evolutionary psychology’ to be a term so fraught with baggage and misunderstanding that I don’t use it to categorize research programs or areas,” Dr. Murray said.

“Coming from early training in the biological sciences it never made sense to me why so many branches of psychology were uninterested in human origins, history, development, and culture. An evolutionarily-informed approach to the study of human cognition and behavior is complimentary to—not mutually exclusive of—the more proximal or situational
perspectives we see in the psychological sciences. It simply addresses our most fascinating ‘why’ questions at a different level of analysis,” said Dr. Murray.

“For example, if you were to try to answer the question, ‘Why do people fall in love?’ A common approach could be to look for all of the environmental and social triggers that cause people to fall in love. A complimentary evolutionary perspective could form answers to this question in a different way, by listing the ways in which the tendency to fall in love helped humans survive and thrive throughout history,” he said.

“It takes answers at both levels to best understand why people do what they do. Just as there’s no such thing as ‘non-evolutionary biology,’ neglecting the evolutionary level of analysis in psychology gives us an incomplete understanding of human cognition and behavior,” Dr. Murray said.

“So more basically my involvement/continued interest in evolutionary perspectives on psychology is that it more persistently asks the deeper ‘why’ question. We don’t get satisfactory answers to that ‘why’ question otherwise.”

Some of his current publications include:

Kerry, N., & Murray, D. R. (in press). Politics and parenting. In V. A. Weekes-Shackelford
&T. K. Shackelford (Eds.), The Oxford Handbook of Evolutionary Psychology and Parenting. Oxford, UK: Oxford University Press.

Kerry, N., & Murray, D. R. (2020). Politics and parental care: Experimental and mediational tests of the causal link between parenting motivation and social conservatism. Social Psychological and Personality Science, 11, 284-292.

Murray, D. R., *Prokosch, M., & *Airington, Z. (2019). PsychoBehavioroImmunology:
Connecting the behavioral immune system to its physiological foundations. Frontiers in Psychology, 7, 10:200. 10.3389/fpsyg.2019.00200

Murray, D. R., Haselton, M. G., Fales, M. R., & Cole, S. W. (2019). Falling in love is associated with immune system gene regulation. Psychoneuroendocrinology, 00, 120- 126.

Damian R. Murray, PhD, is an Associate Professor, Department of Psychology, at Tulane University. He has a PhD in Social Psychology and a PhD in Minor Quantitative Methods, from University of British Columbia, Vancouver, BC.

According to his bio at Tulane, Dr. Murray’s research programs follow two themes:

1) The consequences of a disease-avoidance motive for interpersonal relationships, social attitudes, personality, and cultural differences, and

2) The dynamics of new interpersonal relationships—the individual differences that predict formation, stability, and satisfaction in new romantic relationships, and the implications of these relationships for physiology and health.

A new report warns of soaring overdose deaths from the opioid crisis. Authors from the  Lancet’s, “Responding to the Opioid Crisis in North America and Beyond: Recommendations of  the Stanford-Lancet Commission,” published in February, said that in the USA and Canada, 2020 was the worst year on record for fatal opioid overdoses. The US overdoses rose 37%.

The Centers for Disease Control and Prevention (CDC) said that provisional data analysis  estimates for the 12 months ending in May 2021, there were 75,387 deaths from opioid toxicity.

Opioids—mainly synthetic opioids (other than methadone)—are currently the main driver of  drug overdose deaths, said the CDC, with 72.9% of opioid-involved overdose deaths involving  synthetic opioids. And, overdose deaths involving psychostimulants such as methamphetamine  are increasing with and without synthetic opioid involvement.

Also in February, Medscape reported a surge in the rate of Black Americans dying from a  combination of opioids and cocaine, an increase of 575%. The rate for White Americans  increased by 184%.

A recent analysis in the American Journal of Epidemiology, found that in the South, deaths from  cocaine and opioids increased 26% per year among Black people, 27% per year among Latinx  people, and 12% per year among non-Hispanic Whites.

Dr. Marc Zimmermann is a neuropsychologist and medical psychologist in Baton Rouge, with over 30 years experience. He  is noted for his work in forensic psychology having testified in multiple states and jurisdictions, and he has been a consultant to many chemical dependency programs such as the Serenity Center and Lane Recovery Solutions. He is also a staff member at PTI in Baton Rouge.

Dr.  Zimmermann said that according to the Louisiana Department of Health, the bulk of all  recorded opioid overdose deaths occurred in the parishes of Southeast Louisiana. St. Tammany Parish experienced an average of over 47 opioid overdoses a year and Jefferson Parish  averaged over 71 opioid overdoses a year.

While their age-adjusted rates are not as high as St. Tammany and Jefferson Parishes, Orleans  and East Baton Rouge Parish experienced high average numbers of deaths from opioid  overdoses during the same time period.

Dr. Tiffany Jennings is a Louisiana native who is the Rural Health Coordinator for the Louisiana  Psychological Association and in full time private practice. Dr. Jennings has worked in a variety  of settings, including outpatient, inpatient, state and Federal agencies. She was previously an  Assistant Professor, Department of Neurology, at Ochsner LSU Health Shreveport and a Neuropsychologist at Overton Brooks VAMC in Shreveport, and for the US Army’s Traumatic  Brain Injury Clinic at Fort Polk in Leesville.

How serious does she feel the opioid crisis is in rural settings for Louisiana? “The opioid crisis  continues to be a serious crisis that has not shown any signs of abating,” Dr. Jennings said.

“The COIVD-19 may have exacerbated the crisis. The Louisiana Dept of Health’s website notes  an increase in fatal and nonfatal opioid overdoses as people are ‘cut off from services and  disconnected from support systems, have made it difficult for individuals to seek help.’

“The Louisiana Opioid Surveillance Program has noted an increase in deaths from overdose,”  she said. “This was noted to be in part due to availability of synthetic opioid drugs, which are  much more powerful than morphine. This results in a higher chance of death from use –– such  as fentanyl.”

Has she seen any changes over the last couple of years? “There’s been several high-profile  lawsuits against drug manufacturers for their alleged role in the opioid crisis,” Dr. Jennings said. “I believe there currently four US companies in the process of settling, to the tune of  approximately $26 billion. This has certainly brought attention to the extent of the current  opioid epidemic.

“Many insurance agencies, including Medicaid, expanded telehealth access due to the ongoing  COVID-19 pandemic. Unfortunately, I have not seen much change with regard to access to service for rural health settings in Louisiana. There continues to be a wait list to see Medicaid providers. Reimbursement remains an issue. Also, those in rural areas may not have the  technology to fully utilize telehealth services,” Dr. Jennings said.

The Lancet Commission Report pointed to the lack of accessible, high-quality, non-stigmatising, integrated health and social care services for people with opioid use disorder in the USA. The  authors recommended reforming public and private health insurance systems to address this issue, including cutting off funding for care that is likely to be harmful.

Dr. Geralyn Datz is a licensed Clinical Health and Medical Psychologist and a national educator  of healthcare providers, attorneys and the public. Dr. Datz is licensed in Louisiana, Alabama, and Mississippi, and specializes in pain psychology, forensic assessments, and public speaking. She is President and Clinical Director of Southern Behavioral Medicine Associates PLLC, in Hattiesburg, Mississippi, a group specialty practice devoted to treating patients with chronic  pain, She is a past president of the Southern Pain Society, and previously with New Orleans Veteran Affairs Medical Center and Pennington Biomedical Research Center

We asked Dr. Datz if there is adequate treatment available? “No there is not,” she said. “The  treatment of opioid use disorder is a very large, systems based issue that right now is in dire  straits and vastly underfunded. The short answer is that we need more insurance reimbursed  programs, and the treatment needs to extend well beyond ‘rehab’ as it is traditionally defined. Private treatment centers are one component of treatment, but cannot meet the needs of this  diverse population, which often has serious mental health issues and/or comorbid pain  conditions. There are effective treatment models like Pain Rehabiliation Programs, that help
people with medical conditions come off of opioids, but sadly these are no longer reimbursed  by insurance.

In addition, the treatment of opioid misuse is ideally multidisciplinary and  requires medical and mental health follow up, which frequently does not occur. The Commissions comment on using the Chronic Disease Model for treatment, and in healthcare, is exactly on point.”

Is treatment covered by funding such as insurance for those who need help? “.Again…no. There  are wide ranges in what insurance will and will not cover in treating opioid overuse and addiction. Often, comorbidities, such as pain or severe or even mild mental illness, are left  untreated. In addition, there are variations between what private addiction centers will accept which insurances if any at all. As a result, care ends up being parsed out for opioid-dependent  individuals and not as effective. Furthermore, many individuals do not have insurance coverage at all, further complicating the problem,” Dr. Datz said.

“The 2008 Mental Health Parity and Addiction Equity Act was designed to make treatment of  mental health and substance abuse conditions as easily and fairly reimbursed as medical conditions. This Act was a step in the right direction but is still not fully realized. A recent report  showed that many insurances are non compliant, and showed wide disparities between  behavioral health care and medical/ surgical healthcare. Mental health parity needs increased  attention, and enforcement, in order to address the public health needs that we are now facing.”

Dr. Jennings agrees. “Given the number of deaths from opioid overdose, I would say there is not nearly enough treatment, recovery and support systems in place for this population. This is especially true of those in rural settings,” she said.

“The state has enacted laws in an attempt to better regulate prescriptions and to reduce the chance of ‘doctor shopping’ for those addicted or who have developed a tolerance to their pain medication. Government agencies on federal and state levels are holding providers accountable for illegal prescriptions for opioids,” said Dr. Jennings.

“Louisiana is expecting to receive approximately $325 million from a national settlement of  opioid lawsuits. The intention is to divide monies into addiction treatment, response and recovery services. The goal is to send the monies–divided up over a 20-year period–to local  agencies that directly work with those suffering from opioid addiction,” she said.

“For some patients, education into the nature of chronic pain and their ability to manage pain  can be helpful. There are evidence based psychotherapy treatments (such as Cognitive  Behavioral Therapy for Chronic Pain) that can be used to help a patient manage pain. For  patients in need of an increase in structure or level of care, there is certainly a need for  agencies that provide this care. Again, insurance and location can often be a barrier to treatment.”

Pain costs society up to $635 billion annually, according to the CDC, and is the number one  reason for disability. Pain is becoming better understood as a multifaceted phenomenon with  psychological factors.

In 2016, CDC authors published Guidelines and said that there was no evidence for a long-term  benefit of opioid pain medications. The authors found strong evidence for serious risks, including overdose, opioid use disorder, and motor vehicle injuries. The CDC said that other  treatments, including psychological approaches, had long-term benefits, without the high risks of opioids.

“It is now widely accepted that pain is a biopsychosocial phenomenon,” Dr. Datz, told the Times  in a previous interview. “The Guidelines are really exciting because they explicitly state that  physicians should be using nonpharmacological strategies including cognitive behavioral  therapy as well as exercise for patients with pain,” Datz said.

“This is a departure from the traditional belief that pain was primarily physical, and to be only  treated by medical means, which was the biomedical model,” Datz said.

“The benefits of pain psychology are that the person experiencing chronic pain ultimately has more control over their pain process, their reaction to it, and their life,” Datz said. “This is  accomplished by teaching patients about how their expectations, their attention, and their  stress levels interact with chronic pain and can greatly exacerbated.”

“A large body of research,” said Datz, “has shown that use of structured cognitive behavioral  therapy, and in particular cognitive behavioral therapy combined with physical therapy, as happens in functional restoration programs, are extremely effective ways of dramatically  improving physical function, mental health, and overall well-being in patients with chronic pain,” she said.

“Unfortunately, these methods have been sorely underused, partly due to insurance coverage  issues. With the advent of the ACA however, this is getting a lot better. Also, I think providers and patients are more open to these ideas now that the opioid epidemic has become such a  hot topic nationally,” she said. Among the key messages of the Lancet Commission report, the authors noted that “The profit motives of actors inside and outside the health-care system will  continue to generate harmful over-provision of addictive pharmaceuticals unless regulatory systems are fundamentally reformed.”

Dr. Datz will be presenting “Forced Opioid Tapers and the Culture of the Opioid Crisis: Time to revisit pain psychology” at the American Academy of Pain Medicine in Scottsdale Arizona on  March 19. She will speak about how the approach of using pain psychology during opioid  therapy is not new, but is enjoying a renewed urgency in the context of rising rates of opioid  tapers and the safety issues surrounding preventable side effect from forced opioid tapers.

Lancet Commission authors warned that pharmaceutical companies based in the USA are  actively expanding opioid prescribing worldwide, and are using fraudulent and corrupting tactics that have now been banned domestically.