The perceived vulnerability to disease scale: Cross-cultural measurement invariance and associations with fear of COVID-19 across 16 countries

Arzu KARAKULAK*, Maria STOGIANNI, Itziar ALONSO-ARBIOL, Shanu SHUKLA, Michael BENDER, Victoria Wai Lan YEUNG, Veljko JOVANOVIĆ, Pasquale MUSSO, Rosa SCARDIGNO, Riley A. SCOTT, Jaimee STUART, Maria-Therese FRIEHS, Zena TOH, Nihan ALBAYRAK-AYDEMIR, Alexios ARVANITIS, Carmen BUZEA, Stefanos MASTROTHEODOROS, Jo-Ann TSANG, Filipa MADEIRA, Diana MICONINicole Russell PASCUAL, Wade C. ROWATT, Rosamary L. AL-KIRE, Moty AMAR, Tugce ARAL, Guy ITZCHAKOV, Sushanta Kumar MISHRA, Roni PORAT, Rocco SERVIDIO, Delia STEFENEL, Ergyul TAIR, Alexandros GKOMEZ

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review


Using cross-sectional data from N = 4274 young adults across 16 countries during the COVID-19 pandemic, we examined the cross-cultural measurement invariance of the perceived vulnerability to disease (PVD) scale and tested the hypothesis that the association between PVD and fear of COVID-19 is stronger under high disease threat [that is, absence of COVID-19 vaccination, living in a country with lower Human Development Index (HDI) or higher COVID-19 mortality]. Results supported a bi-factor Exploratory Structural Equation Modeling model where items loaded on a global PVD factor, and on the sub-factors of Perceived Infectability and Germ Aversion. However, cross-national invariance could only be obtained on the configural level with a reduced version of the PVD scale (PVD-r), suggesting that the concept of PVD may vary across nations. Moreover, higher PVD-r was consistently associated with greater fear of COVID-19 across all levels of disease threat, but this association was especially pronounced among individuals with a COVID-19 vaccine, and in contexts where COVID-19 mortality was high. The present research brought clarity into the dimensionality of the PVD measure, discussed its suitability and limitations for cross-cultural research, and highlighted the pandemic-related conditions under which higher PVD is most likely to go along with psychologically maladaptive outcomes, such as fear of COVID-19.
Original languageEnglish
Article numbere12878
JournalSocial and Personality Psychology Compass
Issue number11
Early online date24 Aug 2023
Publication statusPublished - Nov 2023

Bibliographical note

Funding Information:
The authors thank Eric Kenson Yau, Christiane Kraus, and Melis Yetkin for their help in data collection in Hong Kong, Germany, and Türkiye, respectively. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Arzu Karakulak acknowledges the support of the Istanbul Policy Center ‐ Sabanci University‐ Stiftung Mercator Initiative. Itziar Alonso‐Arbiol acknowledges the support of the Spanish Ministry of Science and Innovation (PID2020‐115738GB‐I00) and Basque Government Group Consolidation (IT1598‐22). Shanu Shukla acknowledges the support of the NPO "Systemic Risk Institute" number LX22NPO5101, funded by the European Union–Next Generation EU (Ministry of Education, Youth, and Sports, NPO: EXCELES). Nicole Russell Pascual acknowledges the support of the Economic and Social Research Council (ESRC).

Publisher Copyright:
© 2023 The Authors. Social and Personality Psychology Compass published by John Wiley & Sons Ltd.


  • culture
  • discease threat
  • fear of COVID-19
  • measurement invariance
  • perceived vulnerability to disease


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