Exploring the context of a coughing customer for frontline workers during the Covid-19 pandemic, we utilized the semi-structured interviews of 38 participants to enhance understanding of cognitive, emotional, and vocational challenges present when a frontline worker perceives a health risk (coughing) while working. Using qualitative content analysis to analyze the interviews, we found both contexts of the actual cough and the environment in which the cough occurs to encourage the cognitive process to trigger the behavioral immune system of frontline workers. Furthermore, the findings suggest the behavioral immune system may be similar to the existing biological immune system in its adaptability. Finally, we suggest implications and directions for future research along with propositions.
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Ackerman, J. M., Becker, D. V., Mortensen, C. R., Sasaki, T., Neuberg, S. L., & Kenrick, D. T. (2009). A pox on the mind: Disjunction of attention and memory in the processing of physical disfigurement. Journal of Experimental Social Psychology, 45, 478–485. https://doi.org/10.1016/j.jesp.2008.12.008
Ackerman, J. M., Hill, S. E., & Murray, D. R. (2017). The behavioral immune system: Current concerns and future directions. Soc Personal Psychol Compass, 12, e12371. https://doi.org/10.1111/spc3.12371
Ackerman, J. M., Tybur, J. M., & Mortensen, C. R. (2018). Infectious Disease and Imperfections of Self-Image. Psychological Science, 29(2), 228–241. https://doi.org/10.1177/0956797617733829
Barger, P., & Grandey, A. (2006). “Service with a smile” and encounter satisfaction: Emotional contagion and appraisal mechanisms. Academy of Management Journal, 49(6), 1229–1238.
Bernard, H. R., Wutich, A., & Ryan, G. W. (2017). Analyzing qualitative data: systematic approaches / H. Russell Bernard, Amber Wutich, Gery W. Ryan (2nd ed.). SAGE.
Bhave, D. P., & Glomb, T. M. (2016). The role of occupational emotional labor requirements on the surface acting-job satisfaction relationship. Journal of Management, 42(3), 722–741. https://doi.org/10.1177/0149206313498900
Bono, J. E., & Vey, M. A. (2007). Personality and emotional performance: Extraversion, neuroticism, and self-monitoring. Journal of Occupational Health Psychology, 12(2), 177–192. https://doi.org/10.1037/1076-89126.96.36.199
Boyatzis, R. E. (1998). Transforming qualitative information: Thematic analysis and code development. Sage Publications, Inc.
Brotheridge, C. M., & Grandey, A. A. (2002). Emotional labor and burnout: Comparing two perspectives of “people work.” Journal of Vocational Behavior, 60, 17–39.
Brotheridge, C. M., & Lee, R. T. (2003). Development and validation of the Emotional Labour Scale. Journal of Occupational and Organizational Psychology, 76, 365–379.
Charmaz, K. (2014). Constructing grounded theory. Sage.
Diefendorff, J. M., & Gosserand, R. H. (2003). Understanding the emotional labor process: A control theory perspective. Journal of Organizational Behavior, 24, 945–959. https://doi.org/10.1002/job.230
Diefendorff, J. M., Richard, E. M., & Croyle, M. H. (2006). Are emotional display rules formal job requirements? Examination of employee and supervisor perceptions. Journal of Occupational and Organizational Psychology, 79, 273–298. https://doi.org/10.1348/096317905X68484
Duncan, L. A., & Schaller, M. (2009). Prejudicial attitudes toward older adults may be exaggerated when people feel vulnerable to infectious disease: Evidence and implications. Analyses of Social Issues and Public Policy, 9(1), 97–115. https://doi.org/10.1111/j.1530-2415.2009.01188.x
Gabriel, A. S., & Diefendorff, J. M. (2015). Emotional labor dynamics: a momentary approach. The Academy of Management Journal, 58(6), 1804–1825. https://doi.org/10.5465/amj.2013.1135
Grandey, A. A. (2000). Emotional regulation in the workplace: A new way to conceptualize emotional labor. Journal of Occupational Health Psychology, 5(1), 95–110. https://doi.org/10.1037/1076-89188.8.131.52
Grandey, A. A. (2003). When “the Show Must Go on”: Surface acting and deep acting as determinants of emotional exhaustion and peer-rated service delivery. Academy of Management Journal, 46(1), 86–96. https://doi.org/10.2307/30040678
Grandey, A. A., & Gabriel, A. S. (2015). Emotional labor at a crossroads: Where do we go from here? Annual Review of Organizational Psychology and Organizational Behavior, 2, 323–349. https://doi.org/10.1146/annurev-orgpsych-032414-111400
Grandey, A. A., Dickter, D. N., & Sin, H. P. (2004). The customer is not always right: Customer aggression and emotion regulation of service employees. Journal of Organizational Behavior: The International Journal of Industrial, Occupational and Organizational Psychology and Behavior, 25(3), 397–418.
Grandey, A. A., Fisk, G. M., Mattila, A. S., Jansen, K. J., & Sideman, L. A. (2005). Is “service with a smile” enough? Authenticity of positive displays during service encounters. Organizational Behavior and Human Decision Processes, 96(1), 38–55. https://doi.org/10.1016/j.obhdp.2004.08.002
Grandey, A. A., Kern, J. H., & Frone, M. R. (2007). Verbal abuse from outsiders versus insiders: Comparing frequency, impact on emotional exhaustion, and the role of emotional labor. Journal of Occupational Health Psychology, 12(1), 63–79. https://doi.org/10.1037/1076-89184.108.40.206
Greiner, A. N., Hellings, P. W., Rotiroti, G., & Scadding, G. K. (2011). Allergic rhinitis. Lancet (London, England), 378(9809), 2112–2122. https://doi.org/10.1016/S0140-6736(11)60130-X
Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(3), 271–299. https://doi.org/10.1037/1089-26220.127.116.111
Hitchings, R., & Latham, A. (2021). Qualitative methods III: On different ways of describing our work. Progress in Human Geography, 45(2), 394–403. https://doi.org/10.1177/0309132520901753
Hochschild, A. (1983). The managed heart: Commercialization of human feeling. University of California Press. ISBN 978-0-520-05454-7.
Hochschild, A. (2012). The Managed Heart: Commercialization of Human Feeling. University of California Press.
Huang, J. Y., Sedlovskaya, A., Ackerman, J. M., & Bargh, J. A. (2011). Immunizing against prejudice: Effects of disease protection on attitudes toward out-groups. Psychological Science, 22(12), 1550–1556.
Huang, J. L., Cropanzano, R., Li, A., Shao, P., Zhang, X.-A., & Li, Y. (2017). Employee conscientiousness, agreeableness, and supervisor justice rule compliance: A three-study investigation. Journal of Applied Psychology, 102(11), 1564–1589. https://doi.org/10.1037/apl0000248
Hülsheger, U. R., & Schewe, A. F. (2011). On the costs and benefits of emotional labor: A meta-analysis of three decades of research. Journal of Occupational Health Psychology, 16(3), 361–389. https://doi.org/10.1037/a0022876
Judge, T. A., Woolf, E. F., & Hurst, C. (2009). Is emotional labor more difficult for some than for others? A multilevel, experience-sampling study. Personnel Psychology, 62(1), 57–88.
Kahneman, D. (2003). A perspective on judgment and choice: mapping bounded rationality. The American psychologist, 58(9), 697–720. https://doi.org/10.1037/0003-066X.58.9.697
Kenrick, D. T., Griskevicius, V., Neuberg, S. L., & Schaller, M. (2010). Renovating the pyramid of needs: Contemporary extensions built upon ancient foundations. Perspectives on Psychological Science, 5, 292–314. https://doi.org/10.1177/1745691610369469
Kraus, L., Lauer, E., Coleman, R., & Houtenville, A. (2018). 2017 Disability Statistics Annual Report. University of New Hampshire.
Kupfer, T. R., & Tybur, J. M. (2017). Pathogen disgust and interpersonal personality. Personality and Individual Differences, 116, 379–384.
Lazarus, R. S. (1991). Cognition and motivation in emotion. American Psychologist, 46(4), 352–367. https://doi.org/10.1037/0003-066X.46.4.352
LeCompte, M. D., & Schensul, J. J. (2010). Designing and conducting ethnographic research: An Introduction (Vol. 1). Rowman Altamira.
Leonhardt, J. M., Keller, L. R., & Pechmann, C. (2011). Avoiding the risk of responsibility by seeking uncertainty: Responsibility aversion and preference for indirect agency when choosing for others. Journal of Consumer Psychology, 21(4), 405–413.
Letendre, K., Fincher, C. L., & Thornhill, R. (2010). Does infectious disease cause global variation in the frequency of intrastate armed conflict and civil war? Biological Reviews, 85, 669–683. https://doi.org/10.1111/j.1469-185X.2010.00133.x
Makhanova, A., & Shepherd, M. A. (2020). Behavioral immune system linked to responses to the threat of COVID-19. Personality and Individual Differences, 167, 110221.
Makhanova, A., Miller, S. L., & Maner, J. K. (2015). Germs and the out-group: Chronic and situational disease concerns affect intergroup categorization. Evolutionary Behavioral Sciences, 9(1), 8–19. https://doi.org/10.1037/ebs0000028
Maughan, E., & Adams, R. (2011). Educators’ and parents’ perception of what school nurses do: The influence of school nurse/student ratios. The Journal of School Nursing: The Official Publication of the National Association of School Nurses, 27(5), 355–363.
McCoy, S. B., Gibbons, F. X., Reis, T. J., Gerrard, M., Luus, C. A., & Sufka, A. V. (1992). Perceptions of smoking risk as a function of smoking status. Journal of Behavioral Medicine, 15(5), 469–488. https://doi.org/10.1007/BF00844942
Mortensen, C. R., Becker, D. V., Ackerman, J. M., Neuberg, S. L., & Kenrick, D. T. (2010). Infection breeds reticence: The effects of disease salience on self-perceptions of personality and behavioral avoidance tendencies. Psychological Science, 21(3), 440–447. https://doi.org/10.1177/0956797610361706
Murray, D. R. (2014). Direct and indirect implications of disease threat for scientific and technological innovation. Journal of Cross-Cultural Psychology, 45, 971–985. https://doi.org/10.1177/0022022114532356
Murray, D. R., Jones, D. N., & Schaller, M. (2013). Perceived threat of infectious disease and its implications for sexual attitudes. Personality and Individual Differences, 54(1), 103–108. https://doi.org/10.1016/j.paid.2012.08.021
Neuberg, S. L., Kenrick, D. T., & Schaller, M. (2011). Human threat management systems: Self-protection and disease avoidance. Neuroscience & Biobehavioral Reviews, 35(4), 1042–1051.
Oaten, M., Stevenson, R. J., & Case, T. I. (2009). Disgust as a disease-avoidance mechanism. Psychological Bulletin, 135(2), 303–321. https://doi.org/10.1037/a0014823
Prokosch, M. L., Gassen, J., Ackerman, J. M., & Hill, S. E. (2019). Caution in the time of cholera: Pathogen threats decrease risk tolerance. Evolutionary Behavioral Sciences, 13(4), 311.
Pugh, S. (2001). Service with a smile: Emotional contagion in the service encounter. Academy of Management Journal, 44(5), 1018–1027.
Qi, X., Ji, S., Zhang, J., Lu, W., Sluiter, J. K., & Deng, H. (2017). Correlation of emotional labor and cortisol concentration in hair among female kindergarten teachers. International Archives of Occupational and Environmental Health, 90(1), 117–122. https://doi.org/10.1007/s00420-016-1179-6
Rafaeli, A., & Sutton, R. (1990). Busy stores and demanding customers: How do they affect the display of positive emotion? Academy of Management Journal, 33(3), 623–637.
Reid, S. A., Zhang, J., Anderson, G. L., Gasiorek, J., Bonilla, D., & Peinado, S. (2012). Parasite primes make foreign-accented English sound more distant to people who are disgusted by pathogens (but not by sex or morality). Evolution and Human Behavior, 33(5), 471–478. https://doi.org/10.1016/j.evolhumbehav.2011.12.009
Rho, H. J., Brown, H., & Fremstad, S. (2020). A basic demographic profile of workers in frontline industries. Center for Economic and Policy Research, 7, 10.
Rubin, H. J., & Rubin, I. S. (2011). Qualitative interviewing: The art of hearing data. Sage.
Rupp, D. E., & Spencer, S. (2006). When customers lash out: The effects of customer interactional injustice on emotional labor and the mediating role of discrete emotions. The Journal of Applied Psychology, 91(4), 971–978. https://doi.org/10.1037/0021-9010.91.4.971
Saldaña, J. (2021). The coding manual for qualitative researchers (4th edition ed.). Sage
Schaller, M. (2006). Parasites, behavioral defenses, and the social-psychological mechanisms through which cultures are evoked. Psychological Inquiry, 17(2), 96–101.
Schaller, M. (2011). The behavioural immune system and the psychology of human sociality. Philosophical transactions of the Royal Society of London Series B, Biological Sciences, 366(1583), 3418–3426. https://doi.org/10.1098/rstb.2011.0029
Schaller, M. (2016). The behavioral immune system. In The Handbook of Evolutionary Psychology: Foundations, Vol. 1, 2nd ed. (pp. 206–224). John Wiley & Sons, Inc.
Schaller, M., & Duncan, L. A. (2007). The behavioral immune system: Its evolution and social psychological implications. In J. P. Forgas, M. G. Haselton, & W. von Hippel (Eds.), Evolution and the social mind: Evolutionary psychology and social cognition (pp. 293–307). Routledge/Taylor & Francis Group.
Schaller, M., & Murray, D. R. (2008). Pathogens, personality and culture: Disease prevalence predicts worldwide variability in sociosexuality, extraversion, and openness to experience. Journal of Personality and Social Psychology, 95, 212–221. https://doi.org/10.1037/0022-3518.104.22.168
Schaller, M., & Park, J. (2011). The behavioral immune system (and Why It Matters). Current Directions in Psychological Science, 20(2), 99–103. https://doi.org/10.1177/0963721411402596
Schaller, M., Miller, G. E., Gervais, W. M., Yager, S., & Chen, E. (2010). Mere visual perception of other people’s disease symptoms facilitates a more aggressive immune response. Psychological Science, 21(5), 649–652. https://doi.org/10.1177/0956797610368064
Smith, E. R., & DeCoster, J. (2000). Dual-process models in social and cognitive psychology: Conceptual integration and links to underlying memory systems. Personality and Social Psychology Review, 4(2), 108–131. https://doi.org/10.1207/S15327957PSPR0402_01
Stevenson, R. J., Hodgson, D., Oaten, M. J., Barouei, J., & Case, T. I. (2011). The effect of disgust on oral immune function. Psychophysiology, 48, 900–907. https://doi.org/10.1111/j.1469-8986.2010.01165.x
Sutton, R. I. (1991). Maintaining norms about expressed emotions: The case of bill collectors. Administrative Science Quarterly, 36(2), 245–268. https://doi.org/10.2307/2393355
Sy, T., Côté, S., & Saavedra, R. (2005). The contagious leader: Impact of the leader’s mood on the mood of group members, group affective tone, and group processes. Journal of Applied Psychology, 90(2), 295–305. https://doi.org/10.1037/0021-9010.90.2.295
Thornhill, R., Fincher, C. L., & Aran, D. (2009). Parasites, democratization, and the liberalization of values across contemporary countries. Biological Reviews, 84, 113–131. https://doi.org/10.1111/j.1469-185X.2008.00062.x
Thornhill, R., Fincher, C. L., Murray, D. R., & Schaller, M. (2010). Zoonotic and non-zoonotic diseases in relation to human personality and societal values: Support for the parasite-stress model. Evolutionary Psychology, 8(2), 151–169. https://doi.org/10.1177/147470491000800201
Totterdell, P., & Holman, D. (2003). Emotion regulation in customer service roles: Testing a model of emotional labor. Journal of Occupational Health Psychology, 8(1), 55–73. https://doi.org/10.1037/1076-8922.214.171.124
Tsai, W. (2016). Determinants and consequences of employee displayed positive emotions. Journal of Management, 27(4), 497–512. https://doi.org/10.1177/014920630102700406
Tybur, J. M., & Lieberman, D. (2016). Human pathogen avoidance adaptations. Current Opinion in Psychology, 7, 6–11.
Tybur, J. M., Bryan, A. D., Magnan, R. E., & Caldwell Hooper, A. E. (2011). Smells like safe sex: Olfactory pathogen primes increase intentions to use condoms. Psychological Science, 22, 478–480. https://doi.org/10.1177/0956797611400096
Tybur, J. M., Lieberman, D., Kurzban, R., & DeScioli, P. (2013). Disgust: Evolved function and structure. Psychological Review, 120(1), 65–84. https://doi.org/10.1037/a0030778
Tybur, J. M., Frankenhuis, W. E., & Pollet, T. V. (2014). Behavioral immune system methods: Surveying the present to shape the future. Evolutionary Behavioral Sciences, 8(4), 274–283. https://doi.org/10.1037/ebs0000017
Van Dijk, P., & Kirk-Brown, A. (2008). Emotional labour and tourism-based visitor interactions: Job characteristics as determinants of emotion regulation. Tourism Analysis, 13(3), 233–245. https://doi.org/10.3727/108354208786094843
van Kleef, G. A., De Dreu, C. K. W., & Manstead, A. S. R. (2004). The interpersonal effects of anger and happiness in negotiations. Journal of Personality and Social Psychology, 86(1), 57–76. https://doi.org/10.1037/0022-35126.96.36.199
Wagner, D. T., Barnes, C. M., & Scott, B. A. (2014). Driving it home: How workplace emotional labor harms employee home life. Personnel Psychology, 67(2), 487–516.
Wharton, A. S., & Erickson, R. I. (1993). Managing emotions on the job and at home: Understanding the consequences of multiple emotional roles. Academy of Management Review, 18(3), 457–486.
White, A. E., Kenrick, D. T., & Neuberg, S. L. (2013). Beauty at the ballot box: Disease threats predict preferences for physically attractive leaders. Psychological Science, 24, 2429–2436. https://doi.org/10.1177/0956797613493642
Willgerodt, M. A., Brock, D. M., & Maughan, E. D. (2018). Public school nursing practice in the United States. The Journal of School Nursing, 34(3), 232–244. https://doi.org/10.1177/1059840517752456
Wirtz, J., Lovelock, C., & Chatterjee, J. (2016). Services marketing. Pearson.
Wu, B. P., & Chang, L. (2012). The social impact of pathogen threat: How disease salience influences conformity. Personality and Individual Differences, 53(1), 50–54.
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Aplin-Houtz, M.J., Sanders, M.G., Lane, E.K. et al. Coughing Customer: The Interplay of the Behavioral Immune System and Emotional Labor of Frontline Workers. Employ Respons Rights J 35, 395–415 (2023). https://doi.org/10.1007/s10672-022-09416-3