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, Rosemary 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: Contribution to journalArticlepeer-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 languageAmerican English
Article numbere12878
JournalSocial and Personality Psychology Compass
Issue number11
StatePublished - Nov 2023

Bibliographical note

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


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


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