Diurnal variations of fever in children: results from an app-based observational study.

In recent years, awareness has grown that the broader socioecological environment, including sociopolitical uncertainty and societal instability, can act as potent stressors with long-term consequences for health and well-being (such as living conditions in ongoing armed conflict, sociopolitical uncertainty in Lebanon, or climate change. One stressor of growing global relevance is soft political repression, a covert form of state-organized psychosocial pressure that aims to intimidate, destabilize, or socially isolate targeted individuals to prevent them from engaging in oppositional behavior, while minimizing international attention and accountability (for recent review of categorizations of repression including a broader set of actors and targets, see) . Soft repression constitutes a central instrument of power in authoritarian regimes, but can also be present in democratic or hybrid regimes, including practices such as surveillance, limitations on freedom of speech, or the intentional creation of difficulties in individuals’ private and professional lives. The 2025 Freedom in the World Report depicts a current rise in authoritarianism accompanied by a decline in democratic freedom, suggesting a global increase in soft repression practices. Little is known about the psychological and behavioral consequences of soft repression for affected citizens, and even less about its physiological impact. Evidence from diverse geopolitical contexts, including Hong Kong, Zimbabwe, Colombia, Venezuela, Thailand or Sweden, suggests that soft repression can be associated with psychological outcomes such as fear and depressive states, as well as behavioral effects including self-policing, political retreat or migration. A major obstacle to studying these processes is the difficulty of reaching individuals who are currently exposed to repression, as restrictive conditions severely limit access and participation. Furthermore, fear of reprisals can lead to selective non-response or overly cautious reporting. One way to address these challenges is to draw on historical samples still accessible today. A historically well-documented example of soft political repression is a set of techniques used by the Ministry for State Security (MfS) in the former authoritarian German Democratic Republic (GDR; 1949–1990) known as “Zersetzung” (engl: disintegration). In a recent study, around 10% of former GDR citizens report having been subjected to soft repression during the existence of the GDR. Repression measures included persistent overt and covert surveillance by the Ministry for State Security (known as , the GDR’s secret police), harassment, humiliation, or exclusion in educational and workplace settings, as well as the deliberate damaging of someone’s reputation, by for example spreading rumors or placing an informant in the target’s close circles: