In the coronavirus "infodemic", people are exposed to both official recommendations and to potentially dangerous pseudoscientific advice claimed to protect against COVID-19. We examined whether irrational beliefs predict adherence to COVID-19 guidelines as well as susceptibility to such misinformation. Irrational beliefs were indexed by cognitive intuition, Type I error cognitive biases, COVID-19 knowledge overestimation, and belief in COVID-19 conspiracy theories. Participants (N=407) reported (a) how often they followed guidelines (e.g., handwashing), (b) how often they engaged in pseudoscientific practices (e.g., consuming garlic, colloidal silver), and (c) their intention to receive a COVID-19 vaccine. Conspiratorial beliefs consistently predicted all three outcomes. Cognitive intuition and knowledge overestimation predicted lesser, while cognitive biases predicted greater adherence to guidelines. Cognitive intuition and cognitive biases predicted greater use of pseudoscientific practices. Our results highlight the irrational beliefs predictive of COVID-19 related health behaviors, with conspiracy theories proving to be the most detrimental.

There is evidence that not only believing in one conspiracy theory (CT) makes a person more probable to believe in others, however unrelated their content is, but that people can even believe in contradictory CTs about a single event. After piloting locally relevant conspiracy theories on a convenient Serbian speaking sample (N = 152), we sought to replicate this finding on a larger sample (N = 252), but introduced several changes. We differentiated necessarily and probably mutually exclusive CTs, and interviewed the participants who answered contradictory to understand the reasoning behind it. The participants were more prone to endorse probably than necessarily exclusive items (we registered positive correlations in former and no correlation or negative correlation in later). Two strategies enabled them to overcome the contradiction: (a) distilling the crucial content and downplaying other information and (b) treating the contradictory scenarios as possible versions of events. Taken together, these results indicate that participants are not as irrational as sometimes portrayed.

The study aimed to investigate the role of personality, thinking styles, and conspiracy mentality in health-related behaviors during the COVID-19 pandemic, i.e., recommended health behaviors according to COVID-19 guidelines and engagement in pseudoscientific practices related to COVID-19. Basic personality space was defined by the HEXACO model complemented by Disintegration, which represents psychotic-like experiences and behaviors reconceptualized as a personality trait. Mediation analyses conducted on a convenient sample from the general population recruited via social media and by snowballing (N = 417) showed that engagement in pseudoscientific behaviors was predicted by high Disintegration. However, this relationship was entirely mediated by high experiential and low rational thinking styles. Adherence to health practices recommended by COVID-19 guidelines was predicted by high Honesty traits, while low Disintegration had both direct and indirect effects through conspiracy mentality.

No abstract

ObjectivesWe aimed to (1) develop a novel instrument, suitable for the general population, capturing intentional non-adherence (iNAR), consisting of non-adherence to prescribed therapy, self-medication and avoidance of seeking medical treatment; (2) differentiate it from other forms of non-adherence, for example, smoking; and (3) relate iNAR to patient-related factors, such as sociodemographics, health status and endorsement of irrational beliefs (conspiratorial thinking and superstitions) and to healthcare-related beliefs and experiences ((mis)trust and negative experiences with the healthcare system, normalisation of patient passivity).DesignТо generate iNAR items, we employed a focus group with medical doctors, supplemented it with a literature search and invited a public health expert to refine it further. We examined the internal structure and predictors of iNAR in an observational study.SettingData were collected online using snowball sampling and social networks.ParticipantsAfter excluding those who failed one or more out of three attention checks, the final sample size was n=583 adult Serbian citizens, 74.4% female, mean age 39.01 years (SD=12.10).Primary and secondary outcome measuresThe primary, planned outcome is the iNAR Questionnaire, while smoking was used for comparison purposes.ResultsFactor analysis yielded a one-factor solution, and the final 12-item iNAR Questionnaire had satisfactory internal reliability (alpha=0.72). Health condition and healthcare-related variables accounted for 14% of the variance of iNAR behaviours, whereas sociodemographics and irrational beliefs did not additionally contribute.ConclusionsWe constructed a brief yet comprehensive measure of iNAR behaviours and related them to health and sociodemographic variables and irrational beliefs. The findings suggest that public health interventions should attempt to improve patients' experiences with the system and build trust with their healthcare practitioners rather than aim at specific demographic groups or at correcting patients’ unfounded beliefs.Study registrationThe design and confirmatory analyses plan were preregistered (https://osf.io/pnugm).

Despite insufficient evidence base for some of its practices, traditional, complementary, and alternative medicine (TCAM) use is rapidly growing; psychological roots of this trend are still under-studied. Based on previous research, input from TCAM practitioners, and content analysis of online media, we developed a comprehensive instrument to measure the use of TCAM and administered it to an online community sample (N=583). Factor analysis indicated four domains of TCAM use, in line with theoretical taxonomies: Alternative medical systems, Natural product-based practices, New age medicine, and Rituals/Customs, all converging toward a common tendency. Irrational beliefs and cognitive biases, especially magical health beliefs and naturalness bias, predicted unique variance in both TCAM attitudes and overall TCAM use, above socio-demographic variables, reported health status, and ideological beliefs. Furthermore, each domain of TCAM use, although differing slightly in sociodemographic/psychological profile, was consistently associated with an irrational mindset, even after controlling for other factors. This provides strong evidence for exploring psychological susceptibility to the use of traditional, complementary, and alternative medicine.

Background: The World Health Organization recognizes non-adherence to treatment recommendations as a growing global problem. Questionnaires typically focus on only one non-adhering behavior, e.g., medication-taking, and target people with specific health conditions. In this preregistered study, we aimed to (1) develop a novel instrument suitable to the general population, consisting of non-adherence to prescribed therapy, self-medication, and avoidance to seek medical treatment, capturing intentional non-adherence (iNAR), (2) differentiate it from habitual non-adherence, such as smoking, and (3) relate iNAR to patient-related factors, such as sociodemographics, health status, and endorsement of irrational beliefs (conspiratorial thinking and superstitions), and to a set of healthcare-related beliefs and experiences. Methods: First, medical doctors provided a list of non-adherence behaviors in a focus group. To this list we added behaviors that fitted our definition of intentional non-adherence, identified in a thorough literature search. This initial list of 22 behaviors was further refined by a public health expert. The instrument was then tested on a sample of 583 participants, sufficiently powered to detect effects for all preregistered statistical analysis. Participants were recruited using an online snowballing procedure and via social networks. Results: Factor analysis yielded a one-factor solution, and the final 12-item iNAR questionnaire had satisfactory internal reliability (Cronbach’s alpha = .72). A hierarchical linear regression showed that, as expected, health condition variables and healthcare-related beliefs and experiences accounted for 14% of the variance of iNAR behaviors, whereas sociodemographics and irrational beliefs did not additionally contribute. In comparison, the same regression model with smoking (representative of habitual non-adherence) as a criterion variable, accounted for less than 3% of the variance, with education as the only significant predictor. Conclusions: We have constructed a brief, comprehensive, and reliable measure of iNAR behaviors. Normalization of patients’ passivity and, in particular, negative experiences with the healthcare system contributed to intentional, but not habitual non-adherence. We believe that public health interventions designed to discourage intentional non-adherence should foremost attempt to improve all patients' experiences with the system and build trust with their healthcare practitioners rather than aim at specific demographic groups or at correcting patients' unfounded beliefs.

Background: The World Health Organization recognizes non-adherence to treatment recommendations as a growing global problem. Questionnaires typically focus on only one non-adhering behavior, e.g., medication-taking, and target people with specific health conditions. In this preregistered study, we aimed to (1) develop a novel instrument suitable to the general population, consisting of non-adherence to prescribed therapy, self-medication, and avoidance to seek medical treatment, capturing intentional non-adherence (iNAR), (2) differentiate it from habitual non-adherence, such as smoking, and (3) relate iNAR to patient-related factors, such as sociodemographics, health status, and endorsement of irrational beliefs (conspiratorial thinking and superstitions), and to a set of healthcare-related beliefs and experiences. Methods: First, medical doctors provided a list of non-adherence behaviors in a focus group. To this list we added behaviors that fitted our definition of intentional non-adherence, identified in a thorough literature search. This initial list of 22 behaviors was further refined by a public health expert. The instrument was then tested on a sample of 583 participants, sufficiently powered to detect effects for all preregistered statistical analysis. Participants were recruited using an online snowballing procedure and via social networks.Results: Factor analysis yielded a one-factor solution, and the final 12-item iNAR questionnaire had satisfactory internal reliability (Cronbach’s alpha = .72). A hierarchical linear regression showed that, as expected, health condition variables and healthcare-related beliefs and experiences accounted for 14% of the variance of iNAR behaviors, whereas sociodemographics and irrational beliefs did not additionally contribute. In comparison, the same regression model with smoking (representative of habitual non-adherence) as a criterion variable, accounted for less than 3% of the variance, with education as the only significant predictor. Conclusions: We have constructed a brief, comprehensive, and reliable measure of iNAR behaviors. Normalization of patients’ passivity and, in particular, negative experiences with the healthcare system contributed to intentional, but not habitual non-adherence. We believe that public health interventions designed to discourage intentional non-adherence should foremost attempt to improve all patients' experiences with the system and build trust with their healthcare practitioners rather than aim at specific demographic groups or at correcting patients' unfounded beliefs.