Conspiracy beliefs and COVID-19 guideline adherence in adolescent psychiatric outpatients: the predictive role of adverse childhood experiences

Abstract

Background Conspiracy beliefs have become widespread throughout the COVID-19 pandemic. Previous studies have shown that endorsing conspiracy beliefs leads to lower protective guideline adherence (i.e., wearing face masks), posing a threat to public health measures. The current study expands this research across the lifespan, i.e., in a sample of adolescents with mental health problems. Here, we investigated the association between conspiracy beliefs and guideline adherence while also exploring the predictors of conspiracy beliefs. Methods N = 93 adolescent psychiatric outpatients (57% female, mean age: 15.8) were assessed using anonymous paper–pencil questionnaires. Endorsement of generic and COVID-19 conspiracy beliefs was assessed, in addition to items measuring adherence to protective guidelines and mental health (stress, depressive symptoms, emotional/behavioral problems, and adverse childhood experiences). Multiple regressions and supervised machine learning (conditional random forests) were used for analyses. Results Fourteen percent of our sample fully endorsed at least one COVID-19 conspiracy theory, while protective guidelines adherence was relatively high (M = 4.92, on a scale from 1 to 7). The endorsement of COVID-19 conspiracy beliefs—but not of generic conspiracy beliefs—was associated with lower guideline adherence (β = − 0.32, 95% CI − 0.53 to − 0.11, p < .001). Conditional random forests suggested that adverse childhood experiences and peer and conduct problems were relevant predictors of both conspiracy belief categories. Conclusion While a significant proportion of our sample of adolescents in psychiatric treatment endorsed conspiracy beliefs, the majority did not. Furthermore, and to some degree, contrary to public perception, we found that adolescents show relatively good adherence to public health measures—even while experiencing a high degree of mental distress. The predictive value of adverse childhood experiences and peer/conduct problems for conspiracy beliefs might be explained by compensatory mechanisms to ensure the safety, structure, and inclusion that conspiracies provide.

Conspiracy theory beliefs in the adolescent population: A systematic review

“…Additionally, a small fee was paid for participation and may have led to over‐representation of individuals suffering monetary disadvantage. One study (Goreis et al, 2023) took a sample from psychiatric outpatients to examine conspiracy theories in adolescents with mental health diagnoses. The authors reported that the sample represented approximately 10% of all outpatients within the department and, as such, might not be representative of all adolescents engaged with the outpatient department.…”

“…The included study of adolescent psychiatric outpatients by Goreis et al (2023) reported lower beliefs among adolescents compared with adults in relation to reported generic conspiracy theory beliefs in studies using the same measure. However, the sample age range began at 11 years; given that the current review has reported key stage 4 high school students (11–14 years) as having lower conspiracy theory beliefs, it would be expected that the overall score for the adolescent sample used by Goreis et al would be lower than adult samples.…”

“…As discussed in the included study by Goreis et al (2023), relationships between adverse childhood experiences and belief in conspiracy theories was reported in both an included adolescent study and one study using adult participants (Freeman & Bentall, 2017). As childhood trauma is common, particularly among psychiatric outpatients (Devi et al, 2019), future research would benefit from conducting longitudinal studies to assess differences in how conspiracy theory beliefs present and progress across time when present in those who experience childhood trauma.…”

“…Of the six studies included in the systematic review, only one study justified the sample size (Goreis et al, 2023), with details including software used (G*Power), power value (80%) and α level (.05). The study reported a required sample size of at least 90 participants and achieved a total of 93 participants in the analyses.…”

“…One study (Goreis et al, 2023) explored the relationship between mental health, COVID-19 belief in conspiracy theories, generic belief in conspiracy theories, and adherence to pandemic-related guidelines using measures of depression, perceived stress, childhood trauma, and emotional/behavioral problems. The authors report that in the sample, endorsement of generic belief in conspiracy theories was shown to be low on the scale and lower in relation to adult studies using the same measure.…”