Antecedents and consequences of COVID-19 conspiracy beliefs: A systematic review

Workplace Deceptions During the Pandemic: Differences in Conspiracy Beliefs, Psychological Functioning, and Covid-19 Experiences

The global pandemic has disrupted virtually all countries on health, psychological functioning, and economies, to name a few. Accurate information has also fallen victim to the pandemic, which has been rife with misinformation and conspiracy theories. The current study investigated Covid-19 deceptions related to employment. With complete anonymity via MTurk, 389 participants from the United States rated their likelihood of deception regarding hypothetical four workplace scenarios. The first set of analyses examined differences between high and low risk of deceptions for each scenario based on participants' self-appraisals. The largest differences were found for general conspiracy beliefs and affective disorders, specifically major depression and generalized anxiety. The second set of analyses focused across the workplace scenarios on two operationalized groups with Likely-Deceptive (n = 189) vastly outnumbering Likely-Genuine (n = 55). Personal experiences with Covid-19 dramatically increased deceptions. Testing positive for Covid-19 increased the odds of being in the Likely-Deceptive by twelve-fold. Two discriminant models examined cognitive misbeliefs and psychological functioning. When both were combined, depression and Covid-19 misinformation produced the strongest structure coefficients followed closely by general conspiracy beliefs and generalized anxiety. The far-ranging implications of these findings are discussed.

Delineating between scientism and science enthusiasm: Challenges in measuring scientism and the development of novel scale

Scientism proposes science to be an all-powerful human enterprise, able to answer not only all practical but also philosophical or moral questions. We are taking a psychological approach to scientism, studying uncritical trust in science and uncritical trust in scientists as a part of a unique attitudinal tendency. Our novel measure assesses both kinds of trust through short Thurstone scales allowing us to establish a clear threshold for endorsing scientism, thus effectively delineating it from science enthusiasm, which previous instruments were unable to do. We built and refined a novel scale through five stages in which we consulted relevant literature, experts, and laypeople. We demonstrated that uncritical trust in science and scientists are interrelated, yet distinct constructs. As expected, these two subscales positively correlated with dogmatism, scientific knowledge, and overclaiming, but not with knowledge overestimation. The results suggest the new instrument is reliable, valid, and suitable for the lay public.

The negative impact of misinformation and vaccine conspiracy on COVID-19 vaccine uptake and attitudes among the general public in Iraq

Background

Vaccine hesitancy is a major barrier to infectious disease control. Previous studies showed high rates of COVID-19 vaccine hesitancy in the Middle East. The current study aimed to investigate the attitudes towards COVID-19 vaccination and COVID-19 vaccine uptake among adult population in Iraq.

Methods

This self-administered survey-based study was conducted in August-September 2022. The survey instrument assessed participants' demographics, attitudes to COVID-19 vaccination, beliefs in COVID-19 misinformation, vaccine conspiracy beliefs, and sources of information regarding the vaccine.

Results

The study sample comprised a total of 2544 individuals, with the majority reporting the uptake of at least one dose of COVID-19 vaccination (n = 2226, 87.5 %). Positive attitudes towards COVID-19 vaccination were expressed by the majority of participants (n = 1966, 77.3 %), while neutral and negative attitudes were expressed by 345 (13.6 %) and 233 (9.2 %) participants, respectively. Factors associated with positive attitudes towards COVID-19 vaccination in multivariate analysis included disbelief in COVID-19 misinformation and disagreement with vaccine conspiracies. Higher COVID-19 vaccine uptake was significantly associated with previous history of COVID-19 infection, higher income, residence outside the Capital, disbelief in COVID-19 misinformation, disagreement with vaccine conspiracies, and reliance on reputable information sources.

Conclusion

COVID-19 vaccine coverage was high among the participants, with a majority having positive attitudes towards COVID-19 vaccination. Disbelief in COVID-19 misinformation and disagreement with vaccine conspiracies were correlated with positive vaccine attitudes and higher vaccine uptake. These insights can inform targeted interventions to enhance vaccination campaigns.

Conspire to one's own detriment: Strengthening HPV Program Support Through Debunking Epistemically Suspect Beliefs

The study experimentally tested an intervention that debunks epistemically suspect beliefs about vaccines. After answering questions about pre-existing epistemically suspect beliefs (irrational health beliefs and conspiracy mentality), 565 participants were randomly assigned into one of three conditions and exposed either to neutral information about domestic animals, salient epistemically suspect content about vaccination or an intervention that debunks epistemically suspect beliefs about vaccination. Afterwards, the participants answered questions about vaccination-related conspiracy narratives (manipulation check), vaccination attitudes, intentions to vaccinate against HPV, support for an HPV vaccination programme and intentions to seek health guidance. Although the intervention demonstrated the potential to inhibit the endorsement of conspiracy narratives, we found no differences in the other outcome variables. Nevertheless, across the conditions, pre-existing epistemically suspect beliefs were associated with less favourable attitudes towards vaccination, lower intentions to vaccinate against HPV, less support for the vaccination programme and lower intentions to seek health guidance. The results indicate that debunking may be futile in curbing long-term negative impacts associated with epistemically suspect beliefs, and they contribute to the debate about assessing the effectiveness of interventions related to highly controversial topics such as vaccination. The study enhances understanding of persistent adverse impacts that epistemically suspect beliefs may have on public health outcomes.

The sociodemographic correlates of conspiracism

Despite hundreds of studies examining belief in conspiracy theories, it is still unclear who-demographically-is most likely to believe such theories. To remedy this knowledge gap, we examine survey data containing various operationalizations of conspiracism across diverse sociopolitical contexts. Study 1 employs a 2021 U.S. survey (n = 2021) to examine associations between sociodemographic characteristics and beliefs in 39 conspiracy theories. Study 2 similarly employs a survey of 20 countries (n = 26,416) and 11 conspiracy theory beliefs. Study 3 reports results from a 2020 U.S. survey (n = 2015) measuring perceptions about which groups are engaging in conspiracies. Study 4 interrogates data from nine U.S. surveys (2012-2022; n = 14,334) to examine the relationships between sociodemographic characteristics and generalized conspiracy thinking. Study 5 synchronizes studies 1-4 to provide an intersectional analysis of conspiracy theory belief. Across studies, we observe remarkably consistent patterns: education, income, age (older), and White identification are negatively related to conspiracism, while Black identification is positively related. We conclude by discussing why conspiracy theories may appeal most to historically marginalized groups and how our findings can inform efforts to mitigate the negative effects of conspiracy theories.

Predicting vaccination hesitancy: The role of basic needs satisfaction and institutional trust

Autonomous motivation is considered a powerful driver of health behaviour, but less is known about the specific roles played by basic needs. Drawing on the context of the COVID-19 pandemic, this research examined basic needs as a motivational determinant of vaccination. We hypothesized that satisfaction of basic needs (autonomy, competence, relatedness) has both a direct and an indirect effect (through trust in science and government) on vaccine hesitancy. Two studies (Study 1: N = 968 French and British; Study 2, pre-registered: N = 716 Americans) tested our hypotheses and compared vaccinated and non-vaccinated individuals using multigroup structural equation models. We found positive direct (in both studies) and indirect (in Study 1) effects of autonomy satisfaction on vaccine acceptance. In contrast, competence satisfaction was directly and indirectly, via science mistrust, related to vaccine hesitancy, particularly among non-vaccinated people. Competence satisfaction also indirectly reduced the intention to vaccinate in both studies. We found no impact of relatedness. Complementing previous work on self-determination theory, our research demonstrates the importance of considering the distinct roles of basic needs. Moreover, we highlight that increasing autonomy and science trust may be an efficient strategy to improve vaccine acceptance and vaccination, even among reluctant individuals.

Digital media use, depressive symptoms and support for violent radicalization among young Canadians: a latent profile analysis

BACKGROUND

Despite the prominent role that digital media play in the lives and mental health of young people as well as in violent radicalization (VR) processes, empirical research aimed to investigate the association between Internet use, depressive symptoms and support for VR among young people is scant. We adopt a person-centered approach to investigate patterns of digital media use and their association with depressive symptoms and support for VR.

METHODS

A sample of 2,324 Canadian young people (Mage = 30.10; SDage = 5.44 ; 59% women) responded to an online questionnaire. We used latent profile analysis to identify patterns of digital media use and linear regression to estimate the associations between class membership, depressive symptoms and support for VR.

RESULTS

We identified four classes of individuals with regards to digital media use, named Average Internet Use/Institutional trust, Average internet use/Undifferentiated Trust, Limited Internet Use/Low Trust and Online Relational and Political Engagement/Social Media Trust. Linear regression indicated that individuals in the Online Relational and Political Engagement/Social Media Trust and Average Internet Use/Institutional trust profiles reported the highest and lowest scores of both depression and support for VR, respectively.

CONCLUSIONS

It is essential to tailor prevention and intervention efforts to mitigate risks of VR to the specific needs and experiences of different groups in society, within a socio-ecological perspective. Prevention should consider both strengths and risks of digital media use and simulteaneously target both online and offline experiences and networks, with a focus on the sociopolitical and relational/emotional components of Internet use.

Conspiracy beliefs and intention to use conventional, complementary and alternative medicines: Two vignette studies

OBJECTIVE

Conspiracy beliefs (CBs) can have substantial consequences on health behaviours by influencing both conventional and non-conventional medicine uptake. They can target powerful groups (i.e. upward CBs) or powerless groups (i.e. downward CBs). Considering their repercussions in oncology, it appears useful to understand how CBs are related to the intentions to use conventional, complementary and alternative medicines (CAM).

DESIGN AND METHODS

This paper includes two pre-registered online correlational studies on a general French population (Study 1 N = 248, recruited on social media Mage = 40.07, SDage = 14.78; 205 women, 41 men and 2 non-binaries; Study 2 N = 313, recruited on social media and Prolific, Mage = 28.91, SDage = 9.60; 154 women, 149 men and 10 non-binaries). We investigated the links between generic and chemotherapy-related CBs and intentions to use conventional, complementary and alternative medicines. Study 2 consisted of a conceptual replication of Study 1, considering the orientation of CBs.

RESULTS

Generic CBs and chemotherapy-related CBs appear strongly and positively correlated, negatively correlated with intentions to take conventional medicine and positively with intentions to take CAM. The link between generic CBs and medication intention is fully mediated by chemotherapy-related CBs. When distinguished, upward CBs are a stronger predictor of chemotherapy-related CBs than downward CBs.

CONCLUSIONS

The findings suggest that intentions to use medicine are strongly associated with CBs. This has several important implications for further research and practice, notably on the presence and effects of CBs on medication behaviours in cancer patients.

Conspiring under threats! An investigation of associations between COVID-19 health and economic threats and conspiracy beliefs in Italy and Argentina

Theory and research suggest that threats aroused by a given crisis lead to conspiracy beliefs. Although crises involve the arise of multiple threats (e.g., economic, safety, etc.) diversely affecting various needs and outcomes (i.e., cognition, emotion and behaviour), no research has yet focused on specific relations that different threats may have with the endorsement of conspiracy beliefs. In this study, we distinguished between health and economic threats aroused by the COVID-19 pandemic, and we tested their associations with conspiracy beliefs. Findings from two correlational studies conducted in Italy and Argentina showed that while COVID-19's economic threat was positively and consistently related to conspiracy beliefs, the relationship between COVID-19's health threat and conspiracy beliefs was negative and significant in the Italian sample and non-significant in the Argentinian sample. Results are discussed within the context of the effects of multiple threats elicited by crises on conspiracy beliefs.

Unfounded beliefs, distress and powerlessness: A three-wave longitudinal study

The aim of the study was to examine the relationships between unfounded COVID-19 beliefs and distress and powerlessness, specifically, whether distress and powerlessness are causes or consequences of unfounded COVID-19 beliefs represented by conspiracy beliefs and pseudoscientific beliefs regarding treatment and measures. Unfounded beliefs were assessed using the COVID-19 Unfounded Beliefs Scale; distress was measured with the Symptom Checklist-10, and powerlessness was measured with four items measuring the feeling of losing control. Data collection took place during three phases of the pandemic in Slovakia (October 2021, N = 1838; July 2022, N = 1,420; April 2023, N = 925). Results suggest that individuals with stronger unfounded beliefs about COVID-19 reported greater powerlessness longitudinally, and individuals with stronger COVID-19 unfounded beliefs treatment and measures reported greater distress longitudinally (notably, beliefs about COVID-19 measures in the first wave were associated with distress in the second wave, and beliefs about COVID-19 treatment in the second wave were associated with distress in the third wave). The present findings corroborate an existential threat model of conspiracy theories that says the relationship between unfounded beliefs and indicators of well-being is bidirectional, so interventions should be focused both on eliminating the unfounded beliefs and strengthening well-being.

Dark Triad personality traits and realistic and symbolic COVID-19 threat: The role of conspiracy mentality

The COVID-19 pandemic has profoundly altered global social dynamics through extensive containment measures. Understanding how individuals perceive the virus, distinguishing between realistic and symbolic threats, and considering the influence of personality traits is essential for effective public health messaging and interventions. This study explores the linkage between personality traits and perceived COVID-19 threats, mediated by conspiracy mentality, across diverse international contexts. Online survey data were collected in June 2021 from 13,645 participants across seven European countries, the US, and Colombia. The study explores how individuals with different Dark Triad traits perceive the threat of COVID-19, and whether conspiracy mentality mediates these perceptions. The findings reveal distinct associations. Machiavellianism and narcissism were linked to lower perceived COVID-19 threat, while psychopathy was associated with greater perceived threat. Additionally, individuals with higher conspiracy mentality endorsed greater perceived threat related to COVID-19. This study highlights the influence of Dark Triad personality traits on how individuals perceive the threats posed by COVID-19, with conspiracy mentality mediating this relationship. Understanding these associations provides valuable insights into psychological factors affecting COVID-19 perception, informing future research and public health strategies.

Partisan Bias in COVID-19 Conspiracy Theories: News Reliance and the Moderating Role of Trust in Health Authorities

Neglecting the role of political bias in the public's perceptions of health authorities could be deceptive when studying potentially politicized COVID-19 conspiracy theories (CCTs); however, previous studies often treated health authorities as a single entity and did not distinguish between different types of CCTs. Drawing from motivated reasoning theory, we investigate the politically motivated nature of CCTs by examining their associations with individuals' media reliance, party identification, conspiratorial mentality, and importantly, trust in (politicized or independent) health authorities. In a national survey conducted in late 2020 (N = 2,239) in Turkey, a heavily polarized context, we found that not accounting for political identities shown in CCTs and health authorities could be misleading. While those with a strong conspiracy mentality were more likely to endorse all types of CCTs, party identification and trust in different types of health authorities led people to believe in certain CCTs aligning with their political attitudes. The influence of media reliance on CCTs depended on the level of trust in health authorities, again suggestive of the influence of political partialities.

How do people with long COVID utilize COVID-19 vaccination and rehabilitation services and what are their experiences with these services? results of a qualitative study with 48 participants from Germany

BACKGROUND

Studies estimate that at least 7.5% of adults are affected by long-term symptoms such as fatigue or cognitive impairment after the acute phase of COVID-19. COVID-19 vaccination may reduce the risk of long COVID. Rehabilitation can have a positive impact on recovery. This study aims to present the experiences of people with long COVID with COVID-19 vaccination and rehabilitation. Such research is important because perceptions of these measures can impact healthcare utilization and health status.

METHODS

48 adults with long COVID participated in this qualitative study, 25 of them in one-on-one interviews and 23 in focus groups. Participants were recruited via calls for participation on the websites and social media channels of two university hospitals and with the help of respondents' networks. The conversations were audio-recorded, transcribed, and analyzed using qualitative content analysis. Subsequently, the results were compared, interpreted, and discussed by scientific literature.

RESULTS

35 study participants reported that they had received a COVID-19 vaccination and 16 of them stated that they had utilized a rehabilitation service. These participants had varying experiences with COVID-19 vaccination and rehabilitation. Nine of them stated that they developed long COVID despite vaccination before COVID-19. Ten participants reported vaccine reactions, and two participants reported severe side effects. Two participants reported persistent deterioration of their long COVID symptoms after vaccination. This led to uncertainty about the safety, benefits, and handling of COVID-19 vaccination. However, most participants perceived the vaccine as effective regarding milder COVID-19 sequelae. Four participants felt their rehabilitation was helpful and four participants felt it was unhelpful. Two persons found the combination of inpatient rehabilitation and rehabilitation sport helpful.

CONCLUSIONS

Several implications can be derived from this study: (1) researchers should explore the effects of COVID-19 vaccination on long COVID symptoms; (2) vaccination campaigns should be more responsive to the perspectives of people with long COVID on vaccination; (3) care planners should build rehabilitation facilities specialized in long COVID; (4) rehabilitation providers should train their professionals regarding long COVID and develop rehabilitation programs tailored to different clinical pictures.

TRIAL REGISTRATION

German register for clinical trials DRKS00026007, 09 September 2021.

Health emergencies, science contrarianism and populism: A scoping review

Populism has emerged as a central explanation employed by both media outlets and scholars for the mishandling of the COVID-19 crisis. Nonetheless, the relationship between public health and populism extends before and beyond the pandemic. This paper offers a comprehensive overview of existing evidence and theoretical conceptualisations on the intersection of populism, health emergencies, and contrarian scientific positions, drawing from a diverse range of disciplines. I conducted a scoping review of 283 original studies, analysing their analytical framework, geographic focuses, and methodological approaches. Employing quantitative text analysis, I summarised the research field into 18 common topics, organised into five coherent categories: citizen's perspective, political elites, political communication, pandemic consequences, and non-COVID-related issues. While the scholarly interest in this area has surged since the onset of the pandemic, it has predominantly concentrated on specific cases, such as Brazil and the US, often conflating different policy types. The evidence summary elucidates that populism assumes varying roles within distinct contexts, and there is no linear relationship between political populism and specific approaches to health crises and science. I further compare definitions of populism within the context of health and scientific positions. I propose that future research should employ a policy typology for health emergency responses, assessing political positions based on policy arenas. This paper contributes to the understanding of the complex interplay between political populism, contrarian scientific perspectives, and public health.

Use of immunology in news and YouTube videos in the context of COVID-19: politicisation and information bubbles

Background

The COVID-19 pandemic propelled immunology into global news and social media, resulting in the potential for misinterpreting and misusing complex scientific concepts.

Objective

To study the extent to which immunology is discussed in news articles and YouTube videos in English and Italian, and if related scientific concepts are used to support specific political or ideological narratives in the context of COVID-19.

Methods

In English and Italian we searched the period 11/09/2019 to 11/09/2022 on YouTube, using the software Mozdeh, for videos mentioning COVID-19 and one of nine immunological concepts: antibody-dependent enhancement, anergy, cytokine storm, herd immunity, hygiene hypothesis, immunity debt, original antigenic sin, oxidative stress and viral interference. We repeated this using MediaCloud for news articles.Four samples of 200 articles/videos were obtained from the randomised data gathered and analysed for mentions of concepts, stance on vaccines, masks, lockdown, social distancing, and political signifiers.

Results

Vaccine-negative information was higher in videos than news (8-fold in English, 6-fold in Italian) and higher in Italian than English (4-fold in news, 3-fold in videos). We also observed the existence of information bubbles, where a negative stance towards one intervention was associated with a negative stance to other linked ideas. Some immunological concepts (immunity debt, viral interference, anergy and original antigenic sin) were associated with anti-vaccine or anti-NPI (non-pharmacological intervention) views. Videos in English mentioned politics more frequently than those in Italian and, in all media and languages, politics was more frequently mentioned in anti-guidelines and anti-vaccine media by a factor of 3 in video and of 3-5 in news.

Conclusion

There is evidence that some immunological concepts are used to provide credibility to specific narratives and ideological views. The existence of information bubbles supports the concept of the "rabbit hole" effect, where interest in unconventional views/media leads to ever more extreme algorithmic recommendations.

Experimental manipulation of uncanny feeling does not increase adherence to conspiracy theories

Research over the past decade has shown that endorsement of conspiracy theories (CTs) is shaped by motivated cognition processes. Accordingly, CTs are theorized to stem from compensatory processes, as individuals attempt to cope with existential threats (i.e., uncertainty, loss of control). Based on the meaning maintenance model, we investigated whether this compensatory effect could follow from epistemic threats in domains unrelated to CTs in the form of uncanniness. Feelings of uncanniness were experimentally manipulated through exposure to absurdist art and literature in a set of five studies, followed by a mini meta-analysis (Ntotal  = 1,041). We conducted a final, preregistered sixth study (N = 266) manipulating uncanniness through autobiographical recall. No robust evidence for a compensatory effect was found. We discussed methodological and conceptual limitations of the meaning maintenance model, as well as boundary conditions under which conspiracy theories could have a compensatory function to deal with threats.

Knowledge of the Mpox virus and conspiracy beliefs and their association with self-confidence in managing the virus among Israeli orthopedic surgeons

In 2022, the Mpox viral outbreak signaled a global public health emergency. Infectious disease management and prevention are crucial tasks for healthcare workers. In their line of work, orthopedic surgeons could come across cases of the Mpox virus. The aim of the present study was to explore orthopedic surgeons' knowledge of the Mpox virus, their conspiracy beliefs regarding emerging viral infections, and their self-confidence in managing the Mpox virus. In this cross-sectional survey, 137 orthopedic surgeons completed an online questionnaire. The participants had low knowledge of the Mpox virus, providing on average 11.5 correct answers (SD = 2.68) of a possible 21. In addition, the participants tended to express moderate conspiracy beliefs and to have low self-confidence in managing the Mpox virus. Age 30 or older, a higher knowledge level, and lower conspiracy beliefs predicted greater self-confidence in managing the Mpox virus. In addition, a negative association was found between knowledge of the Mpox virus and conspiracy beliefs. Arab and younger orthopedic surgeons expressed stronger conspiracy beliefs. Interventions should include introduction of material regarding emerging tropical infections in medical curricula and in-service training programs. In addition, special attention should be paid to younger and Arab orthopedic surgeons, as these subgroups may endorse higher conspiracy beliefs.

Coping strategies and belief in COVID-19 conspiracy theories

Conspiracy beliefs have been related to aversive emotional experiences often accompanying major world events and have also been linked to maladaptive ways of coping with stress. In this research, we examined how different coping strategies (i.e. self-sufficient, social-support, avoidance and religious) predicted the adoption of COVID-19 conspiracy theories. In two studies (Study 1, n = 1000 and Study 2, n = 616) conducted among Polish participants, we found that avoidance and religious coping were positively linked to COVID-19 conspiracy beliefs. In Study 1, conspiracy beliefs also mediated the positive relationships between avoidance and religious coping and adherence to safety and self-isolation guidelines during the COVID-19 pandemic. Study 2 additionally showed that the relationship between fear, induced by reading threatening news on COVID-19, and conspiracy beliefs was the strongest among those high in avoidance coping. These studies highlight the role of coping strategies in the adoption of COVID-19 conspiracy beliefs.

To trust or not to trust in the thrall of the COVID-19 pandemic: Conspiracy endorsement and the role of adverse childhood experiences, epistemic trust, and personality functioning

RATIONALE

Conspiracy endorsement is a public health challenge for the successful containment of the COVID-19 pandemic. While usually considered a societal phenomenon, little is known about the equally important developmental backdrops and personality characteristics like mistrust that render an individual prone to conspiracy endorsement. There is a growing body of evidence implying a detrimental role of adverse childhood experiences (ACEs) - a highly prevalent developmental burden - in the development of epistemic trust and personality functioning. This study aimed to investigate the association between ACEs and conspiracy endorsement in the general population, specifically questioning a mediating role of epistemic trust and personality functioning.

METHODS

Based on cross-sectional data from a representative German survey collected during the COVID-19 pandemic (N = 2501), we conducted structural equation modelling (SEM) where personality functioning (OPD-SQS) and epistemic trust (ETMCQ) were included as mediators of the association between ACEs and conspiracy endorsement. Bootstrapped confidence intervals (5000 samples, 95%-CI) are presented for all paths.

RESULTS

ACEs were significantly associated with conspiracy endorsement (β = 0.25, p < 0.001) and explained 6% of its variance. Adding epistemic trust and personality functioning as mediators increased the explained variance of conspiracy endorsement to 19% while the direct association between ACEs and conspiracy endorsement was diminished (β = 0.12, p < 0.001), indicating an indirect effect of personality functioning and epistemic trust in the association between ACEs and conspiracy endorsement. Fit indices confirmed good model fit.

CONCLUSIONS

Establishing an association between ACEs and conspiracy endorsement further increases the evidence for early childhood adversities' far-reaching and detrimental effects. By including epistemic trust and personality functioning, these findings contribute to a deeper understanding of the underlying mechanisms in the way that ACEs may be associated with conspiracy endorsement.

The positive association of education with the trust in science and scientists is weaker in highly corrupt countries

One of the most prominent correlates of trust in science and scientists is education level, possibly because educated individuals have higher levels of science knowledge and thinking ability, suggesting that trusting science and scientists relies more on reflective thinking abilities. However, it is relatively more reasonable for highly educated individuals to suspect authority figures in highly corrupt countries. We tested this prediction in two nationally representative and probabilistic cross-cultural data sets (Study 1: 142 countries, N = 40,085; Study 2: 47 countries, N = 69,332), and found that the positive association between education and trust in scientists (Study 1) and science (Study 2) was weaker or non-existent in highly corrupt countries. The results did not change after statistically controlling for age, sex, household income, and residence. We suggest future research to be more considerate of the societal context in understanding how education status correlates with trust in science and scientists.

"Trust me, do not trust anyone": how epistemic mistrust and credulity are associated with conspiracy mentality

Previous research shows that the propensity to endorse conspiracy theories is associated with disrupted forms of epistemic trust, i.e., the appropriate openness towards interpersonally communicated information. There are associations, first, with an increased mistrust in several actors and institutions responsible for the communication of information in society, and second, with a pronounced credulity in unreliable sources and implausible phenomena (e.g., superstition, astrology). This study aims to investigate whether these phenomena are associated with specific personality-related disruptions of epistemic trust. Based on selfreported data of 417 individuals (mean = 33.28; standard deviation = 11.11) from a UK population sampled online, the potential relationships between disruptions in epistemic trust and the endorsement of a conspiracy mentality are explored. The epistemic stances characterized by mistrust and credulity (independent variables) are measured with the epistemic trust, mistrust, and credulity questionnaire (ETMCQ), and conspiracy mentality (dependent variable) is measured with the conspiracy mentality questionnaire. In a multiple linear regression model, mistrust is associated with the endorsement of a conspiracy mentality, even when accounting for other contributing factors (e.g., individual narcissism, attachment avoidance and anxiety, authoritarianism, loneliness). In a bootstrapped mediation model controlling for other relevant predictors, the association between credulity and conspiracy mentality is fully mediated by mistrust. In future research, the impact of disrupted epistemic trust on conspiracy beliefs should be investigated in terms of the specific epistemic stances of mistrust and credulity. In this respect, the ETMCQ represents a highly promising instrument to assess individual differences in factors underpinning aspects of conspiracy endorsement.

Vaccine conspiracy association with higher COVID-19 vaccination side effects and negative attitude towards booster COVID-19, influenza and monkeypox vaccines: A pilot study in Saudi Universities

Conspiracies regarding vaccines are widely prevalent, with negative consequences on health-seeking behaviors. The current study aimed to investigate the possible association between the embrace of vaccine conspiracies and the attitude to booster COVID-19, seasonal influenza, and monkeypox (mpox) vaccinations as well as the perceived side effects following COVID-19 vaccination. The target population involved academic staff and university students in health colleges in the Kingdom of Saudi Arabia. A self-administered questionnaire was distributed in January 2023 to collect data on participants' demographics, self-reported side effects following each dose, willingness to get booster COVID-19, seasonal influenza, and mpox vaccinations, as well as an evaluation of vaccine conspiracies and attitude to mandatory vaccination. Among the 273 participants, the willingness to receive yearly booster COVID-19 vaccination was observed among 26.0% of the participants, while it was 46.9% and 34.1% for seasonal influenza and mpox vaccinations, respectively. Multinomial logistic regression analyses demonstrated a significant correlation between endorsing vaccine conspiracies and higher frequency of self-reported side effects following uptake of the second and third doses of COVID-19 vaccines. Vaccine conspiracies were also correlated with attitude toward booster COVID-19, influenza, mpox, and mandatory vaccination. The findings of this pilot study highlighted the potential adverse impact of the preexisting notions and negative attitudes toward vaccines, which could have contributed to heightened perceived side effects following COVID-19 vaccination. The study also highlighted the ongoing divisions concerning mandatory vaccination policies, emphasizing the need for cautious implementation of this strategy as a last resort for public health benefit.

Manifestation of Health Denialism in Attitudes toward COVID-19 Vaccination: A Qualitative Study

Science denialism is characterized by the refusal to accept existing consensus and available evidence. Typical strategies denialists employ include spreading conspiracies, selective use of information, relying on fake experts, or general fallacies in logic. A flood of misinformation, fake news, and conspiracy theories accompanied the COVID-19 pandemic. Simultaneously, it was a subject of many denialistic opinions, from denying the existence of the epidemic challenge to claims that questioned the safety and effectiveness of the COVID-19 vaccines. This study's main aim was to assess the manifestations of denialism in attitudes toward the preventive measures recommended during the pandemic, with a special focus on vaccination. In-depth interviews were conducted with fifty representatives of the general population, demonstrating diversified opinions about COVID-19 vaccines and other preventive behaviors. The interviews were performed face to face in participants' houses or at other places they identified as convenient. Some of the interviewees preferred to do the interview via teleconference. The interviews were carried out from November 2022 to March 2023. The interviewees were recruited initially by convenience, and in further stages, the snowball technique was used. The interviewees were residents of four main administrative districts in Poland. Out of 50 participants, 26 were males, 29 were between 18-40, 16 were inhabitants of rural areas, and 28 had a university level of education. The interviews were based on a semi-structured guide that addressed, in addition to views about the origin of the new coronavirus, respondents' attitudes toward vaccination and sanitary recommendation, the health status of interviewees, their use of healthcare services, and their health behaviors. The interviews were transcribed and analyzed with MAXQDA Analytics Pro 2022 software (Release 22.7.0). Thematic analysis (TA) was applied to the content generated from the interviews. Based on the uptake of the COVID-19 vaccine, the participants were divided into three groups: unvaccinated, hesitant, and vaccinated (18, 4, and 28 interviewees, respectively). The main themes were established based on the TA of the interviews: attitudes toward COVID-19 vaccination, perception of sources of information, and the origin of the new coronavirus. The first theme decidedly drew the greatest attention of the interviewees. There was also a clear relationship between vaccination status and the presence of denialist thinking among interviewees. Interestingly, the role of experts as a key source of information about the pandemic was underlined by study participants. However, the criteria for being an expert differed. The subject of the origin of a new coronavirus was not interesting to interviewees. The analysis of the adherence to preventive measures revealed an interplay of diversified attitudes and motivations. Individuals presenting denialist views most frequently abstained from COVID-19 vaccination. However, such views were also present among those who hesitated or even among those who had been vaccinated. Furthermore, denialism was only one of the determinants of adherence to preventive measures.

The effect of the COVID-19 pandemic on the trends and characteristics of natural and unnatural deaths in an urban Sri Lankan cohort viewed through retrospective analysis of forensic death investigations from 2019 to 2022

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has had a severe impact on global health. Apart from the disease itself, the strict restrictions and lockdowns enforced to minimize its spread have also substantially disrupted personal and public health.

METHODS

An analysis of forensic autopsy investigations was conducted between 2019 and 2022 on a selected urban population in Colombo, Sri Lanka, assessing the effects of the COVID-19 pandemic on mortality within these communities.

RESULTS

During the COVID-19 restrictions, there was a 2.5-fold increase in the total number of deaths, with a significantly higher percentage of female deaths than before. The majority of these deaths were due to cardiovascular causes, while COVID-19-related deaths ranked third overall. The highest proportion of COVID-19 deaths occurred among unvaccinated females. The monthly frequency of deaths from traffic accidents, poisoning, and asphyxiation decreased, while deaths from blunt trauma, sharp trauma, burns, and immersion increased. There was also a rise in blunt homicides and a greater number of femicides during the COVID-19 restrictions than in the pre-pandemic period. A significantly higher percentage of males who received the COVID-19 vaccine died from cardiovascular causes compared to those in the unvaccinated group.

CONCLUSION

The significant changes in mortality demographics and causes of death within this community during the COVID-19 restrictions underscore the disruption in healthcare, healthseeking behavior, and social interactions during this period. The vulnerability of individuals residing in highly urbanized areas with lower socioeconomic status, particularly women, is brought into sharp focus.

Unraveling the association between vaccine attitude, vaccine conspiracies and self-reported side effects following COVID-19 vaccination among nurses and physicians in Jordan

Background

The negative impact of vaccine conspiracies is linked with negative health behavior. The aim of the current study was to examine the association between attitudes toward booster COVID-19, influenza, and monkeypox (mpox) vaccinations with post-COVID-19 vaccine side effects, vaccine conspiracies, and attitude towards mandatory vaccination among nurses and physicians in Jordan.

Methods

A structured closed-ended questionnaire was used to collect data on demographics, COVID-19 history, COVID-19 vaccine type and doses received, self-reported side effects post-COVID-19 vaccination, acceptance of booster COVID-19, seasonal influenza, and mpox vaccinations, attitudes towards mandatory vaccination, and beliefs in vaccine conspiracies.

Results

The study sample comprised a total of 341 participants. Acceptance of yearly booster COVID-19 vaccination was expressed by 46.6% of the sample, while 73.3% accepted seasonal influenza vaccination, and only 37.0% accepted mpox vaccination. A higher frequency of self-reported side effects following the first COVID-19 vaccine dose was associated with embrace of vaccine conspiracies and vaccine type. For the second vaccine dose, a higher frequency of self-reported side effects was associated with the embrace of vaccine conspiracies, older age, and affiliation to private sector. In multinomial logistic regression analyses, the lower embrace of vaccine conspiracies was associated with lower odds of reporting side effects post-COVID-19 vaccination. The lower embrace of vaccine conspiracies and favorable attitude towards mandatory vaccination were associated with the willingness to get COVID-19, influenza, and mpox vaccinations.

Conclusion

The study findings highlighted the negative impact of embracing vaccine conspiracies on health-seeking behavior among nurses and physicians. The findings indicated that the willingness to get vaccinated was associated with lower endorsement of vaccine conspiracies. Additionally, the lower embrace of vaccine conspiracies was associated with a lower frequency of self-reported side effects following COVID-19 vaccination. These results emphasize the importance of addressing vaccine misinformation and promoting accurate information to ensure optimal vaccine uptake and public health outcomes.

Perceptions and Knowledge of Public Towards Emerging Human Monkeypox in Yemen: A Cross-Sectional Study

Background

The spread of monkeypox (mpox) worldwide poses a severe threat to human life. This virus leads to a disease with symptoms similar to smallpox in humans. To combat this threat, improving public knowledge and perception toward mpox is vital for public health preventive measures.

Methods

A cross-sectional survey was carried out in Yemen from December 2022 to March 2023 to investigate public perception and knowledge of mpox. Individuals were approached through social media platforms using a convenient sampling approach. Linear regression was used to determine the association between participants' knowledge (dependent variable) and explanatory variables.

Results

A total of 853 individuals consented to take part in the study. A significant proportion of respondents had a low knowledge level (N=572, 67.06%). Most participants knew about the nature of the diseases (75%, n=641), transmission mode (78.1%, n=668), hand sanitizer preventive measures, and skin- related symptoms. However, only 20.8% (n= 178) knew that diarrhea is not a symptom, and 25.4% (n= 217) knew antibiotics are unnecessary for mpox management. A proportion of 57.7% (n=492) of the participants feared human mpox, and 47.7% (n= 407) thought it was a conspiracy. Most participants had a good perception of local and international health authorities controlling the disease. Age, education level, having a health-related certificate, and receiving a 2-dose vaccination for COVID-19 had statistically significant associations with mpox knowledge level (P < 0.05). Social media platforms were the most often used information source about mpox (78.3%, n= 668), followed by articles (41.1%, n=351).

Conclusion

The study reveals a low public knowledge about mpox in Yemen, emphasizing the need for targeted educational campaigns, especially via social media, to strengthen public health measures and disease control. Addressing Knowledge gaps and correcting misconceptions is crucial for improving preparedness and response to the disease.

How does evidence-based medicine training affect medical students' views on traditional, complementary, and alternative medicine and the conspiracy theories about COVID-19: a nationwide study

AIM

It was aimed to explore the relationship between evidence-based medicine (EBM) training and medical students' views on traditional, complementary, and alternative medicine (TCAM) and their views on conspiracies about COVID-19.

BACKGROUND

Medical students constitute the future workforce of primary health care services. The relationship between EBM training and their views on conspiracies about COVID-19 is critical to explore for providing a better primary health care. The relationship EBM training and medical students' views on TCAM is also important in this regard.

METHODS

This is a cross-sectional study. Turkish medical students were surveyed about EBM training, TCAM, and COVID-19 conspiracies. The electronic survey form consisted of five parts: Demographic characteristics, views and self-perceived knowledge about TCAM and the methods, views on the origin of SARS-COV-2, participation in EBM training, and views on TCAM training. A total of 49 medical schools provided response. Along with descriptive statistics, Chi-square test was utilized.

FINDINGS

Among 2577 participants, 24.0% of them believed SARS-COV-2 was artificially designed. The students who have participated in EBM training via both lecture and small group discussions have a less positive view on TCAM than both the students who have not participated in any EBM training (p < 0.05) and the students who participated in only-lectures (p < 0.05). There was a significant association between EBM training and whether believing COVID-19 (SARS-COV-2) has been designed purposefully by some people or it has emerged naturally χ2 (1) = 17.21 p < 0.001. The odds of thinking COVID-19 emerged naturally was 1.85 times higher (95% CI: 1.38-2.47) if the students have participated in EBM training via both lectures and small group discussions than if they have not participated in any EBM training. EBM training affects medical students in terms of beliefs on COVID-19 conspiracies.

Belief in COVID-19 related conspiracy theories around the globe: A systematic review

Conspiracy theories have been widespread in public discourses about COVID-19. Belief in conspiracy theories has negative effects on COVID-19 protective and preventive behaviour. However, evidence on the prevalence of belief in COVID-19 conspiracy theories, remains fragmented. We conducted a systematic review on the adult general population prevalence of belief in different COVID-19 conspiracy theories at country and regional level around the globe. Searches were performed in PubMed, Scopus and Google Scholar databases (end of search: March 22, 2022). We followed guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We identified 1637 potentially relevant titles in our search and included 33 studies in our review, reflecting conspiracy theory endorsement between March 2020 and August 2021. We found high belief in COVID-19 conspiracy theories in most studies: 29 studies measured at least one conspiracy theory belief prevalence ≥20%. For several conspiracy theories, e.g. "Lab origin" or "Destabilization and power gain", prevalence was often between 20 and 50%. Our findings call for increased awareness about COVID-19 conspiracy theories and the need for tailored, context specific conspiracy theory preparedness, prevention and control. Development and integration of a public health oriented communication and infodemic management strategy, alongside the implementation of conspiracy theory endorsement risk assessments are essential for supporting public health policy in future health emergencies.

A Cross-Sectional Study To Assess Knowledge of Monkeypox Among Medical Students and Graduates in India

Background and aim Monkeypox outbreaks in several nations have brought focus to the emerging virus. The clinical presentation of monkeypox is less severe than smallpox but is fairly comparable, presenting with fever, headache, lymphadenopathy, back discomfort, myalgia, and skin rashes. The misinformation spread on social platforms had a major impact on the effectiveness of outbreak control measures. The clinical management of breakouts depends on the adequate knowledge of the healthcare personnel about the disease. This study aims to assess the knowledge of medical students and graduates regarding monkeypox in India. Methods A cross-sectional survey was conducted by circulating a predesigned questionnaire with 20 questions to collect information regarding the demographic characteristics of the study participants, source of knowledge about monkeypox disease, self-perceived knowledge, and number of correctly answered questions regarding the disease. The responses obtained from the questionnaire and teleconsultation were recorded and analyzed.  Results Out of 404 medical students and graduates who participated in the study, the mean age of participants was 23.17±2.14 years, and only 156 students learned about monkeypox in medical colleges. Only 72 (17.82%) participants reported that their medical college or hospital organized an educational class to teach about monkey pox disease. A majority of respondents (n=350, 86.63%) received their knowledge from online sources, which were the first most used source, followed by Instagram.  Conclusions The knowledge assessment about monkeypox revealed that the average correct responses of participants who perceived to be knowledgeable were significantly lower than those who perceived to have good knowledge.

Pervasive Parental Hesitancy and Resistance towards Measles Rubella Vaccination in Jordan

Measles remains a highly contagious and potentially severe infectious disease, necessitating high vaccine coverage. However, misinformation and measles vaccine hesitancy/resistance have posed significant challenges to achieving this goal. The COVID-19 pandemic further exacerbated these challenges, leading to a measles outbreak in Jordan in 2023. This study aimed to investigate the acceptance of the measles rubella (MR) vaccine among parents in Jordan and to identify its associated determinants. This cross-sectional questionnaire-based study was conducted using a previously Arabic-validated version of the Parental Attitudes towards Childhood Vaccines (PACV) survey instrument. Data collection took place in October 2023, and the final study sample comprised a total of 391 parents, with mothers representing 69.8% of the participants (n = 273). The majority of participating parents expressed either resistance (n = 169, 43.2%) or hesitancy (n = 168, 43.0%) towards MR vaccination, while only 54 participants (13.8%) expressed MR vaccine acceptance. Multivariate analysis revealed that trust in vaccine safety/efficacy, behavior, and having fewer offspring were significantly associated with MR vaccine acceptance. The current study revealed a concerning level of MR vaccine hesitancy/resistance among parents in Jordan, which could signal a public health alarm in the country. Urgent and targeted interventions are strongly recommended to address this issue, including mass campaigns aimed at building trust in the MR vaccine's safety/efficacy. Additionally, there is an urgent need for effective public health initiatives to ensure sufficient measles vaccine coverage to prevent future outbreaks of this serious disease.

Conspiracy Theories, Trust in Science, and Knowledge during the Third Wave of the COVID-19 Pandemic in Cyprus

Conspiracy theories flourish during periods of crisis. One way to counteract the believability of conspiracy theories is trust in science and knowledge about the "perceived threat", such as the SARS-CoV-2 virus. A total of 363 adults from Cyprus were recruited via convenience and snowball sampling methods. The data were collected via an internet-based questionnaire that examined participants' belief in 17 conspiracy theory statements, trust in science and scientists, knowledge about the symptoms and the spread of the SARS-CoV-2 virus, phobic anxiety, hostility, somatization, and personality traits based on the Big Five. The results suggest (a) the overall belief in conspiracy theories in Cyprus is low, even though a notable percentage holds a neutral stance towards these theories; (b) trust in science and knowledge about the symptoms and the spread of the SARS-CoV-2 virus is negatively related to conspiracy theories, indicating the importance of trusting science and having knowledge as a means to counteract conspiracy theories; (c) young adults, those residing in rural areas, and those with a low education level are more likely to believe in conspiracy theories; (d) there are no significant associations between conspiracy theories and the psychological dimensions of phobic anxiety, hostility, and somatization; (e) there is difficulty in identifying specific traits related to conspiracy ideation. Public health officials could benefit from the findings when communicating information during periods of crisis.

Prospective Attitudes towards Respiratory Syncytial Virus (RSV) Vaccination: Validation of a Survey Instrument among Young Females in Jordan Pending Vaccine Authorization

In May 2023, the U.S. FDA advisors endorsed Pfizer's pregnancy-administered vaccine (branded ABRYSVO) to protect infants from respiratory syncytial virus (RSV) infection. Vaccination can reduce the burden of RSV-related respiratory disease, with previous studies showing its substantial medical and financial burden in Jordan. However, pregnant women may exhibit hesitancy to get vaccinated due to concerns about potential risks to themselves or their fetuses. This study aimed to assess the acceptance of the RSV vaccine among young females and identify the determinants influencing their decision using a newly constructed instrument. A survey instrument was developed and validated, comprising 26 items to measure RSV vaccine acceptance. A cross-sectional study design was employed, with data collection from a sample of females aged 18 to 45 residing in Jordan during 5-6 July 2023, using a convenient approach via an online distributed questionnaire. The final study sample comprised 315 respondents, with 67.6% who have heard of RSV before the study. If the vaccine was safe, effective, and provided freely, 70.2% showed willingness to get the RSV vaccine, 15.2% resisted, and 14.6% were hesitant. Principal component analysis identified six internally consistent sub-scales with the following suggested themes: Advice, Burden, Conspiracy, Dangers, Efficiency, and Fear, comprising 21 items collectively as assigned as the "ABCDEF" scale for RSV vaccine acceptance. RSV vaccine acceptance in this study was associated with the advice and fear constructs. The validated survey instrument successfully captured important determinants of RSV vaccine acceptance among young females. RSV vaccine promotion efforts should focus on the following: enhancing vaccine education, improving trust in healthcare institutions and providers, reducing burdens through resolving cost issues and focusing on the role of social support, addressing safety concerns, and tailoring communication strategies to effectively promote the benefits of the vaccine. These insights can inform public health policies and interventions aiming to promote RSV vaccination and mitigate the burden of RSV-related diseases among infants. Follow-up studies are recommended with pregnant women as the target group to assess their attitude towards RSV vaccination and to confirm the validity of the conceived ABCDEF survey instrument.

Analyzing factors determining vaccination willingness against COVID-19 in Germany 2020

The study is based on a German single-topic population survey on vaccination willingness against COVID-19 (VWC) by the authors (2020, n = 2014). The single-topic survey allowed us to test several competing explanations for VWC, as discussed in the literature. The VWC in the sample was 67.3%. Logistic regression was used to identify factors affecting VWC. Being at high risk from COVID-19 and having received flu vaccination have a positive impact on VWC. Perceived VWC of friends has a strong positive effect on respondents' VWC. Bivariate relationships of gender, age, and level of education with VWC were no longer significant in a multivariate analysis. Trust in alternative medicine and belief in conspiracy theories have a negative effect on VWC.

Predictive factors of hesitancy to vaccination against SARS-CoV-2 virus in young adults in Spain: Results from the PSY-COVID study

Widespread population vaccination against the SARS-CoV-2 virus is a matter of great interest to public health as it is the main pharmacological measure to contain the COVID-19 pandemic. Hesitancy/reluctance to vaccination has become a main barrier to containing the pandemic. Young adults are the age group with the greatest resistance to vaccination, even in countries with the highest vaccination rates during this pandemic. The objective of this study was to identify the main predictive factors of vaccination intention and profile people with hesitancy/reluctance to vaccinate against SARS-CoV-2 virus in young adults living in Spain during the pandemic. A cross-sectional study was conducted based on the administration of an online survey (PSY-COVID-2) that evaluated the intention of vaccination together with a wide range of sociodemographic, social, cognitive, behavioral and affective variables in a sample of 2210 young adults. 14% of the sample showed hesitancy/reluctance to vaccination at the beginning of their vaccination campaign. A total of 35 factors were associated (small to medium effect sizes) with the intention to get vaccinated. A reduced set of 4 attitudinal and social variables explained 41% of the variability in vaccination intention: attitude to the vaccination, trust in health staff/scientists, conspiracy beliefs about SARS-CoV-2 and time spent being informed about COVID-19. These variables showed good sensitivity/specificity for classifying people as reluctant/not reluctant to vaccination, properly classifying 86% of people. Psychosocial processes related to attitudes, trust and information are the main predictors of vaccination intention in a highly reluctant group such as the young adult population.

Development of a novel instrument for assessing intentional non-adherence to official medical recommendations (iNAR-12): a sequential mixed-methods study in Serbia

OBJECTIVES

We 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).

DESIGN

То 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.

SETTING

Data were collected online using snowball sampling and social networks.

PARTICIPANTS

After 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 MEASURES

The primary, planned outcome is the iNAR Questionnaire, while smoking was used for comparison purposes.

RESULTS

Factor 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.

CONCLUSIONS

We 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 REGISTRATION

The design and confirmatory analyses plan were preregistered (https://osf.io/pnugm).

Predictors and motives for mask-wearing behavior and vaccination intention

Containing a pandemic requires that individuals adhere to measures such as wearing face-masks and getting vaccinated. Therefore, identifying predictors and motives for both behaviors is of importance. Here, we study the decisions made by a cross-national sample in randomized hypothetical scenarios during the COVID-19 pandemic. Our results show that mask-wearing was predicted by empathic tendencies, germ aversion, and higher age, whilst belief in misinformation and presentation of an interaction partner as a family member lowered the safety standards. The main motives associated with taking the mask off included: rationalization, facilitating interaction, and comfort. Vaccination intention was positively predicted by empathy, and negatively predicted by belief in misinformation and higher costs of the vaccine. We found no effect of immunization status of the surrounding social group. The most common motive for vaccination was protection of oneself and others, whereas undecided and anti-vaccine groups reported doubts about the effectiveness and fear of side effects. Together, we identify social and psychological predictors and motives of mask-wearing behavior and vaccination intention. The results highlight the importance of social context for mask-wearing, easy access to vaccines, empathy, and trust in publicly distributed information.

From Conspiracy to Hesitancy: The Longitudinal Impact of COVID-19 Vaccine Conspiracy Theories on Perceived Vaccine Effectiveness

The embrace of coronavirus disease 2019 (COVID-19) vaccine conspiracies has been linked to vaccine hesitancy. This study aimed to investigate the relationship between COVID-19 vaccine conspiracy theories and perceived vaccine effectiveness. The study utilized a longitudinal follow-up study in which adults in Chile completed surveys in December 2020 (T1) and May 2021 (T2). The psychometric properties of the five-item instrument on conspiracy theories for the COVID-19 vaccine were evaluated using data from T1 (n = 578). A confirmatory one-factor structure with suitable indicators of reliability was found. The longitudinal analysis (n = 292) revealed that conspiracy theories about the COVID-19 vaccine in T1 were associated with lower beliefs in its effectiveness in T2. However, no significant association was found between beliefs in effectiveness in T1 and conspiracy theories in T2. The study suggests that beliefs in conspiracy theories may temporally precede beliefs in vaccine effectiveness for COVID-19. The results have implications for strategies to address vaccine conspiracy beliefs and their implementation at the public policy level.

Influence of Stress and Emotions in the Learning Process: The Example of COVID-19 on University Students: A Narrative Review

Emotional instability and stress are the main disturbances that condition the learning process, affecting both teachers and students. The main objective of this review is to analyze the influence of stress and emotions (as part of stress) on the learning environment. Stress is a physiological mechanism that the organism develops to adapt and survive external and internal challenges. In this context, stress tends to be seen as a negative condition in the learning process when it is chronic. Extreme stress situations, such as the COVID-19 pandemic, can generate anxiety and frustration in students. However, other studies indicate that controlled stress can positively enhance the learning process. On the other hand, the quality and intensity of emotions resulting from stress can influence as well the learning process. Positive emotions are healthy and can promote optimal learning. Emotions lead to sentimental, cognitive, behavioral, and physiological changes, which will have a strong influence on intellectual performance. The activation of coping strategies constitutes a key mechanism for dealing positively with problems and challenges, generating positive emotions essential for the self-regulation of learning. In conclusion, correct management of emotions in stressful situations could promote effective learning through enhanced attention and capacity to solve problems.

Linking paranormal and conspiracy beliefs to illusory pattern perception through signal detection theory

Previous research indicates that irrational beliefs (Paranormal beliefs & conspiracy theory endorsement) are associated with the perception of patterns in noise, but the previous findings do not conclusively describe this relationship. This study aims to disentangle the underlying parameters of this association by applying a signal detection theory approach, thus allowing to distinguish illusory pattern perception (false alarms) from perceptual sensitivity and response tendencies-while also taking base rate information into account. Results from a large sample (N = 723) indicate that paranormal beliefs relate to a more liberal response bias and a lower perceptual sensitivity, and that this relationship is driven by illusory pattern perception. Such a clear pattern could not be observed for conspiracy beliefs, for which the increase in false alarm rates was moderated by the base rate. The associations between irrational beliefs and illusory pattern perception were however less substantial compared to other sources of variance. Implications are discussed.

Following the COVID-19 playbook and battling another infodemic: conspiracy beliefs around human monkeypox among the Lebanese population

INTRODUCTION

The non-endemic multicountry outbreak of monkeypox (MPX) has emphasized the issue of conspiracy theories that go viral in times of societal crisis. Now, it is the turn of MPX to join COVID-19 in the conspiracy theory realm. Social media outlets were flooded by a scourge of misinformation as soon as MPX cases began to appear with an evident cross-pollination between diverse conspiracy theories. Given the adverse consequences of conspiracy beliefs, this study aimed to assess the extent of endorsement of MPX conspiracy beliefs among the Lebanese population and to identify its associated factors.

METHODS

Using a convenience sampling technique, a web-based cross section was conducted among Lebanese adults. Data were collected using an Arabic self-reported questionnaire. Multivariable logistic regression was performed to identify the factors associated with the MPX conspiracy beliefs scale.

RESULTS

Conspiracy beliefs regarding emerging viruses including MPX were detected among 59.1% of Lebanese adults. Participants endorsed particularly the conspiracy theories linking the virus to a deliberate attempt to reduce the size of the global population (59.6%), gain political control (56.6%) or pharmaceutical companies' financial gain (39.3%), in addition to the manmade origin of MPX (47.5%). Remarkably, the majority of surveyed adults exhibited a negative attitude toward the government's preparedness for a potential MPX outbreak. However, a positive attitude was revealed toward the effectiveness of precautionary measures (69.6%). Female participants and those having a good health status were less likely to exhibit a higher level of conspiracy beliefs. On the contrary, divorced or widowed adults, those having a low economic situation, poor knowledge level, and negative attitude either toward the government or precautionary measures were more prone to disclose a higher level of conspiracy beliefs. Notably, participants relying on social media to get information about MPX were also more likely to have a higher level of conspiracy beliefs compared to their counterparts.

CONCLUSIONS

The widespread extent of conspiracy beliefs endorsement regarding MPX among the Lebanese population urged the policymakers to find ways to reduce people's reliance on these theories. Future studies exploring the harmful impacts of conspiracy beliefs on health behaviors are recommended.

Conspiracy beliefs, COVID-19 vaccine uptake and adherence to public health interventions during the pandemic in Europe

BACKGROUND

Conspiracy beliefs can be a major hindrance causing a lack of compliance with public health measures, including vaccination. We examined the relationship between individual attitudes, socio-demographic factors, conspiracy beliefs, COVID-19 vaccine hesitancy and preferences about pandemic policies in Europe.

METHODS

We used data from the 10th round of the European Social Survey, conducted in 2021-22 in 17 European countries. Both a conspiracy index and a personal attitude index for each participant were built by using a Latent Class Analysis model. Then, we used a multilevel regression model to investigate the relationship between a personal attitudes index, socio-demographic factors and country of residence, and a conspiracy index. We descriptively analyse the relationship between the conspiracy index and four main items related to COVID-19.

RESULTS

We found that a higher probability of believing in conspiracy theories was associated with male gender, middle age, lower levels of education, unemployment, lower levels of trust and satisfaction and right-wing political orientation. The country of residence was a contextual factor, with eastern European countries having higher levels of conspiracy beliefs. Individuals who expressed conspiracy beliefs had lower COVID-19 vaccine uptake, were less satisfied with the way health services coped with the pandemic and less supportive of governmental restrictions.

CONCLUSIONS

This study provides valuable insights into the factors associated with conspiracy beliefs and their potential impact on public health. The findings highlight the need for effective strategies to address the underlying factors driving conspiracy beliefs, reduce vaccine hesitancy and promote acceptance of public health interventions.

A latent profile analysis of COVID-19 conspiracy beliefs: Associations with thinking styles, mistrust, socio-political control, need for closure and verbal intelligence

Throughout the COVID-19 pandemic, attention has been drawn to conspiracy theories. To date, research has largely examined commonalities in conspiracy theory belief, however it is important to identify where there may be notable differences. The aim of the present research was first to distinguish between typologies of COVID-19 conspiracy belief and explore demographic, social cognitive factors associated with these beliefs. Secondly, we aimed to examine the effects of such beliefs on adherence to government health guidelines. Participants (N = 319) rated well known COVID-19 conspiracy theories, completing measures of thinking style, socio-political control, mistrust, verbal intelligence, need for closure and demographic information. Participants also rated the extent to which they followed government health guidelines. Latent profile analysis suggests three profiles of COVID-19 conspiracy beliefs with low, moderate, and high COVID conspiracy belief profiles and successively stronger endorsement on all but one of the COVID-19 conspiracy theories. Those holding stronger COVID-19 conspiracy theory beliefs are more likely to reason emotively, feel less socio-political control, mistrust others, have lower verbal ability and adhere less to COVID-19 guidelines. The social and health implications of these findings are discussed.

Seven years of studying the associations between political polarization and problematic information: a literature review

This literature review examines the intersection between political polarization and problematic information, two phenomena prominent in recent events like the 2016 Trump election and the 2020 COVID-19 pandemic. We analyzed 68 studies out of over 7,000 records using quantitative and qualitative methods. Our review revealed a lack of research on the relationship between political polarization and problematic information and a shortage of theoretical consideration of these phenomena. Additionally, US samples and Twitter and Facebook were frequently analyzed. The review also found that surveys and experiments were commonly used, with polarization significantly predicting problematic information consumption and sharing.

Approaching differential diagnosis and decisional capacity assessment in the context of COVID-19 conspiracy beliefs: A narrative review and clinical discussion

OBJECTIVE

COVID-19 conspiracy theories have become widespread since the onset of the pandemic and compound the existing challenges of decisional capacity assessment. This paper aims to review the literature pertaining to decisional capacity assessment in the context of COVID-19 conspiracy beliefs and synthesize a practical approach with an emphasis on differential diagnosis and clinical pearls for the practicing physician.

METHODS

We reviewed papers on decisional capacity assessment and differential diagnosis in the context of COVID-19 conspiracy beliefs. A literature search was conducted using the US National Library of Medicine's PubMed.gov resource and Google Scholar.

RESULTS

The resulting article content was utilized to synthesize a practical approach to decisional capacity assessment in the context of COVID-19 conspiracy beliefs. Specifically, aspects related to the history, taxonomy, evaluation, and management are reviewed.

CONCLUSIONS

Appreciating the nuanced differences between delusions, overvalued ideas, and obsessions while with integrating the non-cognitive domains of capacity into the assessment are crucial to navigating the wide differential diagnosis of COVID-19 conspiracy beliefs. It is important to attempt to clarify and optimize patient decision-making abilities by addressing circumstances, attitudes, and cognitive styles specific to patients with seemingly irrational beliefs about COVID-19.

The association of conspiracy beliefs and the uptake of COVID-19 vaccination: a cross-sectional study

The COVID-19 pandemic revealed that health denialism might be an important determinant of adherence to preventive measures during epidemic challenges. Conspiracy beliefs seem to be one of the most visible manifestations of denialism in society. Despite intensive efforts to promote COVID-19 vaccinations, the number of citizens reluctant to get vaccinated was very large in many countries. The main aim of this study was the analysis of the association between the acceptance of the COVID-19 vaccination and conspiracy beliefs among adult Internet users in Poland. The analysis was based on data from a survey performed on a sample of 2008 respondents in October 2021. Uni- and multivariable logistic regression models were applied to evaluate the association between attitudes towards COVID-19 vaccination and generic conspiracist, vaccine-conspiracy, and COVID-19-related conspiracy beliefs. In the multivariable model, the effect of conspiracy beliefs was adjusted for the level of vaccine hesitancy, future anxiety, political sympathies, and socio-demographic variables. Univariate regression models showed that COVID-19 vaccination acceptance is significantly lower among respondents with higher levels of all three types of conspiracy beliefs. In the multivariable model, the effect of COVID-19-related and vaccine conspiracy beliefs, but not generic conspiracist beliefs, was maintained after adjusting for vaccine hesitancy. We conclude that conspiracy beliefs should be treated as a potential indicator of lower adherence to preventive measures during epidemic challenges. The respondents revealing a high level of conspirational thinking are a potential group for intensified actions which employ health educational and motivational interventions.

Community-oriented Motivational Interviewing (MI): A novel framework extending MI to address COVID-19 vaccine misinformation in online social media platforms

Researchers have linked circulating misinformation in online platforms to low COVID-19 vaccine uptake. Two disparate literatures provide relevant initial guidance to address the problem. Motivational Interviewing (MI) effectively reduces vaccine hesitancy in clinical environments; meanwhile, social scientists note inoculation, rebuttal, and appeals to accuracy are persuasive in digital contexts. A tension is inherent in these approaches. MI in digital forums may induce an 'illusory truth effect,' wherein falsehoods appear more accurate through repetition. Yet, rebutting misinformation directly may elicit backfire or reactance effects, motivating some to amplify their presentation of misinformation. Building on Identity Process Theory, we propose a theoretical framework for conducting MI-based infodemiology interventions among digital communities that conceptualizes the community in toto (rather than one specific person) as the unit of focus. Case examples from interventions on public Facebook posts illustrate three processes unique to such interventions: 1) Navigating tension between addressing commenters and "bystanders"; 2) Activating pro-vaccine bystanders; and 3) Reframing uncertainty or information individuals might find concerning or threatening according to implied collective values. This paper suggests community-oriented MI can maximize persuasive effects on bystanders while minimizing potential reactance from those with committed beliefs, thereby guiding community-oriented public health messaging interventions enacted in digital environments.

Are informal caregivers more likely to believe in conspiracy theories during the COVID-19 pandemic?: Findings of a representative study from Germany

OBJECTIVES

This study analyzed the conspiracy mentality of informal caregivers for older persons compared to non-caregivers and whether this association was dependent on age.

METHODS

The sample was collected randomly from a population-based online panel (forsa.omninet) and represents individuals aged ≥40 years from Germany. In total, 3022 participants were questioned about conspiracy mentality (Conspiracy Mentality Questionnaire), informal care provision (N = 489 informal caregivers of older adults), and sociodemographic background. Data assessment took place between 4^th and 19^th March 2021 and the questions referred to the time between December 2020 and March 2021.

RESULTS

No significant differences were found between informal caregivers and non-caregivers. A significant interaction effect was found, indicating a decrease of conspiracy mentality among non-caregivers and an increase among informal caregivers with higher age. After stratifying by gender, this effect was found only among female informal caregivers.

CONCLUSION

Middle-aged informal caregivers had a lower, and older-aged a higher, susceptibility to conspiracy theories during the COVID-19 pandemic compared to non-caregivers. The results indicate that providing care could be protective among middle-aged individuals, whereas older informal caregivers may benefit from interventions to reduce susceptibility to conspiracy theories and the associated risks for health and wellbeing.

I'm Offering You My Pain: Priming COVID-19 Salience Increases Everyday Sadism

The COVID-19 pandemic and its link to the emergence of everyday sadism is a matter of public concern worldwide. However, previous studies are nearly silent regarding the causal relationship between the two variables. We address this gap by theorizing that exposure to information about coronavirus can increase sadistic behavior by inducing state boredom. We conducted three complementary controlled experiments, which comprised multiple participants populations (N = 784, student and community samples) and measurement techniques of sadism, to test our theoretical perspective. Based on self-report measures, Study 1 found that Chinese university students who were exposed to a reminder of COVID-19 exhibited a higher level of everyday sadism than participants in the control condition. Study 2 replicated this finding in a more generalized population. Additionally, results revealed that state boredom mediated this effect. Moving beyond subjective self-report data in Studies 1 and 2, Study 3 assessed a different behavioral operationalization of sadistic tendencies, namely, shredding worms. As expected, priming COVID-19 salience has an immediate, statistically significant influence on sadistic behavior in impactful real-world contexts. Overall, these findings suggest that the COVID-19 pandemic not only has grave effects on economy and society, but has implications for the malevolent side of human nature.