Mistrust and Beliefs in Conspiracy Theories Differently Mediate the Effects of Psychological Factors on Propensity for COVID-19 Vaccine

Abstract

Vaccination is considered a key factor in the sanitary resolution of the COVID-19 pandemic. However, vaccine hesitancy can undermine its diffusion with severe consequences on global health. While beliefs in conspiracy theories, mistrust in science and in policymakers, and mistrust in official information channels may also increment vaccine hesitancy, understanding their psychological causes could improve our capacity to respond to the pandemic. Thus, we designed a cross-sectional study with the aim of probing vaccine propensity in the Italian population and explored its relationship with sociodemographic and psychological variables, and with misbeliefs in COVID-19. A battery of questionnaires was administered to a sample of 374 Italian adults during the first national lockdown (April 2020). The materials included an original instrument—Beliefs in COVID-19 Inventory—and questionnaires measuring perceived stress, anxiety, death anxiety, psychological distress, psychoticism, paranoia, anger, and somatization. The exploratory factor analysis (EFA) on Beliefs in COVID-19 suggested the existence of three factors: belief in conspiracy theories, mistrust in medical information, and mistrust in medicine and science. These factors were positively correlated with female sex, age, religious beliefs, psychiatric conditions, and psychological variables, while negatively correlated with education levels. We conducted a mediation analysis by means of a structural equation model, including psychological factors as predictors, beliefs in COVID-19 scales as mediators, and vaccine propensity as an outcome. The model showed that death anxiety had a direct positive effect on the propensity to get vaccinated. It also showed that death anxiety reduced the propensity to get vaccinated through a mediated path in believing in conspiracy theories, whereas paranoia was linked to a reduction in vaccination adherence with the mediation effect of mistrust in medical science. Psychological distress reduced vaccination propensity by increasing both conspiracy beliefs and mistrust. On the other hand, anxiety increased the propensity to get vaccinated through a decrease in both belief in conspiracy theories and mistrust in science. Our results suggest that psychological dimensions are differentially related to belief in conspiracy theories, to mistrust in science, and to the propensity to get vaccinated. Based on this result, we propose an original interpretation of how conspiracy beliefs build on a paranoid and suspicious attitude. We also discuss the possible clinical implications of treatment for such pathological beliefs.

Evidence for a positive relationship between perceived stress and belief in conspiracy theories

“…The size of this zero-order correlation was similar to that of the partial correlation reported by Swami et al (2016) for US participants (.20 versus .15). It is likewise very similar to the correlation of .20 found in Simione et al (2021). Considering our findings along with the existing literature it seems reasonable to infer that there is now robust evidence of a positive relationship between perceived stress and beliefs in conspiracies -but that this correlation is relatively small.…”

“…An Italian study (Simione et al, 2021) likewise reported a significant correlation (r = .20, p < .01) between perceived stress and belief in conspiracy theories.…”

Through the Second Wave: Analysis of the Psychological and Perceptive Changes in the Italian Population during the COVID-19 Pandemic

“…The well-being worsening across the two waves in Italy may allow us also to better contextualize other Covid-19 related outcomes and phenomena, like vaccination hesitancy. Indeed, lower well-being appeared connected to belief in conspiracy theories and mistrust in medicine and science, which ultimately may lead to avoiding vaccination [40,41].…”

Polish medical students facing the pandemic—Assessment of resilience, well-being and burnout in the COVID-19 era

“…The majority of respondents (80.2%) reported feeling that social aversion and mistrust towards doctors increased during the pandemic, and many of them (43.3%) claimed that it may affect their enthusiasm about their future job. Although there is very little research about mistrust among patients in Poland fueled by the COVID-19 pandemic, scientists from other countries reported that many people endorse conspiracy theories about the origins of the pandemic [39], and some are hesitant to be vaccinated because of their distrust of political and medical institutions, "anti-establishment" sentiments, and conspiratorial and paranoid beliefs [40,41] and, because of the shortage of healthcare professionals [42][43][44], the need to care for COVID-19 patients and prevent further spread of the virus, the "non-COVID" patients are often left waiting in long queues for telehealth that may not be enough, especially for those with lower socioeconomic backgrounds, who can't afford easy access to the devices needed for telemedicine [45]. All these problems have also been present in Poland and may have contributed to the growth of medical mistrust among polish patients.…”