Search

Non-adherence to medical recommendations is a widespread public health challenge, attributed to socioeconomic, healthcare system, condition, therapy, and patient-related barriers (WHO, 2003). The novel iNAR-12 instrument (Puric et al., 2023) assesses intentional non-adherence to medical recommendations which is a result of a deliberate process, including behaviors like treatment avoidance or modification and self-medication. This study investigated the prevalence of intentional non-adherence behaviors in Serbia and its psychological roots. This cross-sectional survey was conducted on a probability sample of 1003 participants, nationally representative of Serbia. The battery of instruments included iNAR-12 and scales assessing personality (HEXACO and Disintegration), health status, socio-demographics, healthcare-related beliefs, and experiences, along with thinking styles, and the "irrational mindset" set of questionnaires, which included magical health beliefs, health-related conspiracies and selected cognitive biases. As much as 91.3% of the Serbian adult population reported at least one instance of intentional non-adherence in their lifetime, with the most frequent behaviors being ignoring symptoms that required a visit to a doctor (78%) and taking antibiotics when not prescribed by a doctor (47%). While there were significant correlations (ps<.01) between iNAR and personality traits (H, X, A, D), and the irrational mindset (medical conspiracies, commitment bias, illusory correlations), the hierarchical linear regression demonstrated that negative experiences with the healthcare system were its strongest predictor. The results suggest that intentional non-adherence is a widespread phenomenon. Future health interventions should address modifiable factors such as enhancing healthcare experiences and tailoring communication to individuals at higher risk of intentional non-adherence.

People resort to various questionable health practices to preserve or regain health - they intentionally do not adhere to medical recommendations (e.g. self-medicate or modify the prescribed therapies; iNAR), or use traditional/complementary/alternative (TCAM) medicine. As retrospective reports overestimate adherence and sufer from recall and desirability bias, we tracked the variations in daily questionable health behaviors and compared them to their retrospectively reported lifetime use. We also preregistered and explored their relations to a wide set of psychological predictors - distal (personality traits and basic thinking dispositions) and proximal (diferent unfounded beliefs and biases grouped under the term irrational mindset). A community sample (N = 224) tracked daily engagement in iNAR and TCAM use for 14 days, resulting in 3136 data points. We observed a high rate of questionable health practices over the 14 days; daily engagement rates roughly corresponded to lifetime ones. Both iNAR and TCAM were weakly, but robustly positively related. Independent of the assessment method, an irrational mindset was the most important predictor of TCAM use. For iNAR, however, psychological predictors emerged as relevant only when assessed retrospectively. Our study ofers insight into questionable health behaviors from both a within and between-person perspective and highlights the importance of their psychological roots.

Introduction We will launch a national survey in Serbia to document the prevalence of two types of questionable health behaviours: (1) intentional non-adherence to medical recommendations and (2) use of traditional, complementary and alternative medicine practices, as well as the relation between the two. We will also investigate their psychological roots, including (a) ‘distal’ predictors such as HEXACO personality traits (plus Disintegration) and thinking dispositions (rational/experiential thinking and cognitive reflexivity), and (b) ‘proximal’ predictors under the umbrella ‘irrational mindset’ (set of unfounded beliefs consisting of conspiratorial thinking, superstition, magical health beliefs as well as selected cognitive biases), which have more content-wise overlap with the health behaviours. Methods and analysis In this cross-sectional study, a research agency will collect data from a nationally representative sample (n=1043; age 18–75 years; estimated start/end—June/November 2023) recruited online (approximately, 70% of the sample, aged 18–54; 11 years) and face-to-face (approximately, 30% of the sample, aged 55–75 years). Participants will complete a battery of tests assessing questionable health behaviours, basic personality traits, thinking dispositions, irrational mindset, sociopolitical beliefs, sociodemographic and health-related variables. Prevalence rates will be calculated using descriptive statistics. To explore the relation between (psychological) predictors and questionable health behaviours, we will use hierarchical regression and partial mediation models (path analysis or full SEM models). Ethics and dissemination Ethical Committees of the Faculty of Philosophy in Belgrade (#935/1), Faculty of Special Education and Rehabilitation (#139/1) and Faculty of Media and Communications (#228) approved the protocol. Only participants who provide informed consent will participate in the study. A research report based on the study results will be submitt

While some health practices are supported by science and recommended by authorities, for others scientific evidence-base might be lacking or is yet to be established. Both non-adhering to recommendations and resorting to non evidence-based practices (typically in the domain of traditional, complementary and alternative medicine (TCAM)) can be detrimental for health. We investigated psychological roots of two types of health practices, focusing on their relationship with an “irrational mindset”, an umbrella term comprising certain cognitive biases, belief in conspiracy theories, superstition and magical health beliefs. In a preregistered study (N = 583) we contrasted how an irrational mindset contributes to the prediction of both types of health practices, above other relevant factors, such as sociodemographics, ideological beliefs, health status or relation to the healthcare system. Although the two types of health practices were positively related, they could be traced to different predictors: non-adherence was primarily explained by negative experiences with the health system, whilst irrational mindset did not additionally contribute. In contrast, irrational mindset consistently added to the prediction of different types of TCAM use, with magical health beliefs being the strongest predictor. We highlight the importance of tailoring interventions to the type of health practices so they also target underlying irrational beliefs, on top of providing correct information.

The Rational-Experiential Inventory-40 (REI-40, Pacini & Epstein, 1999), proposed in the framework of the cognitive-experiential self-theory (CEST) is a widely used instrument for measuring thinking styles. Similar to other dual-processing models, CEST distinguishes between automatic, effortless, rapid (experientiality) and conscious, analytical, effortful, slower (rationality) thinking styles. A short version, REI-10, has already been proposed (Epstein et al., 1996), however, it is based on an outdated REI version and is not compatible with REI-40. There are also modified versions of REI which attempt to capture facets of experientiality, but REI-40 is still used more often than other versions. In the current study we aimed to provide a brief version of REI-40 by employing an Ant Colony Optimisation (ACO) algorithm (Leite et al., 2008; Marcoulides & Drezner, 2009). We used an existing dataset, collected in the Serbian validation of REI-40, comprising N = 813 students (Purić & Jokić, 2022), 68% females, Mage = 19.79 (SD = 1.85). We used the ACO procedure to select four items per each REI scale - Rationality and Experientiality, so as to maximize both confirmatory factor analysis model fit, indicated by high Comparative Fit Index (CFI) and low Root Mean Square of Approximation (RMSEA), and high reliability. The resulting instrument, REI-8 demonstrated good model fit: CFI = .99 and RMSEA = .062 [95% CI .048, .076], as well as reliability - Cronbach’s alpha was .75 for both Rationality and Experientiality, while McDonald’s omega was slightly higher at .78 for both REI-8 scales. The correlations between REI-8 scales and corresponding REI-40 scales were very high, r = .82 and r = .84, for rationality and experientiality, respectively, and the two dimensions were practically uncorrelated r = .04, as the CEST model proposes. Overall, we have constructed a very brief 8-item version of REI which is both reliable and structurally valid. This instrument could be used in large

The widely used Rational-Experiential Inventory-40 (REI-40) assesses Rational and Experiential thinking styles. Recently, the authors have distinguished three aspects of the Experiential style: Intuition, Emotionality and Imagination and developed the Rational-Experiential Multimodal Inventory (REIm). In this study, we examined the internal consistency, structural/factorial, discriminant and known-groups validity of both REI-40 and REIm, in two samples of Serbian students. Participants in Study 1 (N = 819, mean age M = 19.81, 31% males) completed REI-40 and HEXACO Personality Inventory (HEXACO-PI-R), while participants in Study 2 (N = 304, mean age M = 19.47, 29% males) completed REIm, HEXACO-PI-R and Disintegration inventory DELTA. The internal consistency of both REI version subscales was acceptable to good. The results of CFA analyses indicated an acceptable fit for REI-40, while the structural validity of REIm was poor. Both REI-40 subscales (Rationality and Experientiality), as well as REIm Intuition demonstrated only a small content overlap with basic personality traits, while REIm Experientiality, Emotionality and Imagination correlated highly with Openness and Emotionality. We also observed some gender differences in the expected direction.

To understand the reasons behind the trend of growing use of traditional, complementary and alternative (TCAM) practices we should first reflect on how people use them - to prevent disease/promote health, to treat medical conditions by complementing official medical treatments, or as an alternative to them. A total of N = 583 (Mage = 39.01 years, SDage = 12.10; 74.4% females) participants from Serbia completed an online survey including a list of 24 TCAM practices, grouped into four domains: Alternative Medical Systems (e.g., acupuncture, homeopathy), Natural product-based practices (e.g., herbal extracts/supplements), New Age medicine (e.g., yoga, mindfulness) and Rituals/Customs (e.g., visiting monasteries for health). Participants who indicated using a certain practice in the past year were asked to consider their most recent experience with that practice and choose only one option for how they used it: for preventive purposes/advancing health, at the same time with official medicine therapy, instead of official medicine therapy. Participants also provided information on whether a TCAM practitioner was involved in their last use of any of the TCAM practices and how often, in general, they consult TCAM practitioners. Overall, 63%, 95%CI [60, 65] of participants used TCAM practices for preventive purposes, 31% [29, 34] in parallel with, and 6% [5, 8] as an alternative to official treatments. Of the four domains of TCAM use, New Age medicine and Rituals/Customs were most frequently used for prevention, with 78% [74, 83] and 77% [72, 82], respectively, while Natural product-based practices were used for prevention in 57% [54, 60] and Alternative Medical Systems in 41% [33, 49] of the cases. Alternative use of TCAM practices was the most common in the case of Alternative Medical Systems (21% [14, 28]), while it amounted to no more than 7% of participants for any of the other domains. For 24% of participants, a TCAM practitioner was present during their last TCAM use

Knjiga Interne metrijske karakteristike psiholoških instrumenata. Vodič kroz Psihometriju 1 kao svoje osnovne teme postavlja one psihometrijske karakteristike instrumenata koje se mogu utvrditi samo na osnovu rezultata na datom testu, bez njegovog dovođenja u vezu sa drugim konstruktima. U skladu sa tim, kao osnovne teme pojavljuju se diskriminativnost, objektivnost, pouzdanost, homogenost i reprezentativnost testa. Dodatno, ovaj vodič pokriva i različite modele merenja, kao što su Gutmanova teorija merenja i teorija odgovora na stavke, a koje se mogu koristiti komplementarno sa klasičnim pristupom prilikom utvrđivanja internih metrijskih karakteristika instrumenata. Na kraju, iako u procesu izrade instrumenta sledi nakon dokazivanja valjanosti, prikazan je i proces normiranja psiholoških instrumenata, jer je i ovo procedura za koju nisu potrebni dodatni podaci osim odgovora na sam test. Vodič kroz Psihometriju 1 zamišljen je kao vodič i kroz teoriju i kroz praksu provere metrijskih karakteristika instrumenata. Svako poglavlje počinje kratkim uvodom u temu iz laičke perspektive, zatim se uvode i objašnjavaju osnovni teorijski pojmovi, da bi na kraju njihova primena bila ilustrovana primerima na konkretnim podacima. Svako poglavlje takođe sadrži i detaljne instrukcije kako se opisani postupci provere metrijskih karakteristika sprovode u IBM© SPSS© statističkom softveru, odnosno, u slučaju teorije odgovora na stavke, u programu Winsteps/Ministep. Takođe, postoji posebno, dodatno poglavlje u kome je detaljno objašnjen rad u IBM SPSS sintaksi, kao i poglavlje koje opisuje proveru metrijskih karakteristika instrumenta korišćenjem makroa RTT10G, koji se pokreće preko SPSS sintakse.

Despite unknown efficiency, known risks, and associated adverse effects of certain traditional, complementary, and alternative medicine (TCAM) practices, the number of people using them appears to be on the rise. Existing taxonomies of TCAM practices mostly relied on either conceptual reasons, or they relied on attitudes toward TCAM, rather than its actual use. In this study, we sought to group TCAM practices based on their patterns of use. A sample of N = 583 (Mage = 39.01 years, SDage = 12.10; 74.4% females) participants residing in Serbia completed an online survey including a list of 71 TCAM practices. For each practice, they indicated if and when they used it to promote their own or their children's health (options: never heard about it/never used it/more than a year ago/in the past year/during the past two weeks). To evaluate the lifetime use of TCAM, we binarized all TCAM items to reflect whether participants have ever used a given practice (never using a practice was coded as 0, using it at least once as 1). After excluding items with frequencies below 5%, we performed an exploratory factor analysis on the tetrachoric correlation matrix for the remaining 49 items. Using a minimum residual method of extraction and oblimin rotation, we identified four meaningful factors explaining 42% of total variance: 1) Natural product-based practices (NP) comprising the use of products such as extracts and supplements of herbal and non-herbal origin; 2) Rituals/Customs (RC) which reflected the use of traditional medicine and religious practices, such as visiting monasteries; 3) New age medicine (NA) incorporating mind-body therapies and energy medicine practices; and 4) Alternative medical systems (AMS) such as acupuncture, homeopathy, quantum medicine, and osteopathy/chiropractic. Factor correlations ranged from r = .18, p <.001 for RC and AMS to r = .30, p < .001 for NA and AMS. The latent structure we obtained based on the pattern of TCAM use corresponds closely to exis