Integrative medicine or infiltrative pseudoscience?

The Illusory Health Beliefs Scale: preliminary validation using exploratory factor and Rasch analysis

Illusory health beliefs are ill-founded, erroneous notions about well-being. They are important as they can influence allied attitudes, actions, and behaviors to the detriment of personal and societal welfare. Noting this, and the prevalence of paranormal beliefs in contemporary Western society, researchers developed the Paranormal Health Beliefs Scale (PHBS). Modification of the PHBS for use with a United Kingdom-based sample resulted in the instrument broadening to incorporate illusory rather than merely paranormal health beliefs. The present study psychometrically assessed the emergent Illusory Health Beliefs Scale (IHBS). The principal objective was to validate the IHBS using a large, representative sample. Eight hundred and fifty participants (360 males, 482 females, eight non-binary) completed the IHBS alongside instruments assessing theoretically associated constructs (i.e., magical thinking, faith in scientifically unsubstantiated notions, and forms of self-referential, intuitive causation). Exploratory factor analysis revealed the existence of six meaningful IHBS dimensions: Religious/Spiritual, Superstition, Precognitive, Health Myths, Skepticism, and Health Pseudoscience. The IHBS demonstrated satisfactory reliability and convergent validity with theoretically aligned constructs. Rasch analysis at the subscale level revealed good item/person fit and item/person reliability, unidimensionality, and equivalency of items across subgroups (gender and religious affiliation). Analysis confirmed the IHBS was an effective measure of illusory health beliefs. However, researchers should undertake further work to refine the scale and evaluate its performance across different samples and time points.

The paranormal health beliefs scale: an evaluation using cognitive interviewing

Paranormal health beliefs denote the inclination to endorse illusory supernatural notions about well-being and treatment. These ideations are important since they potentially influence perceptions of health and allied behaviors. Noting this, researchers in Italy developed and verified the Paranormal Health Beliefs Scale (PHBS). Despite initial promising outcomes, the construct and measurement properties of the PHBS have remained under investigated. This is likely due to the fact that the instrument draws heavily on traditional Italian social, political, and religious influences and is overly culturally specific. Hence, items do not generalize well across populations and nationalities. Acknowledging these factors, this study used cognitive interviewing (think aloud protocol and concurrent probing) to assess the suitability of the PHBS for general use. Concurrently, the intention was to identify necessary modifications that would enhance scale performance. Fourteen interviewees (eight males and six females), evenly distributed across two rounds, participated. Round 1 focused on comprehension and perception of the PHBS. Cognitive interviews identified issues with culturally particular content/points of reference, phraseology, and wording. To address these a modified version of the PHBS was produced. Round 2 then examined the effectiveness of changes. Analysis revealed fewer concerns, although difficulties with ambiguity, complex terminology, and response scale appropriateness persisted. Overall, interviews indicated that a focus on illusory (rather than paranormal) health beliefs would improve scale utility. Methodologically, cognitive interviewing provided invaluable insights into the effectiveness of the PHBS and identified ways in which researchers could adapt the instrument for use with other cultures.

The engagement of psychology with complementary medicine: A critical integrative review

Amidst the global rise in complementary medicine (CM) use for mental health, a substantial number of clients consulting a psychologist also utilise at least one form of CM. Yet, how psychologists should engage with CM in their clinical practice (e.g., how to respond to a client disclosing CM use or enquiries regarding CM products or services for mental health) remains contested and unclear. In response, a systematic integrative review was conducted to examine empirical literature reporting on one or more aspects of the relationship between psychology (incorporating clinical practice, professional associations and academia) and CM, and how that relationship may relate to or inform psychologists' engagement with CM in their clinical practice. Twenty-seven peer-reviewed articles met the specific inclusion criteria and quality appraisal was employed. Analysis shows a substantial number of psychologists are engaging with, or are interested in engaging with, CM in their clinical practice. Analysis identified a dissonance between psychologists' engagement with CM in clinical practice and the limited engagement of the broader discipline of psychology with CM. Further research is required to understand these differing types of engagement with a view to helping inform relevant policy and practice guidelines, and ultimately assist psychologists in navigating CM in their clinical practice.

Complementary medicine in psychology practice: an analysis of Australian psychology guidelines and a comparison with other psychology associations from English speaking countries

BACKGROUND

Psychologists, and their clients, are engaging with complementary medicine (CM). Increasing evidence for CM approaches, such as improved nutrition and St John's wort, has led to their inclusion in the Royal Australian New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. This research aims to determine in what ways, and to what extent, Australian psychology regulatory bodies and associations consider CM relevant to psychology practice. Specifically, how these regulatory bodies and professional association's ethical and practice guidelines engage with CM.

METHODS

Documents from Australian regulatory bodies and professional associations, that relate to the governance or guidance of psychologists' clinical practice, were systematically searched for key terms relating to CM.

RESULTS

There were no direct references to CM in the 58 ethical and practice guidelines reviewed. There was also no reference to the relevance of CM to ethnocultural groups, such as Aboriginal and Torres Strait Islander traditional healing practices.

CONCLUSION

While other mental health care disciplines are working toward integrating CM, the discipline of psychology in Australia is not currently engaged in such developments. Given the exponential rise of CM use amongst those with mental health problems, psychology associations should consider developing resources and guidelines to assist psychologists in navigating CM in relation to clinical practice to help minimise risks, such as patient safety associated with concurrent CM use.

Critical thinking predicts reductions in Spanish physicians' stress levels and promotes fake news detection

The prevalence of pseudoscientific beliefs and fake news increased during the coronavirus crisis. Misinformation streams such as these potentially pose risks to people's health. Thus, knowing how these pseudoscientific beliefs and fake news impact the community of internists may be useful for improving primary care services. In this research, analyses of stress levels, effectiveness in detecting fake news, use of critical thinking (CP), and attitudes toward pseudosciences in internists during the COVID-19 crisis were performed. A total of 1129 internists participated. Several multiple regression models were applied using the forward stepwise method to determine the weight of CP and physicians' attitudes toward pseudosciences in predicting reductions in stress levels and facilitating the detection of fake news. The use of critical thinking predicted 46.9% of the reduction in stress levels. Similarly, skeptical attitudes and critical thinking predicted 56.1% of the hits on fake news detection tests. The stress levels of physicians during the coronavirus pandemic were clinically significant. The efficacy of fake news detection increases by 30.7% if the individual was a physician. Study outcomes indicate that the use of critical thinking and skeptical attitudes reduce stress levels and allow better detection of fake news. The importance of how to promote critical and skeptical attitudes in the field of medicine is discussed.

Experience With, Knowledge of, and Attitudes Toward Complementary and Alternative Medicine Among Pre-Nursing and Nursing Students

Our study explored pre-nursing and graduating nursing students' experience with, knowledge of, and attitude toward complementary and alternative medicine (CAM). Both pre-nursing and nursing students reported positive attitudes toward CAM in general, indicated being interested in learning about CAM, and planned on making CAM practices part of their future careers.

Evidence of the psychological effects of pseudoscientific information about COVID-19 on rural and urban populations

This research aims to analyze the effects of pseudoscientific information (PI) about COVID-19 on the mental well-being of the general population. A total of 782 participants were classified according to the type of municipality in which they lived (rural municipalities and urban municipalities). The participants answered psychometric questionnaires that assessed psychological well-being, pseudoscientific beliefs and the ability to discriminate between scientific and pseudoscientific information about COVID-19. The results indicated the following: the greater the ability to discriminate between false information and true information, the greater the levels of psychological well-being perceived by the participant. The ability to discriminate predicts up to 32% of psychological well-being only for subjects living in rural municipalities. Residents in urban municipalities showed lower levels of well-being than residents in rural municipalities. It is concluded that new social resources are needed to help the general population of urban municipalities discriminate between pseudoscientific and scientific information.

Apps for pain self-management of older people's arthritic pain, one size doesn't fit all: A qualitative study

Introduction Arthritic pain is a major cause of illness and disability among older people. People living with arthritic pain carry out self-management activities to adequately manage their pain. As the trend of smartphone uptake continues to rise among older people, there are opportunities to explore the role of these devices in helping older people better manage their pain. Aim: To explore the attitudes and experiences of older people with chronic arthritic pain towards using an app for their pain selfmanagement. Methods A qualitative design using semi-structured interviews with community-dwelling older Australians living with arthritic pain (n = 16). Data was analyzed using thematic analysis. Results Four themes emerged from the data: (1) Apps are valuable self-management tool, but they do have the potential for harm; (2) A pain self-management app needs to strictly align with the user's needs; (3) Clinician's involvement is crucial when integrating an app into older people's pain selfmanagement regime; and (4) pain self-management app must be designed with enduser in mind. In addition, suggestions on how to make an app more useful and userfriendly were offered by the participants. Discussion While pain self-management apps have the potential to assist older people in their pain self-management process, this modality is not of interest to all older people. Adaptable apps that offer clinician input may be best placed to offer individual level relevance to older users. Future pain selfmanagement app development endeavors should adopt a co-design approach where older people are involved through all stages of design and development.

Alternative or complementary attitudes toward alternative and complementary medicines

BACKGROUND

Integrative and complementary health approaches (ICHA) are often pursued by patients facing chronic illnesses. Most of the studies that investigated the factors associated with ICHA consumption have considered that the propensity to use ICHA is a stable or fixed characteristic of an individual. However, people may prefer using ICHA in some situations and not in others, depending on the characteristics of the illness to face. Moreover, the attitude toward ICHA may differ within a single individual and between individuals so that ICHA can be used either in addition to (i.e., complementary attitude) or in place of (i.e., alternative attitude). The present study aimed at examining distinct patterns of attitudes toward ICHA in people hypothetically facing chronic illnesses that differed according to severity and clinical expression.

METHODS

We conducted a web-based study including 1807 participants who were asked to imagine that they had a particular chronic illness based on clinical vignettes (mental illnesses: depression, schizophrenia; somatic illnesses: rheumatoid arthritis, multiple sclerosis). Participants were invited to rate their perceived distress and social stigma associated with each illness as well as its perceived treatability. They also rated their belief in treatment effectiveness, and their treatment preference. Four patterns of treatment choice were determined: strictly conventional, weak or strong complementary, and alternative. Bayesian methods were used for statistical analyses.

RESULTS

ICHA were selected as complementary treatment option by more than 95% of people who hypothetically faced chronic illness. The complementary attitude towards ICHA (in addition to conventional treatment) was more frequent than the alternative one (in place of conventional treatment). Factors driving this preference included employment status, severity of illness, age and perceived distress, social stigma and treatability of the illness. When the label of illnesses was included in the vignettes, patterns of treatment preference were altered.

CONCLUSIONS

This study provides evidence that "medical pluralism" (i.e., the integration of ICHA with conventional treatment) is likely the norm for people facing both mental or somatic illness. However, our result must be interpreted with caution due to the virtual nature of this study. We suggest that taking attitudes toward ICHA into account is crucial for a better understanding of patients' motivation to use ICHA.