Naučni članci

  1. Knežević, G., Lazarević, L., Purić, D., Zupan, Z., & Žeželj, I. (2023). Prevalence of questionable health behaviours in Serbia and their psychological roots: Protocol for a nationally representative survey. BMJ Open, 13(10), e075274.

    Pogledaj članak Apstrakt

    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 2021) 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 submitted to peer-reviewed journals and results will be made available to stakeholders through reports on the project website and disseminated via social media.

    Trial registration number NCT05808660

  2. Lazarević, L. B., Knežević, G., Purić, D., Teovanović, P., Petrović, M. B., Ninković, M., Živanović, M., Stanković, S., Branković, M., Lukić, P., Opačić, G., & Žeželj, I. (2023). Tracking variations in daily questionable health behaviors and their psychological roots: A preregistered experience sampling study. Scientific Reports, 13(1), 14058.

    Pogledaj članak Apstrakt

    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 suffer 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 (different 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 offers insight into questionable health behaviors from both a within and between-person perspective and highlights the importance of their psychological roots.

    Ključne reči: intentional non-adherence to medical recommendations, traditional alternative complementary medicine, experience sampling, daily use, psychological predictors, irrational mindse

  3. Lazić, A., Petrović, M., Branković, M., & Žeželj, I. (2023). Quick natural cure-alls: Portrayal of traditional, complementary, and alternative medicine in Serbian online media. Collabra: Psychology, 9(1), 82189.

    Pogledaj članak Apstrakt

    To describe how Serbian online media cover the topic of traditional, complementary, and alternative medicine (TM/CAM), we conducted a content analysis of 182 articles from six news and six magazine websites, published July–December 2021. Biologically based treatments, predominantly herbal products framed as Serbian or Russian folk medicine, were the most common (70.9%, 205/289 practices). The practices were often presented as general health enhancers (18.4%, 71/386 claims); other common reasons given for the use of TM/CAM were to alleviate respiratory problems, boost the immunity, and detox. The tone was overwhelmingly positive, with most of the positive articles (82.4%, 145/176) neglecting to present information on potential harms of TM/CAM use. Few articles provided a recommendation to speak with a healthcare provider (13.6%, 24/176); in contrast, the recommended dosage was often explained (59.7%, 105/176). TM/CAM practitioners (15.9%, 28/176) and conventional medicine practitioners (12.5%, 22/176) were most commonly cited sources. Articles tended to appeal to TM/CAM’s tradition of use (65.3%, 115/176), naturalness (45.5%, 80/176), and convenience (40.9%, 72/176), used pseudoscientific jargon (59.7%, 105/176), and failed to cite sources for the claims that TM/CAM use is supported by science (22.2%, 39/176). Much of the information provided in Serbian online media seems to be uncritical, with a potential for misleading consumers.

    Ključne reči: alternative medicine; complementary therapies; health communication; mass media; traditional medicine

  4. Purić, D., Petrović, M. B., Živanović, M., Lukić, P., Zupan, Z., Branković, M., Ninković, M., Lazarević, L. B., Stanković, S., & Žeželj, I. (2023). Development of a novel instrument for assessing intentional non-adherence to official medical recommendations (iNAR-12): A sequential mixed-methods study in Serbia. BMJ Open, 13(6), e069978.

    Pogledaj članak Apstrakt

    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 (

    Ključne reči: non-adherence, intentional non-adherence, treatment adherence, self- medication, irrational beliefs, conspiracy theories, superstition, experiences with the healthcare system, trust in the healthcare system, patient passivity

  5. Purić, D., Živanović, M., Petrović, M., Lukić, P., Knežević, G., Teovanović, P., Ninković, M., Lazić, A., Opačić, G., Branković, M., Lazarević, L. B., & Žeželj, I. (2022). Something old, something new, something borrowed, something green: How different domains of traditional, alternative, and complementary medicine use are rooted in an irrational mindset [Preprint]. PsyArXiv.

    Pogledaj članak Apstrakt
    Despite insufficient evidence base for some of its practices, traditional, complementary, and alternative medicine (TCAM) use is rapidly growing; psychological roots of this trend are still under-studied. Based on previous research, input from TCAM practitioners, and content analysis of online media, we developed a comprehensive instrument to measure the use of TCAM and administered it to an online community sample (N=583). Factor analysis indicated four domains of TCAM use, in line with theoretical taxonomies: Alternative medical systems, Natural product-based practices, New age medicine, and Rituals/Customs, all converging toward a common tendency. Irrational beliefs and cognitive biases, especially magical health beliefs and naturalness bias, predicted unique variance in both TCAM attitudes and overall TCAM use, above socio-demographic variables, reported health status, and ideological beliefs. Furthermore, each domain of TCAM use, although differing slightly in sociodemographic/psychological profile, was consistently associated with an irrational mindset, even after controlling for other factors. This provides strong evidence for exploring psychological susceptibility to the use of traditional, complementary, and alternative medicine.

    Ključne reči: alternative medicine, traditional medicine, irrational beliefs, magical health beliefs, naturalness bias

  6. Žeželj, I. & Lazarević, Lj. (2022). Psychological Roots of Questionable Health Practices. Studia Psychologica, 64(1), 3-7.

    Pogledaj članak Apstrakt

    Questionable health practices, be it non-adhering to official recommendations or resorting to non-evi-dence based ones, pose a considerable burden to public health. Research in this special issue explores the psychological roots of proneness to this type of health behavior. The authors look into individual differenc-es in personality traits, cognitive styles, but also situational factors such as institutional trust and feeling of economic/health threat as predictors of a broad range of behaviors: non-compliance with COVID health measures/prescribed prophylactic regimen for chronic illnesses, avoiding vaccination, but also endorsing supplements and herbal remedies or alternative psychotherapies. This collection of papers offers valuable insights that could be implemented in tailoring short-term (pandemic-related messages) and long-term (building more trust in institutions or science) guidelines for health communicators.

    Ključne reči: questionable health practices, recommended health behaviors, COVID-19, psychological roots

  7. Budžak, A., & Branković, M. (2022). Alternative ways to mental health: Exploring psychological determinants of preference for CAM treatments. Studia Psychologica, 64 (1), 118-135. DOI: 10.31577/sp.2022.01.843

    Pogledaj članak Apstrakt

    Research suggests a trend toward an increased interest in CAM, complementary and alternative therapies for treating mental health problems, which is paralleled by a relatively favorable attitude of mental health professionals. This study explored psychological predictors of attitude toward CAM therapies: frustration tolerance (measured by the 28-item Frustration Discomfort Scale), self-esteem (measured by the 16-item Revised Version of the Self-Liking/Self-Competence Scale), cognitive styles (measured by REI Scale-short version) and irrational health beliefs (measured by CAM Health Belief Questionnaire – CHBQ). Participants (N = 294) reacted to vignettes describing Bach flower remedies and neuro-linguistic programming to indi-cate their attitude toward CAM. CAM health beliefs (e.g., belief that health is a balance of life forces) and self-esteem positively predicted attitude toward CAM, while the rational style of thinking was a negative predictor. As suggested by mediation analysis, the intuitive thinking style affected the attitude toward CAM via an increase in CAM beliefs. We discuss the implications of our findings for encouraging rational decision-making when seeking help with mental health problems.

    Ključne reči: attitude toward CAM, self-esteem, tolerance for frustrations, cognitive styles, mental health, irrational beliefs

  8. Stanković, S., Lazarević, L. B., & Knežević, G. (2022). The role of personality, conspiracy mentality, REBT irrational beliefs, and adult attachment in COVID-19 related health behaviors. Studia Psychologica, 64(1), 26-44. DOI: 10.31577/sp.2022.01.837

    Pogledaj članak Apstrakt

    There is evidence that different types of irrational thinking and beliefs are significant predictors of questionable and maladaptive COVID-19 related health practices. In this study, we investigated the role of two under-researched types of irrational thinking, more typical for a clinical setting: irrational beliefs defined in Rational Emotive Behavior Therapy (REBT) and attachment anxiety and avoidance. We investigated whether REBT irrational beliefs, attachment dimensions, and conspiracy mentality mediated the relationship between personality traits, on the one side, and COVID-19 health behaviors, on the other. We proposed that HEXACO personality traits, and especially Disintegration (proneness to psychotic-like experiences) predicted irrational thinking and beliefs, which in turn predicted higher susceptibility to questionable health practices. Structural equation modeling on a sample of 287 participants from the general population, showed that Disintegration was related to REBT irrational beliefs, attachment dimensions, and conspiracy mentality, highlighting the important effect of Disintegration on irrational thinking and beliefs. Conspiracy mentality mediated the effects of Disintegration to low adherence to recommended health behaviors – RHB, and greater use of pseudoscientific practices – PSP. Attachment anxiety mediated the relationship between high Disintegration, high Emotionality (E), and low Honesty (H), and lower adherence to RHB. REBT irrational beliefs and attachment avoidance did not mediate the relationship between personality traits and COVID-19 health behaviors.

    Ključne reči: HEXACO, Disintegration trait, conspiracy mentality, adult attachment, REBT, irrational beliefs, COVID-19 health behaviors

  9. Mijatović, N., Šljivić, J., Tošić, N., Conić, L., Petrović, M., & Žeželj, I. (2021, November 19). Big Suppla: Challenging the common view of the supplements and herbs industry impacts the willingness to try and recommend their products. Studia Psychologica, 64(1), 91-103. DOI: 10.31577/sp.2022.01.841

    Pogledaj članak Apstrakt

    Resorting to complementary/alternative medical (CAM) therapies can lead to bad health outcomes or interfere with officially recommended therapies. CAM use is, nevertheless, widespread and growing. This could be partially due to the perception of the CAM industry as powerless and non-profit oriented, in contrast to the pharmaceutical industry (“Big Pharma”). In reality, both industries are highly profitable and powerful; to highlight this similarity, science communicators coined the term “Big Suppla”. Drawing from a sample of 242 participants upon all exclusions, we experimentally tested whether varying these attributes in presenting the industries impacts consumers’ evaluation of the two categories of products (herbs and supplements) and their willingness to try and recommend them. We also tested whether the effect is moderated by conspiratorial thinking, and whether it is due to a change in trust. All hypotheses were pre-registered. As expected, participants who read the Big Suppla vignette decreased the endorsement of both supplements and herbs, whilst, against our hypotheses, there were no significant changes in endorsement in the contrasting “Baby Suppla” group. Conspiratorial thinking was related to more endorsement of CAM, but it did not moderate the experimental effects. We also did not observe the expected mediation by trust. Our most robust results corroborate the idea that challenging the myth of benevolence of the CAM industry makes people more critical in evaluating its products or considering their usage. They support the intuitions of science communicators who coined the term Big Suppla, and can help in tailoring public health

    Ključne reči: complementary and alternative medicine, perception of power, questionable health behaviors, conspiracy theories