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Anti-Vaccination and CAM Reflect a Common Worldview

By Matt Browne

A study has explored the psychosocial factors driving anti-vaccination attitudes.

Critics of complementary and alternative medicine (CAM) wonder why its champions are so dismissive of evidence-based research, but evidence-based research itself suggests that part of the answer lies in personality rather than logic, and requires a need for rethinking how health professionals must address the issue.

In July 2013 I described in this column two psychological traits associated with the use of CAM (http://tinyurl.com/jle2ucp). One was “openness to experience”, which captures (among other things) an individual’s interest in diverse and unconventional ideas. The other was an intuitive cognitive style: a tendency to evaluate information and make decisions based on “gut feelings” and heuristic associations.

These findings shed some light on why logical and evidential arguments in favour of conventional medicine tend to fall on deaf ears. CAM seems to appeal to a personality type that’s suspicious of authority and orthodoxy, and instead values intuitive and highly personal ways of evaluating information.

My colleagues and I have recently considered the relationship of CAM and psychosocial factors to anti-vaccination (AV) attitudes. AV and pro-CAM attitudes have similar features. Both tend to be contrary to scientific and conventional medical advice. Discourse on anti-vaccination websites shows a strong influence of CAM and conspiratorial thinking, with a persuasive technique that is “postmodern” in rejecting conventional evidence in favour of highly idiosyncratic personal interpretations.

Our own published research confirmed that openness to experience, a spiritual epistemology and a preference for CAM over conventional treatment were all positive predictors of AV attitudes. Compared with those who endorsed vaccinations, vaccination sceptics were about twice as likely to prefer CAM to conventional medicine, and to have used herbal treatments, energy-based and homeopathic therapy, and prayer for healing.

Similar relationships were also observed for “lifestyle” practices such as yoga and meditation. No effects were observed for hypnosis or chiropractic or osteopathy, which accords with other psychometric research indicating that these treatments are not perceived by the public as “alternative”.

We have recently analysed a much larger and more detailed survey of AV attitudes, CAM utilisation and alternative health beliefs in 3000 participants. Again we found reliable and strong positive relationships between each of these attitudes.

In our Australian sample, the positive relationship between CAM use and AV attitudes is particularly strong. In terms of demographics, the people most likely to hold these ideas are female, middle-aged and middle-class.

One explanation for the link between CAM and AV attitudes is that CAM practitioners and CAM websites are persuading their users of an anti-vaccination stance.

Alternatively, it could be that CAM and AV both reflect a similar worldview with respect to values around health and well-being. This worldview rejects reductionist notions of treating pathology in favour of personal, autonomous, holistic and even spiritual approaches to optimising one’s health and well-being.

It appears that those to whom these ideas appeal most have the resources and motivation to take an independent and active approach to their health. For them, health-related decisions define a positive self-image of wellness that is core to their self-image and social group.

The bad news for evidence-based medicine is that conventional treatments, such as vaccinations or antibiotics, do not speak to these psychosocial needs in the same way as less effective, but more appealing, alternative therapies.

Others have looked at different forms of evidence rejection, including attitudes towards genetically modified organisms and climate change, showing that adherents to a particular worldview are quick to resort to conspiratorial thinking and other forms of motivated reasoning to maintain an attitude that “feels right”. Confronting these individuals with more “evidence from respected authorities” is unlikely to change a specific attitude.

All this suggests rather pessimistic prospects for changing anti-vaccination attitudes in the short term. Privileged groups in the first world are enjoying unparalleled health and longevity, and as a result are, paradoxically, beginning to place less value on the infrastructure that generated these benefits.

To address the vaccination confidence gap we may need to think larger by considering how we can promote scientific and evidence-based thinking at every opportunity in the educational system, the media and political discourse.


Matt Browne is a Senior Lecturer at CQ University specialising in applied statistics in the social sciences. He has several research foci, including health-related beliefs and the cognitive and behavioural aspects of addiction.