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. 2024 Aug 29;14(9):761.
doi: 10.3390/bs14090761.

Links between Vaccination Fear-, Anxiety-, Alexithymia-, and Type D Personality-Related Vaccination Decisions: A Network Analysis in a Multicultural Sample

Olga Malas  1 , Nada Mallah Boustani  2 , Mirko Duradoni  3 , Dayo Omotoso  4 , Asiye Şengül Avşar  5 , Anastasiia Shyroka  6 , Giulia Colombini  3 , Maria Dolores Tolsá  7
Affiliations

Links between Vaccination Fear-, Anxiety-, Alexithymia-, and Type D Personality-Related Vaccination Decisions: A Network Analysis in a Multicultural Sample

Olga Malas et al. Behav Sci (Basel). .

Abstract

This study examines the links between vaccination status, fear of vaccination (cognitive and somatic symptoms), anxiety, alexithymia, and type D personality (negative affect and social inhibition), to propose policies to increase vaccination rates. A sample of university students (n = 2535; mean age = 20.59, SD = 2.04; male: 26.75%, female: 73.25%) from Spain, Italy, Lebanon, Nigeria, Turkey, and Ukraine completed the Vaccination Fear Scale (VFS-6), the Generalised Anxiety Disorder scale (GAD-7), the Perth Alexithymia Questionnaire-Short Form (PAQ-S), the Type D Scale (DS14), and also a question on vaccination status. Correlation, regression, and network analyses were applied. Cognitive symptoms of fear of vaccination and negative affect were the most significant in the correlation and regression analyses. In the network analysis, negative affect showed the highest values in all centrality indices and positive relationships with other nodes. Vaccination status showed negative relationships with fear of vaccination, alexithymia, and social inhibition. The network structure is similar between the sexes but varies between cultures and sexes within cultures. The relationship between vaccination status and cognitive symptoms of fear of vaccination was the most consistent, allowing for interventions at this level to be advised across cultures. For more specific interventions, cultural context must be considered for optimal results.

Keywords: alexithymia; anxiety; fear; network analysis; personality type D; vaccination.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The network obtained for the total sample. VF: VFS-6 items. GAD: GAD-7 items. PAQ: PAQ-S items. DS: DS14 items.
Figure 2
Figure 2
Total sample network plot (n = 2.535). VFS1: cognitive fear measured with VFS-6. VFS2: somatic fear measured with VFS-6. GAD: generalised anxiety disorder measured with GAD-7. PAQ: alexithymia measured with PAQ-S. NA: negative affect measured with DS14. SI: social inhibition measured with DS14.
Figure 3
Figure 3
Centrality plots for total sample network analysis (n = 2535). VFS1: cognitive fear measured with VFS-6. VFS2: somatic fear measured with VFS-6. GAD: generalised anxiety disorder measured with GAD-7. PAQ: alexithymia measured with GAD-7. NA: negative affect measured with DS14. SI: social inhibition measured with DS14.
Figure 4
Figure 4
Edge stability for total sample network analysis (n = 2535). The edge weights, with each horizontal line representing an edge, are represented by the red line, and the 95% confidence intervals by the grey area. VS: vaccination state. VFS1: cognitive fear measured with VFS-6. VFS2: somatic fear measured with VFS-6. GAD: generalised anxiety disorder measured with GAD-7. PAQ: alexithymia measured with GAD-7. NA: negative affect measured with DS14. SI: social inhibition measured with DS14.
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