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. 2025 Dec 1:390:119915.
doi: 10.1016/j.jad.2025.119915. Epub 2025 Jul 14.

Conspiratorial thinking in a 50-state survey of American adults

Roy H Perlis  1 , Ata Uslu  2 , Sergio A Barroilhet  3 , Paul A Vohringer  3 , Anudeepa K Ramachandiran  4 , Mauricio Santillana  2 , Matthew A Baum  5 , James N Druckman  6 , Katherine Ognyanova  7 , David Lazer  2
Affiliations

Conspiratorial thinking in a 50-state survey of American adults

Roy H Perlis et al. J Affect Disord. .

Abstract

Conspiratorial thoughts as a cognitive aspect are understudied outside small clinical cohorts. We conducted a 50-state non-probability internet survey of respondents age 18 and older, who completed the American Conspiratorial Thinking Scale (ACTS) and the 9-item Patient Health Questionnaire (PHQ-9). Across the 6 survey waves, there were 123,781 unique individuals. After reweighting, a total of 78.6 % somewhat or strongly agreed with at least one conspiratorial idea; 19.0 % agreed with all four of them. More conspiratorial thoughts were reported among those age 25-54, males, individuals who finished high school but did not start or complete college, and those with greater levels of depressive symptoms. Endorsing more conspiratorial thoughts was associated with a significantly lower likelihood of being vaccinated against COVID-19. The extent of correlation with non-vaccination suggests the importance of considering such thinking in designing public health strategies.

Keywords: COVID-19; Conspiratorial thoughts; Depression; Trust; Vaccination.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Roy H. Perlis reports financial support was provided by National Institute of Mental Health. David Lazer reports financial support was provided by National Institute of Mental Health. Katherine Ognyanova reports financial support was provided by National Science Foundation. David Lazer reports financial support was provided by National Science Foundation. James N. Druckman reports financial support was provided by National Science Foundation. Matthew A. Baum reports financial support was provided by National Science Foundation. David Lazer reports financial support was provided by John S and James L Knight Foundation. David Lazer reports financial support was provided by Peter G Peterson Foundation. Roy H. Perlis reports a relationship with Genomind Inc. that includes: consulting or advisory. Roy H. Perlis reports a relationship with Circular Genomics that includes: consulting or advisory and equity or stocks. Roy H. Perlis reports a relationship with Psy Therapeutics that includes: consulting or advisory and equity or stocks. Roy H. Perlis reports a relationship with Alkermes Inc. that includes: consulting or advisory. Roy H. Perlis reports a relationship with Vault Health that includes: equity or stocks. Dr. Perlis is the Editor-in-Chief of JAMA + AI and a paid Associate Editor for JAMA Network. The other authors report no disclosures. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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