The Michigan Odd Beliefs Scale: A Measure of Suggestibility as Assessed by Endorsement of Urban Myths

We describe development and psychometric characteristics of the Michigan Odd Beliefs Suggestibility Scale (MOBS), a brief measure of suggestibility as measured by endorsement of urban myths. One hundred fifteen undergraduate students (57% female, mean age=20.3 years [SD=4.5]) were administered 21 “true” or “false” items, consisting of “urban myths” which are popularly referenced. The MOBS had a mean endorsement of 6.4 items (SD=3.3), with endorsement of greater than 12 items occurring in fewer than five percent of participants. The MOBS had fair-to-moderate internal consistency, with a Cronbach’s alpha of 0.67. The MOBS demonstrated convergent validity with a subscale of Openness on the NEO-FFI but was not significantly associated with other personality traits or need for cognition. These findings support the MOBS as a measure of susceptibility to belief in unsupported axioms; such susceptibility is distinct trait that has not been sufficiently captured by other assessment measures. While we describe the psychometric characteristic of the MOBS in a university population, it is quite possibly similarly applicable in clinical settings.


INTRODUCTION
In the era of the internet, information comes in many forms.
Although some information is supported by empirical evidence, other information is less exhaustively researched, with assertions being made based on anecdotes, hearsay, or other forms of cultural transmission. "Urban myths" are beliefs and fables that have persisted in popular culture despite a lack of concrete supporting evidence. These myths, which include conspiracy theories, scientifically implausible alternative medicine practices, and supernatural beliefs are relatively common and may arise from the human need to make sense of the world [1]. Indeed, this need is engrained biologically in the form of pareidolia, the tendency to see patterns in otherwise meaningless 'noise. ' Similarly, it is well documented that people often judge a message based on the appearance of the source, as opposed to the information contained in the message itself [2]. This desire to understand the world may encourage some individuals to commit logical fallacies by maintaining or even perpetuating a myth, rather than evaluating it using (often opposing) logic and data.
In a healthcare setting, a susceptibility to popular beliefs or myths can have critical medical implications. Patients often ISSN: 2689-8365 DOI: https://doi.org/10.35702/mrj.10001 come to healthcare appointments with preconceived ideas about their diagnoses or possible treatments after reviewing dubious internet stories or hearing a pseudoscientific pitch from a television doctor. Indeed, well-presented pamphlets, polished websites, and emotion-laden stories may influence people in times of vulnerability [3]. Less accurate sources of information may then mislead some healthcare consumers, particularly those who are prone to uncritically accept printed or electronic, but unsupported, information at face value.
Measuring the propensity to embrace unsupported claims may lead to better understanding of varying patient approaches to and compliance with healthcare recommendations and prescriptions.
In principle, most people agree that opinions, no matter how strongly held, should change in the face of sufficient counter evidence. This principle has been put to the test over the past two decades following the publication by Wakefield and colleagues [4] proposing that vaccines confer a significant risk for the development of autism. Many published articles [5] and unpublished anecdotal stories (e.g. some celebrities) supporting this claim surfaced in the years following this publication, providing further evidence of confirmatory bias.
Despite the association between vaccination and Autism being definitively refuted through well-controlled and thorough research [6,7], many intelligent and otherwise rational people continue to advance the idea of the dangers of vaccines.
Irrational beliefs can also be observed within the setting of neuropsychological assessment. For example, the research literature clearly demonstrates short-term cognitive and emotional difficulties following mild traumatic brain injury, or concussion, though little evidence exists to support lasting cognitive or emotional symptoms [8]. Nevertheless, many patients present for neuropsychological assessment, thoroughly convinced that their current symptoms are caused by remote mild head injuries, as opposed to the more parsimonious and likely etiology of premorbid and comorbid factors. Furthermore, information regarding symptoms of mild traumatic brain injury is gathered most frequently from friends and the Internet, followed by medical professionals and informational pamphlets [9]. The skill or ability to distinguish the integrity of information drawn from respected sources (i.e., textbook chapters, peer-reviewed articles in respected journals) from information conveyed through hastily-constructed pamphlets, word-of-mouth, popular media, and poorly-designed websites is not universal.
People are often misled by extraneous information that is unbound to rationality or data. Factors such as a speaker's apparent confidence, enthusiasm, and eloquence can often hold more sway with listeners than the content of his or her central arguments. Likewise, the production quality and technological appearance of an infomercial can leave the viewer with impressions that run completely counter to reality. Influence through these non-informational sources is termed the "peripheral route to persuasion" [10,11]. Individuals likely differ in their vulnerability to this type of influence, but current broad-band assessment instruments commonly

MATERIALS AND PROCEDURES
The MOBS originally consisted of 25 statements that are largely unsupported by evidence, but in many cases have persisted in popular culture (i.e., "urban myths"). Participants responded to items as either being "true" or "false". Items were chosen based on consensual agreement about their general prevalence among the members of the study team; items of a religious or political nature were purposely excluded. The 25 chosen items were examined for internal consistency; four items were removed because they hindered the overall internal consistency of the scale, as measured by Cronbach's alpha. The final 21-item scale is included in Table 1.
The Need for Cognition scale [14] is a self-report measure of an individual's enjoyment of effortful cognitive processing. The test consists of 18 items that are rated on a nine-point Likert scale ranging from "very strong disagreement" to "very strong agreement. " High scores on the Need for Cognition Scale indicate that the individual engages quickly and enthusiastically in processing new topics to sort relevant from irrelevant information [13,15]. Individuals high in need for cognition have been shown to be more conscientious and more open to experience than individuals low in need for cognition [16].
The  One's style of critically evaluating information might have an impact on how likely one is to embrace baseless alternative treatments or believe unsupported claims regarding their health. This issue is particularly relevant for consumers, who often reference the internet or word of mouth [9], and whose symptoms may be influenced by such literature [3]. It also may interact with the general cooperation of patients with psychological assessment procedures which they don't understand, or compliance with healthcare recommendations on the necessity of alternating lifestyle or adhering to medication regimens.
We believe that the MOBS is a useful tool to capture the propensity of individuals or groups to subscribe to non-evidentiary beliefs, and the likelihood to having these beliefs influence health-related behaviors.