Post-Decisional Regret in COVID-19 Vaccination Decisions: Psychological Correlates in a Greek-Speaking Sample
DOI:
https://doi.org/10.5708/EJMH.21.2026.0060Keywords:
post-decisional regret, COVID-19 vaccination, decision-making styles, conspiracy mentality, personality traitsAbstract
Introduction: Health-related decisions made during crises, such as the COVID-19 pandemic, can elicit strong emotional responses, including post-decisional regret. Understanding regret as a psychological response to such decisions may inform public health strategies and support individuals’ adjustment.
Aim: This study examined post-decisional regret in COVID-19 vaccination decisions and its associations with decision-making styles, conspiracy mentality, and personality traits in a Greek-speaking sample.
Methods: 325 adults (83.1% vaccinated, 16.9% unvaccinated) completed an online questionnaire assessing post-decisional regret, decision-making styles, conspiracy mentality, personality traits, and demographics. A pooled hierarchical regression examined associations between demographics, vaccination status, decision-making styles, conspiracy mentality, and postdecisional regret. Personality traits were examined separately using Spearman rank-order correlations due to multicollinearity among dimensions.
Results: Vaccinated individuals reported significantly higher levels of regret than unvaccinated participants. The association between dependent decisionmaking and regret differed by vaccination status, with greater reliance on others associated with greater regret only among unvaccinated participants. A marginal interaction suggested that stronger conspiracy beliefs may be associated with greater regret among vaccinated participants. Personality traits showed modest associations with regret. Among vaccinated participants, higher scores on all Big Five traits were associated with greater regret, whereas among unvaccinated participants, higher Agreeableness was associated with lower regret.
Conclusions: Post-decisional regret appears to be a psychologically meaningful response to health-related decisions and is associated with individual differences in decision-making styles and belief systems. These findings suggest that emotional responses may be an important aspect of health-related decision-making.
References
Andersen, S. K., Butler, R. A., Chang, C.-C. H., Arnold, R., Angus, D. C., & White, D. B. (2023). Prevalence of long-term decision regret and associated risk factors in a large cohort of ICU surrogate decision makers. Critical Care, 27, Article 61.
https://doi.org/10.1186/s13054-023-04332-w
Atiya, N. A. A., Zgonnikov, A., O’Hora, D., Schoemann, M., Scherbaum, S., & Wong-Lin, K. (2020). Changes-of-mind in the absence of new post-decision evidence. PLOS Computational Biology, 16(2), Article e1007149.
https://doi.org/10.1371/journal.pcbi.1007149
Baker, M. N., & Merkley, E. (2023). Dynamic role of personality in explaining COVID-19 vaccine hesitancy and refusal. Frontiers in Psychology, 14, Article 1163570.
https://doi.org/10.3389/fpsyg.2023.1163570
Bayar, M. C., Artman, H., Enders, A., Kahveci, I., Klofstad, C., Krekó, P., Stoler, J., Touchton, M., & Uscinski, J. (2026). Correlates of COVID-19 vaccine regret in the United States. Journal of General Internal Medicine.
https://doi.org/10.1007/s11606-026-10374-x
Brehaut, J. C., O’Connor, A. M., Wood, T. J., Hack, T. F., Siminoff, L., Gordon, E., & Feldman-Stewart, D. (2003). Validation of a Decision Regret Scale. Medical Decision Making, 23(4), 281–292.
https://doi.org/10.1177/0272989X03256005
Brera, A. S., Arrigoni, C., Belloni, S., Conte, G., Magon, A., Arcidiacono, M. A., Pasek, M., Shabat, G., Bonavina, L., & Caruso, R. (2024). Decision regret and vaccine hesitancy among nursing students and registered nurses in Italy: Insights from structural equation modeling. Vaccines, 12(9), Article 1054.
https://doi.org/10.3390/vaccines12091054
Brewer, N. T., DeFrank, J. T., & Gilkey, M. B. (2016). Anticipated regret and health behavior: A meta-analysis. Health Psychology, 35(11), 1264–1275.
https://doi.org/10.1037/hea0000294
Bruder, M., Haffke, P., Neave, N., Nouripanah, N., & Imhoff, R. (2013). Measuring individual differences in generic beliefs in conspiracy theories across cultures: Conspiracy Mentality Questionnaire. Frontiers in Psychology, 4, Article 225.
https://doi.org/10.3389/fpsyg.2013.00225
Caruso, R., Perrone, P. M., Arrigoni, C., Arcidiacono, M. A., Belloni, S., Brera, A. S., Caponetti, S., Conte, G., Cremona, G., Dabbene, M., Guberti, M., Piredda, A., Magon, A., & Castaldi, S. (2025). Vaccine hesitancy and decision regret among nurses in oncology settings in Italy: A cluster-based profile analysis. Scientific Reports, 15, Article 30813.
https://doi.org/10.1038/s41598-025-16759-y
Cerda, A. A., & García, L. Y. (2021). Hesitation and refusal factors in individuals’ decision-making processes regarding a coronavirus disease 2019 vaccination. Frontiers in Public Health, 9, Article 626852.
https://doi.org/10.3389/fpubh.2021.626852
Condie, J., Northstone, K., Major-Smith, D., & Halstead, I. (2024). Exploring associations between the Big Five personality traits and cognitive ability with COVID-19 vaccination hesitancy and uptake among mothers and offspring in a UK prospective cohort study. Vaccine, 42(11), 2817–2826.
https://doi.org/10.1016/j.vaccine.2024.03.018
Constantinou, M., Kagialis, A., & Karekla, M. (2021). COVID-19 Scientific facts vs. conspiracy theories: Is science failing to pass its message? International Journal of Environmental Research and Public Health, 18(12), Article 6343.
https://doi.org/10.3390/ijerph18126343
Diotaiuti, P., Valente, G., Mancone, S., Grambone, A., Chirico, A., & Lucidi, F. (2022). The use of the Decision Regret Scale in non-clinical contexts. Frontiers in Psychology, 13, Article 945669.
https://doi.org/10.3389/fpsyg.2022.945669
Festinger, L. (1957). A theory of cognitive dissonance. Stanford University Press.
https://doi.org/10.1515/9781503620766
Gigerenzer, G., & Gaissmaier, W. (2011). Heuristic decision making. Annual Review of Psychology, 62, 451–482.
https://doi.org/10.1146/annurev-psych-120709-145346
Gosling, S. D., Rentfrow, P. J., & Swann, W. B. (2003). A very brief measure of the Big-Five personality domains. Journal of Research in Personality, 37(6), 504–528.
https://doi.org/10.1016/S0092-6566(03)00046-1
Han, Q., Quadflieg, S., & Ludwig, C. J. H. (2023). Decision avoidance and post-decision regret: A systematic review and meta-analysis. PLOS ONE, 18(10), Article e0292857.
https://doi.org/10.1371/journal.pone.0292857
Imhoff, R., & Lamberty, P. (2020). A Bioweapon or a Hoax? The link between distinct conspiracy beliefs about the coronavirus disease (COVID-19) outbreak and pandemic behavior. Social Psychological and Personality Science, 11(8), 1110–1118.
https://doi.org/10.1177/1948550620934692
Koenig, H. G. (2020). Maintaining health and well-being by putting faith into action during the COVID-19 pandemic. Journal of Religion and Health, 59, 2205–2214.
https://doi.org/10.1007/s10943-020-01035-2
Kroese, F., van den Boom, W., Buskens, V., van Empelen, P., Hulscher, M., Ruiter, R. A. C., Timmermans, D. R. M., de Vries, M., de Bruin, M., & Lambooij, M. (2024). When and why do people change their minds in favor of vaccination? Longitudinal analyses of switching COVID-19 vaccination preferences. BMC Public Health, 24, Article 3392.
https://doi.org/10.1186/s12889-024-20873-3
Luo, C., Chen, H.-X., & Tung, T.-H. (2024). Sex differences in the relationship between post-vaccination adverse reactions, decision regret, and WTP for the booster dose of COVID-19 vaccine in Taizhou, China. Preventive Medicine Reports, 37, Article 102538.
https://doi.org/10.1016/j.pmedr.2023.102538
Luo, C., Jiang, W., Chen, H.-X., & Tung, T.-H. (2022). Post-vaccination adverse reactions, decision regret, and willingness to pay for the booster dose of COVID-19 vaccine among healthcare workers: A mediation analysis. Human Vaccines & Immunotherapeutics, 18(6), Article 2146964.
https://doi.org/10.1080/21645515.2022.2146964
Maftei, A., & Petroi, C. E. (2022). “I’m luckier than everybody else!”: Optimistic bias, COVID-19 conspiracy beliefs, vaccination status, and the link with the time spent online, anticipated regret, and the perceived threat. Frontiers in Public Health, 10, Article 1019298.
https://doi.org/10.3389/fpubh.2022.1019298
Martens, J. P., & Rutjens, B. T. (2022). Spirituality and religiosity contribute to ongoing COVID-19 vaccination rates: Comparing 195 regions around the world. Vaccine: X, 12, Article 100241.
https://doi.org/10.1016/j.jvacx.2022.100241
McCrae, R. R., & Costa, P. T., Jr. (2008). The five-factor theory of personality. In O. P. John, R. W. Robins, & L. A. Pervin (Eds.), Handbook of personality: Theory and research (3rd ed., pp. 159–181). Guilford Press.
Morelli, M., Casagrande, M., & Forte, G. (2022). Decision making: A theoretical review. Integrative Psychological and Behavioral Science, 56, 609–629.
https://doi.org/10.1007/s12124-021-09669-x
Mosconi, G., Barello, S., Bertuccio, P., Fiorentino, M., Vecchi, T., & Odone, A. (2025). Individual voices, collective health: A person-centered cross-sectional study to identify psychological drivers of vaccination attitudes. Humanities and Social Sciences Communications, 12, Article 568.
https://doi.org/10.1057/s41599-025-04834-8
Mousoulidou, M., & Christodoulou, A. (2024, December 11). Adaptation and psychometric evaluation of the Greek versions of the Decision Regret Scale (DRS) and the Conspiracy Mentality Questionnaire (CMQ) [Unpublished Doctoral Colloquium Presentation].
Mousoulidou, M., Christodoulou, A., Siakalli, M., & Argyrides, M. (2023). The role of conspiracy theories, perceived risk, and trust in science on COVID-19 vaccination decisiveness: Evidence from Cyprus. International Journal of Environmental Research and Public Health, 20(4), Article 2898.
https://doi.org/10.3390/ijerph20042898
Mousoulidou, M., & Siakalli, M. (2024, September 10). Adaptation and psychometric evaluation of the Greek version of the General Decision-Making Style Questionnaire [Unpublished Doctoral Colloquium Presentation].
Mousoulidou, M., Siakalli, M., Christodoulou, A., & Argyrides, M. (2023). Conspiracy theories, trust in science, and knowledge during the third wave of the COVID-19 pandemic in Cyprus. International Journal of Environmental Research and Public Health, 20(17), Article 6710.
https://doi.org/10.3390/ijerph20176710
Myrick, J. G., & Bilandzic, H. (2025). Narratives of regret: How anticipated regret and counterfactual thinking can promote COVID-19 vaccination intentions in unvaccinated adults. Mass Communication and Society, 28(6), 1068–1089.
https://doi.org/10.1080/15205436.2025.2481906
Okuhara, T., Shirabe, R., Kagawa, Y., Okada, H., & Kiuchi, T. (2023). Encouraging COVID-19 vaccination by focusing on anticipated affect: A scoping review. Heliyon, 9(12), Article e22655.
https://doi.org/10.1016/j.heliyon.2023.e22655
Romer, D., & Jamieson, K. H. (2020). Conspiracy theories as barriers to controlling the spread of COVID-19 in the U.S. Social Science & Medicine, 263, Article 113356.
https://doi.org/10.1016/j.socscimed.2020.113356
Scott, S. G., & Bruce, R. A. (1995). Decision-making style: The development and assessment of a new measure. Educational and Psychological Measurement, 55(5), 818–831.
https://doi.org/10.1177/0013164495055005017
Simonson, I. (1992). The influence of anticipating regret and responsibility on purchase decisions. Journal of Consumer Research, 19(1), 105–118.
https://doi.org/10.1086/209290
Squire, L. R., Knowlton, B., & Musen, G. (1993). The structure and organization of memory. Annual Review of Psychology, 44, 453–495.
https://doi.org/https://doi.org/10.1146/annurev.ps.44.020193.002321
Stanley, M., Datta, S., Kumar, A., & KhudaBukhsh, A. R. (2026). Investigating vaccine buyer’s remorse: Post-vaccination decision regret in covid-19 social media using politically diverse human annotation. Proceedings of the AAAI Conference on Artificial Intelligence, 40(46), 39294–39302.
https://doi.org/10.1609/aaai.v40i46.41278
Swami, V., Tran, U. S., Barron, D., Afhami, R., Aimé, A., Almenara, C. A., Alp Dal, N., Amaral, A. C. S., Andrianto, S., Anjum, G., Argyrides, M., Atari, M., Aziz, M., Banai, B., Borowiec, J., Brewis, A., Cakir Kocak, Y., Campos, J. A. D. B., Carmona, C., … Voracek, M. (2020). The Breast Size Satisfaction Survey (BSSS): Breast size dissatisfaction and its antecedents and outcomes in women from 40 nations. Body Image, 32, 199–217.
https://doi.org/10.1016/j.bodyim.2020.01.006
Sweeny, K. (2008). Crisis decision theory: Decisions in the face of negative events. Psychological Bulletin, 134(1), 61–76.
https://doi.org/10.1037/0033-2909.134.1.61
Tayhan, A., Bozhan Tayhan, E., & Şahin Büyük, D. (2025). Nursing and midwifery students’ COVID-19 vaccine regrets and future vaccination intentions: A mixed methods study. Nursing & Health Sciences, 27(1), Article e70039.
https://doi.org/10.1111/nhs.70039
Tiwana, M. H., & Smith, J. (2024). Faith and vaccination: A scoping review of the relationships between religious beliefs and vaccine hesitancy. BMC Public Health, 24(1), Article 1806.
https://doi.org/10.1186/s12889-024-18873-4
Wang, Y., & Ruhe, G. (2007). The cognitive process of decision making. International Journal of Cognitive Informatics and Natural Intelligence, 1(2), 73–85.
https://doi.org/10.4018/jcini.2007040105
Wolff, K. (2025). Covid-19 vaccination intentions and uptake pre- and post-vaccine availability: A cross-sectional comparison of theory of planned behavior, anticipated regret, and optimistic bias. Journal of Public Health, 33, 2137–2145.
https://doi.org/10.1007/s10389-023-02189-5
Zeelenberg, M., & Pieters, R. (2007). A theory of regret regulation 1.0. Journal of Consumer Psychology, 17(1), 3–18.
https://doi.org/10.1207/s15327663jcp1701_3




