A history of high-risk and destructive behaviors predict COVID-19 infection: A preliminary study.

Abstract

The COVID-19 pandemic has heightened mental health concerns, but the temporal relationship between these conditions and SARS-CoV-2 infection has not yet been investigated. Specifically, psychological issues, violent behaviors, and substance abuse problems were reported higher during the COVID-19 pandemic when compared to pre-pandemic levels. However, it is unknown whether a pre-pandemic history of these conditions increase an individual's susceptibility for SARS-CoV-2. To better understand the psychological risks underlying COVID-19, it is important to investigate how destructive and risky behaviors (related to externalizing behaviors, substance use, and crime and violence) may increase a person's susceptibility to COVID-19. Here, we analyzed data from a survey of 366 adults across the United States (ages 18-70); this survey was administered between February and March of 2021. Participants were asked to complete the Global Appraisal of Individual Needs-Short Screener (GAIN-SS) questionnaire which indicates a history of high-risk and destructive behaviors and high likelihood of meeting diagnostic criteria. The GAIN-SS includes seven questions related to externalizing behaviors, eight related to substance use issues, and five related to crime and violence. Responses were given on a temporal scale of "0" (never a given behavior) to "4" (experienced a behavior in the past month). Participants were also asked if they ever tested positive for COVID-19 and/or if they ever received a clinical diagnosis of COVID-19. GAIN-SS responses were compared between those reporting and not reporting COVID-19 to deduce if those reporting COVID-19 experienced GAIN-SS behaviors more recently (Wilcoxon Rank Sum test, α=0.05). Three hypotheses surrounding the temporal relationships between the recency of GAIN-SS behaviors to COVID-19 infection were tested using proportions tests (α=0.05). GAIN-SS behaviors that significantly differed (proportions tests, α=0.05) between COVID-19 responses were included as independent variables in multivariable logistic regression (MVLR) models with iterative downsampling. This was performed to assess how well a history of GAIN-SS behaviors statistically discriminated between those reporting, and not reporting, COVID-19. Those reporting COVID-19 more frequently indicated past GAIN-SS behaviors (Q<.05). Further, the proportion of those reporting COVID-19 was higher (Q<.05) in those also reporting a history of GAIN-SS behaviors; specifically, gambling and selling drugs were common across the three proportion tests. MVLR revealed that GAIN-SS behaviors, particularly gambling, selling drugs, and attention problems, accurately modeled self-reported COVID-19 with model accuracies ranging from 77.42-99.55% ± 4.49-5.86%. That is, those that exhibited destructive and high-risk behaviors prior to, and during, the pandemic could be discriminated from those that did not exhibit these behaviors when modeling self-reported COVID-19. Together, this preliminary study provides insight into how a history of destructive and risky behaviors influence infection susceptibility - offering possible explanations for why some persons may be more susceptible to COVID-19, potentially in relation to reduced adherence to prevention guidelines or seeking vaccination.