The Relationship Between a History of High-risk and Destructive Behaviors and COVID-19 Infection: Preliminary Study

Nicole L Vike; Sumra Bari; Khrystyna Stetsiv; Sean Woodward; Shamal Lalvani; Leandros Stefanopoulos; Byoung Woo Kim; Nicos Maglaveras; Aggelos K Katsaggelos; Hans C Breiter

doi:10.2196/40821

The Relationship Between a History of High-risk and Destructive Behaviors and COVID-19 Infection: Preliminary Study

JMIR Form Res. 2023 Apr 14:7:e40821. doi: 10.2196/40821.

Authors

Nicole L Vike¹, Sumra Bari¹, Khrystyna Stetsiv^#², Sean Woodward^#², Shamal Lalvani^#³, Leandros Stefanopoulos^#^{3

4}, Byoung Woo Kim^#¹, Nicos Maglaveras^#⁴, Aggelos K Katsaggelos^{3

5

6}, Hans C Breiter^{1

7}

Affiliations

¹ Department of Computer Science, University of Cincinnati, Cincinnati, OH, United States.
² Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, United States.
³ Department of Electrical Engineering, Northwestern University, Evanston, IL, United States.
⁴ Laboratory of Medical Informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece.
⁵ Department of Computer Science, Northwestern University, Evanston, IL, United States.
⁶ Department of Radiology, Northwestern University, Evanston, IL, United States.
⁷ Laboratory of Neuroimaging and Genetics, Department of Psychiatry, Massachusetts General Hospital and Harvard School of Medicine, Boston, MA, United States.

^# Contributed equally.

PMID: 36888554
PMCID: PMC10148215
DOI: 10.2196/40821

Abstract

Background: The COVID-19 pandemic has heightened mental health concerns, but the temporal relationship between mental health conditions and SARS-CoV-2 infection has not yet been investigated. Specifically, psychological issues, violent behaviors, and substance use were reported more during the COVID-19 pandemic than before the pandemic. However, it is unknown whether a prepandemic history of these conditions increases an individual's susceptibility to SARS-CoV-2.

Objective: This study aimed to better understand the psychological risks underlying COVID-19, as it is important to investigate how destructive and risky behaviors may increase a person's susceptibility to COVID-19.

Methods: In this study, we analyzed data from a survey of 366 adults across the United States (aged 18 to 70 years); this survey was administered between February and March of 2021. The participants were asked to complete the Global Appraisal of Individual Needs-Short Screener (GAIN-SS) questionnaire, which indicates an individual's history of high-risk and destructive behaviors and likelihood of meeting diagnostic criteria. The GAIN-SS includes 7 questions related to externalizing behaviors, 8 related to substance use, and 5 related to crime and violence; responses were given on a temporal scale. The participants were also asked whether they ever tested positive for COVID-19 and whether they ever received a clinical diagnosis of COVID-19. GAIN-SS responses were compared between those who reported and those who did not report COVID-19 to determine if those who reported COVID-19 also reported GAIN-SS behaviors (Wilcoxon rank sum test, α=.05). In total, 3 hypotheses surrounding the temporal relationships between the recency of GAIN-SS behaviors and COVID-19 infection were tested using proportion tests (α=.05). GAIN-SS behaviors that significantly differed (proportion tests, α=.05) between COVID-19 responses were included as independent variables in multivariable logistic regression models with iterative downsampling. This was performed to assess how well a history of GAIN-SS behaviors statistically discriminated between those who reported and those who did not report COVID-19.

Results: Those who reported COVID-19 more frequently indicated past GAIN-SS behaviors (Q<0.05). Furthermore, the proportion of those who reported COVID-19 was higher (Q<0.05) among those who reported a history of GAIN-SS behaviors; specifically, gambling and selling drugs were common across the 3 proportion tests. Multivariable logistic regression 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% to 99.55%. That is, those who exhibited destructive and high-risk behaviors before and during the pandemic could be discriminated from those who did not exhibit these behaviors when modeling self-reported COVID-19.

Conclusions: This preliminary study provides insights into how a history of destructive and risky behaviors influences 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 not seeking vaccination.

Keywords: COVID-19; destructive behaviors; gambling; mental health; substance use; violent behaviors.

©Nicole L Vike, Sumra Bari, Khrystyna Stetsiv, Sean Woodward, Shamal Lalvani, Leandros Stefanopoulos, Byoung Woo Kim, Nicos Maglaveras, Aggelos K Katsaggelos, Hans C Breiter. Originally published in JMIR Formative Research (https://formative.jmir.org), 14.04.2023.