The role of impulsivity and delay discounting in student compliance with COVID-19 protective measures

Characterizing impulsivity in individuals with methamphetamine and methcathinone use disorders

Background

Individuals with substance use disorder (SUD) are characterized by loss of control in drug use, such as increased impulsivity. Methamphetamine and methcathinone are psychostimulants, the use of which is accompanied by a high level of impulsivity. Whether individuals with methamphetamine use disorder (MUD) and methcathinone use disorder (MCUD) differ in different aspects of impulsivity is unclear.

Methods

We investigated impulsivity traits and behaviors in individuals with MUD and MCUD. The Barratt Impulsiveness Scale (BIS), Sensation Seeking Scale (SSS), and delay discounting task (DDT) were assessed in individuals with MUD and MCUD and in healthy controls (HCs); then, we performed network-based analysis and computational modeling to understand the potential differences among the three groups.

Results

MUD subjects scored higher than MCUD subjects in terms of motor impulsivity, nonplanning impulsivity, and total BIS scores. The network analysis revealed that there were no significant differences between MUD and MCUD subjects in any centrality indices. The discount rate of MUD and MCUD subjects was significantly greater than that of HCs, whereas there was no difference in the discount rate between the two addiction groups.

Conclusions

These findings suggest that MUD and MCUD participants differ in impulsivity traits but not in impulsive behaviors, implying that impulsive traits and behaviors represent different aspects of impulsivity.

Assessing the relationship between delay discounting and decisions to engage in various protective behaviors during COVID-19

Research suggests that discounting of delayed rewards (i.e., tendency to choose smaller immediate rewards over large later rewards) is a promising target of intervention to encourage compliance with public health measures (PHM), such as vaccination compliance. The effects of delay discounting, however, may differ across the types of PHMs, given that the benefits of vaccination, unlike other PHMs (physical distancing, handwashing, and mask-wearing), are more temporally delayed. Here, we examined whether delay discounting predicts engaging in COVID-19 PHMs in approximately 7,000 participants recruited from 13 countries in June-August 2021. After controlling for demographic and distress variables, delay discounting was a negative predictor of vaccination, but a positive predictor of physical distancing (when restrictions are in place) and handwashing. There was no significant association between delay discounting and frequency of mask-wearing. It is possible that increasing vaccination compliance may require greater emphasis on future benefits of vaccination, whereas promotion of physical distancing and hand hygiene may require greater focus on the present moment. Further research is needed to investigate the nature of this relationship and its implications for public health messaging.

A network approach to understanding social distancing behaviour during the first UK lockdown of the COVID-19 pandemic

OBJECTIVE

Given the highly infectious nature of COVID-19, social distancing practices are key in stemming the spread of the virus. We aimed to assess the complex interplay among psychological factors, socio-demographic characteristics and social distancing behaviours within the framework of the widely used Capability, Opportunity, Motivation-Behaviour (COM-B) model.

DESIGN

The present research employed network psychometrics on data collected during the first UK lockdown in April 2020 as part of the COVID-19 Psychological Research Consortium (C19PRC) Study. Using a network approach, we examined the predictions of psychological and demographic variables onto social distancing practices at two levels of analysis: macro and micro.

RESULTS

Our findings revealed several factors that influenced social distancing behaviour during the first UK lockdown. The COM-B model was successful in predicting particular aspects of social-distancing via the influence of psychological capability and motivation at the macro-and micro-levels, respectively. Notably, demographic variables, such as education, income, and age, were directly and uniquely predictive of certain social distancing behaviours.

CONCLUSION

Our findings reveal psychological factors that are key predictors of social distancing behaviour and also illustrate how demographic variables directly influence such behaviour. Our research has implications for the design of empirically-driven interventions to promote adherence to social distancing practices in this and future pandemics.

Supplemental data for this article is available online at.

A mini-review on how the COVID-19 pandemic affected intertemporal choice

The coronavirus disease (COVID-19) has extremely harmful effects on individual lifestyles, and at present, people must make financial or survival decisions under the profound changes frequently. Although it has been reported that COVID-19 changed decision-making patterns, the underlying mechanisms remained unclear. This mini-review focuses on the impact of the COVID-19 pandemic on intertemporal choice, and potential psychological, biological, and social factors that mediate this relationship. A search of the Web of Science electronic database yielded 23 studies. The results showed that under the COVID-19 pandemic, people tended to choose immediate and smaller rewards, and became less patient. In particular, people with negative emotions, in a worse condition of physical health, or who did not comply with their government restriction rules tended to become more "short-sighted" in behavioral terms. Future studies should examine more longitudinal and cross-cultural research to give a broad view about the decision-making change under the COVID-19 pandemic.

Hazardous Drinking Mediates the Relation Between Externalizing Personality and Reduced Adherence to COVID-19 Public Health Guidelines in University Students

Using a multigroup path analysis, we examined if hazardous alcohol use mediated the relations between elevated externalizing personality traits (i.e., impulsivity or sensation seeking) and reduced adherence to COVID-19 public health guidelines. We hypothesized that those high in externalizing personality traits would demonstrate less adherence to public health guidelines and that hazardous alcohol use would mediate this relationship. First- and second-year undergraduates (N = 1232; ages 18-25) from five Canadian universities participated in a cross-sectional survey between January to April 2021. Individuals with higher levels of impulsive or sensation seeking personality traits demonstrated poorer adherence to COVID-19 public health guidelines and these relations were mediated by hazardous alcohol use. Results suggest that hazardous drinking is an important target for students high in impulsivity and sensation seeking to increase their adherence to public health guidelines and thereby help control viral spread.

Does pre-COVID impulsive behaviour predict adherence to hygiene and social distancing measures in youths following the COVID-19 pandemic onset? Evidence from a South African longitudinal study

BACKGROUND

Engagement in protective behaviours relating to the COVID-19 pandemic has been proposed to be key to infection control. This is particularly the case for youths as key drivers of infections. A range of factors influencing adherence have been identified, including impulsivity and risk taking. We assessed the association between pre-COVID impulsivity levels and engagement in preventative measures during the COVID-19 pandemic in a longitudinal South African sample, in order to inform future pandemic planning.

METHODS

Data were collected from N = 214 youths (mean age at baseline: M = 17.81 (SD = .71), 55.6% female) living in a South African peri-urban settlement characterised by high poverty and deprivation. Baseline assessments were taken in 2018/19 and the COVID follow-up was conducted in June-October 2020 via remote data collection. Impulsivity was assessed using the Balloon Analogue Task (BART), while hygiene and social distancing behaviours were captured through self-report. Stepwise hierarchical regression analyses were performed to estimate effects of impulsivity on measure adherence.

RESULTS

Self-rated engagement in hygiene behaviours was high (67.1-86.1% "most of the time", except for "coughing/sneezing into one's elbow" at 33.3%), while engagement in social distancing behaviours varied (22.4-57.8% "most of the time"). Higher impulsivity predicted lower levels of hygiene (β = .14, p = .041) but not social distancing behaviours (β = -.02, p = .82). This association was retained when controlling for a range of demographic and COVID-related factors (β = .14, p = .047) and was slightly reduced when including the effects of a life-skills interventions on hygiene behaviour (β = -.13, p = .073).

CONCLUSIONS

Our data indicate that impulsivity may predict adolescent engagement in hygiene behaviours post COVID-19 pandemic onset in a high risk, sub-Saharan African setting, albeit with a small effect size. For future pandemics, it is important to understand predictors of engagement, particularly in the context of adversity, where adherence may be challenging. Limitations include a small sample size and potential measure shortcomings.

Hyperbolic modeling and assessment of hypothetical health behaviors during a viral outbreak using crowdsourced samples

The COVID-19 pandemic provided an opportunity to investigate factors related to public response to public health measures, which could help better prepare implementation of similar measures for inevitable future pandemics. To understand individual and environmental factors that influence likelihood in engaging in personal and public health measures, three crowdsourced convenience samples from Amazon Mechanical Turk (MTurk) completed likelihood-discounting tasks of engaging in health behaviors given a variety of hypothetical viral outbreak scenarios. Experiment 1 assessed likelihood of mask wearing for a novel virus. Experiment 2 assessed vaccination likelihood based on efficacy and cost. Experiment 3 assessed likelihood of seeking health care based on number of symptoms and cost of treatment. Volume-based measures and three-dimensional modeling were used to analyze hypothetical decision making. Hypothetical public and personal health participation increased as viral fatality increased and generally followed a hyperbolic function. Public health participation was moderated by political orientation and trust in science, whereas treatment-seeking was only moderated by income. Analytic methods used in this cross-sectional study predicted population-level outcomes that occurred later in the pandemic and can be extended to various health behaviors.

Which profile of people tends to ignore preventive measures against COVID-19? The role of intelligence and the big five personality traits

Although a considerable amount of research has been done on the role of personality traits in the prediction of compliance with COVID-19 preventive measures, the possible role of intelligence has been studied far less. For this reason, the main goal of the current study was to determine what the predictive role of intelligence is when considered together with the Big Five personality traits. A total of 404 participants answered three instruments: the Overall Personality Assessment Scale (OPERAS), which assesses personality traits, the COmpliance with pandemic COmmands Scale (COCOS), which assesses compliance, and the test of intelligence International Cognitive Ability Resource (ICAR Sample Test). The results show that all variables are correlated with compliance, although the weight of emotional stability on compliance was not significant. The only variable negatively related to compliance was extraversion. The results of the structural equation modelling suggest that intelligence has a direct relationship with compliance, and an indirect relationship through openness to experience. According to the results, intelligence is an important variable that should be considered in the prediction of compliance with these preventive measures.

Episodic future thinking and compassion reduce non-compliance urges regarding public health guidelines: a randomised controlled trial

BACKGROUND

People often feel urges to engage in activities that violate pandemic public health guidelines. Research on these urges has been reliant on measures of typical behaviour, which fail to capture these urges as they unfold. Guideline adherence could be improved through interventions, but few methods allow for ecologically valid observation of the range of behaviours that pandemic guidelines prescribe.

METHODS

In this preregistered parallel randomised trial, 95 participants aged 18-65 from the UK were assigned to three groups using blinded block randomisation, and engaged in episodic future thinking (n = 33), compassion exercises (n = 31), or a control procedure (n = 31). Following an ecological momentary assessment procedure, participants report on the intensity of their occurrent urges (min. 1, max. 10) and their ability to control them. The study further investigates whether, and through which mechanism, state impulsivity and vaccine attitudes affect guideline adherence.

RESULTS

Episodic future thinking (b = -1.80) and compassion exercises (b = -1.45) reduced the intensity of urges. State impulsivity is associated with stronger urges, but we found no evidence that vaccine hesitancy predicts lesser self-control.

CONCLUSIONS

We conclude that episodic future thinking exercises and compassion training may be used to decrease non-compliance urges of individuals who are an acute public health risk for the community, such as those in voluntary isolation.

Adherence of those at low risk of disease to public health measures during the COVID-19 pandemic: A qualitative study

Public health measures (PHMs) proactively and reactively reduce the spread of disease. While these measures target individual behaviour, they require broad adherence to be effective. Consequently, the World Health Organization issued a special appeal to young adults, a known non-adherent population, for increased adherence with COVID-19 guidelines. However, little is known about why these low-risk individuals do or do not adhere to PHMs. This study investigates why young adults in a low-risk setting adhered to PHMs implemented during the COVID-19 pandemic. A qualitative research approach was chosen to gain an in-depth understanding of participants’ thoughts and experiences related to PHM adherence. Semi-structured interviews were conducted in April-May 2021 with 30 young adults living in Prince Edward Island (PEI), the province with the lowest COVID-19 case rate in Canada at that time. Thematic analysis was used to create a codebook based on the Theoretical Domains Framework, which was then inductively modified. The analysis identified eight themes that explained the adherence of young adults: (1) clear, purpose-driven adherence rationale, (2) developing trust in the local leadership, (3) adapting to novel measures, (4) manageable disruption, (5) adhering to reduce anxiety, (6) collective duty towards one’s community, (7) moral culpability and (8) using caution rather than compliance. Together, these themes demonstrate that young adults adhered to PHMs because of their sense of connection to their community, public health leadership, and concerns over stigma. We further argue that clear guidelines and communication from public health officials during both periods of high and low COVID-19 cases facilitate adherence. These findings are important for mitigating future public health emergencies as they explain why young adults, an important segment of the population whose adherence is critical to the success of PHMs, follow PHMs. Further, these findings can inform public health officials and other stakeholders aiming to develop successful adherence strategies.

Risk, Obligation, and Public Noncompliance with Mobility Directives in China during the COVID-19 Pandemic

Human mobility greatly increases the risk of epidemic transmission. This study examines the psychological mechanism of individuals' noncompliance with public health directives and their choice to travel amidst threats through two rounds of surveys (N = 1473 in total) in China at different stages of the COVID-19 pandemic. This research revealed the relative strength of the motivating and impeding factors that determined behavioral intention. In subtle internal conflicts, maladaptive responses (e.g., wishful thinking, denial, fatalism) were identified as a significant factor in negotiating risk-related constraints and encouraging risky travel behavior. Interestingly, both those who traveled amidst threats and those who did not travel agreed that they had social obligations for epidemic prevention. The results demonstrated that obligation could have an indirect negative impact on behavioral intention only via attitude. By unveiling the psychological mechanism of individuals' noncompliance with health directives and travel during the pandemic, this study can aid in the development of appropriate operational strategies to manage population mobility during crises.

Face mask use during the COVID-19 pandemic: how risk perception, experience with COVID-19, and attitude towards government interact with country-wide policy stringency

BACKGROUND

During the 2020 COVID-19 pandemic, governments imposed numerous regulations to protect public health, particularly the (mandatory) use of face masks. However, the appropriateness and effectiveness of face mask regulations have been widely discussed, as is apparent from the divergent measures taken across and within countries over time, including mandating, recommending, and discouraging their use. In this study, we analyse how country-level policy stringency and individual-level predictors associate with face mask use during the early stages of the global COVID-19 pandemic.

METHOD

First, we study how (self and other-related) risk perception, (direct and indirect) experience with COVID-19, attitude towards government and policy stringency shape face mask use. Second, we study whether there is an interaction between policy stringency and the individual-level variables. We conduct multilevel analyses exploiting variation in face mask regulations across countries and using data from approximately 7000 students collected in the beginning of the pandemic (weeks 17 through 19, 2020).

RESULTS

We show that policy stringency is strongly positively associated with face mask use. We find a positive association between self-related risk perception and mask use, but no relationship of mask use with experience with COVID-19 and attitudes towards government. However, in the interaction analyses, we find that government trust and perceived clarity of communication moderate the link between stringency and mask use, with positive government perceptions relating to higher use in countries with regulations and to lower use in countries without regulations.

CONCLUSIONS

We highlight that those countries that aim for widespread use of face masks should set strict measures, stress self-related risks of COVID-19, and use clear communication.

Delay discounting of money and health outcomes, and adherence to policy guidelines during the COVID-19 pandemic

Delay discounting refers to the observation that the subjective value of an outcome decreases as the delay to its receipt increases. It is well-established that steep delay discounting is related to various maladaptive behaviors, including poorer health-related choices. One of the current challenges of public health policies that emerged during the COVID-19 pandemic is to encourage preventive behaviors against infectious diseases. In this study, we aimed to explore possible underpinnings of adherence to COVID-19 related public health policy guidelines such as disinfection, distancing, and masks (DDM). Participants completed monetary and health discounting tasks across two outcome amounts in gain and loss conditions, and they provided self-report measures of adherence to the DDM policy. Contrary to the theoretically plausible prediction that higher discounting rates would be negatively associated with adherence to health-related public policy guidelines, we found no compelling evidence to support such statement. We discuss the potential weaknesses of declarative measurements of attitudes toward COVID-19 and consider using behavioral interventions for influencing discounting rates for complementing and enhancing current policy guidelines.

One-year into COVID-19 pandemic: Decision-making and mental-health outcomes and their risk factors

BACKGROUND

The COVID-19 pandemic represents an unprecedented worldwide crisis with serious socioeconomic, physical and mental health consequences. However, its long-lasting effects on both mental health and decision-making difficulties remain unexplored. This study aimed to determine the prevalence and severity of psychological disorders in Italy's populace one-year after the outbreak; further, we investigated potential risks impacting mental health and decision-making.

METHODS

In March 2021, 586 individuals (18-73 years) completed an online-survey plus a computerized delay discounting task for hypothetical money rewards.

RESULTS

Psychological symptoms prevalence exceeded the Italy's lockdown rates, with about one-third reporting moderate-to-extremely severe depression, another third anxiety, and the rest stress; mirrored by an increase of symptoms at clinically significant severity levels. One year into the pandemic, half of our sample presented at least one psychological problem, and one-third was at risk of developing a more clinically severe psychological outcome. Fear of job loss, loneliness and intolerance of uncertainty were among the major risk factors to mental health. Plus, social-relationships and financial uncertainty were key determinants of depression, while fear of COVID-19 infection predicted anxiety symptoms. For decision-making tendencies, elevated delay discounting rates, implying less future-oriented behaviors, were mostly predicted by increased job loss fear and older age (>35 years).

LIMITATIONS

This study provides cross-sectional evidence.

CONCLUSIONS

Depression, anxiety and stress levels were still alarming one-year into COVID-19. Individuals experiencing financial insecurity, loneliness and intolerance of uncertainty perhaps benefit most from early interventions. Governments need to implement timely recovery plans to reduce financial insecurity, given its significant mental health impact and decision-making outcomes.

Short-sighted decision-making by those not vaccinated against COVID-19

Widespread vaccination is necessary to minimize or halt the effects of many infectious diseases, including COVID-19. Stagnating vaccine uptake can prolong pandemics, raising the question of how we might predict, prevent, and correct vaccine hesitancy and unwillingness. In a multinational sample (N = 4,452) recruited from 13 countries that varied in pandemic severity and vaccine uptake (July 2021), we examined whether short-sighted decision-making as exemplified by steep delay discounting-choosing smaller immediate rewards over larger delayed rewards-predicts COVID-19 vaccination status. Delay discounting was steeper in unvaccinated individuals and predicted vaccination status over and above demographics or mental health. The results suggest that delay discounting, a personal characteristic known to be modifiable through cognitive interventions, is a contributing cause of differences in vaccine compliance.

Long-term orientation and demographics predict the willingness to quarantine: A cross-national survey in the first round of COVID-19 lockdown

To be or not to be quarantined? That is the question posed by COVID-19 pandemic to almost every resident in the world. Approximately three months after the first application of the COVID-19 lockdown to residents in 17 Asian, African, European, American, and Oceanian countries, we carried out a cross-national survey of 26,266 residents via online platforms such as Sojump and Prolific to investigate their willingness to quarantine and its influencing factors. Findings show that 1) The willingness to quarantine is low in countries with high long-term orientation; 2) Females are more willing to be quarantined than males; 3) Gender difference on willingness to quarantine is large among people with older age and low education. Theoretical and managerial implications are discussed. Understanding how culture and demographics affect people's willingness to quarantine not only provides insight into how to respond to the current pandemic, but also helps the world prepare for future crises.