Unrealistic Optimism and Risk for COVID-19 Disease

Area of Science:

• Psychology
• Public Health
• Epidemiology

Background:

• Risk perception and protective behaviors often misalign with actual health risks.
• Unrealistic optimism, a bias where individuals expect better personal outcomes than others, may have evolutionary roots but isn't always adaptive.
• The COVID-19 pandemic presented a novel, large-scale risk, challenging existing risk perception and behavioral models.

Purpose of the Study:

• To examine the relationship between clinical risk for severe COVID-19, individual risk perceptions, and adherence to preventative behaviors.
• To determine if individuals with higher clinical risk for severe COVID-19 exhibit unrealistic optimism and engage in behaviors inconsistent with their risk status.

Main Methods:

• Calculated clinical risk scores for severe COVID-19 in 492 participants from McLennan County, TX.
• Compared risk scores with COVID-19 threat appraisal, compliance with public health recommendations (shelter-in-place, travel restrictions), and potential covariates.
• Controlled for occupational exposure, household size, and other infection probability factors.

Main Results:

• Individuals with higher clinical risk acknowledged a greater likelihood of severe illness but perceived a lower likelihood of infection.
• Higher clinical risk correlated with more recent travel and lower psychological distress (less stress, depression, helplessness).
• No significant differences in behavior were observed between high and low clinical risk groups during shelter-in-place orders.

Conclusions:

• Unrealistic optimism in high-risk individuals may lead to underestimation of infection risk and potentially dangerous non-compliance with public health measures.
• While optimism may offer psychological benefits, it can be detrimental when facing novel or severe threats like a global pandemic.
• The findings highlight the need to address optimism bias in public health messaging, especially for novel infectious diseases.