ABSTRACT
Background: 'Cross-addiction' involves a person substituting one form of addictive behaviour for another. While various cross-addiction presentations have been described throughout the literature (drugs to alcohol, alcohol to smoking, gambling to sex), minimal research has explored whether different types of cross-addiction risk exist. We examined the co-occurrence of substance and behavioral addictions and whether addiction profiles differed in COVID-19-related anxiety. Methods: We recruited 968 participants through social media and online forums in the latter half of 2020. We assessed 10 addictive behaviours and COVID-19-related anxiety with validated instruments. We used Latent Class/Profiling analyses with mean scores on addictive behavior scales to identify different risk profiles and compared proportions who met cut-off scores for each disorder between classes. We conducted t-tests to examine differences in COVID-19 anxiety between classes. Results: Two distinct risk profiles were identified, Cross-Addiction Low-Risk (57.4%) and Cross-Addiction High-Risk (42.6%), with the high-risk profile having higher average scores across all addictive behaviours and more participants who met the diagnostic cut-off for multiple addictions. No individuals in the low-risk profile met cut-off scores for alcohol, drug, or gambling disorders. T-test showed significantly higher levels of COVID-19 anxiety in the high-risk compared to the low-risk profile Discussion & Conclusions: Profiles of those at-risk for addictions do not distinguish between type of addiction so much as severity of multiple addictions and addictions having more severe health impacts. Identification of individuals at risk for multiple addictions has important implications for targeting prevention, treatment, and further research.