A meta-analytic investigation of problem gambling and self-harm: A causal inference perspective

OBJECTIVE

Problem gambling may be an underappreciated treatment target for reducing self-harm. Multivariate studies examining the relationship between problem gambling and self-harm have returned inconsistent results, perhaps due to insufficient power or differences in study quality.

METHOD

We conducted a series of meta-analyses examining the effect of problem gambling on self-harm outcomes of varying severity. We assessed the sensitivity of results to study characteristics, publication bias, and influential cases. To highlight threats to causal inference, we evaluated each study for residual confounding bias.

RESULTS

In total, two types of meta-analyses were adequately powered: those assessing (a) the effect of problem gambling (binary) on suicide ideation and (b) problem gambling (binary) on suicide attempt (k = 14 unique studies between the two meta-analyses). For both meta-analyses, we found a positive, statistically significant average effect of problem gambling on the respective self-harm outcome. We did not detect any influential studies among these two meta-analyses, nor residual confounding. However, these findings are limited by the overall quality of included literature. PET-PEESE analysis detected substantial potential publication bias in the main results, with both meta-analytic effects being reduced to statistical nonsignificance. All included studies also used a cross-sectional design for their analysis of interest, thus simultaneity bias cannot be ruled out.

CONCLUSION

While these findings suggest there is an appreciable relationship between problem gambling and at least two forms of self-harm (suicide ideation and attempts), well-designed longitudinal research is needed to make more firm conclusions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Optimising rabies vaccination of dogs in India

Dog vaccination is the key to controlling rabies in human populations. However, in countries like India, with large free-roaming dog populations, vaccination strategies that rely only on parenteral vaccines are unlikely to be either feasible or successful. Oral rabies vaccines could be used to reach these dogs. We use cost estimates for an Indian city and linear optimisation to find the most cost-effective vaccination strategies. We show that an oral bait handout method for dogs that are never confined can reduce the per dog costs of vaccination and increase vaccine coverage. This finding holds even when baits cost up to 10x the price of parenteral vaccines, if there is a large dog population or proportion of dogs that are never confined. We suggest that oral rabies vaccine baits will be part of the most cost-effective strategies to eliminate human deaths from dog-mediated rabies by 2030.

Responsible product design to mitigate excessive gambling: A scoping review and z-curve analysis of replicability

Objectives

Systematic mapping of evaluations of tools and interventions that are intended to mitigate risks for gambling harm.

Design

Scoping Review and z-curve analysis (which estimates the average replicability of a body of literature).

Search strategy

We searched 7 databases. We also examined reference lists of included studies, as well as papers that cited included studies. Included studies described a quantitative empirical assessment of a game-based (i.e., intrinsic to a specific gambling product) structural feature, user-directed tool, or regulatory initiative to promote responsible gambling. At least two research assistants independently performed screening and extracted study characteristics (e.g., study design and sample size). One author extracted statistics for the z-curve analysis.

Results

86 studies met inclusion criteria. No tools or interventions had unambiguous evidence of efficacy, but some show promise, such as within-session breaks in play. Pre-registration of research hypotheses, methods, and analytic plans was absent until 2019, reflecting a recent embracement of open science practices. Published studies also inconsistently reported effect sizes and power analyses. The results of z-curve provide some evidence of publication bias, and suggest that the replicability of the responsible product design literature is uncertain but could be low.

Conclusion

Greater transparency and precision are paramount to improving the evidence base for responsible product design to mitigate gambling-related harm.

Using Administrative Data to Predict Suicide After Psychiatric Hospitalization in the Veterans Health Administration System

There is a very high suicide rate in the year after psychiatric hospital discharge. Intensive postdischarge case management programs can address this problem but are not cost-effective for all patients. This issue can be addressed by developing a risk model to predict which inpatients might need such a program. We developed such a model for the 391,018 short-term psychiatric hospital admissions of US veterans in Veterans Health Administration (VHA) hospitals 2010-2013. Records were linked with the National Death Index to determine suicide within 12 months of hospital discharge (n=771). The Super Learner ensemble machine learning method was used to predict these suicides for time horizon between 1 week and 12 months after discharge in a 70% training sample. Accuracy was validated in the remaining 30% holdout sample. Predictors included VHA administrative variables and small area geocode data linked to patient home addresses. The models had AUC=.79-.82 for time horizons between 1 week and 6 months and AUC=.74 for 12 months. An analysis of operating characteristics showed that 22.4%-32.2% of patients who died by suicide would have been reached if intensive case management was provided to the 5% of patients with highest predicted suicide risk. Positive predictive value (PPV) at this higher threshold ranged from 1.2% over 12 months to 3.8% per case manager year over 1 week. Focusing on the low end of the risk spectrum, the 40% of patients classified as having lowest risk account for 0%-9.7% of suicides across time horizons. Variable importance analysis shows that 51.1% of model performance is due to psychopathological risk factors accounted, 26.2% to social determinants of health, 14.8% to prior history of suicidal behaviors, and 6.6% to physical disorders. The paper closes with a discussion of next steps in refining the model and prospects for developing a parallel precision treatment model.

When and Why Do Third Parties Punish Outside of the Lab? A Cross-Cultural Recall Study

Punishment can reform uncooperative behavior and hence could have contributed to humans’ ability to live in large-scale societies. Punishment by unaffected third parties has received extensive scientific scrutiny because third parties punish transgressors in laboratory experiments on behalf of strangers that they will never interact with again. Often overlooked in this research are interactions involving people who are not strangers, which constitute many interactions beyond the laboratory. Across three samples in two countries (United States and Japan; N = 1,294), we found that third parties’ anger at transgressors, and their intervention and punishment on behalf of victims, varied in real-life conflicts as a function of how much third parties valued the welfare of the disputants. Punishment was rare (1–2%) when third parties did not value the welfare of the victim, suggesting that previous economic game results have overestimated third parties’ willingness to punish transgressors on behalf of strangers.

Is Empathy the Default Response to Suffering? A Meta-Analytic Evaluation of Perspective Taking’s Effect on Empathic Concern

We conducted a series of meta-analytic tests on experiments in which participants read perspective-taking instructions—that is, written instructions to imagine a distressed persons’ point of view (“imagine-self” and “imagine-other” instructions), or to inhibit such actions (“remain-objective” instructions)—and afterwards reported how much empathic concern they experienced upon learning about the distressed person. If people spontaneously empathize with others, then participants who receive remain-objective instructions should report less empathic concern than do participants in a “no-instructions” control condition; if people can deliberately increase how much empathic concern they experience, then imagine-self and imagine-other instructions should increase empathic concern relative to not receiving any instructions. Random-effects models revealed that remain-objective instructions reduced empathic concern, but “imagine” instructions did not significantly increase it. The results were robust to most corrections for bias. Our conclusions were not qualified by the study characteristics we examined, but most relevant moderators have not yet been thoroughly studied.

Cooperation and Learning in Unfamiliar Situations

Human social life is rife with uncertainty. In any given encounter, one can wonder whether cooperation will generate future benefits. Many people appear to resolve this dilemma by initially cooperating, perhaps because (a) encounters in everyday life often have future consequences, and (b) the costs of alienating oneself from long-term social partners often outweighed the short-term benefits of acting selfishly over our evolutionary history. However, because cooperating with other people does not always advance self-interest, people might also learn to withhold cooperation in certain situations. Here, we review evidence for two ideas: that people (a) initially cooperate or not depending on the incentives that are typically available in their daily lives and (b) also learn through experience to adjust their cooperation on the basis of the incentives of unfamiliar situations. We compare these claims with the widespread view that anonymously helping strangers in laboratory settings is motivated by altruistic desires. We conclude that the evidence is more consistent with the idea that people stop cooperating in unfamiliar situations because they learn that it does not help them, either financially or through social approval.

Digital altruists: Resolving key questions about the empathy-altruism hypothesis in an Internet sample

Researchers have identified the capacity to take the perspective of others as a precursor to empathy-induced altruistic motivation. Consequently, investigators frequently use so-called perspective-taking instructions to manipulate empathic concern. However, most experiments using perspective-taking instructions have had modest sample sizes, undermining confidence in the replicability of results. In addition, it is unknown whether perspective-taking instructions work because they increase empathic concern or because comparison conditions reduce empathic concern (or both). Finally, some researchers have found that egoistic factors that do not involve empathic concern, including self-oriented emotions and self-other overlap, mediate the relationship between perspective-taking instructions and helping. The present investigation was a high-powered, preregistered effort that addressed methodological shortcomings of previous experiments to clarify how and when perspective-taking manipulations affect emotional arousal and prosocial motivation in a prototypical experimental paradigm administered over the Internet. Perspective-taking instructions did not clearly increase empathic concern; this null finding was not due to ceiling effects. Instructions to remain objective, on the other hand, unequivocally reduced empathic concern relative to a no-instructions control condition. Empathic concern was the most strongly felt emotion in all conditions, suggesting that distressed targets primarily elicit other-oriented concern. Empathic concern uniquely predicted the quality of social support provided to the target, which supports the empathy-altruism hypothesis and contradicts the role of self-oriented emotions and self-other overlap in explaining helping behavior. Empathy-induced altruism may be responsible for many prosocial acts that occur in everyday settings, including the increasing number of prosocial acts that occur online. (PsycINFO Database Record