Over-Indebtedness and Problem Gambling in a General Population Sample of Online Gamblers

BACKGROUND

Online gambling has increased in recent years, including online casino games and live sports betting which constitute rapid gambling activities with significant potential for gambling-related harm. There is a paucity of research examining whether specific gambling patterns are related to problem gambling and over-indebtedness, when controlling for psychological distress, gender, and other risk factors.

METHODS

A general population-based web panel of 1,004 online gamblers were examined in an online survey addressing problem gambling symptoms (the PGSI), psychological distress (Kessler- 6), past 30-day gambling activities, past 30-day gambling losses, history of subjective over-indebtedness and expected over-indebtedness in the near future, as well as socio-demographic data.

RESULTS

In logistic regression analyses, problem gambling was associated with psychological distress, recent online casino gambling, and recent combined online casino gambling and live sports betting. History of over-indebtedness was associated with recent combined online casino gambling and live sports betting, and expected over-indebtedness was associated with online casino gambling. Problem gambling, and a history of having borrowed money for gambling, were markedly higher in online casino gamblers, compared to subjects not reporting this gambling activity. Problem gambling was markedly more common in women, but was not associated with gender in the adjusted analysis.

CONCLUSIONS

In online gamblers, high rates of problem gambling and over-indebtedness were seen, and online casino gambling (alone or in combination with live sports betting), was associated with remarkably increased risk. Gender distribution of problem gamblers was clearly in contrast to that found in previous problem gambling literature. These findingsa suggest regulations in the market of online casino gambling, and prevention of over-indebtedness in gambling-related borrowing, in consumer credit counselling and in mental health care. In particular, female gender may need to be addressed as a stronger risk factor than previously described.

Risk Factors for Farmers' Suicides in Central Rural India: Matched Case-control Psychological Autopsy Study

BACKGROUND

Despite more than two decades since recognition of suicides by farmers in India, systematic studies comparing various risk factors are lacking. This is major hurdle for the formulation of strategies for farmers' suicide prevention.

OBJECTIVE

To identify socioeconomic and psychological risk factors and their relative contribution in suicides by farmers.

MATERIALS AND METHODS

A matched case-control psychological autopsy was done on 98 farmers' suicide victims and 98 controls in Central India.

RESULTS

Economic problems, psychiatric illness, and stressful life events were found to be important contributors to farmers' suicides. Important economic risk factors were procurement of debt, especially from multiple sources and for nonagricultural reasons and leasing out farms. Psychiatric illness was present significantly in higher proportion among cases than controls. Crop failure, interpersonal problems, medical illness, and marriage of female family member were significant stressful life events.

CONCLUSIONS

There are socioeconomic and psychological risk factors for suicide by farmers which can be targets of prevention policy.

Gambling-related suicides and suicidality: A systematic review of qualitative evidence

The relationship between gambling and suicides or suicidality has received much research attention in recent years. Review studies have already mapped the quantitative occurrence of suicide attempts, suicides, and self-harm among gamblers, and found a positive association. Related comorbidities and conditions have also been charted in previous reviews. However, there is still a gap in knowledge regarding the actual processes that connect gambling and suicidal behavior. To understand these processes, the current paper conducts a systematic review of qualitative evidence on gambling-related suicides and suicidality. The aim was to identify the role of gambling as well as of confounding factors in suicidality, and what kind of support suicidal individuals have received or would need. We searched for relevant literature in seven scientific databases. We included all studies that presented empirical qualitative evidence on gambling-related suicide, suicidality and/or self-harm (N = 20). The results show two main processes that connect gambling and suicidal behavior: indebtedness and shame. At the same time, suicide is a multifactorial phenomenon, and related to other confounding factors. These include psychiatric conditions, personality traits, and life conditions. In many cases, these appear to emerge as a consequence of gambling. Treatment for suicidality has been effective in some cases, but indebtedness and shame may also function as barriers to help-seeking. We conclude that effective prevention is needed by adapting a more comprehensive public health approach and population-level interventions.

Relationship Between Debt and Depression, Anxiety, Stress, or Suicide Ideation in Asia: A Systematic Review

Background: This article aims to review research manuscripts in the past 5 years that focus on the effects of debt on depression, anxiety, stress, or suicide ideation in Asian countries. Methods: A search for literature based on the PRISMA guidelines was conducted on Medline, PubMed, Web of Science, Scopus, and ScienceDirect, resulting in nine manuscripts meeting inclusion criteria. The studies were conducted in Thailand, Korea, Singapore, Pakistan, India, Cambodia, and China. Results: The findings of the studies show that there is evidence to support that being in debt is related to Asian participants experiencing depression, anxiety, stress, or suicide ideation. However, the studies are limited to quantitative studies only. The definition of debt is also unclear in most manuscripts. Few manuscripts also examined how other factors influence the relationship between debt and mental illness. Conclusion: There are limited studies on the psychological effects of debt on the Asian population. Future studies should focus on the relationship between debt and psychological well-being among this population.

Exploring the determinants of distress health financing in Cambodia

Borrowing is a common coping strategy for households to meet healthcare costs in countries where social health protection is limited or non-existent. Borrowing with interest, hereinafter termed distress health financing or distress financing, can push households into heavy indebtedness and exacerbate the financial consequences of healthcare costs. We investigated distress health financing practices and associated factors among Cambodian households, using primary data from a nationally representative household survey of 5000 households. Multivariate logistic regression was used to determine factors associated with distress health financing. Results showed that 28.1% of households consuming healthcare borrowed to pay for that healthcare with 55% of these subjected to distress financing. The median loan was US$125 (US$200 for loans with interest and US$75 for loans without interest). Approximately 50.6% of healthcare-related loans were to pay for the costs of outpatient care in the past month, 45.8% for inpatient care and 3.6% for preventive care in the past 12 months. While the average period to pay off the loan was 8 months, 78% of households were still indebted from loans taken over 12 months before the survey. Distress financing is strongly associated with household poverty-the poorer the household the more likely it is to borrow, fall into debt and unable to pay off the debt-even for members of the health equity funds, a national scheme designed to improve financial access to health services for the poor. Other determinants of distress financing were household size, use of inpatient care and outpatient consultations with private providers or with both private and public providers. In order to ensure effective financial risk protection, Cambodia should establish a more comprehensive and effective social health protection scheme that provides maximum population coverage and prioritizes services for populations at risk of distress financing, especially poorer and larger households.

How forgiveness promotes offender pro-relational intentions: The mediating role of offender gratitude

Although relationship restoration is an important outcome of forgiveness, little is known about how forgiveness facilitates such an outcome. In addition, in forgiveness research, little attention is paid to the perspective of the offender. We address these two shortcomings simultaneously, testing the idea that forgiveness promotes offender gratitude, which in turn encourages offender pro-relational intentions. Across three experimental studies, participants were induced to believe they had transgressed; recalled a time when they had transgressed; and imagined transgressing. In studies 1 and 2, forgiveness was manipulated; in Study 3, victim motivation for forgiving was manipulated. State gratitude--in comparison with guilt, indebtedness, and positive affect--was consistently found to play the primary mediating role between forgiveness and pro-relational intentions.

When Gratitude Evokes Indebtedness

BACKGROUND

Research in the US found that gratitude increases happiness. We conducted three studies to examine whether gratitude increases happiness among Koreans, as well.

METHODS

Participants were randomly assigned to a gratitude or a control condition in Studies 1 and 2, and into a gratitude toward someone important or a gratitude toward own health condition in Study 3. Their moods were then measured.

RESULTS

Gratitude writing marginally significantly evoked indebtedness among Korean students (Study 1, N = 336) but not among American students (Study 2, N = 219). Equally important, even among Americans, those who wrote about their gratitude toward someone important reported feeling indebtedness marginally more than those who wrote about their gratitude toward something or someone not that important. In Study 3 (N = 181), American participants, randomly assigned to write about their gratitude toward someone important, reported not only more gratitude but also more indebtedness than those assigned to write about their gratitude toward their own health.

CONCLUSIONS

Taken together, these studies suggest that gratitude evokes indebtedness when gratitude is about someone important.

Changes in household debt due to COVID-19 and mental health concerns among adults in Ontario, Canada

BACKGROUND

Canadian households experienced unexpected changes in their economic well-being during the COVID-19 pandemic. The extent of the impact of the pandemic on household debt and its effect on health and mental health remains unknown.

AIM

The aim of the study was to examine the associations of change in household debt due to COVID-19 with serious psychological distress (SPD) and general health measures.

METHODS

Data were from the 2020 Monitor study, a repeated cross-sectional survey of adults 18 years and older in Ontario, Canada. The 2020 cycle employed a web-based panel survey of 3,033 adults. The survey included measures of change in household debt due to the COVID-19 pandemic, mental and general health. Odds ratios (OR) were estimated from logistic regression models accounting for sociodemographic factors.

RESULTS

Overall, 17.5% of respondents reported that their household debt increased due to the COVID-19 pandemic. Such an increase in household debt was significantly associated with SPD (OR = 2.92, 95% CI, 2.05-4.16), fair/poor mental health (OR = 2.02, 95% CI, 1.59-2.56), frequent mental distress days (OR = 1.80, 95% CI, 1.31-2.48), fair/poor general health (OR = 1.93, 95% CI, 1.47-2.52), and suicidal ideation (OR = 3.71, 95% CI, 2.41-5.70) after adjusting for potential confounders including education, income and employment.

CONCLUSIONS

Household debt during the COVID-19 pandemic is an important determinant of health. Individuals who reported an increase in household debt due to COVID-19 were more likely to report serious mental health concerns including suicidal ideation. This suggests that debt-related interventions may be needed to alleviate the adverse effects of indebtedness on health.

Psychometric Properties of the Indebtedness Scale (IS-R) in Spanish University Students

The importance of trait indebtedness in the context of the study of gratitude has been growing in recent years, since both constructs form complex dynamics in response to the reception of a gift. In this work, the disposition to feel indebtedness is studied, through analysis of convergence and divergence, exploratory, and confirmatory analysis in the Spanish population, with the most used measurement instrument, i.e. The Revised Indebtedness Scale, IS-R. This scale depicted a four factor solution interrelated with a high consistency of content, which allows their labeling and describing. To do this, two samples of university students were selected; one of the sample sizes had 229 participants and the other 200 participants. Results also indicated good internal consistency described as follows: Debt for material aspects (α = 0.81), Self-sufficiency and discomfort in receiving help (α = 0.82), Moral self-demand in the reception of help (α = 0.83) and Debt in the receipt of gifts (α = 0.75). Furthermore, it was suggested that the relationships between gratitude and indebtedness are complex: on the one hand, all the indebtedness factors are inversely correlated with gratitude, such as the GQ5, although only Self-sufficiency and discomfort in receiving help and Debt in the receipt of gifts are such to a significant extent. However, the Interpersonal Gratitude scale of the G-20 depicted low correlations only with the Self-sufficiency and discomfort. The results are discussed in relation to the need for conceptual definition of the constructs in Positive Psychology.

Economic Inequality Increases the Preference for Status Consumption

Prior research has shown the relationship between objective economic inequality and searching for positional goods. It also investigated the relationship between social class and low income with conspicuous consumption. However, the causal relationship between economic inequality (the difference in wealth between individuals and groups living in a shared context and consumer behavior) has been less explored. Furthermore, there are also few studies looking for the psychological mechanisms that underlie these effects. The current research’s main goal is to analyze the consequences of perceived economic inequality (PEI) on conspicuous and status consumption and the possible psychological mechanisms that could explain its effects. Furthermore, the current research aims to examine whether there is a causal relationship between PEI and materialism preferences and attitudes toward indebtedness. This work includes two preregister experimental studies. In the Study 1 (n = 252), we manipulated PEI and its legitimacy through a 2 (high vs. low inequality) × 2 (Illegitimate vs. legitimate) between-participants experiment. Results showed a main effect of PEI on status consumption, status seeking, status anxiety, materialism, and attitude toward indebtedness. No interaction effect between legitimacy and inequality was found. In the Study 2 (n = 301), we manipulated the PEI through the Bimboola Paradigm. We replicated the effect of PEI on status consumption, status seeking, and materialism and found that status seeking mediated the relationship between PEI and status and conspicuous consumption. Economic inequality affects consumer behavior and favors consumption preferences for products that provide desirable symbolic values associated with status. These results could have important implications in the interpersonal and intergroup processes, including those related to consumption and purchase.

The Prosocial Outgrowth of Filial Beliefs in Different Cultures: A Conditional Mediation Model Analysis

Filial piety is a concept originated from ancient China which contains norms of children’s feelings, attitudes, and behaviors toward their parents. The dual filial piety model (DFPM) differentiated two types of filial belief: reciprocal vs. authoritarian filial piety (RFP vs. AFP). Recent scholars suggest that the functions of filial piety may differ across cultures. This study examined the mediating effects of empathy, moral identity, gratitude, and sense of indebtedness in the relationship between filial piety and prosocial behavior (PB) and the moderating effects of nation. Questionnaires measuring filial piety, PB, moral identity, gratitude, and sense of indebtedness were administrated to Chinese and Indonesian participants. Moderated mediation modeling was conducted to analyze data. The results showed that empathy, moral identity, gratitude, and a sense of indebtedness have significant mediating effects in the association of filial piety and PB. And nation served as a moderator. (1) RFP could promote PB via enhanced empathy, moral identity, gratitude, and a sense of indebtedness, both among Chinese and Indonesian participants, while AFP did the same job only among Indonesian participants. (2) Among Chinese participants, AFP was not directly associated with PB, but was negatively associated with PB via reduced gratitude and a sense of indebtedness. (3) Nation (China vs. Indonesia) moderated the direct or indirect effect of RFP/AFP on PB, with RFP exerting stronger positive effects on outcome variables among Chinese (relative to Indonesian) participants and AFP exerting stronger positive effects on outcome variables among Indonesian (relative to Chinese) participants. These results showed that RFP can promote prosocial development by the cultivation of empathy, moral identity, gratitude, and a sense of indebtedness, regardless of whether the participants grew up in China or other cultural backgrounds. But the effect of AFP on PB was significantly conditioned by culture. This suggests that the function of RFP may be a cultural universal. However, the mechanisms that AFP influences PB can differ considerably across cultures. Findings of this study further indicate that filial piety beliefs may facilitate prosocial development in the ways conditioned by cultures.

Role of Gambling in Payback Failure in Consumer Credit-Data from a Large Body of Material Regarding Consumer Loan Recipients in Sweden

Indebtedness is associated with poor health outcomes, and problem gambling may contribute to indebtedness through consumer credits related to gambling expenses. The assessment of consumers’ applications for loans may be an opportunity to detect and prevent further problem gambling. The present study analyzed a number of variables including gambling-related transactions and their association with payback failure in 48,197 loans to 20,750 individuals in Sweden. Sums and frequency of gambling deposits or withdrawals generally did not predict failure to pay back loans. Instead, having a loan defaulted at some time was associated with a baseline pattern describing a theoretical loss-of-control gambling pattern (short-term intense gambling), with a higher ratio of gambling deposits or withdrawals per occasion, and with several instances of gambling in close association with a loan. While several group differences were modest, signs of rapid, short-term and intense gambling, rather than gambling itself, may identify risk of payback failure and risk of indebtedness. Implications for early problem-gambling detection and prevention, such as by gambling operators and financial institutes, are discussed and may promote better public health in relation to gambling indebtedness.

Indebtedness and mental health in China: the moderating roles of income and social support

Objective

To explore the effect of indebtedness on mental health and the moderating effects of two types of coping resources (i.e., income and social support) in the Chinese context.

Methods

41,274 adults from four waves of China Family Panel Studies conducted in 2012, 2016, 2018, and 2020. Center for Epidemiologic Studies Depression Scale was used for investigation. Pooled ordinary least squares regressions were used to examine the effect of indebtedness on mental health and the moderating effects of income and social support. Stata 16.0 was used to conduct data analysis.

Results

The results showed that indebtedness had an adverse effect on mental health among Chinese adults. Furthermore, debtors with higher incomes showed fewer mental disorders than those with lower incomes. In terms of social support, monetary support from relatives was able to moderate the negative effects of indebtedness; however, the moderating effects of emotional support were negligible.

Conclusion

The results of this study indicated the adverse mental health outcomes of indebtedness in emerging economies and highlighted that economic resources played protective roles against debtors' mental disorders.

Gratitude Intervention Evokes Indebtedness: Moderated by Perceived Social Distance

Previous study suggests that gratitude intervention evokes indebtedness among people from an interdependent society. This study furtherly hypothesized that perceived social distance moderates the effect of gratitude intervention on felt indebtedness. A total of 275 adolescents were randomly assigned to three gratitude intervention conditions, namely, writing gratitude to significant others, the health of one's own, or nothing. After completing the writing task, they rated their experienced emotions on ten dimensions, including gratitude and indebtedness. They also reported perceived social distance from surrounding people and other demographical information. Results indicated that participants in the condition of writing about gratitude to significant others felt indebted regardless of perceived social distance, while those in the condition of writing about gratitude to his/her own health and those in the control condition experienced lesser indebtedness as the perceived social distance with others becomes closer. Gratitude increases as perceived social connectedness increases across all conditions. Theoretical and practical implications were discussed.

To approach or to avoid: The quadripolar model of achievement motivation revisited in a Confucian-heritage context

Academic challenges and failure are inevitable in pursuit of higher education. According to the self-worth theory, trying hard but failing implies low ability that would be a threat to personal worth, thus preventing students from approaching academic challenges. Nevertheless, previous studies have shown that students in the Confucian-heritage contexts (CHCs) tend to persist rather than quit in the face of academic failure. According to the role obligation theory of self-cultivation (ROT), the CHC learners would perceive academic failure from personal and interpersonal perspectives. The former refers to personal obligations to exert oneself toward the ultimate good, and the latter refers to fulfilling filial obligations to parents by achieving academic excellence. Given the fundamental differences in learners' perceptions of academic failure between the CHCs and the Western, Educated, Industrialized, Rich, and Democratic (WEIRD) contexts, this study examined the applicability of the quadripolar model of achievement motivation based on the self-worth theory in a CHC higher education institution. Results of confirmatory factor analysis (CFA) supported a two-factor model of fear of failure, including a personal and an interpersonal subfactor. Latent class analysis (LCA) showed that apart from the four existing categories of the quadripolar model, two additional CHC categories emerged and constituted half of the sample. The two CHC categories demonstrated different learner characteristics compared with their corresponding quadripolar categories in terms of levels of emotional distress and academic risk-taking tendency. The results may help debunk the myth that learner characteristics in the CHCs are identical to those observed in the WEIRD contexts. The fundamental differences in fear of failure further indicated the inadequacy of the self-worth theory in explaining achievement motivation in the CHCs where relationalism and role obligations are significant parts of the cultural traditions.

Effect of Psychological Factors on Credit Risk: A Case Study of the Microlending Service in Mongolia

This paper determined the predefining factors of loan repayment behavior based on psychological and behavioral economics theories. The purpose of this research is to identify whether an individual’s credit risk can be predicted based on psychometric tests measuring areas of psychological factors such as effective economic decision-making, self-control, conscientiousness, selflessness and a giving attitude, neuroticism, and attitude toward money. In addition, we compared the psychological indicators to the financial indicators, and different age and gender groups, to assess whether the former can predict loan default prospects. This research covered the psychometric test results, financial information, and loan default information of 1118 borrowers from loan-issuing applications on mobile phones. We validated the questionnaire using confirmatory factor analysis (CFA) and achieved an overall Cronbach’s alpha reliability coefficient greater than 0.90 (α = 0.937). We applied the empirical data to construct prediction models using logistic regression. Logistic regression was employed to estimate the parameters of a logistic model. The outcome indicates that positive results from the psychometric testing of effective financial decision-making, self-control, conscientiousness, selflessness and a giving attitude, and attitude toward money enable individuals’ debt access possibilities. On the other hand, one of the variables—neuroticism—was determined to be insignificant. Finally, the model only used psychological variables proven to have significant default predictability, and psychological variables and psychometric credit scoring offer the best prediction capacities.

Debt, Ownership, and Size: The Case of Hospitals in Poland

The goal of this study is to compare the financial performance of public hospitals according to ownership and size. The study covered public hospitals in Poland and covered two hospitals types depending on their founding authority, i.e., hospitals established and financed by the Marshal’s Office (Marshal hospitals) or the City Hall (poviat-commune hospitals). The study was based on an analysis of the hospitals’ financial situation (using debt and solvency ratios) and its relationship to the founding body and size. The verification of hypotheses was carried out using the Mann–Whitney U test. The results led to the conclusion that the vast majority of public hospitals are indebted, and their ownership structure does not affect their financial condition. The study did not confirm a significant relationship between size or ownership and the financial status of the hospital. The article aims to fill the research gap regarding the debt analysis between different types of public hospitals. It also presents a new research direction aimed at finding the factors that determine the difficult financial situation of public hospitals in Poland.

Personal experiences of suicidality in women with gambling disorder - A qualitative interview study

Background

Gambling disorder is associated with increased suicidality, especially in women who also are more likely to have psychiatric comorbid disorders and more often have experiences of traumatic life events. Although suicidality is increased and several risk factors have been identified, knowledge of the suicidal process is lacking, especially for women.

Aim

To explore the lived experiences of suicidality in women with gambling disorder and to investigate potential factors involved in the development of suicidality.

Method

Semi-structured interviews were held with seven women with experiences of gambling disorder and suicidality in Malmö, Sweden between November 2021 and June 2022, when saturation was reached. Interviews were audio-recorded, transcribed, and coded in NVivo. Qualitative content analysis was used to build categories and themes.

Results

Several women had experienced suicidality before developing gambling disorder and gambling-related suicidality. However, for some, suicidality had appeared seemingly only due to the gambling disorder. Suicidality ranged from ideation to severe suicide attempts. Three themes of factors modulating suicidality related to gambling were found; a) guilt shame and self-stigmatization, b) loss of control/chaotic life circumstances, and c) social consequences/fear of guilt and shame from others.

Conclusion

More research on the experience of suicidality in women with gambling disorder is needed. Attempts to address self-stigmatization, guilt, and shame in women with gambling disorder and society at large as well as aiding women to regain a sense of control over their economy and gambling may be ways to reduce suicidality.