Suicidal behaviour in over-indebted individuals: a cross-sectional study in Sweden.

OBJECTIVE: Associations between debt and suicidal behaviour have been identified, but the research is sparse. Thus, more research is needed to understand the association between economic vulnerability and suicide. The study aimed to generate further knowledge about over-indebted individuals who have attempted suicide at least once. METHOD: Participants were a Swedish sample comprising 641 over-indebted individuals. The inclusion criteria were that the participants should be indebted and have been subjected to debt collection measures and/or seizure orders by the Swedish Enforcement Authority. Participants answered questionnaires regarding socio-demographic variables, debt size, history of suicide attempt, critical life events, and social contacts, and filled the Hospital Anxiety and Depression Scale (HADS). In the statistical analyses, Chi2 test for independence and t-test was used, and binary logistic regression to adjust for the confounding effects of the variables on each other. RESULTS: The analysis revealed that nearly one in five (19.3%, N = 123) had attempted suicide at least once. A larger part of the respondents who had a history of suicide attempts reported that they were living alone (OR 2.30 (95% CI 1.34-3.89, p = .002). Many of those living alone were women (χ2 (1, n = 121) = 4.88, p = 0.03, ɸ = 0.22). CONCLUSIONS: The results of the current study point to the fact that economic vulnerability is an important psychosocial aspect to take into serious consideration concerning mental health and suicide prevention. Longitudinal research is needed to explain, predict and prevent suicide due to over-indebtedness.

Coping and financial strain as predictors of mental illness in over- indebted individuals in Sweden.

This cross-sectional study examined psychological mechanisms in order to increase knowledge regarding mental illness amongst 561 over-indebted individuals in Sweden. Differences were explored between individuals with probable clinical depression and/or anxiety and individuals without probable clinical depression and/or anxiety, considering objective measures of the debt, financial strain, coping strategies as well as sociodemographic variables. Furthermore, binary logistic regression analyses were performed in order to construct a model of predictors of mental illness. In order to collect the data, Hospital Anxiety and Depression Scale (HADS), Brief Coping Orientation to Problems Experienced (COPE_, as well as questions formulated by the research team, were used as measures. Prominent results showed that over-indebted individuals with probable clinical depression and/or anxiety were younger, showed greater levels of financial strain, used adaptive coping strategies to a lesser extent, and maladaptive coping strategies to a greater extent. Additionally, financial strain, use of maladaptive and emotion-focused coping, age and employment status were significant predictors of mental illness. These results put emphasis on the importance of adaptive coping as well as the psychological exposure of over-indebted individuals.

The Effect of Nudging in Promoting the Consumption of Organic Fruits and Vegetables.

A field study collecting behavioral data was conducted to investigate effects of behavioral interventions, commonly known as nudges, in promoting the consumption of organic fruits and vegetables. Consumption, both organically and conventionally produced fruits and vegetables, was measured in a grocery store during 4 days (1 day every other week) where consumers were exposed to informational messages in combination with either emotional images or social norm messages. Measurements of daily consumption without exposure to nudges were carried out during four other days (1 day every other week, alternated with the nudging days). The results showed no effect of the nudging strategy; instead, it pointed to the importance of the price as a determinant of buying decisions. Buying ecological alternatives was associated with lower price differences between the ecological and non-ecological alternatives. We conclude that combined nudges and collected psychological data from participants may contribute to more successful nudging interventions. Some political measures in balancing the price difference between organically and conventionally produced products might also be interesting strategies in order to promote the consumption of organic fruits and vegetables.

Sense of coherence relates with smoking.

The present study investigated the relationship between sense of coherence (SOC) and smoking. This study is a sub-study of the Anglo-Scandinavian Cardiac Outcomes Trial. SOC was assessed with a short form self-report questionnaire at baseline and at two-year follow-up. Smoking behaviour was self-reported at both dates. The sample consisted of 841 hypertensive participants, (women 22.1%) at baseline, and 697 (women 23.0%) participants at the follow-up. At baseline the age range was 40-79. Results showed that smoking behaviour was associated with levels of SOC. Current-smokers had a lower mean of SOC. Gender had no statistically significant influence on these results.

Hostility, anger, and sense of coherence as predictors of health-related quality of life. Results of an ASCOT substudy.

OBJECTIVE: The aim of this study was to investigate the relationship of hostility and anger expression to sense of coherence (SOC) and their role as predictors of health-related quality of life (HQL). It was hypothesised that SOC would mediate the impact of hostility and anger on HQL. METHODS: This is a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial, which evaluates different treatment strategies to prevent cardiovascular disease in hypertensive patients. At baseline, SOC was assessed with a short form measure, and hostility-anger with the Cynical Distrust scale and with the Anger Expression scales. HQL was assessed at 6 months with the RAND-36. The sample comprised of 774 subjects (77.5% men). RESULTS: Results showed that strong SOC associates with ability to control expression of anger and with low levels of suppressed or openly expressed anger. Anger control and SOC were related to good HQL; cynicism, anger-out, and anger-in correlated negatively with HQL. Path models revealed that SOC was the strongest predictor of HQL while hostility and anger lost their direct impact on HQL. CONCLUSIONS: Given the significant associations of hostility and anger with SOC, it is concluded that the salutogenic theory of Antonovsky (A. Antonovsky, Health, Stress, and Coping: New Perspectives on Mental Health and Physical Well-Being, Jossey-Bass Inc, San Francisco, 1979) should be extended to include hostility-related constructs. The impact of hostility and anger on HQL is, to a great extent, mediated through SOC, which implies that in future studies, the role of hostility as a risk factor of ill health should be reconsidered from the SOC theory perspective.