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.

Discussion of "The Asymmetric Impact of COVID-19: A Novel Approach to Quantifying Financial Distress across Industries".

The COVID-19 pandemic crisis and the associated lockdown measures have exerted significantly adverse effects on corporate sectors globally. Archanskaia et al. (2023) provide a novel empirical strategy to timely assess corporate financial distress in the EU. The contribution is two-fold. First, this paper's notion of financial distress considers both the equity position and corporate indebtedness. Second, the methodology proposed in this paper allows the authors to estimate corporate financial distress in the EU at a highly granular level and link micro-level simulations to sectoral macroeconomic outcomes. The methodology employed by Archanskaia et al. (2023) consists of three steps. First, the authors apply a nowcasting model to acquire monthly industrial turnover data. Second, they feed the obtained monthly industrial turnover into a profit-generating process via an accounting identity to estimate monthly firm profits at the firm level. Third, the authors use the estimated firm profits with a snapshot of information on pre-existing liquid assets to deduce the firm-level liquidity needs and the depletion of equity through the focus period during COVID-19. These estimated results on firm equity position and indebtedness enable the authors to quantity corporate financial distress in the EU via various angles (e.g., country-level heterogeneity, industry heterogeneity, and the targeting of COVID support policies). The primary advantage of this approach is that it deals with large datasets at the granular level and produces firm-level results almost in real-time. Therefore, it can help policymaking track the effects of crises over time. However, one can quickly critique this three-step approach for its susceptibility to the usual Lucas critique. That said, since the objective here is to estimate firm-level financial distress, a large structural model being more or less aggregate in nature, though able to mitigate the Lucas critique concern, will encounter significant challenges in estimating firm-level results with the requisite level of granularity offered by the available data. Therefore, I broadly concur with the authors' position that 'the specific contribution of this paper consists in striking a better balance between the need to carry out a multi-country evaluation of the pandemic's effects on industrial activity in a strongly integrated region like the EU and the difficulty of capturing time, industry, and country variation in turnover with sufficient granularity.'

Gratitude endures while indebtedness persuades: investigating the unique influences of gratitude and indebtedness in helping.

What is the temporal course of gratitude and indebtedness and how do these feelings influence helping in the context of reciprocity? In an online-game tapping real-life behaviour, Study 1 (N = 106) finds that while gratitude towards a benefactor remains elevated after an opportunity to reciprocate, indebtedness declines along with helping. Yet, indebtedness rather than gratitude better predicts real-life helping of a benefactor. Using a vignette-based experiment, Study 2 (N = 217) finds that after reciprocation indebtedness and likelihood of helping a benefactor reset to a baseline level while gratitude endures. Furthermore, the decrease in helping after reciprocation is better explained by indebtedness than by gratitude. Study 3 (N = 217) assessed the unique influences of gratitude and indebtedness on helping by comparing contexts in which gratitude is at a baseline level but indebtedness is elevated (e.g. before a monetary payment for a service received) to contexts in which indebtedness is at a baseline level but gratitude is elevated (e.g. after reciprocation of benefits freely given by a friend). People are more likely to help in the former compared to latter context, and this difference is better explained by indebtedness rather than by gratitude. We discuss the interrelated and understudied relationships between gratitude, indebtedness, and reciprocity.

Using artificial intelligence to overcome over-indebtedness and fight poverty.

This research examines how artificial intelligence may contribute to better understanding and to overcome over-indebtedness in contexts of high poverty risk. This research uses Automated Machine Learning (AutoML) in a field database of 1654 over-indebted households to identify distinguishable clusters and to predict its risk factors. First, unsupervised machine learning using Self-Organizing Maps generated three over-indebtedness clusters: low-income (31.27%), low credit control (37.40%), and crisis-affected households (31.33%). Second, supervised machine learning with exhaustive grid search hyperparameters (32,730 predictive models) suggests that Nu-Support Vector Machine had the best accuracy in predicting families' over-indebtedness risk factors (89.5%). By proposing an AutoML approach on over-indebtedness, our research adds both theoretically and methodologically to current models of scarcity with important practical implications for business research and society. Our findings also contribute to novel ways to identify and characterize poverty risk in earlier stages, allowing customized interventions for different profiles of over-indebtedness.

Who chooses to enroll in a new national gambling self-exclusion system? A general population survey in Sweden.

BACKGROUND: Self-exclusion from gambling is a common method for prevention and harm reduction in hazardous gambling. However, few national self-exclusion programs, involving a large number of gambling operators and activities in a country, have been assessed scientifically. This study aimed to examine characteristics of individuals who chose to enroll in a recently introduced (January, 2019) national self-exclusion system in Sweden. METHODS: Adults and adolescents (from age 16 and above) were addressed with an online survey sent to members of the web panel of a market survey company (1940 respondents). Psychological distress, previous history of addictive disorders, sociodemographic data, and recent history of gambling patterns and over-indebtedness were recorded. Logistic regression tested associations with self-exclusion, with unadjusted analyses conducted for the sub-group of moderate-risk or problem gamblers. RESULTS: Four percent reported having self-excluded using the new national self-exclusion system. In logistic regression, self-exclusion was significantly associated with younger age (OR 0.65 [0.54-0.79] for increasing age groups) and with the highest level of problem gambling (OR 2.84 [1.10-7.37]). In moderate-risk or problem gamblers, in unadjusted analyses, younger age (p < 0.05) and psychological distress (p = 0.02) were associated with self-exclusion. In none- or low-risk gamblers, 3% had self-excluded, which was significantly associated with younger age (p < 0.001) and self-reported over-indebtedness (p < 0.001). CONCLUSIONS: In a national, multi-venue online and land-based self-exclusion system, aiming to reduce the harm of problem gambling, self-exclusion is expectedly more common in problem gamblers, but also occurs among people without recent gambling problems. Further efforts may be needed in order to increase gambling self-exclusion in problem gamblers, and research in reasons for self-excluding, even in non-problem gamblers, is needed.

Compounding crises of social reproduction: Microfinance, over-indebtedness and the COVID-19 pandemic.

The COVID-19 pandemic has hit at a time when microfinance is at its historical peak, with an estimated 139 million microfinance customers globally. Cambodia's microfinance sector is one of the fastest growing, and like others in the Global South has moved from offering entrepreneurial capital to everyday liquidity, and even disaster relief. In this Viewpoint, however, we argue that the promotion of microfinance as market-based relief and recovery from the pandemic should be a source of concern, not comfort. We firstly suggest that as a result of the health and economic impacts associated with COVID-19, credit-taking is likely to escalate further in terms of the number of borrowers and loan amounts. Second, we contend that a growing reliance on MFIs will leave households undernourished, and further vulnerable to its disciplining and extractive impulses. Third, we argue that the interplay between over-indebtedness, pre-existing malnutrition challenges, and the global public health crisis of COVID-19 represents a major challenge to gender equality and sustainable development. Coordination between the Cambodian government, microfinance lenders, international investors, and development partners is vital to offer debt relief. Furthermore, to reverse the reliance of so many households on the microfinance industry for survival, inclusive socio-economic policies and public welfare services must be prioritised.

Over-indebtedness and its association with sleep and sleep medication use.

BACKGROUND: Over-indebtedness is currently rising in high-income countries. Millions of citizens are confronted with the persistent situation when household income and assets are insufficient to cover payment obligations and living expenses. Previous research shows that over-indebtedness increases the risk of various adverse health effects. However, its association with sleep problems has not yet been examined. The objective of this study was to investigate the association between over-indebtedness and sleep problems and sleep medication use. METHODS: A cross-sectional study on over-indebtedness (OID survey) was conducted in 70 debt advisory centres in Germany in 2017 that included 699 over-indebted respondents. The survey data were combined with the nationally representative German Health Interview and Examination Survey for Adults (DEGS1; n = 7987). We limited analyses to participants with complete data on all sleep variables (OID: n = 538, DEGS1: n = 7447). Descriptive analyses and logistic regression analyses were used to examine the association between over-indebtedness and difficulty initiating and maintaining sleep, and sleep medication use. RESULTS: A higher prevalence of sleep problems and sleep medication use was observed among over-indebted individuals compared to the general population. After adjustment for socio-economic and health factors (age, sex, education, marital status, employment status, subjective health status and mental illness), over-indebtedness significantly increased the risk of difficulties with sleep onset (adjusted odds ratio (aOR) 1.79, 95%-confidence interval (CI) 1.45-2.21), sleep maintenance (aOR 1.45, 95%-CI 1.17-1.80) and sleep medication use (aOR 3.94, 95%-CI 2.96-5.24). CONCLUSIONS: Evidence suggests a strong association between over-indebtedness and poor sleep and sleep medication use independent of conventional socioeconomic measures. Considering over-indebtedness in both research and health care practice will help to advance the understanding of sleep disparities, and facilitate interventions for those at risk. TRIAL REGISTRATION: German Clinical Trials Register: DRKS00013100 (OID survey, ArSemü); Date of registration: 23.10.2017; Date of enrolment of the first participant: 18.07.2017, retrospectively registered.

Cost-related medication nonadherence among over-indebted individuals enrolled in statutory health insurance in Germany: a cross-sectional population study.

BACKGROUND: Millions of citizens in high-income countries face over-indebtedness that implies being unable to cover payment obligations with available income and assets on an ongoing basis. Studies have shown an association between over-indebtedness and health outcomes, independent of standard socioeconomic status measures. Patterns of cost-related medication nonadherence (CRN) among over-indebted individuals are yet unclear. The aim of this study was to examine the frequency of nonadherence to prescribed medications due to cost, and to identify risk factors for CRN among over-indebted individuals in Germany. METHODS: In 2017, we conducted a cross-sectional survey among over-indebted individuals recruited in 70 debt advice agencies in North Rhine-Westphalia, Germany. Data on CRN in the last 12 months (i.e. not filling prescriptions, skipping or decreasing doses of prescribed medication due to financial problems) were collected by a survey using a self-administered written questionnaire that was returned by 699 individuals with a response rate of 50.2%. Prevalence of CRN was assessed using descriptive statistics. Multiple logistic regression analysis was performed to examine risk factors of CRN, including participants enrolled in statutory health insurance with complete data (n = 521). RESULTS: The prevalence of CRN was 33.6%. The chronically ill had significantly greater odds of cost-related medication nonadherence (aOR 1.96; 95% CI 1.27-3.03) than individuals without a chronic illness. CRN was more likely to occur in individuals who had discussed financial problems with their general practitioner (aOR 1.58; 95% CI 1.01-2.47). There was no association between CRN and other sociodemographic factors or socioeconomic status. CONCLUSIONS: Medication nonadherence due to financial pressures is common among over-indebted citizens enrolled in statutory health insurance in Germany. Stakeholders in social policy, research and health care need to address over-indebtedness to develop strategies to safeguard access to relevant medications, especially among those with high morbidity. TRIAL REGISTRATION: Arzneimittelkonsum, insbesondere Selbstmedikation bei überschuldeten Bürgerinnen und Bürgern in Nordrhein-Westfalen (ArSemü), (engl. 'Medication use, particularly self-medication among over-indebted citizens in North Rhine-Westphalia'), German Clinical Trials Register: DRKS00013100. Date of registration: 23.10.2017. Date of enrolment of the first participant: 18.07.2017, retrospectively registered.

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.

Reconsidering the roles of gratitude and indebtedness in social exchange.

Receiving favors is often a mixed blessing and commonly triggers two emotions: the positive emotion gratitude and negative emotion indebtedness. In three studies, we examined the hypothesis that gratitude and indebtedness have distinct functions in social exchange. Contrary to current views, we believe that the function of gratitude does not primarily reside in facilitating social exchange. Instead, we propose that indebtedness motivates people to repay favours received, and thus accounts for most of the prosocial effects commonly attributed to gratitude. On the other hand consistent with current views, we believe that gratitude signals the potential for developing a relationship and fosters proximity seeking. Supporting these assumptions, in Study 1 we found that gratitude and indebtedness were associated with aspects of the favour that reflect the concern for relationship and the level of inequity. Studies 2 and 3 provided causal support for these relations, and revealed the unique associations between gratitude and the motivation of proximity seeking, and between indebtedness and the motivation to reciprocate. We argue that this functional distinction has escaped research attention as gratitude and indebtedness are naturally correlated because they stem from the same eliciting event. To appreciate this functional distinction, both emotions should be studied simultaneously in the context of social exchange.

Financial access to health care for older people in Cambodia: 10-year trends (2004-14) and determinants of catastrophic health expenses.

BACKGROUND: Older people make up an increasing proportion of the population in low- and middle-income countries. This brings a number of challenges, as their health needs are greater than, and different from, those of younger people. In general, these health systems are not geared to address their needs, and traditional support systems tend to erode, potentially causing financial hardship when accessing health care. This paper provides an overview of older Cambodians' financial access to health care over time, using nationally representative data to enable the formulation of appropriate responses. METHODS: Using data from three nationally representative household surveys from 2004, 2009 and 2014, we assess key indicators of financial access to health care for households with older people (aged 60 years or older), and compare these with households without older members. For 2014 data, the determinants of catastrophic health expenses at the 10 and 40 % threshold were determined for older people. Data was stratified by age and place of residence (urban/rural), and analysed using Stata statistical software. Sample weights were calibrated to reflect accurate population composition at the time of the survey. Monetary values for 2004 and 2009 were transformed into 2014 values using annual inflation rate figures. RESULTS: Care-seeking when sick among older people increased considerably from 2004 to 2014, irrespective of gender or place of residence. There were positive trends in the incidence of catastrophic and impoverishing healthcare expenses over the studied time periods. This was also the case for indebtedness. Rural households with older people were considerable more likely to suffer financial hardship due to health-related expenses than their urban equivalents. In 2014, older people spent 50 % more per month on health care than younger people. Determinants of catastrophic health expenditures among households with older people were residing in a rural area, and having a household member with an illness, especially a non-communicable disease. CONCLUSION: In order to make health care more equitable for older people, efforts should be directed to rural areas. Interventions should include improving management of non-communicable diseases at the primary care level, together with a reconfiguration of social health protection schemes to increase the inclusion of older people.

Loot box purchasing and indebtedness: The role of psychosocial factors and problem gambling.

Introduction: Loot boxes are increasingly common random-reward monetization mechanisms in digital games. They are popular among gamblers and pose various risks due to their gambling-like nature, but little is known about psychosocial vulnerabilities and financial consequences of purchasing them. This article examined psychosocial associations with self-reported increase in loot box purchasing and indebtedness among past-year gamblers during the COVID-19 pandemic. Methods: Cross-sectional survey data were collected in April 2021 from Finnish, Swedish, and British past-year gamblers aged 18 to 75 (n = 2,022). Measures of loneliness, psychological resilience, and problem gambling were studied in relation to loot box purchasing and indebtedness. Structural equation modeling was used as an analytical technique. Results: Loneliness was positively associated with self-reported increase in loot box purchasing. No evidence was found regarding the protective role of psychological resilience in loot box purchasing. Increased loot box purchasing was associated with problem gambling. Problem gambling mediated the relationship between loot box purchasing and indebtedness. Conclusions: The findings bring valuable insight into the psychosocial vulnerabilities and financial consequences in loot box purchasing. Loot box purchasing can add to one's financial strain particularly among vulnerable individuals such as problem gamblers, making it crucial to regulate such monetization practices.

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.

Debt Problem of One Partner and Depressive Morbidity in the Other: A 2-Year Follow-up Register Study of Different-Sex Couples in Sweden.

This study sets out to examine whether depressive morbidity varies by status of financial indebtedness of a spouse or cohabiting partner. For this purpose, individuals aged between 20 and 60 with a different-sex spouse/cohabiting partner with a registration date for a debt at the Swedish Enforcement Authority (SEA) during 2017 (n = 6979) are followed-up for a 2-year period for prescriptions of antidepressants and compared with a sample from the general Swedish population (n = 29,708). The analysis is based on penalized maximum likelihood logistic regressions. Both women and men were more likely to suffer from depressive morbidity if the spouse/cohabiting partner had been registered at the SEA in 2017 and was still active for a debt in the SEA's register in 2018 (OR 1.31 and OR 1.57, respectively), irrespective of their own health, employment, socioeconomic status, and other background variables. This also held true for men if a wife/cohabiting partner had been registered at the SEA in 2017 but was no longer active for a debt in the SEA's register in 2018 (OR 1.29). For women, on the other hand, only those with no history (11-year period) of prescription of psychotropic medications were also at an enhanced risk of depressive morbidity if a husband/cohabiting partner had gone from being registered for a debt at the SEA in 2017, to not being registered as active for a debt in the SEA's register in 2018 (OR 1.24). The results reinforce the importance of acknowledging that negative effects of financial indebtedness extend beyond the individual debtor.

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.

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.

Gender and maladaptive personality correlates in problem gambling and over-indebtedness: Novel findings from a cross-sectional study in Sweden.

Although most individuals consider gambling to be an innocent and fun activity, when it develops into problem gambling, it can have detrimental outcomes to one's life, such as over-indebtedness. This cross-sectional study explores the role of maladaptive personality traits and gender in both problem gambling and over-indebtedness, in an online sample of 1479 adult gamblers (65% males) in Sweden. Participants were administered the Problem Gambling Severity Index (PGSI), the Personality Inventory for DSM-5-Brief Form (PID-5-BF), and questions addressing subjective over-indebtedness and other risk factors. Quasi-Poisson loglinear models and logistic regression analyses demonstrated that Disinhibition (OR = 1.38, 95% CI [1.24, 1.53]), and Antagonism (OR = 1.23, 95% CI [1.14, 1.34]) showed the strongest associations to problem gambling, and that only Disinhibition (OR = 1.72, 95% CI [1.22, 1.43]) and Antagonism (OR = 2.00, 95% CI [1.52, 2.66]) were significantly related to over-indebtedness. The prevalence of problem gambling and over-indebtedness was more common among women, and gender moderated the univariate relationships of Negative Affectivity, Disinhibition and Psychoticism to problem gambling. These findings call for future research addressing maladaptive personality traits, problem gambling and over-indebtedness, and highlight the need for tailored interventions and prevention strategies, particularly for women who may be at higher risk.

The association between social support provision, psychological capital, subjective well-being and sense of indebtedness among undergraduates with low socioeconomic status.

BACKGROUND: Social support consists of receipt and provision in the interpersonal exchange process. Many studies have explored and verified the effect of received social support. This study focuses on whether and when social support provision can benefit the providers' positive psychological capital and subjective well-being. METHODS: A sample of 732 Chinese undergraduates with low socioeconomic status completed questionnaires on social support provision, psychological capital, life satisfaction, positive affect, negative affect, and sense of indebtedness. RESULTS: The correlation and regression analyses showed that impoverished college students' social support provision was positively associated with life satisfaction, positive affect, and psychological capital and negatively associated with negative affect. The interaction between the sense of indebtedness and social support provision was negatively associated with life satisfaction, positive affect, and psychological capital, not significantly associated with negative affect. CONCLUSION: The results demonstrated that giving social support can be as beneficial as receiving social support, and the sense of indebtedness can limit the benefits. Individuals with a lower sense of indebtedness are more likely to benefit from social support provision. The findings have implications for marginalized groups' subjective well-being and positive psychological capital and show the necessity of guiding individuals to provide social support while maintaining their autonomy.

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.

Climate Change and Household Debt in Rural India.

Climate change and indebtedness have been repeatedly highlighted as major causes of distress for rural households in India. However, despite the close connection between climate conditions and rural livelihoods, there has been little attempt to systematically examine the association between the two. To address this gap, we combine national-level longitudinal data from IHDS, MERRA-2, and the Indian Ministry of Agriculture to study the impact of climate anomalies on household indebtedness across rural India. Using a longitudinal approach that accounts for potential confounders at household, village, and district levels, we find pervasive effects of season-specific, five-year climate anomalies on multiple dimensions of household debt, particularly in arid and semi-arid areas. Most notably, temperature anomalies in the winter cropping season in arid and semi-arid areas are associated with increasing household indebtedness. We further find that climate change interacts with existing socioeconomic differences-caste and landholding in particular-to deepen both the size and the depth of indebtedness for rural households.