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Full citation
Oksanen, A., Savolainen, I., Sirola, A., & Kaakinen, M. (2018). Problem gambling and psychological distress: A cross-national perspective on the mediating effect of consumer debt and debt problems among emerging adults. Harm Reduction Journal, 15, Article 45. https://doi.org/10.1186/s12954-018-0251-9
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Region & Target Population
- Regions compared: Finland and the United States
- Target population: Emerging adults aged 18–29
Study Design
- Cross-sectional, cross-national survey study
- Based on three empirical samples:
- Two independent samples from Finland
- One nationally representative sample from the United States
Sample Characteristics (with data-collection years)
- Finland – Study 1 (nationally representative):
- n = 985, ages 18–2531
- Data collected: March–April 2017
- Finland – Study 2 (social media / convenience sample):
- n = 205, ages 18–29
- Data collected: April–June 2017
- United States – Study 3 (nationally representative):
- n = 883, ages 18–25
- Data collected: January 2018
- Total sample size: N = 2,073
- Gender: Both men and women included in all samples
Cross-National Comparison Framework
- Comparison focused on Finland vs the United States, representing:
- Different gambling systems
- Different welfare and debt contexts
- Analytical emphasis on whether core harm mechanisms linking gambling and distress are consistent across countries, rather than on product-specific prevalence differences
Measures Used
- Problem gambling: Brief standardized screening measure assessing gambling-related problems (non-clinical severity scale)
- Psychological distress: Validated measure of distress symptoms (e.g., anxiety and depressive affect)
- Debt and financial strain:
- Consumer debt (presence and level)
- Self-reported debt problems
- Demographics: Age, Gender, Country of residence
Research Questions
- Is problem gambling associated with psychological distress among emerging adults in Finland and the United States?
- Are consumer debt and debt problems associated with psychological distress in emergingn adulthood?
- Do debt and debt problems mediate the relationship between problem gambling and psychological distress, and is this mediation pattern consistent across the two countries?
8. Key Findings
- Association between gambling and distress: Problem gambling was positively associated with psychological distress in both Finnish and U.S. samples.
- Central role of debt: Consumer debt and debt problems showed a strong and consistent association with psychological distress across all samples.
- Mediation effect: The relationship between problem gambling and psychological distress was largely mediated by debt and debt problems, indicating that financial strain plays a central role in gambling-related harm.
- Cross-national consistency: Despite differences in gambling systems and welfare contexts, the debt–distress pathway operated similarly in Finland and the United States.
Study Conclusion
The authors conclude that gambling-related harm among emerging adults is best understood as a financial stress process, rather than as a purely psychological or behavioral phenomenon. Across both Finland and the United States, problem gambling was linked to psychological distress primarily through consumer debt and debt-related problems, rather than through a strong direct effect.
They emphasize that while gambling participation and regulatory environments differ between countries, the core mechanism linking gambling problems to distress is similar, underscoring the central role of financial vulnerability in emerging adulthood. The authors argue that effective harm-reduction strategies should therefore extend beyond gambling-focused interventions to include debt prevention, financial counseling, and broader economic support, particularly for young adults navigating unstable financial conditions.
