* for medical professionals to read only
In the past two years, blind boxes have frequently "been out of the circle". Toys, cultural and creative, shoes and clothing, beauty and other industries have launched "shock-breaking" packages. "Everything is blind box" has become a hot spot for young people, and the limelight is unparalleled! Why is the blind box so popular in ? Will the blind box fever affect the mental health of consumers, especially teenagers? The magic of
blind box makes consumers unable to stop: you never know what the next one is like, so you always want to disassemble another one. Just like gambling, I always feel that I can "turn the tables against the wind" in the next move. The psychological expectation of requires a lot of money to satisfy, is full of uncertainty and is prone to "psychological addiction", which leads to consumers undergoing emotional changes after being economically hurt.
Some studies have confirmed that virtual electronic game blind box is related to mental health [1-4], and gambling is significantly related to suicide behavior [5-7]. However, it is still unknown whether the excessive consumption of the physical cute doll blind box that is popular in China is related to suicide risk and whether there is a gender difference in this relationship.
Recently, Dr. Chen Runsen from Tsinghua University led a team to publish important research results in the Lancet issue eClinicalMedicine [8]. They found that excessive blind box consumption of is actually related to the increased risk of suicide among young people ! Compared with those who did not participate in blind box purchases, excessive blind box consumption for male college students was related to an increase in suicide risk by 121%, while excessive blind box consumption for female college students was related to an increase in suicide risk by 64%! and after adjusting for influencing factors, this association still exists.
Paper homepage screenshot
Researchers used convenient sampling method to collect data in all universities and college students in Jilin Province, China from October 26 to November 18, 2021. Finally, a total of 73,206 participants completed the valid data survey of this study, including 28,762 males (39.29%) and 44,444 females (60.71%) with an average age of 19.59 years.
Researchers evaluated the participants' blind box participation from five directions, namely frequency (blind box consumption frequency), gambling (expenditure exceeding affordability), tolerance (addiction level), borrowing (amount of blind box investment), and blind box consumption history, and investigated and counted the participants' suicide risk, depression, anxiety, drinking, smoking habits and socio-demographic characteristics.
uses univariate and multivariate binary logistic regression models to perform statistical analysis: 1. Test the relationship between blind box consumption and suicide risk in all participants. 2. People with depression and anxiety are more likely to buy blind boxes for psychological satisfaction, so they test whether depression and anxiety mediate the relationship between blind box consumption and suicide risk. 3. Analyze the independent relationship between five types of blind box consumption behaviors and suicide risk.
study found that 4195 participants (5.73%) had used blind boxes, including 3255 women (77.59%) and 940 men (22.41%). Among them, 9891 (13.51%) participants were at risk of suicide. (Figure 1)
Figure 1 Suicide risk is related to gender classification of blind box consumers
univariate model shows that compared with students who have not purchased blind box, excessive blind box consumption of male college students was associated with a 121% increase in suicide risk (OR[95% CI]=2.21[1.86-2.13]), and excessive blind box consumption of female college students was associated with a 64% increase in suicide risk (OR[95% CI]=1.64[1.50-1.78]) . (Figure 2)
In a multivariate model that adjusted for age, subjective socioeconomic status, per capita disposable income of , and drinking and smoking habits, blind box consumption is still related to the increased risk of suicide in men and women (male: OR=2.25, 95%CI=1.89-2.68; female: OR=1.58, 95%CI=1.45-1.73) . (Figure 2)
Figure 2 The relationship between blind box consumption and suicide risk
In the relationship between blind box consumption and suicide risk, the mediated proportion of depression in male and female participants was 31% and 20% , respectively (male: indirect effect = 0.31, SE=0.04, p0.001; female: indirect effect = 0.20, SE=0.02, p0.001); the mediated proportion of anxiety in male and female participants was 26% and 13% , respectively (male: indirect effect = 0.26, SE=0.03, p0.001; female: indirect effect = 0.13, SE=0.02, p0.001).(Figure 3)
Figure 3 Mediational role of depression and anxiety in the relationship between blind box consumption and suicide risk
In each subdivided blind box consumption group, the degree of addiction and blind box investment amount were independently related to the participants' suicide risk (P 0.05).
To sum up, the results of this study show that blind box consumption is related to increased risk of suicide, and there are gender differences in this association. Dear boys and girls, will the blind box in their hands be smelly in an instant when they see it?
How does that small blind box have something to do with the risk of suicide? Researchers give the following reasons: Psychological addiction, economic stress, mental health and problems Gambling psychology may be potentially related causes of increased risk of blind box consumption and suicide .
Nowadays, the meaning of "blind box" as a term has expanded from a commodity to a popular marketing strategy, further enhancing consumers' addictive psychology. During repeated spending of money to buy blind boxes, consumers' economic and mental health often deteriorates, and this "psychological addiction" characteristic is similar to gambling.
Photo source丨veer
Study has shown that gambling can cause mental health problems such as anxiety and depression, thereby increasing the risk of suicide [9]. Therefore, future research in should continue to explore the paths and mechanisms of blind boxes and suicide risks, and determine whether blind boxes are related to suicide risks through gambling .
Another important discovery is that the relationship between blind box consumption and suicide risk is gender different. The proportion of female blind box consumers among participants in this study is relatively high, indicating that blind box consumption is different in essence from traditional gambling (the proportion of male consumers in traditional gambling is large). Therefore, it is necessary to explore the blind box consumption type and motivation to explain the potential reasons for this gender difference.
This study investigated the relationship between blind box consumption and suicide risk in young people for the first time. But unfortunately, due to the cross-sectional nature of the data, researchers were unable to determine the causal relationship between the two.
As blind box sales continue to soar and as a popular marketing strategy, the industry has experienced problems of unregulated or insufficient market supervision at present. In the future, more in-depth investigations are needed to explore the internal relationship between blind box consumption, gambling and suicide risks to assist decision makers in determining the appropriate level of supervision and designing relevant regulations. Ultimately promote the healthy development of the blind box industry and ensure the mental health of young people.
References:
[1]. Delfabbro P, Georgiou N, King DL. Measuring Gambling Harm: The Influence of Response Scaling on Estimates and the Distribution of Harm Across PGSI Categories. J Gambl Stud. 2021;37(2):583-598. doi:10.1007/s10899-020-09954-1
[2]. Li WZ, Yang Y, Liu K, et al. FGL2 Prothrombinase contributes to the early stage of coronary microvascular observation through a fibrin-dependent pathway. Int J Cardiol. 2019;274:27-34. doi:10.1016/j.ijcard.2018.09.051
[3]. Zendle D, Cairns P. Video game loop boxes are linked to problem gambling: Results of a large-scale survey [published correction appears in PLoS One. 2019 Mar 14;14(3):e0214167]. PLoS One. 2018;13(11):e0206767. Published 2018 Nov 21. doi:10.1371/journal.pone.0206767
[4]. Brooks GA, Clark L. Associations between loop box use, problematic gaming and gambling, and gambling-related cognitions. Addict Behav. 2019;96:26-34. doi:10.1016/j.addbeh.2019.04.009
[5]. Karlsson A, Håkansson A. Gambling disorder, increased mortality, suicidality, and associated comorbidity: A longitudinal nationwide register study. J Behav Addict. 2018;7(4):1091-1099. doi:10.1556/2006.7.2018.112
[6]. Mallorquí-Bagué N, Mena-Moreno T, Granero R, et al. Suicidal idea and history of suicide attempts in treatment-seeking patients with gambling disorder: The role of emotion dysregulation and high trait impulsivity. J Behav Addict. 2018;7(4):1112-1121. doi:10.1556/2006.7.2018.132
[7]. Andreeva, M. , Information, V. F. A. , Audette-Chapdelaine, S. , Information, V. F. A. , Brodeur, M. , [email protected], et al. Gambling-related completed suitides: a scoping review.
[8]. Duan Y, Xu S, Wang Y, Zhang Y, Wang Y, Chen R. Blind box over-engagement and suicide risk among adolescents and young adults: Results of a large-scale survey. EClinicalMedicine. 2022;51:101575. Published 2022 Jul 18. doi:10.1016/j.eclinm.2022.101575
[9]. Spicer SG, Fullwood C, Close J, Nicklin LL, Lloyd J, Lloyd H. Loot boxes and problem gambling: Investigating the "gateway hypothesis". Addict Behav. 2022;131:107327. doi:10.1016/j.addbeh.2022.107327
ADtaxi ——Recalling "Remembering" Chengche
Editor-in-charge丨Wang Xuening
