Kounseok Lee

Introduction: Online–offline gambling comparisons rarely distinguish debt occurrence from debt amount. Problem-stage gambling modality and recalled modality pathways were examined in relation to symptom severity and gambling-related debt. Methods: This retrospective cross-sectional study analyzed 2019–2024 intake records from South Korea’s national gambling counseling service. The sample comprised 567 help-seeking individuals meeting DSM-5 criteria for gambling disorder. Regression models examined DSM-5 criterion count, Problem Gambling Severity Index (PGSI) score, any debt, and debt amount among those with debt. Models adjusted for age, sex, assessment year, product group, and legal status. Additional analyses examined modality pathways, recalled age at first gambling, and age-related differences. Results: At the problem stage, 89.8% reported online gambling. Among 553 participants in three modeled pathways, 9.4% were persistent offline, 14.1% migrated online, and 76.5% were persistent online. Fully adjusted models showed no clear online–offline differences in DSM-5 criterion count, PGSI score, or any debt. Among 242 complete cases with debt, adjusted mean debt was twice as high online as offline (ratio 2.00, 95% CI 1.11–3.62). Persistent-online participants also had higher debt than persistent-offline participants (ratio 2.56, 95% CI 1.32–4.95). Online gambling was associated with greater recent gambling intensity. Persistent-online participants reported a younger recalled age at first gambling. An exploratory interaction suggested a larger online–offline debt ratio at older ages. Conclusion: Online gambling was associated with larger debt among participants with debt, despite no clear differences in symptom severity or debt occurrence. Clinical assessment should record debt amount alongside symptom severity and modality history.

Objective: To estimate the prevalence of suicidal ideation among Canadians, identify psychiatric and sociodemographic correlates of past-12-month ideation and its association with community belonging, and compare the out-of-fold predictive performance of logistic regression and random forest models. Method: We analyzed the nationally representative 2022 Mental Health and Access to Care Survey (analytic n = 8,080; weighted population = 25,828,546). Survey-weighted logistic and multinomial regression used the master weight with 1,000 Fay-adjusted bootstrap replicate weights. Five-fold nested cross-validation compared a sociodemographic-plus-psychiatric logistic model, the same model with belonging added, and a random forest, using out-of-fold discrimination, average precision, Brier scores, and grouped permutation importance. Results: Past-12-month suicidal ideation was reported by 3.4% (95% CI, 2.9% to 3.9%) and lifetime-only ideation by 7.4% (95% confidence interval (CI), 6.7% to 8.2%). Independent correlates of past-12-month ideation were major depressive episode (MDE) (adjusted odds ratio (aOR) = 5.80; 95% CI, 3.61 to 9.33), very weak community belonging (aOR = 3.64; 95% CI, 1.88 to 7.04), generalized anxiety disorder (aOR = 2.65; 95% CI, 1.56 to 4.50), bipolar disorder (aOR = 2.43; 95% CI, 1.27 to 4.66), and separation/divorce (aOR = 2.25; 95% CI, 1.22 to 4.17). Adjusted probability rose from 2.0% at very strong to 6.0% at very weak belonging. No interaction was supported. Adding belonging did not improve discrimination (area under the curve (AUC), 0.823 vs. 0.823; difference = 0.000; 95% CI, −0.011 to 0.011); the random forest AUC was 0.843 (difference = 0.020; 95% CI, 0.004 to 0.038). Conclusions: Psychiatric morbidity, separation/divorce, younger age, and very weak community belonging were associated with past-12-month suicidal ideation. Community belonging was independently associated but did not improve cross-validated discrimination, whereas MDE was the most robust correlate.

Objectives: We examined whether work during free time was associated with greater exhaustion among workers with high work-time control. Methods: Wage employees aged 18–64 years in the 2023 (n=22,036) and 2020 (n=23,971) Korean Working Conditions Surveys were analyzed. Four profiles combined work-time control and work during free time. Survey-weighted models estimated differences in a two-item exhaustion score, adjusting for demographic and work factors. The 2023 comparison was primary; the 2020 comparison assessed reproducibility. Results: Among workers with high control, repeated work during free time (unbounded autonomy) was associated with greater exhaustion than rare or no such work (bounded autonomy) in 2023 (β=0.36, 95% CI 0.10 to 0.61) and 2020 (β=0.31, 95% CI 0.02 to 0.59). The interaction with control was not significant in 2023 (P = .600) but was negative in 2020 (P = .008). Sensitivity analyses supported the 2023 association; in 2020, confidence intervals under both weekly-or-more definitions included zero. Unbounded autonomy was also associated with sleep disturbance and work-to-family conflict. Conclusions: Repeated work during free time was associated with greater exhaustion even among workers with high work-time control. Control did not consistently modify this association across waves. These cross-sectional findings support considering work during free time alongside scheduling flexibility.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity, and it frequently persists beyond childhood and adoles...

Introduction: After-hours work-related technology use may erode boundaries between work and private life. We examined whether after-hours technology use was associated with exhaustion through work-to-family interference (WIF), whether the modeled associations differed by gender, and whether men and women had different covariate-standardized outcome levels. Methods: Pooled cross-sectional data were obtained from 56,640 wage workers in the 6th (2020–2021) and 7th (2023) Korean Working Conditions Survey. Primary analyses used wave-specific standardized survey weights, probability-weighted linear regression with HC3 robust standard errors, and 5,000 multiplier-bootstrap replications. Results: After-hours technology use was associated with higher WIF (B = 0.064, 95% CI 0.053–0.074; standardized beta = 0.10) and exhaustion in the total-association model (B = 0.042, 95% CI 0.031–0.052; beta = 0.07). WIF was associated with exhaustion (B = 0.329, 95% CI 0.314–0.344; beta = 0.34), and the remaining direct association was small (B = 0.021; beta = 0.03). The technology-by-gender interactions in the WIF and total-association models and the gender difference in the conditional indirect association met the stated post hoc equivalence criteria; the other path interactions were not statistically significant. Indirect associations were 0.021 (95% CI 0.017–0.025) for men and 0.018 (95% CI 0.014–0.021) for women; the difference was −0.003 (95% CI −0.008 to 0.002). After standardization to a common distribution of measured paid-work characteristics, women had higher exhaustion than men (difference = 0.087, 95% CI 0.066–0.109). Exploratory categorical analyses suggested a localized, non-monotonic gender difference at several-times-per-month use; this pattern was observed in both waves without detectable wave heterogeneity. Discussion: The associations were small in absolute magnitude, and the cross-sectional design precludes causal interpretation.