Stigma and Purpose in Life in Gambling Disorder: A Mixed-Methods Study With a Gender Perspective

Gambling disorder carries a heavy burden of social stigma that severely impacts recovery and psychological well-being. However, the intersection between discrimination, existential meaning and gender roles within clinical populations remains insufficiently explored. This study analyzed the relationship between perceived stigma and Purpose in Life within a gambling population, adopting a gender perspective, to examine structural asymmetries. Using a mixed-methods design, the study integrates quantitative measures (N = 79; 24.1% women) with qualitative narratives (N = 113; 31% women) from 12 focus groups and an in-depth interview. Data integration revealed three core findings. First, perceived discrimination operates through systemic moral labeling rather than direct clinical severity, driven by the public framing of gambling as a moral vice instead of a medical condition. Second, while stigma directly affects negatively patients' purpose in life (PIL), qualitative narratives highlighted identity reclamation and family restoration as key themes buffering against existential despair. Third, although no statistically significant moderation by gender was observed in the relationship between stigma and existential meaning, women present significantly higher baseline discrimination. Crucially, perceived discrimination fully mediates women's lower baseline PIL, reflecting a qualitative paradox of accumulation involving caregiving obligations, a double moral standard and internalized guilt framed around relieving others of a burden. Therefore, while discrimination undermines existential meaning across all patients, its role as a full mediator for women highlights the urgent need for gender-specific therapeutic spaces to tackle their unique structural burden.