The Critical Epidemiology of Greed and Mental Health: A systematic review

The Critical Epidemiology of Greed and Mental Health: A systematic review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Critical Epidemiology of Greed and Mental Health: A systematic review Manuel Capella, Nadia Soria, Cristian Montenegro This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8845297/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose Greed´s relevance for understanding economic, political, and cultural processes that determine mental health remains overlooked. This study explores the empirical relationship between greed and mental health through the lenses of Critical Epidemiology. Methods we conducted a systematic review. After identifying a total of 3,657 sources published between 2015 and 2025 (Web of Science, Scopus, PsycINFO, PubMed, Cochrane Library), 72 studies were included. Results The empirical evidence suggests a predominately destructive association between greed and mental health (i.e. life dissatisfaction and unhappiness, potentially harmful individual characteristics, symptoms of addiction involving buying and gambling, and symptoms of depressive mood). Given the inherent design of the research, included studies were mostly individualist and decontextualising, driven by empiricist fetichism; no study appears to have engaged with processes of social determination. Discussion . We propose a critical interpretation of findings to better understand the social determination of unhealthy greedy identity. We argue for a shift towards collaborative, greed-focused deep prevention: a transdisciplinary, intercultural, participatory, politically committed approach that considers the connection of capitalist greed, greedy communities, and greedy individuals. Conclusion Greed is predominantly destructive to health – including mental health. This review contributes to a growing conversation around innovative frameworks to rethink prevention and well-being beyond individual pathology. greed collective mental health critical epidemiology critical psychiatry critical psychology Latin American social medicine Figures Figure 1 Introduction When people want more than they need of a given resource - especially wealth and status – they may be accused of being greedy. The relation between greed and mental health has been theorised from ethical standpoints and explored in scientific studies. Yet a more critical, ecological and robust interpretation of an empirical link is yet to be fully articulated. Advancing such articulation is key to understand how inequality determines health, given that inequality is sustained by a neoliberal ethos of greed that produces “an absurd concentration of private wealth” [ 1 ]. Greed antagonizes an ethos of life , thus impeding comprehensive security for humans and their ecosystems, impeding “a society-nature metabolism that is healthy and protective” [ 1 ]. Importantly, greed relates to what many authors study as commercial determinants of health[ 2 ] – including those which determine mental health problems [ 3 ]. In this paper, we synthesize evidence on the empirical link of greed and mental health, interpreted from critical lenses. To ignite global and local innovative dialogues, we highlight the predominately destructive nature of greed [ 4 , 5 ]; and suggest ways to better understand and prevent it. Although our approach is relatively novel, a concern with greed is far from being new. Philosophies and religions from around the world have discussed greed, including modernist western discourses that shaped the 20th century [ 6 – 8 ]. Through explorations of ecology, economy, politics, ideology, governance, grievances and identity, 21st century greed has been associated to diverse destructive phenomena. For example, climate breakdown [ 9 – 11 ], predatory wars and lethal violence [ 12 , 13 ], opioid epidemics [ 14 ], problems in national health systems [ 15 ], and public health disinformation [ 16 ]. These associations point to greed as a structural and cultural force behind several contemporary global challenges [ 17 ]. It comes with no surprise that epidemiologists critical of greed have framed it as destructive to collective health since the 1970s [ 1 , 18 , 19 ]. As our results will illustrate, addressing the link of greed and mental health may open new territories for future theoretical and applied innovation. Greed and Collective Mental Health Our approach – known as Collective Health, Latin American Critical Epidemiology and Social Medicine - understands health as part of a socially determined process, a dialectical movement with objective and subjective dimensions embodied in practices [ 1 , 18 , 19 ]. A central concept in this tradition is deep prevention , which focuses on preventing the structural roots of suffering. This is pursued by understanding critical processes which occur at three interconnected dimensions: society as a whole (e.g., political economy, dominant culture), specific ways of life of different communities (e.g., shaped by class, gender, ethnicity, and territory), and individual lifestyles [ 1 , 18 , 19 ]. From such an approach, individual distress is an embodiment of the entire process of social determination [ 1 , 18 , 19 ]. We understand collective mental health as an intersubjective expression of such wider, ecological processes, in ways that open space for dialogue with diverse other approaches and theories [ 20 – 22 ]. From such a perspective, greed is both socially determined (i.e. an ethos of greed is learned through socialization, shaped by critical processes) and determining (i.e. ethos of greed embodied in communities and individuals determine unhealthy processes for the greedy, others and nature, while reproducing such ethos itself). Because an ethos of greed is produced in the context of critical processes, it can also be challenged and transformed using relative autonomy [ 1 , 18 , 19 ]. We articulate such approach into an operative definition for the present study: Greed is an embodied, socially determined and socially determining, unsustainable, seemingly insatiable aspiration for wealth, status and other valued and limited resources by an individual or group, which they believe will enhance their wellbeing, often enacted at the expense of others. Our definition is informed by a recent scoping review, englobing some of the more relevant categories identified in such study [ 23 ]. Two categories mention “greed” explicitly - dispositional greed and greed-avoidance – while an important third one “shares some similar qualities to greed”[ 24 ] – materialism (or materialist value orientation). Dispositional greed refers to “an insatiable desire for more income, more possessions, more influence, more power, more sex, more privileges, more of anything good…a strong drive for acquisitiveness with respect to valued outcomes” [ 5 ]. Greed-avoidance refers to a low desire for wealth, material gains and exploitation/manipulation (a facet of honesty-humility personality factor); it can also be framed as an expression of ethical virtue [ 25 ]. Excessive materialism refers “to acquire money and material goods to achieve certain expected psychological benefits, in particular an attractive image, recognition, status, and greater happiness” [ 24 ]. Additionally, other expressions refer to greed implicitly[ 23 ], related to love of money attitudes[ 26 ] and conspicuous consumption – including that associated with luxury [ 27 ]. Critical Epidemiology and empirical evidence Breilh – a seminal author in Critical Epidemiology - opposes hegemonic Cartesian, positivist, functionalist and empiricist epistemologies. Yet he also acknowledges that empirical findings can be “important valid scientific evidence” [ 19 ]. This may include “the review of conventional literature”, which can lead to proper recognition of preconditions for certain harmful epidemiological processes to occur” [ 19 ]. Following Breilh, we acknowledge “the importance of the empirical elements involved as valuable knowledge tools”, as long as we “reinsert them in the complex multidimensional movement that critical epidemiology provides”, [ 19 ]. Importantly, “when we criticize empiricist causal factor logic, we are not implying that causal relations and factors incidence do not exist. What we mean is that these factors are not the exclusive nor the decisive elements of health determinations” [ 19 ]. We value empirical findings yet critique the “central fetichism” of conventional approaches to evidence: disguising social relations that produce health, by focusing on supposedly “objective, calculable, and precise reflex of the true characteristics of health as an empirical construct[ 19 ]”. In contrast, our aim when reviewing published findings is to “reconnect them from the social determination perspective”; disengage them from mechanistic “empiricist linearity”; and “recover their epistemic potentiality”[ 19 ]. Methods We conducted a systematic review [ 28 ]. Our research question was: What is the empirical relationship between greed and mental health? Our secondary sub-questions asked if there is evidence of any aspect of greed that is beneficial to mental health; detrimental to mental health; and if there is any mental health intervention (i.e. promotion, prevention, therapy) that incorporates greed as the main element. Relying on non-greedy/less-greedy subjects as comparison -, we were interested in identifying any type of empirical association between greed and mental health (descriptive & case-based, correlational, casual, none), in any population. Search strategy and databases Searches were conducted in Scopus, Web of Science, PubMed, PsycInfo, Cochrane Library; in September 2024. In all cases, we searched by title, abstract and keywords, adapting this criterion for each database. We approached mental health via lexicon utilized within “critical” frameworks, as well as through lexicon utilized for conventional formulations and diagnoses; and we approached greed based on a previous scooping review [ 23 ]. Such terminology informed our search strategy (Table 1 ). Table 1 Search strategy Block Keywords used #1 (greed OR avarice OR codicia OR avaricia OR “love of money” OR “amor al dinero” OR acquisitiveness OR adquisitividad OR selfish* OR egois* OR egotist* OR pro-self OR “pro self” OR “self-promotion values” OR “valores de auto-promoción” OR “materialistic values” OR “valores materialistas” OR individualism OR individualismo OR luxury OR opulence OR lujo OR opulencia) #2 (“collective mental health” OR “salud mental colectiva” OR “social determinants” OR “commercial determinants” OR “determinantes sociales” OR “determinantes comerciales” OR “determinación social” OR “social determination” OR “critical epidemiology” OR “epidemiología crítica” OR “deep prevention” OR “prevención profunda” OR “critical global health” OR “salud global crítica” OR “critical mental health” OR “salud mental crítica” OR “structural competency” OR “competencia structural” OR “intercultural competency” OR “competencia intercultural” OR “cultural competence” OR “competencia cultural”) (“mental health" OR "salud mental" OR “mental wellbeing” OR “mental well-being” OR “bienestar mental” OR “life satisfaction” OR “satisfacción con la vida” OR “quality of life” OR “calidad de vida” OR depression OR depresión OR anxiety OR ansiedad OR "substance abuse" OR “abuso de sustancias” OR adicción OR addiction OR stress OR estrés OR trauma OR loneliness OR soledad OR psychiatry OR psiquiatría OR “clinical psychology” OR “psicología clínica” OR “health psychology” OR “psicología de la salud”) Search #1 AND #2; and #1 AND #3 We relied on two search strategies to identify studies focused on mental health sources in all databases: search strategy 1 (“critical” mental health literature: blocks #1 AND #2) and search strategy 2 (broader mental health literature: blocks #1 AND #3). We did not conduct reference tracking, prioritizing the most recent publications covering the subject. Additionally, we aimed at conducting manual searches of sources which have such an explicit focus, which lead to no new inclusions. Selection of studies We selected studies based on the following inclusion criteria: studies that were published between 1 January 2015 and 20 September 2024; in English or Spanish; published as articles in journals; that included empirical data associating greed with mental health; with any methodological design (quantitative; qualitative; mix-methods; scooping or systematic reviews). We excluded studies that did not meet such criteria (with the exception of seven studies published between September 2024 and 2025, as will be explain in further paragraphs); this led us to exclude sources that analyze greed or mental health without making any connection (not even weak or indirect) between both, as well as theoretical narrative reviews and essays. We decided to search sources since 2015, considering that the notions of commercial determinants of health had just been introduced a couple of years prior, as well as it being a year that showed an increasing interest in researching greed [ 29 ]. Figure 1 illustrates the procedure. Figure 1 Procedure of the review We identified an aggregate of 3657 results (through search strategies one and two combined); after deleting duplicates, 2061 sources were available for screening. Based on our operative definition of greed and the study´s exclusion criteria, we conducted an automated search of sources that did not mention the terms “greed”, “avarice”, “acquisitiveness”, “motivation”, “values”, “excess”, money” nor “luxury”; such sources were excluded (n = 566). Authors 1 and 2, independently, screened titles and abstracts of the remaining 1495 sources. Authors 1 and 2 included 186 and 70 sources, respectively, and disagreed on the inclusion or exclusion of a combined number of 185 sources; disagreements were settled by the diriment, independent, criteria of the third author. After this, 96 sources were sought for retrieval. Authors 1 and 2 read the full text of these 96 sources, after agreeing to reinforce the strictness of the inclusion criteria regarding the association of greed with mental health. Specifically, by limiting inclusion only to studies that: a) mention greed or avarice explicitly (anywhere in the text), as long as they also mention (anywhere in the text) any broad category for mental health/illness (i.e. health, illness, wellbeing, distress, suffer, satisfaction, happiness, loneliness) or a psychopathological term (i.e. stress, anxiety, depression, addiction); or b) do not mention greed or avarice explicitly, but closely linked variables (i.e. materialism, materialistic values, egoism, love of money, luxury), only if they also mention explicitly a psychopathological term. After such process, authors 1 and 2 held no disagreements, and, after consensus across all three authors, 66 studies were included. In September 2025, the first author conducted an additional search in all databases to explore any updated articles with an explicit focus on greed (keywords “greed” or “avarice”, in English and Spanish, 2024–2025) and included seven additional sources (sequentially: PubMed, 31 hits, 1 included; Scopus, 286 hits, 6 included; WoS, 232 hits, none included after dismissing articles already retrieved from Scopus; PsycInfo and Cochrane Library: 0 hits). Finally, 72 sources were included for review. Data extraction, analysis and synthesis Data extraction and quality/bias assessment was conducted by Author 1 and 2; later, this was consolidated, addressing a few minor disagreements and ambiguities through the diriment criteria of Author 3, and through final consensus. Quality of studies and potential biases was assessed utilizing the checklist from Mixed Methods Appraisal Tool (MMAT) [ 30 ]. Our use of such tool was adjusted to our expertise, our theoretical perspective and the specific aim of the review. All studies met acceptable quality criteria. We present findings through a narrative synthesis[ 31 ], aspiring to be coherent with the perspective of collective health, as well as considering the strengths and limitations of our procedure. Our narration attempts to consider context, study design, and exploration of some significant patterns within and across subgroups of publications; organized in the form of a thematic analysis. Results Greed is predominantly detrimental to mental health, as suggested by diverse studies conducted in their respective cultural contexts (Table 2 ). Table 2 Populations, conceptual focus and type of association Populations Participants from European nations (≥ 21) and United Kingdom (≥ 6); China (≥ 14) and other Asian nations (≥ 9); USA (≥ 12); Latin America (Brazil, Ecuador: ≥2); Australia (≥ 1). Populations of interest included: unspecified (general) population, university students, buyers/consumers – physical and online - with problematic behavior (e.g. impulsive, compulsive, addictive); different studies stratified participants according to class (socio economic status and subjective social class), gender, occupation, age, religion, among other criteria. An absolute minority of studies (≥ 3) did not specify country of participants or reported samples from multiple, unspecified nations. No study approached participants from the perspective of “collective mental health” (nor its inherent critical interculturality). Main focus Psychological processes (33%, N = 24); mental health (24%, N = 17); business & marketing (35%, N = 25); ecology/sustainability (4%, N = 3); neuroscience (3%, N = 2); and philosophy (1%, N = 1). All sources with diverse degree of implications for mental health; relative overlapping of focus (e.g. all studies examined psychological processes, despite their diverse emphases). No study reported “collective mental health” as its explicit focus. Categories of study (greed) : Materialism (f = 26); dispositional greed (f = 13); overconsumption, conspicuous consumption/behavior - includes luxury buying (f = 12); avaricious money attitudes/love of money/affluenza (f = 5); greed/greed avoidance/greed resistance (f = 4). Terms with f = < 2: extrinsic goals/values (e.g. image, financial success, popularity, conformity, hedonism); acquisitiveness; exposure to money; material wellbeing; consumer-oriented-engagement; vulnerability to marketing; economic inequality. No study approached these phenomena explicitly as socially determined embodiments. Categories of study (collective mental health) : Individual wellbeing – e.g., life satisfaction, happiness, psychological and personal wellbeing/distress, quality of life (f = 29); impulsive, compulsive, obsessive and pathological buying-shopping (f = 11); anxiety – status/social (f = 11); anxiety – death/existential (f = 7); depression (f = 6); stress (f = 4); brand addiction/obsession/attachment (f = 4); gambling disorder or problem/maladaptive gambling (f = 3); hoarding behavior (f = 3); self-esteem (f = 3); attachment (N = 3); personality traits – including “big 5” factors (f = 3). Terms with f = < 2: mixed symptoms; negative affect; impulsivity; loss of interest; anhedonia; aggression; anger; mental rumination; autonomy, self-sufficiency; coping strategies; self-control; perceived health; positive mood, health awareness; mindfulness; flow; purpose in life; positive relationships; social dissatisfaction, loneliness/isolation, objectification; prosocial behavior; gratitude; revenge consumption; fear; debt stress; identity diffusion; flourishing/wisdom. No study approached these phenomena explicitly as socially determined embodiments. Type of empirical link Predominantly correlational : “non-randomized quantitative” (86%, N = 62); experimental/causal : “randomized quantitative” (0,11%, N = 8); qualitative – descriptive (3%, N = 2). Several “non-randomized quantitative studies tested models via factor analyses and concluded tendencies (via regression analyses and structural equations); however, authors acknowledge that more robust claims regarding causality would require randomized experiments and representative probabilistic samples. Randomized quantitative studies mostly focused on psychological processes (although they also included two articles interested in marketing & business and one interested in ecology/sustainability). Qualitative studies focused on business & marketing. No study explicitly approached the link of greed and mental health as dialectical. Note : classifications are relative, based on what we consider the most salient/declared operative terms; interests in diverse populations, concepts and empirical designs occasionally overlap. As reported in Table 3 , greed seems associated to diverse expressions of affected mental health – what we interpret as individual embodiments. While this is true, mere presence or absence of individual greed does not necessarily predict mental health problems by itself. One example, among many others, is research in Bangladesh that found how self-control played a more important role than greed in predicting high levels of stress [ 32 ]. The role of primary socialization in the development of allegedly “individual” characteristics and embodiments is also important to consider: plausibly, greed is first learned in families when children are as young as 4–6 years old (with secondary socialization expected to shape identity in further years); in some European contexts, maternal anxiety and negative affect may be associated to such early learning[ 33 ]. If we accept the thesis that greed is, fundamentally, learned through interactions in context, we must read empirical findings as referring to context-dependent processes. Table 3 Greed and mental health: individual embodiments Dissatisfaction and unhappiness Greed can lead to marginal and relative individual satisfaction for some people in certain situations, such as accomplishing envied goals [ 34 ]; enjoying wellbeing if economically able to afford luxury [ 35 ]; obtaining benefits from using people (e.g. friends) instrumentally [ 36 ] and feeling congruent with greedy family values and subjective past values [ 37 , 38 ]. In contrast with these minoritarian examples, greed is predominately associated, not only to planetary ill-health via ecologically destructive overconsumption [ 39 ], but to the dissatisfaction and unhappiness of greedy individuals themselves. There is evidence of this in multiple studies that measured their life dissatisfaction [ 34 , 37 , 38 , 40 – 47 ] and unhappiness [ 48 – 55 ]. Potentially harmful individual characteristics Greed is associated with individual characteristics that imply potential harms for mental health: high neuroticism, low conscientiousness, low agreeableness, [ 56 ]; and malicious envy [ 34 ]. In China, greed was found to be associated with negative psychopathology , including “ mixed symptoms…loss of interest, and negative affect” [ 57 ]; greed correlated positively with aggression (reactive and proactive; physical, verbal, indirect or driven by anger) as well as extrinsic motivation and compensation; and correlated negatively with healthy social relations, autonomy and purpose in life. In the USA, a study informed by an Aristotelian perspective concluded that greed avoidance – alongside other virtues - was predicted by wisdom (cognitive, reflective and compassionate qualities to achieve common good), and that such wisdom led to flourishing: self-acceptance, mastery, purpose in life, and personal growth [ 25 ]. In contrast, the greedy individual can have limited empathy and moral reasoning [ 58 ]. Greed´s neurological substrates are linked to impulsiveness, reward and satisfaction – framed both as traits and risk factors [ 57 , 59 ]. Greed is also associated with loneliness and dissatisfaction with certain relationships [ 36 ]. Symptoms of depression Evidence focused on symptoms of depressive mood are relatively contradictory. Studies suggest that greed has a positive correlation with depression among specific Chinese youth [ 57 ]; a negative correlation with depression among specific youth from the USA – only if they perceived to be congruent with the greedy values of their family [ 38 ]; and that greed can have a similar effects in some adults in Brazil, regardless if they report symptoms of depression - as well as anxiety or stress - or not [ 42 ]. Greed among specific young adults in the USA can indeed be a risk factor for depression (as well as for other related symptoms such as low self-esteem and obsessive-compulsive tendencies) [ 60 ]; authors of the study suggest that such experiences may also be associated with some risks for addiction to shopping of gambling (see “symptoms of addiction”, below in this table). A study from Belgium concluded that problems in identity formation were associated with higher tendency towards depression among adult buyers [ 61 ]; a study from Australia showed how depression did not predict the severity of buying disorder [ 62 ]; while there is evidence that greed – but not anhedonia - can predict problematic gambling [ 63 ]. Symptoms of addiction Problematic gambling. Problematic gambling seems to be associated with dispositional greed, as analyzed in Netherlands and UK: greedy gamblers – regardless of their level of impulsiveness - showed more cognitive distortions leading to irrational risks- taking and feeling unable to stop [ 64 ]. Similarly, in a USA-based study concluded that greed mediated severity of problematic gambling [ 63 ]. Problematic buying. Compulsive buying can be associated to hedonism and goals linked to material success and social image, little care for others, high neuroticism, low responsibility and agreeableness, and with a tendency towards passive coping strategies [ 56 , 65 ] [ 66 ].; with materialism, increased psychological distress (symptoms of anxiety, depression and obsession-compulsion) and decreased subjective wellbeing (self-esteem, life satisfaction and optimism) [ 67 ]; and with cognitive biases, materialism and psychological distress [ 68 ]. Personality traits can be important mediators (see “potentially harmful individual characteristics”, in this table): there seems to be a link between dark traits (narcissism, machiavelism psychopathy) and disvalues consistent with deadly sins (including greed); importantly, high conscientiousness, agreeableness and openness can be protective factors [ 66 ]. Insecure patterns of attachment have been associated with greedy shopping as well [ 39 ]. In some cases, research focused on greedy shopping of luxury , mostly approached from a marketing perspective; for example, we know that some individuals feeling fear – as well as anxiety, low self-control and low self – efficacy – seek emotional compensation via excessive luxury buying [ 101 ]. Although individualistic in their approach, some studies do suggest the importance of considering social context. In China, for example, compulsive buying can be present in both men and women, yet the later shop more, with mood compensation being a more powerful mediator for them [ 68 ]; such gender difference in prevalence was also observed in Spain [ 69 ]. Love of money is influential in how attachment produces ethical behavior in both China and France; yet, unlike Chinese teenagers, French adolescents ´s attachment to parents was associated with less dishonesty, but attachment to peers was linked to more dishonesty [ 70 ]. Among Latino families in the USA, changes in income, parental influence and educational level can decrease materialism and increase life satisfaction.[ 46 ] A study found that luxury consumption was associated with high subjective wellbeing (e.g. self-esteem, social status, accomplishment, associated with internal goals) for Chinese, but not Portuguese, participants; interpretations include the role of living costs and guilt due to status-driven overspending [ 35 ]. In USA and China, participants increased their luxury consumption even when reporting higher stress due to debt [ 71 ]; also, Chinese participants high in self-objectification (i.e. basing their identity in how others perceive their status) engaged more in luxury buying – specially of products relevant to their appearance [ 72 ]. Religion is another example of the importance of cultural context. For example, a Pakistani study concluded that Islamic participants – who also showed high self-esteem – tended to be less materialistic [ 73 ]. Existential anxiety and greedy identity Existential anxiety may appear when individuals remind their identity as mortal beings ; sometimes, it is studied as death anxiety or fear of death. The covid-19 pandemic (2019–2023) is a relevant context to understand how existential anxiety may be linked to greed – as explored in studies from, mostly, USA and UK. Some participants – form USA and Ecuador - sought compensatory emotional satisfaction via over-consumption[ 74 ]; others increased materialism, not due to the threat of death itself, but influenced by stress and media consumption (see section “Marketing, social media and greedy identity”) leading to negative affect, anxiety and social isolation [ 75 ]; while isolation increased luxury buying for some (driven by aspirational status), existential anxiety and social capital determined how this impacted their subjective wellbeing [ 76 ]; participants who were greedy, egoist, narcissist and justifying of the social system donated more money – interpreted as a materialistic strategy to reduce existential anxiety, feel morally good about themselves, and display power. [ 77 ]; for some workers, existential anxiety increased susceptibility to the effects of their workplace´s greed, producing emotions of shame [ 78 ]. Overall, evidence regarding existential anxiety and the formation of greedy identity is relatively contradictory. One experiment with students conduced in Europe suggests that existential anxiety increases greed (i.e. luxury buying) [ 79 ]; while a different experiment with students conducted in China suggests that it decreases greed (i.e., less love of money and more prosocial spending) [ 80 ]. In the latter study, when reminded of their own death, less spiritual subjects shared their money more. For some experimental subjects from Poland and the USA, thinking about money decreased their existential anxiety; importantly – and stressing the key role of status - the more a subject linked their existential value to their subjective socio-economic status, the more this effect was observed [ 81 ]. Status anxiety and greedy identity As suggested in previously reported studies, status anxiety is key to understanding some manifestations of greed. Status anxiety may appear when individuals think of their identity as being inferior to that of others , via a process of social comparison; sometimes, it is studied as social anxiety. In China, for example, a study found that social comparison and subjective social class determined participant´s reports of status anxiety – which itself predicted greedy luxury buying with risks for both mental health and ecological sustainability [ 27 ]. Social comparison – an inherently interactional processes that may lead to status anxiety - is shaped by both individual variability and economic inequality. An example of the first: among participants from China and USA, narcissist individual traits mediated how they engaged in social comparison [ 82 ]. Two examples of the later: in perceived conditions of increased economic inequality, status consumption – mediated by status anxiety – tends to increase as well [ 83 ]; moreover, as concluded in a Icelandic longitudinal study, participants with lower subjective social class were more likely to be materialistic and report less well-being – but their status anxiety decreased (and their wellbeing decreased) when the country reduced economic inequality [ 84 ]. As suggested in a European study on problematic buying, psychological strategies to deal with status anxiety may be key in the formation of greedy identity. Participants with more identity diffusion – difficulties to define who they are – can be more accepting of materialist values and buy excessive material commodities as a compensatory strategy of identity substitution [ 61 , 85 ]. However, such compensation leads to negative emotions – even potential depression; still longing to define their identity, subjects then increase their excessive shopping as a mood compensation strategy; such an unhealthy compensation sustains pathological buying and hoarding. Marketing, social media and greedy identity Marketing strategies design plenty of mass media content which can shape greedy identity. Marketing that promotes consumerism online can diminish subjective wellbeing and increase excessive spending, an effect mediated by social comparison and moderated by materialist values [ 86 ]. Marketing strategies can rely on social comparison processes by specific subjects – linked to fear, need for safety, status anxiety and potential identity substitution -, framing such consumers as vulnerable to marketing [ 87 ]; some of these consumers may feel that they improve their personality via luxury consumption [ 88 ]. For some people, consuming material commodities can reduce fear, provide safety, and thus increase – at least temporarily, their subjective satisfaction [ 89 ].In such context, marketing practices can lead to potentially addictive consumption, such as “brand attachment”[ 90 ] or “brand addiction” that can themselves lead to hoarding and deteriorate social relationships[ 91 ] – even if shoppers experience relative and marginal satisfaction [ 92 ]. Social media is a digital field in which both marketing and organic content circulates. For some people, materialist values can predict higher stress and rumination after consuming social media content [ 93 ]. Unlike downward comparison, upward comparison (comparing when exposed to online images of wealth) can increase conspicuous consumption; greed – alongside materialism, need for status, tendency toward social comparison – plays a pivotal role as moderator [ 94 ]. Greed can impact digital hoarding behavior among social media users, as it moderates the effect of discarding difficulty; the link between technostress, digital withholding and anticipated regret; and the link between digital withholding and perceived materialism [ 95 , 96 ]. Chinese studies conclude that online upward social comparison (comparing oneself with others of higher status) can predict fear of missing out and hoarding, an effect mediated by dispositional greed [ 97 ]; and that social media consumption among subjects with low self-acceptance reduced self-control, which itself increased greed [ 98 ]. Discussion Greed is predominately associated with dissatisfaction and unhappiness; and several studies suggest a link to what conventional epidemiologists would frame as mental health risks (e.g. potentially harmful individual characteristics, impacting social relationships and purpose in life; behavioral addictions such as gambling and buying, including luxury buying; and, in some cases, depressive mood). This is consistent with previous reviews on the negative effect of dispositional greed and excessive materialistic values [ 2 , 4 , 5 , 23 , 24 ]. The reviewed evidence, however, has epistemological limitations, as it tends to reproduce empiricist fetichism and to focus almost exclusively on the individual dimension. None of the reviewed studies analyzed critical processes of social determination. Following Breilh, we suggest that the studies’ valuable findings need to be interpretated from the perspective of Critical Epidemiology, as to recover their “epistemic potentiality”. The social determination of greedy identity We believe that focusing on the formation of greedy identity best enables epistemic possibilities to understand social determination, as it refers to a sociopsychological process, rather than as a sum of allegedly stable, internal, objectively measurable individual variables (Table 4 ). Table 4 The social determination of greedy identity Capitalist greed None of the reviewed studies explicitly analyzed capitalist greed. Yet capitalism constitutes the macro-social cultural roots of contemporary “ethos of greed”. Such capitalist greed leads to exacerbated economic inequality and unsustainable overproduction and overconsumption; it also subsumes economic practices in cyberspace, including marketing practices and the production of particular social media content that may promote the formation of greedy identity. There is a fundamental contradiction : capitalist greed clashes with people´s health [ 19 ] – including their mental health (and how it relates to communities and nature). A revealing example of this are marketing practices that frame “brand addiction” as potentially beneficial and persuade consumers that luxury consumption is a mean for self-improvement. In its most individualistic and alienating iterations (i.e. neoliberal governance) such contradiction intensifies. Within fields conventionally associated to “mental health”, capitalist greed may prioritize profits for pharmaceutical corporations; publishers of diagnostic manuals, test and self-improvement content; professional training and practice; corporation that sell excessive, opulent individualistic satisfaction; etc. Greedy communities Capitalist greed subsumes the way of life of particular communities in context; based on class, gender, ethnicity, religion/spirituality and territory. None of the reviewed studies explicitly analyzed community embodiments of capitalist greed; however, some evidence included relevant analysis regarding: - Class. Subjective social class and social comparison reported by individuals (which, we speculate theoretically, is constructed through community interactions) may lead to status anxiety and greed (which is acted upon as part of communities, as well). In some contexts, for communities perceived as being of “lower” class, status anxiety and greed may decrease when public policy reduces nation-level economic inequality (coinciding with elite communities experiencing lower relative well-being). Although populations that consume luxury were of interest for some studies, no research focused explicitly on elite communities. - Gender . Culturally learned gender roles result in different ways of embodying greed (e.g. some women shop more, while some men gamble and drink alcohol more; some women may rely on emotional compensation more). - Religion/spirituality . In some contexts, being religious can reduce greed; in others, religion seems less influential; and spiritual subjects can even be greedier than non-spiritual subjects in certain situations. - Cyberspace can be a territory with content that may promote the formation of greedy communities. Greedy subjects While some greedy subjects may experience satisfaction, this seems to be marginal, as unhappiness and dissatisfaction with life prevail. Existential anxiety in some cases, and status anxiety (via social comparison) more commonly, can lead to the formation of greedy identity (conditioned, we speculate theoretically, by how greedy or not their communities of belonging are). Greedy identity can harm immediate social relationships and alienate people from their purpose in life. Contributors to such unhealthy process may include: fear; need for safety; low-self-control; high stress; dark traits (psychopathy, narcissism, machiavelism); high neuroticism, low conscientiousness, low agreeableness, low openness; low greed-avoidance; malicious envy; negative affect; loss of interest; aggression; extrinsic motivation and compensation; low autonomy; scant wisdom (and thus, decreased self-acceptance, mastery and personal growth); low empathy and moral reasoning; impulsiveness and high need for reward and satisfaction; and loneliness. In some cases, individual embodiments can manifest as symptoms of behavioral addiction (e.g. to buying; to gambling) and depressive mood. Subjects that embody a greedy identity deteriorate their own wellbeing and harm that of others (as well as planetary health, via overconsumption). In most contexts, greedy communities and subjects embody the contradictions of an unhealthy society fueled by capitalist greed. This is not a mere problem of personal “satisfaction”, but of a socially produced destructive process: an ethos of greed constrains our sense of identity to that of unhealthy, unsustainable, competitive consumers and accumulators of wealth and status 1 . It is in such a context that we interpret the existence of sociopsychological problems of identity diffusion and substitution [ 61 , 85 ], linked with self-objectification [ 72 ]. The social determination of greedy identity produces many of the unhealthy phenomena reviewed in our study; as well as other excluded from the review, such as DSM-5´s socially aversive personality psychopathology [ 99 ], compensatory short-term pride [117] – and diminished empathy and moral reasoning, increased aggression, and cognitive justifications of inequality and domination [ 2 ]. Different than self-interest – present in all of us in one way or another [116] - greedy identity is fundamentally destructive to most humans and planetary health. We agree with marketing academics in the need for regulations to prevent idealized aspirational models [ 90 ]. We strongly disagree with them when they speculate that brand addiction may be a “healthy addiction”[ 92 ] or when they promote it as mean for “personality improvement via ownership and consumption of luxury items”[ 88 ]. The particular dimension is key to understanding how communities accept or challenge greed. This is because community provides identity: “lived experience, something which gives meaning to ourselves and gives us an understanding of others” [ 100 ]. Communities around class, gender, religion/spirituality, territory (including cyberspace communities) and ethnicity may organize spaces to talk about greed; the harmful exploitation of community-specific marketing vulnerabilities and more existential and spiritual ideas of what constitutes wisdom and good life (and a good death) – rooted in both western thought [ 25 ] and indigenous thought, including traditions from the Global South [ 19 ]. We suggest that elites need to be a pivotal part of the discussion [ 19 , 101 ]; this is because their greed plays a significant role in massive societal suffering in diverse contexts, as well for wider planetary health. The deep prevention of greed Initiatives for the deep prevention of greed seem absent from the review literature. Yet communities and subjects do have relative power to advance non-greedy lifestyles, cultures and economic-political systems [ 1 , 18 , 19 ]; focusing on the three dialectically connected dimensions presented in Table 4 . Thus, building an ethos of life that enables safety, pleasure, spirituality and vital energy in ways that are inherently connected to ecologically sustainability [ 1 , 19 ]. In such context, “solidarity-based modes of living emerge to achieve full life in individuals -with their individual phenotypes, genotypes, psychic profiles, and a proactive and hopeful spirituality- in specific scenarios of individual reproduction [ 1 ]. A few documented experiences – albeit not rooted in Critical Epidemiology - suggest that valuable actions may include reducing social anxiety [118]; and practice mindfulness to reduce greed for money [106].Advancing an ethos of life that opposes greed requires ongoing collective awareness [ 1 , 19 ]: examining greed in relation to work conditions; consumption patterns; community organization and support; cultural-spiritual power to build sovereignty and emancipation; and society-nature metabolism (quality and sustainability our ecological link with nature). It is possible to form non-greedy, or at least less-greedy, identities. For example, via wiser social comparison (e.g. downwards comparison, as well as reflections around class consciousness and ecological sustainability); consumption and production; fostering solidarity; engaging with media content and marketing more critically; and overall protecting collective health, increasing corporate social responsibility, decreasing corruption and strengthening justice and peace [ 24 ].[ 20 – 22 ] [ 102 ]. While deep prevention seems important across the entire lifespan, we suggest that adolescence and young adulthood are key moments to engage with it. As preliminary prompts for action, we suggest asking problematizing questions : How does your greed (and that of your communities) impact on others? How does other´s greed impact on you (and your communities)? Analyses of context and power are essential: which meanings of greed, linked to whose identity, greed for what, and affecting which others. Limitations and further research Our study has limitations. Conventional systematic reviews acritical of empiricist fetichism would have displayed more precise and systematized quantification; while more radical counter-hegemonic qualitative approaches would have problematized scientific evidence further than we did. Reflexive of this, we argue for future intercultural and transdisciplinary epistemic dialogue. This includes – but is not limited to – voices and participation coming from indigenous wisdom, communities most affected by greed, elite communities, and diverse critical academics and professionals from different fields and perspectives. Our review could also have expanded more on how geopolitical contexts shape knowledge; reviewed studies probably represent the dominant values of specific societies and researchers [116, 120]. Further research is needed. For example, to understand how greed sustains inequality in specific contexts, and how this may be related to mental health. There seems to not be a direct link between national-level economic inequality and mental health “outcomes”, but such inequality interacts with other so-called “determinants” such as poverty and inflation[ 103 ]. We need complex and situated research around such thesis, which considers the role of greed in dialectical – instead of linear – contextualized processes. We also need to address the core political problem of power and normativity: who gets to say what is “normal” or “excessive” – including who is greedy or not, and if greed is “good” or “bad” [116, 121–123]. We can take inspiration from classic critical arguments, while advancing original innovations [ 6 , 7 , 104 , 105 ]. We suggest the need for a more developed theoretical understanding of the social determination of greedy identity; more critical, complex, and situated analyses; a better understanding of values of solidarity and life; and more profound engagements with communities to advance the deep prevention of greed. Conclusion Greed is predominantly destructive to collective mental health. Guided by Critical Epidemiology, we provide an interpretation that values scientific findings yet poses a relative problematization of empiricist fetichism. Given the design inherent to our research, reviewed evidence was mostly produced via correlations and structural equation models, followed in frequency by experimental approaches; these relied on individualistic and decontextualized epistemic traditions, with no analytic consideration of the critical processes that socially determine mental health. In contrast, we propose an interpretation of the valuable findings identified in scientific literature through a focus on the social determination of greedy identity (i.e. considering the dialectical, critical and ecological connection of capitalist greed, greedy communities and greedy subjects). Individuals may embody such process in the form of dissatisfaction and unhappiness, potentially harmful characteristics, as well as symptoms of addiction (i.e. to shopping, including luxury buying; to gambling) and depressive mood. Our findings open possibilities for future research and action, which require collaborative efforts to rethink mental health as a socially produced process rather than as a sum of individual factors and outcomes. Declarations The authors declare no formal conflict of interest; they do declare holding ethical-political positions critical of greed. The study was supported by the universities that employed authors between 2024–2026, in the form of paid hours to conduct research. Given its lack of direct contact with human subjects, the study did not require formal ethical approval; all efforts were made to engage with ethical practices during the review of the literature. All sources utilized for the review are available in their respective journals/databases. Authors’ contribution was as follows. Author 1 : Conceptualization, theoretical framework development and study design; data gathering and analysis; interpretation of results; critical revision of intellectual content; writing the original manuscript, reviewing and editing; final revision and approval of the paper. Author 2 : data gathering and analysis; final revision and approval of the paper. Author 3 : data gathering (solving inclusion/exclusion discrepancies); critical revision of intellectual content; final revision and approval of the paper. Author Contribution Authors’ contribution was as follows. *M.C:* Conceptualization, theoretical framework development and study design; data gathering and analysis; interpretation of results; critical revision of intellectual content; writing the original manuscript, reviewing and editing; final revision and approval of the paper. *N.S.* : data gathering and analysis; final revision and approval of the paper. *C.M.:* Solving inclusion/exclusion discrepancies; critical revision of intellectual content; final revision and approval of the paper. Data Availability All sources utilized for the review are available in their respective journals/databases References Breilh J (2023) The social determination of health and the transformation of rights and ethics: A meta-critical methodology for responsible and reparative science. 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Nature 649:926–937. https://doi.org/10.1038/s41586-025-09797-z Martín-Baró I (1994) Writings for a Liberation Psychology. Harvard University Press, Cambridge, MA Fanon F (2004) The Wretched of the Earth. Grove, New York Footnotes Evidently, an ethos of greed also plays a role within several political systems that critique capitalism; inequality, existential anxiety and social anxiety do exist in such contexts. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8845297","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":605501515,"identity":"467c9de0-7ec6-4a28-8a23-0e83557e8e73","order_by":0,"name":"Manuel Capella","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAzElEQVRIiWNgGAWjYNCCAgsGfgiLmVgtBhIMkg0kazE4QKwW3fbDzx58MJCQN76R/EyCocI6sUEixwCvFrMzaeaGMwwkDLfdSDOTYDiTToSWGwxm0jwGEozbbuSwSTC2HSZGC/s36T8GEvabZ4C0/CNKC4+ZNND7iRskQFoaiNFyJqfcsMdAInnGmWfGFgnH0o3beJ4V4Ndy/Pi2Bz8qbGz725Mf3vhQYy3bz568Aa8WIGBDMBPAXA78DkPVAgHsDwhpGQWjYBSMgpEFAAFlQOly+U0VAAAAAElFTkSuQmCC","orcid":"","institution":"Catholic University of Uruguay","correspondingAuthor":true,"prefix":"","firstName":"Manuel","middleName":"","lastName":"Capella","suffix":""},{"id":605501517,"identity":"b9940162-8bb4-4dcd-9371-b2c3a3c7d6cc","order_by":1,"name":"Nadia Soria","email":"","orcid":"","institution":"University of Guayaquil","correspondingAuthor":false,"prefix":"","firstName":"Nadia","middleName":"","lastName":"Soria","suffix":""},{"id":605501518,"identity":"86b75115-8436-4c06-bda8-cbbf65ee0c0e","order_by":2,"name":"Cristian Montenegro","email":"","orcid":"","institution":"King's College London","correspondingAuthor":false,"prefix":"","firstName":"Cristian","middleName":"","lastName":"Montenegro","suffix":""}],"badges":[],"createdAt":"2026-02-10 21:23:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8845297/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8845297/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107283531,"identity":"833716bf-a232-4b23-bd51-8b57535eeea0","added_by":"auto","created_at":"2026-04-20 03:07:59","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":44366,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eProcedure of the review\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8845297/v1/80184d0b9e16c1d69ea31e05.png"},{"id":107483496,"identity":"e06534f0-d842-4b35-a218-8e5776c7c884","added_by":"auto","created_at":"2026-04-22 02:27:52","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1673272,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8845297/v1/e186b1fa-1d17-4789-ae3a-86e5abf11681.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Critical Epidemiology of Greed and Mental Health: A systematic review","fulltext":[{"header":"Introduction","content":"\u003cp\u003eWhen people want more than they need of a given resource - especially wealth and status \u0026ndash; they may be accused of being greedy. The relation between greed and mental health has been theorised from ethical standpoints and explored in scientific studies. Yet a more critical, ecological and robust interpretation of an empirical link is yet to be fully articulated. Advancing such articulation is key to understand how inequality determines health, given that inequality is sustained by a neoliberal \u003cem\u003eethos of greed\u003c/em\u003e that produces \u0026ldquo;an absurd concentration of private wealth\u0026rdquo; [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Greed antagonizes an \u003cem\u003eethos of life\u003c/em\u003e, thus impeding comprehensive security for humans and their ecosystems, impeding \u0026ldquo;a society-nature metabolism that is healthy and protective\u0026rdquo; [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Importantly, greed relates to what many authors study as commercial determinants of health[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] \u0026ndash; including those which determine mental health problems [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In this paper, we synthesize evidence on the empirical link of greed and mental health, interpreted from critical lenses. To ignite global and local innovative dialogues, we highlight the predominately destructive nature of greed [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]; and suggest ways to better understand and prevent it.\u003c/p\u003e\u003cp\u003eAlthough our approach is relatively novel, a concern with greed is far from being new. Philosophies and religions from around the world have discussed greed, including modernist western discourses that shaped the 20th century [\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Through explorations of ecology, economy, politics, ideology, governance, grievances and identity, 21st century greed has been associated to diverse destructive phenomena. For example, climate breakdown [\u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], predatory wars and lethal violence [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], opioid epidemics [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], problems in national health systems [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e], and public health disinformation [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. These associations point to greed as a structural and cultural force behind several contemporary global challenges [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. It comes with no surprise that epidemiologists critical of greed have framed it as destructive to collective health since the 1970s [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. As our results will illustrate, addressing the link of greed and mental health may open new territories for future theoretical and applied innovation.\u003c/p\u003e\n\u003ch3\u003eGreed and Collective Mental Health\u003c/h3\u003e\n\u003cp\u003eOur approach \u0026ndash; known as Collective Health, Latin American Critical Epidemiology and Social Medicine - understands health as part of a socially determined process, a dialectical movement with objective and subjective dimensions embodied in practices [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. A central concept in this tradition is \u003cem\u003edeep prevention\u003c/em\u003e, which focuses on preventing the structural roots of suffering. This is pursued by understanding critical processes which occur at three interconnected dimensions: society as a whole (e.g., political economy, dominant culture), specific ways of life of different communities (e.g., shaped by class, gender, ethnicity, and territory), and individual lifestyles [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. From such an approach, individual distress is an \u003cem\u003eembodiment\u003c/em\u003e of the entire process of social determination [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. We understand collective mental health as an intersubjective expression of such wider, ecological processes, in ways that open space for dialogue with diverse other approaches and theories [\u003cspan additionalcitationids=\"CR21\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFrom such a perspective, greed is both socially determined (i.e. an ethos of greed is learned through socialization, shaped by critical processes) and determining (i.e. ethos of greed embodied in communities and individuals determine unhealthy processes for the greedy, others and nature, while reproducing such ethos itself). Because an ethos of greed is produced in the context of critical processes, it can also be challenged and transformed using relative autonomy [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. We articulate such approach into an operative definition for the present study:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eGreed is an embodied, socially determined and socially determining, unsustainable, seemingly insatiable aspiration for wealth, status and other valued and limited resources by an individual or group, which they believe will enhance their wellbeing, often enacted at the expense of others.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eOur definition is informed by a recent scoping review, englobing some of the more relevant categories identified in such study [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Two categories mention \u0026ldquo;greed\u0026rdquo; explicitly - \u003cem\u003edispositional greed\u003c/em\u003e and \u003cem\u003egreed-avoidance\u003c/em\u003e \u0026ndash; while an important third one \u0026ldquo;shares some similar qualities to greed\u0026rdquo;[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] \u0026ndash; \u003cem\u003ematerialism\u003c/em\u003e (or materialist value orientation). Dispositional greed refers to \u0026ldquo;an insatiable desire for more income, more possessions, more influence, more power, more sex, more privileges, more of anything good\u0026hellip;a strong drive for acquisitiveness with respect to valued outcomes\u0026rdquo; [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Greed-avoidance refers to a low desire for wealth, material gains and exploitation/manipulation (a facet of honesty-humility personality factor); it can also be framed as an expression of ethical virtue [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Excessive materialism refers \u0026ldquo;to acquire money and material goods to achieve certain expected psychological benefits, in particular an attractive image, recognition, status, and greater happiness\u0026rdquo; [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Additionally, other expressions refer to greed implicitly[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], related to \u003cem\u003elove of money\u003c/em\u003e attitudes[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] and \u003cem\u003econspicuous consumption \u0026ndash;\u003c/em\u003e including that associated with \u003cem\u003eluxury\u003c/em\u003e [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eCritical Epidemiology and empirical evidence\u003c/h3\u003e\n\u003cp\u003eBreilh \u0026ndash; a seminal author in Critical Epidemiology - opposes hegemonic Cartesian, positivist, functionalist and empiricist epistemologies. Yet he also acknowledges that empirical findings can be \u0026ldquo;important valid scientific evidence\u0026rdquo; [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. This may include \u0026ldquo;the review of conventional literature\u0026rdquo;, which can lead to proper recognition of preconditions for certain harmful epidemiological processes to occur\u0026rdquo; [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Following Breilh, we acknowledge \u0026ldquo;the importance of the empirical elements involved as valuable knowledge tools\u0026rdquo;, as long as we \u0026ldquo;reinsert them in the complex multidimensional movement that critical epidemiology provides\u0026rdquo;, [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eImportantly, \u0026ldquo;when we criticize empiricist causal factor logic, we are not implying that causal relations and factors incidence do not exist. What we mean is that these factors are not the exclusive nor the decisive elements of health determinations\u0026rdquo; [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. We value empirical findings yet critique the \u0026ldquo;central fetichism\u0026rdquo; of conventional approaches to evidence: disguising social relations that produce health, by focusing on supposedly \u0026ldquo;objective, calculable, and precise reflex of the true characteristics of health as an empirical construct[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u0026rdquo;. In contrast, our aim when reviewing published findings is to \u0026ldquo;reconnect them from the social determination perspective\u0026rdquo;; disengage them from mechanistic \u0026ldquo;empiricist linearity\u0026rdquo;; and \u0026ldquo;recover their epistemic potentiality\u0026rdquo;[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e "},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003cp\u003eWe conducted a systematic review [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Our research question was: What is the empirical relationship between greed and mental health? Our secondary sub-questions asked if there is evidence of any aspect of greed that is beneficial to mental health; detrimental to mental health; and if there is any mental health intervention (i.e. promotion, prevention, therapy) that incorporates greed as the main element. Relying on non-greedy/less-greedy subjects as comparison -, we were interested in identifying any type of empirical association between greed and mental health (descriptive \u0026amp; case-based, correlational, casual, none), in any population.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSearch strategy and databases\u003c/h3\u003e\n\u003cp\u003eSearches were conducted in Scopus, Web of Science, PubMed, PsycInfo, Cochrane Library; in September 2024. In all cases, we searched by title, abstract and keywords, adapting this criterion for each database. We approached mental health via lexicon utilized within \u0026ldquo;critical\u0026rdquo; frameworks, as well as through lexicon utilized for conventional formulations and diagnoses; and we approached greed based on a previous scooping review [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Such terminology informed our search strategy (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eSearch strategy\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlock\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKeywords used\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e#1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(greed OR avarice OR codicia OR avaricia OR \u0026ldquo;love of money\u0026rdquo; OR \u0026ldquo;amor al dinero\u0026rdquo; OR acquisitiveness OR adquisitividad OR selfish* OR egois* OR egotist* OR pro-self OR \u0026ldquo;pro self\u0026rdquo; OR \u0026ldquo;self-promotion values\u0026rdquo; OR \u0026ldquo;valores de auto-promoci\u0026oacute;n\u0026rdquo; OR \u0026ldquo;materialistic values\u0026rdquo; OR \u0026ldquo;valores materialistas\u0026rdquo; OR individualism OR individualismo OR luxury OR opulence OR lujo OR opulencia)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e#2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(\u0026ldquo;collective mental health\u0026rdquo; OR \u0026ldquo;salud mental colectiva\u0026rdquo; OR \u0026ldquo;social determinants\u0026rdquo; OR \u0026ldquo;commercial determinants\u0026rdquo; OR \u0026ldquo;determinantes sociales\u0026rdquo; OR \u0026ldquo;determinantes comerciales\u0026rdquo; OR \u0026ldquo;determinaci\u0026oacute;n social\u0026rdquo; OR \u0026ldquo;social determination\u0026rdquo; OR \u0026ldquo;critical epidemiology\u0026rdquo; OR \u0026ldquo;epidemiolog\u0026iacute;a cr\u0026iacute;tica\u0026rdquo; OR \u0026ldquo;deep prevention\u0026rdquo; OR \u0026ldquo;prevenci\u0026oacute;n profunda\u0026rdquo; OR \u0026ldquo;critical global health\u0026rdquo; OR \u0026ldquo;salud global cr\u0026iacute;tica\u0026rdquo; OR \u0026ldquo;critical mental health\u0026rdquo; OR \u0026ldquo;salud mental cr\u0026iacute;tica\u0026rdquo; OR \u0026ldquo;structural competency\u0026rdquo; OR \u0026ldquo;competencia structural\u0026rdquo; OR \u0026ldquo;intercultural competency\u0026rdquo; OR \u0026ldquo;competencia intercultural\u0026rdquo; OR \u0026ldquo;cultural competence\u0026rdquo; OR \u0026ldquo;competencia cultural\u0026rdquo;)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(\u0026ldquo;mental health\" OR \"salud mental\" OR \u0026ldquo;mental wellbeing\u0026rdquo; OR \u0026ldquo;mental well-being\u0026rdquo; OR \u0026ldquo;bienestar mental\u0026rdquo; OR \u0026ldquo;life satisfaction\u0026rdquo; OR \u0026ldquo;satisfacci\u0026oacute;n con la vida\u0026rdquo; OR \u0026ldquo;quality of life\u0026rdquo; OR \u0026ldquo;calidad de vida\u0026rdquo; OR depression OR depresi\u0026oacute;n OR anxiety OR ansiedad OR \"substance abuse\" OR \u0026ldquo;abuso de sustancias\u0026rdquo; OR adicci\u0026oacute;n OR addiction OR stress OR estr\u0026eacute;s OR trauma OR loneliness OR soledad OR psychiatry OR psiquiatr\u0026iacute;a OR \u0026ldquo;clinical psychology\u0026rdquo; OR \u0026ldquo;psicolog\u0026iacute;a cl\u0026iacute;nica\u0026rdquo; OR \u0026ldquo;health psychology\u0026rdquo; OR \u0026ldquo;psicolog\u0026iacute;a de la salud\u0026rdquo;)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSearch\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e#1 AND #2; and #1 AND #3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eWe relied on two search strategies to identify studies focused on mental health sources in all databases: search strategy 1 (\u0026ldquo;critical\u0026rdquo; mental health literature: blocks #1 AND #2) and search strategy 2 (broader mental health literature: blocks #1 AND #3). We did not conduct reference tracking, prioritizing the most recent publications covering the subject. Additionally, we aimed at conducting manual searches of sources which have such an explicit focus, which lead to no new inclusions.\u003c/p\u003e\n\u003ch3\u003eSelection of studies\u003c/h3\u003e\n\u003cp\u003eWe \u003cem\u003eselected\u003c/em\u003e studies based on the following inclusion criteria: studies that were published between 1 January 2015 and 20 September 2024; in English or Spanish; published as articles in journals; that included empirical data \u003cem\u003eassociating greed with mental health;\u003c/em\u003e with any methodological design (quantitative; qualitative; mix-methods; scooping or systematic reviews). We excluded studies that did not meet such criteria (with the exception of seven studies published between September 2024 and 2025, as will be explain in further paragraphs); this led us to exclude sources that analyze greed or mental health without making any connection (not even weak or indirect) between both, as well as theoretical narrative reviews and essays. We decided to search sources since 2015, considering that the notions of commercial determinants of health had just been introduced a couple of years prior, as well as it being a year that showed an increasing interest in researching greed [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Figure\u0026nbsp;1 illustrates the procedure.\u003c/p\u003e \u003cp\u003e \u003cb\u003eFigure 1\u003c/b\u003e \u003c/p\u003e\n\u003ch3\u003eProcedure of the review\u003c/h3\u003e\n\u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eWe identified an aggregate of 3657 results (through search strategies one and two combined); after deleting duplicates, 2061 sources were available for screening. Based on our operative definition of greed and the study\u0026acute;s exclusion criteria, we conducted an automated search of sources that did \u003cem\u003enot\u003c/em\u003e mention the terms \u0026ldquo;greed\u0026rdquo;, \u0026ldquo;avarice\u0026rdquo;, \u0026ldquo;acquisitiveness\u0026rdquo;, \u0026ldquo;motivation\u0026rdquo;, \u0026ldquo;values\u0026rdquo;, \u0026ldquo;excess\u0026rdquo;, money\u0026rdquo; nor \u0026ldquo;luxury\u0026rdquo;; such sources were excluded (n\u0026thinsp;=\u0026thinsp;566). Authors 1 and 2, independently, screened titles and abstracts of the remaining 1495 sources. Authors 1 and 2 included 186 and 70 sources, respectively, and disagreed on the inclusion or exclusion of a combined number of 185 sources; disagreements were settled by the diriment, independent, criteria of the third author. After this, 96 sources were sought for retrieval.\u003c/p\u003e \u003cp\u003eAuthors 1 and 2 read the full text of these 96 sources, after agreeing to reinforce the strictness of the inclusion criteria regarding the association of greed with mental health. Specifically, by limiting inclusion only to studies that: a) mention greed or avarice explicitly (anywhere in the text), as long as they also mention (anywhere in the text) any broad category for mental health/illness (i.e. health, illness, wellbeing, distress, suffer, satisfaction, happiness, loneliness) or a psychopathological term (i.e. stress, anxiety, depression, addiction); or b) do not mention greed or avarice explicitly, but closely linked variables (i.e. materialism, materialistic values, egoism, love of money, luxury), only if they also mention explicitly a psychopathological term. After such process, authors 1 and 2 held no disagreements, and, after consensus across all three authors, 66 studies were included.\u003c/p\u003e \u003cp\u003eIn September 2025, the first author conducted an additional search in all databases to explore any updated articles with an explicit focus on greed (keywords \u0026ldquo;greed\u0026rdquo; or \u0026ldquo;avarice\u0026rdquo;, in English and Spanish, 2024\u0026ndash;2025) and included seven additional sources (sequentially: PubMed, 31 hits, 1 included; Scopus, 286 hits, 6 included; WoS, 232 hits, none included after dismissing articles already retrieved from Scopus; PsycInfo and Cochrane Library: 0 hits). Finally, 72 sources were included for review.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eData extraction, analysis and synthesis\u003c/h2\u003e \u003cp\u003eData extraction and quality/bias assessment was conducted by Author 1 and 2; later, this was consolidated, addressing a few minor disagreements and ambiguities through the diriment criteria of Author 3, and through final consensus. Quality of studies and potential biases was assessed utilizing the checklist from Mixed Methods Appraisal Tool (MMAT) [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Our use of such tool was adjusted to our expertise, our theoretical perspective and the specific aim of the review. All studies met acceptable quality criteria. We present findings through a narrative synthesis[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e], aspiring to be coherent with the perspective of collective health, as well as considering the strengths and limitations of our procedure. Our narration attempts to consider context, study design, and exploration of some significant patterns within and across subgroups of publications; organized in the form of a thematic analysis.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eGreed is predominantly detrimental to mental health, as suggested by diverse studies conducted in their respective cultural contexts (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003ePopulations, conceptual focus and type of association\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003ePopulations\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eParticipants from European nations (\u0026ge;\u0026thinsp;21) and United Kingdom (\u0026ge;\u0026thinsp;6); China (\u0026ge;\u0026thinsp;14) and other Asian nations (\u0026ge;\u0026thinsp;9); USA (\u0026ge;\u0026thinsp;12); Latin America (Brazil, Ecuador: \u0026ge;2); Australia (\u0026ge;\u0026thinsp;1). Populations of interest included: unspecified (general) population, university students, buyers/consumers \u0026ndash; physical and online - with problematic behavior (e.g. impulsive, compulsive, addictive); different studies stratified participants according to class (socio economic status and subjective social class), gender, occupation, age, religion, among other criteria. An absolute minority of studies (\u0026ge;\u0026thinsp;3) did not specify country of participants or reported samples from multiple, unspecified nations. \u003cem\u003eNo study approached participants from the perspective of \u0026ldquo;collective mental health\u0026rdquo; (nor its inherent critical interculturality).\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMain focus\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePsychological processes (33%, N\u0026thinsp;=\u0026thinsp;24); mental health (24%, N\u0026thinsp;=\u0026thinsp;17); business \u0026amp; marketing (35%, N\u0026thinsp;=\u0026thinsp;25); ecology/sustainability (4%, N\u0026thinsp;=\u0026thinsp;3); neuroscience (3%, N\u0026thinsp;=\u0026thinsp;2); and philosophy (1%, N\u0026thinsp;=\u0026thinsp;1). All sources with diverse degree of implications for mental health; relative overlapping of focus (e.g. all studies examined psychological processes, despite their diverse emphases). \u003cem\u003eNo study reported \u0026ldquo;collective mental health\u0026rdquo; as its explicit focus.\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eCategories of study (greed)\u003c/em\u003e:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaterialism (f\u0026thinsp;=\u0026thinsp;26); dispositional greed (f\u0026thinsp;=\u0026thinsp;13); overconsumption, conspicuous consumption/behavior - includes luxury buying (f\u0026thinsp;=\u0026thinsp;12); avaricious money attitudes/love of money/affluenza (f\u0026thinsp;=\u0026thinsp;5); greed/greed avoidance/greed resistance (f\u0026thinsp;=\u0026thinsp;4). Terms with f\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;2: extrinsic goals/values (e.g. image, financial success, popularity, conformity, hedonism); acquisitiveness; exposure to money; material wellbeing; consumer-oriented-engagement; vulnerability to marketing; economic inequality. \u003cem\u003eNo study approached these phenomena explicitly as socially determined embodiments.\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eCategories of study (collective mental health)\u003c/em\u003e:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIndividual wellbeing \u0026ndash; e.g., life satisfaction, happiness, psychological and personal wellbeing/distress, quality of life (f\u0026thinsp;=\u0026thinsp;29); impulsive, compulsive, obsessive and pathological buying-shopping (f\u0026thinsp;=\u0026thinsp;11); anxiety \u0026ndash; status/social (f\u0026thinsp;=\u0026thinsp;11); anxiety \u0026ndash; death/existential (f\u0026thinsp;=\u0026thinsp;7); depression (f\u0026thinsp;=\u0026thinsp;6); stress (f\u0026thinsp;=\u0026thinsp;4); brand addiction/obsession/attachment (f\u0026thinsp;=\u0026thinsp;4); gambling disorder or problem/maladaptive gambling (f\u0026thinsp;=\u0026thinsp;3); hoarding behavior (f\u0026thinsp;=\u0026thinsp;3); self-esteem (f\u0026thinsp;=\u0026thinsp;3); attachment (N\u0026thinsp;=\u0026thinsp;3); personality traits \u0026ndash; including \u0026ldquo;big 5\u0026rdquo; factors (f\u0026thinsp;=\u0026thinsp;3). Terms with f\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;2: mixed symptoms; negative affect; impulsivity; loss of interest; anhedonia; aggression; anger; mental rumination; autonomy, self-sufficiency; coping strategies; self-control; perceived health; positive mood, health awareness; mindfulness; flow; purpose in life; positive relationships; social dissatisfaction, loneliness/isolation, objectification; prosocial behavior; gratitude; revenge consumption; fear; debt stress; identity diffusion; flourishing/wisdom. \u003cem\u003eNo study approached these phenomena explicitly as socially determined embodiments.\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eType of empirical link\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePredominantly \u003cem\u003ecorrelational\u003c/em\u003e: \u0026ldquo;non-randomized quantitative\u0026rdquo; (86%, N\u0026thinsp;=\u0026thinsp;62); \u003cem\u003eexperimental/causal\u003c/em\u003e: \u0026ldquo;randomized quantitative\u0026rdquo; (0,11%, N\u0026thinsp;=\u0026thinsp;8); \u003cem\u003equalitative\u003c/em\u003e \u0026ndash; descriptive (3%, N\u0026thinsp;=\u0026thinsp;2). Several \u0026ldquo;non-randomized quantitative studies tested models via factor analyses and concluded tendencies (via regression analyses and structural equations); however, authors acknowledge that more robust claims regarding causality would require randomized experiments and representative probabilistic samples. Randomized quantitative studies mostly focused on psychological processes (although they also included two articles interested in marketing \u0026amp; business and one interested in ecology/sustainability). Qualitative studies focused on business \u0026amp; marketing. \u003cem\u003eNo study explicitly approached the link of greed and mental health as dialectical.\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"2\"\u003e\u003cem\u003eNote\u003c/em\u003e: classifications are relative, based on what we consider the most salient/declared operative terms; interests in diverse populations, concepts and empirical designs occasionally overlap.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAs reported in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, greed seems associated to diverse expressions of affected mental health \u0026ndash; what we interpret as individual embodiments. While this is true, mere presence or absence of individual greed does not necessarily predict mental health problems by itself. One example, among many others, is research in Bangladesh that found how self-control played a more important role than greed in predicting high levels of stress [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. The role of primary socialization in the development of allegedly \u0026ldquo;individual\u0026rdquo; characteristics and embodiments is also important to consider: plausibly, greed is first learned in families when children are as young as 4\u0026ndash;6 years old (with secondary socialization expected to shape identity in further years); in some European contexts, maternal anxiety and negative affect may be associated to such early learning[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. If we accept the thesis that greed is, fundamentally, learned through interactions in context, we must read empirical findings as referring to context-dependent processes.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eGreed and mental health: individual embodiments\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDissatisfaction and unhappiness\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGreed can lead to marginal and relative individual satisfaction for some people in certain situations, such as accomplishing envied goals [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]; enjoying wellbeing if economically able to afford luxury [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]; obtaining benefits from using people (e.g. friends) instrumentally [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e] and feeling congruent with greedy family values and subjective past values [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. In contrast with these minoritarian examples, greed is predominately associated, not only to planetary ill-health via ecologically destructive overconsumption [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e], but to the dissatisfaction and unhappiness of greedy individuals themselves. There is evidence of this in multiple studies that measured their \u003cem\u003elife dissatisfaction\u003c/em\u003e [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan additionalcitationids=\"CR41 CR42 CR43 CR44 CR45 CR46\" citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e] and \u003cem\u003eunhappiness\u003c/em\u003e [\u003cspan additionalcitationids=\"CR49 CR50 CR51 CR52 CR53 CR54\" citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e].\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePotentially harmful individual characteristics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGreed is associated with individual characteristics that imply potential harms for mental health: high neuroticism, low conscientiousness, low agreeableness, [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e]; and malicious envy [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. In China, greed was found to be associated with \u003cem\u003enegative psychopathology\u003c/em\u003e, including \u003cem\u003e\u0026ldquo;\u003c/em\u003emixed symptoms\u0026hellip;loss of interest, and negative affect\u0026rdquo; [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e]; greed correlated positively with aggression (reactive and proactive; physical, verbal, indirect or driven by anger) as well as extrinsic motivation and compensation; and correlated negatively with healthy social relations, autonomy and purpose in life. In the USA, a study informed by an Aristotelian perspective concluded that greed avoidance \u0026ndash; alongside other virtues - was predicted by wisdom (cognitive, reflective and compassionate qualities to achieve common good), and that such wisdom led to flourishing: self-acceptance, mastery, purpose in life, and personal growth [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. In contrast, the greedy individual can have limited empathy and moral reasoning [\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e]. Greed\u0026acute;s neurological substrates are linked to impulsiveness, reward and satisfaction \u0026ndash; framed both as traits and risk factors [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e]. Greed is also associated with loneliness and dissatisfaction with certain relationships [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e].\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSymptoms of depression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEvidence focused on symptoms of depressive mood are relatively contradictory. Studies suggest that greed has a positive correlation with depression among specific Chinese youth [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e]; a negative correlation with depression among specific youth from the USA \u0026ndash; only if they perceived to be congruent with the greedy values of their family [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]; and that greed can have a similar effects in some adults in Brazil, regardless if they report symptoms of depression - as well as anxiety or stress - or not [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. Greed among specific young adults in the USA can indeed be a risk factor for depression (as well as for other related symptoms such as low self-esteem and obsessive-compulsive tendencies) [\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e]; authors of the study suggest that such experiences may also be associated with some risks for addiction to shopping of gambling (see \u0026ldquo;symptoms of addiction\u0026rdquo;, below in this table). A study from Belgium concluded that problems in identity formation were associated with higher tendency towards depression among adult buyers [\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e]; a study from Australia showed how depression did not predict the severity of buying disorder [\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e]; while there is evidence that greed \u0026ndash; but not anhedonia - can predict problematic gambling [\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e].\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSymptoms of addiction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eProblematic gambling.\u003c/em\u003e Problematic gambling seems to be associated with dispositional greed, as analyzed in Netherlands and UK: greedy gamblers \u0026ndash; regardless of their level of impulsiveness - showed more cognitive distortions leading to irrational risks- taking and feeling unable to stop [\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e]. Similarly, in a USA-based study concluded that greed mediated severity of problematic gambling [\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e].\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eProblematic buying.\u003c/em\u003e Compulsive buying can be associated to hedonism and goals linked to material success and social image, little care for others, high neuroticism, low responsibility and agreeableness, and with a tendency towards passive coping strategies [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e] [\u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e].; with materialism, increased psychological distress (symptoms of anxiety, depression and obsession-compulsion) and decreased subjective wellbeing (self-esteem, life satisfaction and optimism) [\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e]; and with cognitive biases, materialism and psychological distress [\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e]. Personality traits can be important mediators (see \u0026ldquo;potentially harmful individual characteristics\u0026rdquo;, in this table): there seems to be a link between dark traits (narcissism, machiavelism psychopathy) and disvalues consistent with deadly sins (including greed); importantly, high conscientiousness, agreeableness and openness can be protective factors [\u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e]. Insecure patterns of attachment have been associated with greedy shopping as well [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. In some cases, research focused on greedy shopping of \u003cem\u003eluxury\u003c/em\u003e, mostly approached from a marketing perspective; for example, we know that some individuals feeling fear \u0026ndash; as well as anxiety, low self-control and low self \u0026ndash; efficacy \u0026ndash; seek emotional compensation via excessive luxury buying [\u003cspan citationid=\"CR101\" class=\"CitationRef\"\u003e101\u003c/span\u003e].\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAlthough individualistic in their approach, some studies do suggest the importance of considering social context. In China, for example, compulsive buying can be present in both men and women, yet the later shop more, with mood compensation being a more powerful mediator for them [\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e]; such gender difference in prevalence was also observed in Spain [\u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e]. Love of money is influential in how attachment produces ethical behavior in both China and France; yet, unlike Chinese teenagers, French adolescents \u0026acute;s attachment to parents was associated with less dishonesty, but attachment to peers was linked to more dishonesty [\u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e]. Among Latino families in the USA, changes in income, parental influence and educational level can decrease materialism and increase life satisfaction.[\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e] A study found that luxury consumption was associated with high subjective wellbeing (e.g. self-esteem, social status, accomplishment, associated with internal goals) for Chinese, but not Portuguese, participants; interpretations include the role of living costs and guilt due to status-driven overspending [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. In USA and China, participants increased their luxury consumption even when reporting higher stress due to debt [\u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e]; also, Chinese participants high in self-objectification (i.e. basing their identity in how others perceive their status) engaged more in luxury buying \u0026ndash; specially of products relevant to their appearance [\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e]. Religion is another example of the importance of cultural context. For example, a Pakistani study concluded that Islamic participants \u0026ndash; who also showed high self-esteem \u0026ndash; tended to be less materialistic [\u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e73\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cb\u003eExistential anxiety and greedy identity\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eExistential anxiety\u003c/em\u003e may appear when individuals remind their identity as \u003cem\u003emortal beings\u003c/em\u003e; sometimes, it is studied as death anxiety or fear of death. The covid-19 pandemic (2019\u0026ndash;2023) is a relevant context to understand how existential anxiety may be linked to greed \u0026ndash; as explored in studies from, mostly, USA and UK. Some participants \u0026ndash; form USA and Ecuador - sought compensatory emotional satisfaction via over-consumption[\u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e74\u003c/span\u003e]; others increased materialism, not due to the threat of death itself, but influenced by stress and media consumption (see section \u0026ldquo;Marketing, social media and greedy identity\u0026rdquo;) leading to negative affect, anxiety and social isolation [\u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e75\u003c/span\u003e]; while isolation increased luxury buying for some (driven by aspirational status), existential anxiety and social capital determined how this impacted their subjective wellbeing [\u003cspan citationid=\"CR76\" class=\"CitationRef\"\u003e76\u003c/span\u003e]; participants who were greedy, egoist, narcissist and justifying of the social system donated more money \u0026ndash; interpreted as a materialistic strategy to reduce existential anxiety, feel morally good about themselves, and display power. [\u003cspan citationid=\"CR77\" class=\"CitationRef\"\u003e77\u003c/span\u003e]; for some workers, existential anxiety increased susceptibility to the effects of their workplace\u0026acute;s greed, producing emotions of shame [\u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e78\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOverall, evidence regarding existential anxiety and the formation of greedy identity is relatively contradictory. One experiment with students conduced in Europe suggests that existential anxiety increases greed (i.e. luxury buying) [\u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e79\u003c/span\u003e]; while a different experiment with students conducted in China suggests that it decreases greed (i.e., less love of money and more prosocial spending) [\u003cspan citationid=\"CR80\" class=\"CitationRef\"\u003e80\u003c/span\u003e]. In the latter study, when reminded of their own death, less spiritual subjects shared their money more. For some experimental subjects from Poland and the USA, thinking about money decreased their existential anxiety; importantly \u0026ndash; and stressing the key role of \u003cem\u003estatus\u003c/em\u003e - the more a subject linked their existential value to their subjective socio-economic status, the more this effect was observed [\u003cspan citationid=\"CR81\" class=\"CitationRef\"\u003e81\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eStatus anxiety and greedy identity\u003c/h2\u003e \u003cp\u003eAs suggested in previously reported studies, status anxiety is key to understanding some manifestations of greed. Status anxiety may appear when individuals think of their identity as \u003cem\u003ebeing inferior to that of others\u003c/em\u003e, via a process of social comparison; sometimes, it is studied as social anxiety. In China, for example, a study found that social comparison and subjective social class determined participant\u0026acute;s reports of status anxiety \u0026ndash; which itself predicted greedy luxury buying with risks for both mental health and ecological sustainability [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSocial comparison \u0026ndash; an inherently interactional processes that may lead to status anxiety - is shaped by both individual variability and economic inequality. An example of the first: among participants from China and USA, narcissist individual traits mediated how they engaged in social comparison [\u003cspan citationid=\"CR82\" class=\"CitationRef\"\u003e82\u003c/span\u003e]. Two examples of the later: in perceived conditions of increased economic inequality, status consumption \u0026ndash; mediated by status anxiety \u0026ndash; tends to increase as well [\u003cspan citationid=\"CR83\" class=\"CitationRef\"\u003e83\u003c/span\u003e]; moreover, as concluded in a Icelandic longitudinal study, participants with lower subjective social class were more likely to be materialistic and report less well-being \u0026ndash; but their status anxiety decreased (and their wellbeing decreased) when the country reduced economic inequality [\u003cspan citationid=\"CR84\" class=\"CitationRef\"\u003e84\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAs suggested in a European study on problematic buying, psychological strategies to deal with status anxiety may be key in the formation of greedy identity. Participants with more \u003cem\u003eidentity diffusion\u003c/em\u003e \u0026ndash; difficulties to define who they are \u0026ndash; can be more accepting of materialist values and buy excessive material commodities as a compensatory strategy of \u003cem\u003eidentity substitution\u003c/em\u003e [\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan citationid=\"CR85\" class=\"CitationRef\"\u003e85\u003c/span\u003e]. However, such compensation leads to negative emotions \u0026ndash; even potential depression; still longing to define their identity, subjects then increase their excessive shopping as a mood compensation strategy; such an unhealthy compensation sustains pathological buying and hoarding.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eMarketing, social media and greedy identity\u003c/h2\u003e \u003cp\u003eMarketing strategies design plenty of mass media content which can shape greedy identity. Marketing that promotes consumerism online can diminish subjective wellbeing and increase excessive spending, an effect mediated by social comparison and moderated by materialist values [\u003cspan citationid=\"CR86\" class=\"CitationRef\"\u003e86\u003c/span\u003e]. Marketing strategies can rely on social comparison processes by specific subjects \u0026ndash; linked to fear, need for safety, status anxiety and potential identity substitution -, framing such consumers as \u003cem\u003evulnerable to marketing\u003c/em\u003e [\u003cspan citationid=\"CR87\" class=\"CitationRef\"\u003e87\u003c/span\u003e]; some of these consumers may feel that they improve their personality via luxury consumption [\u003cspan citationid=\"CR88\" class=\"CitationRef\"\u003e88\u003c/span\u003e]. For some people, consuming material commodities can reduce fear, provide safety, and thus increase \u0026ndash; at least temporarily, their subjective satisfaction [\u003cspan citationid=\"CR89\" class=\"CitationRef\"\u003e89\u003c/span\u003e].In such context, marketing practices can lead to potentially addictive consumption, such as \u0026ldquo;brand attachment\u0026rdquo;[\u003cspan citationid=\"CR90\" class=\"CitationRef\"\u003e90\u003c/span\u003e] or \u0026ldquo;brand addiction\u0026rdquo; that can themselves lead to hoarding and deteriorate social relationships[\u003cspan citationid=\"CR91\" class=\"CitationRef\"\u003e91\u003c/span\u003e] \u0026ndash; even if shoppers experience relative and marginal satisfaction [\u003cspan citationid=\"CR92\" class=\"CitationRef\"\u003e92\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSocial media is a digital field in which both marketing and organic content circulates. For some people, materialist values can predict higher stress and rumination after consuming social media content [\u003cspan citationid=\"CR93\" class=\"CitationRef\"\u003e93\u003c/span\u003e]. Unlike downward comparison, upward comparison (comparing when exposed to online images of wealth) can increase conspicuous consumption; greed \u0026ndash; alongside materialism, need for status, tendency toward social comparison \u0026ndash; plays a pivotal role as moderator [\u003cspan citationid=\"CR94\" class=\"CitationRef\"\u003e94\u003c/span\u003e]. Greed can impact digital hoarding behavior among social media users, as it moderates the effect of discarding difficulty; the link between technostress, digital withholding and anticipated regret; and the link between digital withholding and perceived materialism [\u003cspan citationid=\"CR95\" class=\"CitationRef\"\u003e95\u003c/span\u003e, \u003cspan citationid=\"CR96\" class=\"CitationRef\"\u003e96\u003c/span\u003e]. Chinese studies conclude that online upward social comparison (comparing oneself with others of higher status) can predict fear of missing out and hoarding, an effect mediated by dispositional greed [\u003cspan citationid=\"CR97\" class=\"CitationRef\"\u003e97\u003c/span\u003e]; and that social media consumption among subjects with low self-acceptance reduced self-control, which itself increased greed [\u003cspan citationid=\"CR98\" class=\"CitationRef\"\u003e98\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eGreed is predominately associated with dissatisfaction and unhappiness; and several studies suggest a link to what conventional epidemiologists would frame as mental health risks (e.g. potentially harmful individual characteristics, impacting social relationships and purpose in life; behavioral addictions such as gambling and buying, including luxury buying; and, in some cases, depressive mood). This is consistent with previous reviews on the negative effect of dispositional greed and excessive materialistic values [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. The reviewed evidence, however, has epistemological limitations, as it tends to reproduce empiricist fetichism and to focus almost exclusively on the individual dimension. None of the reviewed studies analyzed critical processes of social determination. Following Breilh, we suggest that the studies\u0026rsquo; valuable findings need to be interpretated from the perspective of Critical Epidemiology, as to recover their \u0026ldquo;epistemic potentiality\u0026rdquo;.\u003c/p\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eThe social determination of greedy identity\u003c/h2\u003e \u003cp\u003eWe believe that focusing on the formation of \u003cem\u003egreedy identity\u003c/em\u003e best enables epistemic possibilities to understand social determination, as it refers to a sociopsychological process, rather than as a sum of allegedly stable, internal, objectively measurable individual variables (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eThe social determination of greedy identity\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCapitalist greed\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNone of the reviewed studies explicitly analyzed capitalist greed. Yet capitalism constitutes the macro-social cultural roots of contemporary \u0026ldquo;ethos of greed\u0026rdquo;. Such capitalist greed leads to exacerbated economic inequality and unsustainable overproduction and overconsumption; it also subsumes economic practices in cyberspace, including marketing practices and the production of particular social media content that may promote the formation of greedy identity. There is a \u003cem\u003efundamental contradiction\u003c/em\u003e: capitalist greed clashes with people\u0026acute;s health [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] \u0026ndash; including their mental health (and how it relates to communities and nature). A revealing example of this are marketing practices that frame \u0026ldquo;brand addiction\u0026rdquo; as potentially beneficial and persuade consumers that luxury consumption is a mean for self-improvement. In its most individualistic and alienating iterations (i.e. neoliberal governance) such contradiction intensifies. Within fields conventionally associated to \u0026ldquo;mental health\u0026rdquo;, capitalist greed may prioritize profits for pharmaceutical corporations; publishers of diagnostic manuals, test and self-improvement content; professional training and practice; corporation that sell excessive, opulent individualistic satisfaction; etc.\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGreedy communities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCapitalist greed subsumes the way of life of particular communities in context; based on class, gender, ethnicity, religion/spirituality and territory. None of the reviewed studies explicitly analyzed community embodiments of capitalist greed; however, some evidence included relevant analysis regarding:\u003c/p\u003e \u003cp\u003e- \u003cem\u003eClass.\u003c/em\u003e Subjective social class and social comparison reported by individuals (which, we speculate theoretically, is constructed through community interactions) may lead to status anxiety and greed (which is acted upon as part of communities, as well). In some contexts, for communities perceived as being of \u0026ldquo;lower\u0026rdquo; class, status anxiety and greed may decrease when public policy reduces nation-level economic inequality (coinciding with elite communities experiencing lower relative well-being). Although populations that consume luxury were of interest for some studies, no research focused explicitly on elite communities.\u003c/p\u003e \u003cp\u003e- \u003cem\u003eGender\u003c/em\u003e. Culturally learned gender roles result in different ways of embodying greed (e.g. some women shop more, while some men gamble and drink alcohol more; some women may rely on emotional compensation more).\u003c/p\u003e \u003cp\u003e- \u003cem\u003eReligion/spirituality\u003c/em\u003e. In some contexts, being religious can reduce greed; in others, religion seems less influential; and spiritual subjects can even be greedier than non-spiritual subjects in certain situations.\u003c/p\u003e \u003cp\u003e- \u003cem\u003eCyberspace\u003c/em\u003e can be a territory with content that may promote the formation of greedy communities.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGreedy subjects\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhile some greedy subjects may experience satisfaction, this seems to be marginal, as unhappiness and dissatisfaction with life prevail. Existential anxiety in some cases, and status anxiety (via social comparison) more commonly, can lead to the formation of greedy identity (conditioned, we speculate theoretically, by how greedy or not their communities of belonging are). Greedy identity can harm immediate social relationships and alienate people from their purpose in life. Contributors to such unhealthy process may include: fear; need for safety; low-self-control; high stress; dark traits (psychopathy, narcissism, machiavelism); high neuroticism, low conscientiousness, low agreeableness, low openness; low greed-avoidance; malicious envy; negative affect; loss of interest; aggression; extrinsic motivation and compensation; low autonomy; scant wisdom (and thus, decreased self-acceptance, mastery and personal growth); low empathy and moral reasoning; impulsiveness and high need for reward and satisfaction; and loneliness. In some cases, individual embodiments can manifest as symptoms of behavioral addiction (e.g. to buying; to gambling) and depressive mood. Subjects that embody a greedy identity deteriorate their own wellbeing and harm that of others (as well as planetary health, via overconsumption).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn most contexts, greedy communities and subjects embody the contradictions of an unhealthy society fueled by capitalist greed. This is not a mere problem of personal \u0026ldquo;satisfaction\u0026rdquo;, but of a socially produced destructive process: an ethos of greed constrains our sense of identity to that of unhealthy, unsustainable, competitive consumers and accumulators of wealth and status\u003csup\u003e1\u003c/sup\u003e. It is in such a context that we interpret the existence of sociopsychological problems of \u003cem\u003eidentity\u003c/em\u003e diffusion and substitution [\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan citationid=\"CR85\" class=\"CitationRef\"\u003e85\u003c/span\u003e], linked with self-objectification [\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe social determination of greedy identity produces many of the unhealthy phenomena reviewed in our study; as well as other excluded from the review, such as DSM-5\u0026acute;s socially aversive personality psychopathology [\u003cspan citationid=\"CR99\" class=\"CitationRef\"\u003e99\u003c/span\u003e], compensatory short-term pride [117] \u0026ndash; and diminished empathy and moral reasoning, increased aggression, and cognitive justifications of inequality and domination [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Different than self-interest \u0026ndash; present in all of us in one way or another [116] - greedy identity is fundamentally destructive to most humans and planetary health. We agree with marketing academics in the need for regulations to prevent idealized aspirational models [\u003cspan citationid=\"CR90\" class=\"CitationRef\"\u003e90\u003c/span\u003e]. We strongly disagree with them when they speculate that brand addiction may be a \u0026ldquo;healthy addiction\u0026rdquo;[\u003cspan citationid=\"CR92\" class=\"CitationRef\"\u003e92\u003c/span\u003e] or when they promote it as mean for \u0026ldquo;personality improvement via ownership and consumption of luxury items\u0026rdquo;[\u003cspan citationid=\"CR88\" class=\"CitationRef\"\u003e88\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe \u003cem\u003eparticular dimension\u003c/em\u003e is key to understanding how communities accept or challenge greed. This is because community provides identity: \u0026ldquo;lived experience, something which gives meaning to ourselves and gives us an understanding of others\u0026rdquo; [\u003cspan citationid=\"CR100\" class=\"CitationRef\"\u003e100\u003c/span\u003e]. Communities around class, gender, religion/spirituality, territory (including cyberspace communities) and ethnicity may organize spaces to talk about greed; the harmful exploitation of community-specific marketing vulnerabilities and more existential and spiritual ideas of what constitutes wisdom and good life (and a good death) \u0026ndash; rooted in both western thought [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] and indigenous thought, including traditions from the Global South [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. We suggest that \u003cem\u003eelites\u003c/em\u003e need to be a pivotal part of the discussion [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR101\" class=\"CitationRef\"\u003e101\u003c/span\u003e]; this is because their greed plays a significant role in massive societal suffering in diverse contexts, as well for wider planetary health.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eThe deep prevention of greed\u003c/h2\u003e \u003cp\u003eInitiatives for the deep prevention of greed seem absent from the review literature. Yet communities and subjects do have relative power to advance non-greedy lifestyles, cultures and economic-political systems [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]; focusing on the three dialectically connected dimensions presented in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. Thus, building an \u003cem\u003eethos of life\u003c/em\u003e that enables safety, pleasure, spirituality and vital energy in ways that are inherently connected to ecologically sustainability [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. In such context, \u0026ldquo;solidarity-based modes of living emerge to achieve full life in individuals -with their individual phenotypes, genotypes, psychic profiles, and a proactive and hopeful spirituality- in specific scenarios of individual reproduction [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. A few documented experiences \u0026ndash; albeit not rooted in Critical Epidemiology - suggest that valuable actions may include reducing social anxiety [118]; and practice mindfulness to reduce greed for money [106].Advancing an ethos of life that opposes greed requires ongoing collective awareness [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]: examining greed in relation to work conditions; consumption patterns; community organization and support; cultural-spiritual power to build sovereignty and emancipation; and society-nature metabolism (quality and sustainability our ecological link with nature).\u003c/p\u003e \u003cp\u003eIt is possible to form non-greedy, or at least less-greedy, identities. For example, via wiser social comparison (e.g. downwards comparison, as well as reflections around class consciousness and ecological sustainability); consumption and production; fostering solidarity; engaging with media content and marketing more critically; and overall protecting collective health, increasing corporate social responsibility, decreasing corruption and strengthening justice and peace [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].[\u003cspan additionalcitationids=\"CR21\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] [\u003cspan citationid=\"CR102\" class=\"CitationRef\"\u003e102\u003c/span\u003e]. While deep prevention seems important across the entire lifespan, we suggest that adolescence and young adulthood are key moments to engage with it. As preliminary prompts for action, we suggest asking \u003cem\u003eproblematizing questions\u003c/em\u003e: How does your greed (and that of your communities) impact on others? How does other\u0026acute;s greed impact on you (and your communities)? Analyses of context and power are essential: which meanings of greed, linked to whose identity, greed for what, and affecting which others.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eLimitations and further research\u003c/h2\u003e \u003cp\u003eOur study has limitations. Conventional systematic reviews acritical of empiricist fetichism would have displayed more precise and systematized quantification; while more radical counter-hegemonic qualitative approaches would have problematized scientific evidence further than we did. Reflexive of this, we argue for future intercultural and transdisciplinary epistemic dialogue. This includes \u0026ndash; but is not limited to \u0026ndash; voices and participation coming from indigenous wisdom, communities most affected by greed, elite communities, and diverse critical academics and professionals from different fields and perspectives. Our review could also have expanded more on how geopolitical contexts shape knowledge; reviewed studies probably represent the dominant values of specific societies and researchers [116, 120].\u003c/p\u003e \u003cp\u003eFurther research is needed. For example, to understand how greed sustains inequality in specific contexts, and how this may be related to mental health. There seems to \u003cem\u003enot\u003c/em\u003e be a direct link between national-level economic inequality and mental health \u0026ldquo;outcomes\u0026rdquo;, but such inequality interacts with other so-called \u0026ldquo;determinants\u0026rdquo; such as poverty and inflation[\u003cspan citationid=\"CR103\" class=\"CitationRef\"\u003e103\u003c/span\u003e]. We need complex and situated research around such thesis, which considers the role of greed in dialectical \u0026ndash; instead of linear \u0026ndash; contextualized processes. We also need to address the core political problem of power and normativity: who gets to say what is \u0026ldquo;normal\u0026rdquo; or \u0026ldquo;excessive\u0026rdquo; \u0026ndash; including who is greedy or not, and if greed is \u0026ldquo;good\u0026rdquo; or \u0026ldquo;bad\u0026rdquo; [116, 121\u0026ndash;123]. We can take inspiration from classic critical arguments, while advancing original innovations [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR104\" class=\"CitationRef\"\u003e104\u003c/span\u003e, \u003cspan citationid=\"CR105\" class=\"CitationRef\"\u003e105\u003c/span\u003e]. We suggest the need for a more developed theoretical understanding of the social determination of greedy identity; more critical, complex, and situated analyses; a better understanding of values of solidarity and life; and more profound engagements with communities to advance the deep prevention of greed.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eGreed is predominantly destructive to collective mental health. Guided by Critical Epidemiology, we provide an interpretation that values scientific findings yet poses a relative problematization of empiricist fetichism. Given the design inherent to our research, reviewed evidence was mostly produced via correlations and structural equation models, followed in frequency by experimental approaches; these relied on individualistic and decontextualized epistemic traditions, with no analytic consideration of the critical processes that socially determine mental health. In contrast, we propose an interpretation of the valuable findings identified in scientific literature through a focus on the social determination of greedy identity (i.e. considering the dialectical, critical and ecological connection of capitalist greed, greedy communities and greedy subjects). Individuals may embody such process in the form of dissatisfaction and unhappiness, potentially harmful characteristics, as well as symptoms of addiction (i.e. to shopping, including luxury buying; to gambling) and depressive mood. Our findings open possibilities for future research and action, which require collaborative efforts to rethink mental health as a socially produced process rather than as a sum of individual factors and outcomes.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eThe authors declare no formal conflict of interest; they do declare holding ethical-political positions critical of greed. The study was supported by the universities that employed authors between 2024\u0026ndash;2026, in the form of paid hours to conduct research. Given its lack of direct contact with human subjects, the study did not require formal ethical approval; all efforts were made to engage with ethical practices during the review of the literature. All sources utilized for the review are available in their respective journals/databases. Authors\u0026rsquo; contribution was as follows. \u003cem\u003eAuthor 1\u003c/em\u003e: Conceptualization, theoretical framework development and study design; data gathering and analysis; interpretation of results; critical revision of intellectual content; writing the original manuscript, reviewing and editing; final revision and approval of the paper. \u003cem\u003eAuthor 2\u003c/em\u003e: data gathering and analysis; final revision and approval of the paper. \u003cem\u003eAuthor 3\u003c/em\u003e: data gathering (solving inclusion/exclusion discrepancies); critical revision of intellectual content; final revision and approval of the paper.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAuthors\u0026rsquo; contribution was as follows. *M.C:* Conceptualization, theoretical framework development and study design; data gathering and analysis; interpretation of results; critical revision of intellectual content; writing the original manuscript, reviewing and editing; final revision and approval of the paper. *N.S.* : data gathering and analysis; final revision and approval of the paper. *C.M.:* Solving inclusion/exclusion discrepancies; critical revision of intellectual content; final revision and approval of the paper.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eAll sources utilized for the review are available in their respective journals/databases\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBreilh J (2023) The social determination of health and the transformation of rights and ethics: A meta-critical methodology for responsible and reparative science. 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Grove, New York\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Footnotes","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003e Evidently, an ethos of greed also plays a role within several political systems that critique capitalism; inequality, existential anxiety and social anxiety do exist in such contexts.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"greed, collective mental health, critical epidemiology, critical psychiatry, critical psychology, Latin American social medicine","lastPublishedDoi":"10.21203/rs.3.rs-8845297/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8845297/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePurpose\u003c/h2\u003e \u003cp\u003eGreed\u0026acute;s relevance for understanding economic, political, and cultural processes that determine mental health remains overlooked. This study explores the empirical relationship between greed and mental health through the lenses of Critical Epidemiology.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003ewe conducted a systematic review. After identifying a total of 3,657 sources published between 2015 and 2025 (Web of Science, Scopus, PsycINFO, PubMed, Cochrane Library), 72 studies were included.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe empirical evidence suggests a predominately destructive association between greed and mental health (i.e. life dissatisfaction and unhappiness, potentially harmful individual characteristics, symptoms of addiction involving buying and gambling, and symptoms of depressive mood). Given the inherent design of the research, included studies were mostly individualist and decontextualising, driven by empiricist fetichism; no study appears to have engaged with processes of social determination.\u003c/p\u003e\u003ch2\u003eDiscussion\u003c/h2\u003e \u003cp\u003e. We propose a critical interpretation of findings to better understand the social determination of unhealthy greedy identity. We argue for a shift towards collaborative, greed-focused deep prevention: a transdisciplinary, intercultural, participatory, politically committed approach that considers the connection of capitalist greed, greedy communities, and greedy individuals.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eGreed is predominantly destructive to health \u0026ndash; including mental health. This review contributes to a growing conversation around innovative frameworks to rethink prevention and well-being beyond individual pathology.\u003c/p\u003e","manuscriptTitle":"The Critical Epidemiology of Greed and Mental Health: A systematic review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-20 03:07:55","doi":"10.21203/rs.3.rs-8845297/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"00646e6b-3cf0-4da7-891d-dcb8a491ff2b","owner":[],"postedDate":"April 20th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-20T03:07:55+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-20 03:07:55","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8845297","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8845297","identity":"rs-8845297","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}