Impacts of gambling problems on partners: partners’ interpretations

Harms from Other People's Gambling: Associations with an Individual's Own Gambling Behaviours, Health Risk Behaviours, Financial Problems, General Health, and Mental Wellbeing

This study aimed to explore relationships between being an 'affected other' (AO) and an individual's own gambling, health risk behaviours, financial problems, poor general health, and low mental wellbeing. A cross-sectional survey using representative and supplementary convenience samples was undertaken with 1234 residents of a British Island aged 16 + years. Being an AO was measured as having a partner or relative who has been gambling regularly in the past 12 months. PGSI was used to assess gambling severity. Health risk behaviours included: poor diet, low physical activity, daily smoking, and binge drinking. Other measures included experiencing financial problems, poor general health, and low mental wellbeing. Analyses were performed using χ2 and binary logistic regressions. 11.0% of participants were AOs. AOs were more likely to gamble at at-risk/problem-gambling levels and experience financial problems compared to those who were not affected others. The significant relationship between being an AO and low mental wellbeing was mediated by experiencing financial problems. The relationship between being an AO and engaging in two or more health risk behaviours was no longer significant after controlling for sociodemographics and an individual's own gambling. The relationship between being an AO and poor general health was no longer significant after controlling for sociodemographics, health risk behaviours and an individual's own gambling. AOs experienced risks to health and wellbeing, with findings not limited to AOs specifically with a relationship to an individual with problem-gambling. Therefore, support for AOs should be more widely available, aiming to address AOs' needs holistically.

Exploring the Precipitating Events and Gambling-Related Activities that Prompt Problem Gamblers and Spouses/Cohabitants to Contact a Gambling Helpline

Gambling helplines have progressed to offer support and brief interventions for both the problem gambler (PG) and their spouse/cohabitant (S/C). S/Cs play an important role in assisting their partner with their recovery from a gambling disorder. However, few studies have investigated the concerns of both PGs and S/Cs who contact gambling helplines. The purpose of this study is to examine the reasons, gambling activities, and gambling locations/venues endorsed by PGs and S/Cs who contacted a state-wide gambling helpline. 938 individuals (809 PGs; 129 S/Cs) from the state of Florida contacted the Florida Council on Compulsive Gambling helpline to discuss gambling-related concerns. Helpline contacts (calls, texts, e-mails, and live chat interactions) between the period of July 1st, 2019, to June 30th, 2020, were examined. Callers/contacts provided information related to their demographic characteristics, the precipitating event leading to contact, the PG's primary gambling activity, and venue most often used by the PG. Chi-square tests were utilized to examine relationships and gender differences between PGs and S/Cs. Significant differences were found between the precipitating events for contacting the helpline and primary gambling locations/venues identified by PGs and S/Cs. Furthermore, gender differences were observed in the primary gambling activities and gambling locations/venues endorsed by the PG and S/C. The results suggest that PGs and S/Cs held different reasons when contacting the helpline. Future research should delve deeper into these disparities in order to build intervention programs tailored to the needs of both PGs and their S/Cs.

Intimate partner violence linked to gambling: cohort and period effects on the past experiences of older women

BACKGROUND

Problem gambling increases the risk of experiencing intimate partner violence (IPV). People impacted by gambling-related IPV face distinctive challenges, and these may be compounded by intersections with gender, generational influences and contextual factors. This study explored the past experiences of older women affected by male partner violence linked to gambling, and how these were shaped by cohort and period effects and problem gambling. Cohort effects are the generational characteristics of a group born at a particular time, while period effects relate to prevailing external conditions at the time of the abuse, including laws, services and practices.

METHODS

A larger study exploring the nature of the relationship between problem gambling and IPV recruited 72 women through help services and advertising. The current study analysed a subset of interviews with 22 women aged 50 years or over. We analysed the data using adaptive grounded theory to explore the intersection between IPV, gambling, and cohort and period effects.

RESULTS

Cohort effects on the women's experiences of IPV included gendered attitudes, traditional views of marriage, silence surrounding IPV, reticence to disclose the abuse, and little understanding of problem gambling. These influences deterred women from questioning their partner's gambling, and to instead keep the gambling and abuse hidden. Many women did not recognise abuse linked to gambling as IPV, since gambling was considered a normal, harmless pastime. Having a gambling problem exacerbated violence and coercive control by male partners as traditional gender norms supported male authority over their female partner. Women with a gambling problem sometimes felt they deserved the abuse. Period effects included a lack of IPV and gambling services, gendered service responses, failure to prioritise the women's safety, and no consideration by services of the role of gambling in the abuse.

CONCLUSION

Reducing gender inequality is critical to reduce male partner violence towards women. Women impacted by gambling-related IPV, including the legacy of past abuse, need service responses that recognise all forms of abuse, understand the historical and contextual factors that exacerbate it, and recognise how gambling can amplify IPV. A reduction in problem gambling is needed to reduce gambling-related IPV.

An integrative review of research on gambling and domestic and family violence: Fresh perspectives to guide future research

This paper presents an integrative review of research on domestic and family violence (DFV), including intimate partner violence (IPV), experienced by victims and perpetrators with a gambling problem. It aims to review, critique, and synthesize research on this topic to generate fresh and alternative perspectives to guide future research. Based on a systematic search of the academic literature and a targeted search of gray literature, the paper summarizes findings from empirical studies pertaining to the prevalence of perpetration and victimization, characteristics of perpetrators and victims, and explanations for this violence. Based on this review, the paper suggests several potential improvements that can be considered in future studies. These include a shift from focusing on situational violence to also include coercive control; greater sensitivity in research design and interpretation to gender differences in experiences of violence; and the need to include economic abuse as a form of DFV/IPV. Adopting a public health lens is also recommended to broaden the research focus from victims and perpetrators to also consider contextual factors. In particular, gambling research should examine the contribution of gambling products, practices, environments, and marketing to DFV/IPV and how this might be ameliorated. While research to date has drawn much needed attention to the risks that gambling presents for DFV/IPV, this review provides some suggestions for future research so that it can provide more nuanced findings to inform policy and practice.

Integrative couple treatment for pathological gamblers with an emphasis on forgiveness processes: A case study with three couples

Gambling's impact on a couple's relationship is an essential element in the gambling disorder (GD). Gamblers tend to lie to their partner to conceal the extent of their gambling problems and debts, which can lead to a serious relational transgression for the couple. One promising avenue is a couple treatment focusing on forgiveness processes. The objective of this study was to determine whether the Integrative Couple Treatment for Pathological Gamblers (ICT-PG) with an emphasis on forgiveness processes helped couples to enhance these processes. A Single-Case Research Design (SCRD) was used with three couples in which one of the members had a GD. The results highlight the importance of jointly analyzing the forgiveness processes between the gamblers and their partner, which constantly influenced each other. These promising results illustrate the relevance of integrating forgiveness processes in treatment for couples where one of the members has a GD.

Gambling-Related Intimate Partner Violence Against Women: A Grounded Theory Model of Individual and Relationship Determinants

This study aimed to examine how problem gambling interacts with gendered drivers of intimate partner violence (IPV) against women to exacerbate this violence. Interviews were conducted with 48 female victims of IPV linked to a male partner's gambling; 24 female victims of IPV linked to their own gambling; and 39 service practitioners from 25 services. Given limited research into gambling-related IPV, but a stronger theoretical base relating to IPV against women, this study used an adaptive grounded theory approach. It engaged with existing theories on gendered drivers of violence against women, while also developing a grounded theory model of individual and relationship determinants based on emergent findings from the data. Gambling-related IPV against women was found to occur in the context of expressions of gender inequality, including men's attitudes and behaviors that support violence and rigid gender expectations, controlling behaviors, and relationships condoning disrespect of women. Within this context, the characteristics of problem gambling and the financial, emotional and relationship stressors gambling causes intensified the IPV. Alcohol and other drug use, and co-morbid mental health issues, also interacted with gambling to intensify the IPV. Major implications. Reducing gambling-related IPV against women requires integrated, multi-level interventions that reduce both problem gambling and gendered drivers of violence. Gambling operators can act to reduce problem gambling and train staff in responding to IPV. Financial institutions can assist people to limit their gambling expenditure and families to protect their assets. Service providers can be alert to the co-occurrence of gambling problems and IPV and screen, treat, and refer clients appropriately. Public education can raise awareness that problem gambling increases the risk of IPV. Reducing gender inequality is also critical.

Women's perceptions of strategies to address the normalisation of gambling and gambling-related harm

OBJECTIVE

Research has demonstrated that gambling is becoming increasingly normalised for women. As limited research has sought to understand women's perspectives on this issue, we sought women's opinions about the factors that may contribute to the normalisation of gambling for women, and the strategies that may counter this normalisation.

METHODS

Semi-structured interviews were conducted with 41 women in young and middle adulthood, aged 20-40 years.

RESULTS

Participants suggested that gambling was normal for women because gambling environments had been designed to appeal to women, newer technologies had removed the stigma of attending physical venues, and the growing equality and independence of women. To de-normalise gambling, women suggested addressing the influential role of marketing, designing new public education strategies, addressing the availability and accessibility of gambling, and restricting engagement with gambling products.

CONCLUSION

This study highlighted women's perceptions of strategies to address the normalisation of gambling and the importance of providing risk information paired with broader policy reform and prevention initiatives to address the range of determinants that normalise gambling for women.

IMPLICATIONS FOR PUBLIC HEALTH

Involving women in advocacy and understanding their perspectives is important in developing relevant public health responses to the normalisation of gambling for women.

"They loved gambling more than me." Women's experiences of gambling related harm as an affected other

BACKGROUND

Gambling poses a global threat to public health due to its far-reaching impacts. Research has demonstrated a ripple effect of harmful gambling on social network members and broader communities. While researchers have documented extreme harms associated with an affected other, limited research has qualitatively investigated how women describe their concerns about the gambling of a social network member, and any subsequent negative impacts on their own lives.

METHODS

Online panel survey with women aged 18 years and older, who gambled at least once in the last 12 months, and resided in the Australian states of Victoria and New South Wales. This paper focused on the open text responses of a subsection of the sample (n = 136) who reported being negatively impacted by someone else's gambling. The study utilised thematic analysis to interpret the data.

RESULTS

Results indicated that women were concerned about the gambling behaviours of a broad range of social network members. Open text responses regarding the nature of these concerns mostly related to individualised paradigms of gambling behaviour - including whether the participant perceived their network member could afford to gamble, was being responsible with their gambling, or were gambling too frequently. Participants experienced a range of negative impacts including significant financial issues, relationship difficulties and poorer emotional wellbeing as a result of worrying about the gambler and loss of trust, with some describing the negative experiences associated with growing up with a problem gambler parent.

CONCLUSION

The research demonstrates the far-reaching impacts of gambling on affected others. This study enhances our understanding of how women are harmed by gambling and considers the complexities of their experiences and relationships with the gambler. This extends knowledge beyond quantitative descriptors of harm among affected others and provides a critical reflection on the nuances of women's experiences with gambling and gambling harm.

Secrecy, self-blame and risks for social exclusion-Family members' experiences of gambling problems in Japan

The predominant gambling policy to respond to the adverse consequences of excessive gambling has been the Reno Model, which places the responsibility for gambling-caused problems on gamblers themselves. The newly implemented Japanese gambling policy, which shares basic premises with the Reno Model, focuses on the individual pathology of gamblers. However, this model lacks other critical perspectives: environmental and structural factors. To fully understand the harms caused by gambling; it is important to also pay attention to the negative consequences for affected others. In this brief report, we explore family members' experiences of gambling problems within the specific context of the Japanese gambling policy. Interviews with family members reveal self-stigma of being bad parents which elicits shame and efforts to maintain secrecy, as well as public stigma involving labeling, isolation, risks of status loss, social exclusion and discrimination. The focus on individual pathology in Japanese legislation as well as in public and professional perception, reinforces self-blame, anxiety, and remorse on the part of affected family members. When contrasted with the lived experiences of gamblers' family members, the inconsistencies and unreasonableness of the individual pathology paradigm in Japanese gambling policy become evident. It is necessary to shift the focus of gambling policies from individual to socio-political-cultural factors, investigating how these factors influence gambling-caused harm, especially in the Japanese context.

Theoretically informed gender analysis for gambling harm reduction: a New Zealand study

BACKGROUND

Gambling harm affects men and women relatively equally, and gender influences the social determinants of gambling harm. Responses to preventing and minimising women's gambling harm have been shaped and constrained by population research identifying male gender as a key risk factor for gambling problems. Gender analysis in gambling studies is rare and has lacked theoretical underpinning and coherence, limiting possibilities for gender-responsive and gender-aware harm prevention and reduction activities.

METHODS

Two influential qualitative studies of gambling harm in New Zealand (involving total n = 165 people who gambled, affected others, community leaders, gambling and community support service providers, policy makers and academics) neglected to explore the role of gender. This study revisited data collected in these studies, using thematic analysis informed by feminist social constructionist theory. The overarching research questions were: How do gender-related issues, notions and practices influence women's gambling related harm? What are the implications for women's gambling harm reduction?

RESULTS

Women's socio-cultural positioning as primary caregivers for families and children constrained their ability to access a range of recreational and support options and increased the attractiveness of local gambling opportunities as accessible and 'safe' outlets for stress reduction. Patriarchal practices of power and control within family contexts operated to maintain gambling behaviour, shut down alternative recreational opportunities, and limit women's autonomy. Consideration of these themes in relation to current health promotion practice in New Zealand revealed that national programmes and strategies appear to be operating without cognisance of these gender dynamics and therefore have the potential to exacerbate or cause some women harm.

CONCLUSIONS

This study demonstrates the value of theoretically informed gender analysis for gambling harm reduction research, policy and practice. International guidelines for gender-aware and gender-responsive health research and practice should be engaged as a foundation for strategic and effective gambling harm reduction programmes, projects, research and policy, and as an essential part of developing and implementing interventions for gambling harm.

Gambling-Related Harms for Affected Others: A Finnish Population-Based Survey

Aims This study explores the prevalence of being a past-year affected other (AO) of a problem gambler by gender. The aims were to study the amount and type of gambling-related harms (GRHs) for subgroups of AOs and to distinguish GRH profiles for AO subgroups. Methods A total of 7186 adults aged 18 years and over participated in the Gambling Harms Survey evaluating year 2016. The data were analyzed using descriptive statistics and binary logistic regression. Results Of all respondents, 12.9% were defined as past-year AOs (women 13.7%; men 12.1%). The proportion of affected non-family members (ANFs) was 8.4%, and 5.6% were affected family members (AFMs). AFMs were usually women, and ANFs were usually men. Emotional, relationship, and financial harms were the most common types of harm. The odds of experiencing financial harm were highest for the 18- to 34-year-olds (OR 1.82) and for those whose partner/ex-partner had a gambling problem (OR 3.91). Having a parent/step-parent (OR 1.93) and child/stepchild (OR 3.64) increased the odds of experiencing emotional harm, whereas male gender (OR 0.50) and being an ANF (OR 0.58) decreased emotional harm. Relationship harm was evident for partners/ex-partners (OR 1.97-5.07). Conclusions GRH profiles for AO subgroups varied, which emphasizes the need for effective harm minimization strategies for those in need.

Do the Consequences Experienced by the People in the Life of a Problem Gambler Differ Based on the Nature of Their Relationship with the Gambler?

Consequences experienced by the partners of individuals with a gambling disorder are well documented. However, little is known about the deleterious effects experienced by other people than partners of gamblers. A better understanding of these consequences could help improve clinical practices. The goal of this paper is to compare the consequences experienced by partners of gamblers with those experienced by their close family members (parents, adult children, siblings) by using the categorization method proposed by Langham et al. (BMC Public Health, 2016). To achieve this goal, 46 semi-structured interviews were conducted. Results indicate that the extent and intensity of the consequences experienced vary widely based on their level of emotional and financial involvement with the gambler. Considering the specific elements involved for each type of person in a gambler's life, future research should distinguish participants based on the nature of their relationship with the gambler.

What's in a Name? Evaluating the Public Stigma of Gambling Disorder

Public stigma of gambling disorder has negative effects on the mental health and functioning of affected individuals and impedes treatment-seeking. One factor thought to be implicated in stigma is the label used to describe the condition. The aims of this research were to: (1) evaluate whether different labels for problematic gambling behavior influence public stigma; and (2) compare public stigma of gambling disorder to other health conditions. Separate samples of university student (Study 1) and general population (Study 2) participants were randomly assigned to label conditions and completed questionnaires assessing stigma and attitudes towards the assigned label. In Study 1, the eight conditions included four gambling labels (problem gambling, pathological gambling, gambling disorder, and gambling addiction) and four psychiatric or health comparison labels (depression, obsessive-compulsive disorder, alcohol use disorder, and asthma). In Study 2, compulsive buying disorder was added as a fifth psychiatric comparison for a total of nine conditions. The results indicated that the four gambling label conditions elicited similar attitudes and stigma. Those conditions were also more stigmatized than the depression, obsessive-compulsive disorder, and asthma conditions. The gambling conditions elicited similar stigmatizing attitudes as alcohol use disorder but were slightly more stigmatized than compulsive buying disorder, with these conditions showing both similarities and differences across the stigma-related outcomes. The results were largely consistent across both samples and contribute to knowledge of the nature and origins of gambling-related stigma.

How Can Partners Influence the Gambling Habits of Their Gambler Spouse?

An increasing number of clinical and empirical studies document the coping strategies used by partners of pathological gamblers (PGs). A postulate for this is that they may be useful for dealing with their partner's problematic gambling behaviors. Despite a widespread endorsement of this postulate, no study has yet documented their effectiveness: does the use of these coping strategies impact the gambler's behavior? To answer this question, semi-structured interviews were conducted with 19 participants (8 couples comprising one PG and his or her partner, one partner of a PG, and 2 PGs). Qualitative analysis of the interviews lead to a first main observation: via diverse coping strategies, partners of PGs can influence their spouse's gambling behaviors. The impact of these strategies may occur as initially expected by partners, that is by a reduction of gambling behaviors. However, the use of certain strategies can also increase the PG's gambling cravings, though this is not generally their partner's intention.

The Relationship Between Family Gambling Problems, Other Family Stressors, and Health Indicators in a Large Population-Representative Sample of Australian Adults

PURPOSE

Harms due to excessive gambling can be experienced by gamblers and those close to them. Family gambling problems (FGPs) are currently under-researched, particularly in population-representative samples. This study aimed to identify prevalence, risk factors, and the complex of stressors and health-related consequences associated with FGPs, as well as isolating the impact of FGPs on physical and psychological health problems.

METHODS

We analysed data from the National Health Survey 2011-13, a large (N = 15,475) nationally representative sample of Australian adults. Participants reported on the presence of 14 family stressors (including FGPs), self-assessed health status, and risky health behaviours. Psychological impact was measured by the Kessler Psychological Distress Scale-10, as well as several indicators of the presence of mental health problems.

RESULTS

Overall, 1.7% of households reported a FGP. Interviewees in these households reported three times the number of other stressors than those without a FGP. In addition, they were around eight times more likely to be experiencing other addictions (drug and alcohol related problems) and stressors associated with socially deviant behaviours (trouble with police, abuse or violent crime, and witness to violence). Once age, gender, socioeconomic disadvantage, and other stressors were controlled for, FGPs significantly predicted lower self-assessed health and higher psychological distress.

CONCLUSIONS

FGPs occur within a complex of other addictions and stressors, impacting the quality of life of people close to problem gambling. The findings are discussed in relation to their support for General Strain Theory (Agnew, Criminology 30:47-87, 1992).

What Can be Done to Reduce the Public Stigma of Gambling Disorder? Lessons from Other Stigmatised Conditions

Gambling is embedded in Australian cultural history, and perceived as a normal, legitimate leisure activity. Despite this normalisation, people who experience gambling problems are heavily stigmatised which can lead to a variety of harms that extend beyond the individual. The stigma from the general public appears to be based on a stereotype of a typical "problem gambler"-selfish, greedy, impulsive and irresponsible. However, research suggests that people experiencing gambling problems have widely varying characteristics and do not conform to this stereotype. Regardless of whether the stigma is justified, it is both present and problematic. Gamblers experiencing problems delay help-seeking due to feelings of shame and, not unwarranted, expectations of negative judgement because of the heavy stigma associated with the stereotype. As stigma is a primary barrier to treatment and a reason why gambling problems can take longer to acknowledge, it is important to understand and address how stigma can be reduced to minimise the negative consequences of gambling on individuals, their families and friends and the wider community. There is little research on reducing gambling-related stigma, so there is a need to examine strategies used in other stigmatised conditions, such as mental health, to understand the general principles of effective stigma reduction measures. Because gambling disorder is unique, well-hidden and consequently not well understood, there is a need to recognise that techniques used in other domains may differ in their effectiveness within the context of gambling stigma.

Weighing up the risks and benefits of community gambling venues as recreational spaces for people with lifelong disability

BACKGROUND

Community gambling venues (pubs and clubs) are commonly associated with leisure and recreational options in Australian communities. While these venues offer a range of activities and facilities, including social opportunities, sporting facilities, live entertainment, they also contain gambling products that are known to cause significant harm to individuals, their families and communities. Although researchers have explored how adults and children engage with these venues, there is limited understanding about the potential risks and benefits of these venues for people with lifelong disability.

METHODS

Semi structured interviews were conducted with nineteen people aged 20-70 years with lifelong disability (includes in this context intellectual disability, autism spectrum disorder, ADHD, and learning disability), predominately intellectual disability. The interviews occurred in a large Australian city and explored interviewees' experiences and attitudes towards pubs and clubs. Using a range of visual prompts (if needed), participants were asked to describe their engagement in different activities offered within the venue. Interviews were audio-recorded and transcribed, with a thematic analysis used to identify themes across the group.

RESULTS

Most participants attended venues with family, friends, and supporters, with a few attending on their own. Participants described socialising in the venue, going for reduced price meals, and attended for a range of activities including recreational activities, live entertainment and sport. Some participants also valued being a member of venues, and the interactions with staff members. While participants were cautious about the consumption of alcohol, most had gambled, particularly on electronic gambling machines (EGMs, pokies, or slots). Some participants stated that they had experienced problems with gambling.

CONCLUSIONS

While many people with lifelong disability have positive experiences in pubs and clubs, some are vulnerable to the harms associated with risky products such as gambling within the venue. While it is important to acknowledge the positives associated with recreational facilities and encourage engagement in leisure activities for people with lifelong disability, further consideration is needed to ensure people are informed and protected from the harms associated with gambling and other products that are provided within these spaces.

Perceived social stigmatisation of gambling disorders and coping with stigma

Aim:

This study concerns perceived social stigmatisation of gambling disorder and its determinants, the self-perceptions of people with gambling disorder (self-stigma) and how they cope with stigma.

Design:

In total, 30 interviews with persons with gambling disorder and 60 with professionals were conducted. Selective sampling procedures were employed in the recruitment phase. In the case of professionals, the inclusion criteria were employment in facilities where treatment of gambling disorder is offered, and profession. For people with gambling disorder, the criterion was a diagnosis confirmed by a psychiatrist.

Results:

Elements revealed in past research on stigma-creation processes were reflected in respondents’ statements. The type of gambling, the occurrence of negative consequences, the possibility of hiding, personal responsibility, social status and contact with stigmatised populations are perceived determinants of problem gamblers’ stigmatisation. Gambling disorder sufferers experience anxiety associated with the possibility of rejection and a fear related to their condition being revealed to others. Various manifestations of cognitive distancing and hiding were coping mechanisms identified in the study.

Conclusions:

People with gambling disorder experience anxiety associated with the possibility of rejection, and they often conceal their disorder, which may hinder their treatment. Therefore the issue of stigma should be addressed in therapy.

Public health effects of gambling - debate on a conceptual model

BACKGROUND

Gambling for money is a popular leisure time activity in most countries, which has major social and economic impacts not only affecting the gambler, but his/her significant others, and the society. Gambling impact studies can help researchers and policymakers compare the health and social costs and benefits of different gambling policies and can be used when considering which gambling policies will reduce or increase costs or benefits the most. In a public health approach, the impacts of gambling, negative and positive, are assessed across the entire severity spectrum of the activity. Although some studies have created basic principles for conducting impact studies, a theoretical model is currently lacking. The aim of this debate is to review complementing and contrasting views on the effects of gambling to create a conceptual model, where a public health perspective is applied.

MAIN TEXT

The effects of gambling can be structuralized using a conceptual model, where impacts are divided into negative and positive; costs and benefits. Costs and benefits are categorized into three classes: financial, labor and health, and well-being. These classes manifest in personal, interpersonal, and societal levels. Individual impacts cause effects on a personal level to gamblers themselves. External impacts influence the interpersonal and society/community levels and concern other people. The temporal level refers to the development, severity and scope of the gambling impact. These include general impacts, impacts of problem gambling and long-term impacts of gambling.

CONCLUSIONS

The conceptual model offers a base on which to start building common methodology for assessing the impact of gambling on the society. While measuring monetary impacts is not always straightforward, the main issue is how to measure the social impacts, which are typically ignored in calculations, as are personal and interpersonal impacts. The reviewed empirical work largely concentrated on the costs of gambling, especially costs on the community level. The Model can be used to identify areas where research is scarce. Filling the gaps in knowledge is essential in forming a balanced evidence base on the impacts of gambling. Ideally, this evidence could be the starting point in formulating public policies on gambling.

Gambling and family: A two-way relationship

Background and aims Families play an important role in the evolution of gambling and are also adversely affected by the disordered gambling of any one of their members. The aims of this study were to explore both the role families play in gambling initiation, maintenance, and help-seeking, and the harm caused to families by the gambling behavior using a qualitative approach. Methods Regular older adult gamblers were included in the study. In-depth interviews were conducted with 25 older adults to gain an understanding of gambling from their perspective. Older adult gamblers described their lived experience of gambling ranging from initiation to harm and attempts to cut down or limit gambling. Data were analyzed using thematic network analysis. Results The mean age of the 25 participants was 66.2 years. The majority were male (n = 18), of Chinese ethnicity (n = 16), had secondary education (n = 9), were married (n = 20), and currently employed (n = 15). Four organizing themes related to the role of families in initiation and maintenance of gambling, harm caused to family members, and their role in help-seeking were identified. Discussion and conclusions The study emphasizes the role of Asian families in both initiation and maintenance of gambling. Hence, families must be involved in prevention and outreach programs. Family members must be educated, so that they can encourage help-seeking to ensure early treatment and recovery. There is a need for interventional studies for reducing stress and improving coping among family members.

The Public Stigma of Problem Gambling: Its Nature and Relative Intensity Compared to Other Health Conditions

Problem gambling attracts considerable public stigma, with deleterious effects on mental health and use of healthcare services amongst those affected. However, no research has examined the extent of stigma towards problem gambling within the general population. This study aimed to examine the stigma-related dimensions of problem gambling as perceived by the general public compared to other health conditions, and determine whether the publicly perceived dimensions of problem gambling predict its stigmatisation. A sample of 2000 Australian adults was surveyed, weighted to be representative of the state population by gender, age and location. Based on vignettes, the online survey measured perceived origin, peril, concealability, course and disruptiveness of problem gambling and four other health conditions, and desired social distance from each. Problem gambling was perceived as caused mainly by stressful life circumstances, and highly disruptive, recoverable and noticeable, but not particularly perilous. Respondents stigmatised problem gambling more than sub-clinical distress and recreational gambling, but less than alcohol use disorder and schizophrenia. Predictors of stronger stigma towards problem gambling were perceptions it is caused by bad character, is perilous, non-recoverable, disruptive and noticeable, but not due to stressful life circumstances, genetic/inherited problem, or chemical imbalance in the brain. This new foundational knowledge can advance understanding and reduction of problem gambling stigma through countering inaccurate perceptions that problem gambling is caused by bad character, that people with gambling problems are likely to be violent to other people, and that people cannot recover from problem gambling.