Gambling-related harm as reported by concerned significant others: a systematic review and meta-synthesis of empirical studies

The availability of legalized gambling products has increased over the past three decades. Though the negative personal consequences of problem gambling (PG) are well documented, a comprehensive picture of gambling-related harm from the perspective of concerned significant others (CSOs) is lacking. The aim of this systematic review was firstly, to describe the nature of existing peer-reviewed published studies from inception through to July 2018 that have directly engaged CSOs concerning gambling-related harm. Secondly, to synthesize this literature and describe the impacts of PG on CSOs; how CSOs respond to gambling-related harm; identify gaps in the literature, and provide specific directions for future research. A systematic search strategy identified 53 studies. Following the extraction of data, a meta-synthesis was conducted on the 26 quantitative, 21 qualitative and 6 mixed-methods studies. Partners are especially impacted, suffering both mental and physical health problems. Children are also particularly affected, and appear to suffer silently due to their reluctance to disclose their parental PG worries. Problem gambling treatment and counselling services should take into account the pervasiveness of the impacts of PG, and be equipped to respond appropriately to the needs of CSOs. Future research should focus on male CSOs, and CSOs associated with non-help-seeking problem gamblers.