The impact of gambling problems on families

AGRC Discussion Paper No. 1 – November 2014

What are the impacts of gambling problems on families?

  • Gambling problems affect the functioning of family and intimate relationships.
  • Gambling problems affect intimate partners, as well as other family members including children, parents, siblings and grandparents.
  • Impaired family relationships, emotional problems and financial difficulties are some of the most common impacts on family members of people with gambling problems.
  • There is consistent evidence of an association between gambling problems and family violence.
  • The children of problem gambling parents are at a much higher risk of developing gambling problems than the children of non-problem gambling parents.

What are the effects on intimate relationships?

The effects of gambling problems on intimate relationships have been divided into three distinct phases: (1) the denial phase, (2) the stress phase, and (3) the exhaustion phase (Custer & Milt, 1985). These phases are visualised in Figure 1, which displays the typical course for the effect of gambling problems on intimate relationships. The types of impacts identified in this model have generally been confirmed by recent research, which suggests that the intimate relationships of people with gambling problems involve poor communication, relationship and sexual dissatisfaction, conflict and arguments, and consideration of separation or divorce (Dowling, Smith, & Thomas, 2009; Hodgins, Shead, & Makarchuk, 2007).

Figure 1: Typical course for the effect of gambling problems on intimate relationships

Figure 1: Typical course for the effect of gambling problems on intimate relationships - as described in text.

Source: Adapted from Custer & Milt (1985)

I've lost two relationships to it, lost three children, and lost the house to it ... a big impact. (Source: Dowling, Suomi, Jackson, & Lavis, 2014a)

What are the impacts on family environments?

The family environments of people with gambling problems are also characterised by high levels of anger and conflict as well as low levels of clear and effective communication, less independence, less engagement in intellectual and cultural activities, a lack of commitment and support, little direct expression of feelings, and less participation in social and recreational activities (Ciarrocchi & Hohmann, 1989; Ciarrocchi & Reinert, 1993; Dowling et al., 2009). These family environments are comparable to those of people with drinking problems (Ciarrocchi & Hohmann, 1989). Moreover, the children of people with gambling problems are exposed to a range of family stressors, including financial and emotional deprivation, physical isolation, inconsistent discipline, parental neglect/abuse and rejection, poor role modelling, family conflict, and reduced security and stability (Darbyshire, Oster, & Carrig, 2001). Kalischuk and colleagues summarised the most common problems reported by family members of people with gambling problems (see Box 1) (Kalischuk, Nowatzki, Cardwell, Klein, & Solowoniuk, 2006).

My children have gone without, there are unpaid debts, we never had the money to go away. (Source: Dowling, Suomi et al., 2014a)

It has changed the way I communicate with my two children, son 10 years old and daughter 16 years old. I'm less patient with them or I cut myself off from them after a gambling episode. Then, I isolate myself and lock myself in my bedroom. (Source: Dowling, Suomi et al., 2014a)

Box 1: Common problems reported by family members of people with gambling problems

Common gambling problems reported by family members include:

  • the loss of household or personal money;
  • arguments;
  • anger and violence;
  • lies and deception;
  • neglect of family;
  • negatively affected relationships;
  • poor communication;
  • confusion of family roles and responsibilities;
  • the development of gambling problems or other addictions within the family.

Source: Kalischuk et. al. (2006)

Is there a relationship between gambling problems and family violence?

There is now consistent international evidence that gambling problems are associated with intimate partner violence (IPV) and family violence more broadly (Dowling et al., in press). The relationships are complex; however, people with gambling problems are more likely than people without gambling problems to be victims and perpetrators of IPV.

The World Health Organization (2002) defines IPV as any behaviour within an intimate relationship that causes physical, psychological or sexual harm to those in that relationship. This can include acts of physical violence, sexual violence, emotional (psychological) abuse and controlling behaviours. According to a systematic review of the available research conducted internationally (Dowling et al., in press), over one-third of people with gambling problems report being the victims of physical IPV (38%) or the perpetrators of IPV (37%). Moreover, 11% of offenders of IPV report gambling problems.

Although most of the evidence relates to intimate relationships, there is some evidence that the victimisation and perpetration of violence extends to children and other members of the broader family (Dowling, Jackson, et al., 2014; Dowling et al., in press; Suomi et al., 2013). According to the systematic review, over half of people with gambling problems (56%) report perpetrating physical violence against their children (Dowling et al., in press). Moreover, several recent Australian studies have found that one-third to one-half (34-53%) of people with gambling problems and their family members report some form of family violence in the previous 12 months (victimisation (27-41%), perpetration (23-33%); Dowling, Jackson et al., 2014; Suomi et al., 2013). In these studies, parents, current partners and former partners were both the most common perpetrators and victims of the family violence. However, results from studies involving family members other than partners must be interpreted with caution. Only a few studies are available with large variability in reported prevalence estimates. In addition, many studies are not representative of the general population, include only small numbers of problem gamblers, use groups that may experience multiple problems in addition to gambling-related issues, and use different definitions of violence. Further research is required to provide information about the relationship between problem gambling and violence that extends into the family beyond intimate partners.

The exact nature of the relationship between problem gambling and family violence is yet to be determined. Preliminary findings from family members in an Australian study suggest that gambling problems precede both victimisation and perpetration of family violence (Suomi et al., 2013). Gambling-related stressors - such as financial losses, mistrust and poor communication - can lead to chronic stress, family conflict and the perpetration of violence by family members against the gambler. Gambling losses and other problems can also lead to the perpetration of violence by people with gambling problems against family members as a result of stress, anger and financial crisis within the home. These explanations imply that the stress and strain of living with a problem gambling family member results in a heightened risk of family violence. However, it must be noted that a commonly held view is that some people gamble as a mechanism to cope with being a victim of family violence. Much more research is needed to increase our understanding of the complex relationship between gambling problems and family violence.

Regardless of whether gambling problems or family violence comes first, the findings of the systematic review suggest that several factors are implicated in the relationship between gambling problems and IPV (Dowling et al., in press). Less than full employment and anger problems seem to exacerbate the relationship between gambling problems and being a victim of IPV, while younger age, less than full employment, anger problems, impulsivity, and alcohol and drug use seem to exacerbate the relationship between gambling problems and perpetrating IPV. These findings highlight the need for public health and treatment services to routinely screen and assess for a range of issues, including gambling problems, family violence, alcohol and drug use problems and mental health issues, and provide treatments designed to manage this cluster of conditions.

What are the effects on the health and wellbeing of family members?

Gambling problems adversely affect intimate partners and children in a number of ways (Dickson-Swift, James, & Kippen, 2005; Hodgins, Shead, et al., 2007; Vitaro, Wanner, Brendgen, & Tremblay, 2008). While emotional difficulties, physical complaints and behavioural difficulties are common, they can be experienced and expressed quite differently, as seen in Box 2.

Box 2: Effects on family member health and wellbeing

  Intimate partners Children
Emotional disturbances Anger
Resentment
Depression
Anxiety
Depression
Hopelessness
Anxiety
Confusion Guilt
Physical complaints Headaches
Gastrointestinal ailments
Hypertension
Asthma
Allergies
Chronic headaches
Behavioural difficulties Excessive drinking
Smoking
Over/under-eating
Impulsive spending
Running away
Alcohol and tobacco abuse
Over-eating
Lower academic/employment performance
Illegal acts

It's stressed [my family], they are trying to help me financially … so I've put a lot of pressure on them. They are worried and concerned about my health and mental health, and what has caused my gambling. (Source: Dowling, Suomi et al., 2014a)

Are gambling problems transmitted from one generation to the next?

The children of problem gambling parents are also at risk of developing gambling problems themselves. The findings across four independent studies exploring the intergenerational and familial transmission of gambling problems in Australia (see Dowling, Jackson, Thomas, & Frydenberg, 2010 for a review) revealed that people who had a parent or sibling with a gambling problem were two to ten times more likely to experience gambling problems than people without a parent or sibling with a gambling problem. People with problem gambling fathers were 11 to 14 times more likely to have gambling problems and people with problem gambling mothers were 7 to 11 times more likely to have gambling problems. Box 3 provides a summary of the main risk and protective factors related to the intergenerational transmission of gambling problems.

Box 3: Risk and protective factors for the intergenerational transmission of gambling problems

Risk factors:

  • gambling at a young age;
  • parental drug and mental health problems;
  • personal drug use;
  • gambling to reduce negative emotions or increase positive emotions;
  • gambling to socialise;
  • expecting gambling will lead to positive outcomes (e.g., feelings of control or financial gain).

Protective factors:

  • being female;
  • having higher social resources and networks;
  • being born in Australia;
  • having more siblings;
  • expecting gambling will lead to negative outcomes (e.g., depression or over-involvement).

Source: Dowling et al. (2010)

I suppose once it runs in your family, it runs in your blood. (Source: Dowling et al., 2010)

I used to put a bet on for them but my wife asked me to stop - when I grew up it was the normal thing to do. (Source: Dowling et al., 2010)

What are the impacts reported by family members attending gambling services?

One final line of evidence relating to the impacts of gambling problems on families comes from family members who access gambling counselling services. The most common presenting issues for the family members who attend Australian gambling support services relate to impaired family relationships, emotional problems and financial difficulties, followed by social difficulties, impaired physical health and employment problems (Crisp, Thomas, Jackson, & Thomason, 2001; Dowling, Rodda, et al., 2014; Dowling, Suomi et al. 2014a; Hing, Tiyce, Holdsworth, & Nuske, 2013). For example, data from an Australian national online gambling support service found that family members are most likely to report emotional distress (98%), negative impacts on their relationship with the gambler (96%), negative impacts on their social life (92%) and financial hardship (91%), followed by diminished work capacity (84%) and physical health problems (77%) (Dowling, Rodda, et al., 2014). Although help-seekers were most often intimate partners, there were few differences in the profile of impacts between family members (i.e., partners, children, parents and siblings) (see Figure 2).

Figure 2: Impacts reported by different family members Figure 2:	Impacts reported by different family members - as described in text.

Source: Dowling, Suomi et al. (2014)

An indication of more specific family impacts is provided by a study exploring the family impacts of gambling problems from the perspective of gamblers accessing Australian face-to-face gambling counselling services (Dowling, Suomi et al., 2014a). The most common responses from family were a loss of trust in the gambler (63%), anger towards the gambler (61%), depression or sadness (59%), anxiety (58%), distress due to gambling-related absences (56%), reduced quality of time spent with the gambler (52%), and a breakdown in communication (52%).

My gambling financially ruined everything we had worked hard for. (Source: Dowling, Suomi et al., 2014a)

The lying and stealing has created trust issues for my family. (Source: Dowling, Suomi et al., 2014a)

Despite these findings, there remains a dearth of information about how gambling problems impact on the health and wellbeing of family members. Further research that explores how different family members are affected and the factors that influence adverse effects is clearly required. Moreover, because it is likely that problem gamblers under-report family impacts (Dowling, Suomi et al., 2014a), it will be important for research to involve family members as well.