Problem gambling and affected others: health, relational and economic outcomes across longitudinal trajectories in a population-based Swedish study

Abstract

Abstract Background Exposure to another person’s gambling problems has been linked to a range of adverse outcomes among affected others (AOs); however, most evidence is based on cross-sectional studies. Less is known about how such outcomes vary over time and across different patterns of exposure. Aim This study examined health (including mental distress, suicidal ideation, hazardous alcohol use, and own gambling behaviour), relational (arguing, exposure to violence), and economic outcomes longitudinally across different trajectories of AO exposure in the general population. Methods Data were drawn from two waves (2018 and 2021) of the Swedish Longitudinal Gambling Study (Swelogs). The analytic sample included 2 814 respondents who participated in both waves. AO status was based on a single item asking whether the respondent knew someone close to them who, in their own opinion, had problems with gambling in the past 12 months, and was classified into four trajectories: never AO, former AO, newly AO, and persistent AO. Outcomes in 2021 were compared between each AO trajectory and never AO respondents using chi-square tests and logistic regression models, adjusting for sex, age, and own gambling. Results Persistent AOs showed consistently higher prevalence and odds of adverse outcomes across all domains, including serious mental distress, hazardous alcohol use, relational conflict, violence exposure, and economic hardship. Former AOs generally showed attenuated risks relative to persistent AOs, although economic hardship remained significantly elevated after adjustment. Newly AOs exhibited elevated odds of hazardous alcohol use, increased arguing, and economic hardship compared to never AOs. Conclusions The findings suggest that AO status may be better conceptualised as a dynamic condition than a fixed one. Both sustained and past exposure to another person’s gambling problems were associated with adverse outcomes, with economic hardship showing a particularly persistent pattern. Prevention and support initiatives should consider not only current exposure but also exposure history when identifying individuals at risk. In addition, given the consistent associations observed between AO status and hazardous alcohol use, relational conflict, and economic hardship, individuals presenting with these difficulties in clinical or support settings may also benefit from being asked about exposure to a close other’s gambling problems.