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Table 2 A taxonomy of harms experienced by affected others of people who gamble

From: Understanding gambling related harm: a proposed definition, conceptual framework, and taxonomy of harms

  General Crisis Legacy
Financial Harm • Additional costs due to lack of capacity of person who gambles to meet their costs or joint costs (minor to major items)
• Reduction or loss of capacity to purchase luxury items such as holidays, electronics
• Reduction or loss of discretionary spending such as non-gambling related entertainment or other family members’ activities (ie. children’s sports)
• Erosion of savings
• Activities to manage short term cash-flow issues:
o Additional employment or other forms of income generation
o Accessing more credit
o Use of credit cards (kite flying)
o Selling or pawning items
o Pay day loans
o Non-payment or juggling of large bills such as utilities or rates
• Cost of replacing items sold or pawned as part of short term cash strategies
• Reduction or loss of non-immediate consequence expenditure
o Insurance (health, home, car, income protection, business)
o Repairs or maintenance costs (home, car, business)
o Health promotion activities (check-ups, long term medications, allied health support)
o Household items
• Reduction or loss of expenditure on items of immediate consequence:
o Children’s expenses (education)
o Medication or health care
o Clothing
o Food (including use of food parcel)
o Housing or accommodation
o Needing assistance with bill payments from welfare organisations or inability to pay bills (eg utilities)
o Transport costs (petrol, fares)
• Loss of capacity to meet requirements of essential needs (food)
• Loss of normal accommodation requiring temporary accommodation or resulting in homelessness
• Loss of major assets (car, home, business)
• Bankruptcy
• Reliant on welfare
• Restrictions due to bankruptcy or credit rating
• Ongoing financial hardship
• “Forced” cohabitation or involvement in unhealthy relationship due to financial constraint
• Further financial harm from attempts to manage debt (ie. Non-reputable finance providers for debt consolidation)
• Ongoing issues relating to financial security, poverty, or financial disadvantage.
• Higher costs associated with poor credit rating including premium cost of pay as you go services or increased security bonds.
Relationship Disruption, Conflict or Breakdown • Dishonest communication within relationship from person who gambles to affected other
• Person who gambles is unreliable or unavailable to affected other
• Reduced amount of time spent with person who gambles
• Reduced quality of time spent with person who gambles
• Feelings of unequal contribution to relationship with person who gambles
• Disengagement or withdrawal from relationship responsibilities by person who gambles
• Increased levels of neglect of relationship by person who gambles
• Reduced engagement in family or social events with person who gambles,
• Tension in relationship with person who gambles
• Tension in other relationships due to emotional and/or material demands of trying to manage relationship with person who gambles
• Minor or occasional conflict due to increased involvement in gambling or suspicion of increased involvement with gambling by person who gambles
• Serious or regular conflict due to increased involvement in gambling or suspicion of increased involvement with gambling by person who gambles
• Major or constant conflict due to increased involvement in gambling or suspicion of increased involvement with gambling by person who gambles
• Loss of trust from relationship with person who gambles
• Episodic distortion of relationship roles (infantilising the person gambling, others including children having to take parental type role)
• Significant disruption to other relationships due to emotional and/or material demands of trying to manage relationship with person who gambles
• Episodic distortion of relationship between affected others (ie. Spouse of person who gambles using children of relationship as confidant)
• Incidence or escalation of family violence or intimate partner violence
• Contemplation of separation or rejection from relationship with person who gambles
• Actual separation or rejection from relationship with person who gambles and potentially related others
• Loss of other relationships due to emotional and/or material demands of trying to manage or remaining in relationship with person who gambles
• Social isolation due to feelings of shame or being stigmatised
• Loss of relationship (temporary or permanent) with spouse, partner, children, family, friends or community
• Distortion of relationship roles (infantilising the person gambling, others including children having to take parental type role)
• Incidence or escalation of family violence or intimate partner violence
• Feelings of guilt over ending relationship with person who gambles and potential impact
• Social isolation due to ongoing estrangement from other relationships
• Vulnerability to continuing in ongoing unhealthy relationship with person who gambles (episodic reconciliations) for reasons of guilt or inadequacy
• Inability or reluctance to participate in social functions at gambling venues to protect person who gambles
• Ongoing resentment and shame within relationship with person who gambles
• Relationship rebuilding or reconciliation
• Ongoing involvement of family court in parenting or co-parenting
• Long term damage or estrangement from person who gambles and potentially related others
• Ongoing distortion of relationship roles (infantilising the person gambling, others including children having to take parental type role or confidant role)
• Inability to form trusting relationships with others or hypervigilance within relationships
• Incidence or escalation of family violence or intimate partner violence
Emotional or Psychological Distress • Feelings of frustration over person who gamble’s behaviour
• Anxiety when person who gambles does not respond to normal communication methods
• Emotional and psychological distress caused by difference to own value system
• Emotional or psychological distress of feelings of suspicion or being lied to
• Reduced feelings of self-worth
• Feelings of shame or guilt
• Loss of feeling safe and secure in life
• Increased feelings of inadequacy or personal failing because of inability to help person who gambles
• Emotional or psychological distress from being manipulated or threatened (threats to the affected other or threats of self harm by person who gambles)
• Perceptions of being stigmatised
• Anxiety when person who gambles disappears for extended periods of time without contact (days)
• Emotional or psychological distress of being blamed for other person’s gambling
• Emotional or psychological distress at people arguing because of gambling behaviours (children)
• Increased feelings of insecurity and vulnerability
• Emotional or psychological distress caused by other harms
• Loss of “face” or reputation due to impact of other harms
• Loss of sense of future or ability to get ahead
• Increasing feelings of powerlessness
• Guilt over harms to other affected others
• Increased feelings of anger and frustration
• Fear and distress from follow up and harassment by creditors (legal and illegal)
• Feelings of guilt if affected other was the person who introduced the person who gambles to gambling
• Increased risk to emotional or psychological wellbeing of affected other in the care of the person who gambles due to their distraction or tiredness
• Extreme emotional or psychological distress in relation to other harms
• Extreme emotional or psychological distress due to harm caused to other affected others
• Extreme emotional or psychological distress caused by living in constant feelings of insecurity and vulnerability
• Complete loss of feelings of self-worth and pride
• Extreme shame
• Extreme sense of hopelessness and powerlessness
• Emotional or psychological distress of dealing with person who gambles problems including their distress, self harm, suicidal ideation or completion.
• Loss of “face” or reputation (stigma) if person who gambles’ problem with gambling becomes publicly known
• Emotional or psychological distress of supporting and/or assisting person who gambles to seek treatment
• Extreme fear and distress from follow up and harassment by creditors (legal and illegal)
• Grief and/or resentment for loss of security, lifestyle, relationship
• Feelings of rejection that gambling is chosen over them
• Experienced and perceived stigma
• Ongoing guilt and shame
• Emotional and psychological impacts of supporting recovery or harm minimisation strategies including constant vigilance and behavioural adaptation
• Ongoing feelings of insecurity and vulnerability
• Ongoing emotional and psychological distress in relation to other harms
• Ongoing emotional or psychological distress due to harm caused to other affected others
• Ongoing emotional or psychological distress of vigilance to mental health status of person who gambles including distress, self harm, suicidal ideation or completion
• Ongoing feelings of grief, resentment and anger
Decrements to Health • Physical impacts of other harms
• Biological manifestation of emotional and psychological distress eg. Feeling tired, increased blood pressure, loss of sleep, migraine, nausea, diarrhoea
• Reduced levels of self-care:
o nutrition
o hygiene
o sufficient sleep
o compliance with medical care
o physical activity
o reduced quality of living circumstances (ie cannot afford heating)
• Incidence of disease or injury due to reduced levels of self care
• Increased risk due to gateway effect, interaction with, or exacerbation of other health risk factors (drinking, smoking, illegal substances)
• Increased risk due to gateway to, interaction with, or exacerbation of morbidities (depression, anxiety, biophysical chronic disease)
• Increased experience of family violence due to involvement with person who gambles
• Incidence of self-harm
• Increased risk to physical wellbeing of affected other in the care of the person who gambles due to their distraction or tiredness
• Onset of health condition due to exacerbation of risk factors or continued stress from other harms
• Physical impacts of living rough due to homelessness, including increased risk of disease, violence and impact of poor living conditions
• Experience of violence due to involvement with person who gambles
• Medical emergency (including mortality) due to onset, exacerbation, or failure to diagnose condition due to impacts of person who gamble’s behaviours
• Serious self-harm
• Attempted (or completed) suicide
• Ongoing disability or decrement to health through attempted suicide or other forms of self-harm
• Ongoing increased risk of disease or decrement to health due to legacy effects of risk factors or poor self-care
• Ongoing disability or decrement to health due to other medical conditions exacerbated or advanced due to involvement with person who gambles
Cultural Harm • Reduced engagement in cultural rituals
• Culturally based shame in relation to cultural roles and expectations
• Reduction of contribution to community and cultural practices of the community
• Reduction of cultural practices
• Reduced connection to cultural community
• Harm to individual through reduced connection to community and culture in terms of increased social exclusion or isolation
• Extreme cultural shame in relation to culturally based roles and expectations
• Loss of contribution to community
• Impact (loss) on cultural practices
• Damaged or lost connection to community and culture
• Damage to individual through reduced or lost connection to community
• Ongoing (including intergenerational) cultural shame in relation to culturally based roles and expectations
• Ongoing reduction or loss of contribution to community
• Ongoing reduction or loss of cultural practices
• Ongoing loss of connection to community
• Ongoing (intergenerational)damage to individual through reduced connection to community
Reduced Performance at Work or Study • Reduced performance due to tiredness or distraction
• Increased absenteeism due to time spent supporting or addressing problems of person who gambles
• Reduced availability to contribute to the community through volunteer work
• Theft or fraud involving employment or educational institution
• Loss of job, suspension or exclusion from educational institution
• Exacerbation or contribution to other harms due to job loss (including loss of wage)
• Impact on others of loss of job or education
• Reduced opportunity for employment or enrolment due to past poor performance or criminal activity
• Trans-generational impact of loss of income and reduced future ability to participate in employment
• Ongoing impact in participation in volunteer work (linked to reputation and restriction of activities)
Criminal Activity • Victim of crime from person who gambles – petty theft of items or small amounts of cash.
• Vulnerability to illegal activities that can provide fast access to funds
• Engagement in crimes of opportunity - petty theft including from family members
• Engagement in crimes of opportunity - property crimes for funds, illicit lending, fraudulent efforts to attain funds
• Engagement in crimes of duress - relating to repaying debt such as drug trafficking and prostitution
• Victim of crime from person who gambles –fraud
• Victim of crime from person who gambles – significant theft of money or items
• Victim of crime from involvement of person who gambles in illegal activities
• Arrest and/or conviction of criminal activity of opportunity
• Arrest and/or conviction of criminal activity of duress
• Arrest and/or conviction of criminal activity of negligence
• Ongoing impacts from being victim of crime
• Impact of criminal record on future employment opportunities, voluntary and community opportunities, travel restrictions
• Disruption to relationships of custodial sentence
• Ongoing impact on spouse, partner, child, family and friends due to impact of criminal record or custodial sentence through other mechanisms
• Trans-generational impact of criminal record or custodial sentence
• Shame and stigma of criminal conviction or involvement in criminal activity
Lifecourse and Intergenerational Harms
• Delay in life course events and matters of financial security and achievement
• Generational loss relating to financial security or financial achievement (ongoing impact caused by loss of major asset, superannuation)
• Loss of lifecourse events such as engagement/marriage/having children (generational loss)
• Loss of primary relationships and social connection (including parents/children/community)
• Homelessness
• Having to move towns / states due to impact of person who gambles or other harms
• Incarceration