Exploring the prevalence of gambling harm among active duty military personnel: a systematic scoping review

The prevalence of gambling harm among active-duty military personnel is a largely unexplored topic. With different forms of social gambling often found within (or near) military bases around the world, understanding the extent of gambling activities and consequent harms occurring within military contexts warrants further attention. This review aims to identify, describe, and thematically synthesize published literature on gambling harm and related issues among active-duty military personnel. Scoping review methods were applied to understand this relatively under-researched population and understand appropriate avenues for future research.

Findings

Military Culture: Features unique to military environments may inadvertently encourage engagement with gambling activities and at the same time contribute to concealment of potential issues or deterring access to treatment.

• The hierarchical structure of the military affects self-disclosure. The very leaders designated to provide advice, referral, and support to service members are also the authority figures that have the power to discipline, demote, and discharge personnel with problem gambling (PG) related issues.
• Studies have found PG can have a negative impact on military readiness which in turn causes reluctance among service members to disclose issues.
• Studies suggest the military is quick to reprimand personnel but slow to provide assistance.
• Risk of prosecution for crimes related to PG discourages military personnel to seek treatment and counseling.
• Inadequate screening related to the belief PG is not common among service members may be the reason for PG being underdiagnosed.

Risk Factors: There are numerous risk factors for PG behavior among military personnel relative to the general population.

• Gambling is increasingly available and impactful in military life.
• Slot machine gambling is available on most overseas U.S. military bases.
• The impact of online gambling on military personnel is underassessed.
• Active service military personnel are at an increased risk for PG.
• Service members that are male, a person of color, and under 30 years of age are at an increased risk for PG.

Comorbidity: There is evidence of an association between problem gambling and various comorbid psychiatric and substance use conditions.

• Military personnel have higher rates of risk taking and sensation seeking than their civilian counterparts. Studies suggest these variables correlate highly with PG behavior.
• 8 out of 10 studies in this review acknowledge the potential for gambling related issues to be higher when alcohol and substance misuse are reported.
• 9 out of 35 individuals receiving treatment for gambling were also subsequently treated for major depressive disorder.
• Two thirds of those in treatment for PG in the U.S. military also reported a prior psychological condition.
• 20% of service members in treatment for PG endorsed suicidal ideation, 11% reported making a previous suicide attempt.
• A strong case has been made for the inclusion of gambling screening into pre-existing mental and physical health exams.