title: The concerned significant others of people with gambling problems in a national representative sample in Sweden - a 1 year follow-up study.
abstract: BACKGROUND
  Research into the impact of problem gambling on close social networks is scarce with the majority of studies only including help-seeking populations. To date only one study has examined concerned significant others (CSOs) from an epidemiological perspective and it did not consider gender. The aim of this study is to examine the health, social support, and financial situations of CSOs in a Swedish representative sample and to examine gender differences.
  
  
  METHODS
  A population study was conducted in Sweden in 2008/09 (n = 15,000, response rate 63%). Respondents were defined as CSOs if they reported that someone close to them currently or previously had problems with gambling. The group of CSOs was further examined in a 1-year follow up (weighted response rate 74% from the 8,165 respondents in the original sample). Comparisons were also made between those defined as CSOs only at baseline (47.7%, n = 554) and those defined as CSOs at both time points.
  
  
  RESULTS
  In total, 18.2% of the population were considered CSOs, with no difference between women and men. Male and female CSOs experienced, to a large extent, similar problems including poor mental health, risky alcohol consumption, economic hardship, and arguments with those closest to them. Female CSOs reported less social support than other women and male CSOs had more legal problems and were more afraid of losing their jobs than other men. One year on, several problems remained even if some improvements were found. Both male and female CSOs reported more negative life events in the 1 year follow-up.
  
  
  CONCLUSIONS
  Although some relationships are unknown, including between the CSOs and the individuals with gambling problems and the causal relationships between being a CSO and the range of associated problems, the results of this study indicate that gambling problems not only affect the gambling individual and their immediate close family but also the wider social network. A large proportion of the population can be defined as a CSO, half of whom are men. While male and female CSOs share many common problems, there are gender differences which need to be considered in prevention and treatment.
authors.affiliation: Department of Health Science, Mid Sweden University, Östersund, Sweden. jessika.svensson@fhi.se.
authors.forename: Jessika
authors.initials: J
authors.lastname: Svensson
authors.forename: Ulla
authors.initials: U
authors.lastname: Romild
authors.forename: Emma
authors.initials: E
authors.lastname: Shepherdson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004651:Employment / Q000523:psychology; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D005715:Gambling / Q000191:economics / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D012944:Social Support; D018454:Spouses / Q000523:psychology* / Q000706:statistics & numerical data; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult