Methodological and Conceptualisation Issues in the Measurement of Gambling Harm

Abstract Purpose of Review In this paper, we review recent developments in the conceptualisation and measurement of gambling harm. Recent Findings We review the strengths and limitations of gambling-harm measures, including the Short Gambling Harm Screen (SGHS) and 7-item Domain- General Harm Screen (DGHS-7). We also review evidence concerning the distribution of harm across the risk continuum. The paper shows that there is consensus around the principal domains of harm and that there are now reliable and valid measures to index general levels of harm, but that further development may be required to capture more nuanced assessments of the severity and types of harm. Summary We argue that burden-of-harm studies which show a high concentration of harm in lower risk groups are of good quality, but that important methodological issues remain. These include: the sensitivity of these estimates to measurement differences; the need for more consideration of the severity rather than the prevalence of harm ‘instances’; and, whether life-time problem gambling or legacy harms need to be taken into account when assessing the status of lower risk gamblers.