Table 4.

Thematic mapping

		Ashley and Shannon (2017)	Bray (1992, 2003)	GAO (2017)	GSU (2010)	Kennedy et al. (2006)	Kennedy (2006)	Little (1988)	Steenbergh (2008)	Weis and Manos (2007)	Wilson et al. (2018)
Themes	Subthemes
Defence culture	Stigma**	Y	N	Y	Y	Y	N	N	N	Y	N
	Barriers to treatment options**	Y	N	Y	N	Y	N	N	N	Y	N
	Suspected underdiagnoses*	N	Y	Y	N	N	N	N	N	Y	N
	Screening (or lack of)***	Y	N	Y	Y	N	Y	N	N	Y	Y
	Impact on military readiness***	Y	Y	Y	Y	N	N	Y	Y	N	N
	Punitive response to GD***	Y	N	Y	Y	Y	Y	Y	N	N	N
Risk factors	Inadequate guidelines/policy**	N	N	Y	N	Y	Y	Y	N	N	Y
	Risk relative to the general population***	Y	Y	Y	Y	N	N	N	Y	Y	Y
	Demographic variables***	N	Y	N	Y	Y	N	N	Y	Y	Y
	Availability of gambling activities (on/off line)***	Y	N	N	Y	Y	N	N	Y	Y	Y
	Assessment of prevalence**	N	Y	Y	Y	N	N	N	Y	Y	N
	Risk-taking/sensation seeking*	Y	N	N	N	N	N	N	Y	N	N
Comorbidity	Mental health & PTSD**	N	N	Y	Y	Y	N	N	N	Y	Y
	Alcohol and substance misuse***	N	Y	Y	Y	Y	Y	N	Y	Y	Y
	Suicide prevention**	Y	N	Y	Y	Y	N	N	N	Y	N
	Secondary diagnosis/behavioural disorder**	N	N	Y	Y	Y	N	N	Y	N	N
	Combined screening/treatment*	N	N	Y	N	Y	Y	N	N	N	N
Key
*	Minor theme (< 3 'Y's)	3
**	Midrange theme (4, 5 'Y's)	7
***	Majar theme (6 > 'Y's)	7

Themes	Subthemes	Quote
Defence culture	Stigma
	Barriers to treatment options
	Suspected underdiagnoses
	Screening (or lack of)	Without incorporating medical screening questions specific to [GD], gambling problems may not be identified until they reach a critical point affecting the individual’s readiness in addition to harming the financial situation of the servicemember ….” GAO 2017
	Impact on military readiness
	Punitive response to GD
	Inadequate guidelines/policy
Risk factors	Demographic variables
	Risk-taking/sensation seeking
	Availability of gambling activities (on/off line)	Given the ease of accessibility across jurisdictional boundaries, it may be an enticing entertainment option for those posted overseas or in geographically isolated areas (Ashley)
	Risk relative to the general population
	Assessment of prevalence
Comorbidity	Veterans at increased risk
	Mental health & PTSD
	Alcohol and substance misuse	If personnel are not screened for gambling-related problems when they enter alcohol treatment, these problems may very well go undetected. Furthermore, an even higher prevalence of gambling-related problems might be found among those personnel whose alcohol problems are currently undetected or untreated. Overall, these data support the relationship found in existing studies between alcohol use and abuse and gambling-related problems. Finally, given that veterans have been found to have problems with pathological gambling and alcohol use (Daghestani et al., 1996), it is not surprising to find a similar situation among active-duty personne (Bray 2003)
	Suicide prevention
	Secondary diagnosis/behavioural disorder	“[G]ambling is significantly different from substance abuse in relation to military policy and confidentiality. Whereas substance abuse has to be reported to a command, a gambling problem per se does not... Unless a service member who seeks help for pathological gambling presents with suicidality or another issue that requires mandatory reporting, he or she will enjoy a significant degree of confidentiality and can self-refer.” Kenedy 2016
	Combined screening/treatment