Linking empathy to visuospatial perspective-taking in gambling addiction

Impairments of Sociocognitive Functions in Individuals with Behavioral Addictions: A Review Article

Since little is known about the exact pattern of social cognitive impairments related to behavioral addictions, the aim of the PRISMA-oriented review was to (i) provide an overview of relevant empirical publications, and to (ii) to elucidate which specific aspects of social cognition (i.e., emotion recognition, empathy, and theory of mind (ToM)) are impaired in different types of behavioral addictions. Behavioral addictions have been associated with cognitive deficits which may contribute to impaired social cognitive functioning. More recently, this domain has been investigated in patients with behavioral addictions as impaired social cognition detrimentally affects daily functioning and thus forms a relevant target for treatment. A systematic search in the PubMed and Web of Science databases was performed focusing on social cognitive functions in behavioral addictions. Studies focusing on the same social cognitive component were grouped together, this was done based on the used assessment measures. In total, 18 studies met the specified inclusion criteria. Five studies focusing on emotion recognition concluded that individuals with behavioral addictions show impairments in this domain. As for the 13 studies focusing on empathy and/or ToM, most of them found deficits linked to different types of behavioral addictions. Only two studies, one of which was investigating a distinct population (multiplayer online role-playing gamers) did not link empathy to behavioral addictions. The results show that the majority of studies focusing on social cognition and behavioral addictions found some deficits. Additional research focusing on this topic is urgently needed in behavioral addictions, addressing several methodological issues.

Is pain empathy associated with pain indices and trauma history? A comparison between patients receiving methadone maintenance treatment and healthy controls

BACKGROUND

To study whether pain empathy and theory of mind (ToM) are related to pain indices and trauma experience, we studied opioid users receiving methadone maintenance treatment (MMT), a population with a history of traumas and a high prevalence of chronic pain.

METHODS

MMT patients (n = 53), substance abuse-free, with no impaired cognition (Montreal Cognitive Assessment (MoCA) ≥24), were compared to healthy controls (HC) matched by age and gender (n = 66). All participants were assessed using Reading the Mind in the Eyes (RMET) for ToM, empathy (Interpersonal Reactivity Index [IRI], Empathy Quotient Scale for Adults [EQ60]), and Pain Empathy [PE task]). An algometer was used for pain pressure threshold, and supra-pain threshold was rated using a visual analog scale (VAS). Catastrophizing, McGill pain, Negative life events (NLE), and MoCA questionnaires were administered. Substance abuse was tested in the urine of MMT patients and self-reported by HC.

RESULTS

MMT, compared to HC, were less educated with more NLE and a lower RMET (logistic regression). Groups had comparable empathy and pain indices, except for higher supra-threshold VAS rating and catastrophizing in univariate analyses. Pain empathy (PE) correlated with NLE in HC, and in MMT, with catastrophizing, which correlated with NLE, perceived stress, and pain intensity. Higher empathy was observed in 18 participants with a history of sexual abuse (83.3 % belong to the MMT group).

CONCLUSIONS

Pain Empathy was found to be associated with personal suffering experience in both groups, as reflected by correlations with NLE in HC and with catastrophizing, which correlates with NLE, stress, and pain intensity, in MMT.

The protective effects of cognitive empathy and emotional empathy on gambling disorder are mediated by risk aversion and responsible gambling attitude

BACKGROUND

Based on social cognitive theory, this study aimed to examine whether and how social abilities (i.e., cognitive empathy and emotional empathy) are associated with gambling disorder (GD) by incorporating attitudes toward general risk (i.e., risk aversion) and responsible gambling as potential mediators of this link.

METHODS

A convenience sample of 580 past-year lottery gamblers (Mage = 34.07, SD = 13.36; 50.4% female), recruited near lottery sales shops, completed an anonymous paper-version questionnaire on site. Data were collected using the DSM-5 diagnostic criteria for GD, Interpersonal Reactivity Index, Risk Aversion Scale, Positive Play Scale, and demographic items. Path analysis and mediation analysis were applied to examine the effects of cognitive empathy and emotional empathy on GD and the mediating roles of risk aversion and responsible gambling attitude.

RESULTS

Our results showed that cognitive empathy, but not emotional empathy, was significantly and negatively correlated with GD. Also, the effect of cognitive empathy on GD was fully mediated by risk aversion and responsible gambling attitude, whilst the total indirect effect of emotional empathy on GD was nonsignificant. As hypothesized, the indirect paths from both types of empathy to GD were significantly and serially mediated by risk aversion and responsible gambling attitude.

CONCLUSION

Cognitive empathy, distinct from emotional empathy, was a statistically significant correlate of GD. Moreover, the path model results also suggest that responsible gambling attitude was a salient protective factors against GD. Future GD prevention efforts may benefit from paying more attention to the role of responsible gambling attitude.

Online Assessment of Social Cognition in a Population of Gamers and Gamblers: Results of the eSMILE Study

The purpose of the eSMILE study was to explore social cognition (SC) in the two behavioural addictions (BAs) included in international classifications: gaming disorder and gambling disorder. In these disorders, cognitive functioning is involved in the development and maintenance of addiction. Nevertheless, SC have received less attention than other cognitive functions. The eSMILE study was conducted online and included 105 participants (gamers and gamblers). This study included: the Penn emotion recognition task, the Condensed and Revised Multifaced Empathy Test, the Interpersonal Reactivity Index, the Chicken Game, social metacognition questions, and the Toronto Alexithymia Scale. We analysed the relationships among SC measures, addiction levels, and behaviour frequency. For gamers, we showed that the higher their level of addiction was, the lower their self-confidence following the identification of basic emotions, although the more frequently they played, the better their performance on this task. Additionally, we found lower performance on the identification of more complex emotions by gamblers, which seems to be the result of their levels of addiction rather than the frequency of their gambling behaviour. This study contributes to our understanding of the cognitive processes underlying BAs. Additionally, working on SC abilities may be an additional management mode for BAs that could be added to existing treatments.

Altered hierarchical organization between empathy and gambling networks in disordered gamblers

BACKGROUND

Despite the demonstrated association between empathy and gambling at the behavioral level, limited neuroimaging research on empathy and gambling disorder (GD) has been conducted. Whether and how the brain network of empathy and that of gambling interact in disordered gamblers has not been investigated. This study aimed to address this research gap by examining the hierarchical organizational patterns, in which the differences of causal interactions of these networks between disordered gamblers and healthy controls were revealed.

METHODS

Resting-state functional magnetic resonance imaging (fMRI) data of 32 disordered gamblers and 56 healthy controls were included in the formal analysis. Dynamic causal modeling was used to examine the effective connectivity within and between empathy and gambling networks among all participants.

RESULTS

All participants showed significant effective connectivity within and between empathy and gambling networks. However, compared with healthy controls, disordered gamblers displayed more excitatory effective connectivity within the gambling network, the tendency to display more excitatory effective connectivity from the empathy network to the gambling network, and reduced inhibitory effective connectivity from the gambling network to the empathy network.

CONCLUSION

The exploratory study was the first to examine the effective connectivity within and between empathy and gambling networks among disordered gamblers and healthy controls. These results provided insights into the causal relationship between empathy and gambling from the neuroscientific perspective and further confirmed that disordered gamblers show altered effective connectivity within and between these two brain networks, which may be considered to be a potential neural index for GD identification. In addition, the altered interactions between empathy and gambling networks may also indicate the potential targets for the neuro-stimulation intervention approach (e.g., transcranial magnetic stimulation).

Trait Empathy Modulates Patterns of Personal and Social Emotions During the COVID-19 Pandemic

The COVID-19 pandemic has caused profound consequences on people's personal and social feelings worldwide. However, little is known about whether individual differences in empathy, a prosocial trait, may affect the emotional feelings under such threat. To address this, we measured 345 Chinese participants' personal emotions (e.g., active, nervous), social emotions (i.e., fearful and empathetic feelings about various social groups), and their empathy traits during the COVID-19 pandemic. Using the representational similarity analysis (RSA), we calculated the pattern similarity of personal emotions and found the similarity between the positive and negative emotions was less in the high vs. low empathy groups. In addition, people with high (vs. low) empathy traits were more likely to have fearful and sympathetic feelings about the disease-related people (i.e., depression patients, suspected COVID-19 patients, COVID-19 patients, flu patients, SARS patients, AIDS patients, schizophrenic patients) and showed more pattern dissimilarity in the two social feelings toward the disease-related people. These findings suggest a prominent role of trait empathy in modulating emotions across different domains, strengthening the polarization of personal emotions as well as enlarging social feelings toward a set of stigmatized groups when facing a pandemic threat.

Is Empathy Associated with Gambling and Its Addiction? A Scoping Review of Empirical Studies

Considering the low levels of empathy associated with substance-related addictions and the similarities between gambling disorder (GD) and substance-related addiction, understanding the relationship between empathy and GD may clarify the mechanism of addiction development. This scoping review aimed to evaluate the empirical evidence for the potential protective role of emotional and cognitive empathy against GD development via internalizing and/or externalizing pathways. We followed the preferred reporting items for systematic review and meta-analyses extension for scoping reviews and 11 articles met the inclusion criteria. Although most of the reviewed studies used correlational designs and non-gambling-specific samples, this review highlights (1) significant relationships between both types of empathy and the neural activity of gambling behaviors, and (2) reduced cognitive empathy (i.e., fantasy and perspective taking) and increased emotional empathy (i.e., personal distress) among problem gamblers than their gambling counterparts. Despite the lack of studies directly testing the protective role of empathy against GD, the existing studies (n = 8) nevertheless shed light on the potential protective effects of both types of empathy on GD development. This review identified research gaps, which can be addressed in future studies by discovering the underlying mechanisms (e.g., internalizing and externalizing pathways) of these relationships. Experimental or longitudinal studies in gamblers investigating how different types of empathy are associated with GD via these pathways are called for as their findings have implications for prevention and intervention designs for GD and other addictive disorders.

Observer descriptions of the empathic person: a look at the Davis IRI and Hogan empathy scales

We report the different personality profiles associated with five different empathy scales assessed by the face valid Davis Interpersonal Reactivity Index and the empirically derived Hogan Empathy Scale. Participants arranged in groups of 5-7 worked and socialized together in groups for nine weeks before evaluating each other using Ten-Item Personality Inventory. We also recruited the friends and family members of participants to complete Q-Set descriptions of them. As hypothesized, Empathic Concern from the IRI was associated with a target's apparent Agreeableness, a trait that includes the sub-trait of being altruistic. Hogan Empathy, however, was associated more strongly with judgments of a target's Extraversion and Openness, which are traits more aligned with the notion of an empathic counselor as opposed to a bystander intervener. These results make it clear that different empathy scales not only assess theoretically distinct empathy facets but also qualitatively different interpersonal behavior (i.e., perceptions made by family, friends, and colleagues of a target's behavioral and interaction tendencies).

The Relationship Between Cognitive Abilities and Trait Clinical Features in Patients With Borderline Personality Disorder

Very few studies have focused on the relationship between cognitive functions and clinical features in borderline personality disorder (BPD). Subjects with BPD and healthy controls were administered the Repeatable Battery for the Assessment of Neuropsychological Status, Trail Making Test A and B, and the Wisconsin Card Sorting Test. The Brief Symptom Inventory (BSI-53) was used to assess the severity of current symptoms. Attachment style was assessed with the Experiences in Close Relationship Questionnaire, identity integration with the Personality Structure Questionnaire, and other domains of personality dysfunction with the RUDE Scale for Personality Dysfunction. Patients with BPD performed significantly worse than healthy controls in all cognitive domains. Cognitive functions, particularly delayed memory and visuospatial abilities, displayed meaningful associations with trait-like clinical features, above the effect of global cognition and state psychopathology. These findings highlight the need to evaluate effects of cognitive rehabilitation on trait features among individuals with BPD.

Prosocialness in young males with substance and behavioral addictions

BACKGROUND AND AIMS

Social determinants are closely related to addiction, both as a cause and a consequence of substance use and other addictive behaviors. The present paper examines prosocialness (i.e. the tendency to help, empathize, and care for others) among a population of young males. We compared prosocialness across different types of addiction and examined whether prosocialness varied according to the presence of multiple addictions.

METHODS

A sample of 5,675 young males, aged 19-29 years old (Mean = 21.4; Median = 21), completed a questionnaire that included screening tools to identify addictive behaviors with regards to alcohol, nicotine, cannabis, gambling, and gaming. The questionnaire also included a scale to measure prosocialness.

RESULTS

Compared to a no-addiction control group, the subgroups of young men suffering from behavioral addictions (i.e., gambling and gaming) reported the lowest levels of prosocialness. Respondents with an alcohol addiction also showed lower prosocialness compared to no-addiction controls. By contrast, no significant differences in prosocialness were found between respondents with nicotine disorder or cannabis disorder and the no-addiction controls. Furthermore, the number of addictions had no clear, observable effects on prosocialness. Significant differences were found between the no-addiction control group and the groups reporting one or more addictions, but not between the separate groups reporting one, two, and three or more addictions.

DISCUSSION AND CONCLUSIONS

A better understanding of the social dimension affecting young males with addiction, particularly gambling and gaming addictions, may be useful for their prevention and treatment.

Impulse Control Disorders in Parkinson's Disease: Epidemiology, Pathogenesis and Therapeutic Strategies

Impulse control disorders (ICDs) in Parkinson's disease (PD) are aberrant behavior such as pathological gambling, hypersexuality, binge eating, and compulsive buying, which typically occur as a result of dopaminergic therapy. Numerous studies have focused on the broad spectrum of ICDs-related behaviors and their tremendous impact on patients and their family members. Recent advances have improved our understanding of ICDs. In this review, we discuss the epidemiology, pathogenesis and treatment of ICDs in the setting of PD.

Assessment of the Effectiveness of Group Cognitive Behavioural Therapy in Reducing Pathological Gambling

Pathological gambling is a developmental disorder usually associated with a continuous loss of control over gambling; it also involves a preoccupation with gambling and with obtaining money for the same purpose of gambling, irrational thinking, and a continuation of the behaviour despite being aware of its adverse consequences. This study examined the effectiveness of group cognitive-behavioural therapy (GCBT) on pathological gambling among Nigerian students. The study used a group randomised controlled trial design to assign participants to intervention and control groups. A total of 40 undergraduate students, aged 18-30, were classified as pathological gamblers (participants) in this study. Participants completed self-report scales titled South oaks gambling screen and Gambling Symptom Assessment Scale at three-time points. The intervention lasted for 8 weeks. The data collected were statistically analysed using repeated-measures ANOVA. Results revealed that GCBT has a significant effect in decreasing the symptoms of pathological gambling among the participants in GCBT compared to those in the control group and that the improvements were maintained at follow-up. The study concluded that group cognitive-behavioural therapy is impactful therapy in reducing pathological gambling among students. It has also validated the effectiveness of cognitive-behavioural therapy in altering erroneous thoughts and replacing it with a better alternative realistic way of thinking.

Personal distress as a mediator between self-esteem, self-efficacy, loneliness and problematic video gaming in female and male emerging adult gamers

The aim of our research was to investigate the predictors of Problematic Video Gaming (PVG) in emerging adulthood. From among the factors which were considered significant in previous studies, we decided to include the following in our research: empathy, self-esteem, self-efficacy and loneliness. Additionally, we wanted to examine which predictors have a direct or indirect effect on PVG in female and male emerging adult gamers group. Including a sample of 370 video game players (201 female gamers) aged 18-30 years (M = 21.66 years, SD = 2.83) participated in this study and were asked to complete self-report measures. The questionnaires included: Problem Videogame Playing Questionnaire, The Interpersonal Reactivity Index, Rosenberg Self-Esteem Scale, De Jong Gierveld Loneliness Scale, General Self-Efficacy Scale. Our results indicate that empathy dimension associated with personal distress, the time spent playing computer games per week is directly associated with PVG. Also, there were found full mediation between self-esteem, loneliness, self-efficacy and PVG via personal distress in emerging adult male gamers group. In emerging adult female gamers group personal distress fully mediated relation between self-esteem, self-efficacy and PVG. Our findings indicate that the time spent playing video games, as well as personal distress as a function of self-esteem, loneliness and self-efficacy, are predictors of problematic video gaming. Additionally, our results may lead to a better understanding of PVG among emerging adults. In particular, they may point to the importance of personal distress in relation to PVG during emerging adulthood, which is a developmental stage of many changes in social and professional life.

Gambling and Social Cognition: a Systematic Review

Purpose of Review

The aim of this article was to review current research regarding social cognition (SC) in gambling disorder (GD), to (i) compile and synthetize the current state of existing literature on this topic, and (ii) propose cognitive remediation therapy approaches focused on SC for clinicians.

Recent Findings

It is well known that disordered gamblers show impairment regarding non-social cognitive functions such as inhibition, attention, and decision-making. Furthermore, patients with substance use disorders also present certain deficits regarding social information processing which are difficult to differentiate from the intrinsic toxic effects linked to drugs or alcohol consumption.

Summary

To date, relatively little research has been undertaken to explore SC in gambling disorder (GD) with neuropsychological tasks. Preliminary results suggest impaired non-verbal emotion processing, but only one study has directly measured SC in GD. As a consequence, future research on this framework should propose diverse measures of SC, while controlling for other factors such as personality traits and subtypes of disordered gamblers.

Cognitive training: A new avenue in gambling disorder management?

INTRODUCTION

Cognitive deficits are being robustly documented in gambling disorder. Cognitive training has been increasingly investigated as a treatment of substance use disorders. Four training components have been listed to date: cognitive bias, response inhibition, working memory, and goal-directed. This review aimed at the identification of use and efficacy findings in cognitive training in gambling disorder.

METHODS

We conducted a systematic search to identify use and efficacy data of cognitive training in gambling disorder. No use or efficacy data was available.

DISCUSSION AND PERSPECTIVES

Studies assessing cognitive training in gambling disorder are being conducted and first results should be upcoming. Methodological challenges have been identified. Several candidate target cognitive functions of training programs are being investigated, relying on the most documented impairments in gambling disorder, inhibition, reward sensitivity and decision making. Gambling-specific or neutral environments are to be distinguished clearly and do not rely on similar assumptions, i.e. general vulnerability or vulnerability expressed only in the specific context of gambling. Proper control groups with placebo conditions should be implemented. Assessment of efficacy should include clinical and neuropsychological assessments to give information of underlying mechanisms of action.

Let's Open the Decision-Making Umbrella: A Framework for Conceptualizing and Assessing Features of Impaired Decision Making in Addiction

Decision-making impairments play a pivotal role in the emergence and maintenance of addictive disorders. However, a sound conceptualization of decision making as an umbrella construct, encompassing its cognitive, affective, motivational, and physiological subcomponents, is still lacking. This prevents an efficient evaluation of the heterogeneity of decision-making impairments and the development of tailored treatment. This paper thus unfolds the various processes involved in decision making by adopting a critical approach of prominent dual- or triadic-process models, which postulate that decision making is influenced by the interplay of impulsive-automatic, reflective-controlled, and interoceptive processes. Our approach also focuses on social cognition processes, which play a crucial role in decision making and addictive disorders but were largely ignored in previous dual- or triadic-process models. We propose here a theoretical framework in which a range of coordinated processes are first identified on the basis of their theoretical and clinical relevance. Each selected process is then defined before reviewing available results underlining its role in addictive disorders (i.e., substance use, gambling, and gaming disorders). Laboratory tasks for measuring each process are also proposed, initiating a preliminary process-based decision-making assessment battery. This original approach may offer an especially informative view of the constitutive features of decision-making impairments in addiction. As prior research has implicated these features as risk factors for the development and maintenance of addictive disorders, our processual approach sets the scene for novel and transdiagnostic experimental and applied research avenues.

Conceptualizing gambling disorder with the process model of emotion regulation

Introduction Nowadays, gambling disorder (GD) is a worldwide health issue and there is a growing need to both improve our understanding of this disorder and to tailor specific interventions for its treatment. Moreover, theoretical models and preliminary empirical results suggest that difficulty in regulating emotional states might be involved in GD. However, literature describing clinical and theoretical aspects of emotional dysregulation among pathological gamblers (PGs) shows a lack of systematic description. Objectives We aimed to provide, within an exhaustive theoretical framework of emotion regulation (ER) processing, empirical evidence supporting a conceptual model of GD as an ER affliction. Methods We commented on empirical evidence on the relationship between ER and GD in the light of two main conceptual models of emotion (dys)regulation. Results The results suggest there are actual deficits of ER processing among PGs, manifesting themselves through different ways and in different steps of the ER timeline. In addition, dysregulation of positive emotions may play a central role in GD. From a clinical point of view, we pointed out that deficits in ER might be multiple in nature and an assessment for GD should be accurate to identify the specific components accounting for the development and maintenance of the disorder. It should also orientate the clinician in selecting therapeutic objectives. Conclusions The nature of emotional states that are difficult to regulate might account for the GD severity and indicate the subtype of PGs the patient belongs to. Treatment programs should be tailored on the specificity of PGs.

Agent-specific learning signals for self-other distinction during mentalising

Humans have a remarkable ability to simulate the minds of others. How the brain distinguishes between mental states attributed to self and mental states attributed to someone else is unknown. Here, we investigated how fundamental neural learning signals are selectively attributed to different agents. Specifically, we asked whether learning signals are encoded in agent-specific neural patterns or whether a self–other distinction depends on encoding agent identity separately from this learning signal. To examine this, we tasked subjects to learn continuously 2 models of the same environment, such that one was selectively attributed to self and the other was selectively attributed to another agent. Combining computational modelling with magnetoencephalography (MEG) enabled us to track neural representations of prediction errors (PEs) and beliefs attributed to self, and of simulated PEs and beliefs attributed to another agent. We found that the representational pattern of a PE reliably predicts the identity of the agent to whom the signal is attributed, consistent with a neural self–other distinction implemented via agent-specific learning signals. Strikingly, subjects exhibiting a weaker neural self–other distinction also had a reduced behavioural capacity for self–other distinction and displayed more marked subclinical psychopathological traits. The neural self–other distinction was also modulated by social context, evidenced in a significantly reduced decoding of agent identity in a nonsocial control task. Thus, we show that self–other distinction is realised through an encoding of agent identity intrinsic to fundamental learning signals. The observation that the fidelity of this encoding predicts psychopathological traits is of interest as a potential neurocomputational psychiatric biomarker.

In order for people to have meaningful social interactions, they need to infer each other’s beliefs. Converging evidence from humans and nonhuman primates suggests that a person’s brain can represent a second person’s beliefs by simulating that second person’s brain activity. However, it is not known how the outputs of those simulations are identified as ‘yours and not mine’. This ability to distinguish self from other is required for social cognition, and it may be impaired in mental health disorders with social cognitive deficits. We investigated self–other distinction in healthy adults learning about an environment both from their own point of view and the point of view of another person. We used computationally identified learning variables and then detected how these variables are represented by measuring magnetic fields in the brain. We found that the human brain can distinguish self from other by expressing these signals in dissociable activity patterns. Subjects who showed the largest difference between self signals and other signals were better at distinguishing self from other in the task and also showed fewer traits of mental health disorders.