Heterogeneity in Disordered Gambling: Decision-Making and Impulsivity in Gamblers Grouped by Preferred Form

A familial subtype of gambling disorder

Background

Although family history of psychiatric disorders has often been considered potentially useful in understanding clinical presentations in patients, it is less clear what a positive gambling family history means for people with gambling disorder. We sought to understand the clinical impact of having a first-degree relative with gambling disorder in a sample of adults with gambling disorder.

Methods

Data from 455 participants (aged 18-65 years) who had participated in previous pharmacological and psychotherapeutic clinical trials for gambling disorder were pooled in a secondary analysis. Demographic and clinical variables were compared between those who did versus did not have one or more first-degree relative(s) with gambling disorder. Additionally, we examined whether a family history of gambling disorder was associated with treatment outcome.

Results

223 (49.0%) participants had at least one first-degree family member(s) with gambling disorder. In terms of clinical variables, family history of gambling disorder was significantly associated with being female, having an earlier age of gambling onset, longer duration of untreated gambling illness, a greater likelihood of developing legal problems secondary to gambling, and higher rates of alcohol use disorder in family members. Family history of gambling disorder was also associated with a greater gambling symptom improvement from pharmacotherapy.

Conclusions

These results indicate that gamblers with a first-degree family member with a gambling disorder may have a unique clinical presentation and better response to treatment interventions.

Getting even: chasing behavior, decision-making, and craving in habitual gamblers

BACKGROUND

Dysfunctional decision-making and intense craving represent pivotal aspects across all addictive behaviors, notably evident in gambling addiction where these factors significantly shape chasing behavior-continuing gambling to recoup losses-indicative of problematic gambling. This study explores the correlation between chasing behavior, craving, affective decision-making, decision-making styles, and gambling severity among habitual Italian gamblers.

METHODS

One hundred and sixty-six participants from diverse gambling venues completed assessments including the South Oaks Gambling Screen (SOGS), the Iowa Gambling Task (IGT), the General Decision-Making Style (GDMS), the Gambling Craving Scale (GACS), and a computerized task to measure chasing behavior. Participants were randomly assigned to Control and Loss chasing conditions.

RESULTS

Regression analyses revealed craving as a predictor of chasing behavior. Interestingly, individuals with a dependent decision-making style exhibited lower tendencies to chase. While IGT performance correlates with chasing frequency, it is not associated with the decision to continue or cease gambling. Intriguingly, gambling severity (SOGS total score) did not feature in the final models of both regression analyses.

DISCUSSION

These findings emphasize the significant role of craving in driving chasing behavior. Additionally, this study introduces, for the first time, the idea that a dependent decision-making style could potentially serve as a safeguard against chasing proneness.

CONCLUSIONS

The study suggests a fundamental dichotomy between chasers and nonchasers among gamblers, irrespective of gambling severity. This distinction could be instrumental in tailoring more effective intervention strategies for gambling disorder treatment.

Learning and memory processes in behavioural addiction: A systematic review

Similar to addictive substances, addictive behaviours such as gambling and gaming are associated with maladaptive modulation of key brain areas and functional networks implicated in learning and memory. Therefore, this review sought to understand how different learning and memory processes relate to behavioural addictions and to unravel their underlying neural mechanisms. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched four databases - PsycINFO, PubMed, Scopus, and Web of Science using the agreed-upon search string. Findings suggest altered executive function-dependent learning processes and enhanced habit learning in behavioural addiction. Whereas the relationship between working memory and behavioural addiction is influenced by addiction type, working memory aspect, and task nature. Additionally, long-term memory is incoherent in individuals with addictive behaviours. Consistently, neurophysiological evidence indicates alterations in brain areas and networks implicated in learning and memory processes in behavioural addictions. Overall, the present review argues that, like substance use disorders, alteration in learning and memory processes may underlie the development and maintenance of behavioural addictions.

Relationship Between Non-Suicidal Self-Injury and Emotion Dysregulation Among Male and Female Young Adults

Over recent years, non-suicidal self-injury (NSSI) has been associated with emotion dysregulation. However, only a few quantitative studies have empirically investigated differences in emotion dysregulation among people who self-harm, while none have explored gender differences in this regard. Thus, this research study aimed to further examine the association between NSSI and emotion regulation deficits and strategies in young adults. A total of 201 participants (mean age = 21.82 years) were recruited from different support groups dedicated to NSSI and from health care centres and were divided into two groups: a control group (CG, n = 100, mean age = 21.92 years, comprised of 30% males) and an NSSI group (NSSIG, n = 101, mean age = 21.72 years, comprised of 16% males). All participants completed the Deliberate Self-Harm Inventory, the Difficulties in Emotion Regulation Scale, and the Emotion Regulation Questionnaire. The results showed that compared to the CG participants, those from the NSSIG had increased emotion regulation deficits, higher expressive suppression scores, and lower cognitive re-evaluation scores. Within the NSSIG, females had higher impulse control difficulties and limited access to emotion regulation strategies, while males had higher expressive suppression scores. Factors associated with NSSI also differed by gender. These results indicate the necessity to take gender into account when planning treatment, since treatment protocols must be adapted to the specific emotion regulation difficulties concerned.

Mediating Role of Impulsivity in the Contributory Roles of Upward Versus Downward Counterfactual Thinking in Youth Gambling Intention

The proliferation of gambling shops, and the growing gambling prevalence in Nigeria, youths have constantly engaged in gambling activities even during school period. This has raised concerns among therapists and parents as the trend could degenerate to problem gambling and its associated psychosocial problems if left unchecked. Our study examined the role of impulsivity as a mediator in the association between two types of counterfactual thinking (CFT) and gambling intention in a non-clinical sample. A self-report measure containing South Oaks Gambling Screen: Reversed for Adolescents (SOGS: RA), CFT, and impulsivity scales was completed by 371 Nigerian adolescents who had gambled for money (mean age = 17.37 years; SD = 4.13). After controlling for age, increase in downward CFT was associated with decreased gambling intention, whereas increase in upward CFT and impulsivity were associated with increased gambling intention. Upward CFT contributed more to gambling intention than downward CFT. Mediation result showed that Impulsivity significantly mediated only the association between upward CFT and gambling intention. We concluded that gambling therapies should include treatment packages that enhance impulse control abilities and gambling-related downward CFT and at the same time, attenuate gambling-related upward CFT.

An empirical investigation of the Pathways Model of problem gambling through the conjoint use of self-reports and behavioural tasks

BACKGROUND AND AIMS

Blaszczynski and Nower (2002) conceptualized their Pathways Model by postulating the existence of three subtypes of problem gamblers who share common characteristics, but also present specific ones.

METHODS

This study investigated how the psychological mechanisms postulated in the Pathways Model predict clinical status in a sample that combined treatment-seeking gamblers (n = 59) and non-problematic community gamblers (n = 107). To test the Pathways Model, we computed a hierarchic logistic regression in which variables associated with each postulated pathway were entered sequentially to predict the status of the treatment-seeking gambler. Self-report questionnaires measured gambling-related cognitions, alexithymia, emotional reactivity, emotion regulation strategies and impulsivity. Behavioural tasks measured gambling persistence (slot machine task), decision-making under uncertainty (Iowa Gambling Task) and decision-making under risk (Game of Dice Task).

RESULTS

We showed that specific factors theorized as underlying mechanisms for each pathway predicted the status of clinical gambler. For each pathway, significant predictors included gambling-related cognitive distortions and behaviourally measured gambling persistence (behaviourally conditioned pathway), emotional reactivity and emotion regulation strategies (emotionally vulnerable pathway), and lack of premeditation impulsivity facet (impulsivist-antisocial pathway).

DISCUSSION AND CONCLUSIONS

Our study adds to the body of literature confirming the validity of the Pathways Model and hold important implications in terms of assessment and treatment of problem gambling. In particular, a standardized assessment based on the Pathways Model should promote individualized treatment strategies to allow clinicians to take into account the high heterogeneity that characterizes gambling disorder.

Inhibitory control in poker: Do experienced non-pathological poker gamblers exhibit better performance than healthy controls on motor, verbal and emotional expression inhibition?

BACKGROUND AND AIMS

Strategic games, such as poker, require gamblers to develop several skills to perform better than others and to expect a potential gain. Players must remain as unpredictable and unreadable as possible by inhibiting the expression of their emotions in response to both good and bad poker events. The aim of the present study was to compare several aspects of the inhibition process in experienced poker gamblers and controls to better understand how inhibitory control is involved in poker performance.

METHODS

Thirty experienced non-pathological poker gamblers (EG) and thirty healthy controls with no or limited poker experience (HC) completed 3 cognitive tasks. Each task measured a specific type of inhibition: motor inhibition [Go/No-Go task], verbal inhibition [Hayling Sentence Completion Task] and expressive inhibition [expressive suppression task, which combines subjective, expressive (facial EMG) and physiological (skin conductance, heart interbeat interval, cardiovascular and respiratory activation) measures of emotional experience]. Linear mixed models with random effects were performed.

RESULTS

Inhibitory control skills were similar between the two groups, regardless of the form of inhibition tested. The only difference observed in EG was a higher ability to partially suppress the physiological expression of emotion. However, this difference was only present for negative and positive emotional induction and was not maintained for emotional induction related to poker situations.

DISCUSSION AND CONCLUSIONS

The development of specific inhibition skills in experienced poker gamblers was not supported and raises questions about the transferability of poker skills previously discussed in the literature.

Impulsive decision-making and gambling severity: The influence of γ-amino-butyric acid (GABA) and glutamate-glutamine (Glx)

Discounting larger, delayed rewards for smaller, immediate rewards is a stable psychological trait known to be impaired in gambling disorder (GD). Neuroimaging with non-GD populations indicates involvement of anterior cingulate (ACC) and dorsolateral prefrontal cortex (dlPFC) in delay discounting. However, little is known about the role of intrinsic properties of brain functioning, such as neurotransmitter action, in impaired discounting in GD. Here, we used magnetic resonance spectroscopy to assess glutamate-glutamine (Glx) and γ-amino-butyric acid (GABA+) concentrations in the dorsal ACC (dACC), dlPFC and occipital cortex of human males with and without GD. Gambling symptom severity correlated negatively with Glx levels in the dACC and occipital voxels. Discounting of small and medium delayed rewards was negatively associated with GABA+ in the dACC, while the discounting of large delayed rewards was negatively associated with GABA+/Glx ratios in the dlPFC. Additionally, in GD, discounting of large delayed rewards was negatively correlated with occipital GABA+ levels. Overall, these findings show that high gambling symptom severity is associated with low levels of Glx and that dACC (GABA+), right dlPFC (GABA+/Glx), and occipital areas (GABA+) track the magnitude of delayed rewards during discounting.