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

No evidence for the role of intentional emotion regulation in gambling-related problems: Insights from self-report, behavioral, and heart rate variability measures

Background

Emotion regulation strategies are central in models of gambling disorder. However, findings regarding the association between gambling-related problems and these strategies are mixed and mostly based on case-control studies with self-report measures.

Methods

This study examines associations of gambling problems' severity (SOGS) and gambling-related craving with strategic emotion-regulation (the Emotion Regulation Questionnaire [ERQ], an experimental reappraisal task, and task-related vagally-mediated heart rate variability [vmHRV]) in community gamblers. Bayesian correlations between all constructs of interest were computed; Bayesian ANOVAs were used to examine the course of vmHRV over time-on-task, and its sensitivity to predictive constructs; and Bayesian regressions to investigate whether gambling problems' severity predicted the use of ERQ strategies, and to determine if the effect of emotion regulation demands on vmHRV could be predicted from the SOGS score.

Results

Correlations did not show reliable relationships of SOGS scores and craving with intentional emotion regulation. The dispositional use of reappraisal and suppression (ERQ) did not predict differences in gambling problems' severity or craving. SOGS and craving scores predicted neither performance in the cognitive reappraisal task, nor task-related vmHRV. However, SOGS and craving correlated with urgency, and suppression and positive urgency predicted a stronger impact of time-on-task on vmHRV, independently of severity.

Discussion

These results show no reliable evidence of differences in emotion regulation strategies or their vmHRV correlates traceable to gambling problems' severity or craving, and thus challenge the widespread role of intentional emotion regulation in gambling-related problems. Implications regarding the prevalence of neurocognitive alterations in non-clinical gamblers are discussed.

Hazardous gambling behavior is associated with amplified emotional reactivity to gambling outcomes

Background and aims

Emotion dysregulation has been suggested to play a role in gambling-related harm, but past gambling research has typically assessed emotion dysregulation via self-report surveys rather than in a gambling context. Here, we sought to investigate how the severity of participants' hazardous gambling behavior was associated with their emotional reactivity and choice behavior within a simulated slot-machine task.

Methods

Participants (N = 100) recruited via Prolific completed a behavioral task involving repeated choices between two simulated slot-machines. When chosen, slot-machines could produce one of five outcome types (win/near-win/neutral/near-loss/loss). After each outcome, participants reported their subjective emotional valence. Emotion data were analysed using a beta-autoregressive computational model, allowing us to extract per-participant estimates of trial-by-trial emotional reactivity to different slot-machine outcomes.

Results

Correlation analyses revealed that people who engaged in more hazardous gambling behavior (higher PGSI scores) showed greater emotional reactivity to all slot-machine outcome types (all Spearman ρ > |0.31|, all p < 0.01, corrected for multiple comparisons). There were no significant associations between patterns of choice behavior and PGSI scores.

Discussion and conclusions

Within a simulated slot-machine task, individuals who engaged in more hazardous gambling behavior showed greater emotional reactivity in general (more positive emotional reactions to wins and more negative emotional reactions to unpleasant events such as losses and near-wins). These results are consistent with a model in which emotion dysregulation is a risk factor for gambling-related harm, and serve to validate this model in a more naturalistic setting.

An Empirical Investigation of the Three-Pathway Model and its Contribution to the Gambling Disorder Psychopathology

BACKGROUND

Blaszczynski and Nower (2002) proposed a theoretical model that leads to problem gambling via three pathways: (1) operant conditioning; (2) emotional vulnerability; and (3) impulsivity and psychopathy. In the current investigation, we explored the relationship between these three putative causative dimensions and clinical core features of Gambling Disorder (GD): gambling craving, gambling-related cognitive distortions, gambling (wagering) behavior, and gambling severity.

RESULTS

Data on 343 people with disordered gambling were analyzed. Measures representing the three pathways were analyzed using principal component analysis (PCA). The PCA generated three profiles. The original dimension of impulsivity/psychopathy was divided into two parts; the impulsivity-related traits were combined with symptoms of depression and anxiety to form one single component representing a volatile emotional, cognitive and behavioral style, named the Affect-instability component. The other two components were Psychopathy and Operant Behavior. Linear regression models for each PCA component found that the Affect-instability component was associated with all core features of GD, i.e., craving, cognitive distortions, gambling behavior and severity (standardized Β range: 0.298-0.448, all p < 0.001). Operant Behavior was significantly associated with gambling behavior (standardized Β=-0.137, p = 0.038) and gambling severity (standardized Β=-0.157, p = 0.006). Psychopathy was associated only with gambling cognitive distortions (standardized Β=-0.300, p < 0.001), suggesting a wider dimension of cognitive challenges in GD.

DISCUSSION

An instability component encompassing emotional and cognitive dysregulation was the strongest predictor of all clinical features of GD. The correlation between operant conditioning and gambling severity suggests that behavioral conditioning plays a role in the persistence of maladaptive gambling.

The Iowa Gambling Task: Men and Women Perform Differently. A Meta-analysis

The Iowa Gambling Task (IGT) was designed to assess decision-making under conditions of complexity and uncertainty; it is currently one of the most widely used tests to assess decision-making in both experimental and clinical settings. In the original version of the task, participants are given a loan of play money and four decks of cards and are asked to maximize profits. Although any single card unpredictably yields wins/losses, variations in frequency and size of gains/losses ultimately make two decks more advantageous in the long term. Several studies have previously suggested that there may be a sex-related difference in IGT performance. Thus, the present study aimed to explore and quantify sex differences in IGT performance by pooling the results of 110 studies. The meta-analysis revealed that males tend to perform better than females on the classic 100-trial IGT (UMD = 3.381; p < 0.001). Furthermore, the significant heterogeneity observed suggests high variability in the results obtained by individual studies. Results were not affected by publication bias or other moderators. Factors that may contribute to differences in male and female performance are discussed, such as functional sex-related asymmetries in the ventromedial prefrontal cortex and amygdala, as well as differences in sensitivity to wins/losses.

Cluster analysis based on gambling variables and mental health in a clinical population of gamblers

BACKGROUND

Interest in characterizing individuals involved in addictive behaviors has been growing, which allows tailoring prevention and intervention strategies to the gambler's needs. The study aimed to 1) identify clusters of gamblers according to gambling-related characteristics and mental health; and 2) analyze differences in psychological variables between the clusters.

METHODS

A total of 83 participants undergoing treatment for gambling disorder (Mage = 45.52, 51.8 % female) completed a set of questionnaires. Hierarchical cluster analysis was performed to classify gambling based on gambling variables (i.e., gambling severity and gambling motives) and mental health (i.e., depression, anxiety, and hostility). Several ANOVAs were conducted to illustrate the distinguishing features of each cluster, encompassing both the variables included in the cluster analysis and other relevant psychological variables.

RESULTS

Findings suggest that gamblers can be classified into three clusters based on these variables: 1) "high gambling severity and good mental health," 2) "high gambling severity and poor mental health," and 3) "low gambling severity and good mental health." These clusters were differentiated as a function of psychological variables, such as emotional dependence, alexithymia, and stressful life events.

CONCLUSIONS

Classifying gamblers according to their profile provides a better understanding of their needs and problems, allowing for a more tailored approach in terms of prevention and intervention strategies.

Pharmacological management of gambling disorder: an update of the literature

INTRODUCTION

Gambling disorder (GD) is a mental health condition characterized by persistent and problematic betting behavior. GD generates distress and impairment, and treatment options include psychological and pharmacological interventions.

AREAS COVERED

This narrative review explores existing pharmacological treatments for GD. The following classes of medications were considered: opioid-receptor antagonists (e.g. naltrexone and nalmefene), serotonin reuptake inhibitors (e.g. fluvoxamine, paroxetine, sertraline, escitalopram, and citalopram), glutamatergic agents (e.g. N-acetylcysteine (NAC), acamprosate, and memantine), mood stabilizers (e.g. topiramate, carbamazepine, lithium), and other medications (e.g. modafinil, nefazodone, olanzapine, haloperidol, tolcapone, and bupropion).

EXPERT OPINION

Due to the limitations of the studies reviewed, solid conclusions regarding the optimal choice of pharmacotherapy for individuals with GD are challenging to draw at this time. Despite some medications, such as naltrexone and nalmefene, showing promising results, efficacy has varied across studies. The review highlights current gaps/limitations, including small sample sizes, limited diversity in participant demographics, the need for exploring different gambling subtypes and treatment responses, high placebo response rates, lack of longer-term longitudinal information, limited investigation of neurobiological correlates and co-occurring disorders, and the importance of implementation research. Further research is needed to address these gaps and explore additional medications, as well as interventions like neuromodulation.