RESUMO
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).
RESUMO
Segmentation of gamblers is useful for understanding their distinctive characteristics and enforcing customized measures in harm minimization work. Previous research has commonly adopted gambling motivation and involvement as segmentation criteria. However, these criteria are less identifiable through observation. Gambling forms, used in recent gambling segmentation research, are more observable, facilitating the prevention and treatment work of governments and practitioners, as the identified segments have distinctive gambling disorder symptoms. As gambling is widespread in the Chinese population and little is known about this ethnic group in terms of gambling form segments, latent class analysis was used to classify 855 Chinese gamblers in Macau based on their participation in 11 gambling forms in the previous 12 months. The analysis identified three distinct segments: casino gamblers, lottery gamblers, and sociable gamblers. Socio-demographic differences between the three segments were revealed. Casino gamblers, compared with their counterparts, were more likely to have DSM-V symptoms, particularly escape and bailouts. Lottery gamblers and sociable gamblers only differed in one symptom, the latter having a higher probability of chasing their losses. Based on these results, Macau policymakers are advised to prioritize their harm minimization measures such as requiring casinos to provide training to workers to help to identify gambling disorder symptoms and that workers should intervene when the symptoms of escape and bailouts were identified from the gamblers. Special attention should be given to Macau casino gamblers who are male, unemployed, or with highest education of high school diploma.