How are illness representations of gambling disorder associated with gambling behaviors? A latent profile analysis.

Gambling disorder (GD) is a behavioral addiction that causes serious harm to individuals' mental health and social functioning. This study aimed to explore whether gamblers' illness representations (IR) for GD are related to disordered and/or controlled patterns of gambling under the framework of commonsense model of self-regulation (CSM). Based on CSM, different facets of IR do not exist in isolation but together form a total illness schema; we hence used a person-centered analysis method, latent profile analysis (LPA), to classify gamblers by their overall IR for GD (including consequences, personal and treatment control, timeline cyclical, emotional representations, and coherence) into groups and then tested whether these groups differed in GD symptoms, controlled gambling behaviors, and help-seeking intention. An anonymous online survey was conducted on a social media platform, and valid responses from 589 past-year adult gamblers were collected. LPA results supported a four-profile model, revealing four profiles of GD representations: the weak-perception profile, average profile, tensed-up profile, and rational profile. Significant differences were found in all outcome variables in these four profile groups. In particular, the rational group exhibited the lowest levels of GD symptoms and impaired behavioral control, the highest levels of responsible and controlled gambling, and the highest levels of help-seeking intention, whereas the weak-perception group reported the lowest levels of responsible and controlled gambling behaviors. The findings provide empirical support for the application of CSM to addictive behaviors, as well as preliminary evidence for the potential use of CSM-based interventions for GD prevention.

Impact of Gambling on the Internet on Middle-Term and Long-Term Recovery from Gambling Disorder: A 2-Year Longitudinal Study.

Online gamblers are more likely to experience gambling problems. The main objective was to compare the frequency of recovery one (middle-term) and two (long-term) years after treatment initiation, according to the gambling medium (Internet vs. land-based gambling). The secondary objectives were (i) to compare online and offline gamblers at inclusion and (ii) to investigate whether the gambling medium was a predictive factor of recovery. Outpatients beginning treatment for a GD (n = 237) were assessed at inclusion (treatment initiation) and after 1 and 2 years. Bivariate analyses were performed to compare online and offline gamblers at inclusion and on the frequency of recovery at one and two years. Two multivariate logistic regressions were then performed to identify factors associated with middle- and long-term recovery. The majority of patients achieved middle (74.2%) and long-term (78.9%) recovery, with no difference between online and offline gamblers. The gambling medium was not a predictive factor of recovery. Patients with a higher perceived self-efficacy (OR = 1.04 [1.01-1.07], p = .046) and having no history of mood disorders (OR = 11.18 [2.53-49.50], p < .001) at inclusion were more likely to achieve middle-term recovery, while long-term recovery was associated with a lower level of sensation seeking (OR = 0.67 [0.48-0.92], p = .015) at treatment initiation. Online gambling did not seem to influence middle- and long-term recovery compared to offline gambling. Enhancement of perceived self-efficacy and treatment of mood disorders, and treatment strategies focused on sensation-seeking may represent helpful care strategies for favouring achievement of middle-term recovery and maintenance of long-term recovery, respectively. ClinicalTrials.gov NCT01248767, date of first registration: November 25, 2010.

Dopamine mediates a directionally opposite correlation between empathy and the reinforcing effects of amphetamine and gambling in people with gambling disorder vs. healthy controls.

Understanding the relationship between empathy, subjective effects of addictive reinforcers and dopamine function in people with gambling disorder (PGD) vs. healthy controls (HCs) may inform GD treatment. The current investigation addressed this issue via retrospective analysis of data from three studies using amphetamine and a slot machine (SLOTS) as reinforcers in PGD and HCs. The Empathy scale of Eysenck's Impulsiveness Questionnaire assessed trait Empathy. The Gamblers Beliefs Questionnaire assessed cognitive distortions. The Eysenck Lie scale assessed socially desirable responding. PET scans quantified dopamine receptor expression and amphetamine-induced dopamine release in Study 1. Pre-treatment with the D2-receptor (D2R)-preferring antagonist, haloperidol or D1R-D2R antagonist, fluphenazine before SLOTS tested the role of D2 autoreceptors and post-synaptic D2R in Study 2. Pre-treatment with the multi-system indirect dopamine agonist, modafinil before SLOTS assessed the reliability of correlations in PGD. Striatal D2R expression predicted greater Empathy and lower amphetamine 'Liking' in HCs, and predicted greater symptom severity in PGD. Empathy predicted lower 'Exciting' effects of SLOTS under placebo in HCs; no correlation emerged under either antagonist. Relative to placebo, haloperidol decreased, whereas fluphenazine increased, the positive correlation between Empathy and Exciting effects of SLOTS in PGD. Modafinil markedly reduced the positive correlation between Empathy and Exciting effects of SLOTS seen under placebo in PGD. Empathy predicted greater cognitive distortions in PGD in all studies. Lie scale variance influenced several primary effects. Prior research linking the insula with Empathy, reactivity to interoceptive signals for risky rewards (uncertainty), and cognitive distortions, provides a parsimonious account for these results.

Systematic Assessment of Gambling Type Involvement: Reliability and Validity of the Gambling Disorder Identification Test (GDIT).

Gambling type involvement, both in terms of participation (engagement in specific gambling types) and diversity (how many gambling types an individual engages in), is a key feature to address in gambling self-report measures, but such systematic measurement procedures are scarce. The aim of this study was to test the psychometric performance of the gambling type assessment in the recently developed Gambling Disorder Identification Test (GDIT), in terms of test-retest reliability, convergent validity, and patterns of gambling diversity, among help-seeking and general population gambling samples (total n = 603). Overall, online gambling was more commonly reported as problematic than land-based gambling. Retest reliability varied for specific gambling types (ICC range 0.32-0.64, rtet range 0.66-0.85). In terms of gambling participation, online gambling showed stronger correlations with GDIT total score (i.e., symptom severity) than land-based gambling, where Slots showed the strongest correlation (r = 0.52), followed by Casino table games (r = 0.25), Sports and Horse betting (r = 0.16 and r = 0.14, respectively), and Poker (r = 0.14). Lotteries showed no correlation with GDIT total score (r=-0,01). For Slots gambling, all gambling diversity levels (including Slots as a single gambling type) were on average associated with the highest diagnostic severity level (GDIT total score > 30; severe gambling disorder). Finally, explorative configural frequency analysis identified typical and antitypical gambling diversity patterns. The result from the current study corroborates findings that engagement in specific gambling types matter, and that such features should be included in gambling measurement. We conclude that the GDIT is a reliable and valid measure for systematic assessment of gambling type involvement. The GDIT can be used to assess gambling participation and diversity, as part of a broad measurement setup for problem gambling and gambling disorder.

Applying General Strain Theory to the Relationship Between Strain from Another Person's Gambling Behavior and Gambling Disorder.

Prior research has identified a host of factors that increase the likelihood that an individual will develop problem gambling, clinically diagnosed as Gambling Disorder (GD), most of which would be identified by criminologists as "strains" under the framework of General Strain Theory (GST). This study utilizes propositions from GST to determine whether strain from another person's gambling may be related to why people develop GD and whether gender is a moderating factor in this relationship. Secondary data is analyzed to assess levels of strain individuals experience from another person's gambling behavior, its relationship to the individual's risk of Gambling Disorder, and the role gender plays in this relationship. Findings demonstrate a relationship between the strain from the perceived problem gambling of someone with a close relationship and having a gambling disorder. Experiencing strain from a spouse/partner who is perceived as a problem gambler has the strongest correlation with an individual also having Gambling Disorder. Considering gender as a moderating factor, this effect was stronger on men than women, calling into question the strong belief that it is primarily women who gamble to escape problems.

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.

Statistical predictors of the co-occurrence between gambling disorder and problematic pornography use.

Co-occurrence between gambling disorder (GD) and other mental disorders is common, but its association with problematic pornography use (PPU) remains unexplored. This study aimed to investigate relationships between sociodemographic variables, personality measures, psychopathology, emotional regulation, and impulsivity and the co-occurrence of GD and PPU using structural equation modeling (SEM). The sample consisted of 359 adults seeking treatment for GD. The short version of the Problematic Pornography Consumption Scale (PPCS-6) identified patients with GD + PPU. Psychopathology, impulsivity, emotional regulation, and personality were also assessed. Higher impulsivity levels statistically predicted co-occurrence between GD and PPU. Impulsivity mediated the relationship between younger age, maladaptive personality features, and emotional dysregulation and co-occurrence. Psychopathological distress did not directly associate with GD + PPU co-occurrence. Impulsivity relates importantly to the co-occurrence of GD and PPU. Younger age, maladaptive personality, and emotional dysregulation contribute to increased impulsivity levels and co-occurrence. The findings highlight the importance of addressing impulsivity in understanding and treating co-occurring GD and PPU.

Sleep Problems and Gambling Disorder: Cross-Sectional Relationships in a Young Cohort.

AIMS: To investigate the potential association between gambling disorder and symptoms of sleep problems (including insomnia and excessive daytime sleepiness). It was hypothesised that, compared to controls, individuals with gambling disorder would have significantly greater disturbance of sleep, as indicated by increased scores in: (1) sleep items on the Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Rating Scale for Depression (HAM-D); (2) total score on the HAM-A and HAM-D; and (3) the Epworth Sleepiness Scale (ESS). METHODS: Secondary analysis of previously published data from 152 young adults, aged 18-29 years. Individuals were stratified into three groups: controls, those at risk of gambling disorder, and those with gambling disorder. One-way ANOVAs with post-hoc tests were conducted to determine whether groups differed significantly in sleep item scores and total scores of the HAM-A and HAM-D, and the ESS. RESULTS: HAM-D scale insomnia item scores were significantly higher in the disorder group, when compared to controls, this being particularly marked for middle and late insomnia. The HAM-A item score indicated significantly worse sleep quality in the disorder group, compared to at risk and control groups. Total HAM-A and HAM-D scores were significantly higher in the disorder group, but ESS scores did not differ significantly. CONCLUSION: Measures of disruptions in sleep were significantly higher in gambling disorder than controls. Anxiety and depressive symptom severity was also significantly higher in the gambling disorder group. Further research could have implications for identification and treatment of sleep disorders and psychiatric comorbidities in gambling disorder.

Gambling Habits and Attitudes among Athlete and Non-Athlete High School Students in Skåne Region, Sweden.

Previous literature has reported increased rates of gambling problems in athletes compared to non-athletes. More liberal gambling-related attitudes have been suggested as a reason, although this rarely has been researched. The present study aimed to examine gambling experience, gambling problems, and gambling-related attitudes and parental gambling experience in high school students, comparing student-athletes to students at conventional schools. This is a cross-sectional web survey study in high school students (N = 473, 53% at sports high schools, 57% male) at eleven schools in the Skåne region, Sweden, who answered a web survey addressed gambling experiences, parental gambling and gambling-related attitudes, and included validated screening instruments for gambling problems and psychological distress. A history of any gambling was common and increased with age. Problem gambling was detected in 10% (13% of males and 5% of females, p < .001), and was associated with paternal and maternal gambling but not with psychological distress. Sports high school students were not more likely (9%) than other students (10%) to endorse gambling problems and history of each gambling type. However, paternal (but not maternal) gambling was more commonly reported in athletes, who also had more positive attitudes to gambling's effects on society and gambling availability. In contrast to other studies, this study did not demonstrate higher prevalence of gambling or gambling problems among young athletes than among other students, but liberal attitudes towards gambling, and experience of parental gambling on the father's side, were more common among athletes than among non-athletes. Gambling attitudes in adolescents may need to be targeted in future preventive efforts in young athletes and others.

Somatic and psychiatric comorbidity in people with diagnosed gambling disorder: A Finnish nation-wide register study.

BACKGROUND AND AIMS: This is the first nation-wide register study based on a total population sample measuring the gender-specific incidences of chronic diseases and conditions among adults diagnosed with gambling disorder (GD). DESIGN, SETTING AND PARTICIPANTS: The study used aggregated data for 2011-22 retrieved from the Register of Primary Health Care visits, Care Register for Health Care and Care Register for Social Welfare, including specialized outpatient and inpatient health care, inpatient social care and institutional care and housing services with 24-hour or part-time assistance, set in mainland Finland. Participants comprised people aged 18-90+ years with GD diagnosis [corresponding to pathological gambling, International Classification of Diseases 10th revision (ICD-10) code F63.0, n = 3605; men n = 2574, women n = 1031] and the general population (n = 4 374 192). MEASUREMENTS: Incidences of somatic diseases and psychiatric disorders were calculated for the people with diagnosed GD and for the general population, separately for women and men. FINDINGS: After standardizing for age, the incidence of each diagnostic group was systematically higher for people with GD compared with the general population, except for cancer. The highest standardized incidence ratio (SIR) values were for psychiatric disorders [SIR = 234.2; 95% confidence interval (CI) = 226.1-242.4], memory disorders (SIR = 172.1; 95% CI = 119.1-234.8), nervous system diseases (SIR = 162.8; 95% CI = 152.8-173.1), chronic respiratory diseases (SIR = 150.6; 95% CI = 137.6-164.2), diabetes (SIR = 141.4; 95% CI = 127.9-155.5) and digestive diseases (SIR = 134.5; 95% CI = 127.1-142.2). CONCLUSIONS: In Finland, the incidence of chronic diseases and conditions among people with gambling disorder is higher compared with the general population, apart from cancer.

Problematic Gambling Behavior in a Sample of Gamblers: The Role of Alexithymia, Dissociation Features, and External Locus of Control.

Gambling disorder is a severe condition that significantly compromises the lives of those affected. In light of this clinical relevance, the literature on the antecedents of this form of addiction is constant and continually evolving. Consistently with this framework, the present research aimed at investigating the role of some risk factors in gambling disorder, with a specific focus on alexithymia, dissociation, and locus of control. The research involved a sample of 290 participants (183 males and 107 females; Mage = 34.43, SD = 14.65) who practice gambling at least occasionally. They completed an online survey including the South Oaks Gambling Screen, Twenty-Items Toronto Alexithymia Scale, Dissociative Experience Scale-II, and Locus of Control of Behavior. ANOVA and a moderated-mediation model were implemented to analyse the collected data. Results showed that 19.0% of the participants were At Risk and Problem Gamblers, while 27.6% fell into the category of Problematic Gamblers. Problematic Gamblers showed significantly higher levels of alexithymia, dissociation, and external locus of control. Moreover, a significant association between alexithymia and the severity of problematic gambling behaviour was found and was significantly mediated by absorption (a dissociation feature). Furthermore, the external locus of control significantly moderated this indirect effect. The role of gender as a covariate was also investigated. Such findings may offer further insights into the field of clinical research on gambling disorder and may provide useful information for effective clinical practice.

Does the loot box open the door to addiction? A case report of gaming disorder with high charges for loot box purchases.

Background: A loot box is a gaming term for an electronic lottery that randomly provides items that enhance the gaming experience. In recent years, loot boxes have been increasingly discussed as a risk factor of gaming disorder (GD). While they may be purchased for a few dollars at a time, the cumulative expenses resulting from their addictive use have become a social problem. Case Presentation: This paper presents a case of GD involving a substantial financial burden incurred through the use of a Japanese loot box called Gacha. Conclusion: The randomness in the selection of virtual items in loot boxes resembles gambling, triggering the reward system and contributing to an addiction to purchasing more loot boxes. For therapeutic purposes, understanding the motivations behind purchasing loot boxes and considering individual developmental characteristics are crucial to helping patients find satisfaction and a sense of achievement in activities besides gaming.

Frontal white and gray matter abnormality in gambling disorder: A multimodal MRI study.

Background: Changes in brain structural connections appear to be important in the pathophysiology of substance use disorders, but their role in behavioral addictions, such as gambling disorder (GD), is unclear. GD also offers a model to study addiction mechanisms without pharmacological confounding factors. Here, we used multimodal MRI data to examine the integrity of white matter connections in individuals with GD. We hypothesized that the affected areas would be in the fronto-striatal-thalamic circuit. Methods: Twenty individuals with GD (mean age: 64 years, GD duration: 15.7 years) and 40 age- and sex-matched healthy controls (HCs) underwent detailed clinical examinations together with brain 3T MRI scans (T1, T2, FLAIR and DWI). White matter (WM) analysis involved fractional anisotropy and lesion load, while gray matter (GM) analysis included voxel- and surface-based morphometry. These measures were compared between groups, and correlations with GD-related behavioral characteristics were examined. Results: Individuals with GD showed reduced WM integrity in the left and right frontal parts of the corona radiata and corpus callosum (pFWE < 0.05). WM gambling symptom severity (SOGS score) was negatively associated to WM integrity in these areas within the left hemisphere (p < 0.05). Individuals with GD also exhibited higher WM lesion load in the left anterior corona radiata (pFWE < 0.05). GM volume in the left thalamus and GM thickness in the left orbitofrontal cortex were reduced in the GD group (pFWE < 0.05). Conclusions: Similar to substance addictions, the fronto-striatal-thalamic circuit is also affected in GD, suggesting that this circuitry may have a crucial role in addictions, independent of pharmacological substances.

Psychometric Validation of the Gambling Craving Scale in a Treatment-Seeking Sample.

The Gambling Craving Scale (GACS) is a multifaceted measure of gambling craving. Initial validation work by Young and Wohl (2009) in university student samples showed that the GACS had a three-factor structure capturing dimensions of Desire, Anticipation, and Relief. Despite its potential clinical utility as a measure of craving, the GACS has yet to be validated in people seeking treatment for gambling problems. Accordingly, we examined the psychometric properties in a sample of people (N = 209; Mage = 37.66; 62.2% female) participating in a randomized controlled trial testing a novel online treatment for problem gambling. We predicted the GACS would have a three-factor structure. In addition, we also examined measurement invariance across sex and problem gambling risk status. Finally, we assessed concurrent validity of the factors with other measures of problem gambling severity and involvement. Exploratory structural equation modeling findings supported a three-factor structure that was invariant across the groups tested. Each of the Desire, Anticipation, and Relief subscales were significant positive predictors of problem gambling severity and symptoms, and some form of gambling behaviour. Findings show the GACS is a promising scale to assess multidimensional craving experiences among people in treatment for gambling problems.

Desire Thinking About Gambling: Assessment and Associations With Gambling Disorder and Responsible Gambling Among Chinese Gamblers.

Desire thinking, within the metacognitive model of addictive behaviors, is conceptualized as a transdiagnostic process linked to the escalation and maintenance of craving for various addictive disorders; however, its application to the understanding of gambling and the Chinese community remains at an early stage. The present study aimed to introduce desire thinking into gambling research in the Chinese context by: (1) testing the applicability of its two-factor conceptualization and assessment tool, the Desire Thinking Questionnaire (DTQ), and (2) exploring its association with dysregulated and regulated engagements in gambling (i.e., Gambling Disorder [GD] and responsible gambling [RG], respectively). We conducted a telephone survey in Macao, China, and obtained a probability sample of 837 Chinese adult past-year gamblers (48.5% men; age: M = 41.11, SD = 14.31) with a two-stage cluster random sampling method. Our data indicated the psychometric adequacy of the two-factor DTQ (i.e., verbal perseveration and imaginal prefiguration) for measuring Chinese gamblers' desire thinking about gambling. After controlling for craving and demographics, desire thinking contributed to an additional 12.1% and 18.9% variance explained in GD tendency and RG behaviors, respectively. This study provides the first empirical evidence of the utility of desire thinking and the DTQ in facilitating gambling research on Chinese gamblers. Our findings also suggest the value of incorporating desire thinking in detecting and treating GD and in promoting RG.

A Self-Applied Psychological Treatment for Gambling-Related Problems via The Internet: A Pilot, Feasibility Study.

The main purpose of this study was to evaluate the feasibility of an online psychological intervention for individuals with gambling-related problems, supported by ecological momentary assessments and interventions (EMAs and EMIs), along with weekly phone-calls, before conducting a randomized controlled trial. Participants were required to complete 3 of the 8 modules of the program based on cognitive-behavioral therapy (CBT) and extensions and innovations of CBT. The study measured the outcomes of feasibility (i.e., reach, appropriateness, technology literacy and technology usability, fidelity, and adherence). In terms of reach, 19.8% (n = 11) of the initial population met the inclusion criteria and completed the three modules (mean age = 41; 90.9% men). The perceived appropriateness and the technology usability after the first use were both excellent, fidelity and adherence to the online treatment (73.3%) were adequate. Adherence to the EMAs and the weekly phone calls were more modest (54.51% and 66.67%, respectively). The results of the present study show that an online treatment for gambling problems enhanced by EMA and EMI might be feasible but challenges were noted in terms of reach and adherence to these assessments and calls. These challenges are important to consider for future trials and the scalability of treatments for individuals with gambling disorders.

Associations between Adverse Childhood Experiences and Gambling Severity in Youth Online Gamblers: The Mediating Roles of Internalizing, Attention and Externalizing Problems.

BACKGROUND: This study examined the association between Adverse Childhood Experiences (ACEs) and Gambling Severity (gambling severity), considering the mediating roles of internalizing, externalizing, and attention among youth online gamblers. METHODS: 762 youth (agemean±SD= 15.03 ± 2.40; agerange = 10-18 years; 75.3% boys) completed the Persian Gambling Disorder Screening Questionnaire (GDSQ-P), Pediatric Symptom Checklist - Youth Report (Y-PSC), and Behavioral Risk Factor Surveillance System Questionnaire (ACE's section, modified by authors). The analysis was done using the SMART PLS software. RESULTS: The reliability and discriminant validity of the provided model were assessed using Partial Least Squares-Structural Equation Modeling (PLS-SEM). According to the results of the PLS-SEM analysis, the present model demonstrated suitable levels of reliability and validity. Adverse Childhood Experiences (ACEs) significantly affected attention, internalizing, externalizing problems, and gambling severity. Additionally, the level of gambling was directly correlated with ACEs. Moreover, the indirect influence of the independent variable on the dependent variable via the mediators was found to be statistically significant (P < .001).These findings suggest that externalizing behaviors, attention problems, and internalizing symptoms mediate the effect of ACEs on gambling severity. Lastly, fitness indices indicated that our proposed model fit the data well (SRMR = 0.06, d_ULS = 1.15, Chi-square = 1291.461, and NFI = 0.71). CONCLUSION: Our study found that ACEs significantly influence gambling severity among youth online gamblers, with internalizing, externalizing, and attention problems mediating this relationship. Practical implications include integrating ACE screening and targeted interventions for associated mental health issues into youth gambling prevention programs to mitigate the risk of problematic gambling behavior.

Decomposition of Reinforcement Learning Deficits in Disordered Gambling via Drift Diffusion Modeling and Functional Magnetic Resonance Imaging.

Gambling disorder is associated with deficits in reward-based learning, but the underlying computational mechanisms are still poorly understood. Here, we examined this issue using a stationary reinforcement learning task in combination with computational modeling and functional resonance imaging (fMRI) in individuals that regular participate in gambling (n = 23, seven fulfilled one to three DSM 5 criteria for gambling disorder, sixteen fulfilled four or more) and matched controls (n = 23). As predicted, the gambling group exhibited substantially reduced accuracy, whereas overall response times (RTs) were not reliably different between groups. We then used comprehensive modeling using reinforcement learning drift diffusion models (RLDDMs) in combination with hierarchical Bayesian parameter estimation to shed light on the computational underpinnings of this performance deficit. In both groups, an RLDDM in which both non-decision time and decision threshold (boundary separation) changed over the course of the experiment accounted for the data best. The model showed good parameter and model recovery, and posterior predictive checks revealed that, in both groups, the model accurately reproduced the evolution of accuracies and RTs over time. Modeling revealed that, compared to controls, the learning impairment in the gambling group was linked to a more rapid reduction in decision thresholds over time, and a reduced impact of value-differences on the drift rate. The gambling group also showed shorter non-decision times. FMRI analyses replicated effects of prediction error coding in the ventral striatum and value coding in the ventro-medial prefrontal cortex, but there was no credible evidence for group differences in these effects. Taken together, our findings show that reinforcement learning impairments in disordered gambling are linked to both maladaptive decision threshold adjustments and a reduced consideration of option values in the choice process.

Linking Striatal Dopaminergic Asymmetry with Personality Traits: Insights from Gambling Disorder.

The role of dopamine in the pathophysiology of gambling disorder (GD) remains incompletely understood, with disparate research findings concerning presynaptic and postsynaptic structures and dopaminergic synthesis. The aim of this study was to investigate potential correlations between striatal dopamine transporter (DAT) lateralization and asymmetry index, as assessed by 123I-FP-CIT SPECT, and temperamental traits, as measured by Cloninger's Temperament and Character Inventory (TCI), in GD subjects. Significant associations were found between DAT binding asymmetries in the caudate and putamen and the temperamental dimensions of harm avoidance and novelty seeking. Specifically, high novelty seeking scores correlated with increased DAT binding in the left caudate relative to the right, whereas higher harm avoidance scores corresponded to increased DAT binding in the right putamen relative to the left. These observations potentially imply that the asymmetry in DAT expression in the basal ganglia could be an outcome of hemispheric asymmetry in emotional processing and behavioural guidance. In summary, our study provides evidence supporting the relationship between DAT asymmetries, temperamental dimensions and GD. Future investigations could be directed towards examining postsynaptic receptors to gain a more comprehensive understanding of dopamine's influence within the basal ganglia circuit in disordered gambling. If confirmed in larger cohorts, these findings could have substantial implications for the tailoring of individualized neuromodulation therapies in the treatment of behavioural addictions.