The associative learning roots of affect-driven impulsivity and its role in problem gambling: A replication attempt and extension of Quintero et al. (2020).

Background and aims: Negative/positive urgency (NU/PU) refers to the proneness to act rashly under negative/positive emotions. These traits are proxies to generalized emotion dysregulation, and are well-established predictors of gambling-related problems. We aimed to replicate a previous work (Quintero et al., 2020) showing NU to be related to faulty extinction of conditioned stimuli in an emotional conditioning task, to extend these findings to PU, and to clarify the role of urgency in the development of gambling-related craving and problems. Methods: 81 gamblers performed an acquisition-extinction task in which neutral, disgusting, erotic and gambling-related images were used as unconditioned stimuli (US), and color patches as conditioned stimuli (CS). Trial-by-trial predictive responses were analyzed using generalized linear mixed-effects models (GLME). Results: PU was more strongly related than NU to craving and severity of gambling problems. PU did not influence acquisition in the associative task, whereas NU slightly slowed it. Extinction was hampered in individuals with high PU, and a follow-up analysis showed this effect to depend on relative preference for skill-based and casino games. Discussion and conclusions: Results suggest that resistance to extinction of emotionally conditioned cues is a sign of malfunctioning emotion regulation in problematic gambling. In our work, the key effect was driven by PU (instead of NU), and gambling craving and symptoms were also more closely predicted by it. Future research should compare the involvement of PU and NU in emotion regulation and gambling problems, for gamblers with preference for different gambling modalities (e.g., pure chance vs skill games).