title: An eight component decision-making model for problem gambling: a systems approach to stimulate integrative research.
abstract: Problem Gambling (PG) represents a serious problem for affected individuals, their families and society in general. Previous approaches to understanding PG have been confined to only a subset of the psychobiological factors influencing PG. We present a model that attempts to integrate potential causal factors across levels of organization, providing empirical evidence from the vast literature on PG and complimentary literatures in decision-making and addiction. The model posits that components are arranged systematically to bias decisions in favor of either immediately approaching or avoiding targets affording the opportunity for immediate reward. Dopamine, Testosterone and Endogenous Opioids favor immediate approach, while Serotonin and Cortisol favor inhibition. Glutamate is involved in associative learning between stimuli and promotes the approach response through its link to the DA reward system. GABA functions to monitor performance and curb impulsive decision-making. Finally, while very high levels of Norepinephrine can induce arousal to an extent that is detrimental to sound decision-making, the reactivity of the Norepinephrine system and its effects of Cortisol levels can shift the focus towards long-term consequences, thereby inhibiting impulsive decisions. Empirical evidence is provided showing the effects of each component on PG and decision-making across behavioural, neuropsychological, functional neuroimaging and genetic levels. Last, an effect size analysis of the growing pharmacotherapy literature is presented. It is hoped that this model will stimulate multi-level research to solidify our comprehension of biased decision-making in PG and suggest pharmacological and psychological approaches to treatment.
authors.affiliation: Department of Psychology, University of Toronto Scarborough, SW414 1265 Military Trail, Toronto, ON, M1C 1A4, Canada. dnussbaum@utsc.utoronto.ca
authors.forename: David
authors.initials: D
authors.lastname: Nussbaum
authors.forename: Kimia
authors.initials: K
authors.lastname: Honarmand
authors.forename: Richard
authors.initials: R
authors.lastname: Govoni
authors.forename: Martina
authors.initials: M
authors.lastname: Kalahani-Bargis
authors.forename: Stephanie
authors.initials: S
authors.lastname: Bass
authors.forename: Xinqun
authors.initials: X
authors.lastname: Ni
authors.forename: Kaitlyn
authors.initials: K
authors.lastname: Laforge
authors.forename: Andrea
authors.initials: A
authors.lastname: Burden
authors.forename: Kristoffer
authors.initials: K
authors.lastname: Romero
authors.forename: Sonya
authors.initials: S
authors.lastname: Basarke
authors.forename: Christine
authors.initials: C
authors.lastname: Courbasson
authors.forename: Wade
authors.initials: W
authors.lastname: Deamond
mesh_terms: D016739:Behavior, Addictive / Q000145:classification / Q000175:diagnosis / Q000523:psychology*; D003657:Decision Making; D005260:Female; D005715:Gambling / Q000145:classification / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008960:Models, Psychological; D011209:Power, Psychological; D015203:Reproducibility of Results; D012309:Risk-Taking; D012649:Self Concept; D020377:Self Efficacy; D012919:Social Behavior