title: Selective decision-making deficits in at-risk gamblers.
abstract: Despite reasonable knowledge of pathological gambling (PG), little is known of its cognitive antecedents. We evaluated decision-making and impulsivity characteristics in people at risk of developing PG using neuropsychological tests. Non-treatment seeking volunteers (18-29 years) who gamble ≥ 5 times/year were recruited from the general community, and split into two groups: those "at risk" of developing PG (n=74) and those social, non-problem gamblers (n=112). Participants undertook the Cambridge Gamble and Stop-signal tasks and were assessed with the Mini-International Neuropsychiatric Interview and the Yale Brown Obsessive Compulsive Scale Modified for Pathological Gambling. On the Cambridge Gamble task, the at-risk subjects gambled more points overall, were more likely to go bankrupt, and made more irrational decisions under situations of relative risk ambiguity. On the Stop-signal task, at-risk gamblers did not differ from the social, non-problem gamblers in terms of motor impulse control (stop-signal reaction times). Findings suggest that selective cognitive dysfunction may already be present in terms of decision-making in at-risk gamblers, even before psychopathology arises. These findings implicate selective decision-making deficits and dysfunction of orbitofronto-limbic circuitry in the chain of pathogenesis between social, non-problematic and pathological gambling.
authors.affiliation: Department of Psychiatry, University of Minnesota Medical Center, Minneapolis, Minnesota 55454, USA.
authors.forename: Jon Edgar
authors.initials: JE
authors.lastname: Grant
authors.forename: Samuel Robin
authors.initials: SR
authors.lastname: Chamberlain
authors.forename: Liana Renne Nelson
authors.initials: LR
authors.lastname: Schreiber
authors.forename: Brian Lawrence
authors.initials: BL
authors.lastname: Odlaug
authors.forename: Suck Won
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D003072:Cognition Disorders / Q000209:etiology*; D003657:Decision Making / Q000502:physiology*; D005260:Female; D005715:Gambling / Q000150:complications* / Q000523:psychology*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011930:Reaction Time / Q000502:physiology; D055815:Young Adult