title: Trait and neurobiological underpinnings of negative emotion regulation in gambling disorder.
abstract: OBJECTIVE
  Gambling disorder is characterized by poor regulation of negative emotions and impulsive behaviours. This study aimed to (1) compare gambling disorder patients (GDPs) and healthy controls (HCs) in self-report and brain activation measures of emotion regulation; and (2) establish its relationship with negative emotion-driven impulsivity.
  
  
  METHODS
  Two cross-sectional case-control studies including GDPs and HCs.
  
  
  METHODS
  GDPs and HCs were recruited from specialized gambling clinics in Andalusia (Spain), where they were following out-patient treatment, and from the community, respectively. Study 1 included 41 GDPs and 45 HCs [All males; Mage= 35.22, 33.22; standard deviation (SD) = 11.16, 8.18; respectively]. Study 2 included 17 GDPs and 21 HCs (16/20 males; Mage= 32.94, 31.00; SD = 7.77, 4.60; respectively).
  
  
  METHODS
  In study 1, we compared both groups on suppression and re-appraisal emotion regulation strategies [Emotion Regulation Questionnaire (ERQ)]. In study 2, we compared GDPs with HCs on brain activation associated with down-regulation of negative emotions in a cognitive re-appraisal task, measured with functional magnetic resonance imaging (fMRI). In both studies, we correlated the measures of emotion regulation with mood-related impulsivity indicated by negative urgency (UPPS-P impulsive behaviour scale).
  
  
  RESULTS
  GDPs relative to HCs showed higher levels of emotional suppression [F = 4.525; P = 0.036; means difference MHCs-MGDPs= -2.433, 95% confidence interval (CI) = -4.706, -0.159] and higher activation of the premotor cortex and middle frontal gyrus during negative emotion regulation in the fMRI task [P ≤ 0.005, cluster size (CS) > 50 voxels]. Negative urgency correlated positively with emotional suppression (r = 0.399, 95% CI = 0.104, 0.629, one-tailed P = 0.005) and middle frontal gyrus activation during negative emotion regulation (P ≤ 0.005, CS > 50) in GDPs.
  
  
  CONCLUSIONS
  Gambling disorder is associated with greater use of emotional suppression and stronger pre-motor cortex and middle frontal gyrus activation for regulating negative emotions, compared with healthy controls. Emotional suppression use and middle frontal gyrus activation during negative emotion regulation are linked with negative emotion-driven impulsivity in this disorder.
authors.affiliation: Department of Experimental Psychology, University of Granada, Granada, Spain.|Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Navas
authors.affiliation: Department of Psychiatry, Bellvitge Biomedical Research Institute, Barcelona, Spain.
authors.forename: Oren
authors.initials: O
authors.lastname: Contreras-Rodríguez
authors.affiliation: Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.|Department of Personality, Assessment and Clinical Treatment, University of Granada, Granada, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Verdejo-Román
authors.affiliation: Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Perandrés-Gómez
authors.affiliation: School of Psychology, Cognitive Neuroscience Unit, Deakin University, Burwood, Australia.
authors.forename: Natalia
authors.initials: N
authors.lastname: Albein-Urios
authors.affiliation: Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Melbourne, Australia.|Red de trastornos adictivos, University of Granada, Granada, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Verdejo-García
authors.affiliation: Department of Experimental Psychology, University of Granada, Granada, Spain.|Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.|Red de trastornos adictivos, University of Granada, Granada, Spain.
authors.forename: José C
authors.initials: JC
authors.lastname: Perales
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000150:complications* / Q000503:physiopathology*; D000367:Age Factors; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004522:Educational Status; D004644:Emotions / Q000502:physiology; D005715:Gambling / Q000150:complications* / Q000503:physiopathology*; D006801:Humans; D007175:Impulsive Behavior; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D017533:Marital Status; D012959:Socioeconomic Factors; D013030:Spain
keywords: Cognitive re-appraisal; emotion regulation; emotional suppression; fMRI; gambling disorder; middle frontal gyrus; negative urgency