Abstract
Compulsivity is a core feature of addictive disorders, including gambling disorder. However, it is unclear to what extent this compulsive behavior in gambling disorder is associated with abnormal compulsivity-related neurocognitive functioning. Here, we summarize and synthesize the evidence for compulsive behavior, as assessed by compulsivity-related neurocognitive tasks, in individuals with gambling disorder compared to healthy controls (HCs). A total of 29 studies, comprising 41 task-results, were included in the systematic review; 32 datasets (n = 1072 individuals with gambling disorder; n = 1312 HCs) were also included in the meta-analyses, conducted for each cognitive task separately. Our meta-analyses indicate significant deficits in individuals with gambling disorder in cognitive flexibility, attentional set-shifting, and attentional bias. Overall, these findings support the idea that compulsivity-related performance deficits characterize gambling disorder. This association may provide a possible link between impairments in executive functions related to compulsive action. We discuss the practical relevance of these results, their implications for our understanding of gambling disorder and how they relate to neurobiological factors and other ‘disorders of compulsivity’.
Highlights
Pathological gambling has recently been reclassified as a behavioral addiction and renamed as Gambling Disorder (DSM-5; American Psychiatric Association, 2013)
That gambling is reclassified as a behavioral addiction, there is an increased need to focus on the compulsive aspects of the behavior, which may be central to understanding the pathology of gambling disorder (e.g. El-Guebaly et al, 2012; Leeman and Potenza, 2012), and addiction in general
We found that individuals with gambling disorder, compared to healthy controls (HCs), show performance deficits in a broad range of compulsivity-related neuropsychological functions
Summary
Pathological gambling has recently been reclassified as a behavioral addiction and renamed as Gambling Disorder (DSM-5; American Psychiatric Association, 2013). This decision was largely based on clinical and neurobiological similarities with substance-use disorders (FauthBühler et al, 2017; Romanczuk-Seiferth et al, 2014). Because gambling disorder may provide a model of drug-free addiction, it offers the opportunity to investigate compulsivity as an endophenotype for addiction. Other behaviors, such as food, sex, and Internet addiction, can potentially be compulsive too (Morris and Voon, 2016). These behaviors were outside the scope of the current review, as they are not included under the ‘Substance-related and Addictive Disorders’ category in the DSM-5 due to insufficient research
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