Abstract
This study explored how different forms of reward-based decision-making are associated with pathological gambling (PG) among abstinent individuals with prior dependence on different classes of drugs. Participants had lifetime histories of either “pure” heroin dependence (n = 64), “pure” amphetamine dependence (n = 51), or polysubstance dependence (n = 89), or had no history of substance dependence (n = 133). Decision-making was assessed via two neurocognitive tasks: (1) the Iowa Gambling Task (IGT), a measure of decision-making under ambiguity (i.e., uncertain risk contingencies); and (2) the Cambridge Gambling task (CGT), a measure of decision-making under risk (i.e., explicit risk contingencies). The main effects of neurocognitive performance and drug class on PG (defined as ≥3 DSM-IV PG symptoms) as well as their interactional effects were assessed via multiple linear regression. Two CGT indices of decision-making under risk demonstrated positive main effects on PG. Interaction effects indicated that the effects of decision-making under risk on PG were largely consistent across participant groups. Notably, a linear relationship between greater CGT Risk-Taking and PG symptoms was not observed among amphetamine users, whereas IGT performance was selectively and positively associated with PG in polysubstance users. Overall, results indicate that reward-based decision-making under risk may represent a risk factor for PG across substance users, with some variations in these relationships influenced by specific class of substance of abuse.
Highlights
Pathological gambling (PG)1 is an addictive disorder characterized by recurrent patterns of compulsive gambling behavior that is associated with psychosocial burdens including financial debt, loss of productivity, legal difficulties, and psychiatric morbidity [1,2,3,4]
This study investigated the relative contributions of decisionmaking under ambiguity and decision-making under risk to pathological gambling (PG) within abstinent heroin, amphetamine, and polysubstance users
We hypothesized that both forms of reward-based decision-making would predict PG symptoms across all drug users, and that history of dependence on any drugs of abuse would be associated with PG symptoms
Summary
Pathological gambling (PG) is an addictive disorder characterized by recurrent patterns of compulsive gambling behavior that is associated with psychosocial burdens including financial debt, loss of productivity, legal difficulties, and psychiatric morbidity [1,2,3,4]. Recent studies utilizing neurochemical [18, 19], structural neuroimaging [20, 21], and functional neuroimaging methods [22,23,24] indicate shared neurobiological substrates between PG and SUD, which share similar psychiatric comorbidity. Based on this evidence and in recognition of the serious public health challenges posed by this condition, PG was recently included in DSM 5 as Gambling Disorder [16, 25]
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