Neuropsychological performance, impulsivity, symptoms of ADHD, and Cloninger's personality traits in pathological gambling

Abstract

Pathological gambling (PG) is a prevalent public health problem associated with fronto-temporal dysfunction and maladaptive personality traits. To further test these associations, we assessed neuropsychological performance in pathological gamblers (PGs) and controls. We also examined selected personality characteristics and symptoms of attention deficit hyperactivity disorder (ADHD). Subjects were recruited from the community. All received a comprehensive neuropsychological battery, the ADHD Rating Scale, and personality measures including the Barratt Impulsiveness Scale and a version of the Temperament and Character Inventory. People with DSM-IV PG (n = 54) and controls (n = 65) were comparable in age, sex, and education level. PGs were more likely to have comorbid lifetime mood, anxiety, and substance use disorders; antisocial personality disorder; and other impulse control disorders. PGs performed significantly worse on the Wisconsin Card Sort Test-64 perseverative responses subscale and the Trails B test; they also had lower performance and full scale IQs. PGs had elevated levels of depression, ADHD symptoms, trait impulsivity, novelty seeking, and harm avoidance, but lower levels of reward dependence. High levels of self-reported impulsivity or ADHD symptoms in PGs did not predict worse neuropsychological performance. We conclude that PGs performed worse than controls on two measures of executive function and had lower IQs. They also had more psychiatric comorbidity, higher levels of trait impulsivity and ADHD symptoms, and both novelty seeking and harm-avoidance, but lower levels of reward-dependence. This study does not support the notion that there is a pattern of neuropsychological deficits associated with high levels of impulsivity or ADHD symptoms in PGs.