Reward-Related Decision-Making in Current and Past Disordered Gambling: Implications for Impulsive Choice and Risk Preference in the Maintenance of Gambling Disorder

Magdalen G Schluter,David C Hodgins

doi:10.3389/fnbeh.2021.758329

Abstract

Impulsive reward-related decision-making (RRDM) is robustly associated with gambling disorder (GD), although its role in the development and perpetuation of GD is still being investigated. This project sought to examine the possible roles of impulsive and risky choice, two aspects of RRDM, in the perpetuation of GD. Additionally, the potential moderating role of comorbid substance misuse was considered. A total of 434 participants with symptoms of current GD and symptoms of concurrent substance use disorder (SUD; n = 105), current GD with past SUD (n = 98), past GD with current SUD (n = 53), or past GD with past substance use disorder (SUD; n = 92), and 96 healthy controls were recruited through MTurk. Participants completed a randomly adjusting delay discounting (a measure of impulsive choice) and probabilistic discounting (a measure of risky choice) task and self-report questionnaires of gambling participation, GD and SUD symptomology, and trait impulsivity. Although control participants showed significantly greater delay discounting compared to individuals with a current or history of GD, no significant group differences emerged between individuals with current GD or a history of GD. Individuals with current GD showed significantly less probabilistic discounting compared to individuals with a history of GD and control participants showed the greatest rates of probabilistic discounting. These effects remained after controlling for lifetime gambling symptom severity and trait impulsivity. Overall, these findings suggest a potential maintaining role of risky choice in gambling disorder, but do not support a maintaining role for impulsive choice.

Highlights

Gambling shares many conceptual, neurobiological, and clinical similarities with substance use including associations with various facets of impulsivity (Grant et al, 2010)
One-hundred twentythree participants who completed part 2 showed inconsistently endorsed Gambling disorder (GD) symptoms, characterized by negative endorsement of a symptom on the NODS-CLiP that had been endorsed in part 1, and 66 participants were excluded for logically inconsistent responding on the discounting task
We theorized that if impulsive choice is involved in the maintenance of problem gambling behavior, we would expect to see a difference in delay discounting between individuals currently experiencing a problem and those who had successfully recovered

Summary

Introduction

Neurobiological, and clinical similarities with substance use including associations with various facets of impulsivity (Grant et al, 2010). Gambling disorder (GD) is defined as “persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress,” indicated by symptoms including. Given the harms that can result from GD, there is a clear need to understand both risk factors for developing and those involved in maintaining disordered gambling behavior. Impulsive reward-related decision-making (RRDM) may be one such factor (Petry and Madden, 2010), its precise role is still being investigated. Aberrations in RRDM are a hallmark of addiction (MacKillop et al, 2011) and is an increasingly popular area of research for understanding factors involved in GD. Two aspects of RRDM that may be relevant for GD are delay and probabilistic discounting

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