Men experience an increased risk of harmful gambling. As with other determinants of gambling harms, this can be due to a combination of biological, psychological, and social factors, such as the construct of masculinity, which cuts across these factors. Here we focus on a facet of gender ideology, the endorsement of masculine role norms about how men should behave (as measured by the five-item MRNI-VB scale; e.g., "Men should watch football games instead of soap operas"). These role norms can be endorsed by anyone, and are therefore distinct from gender identity. We conducted a cross-sectional online study (data retained for 4193 participants reporting past 12-month gambling engagement), exploring associations between masculine role norm endorsement and harmful gambling among men (n=2070), and among women-and-others (n=2123). Masculine role norm endorsement as measured by the MRNI-VB scale consistently predicted higher levels of gambling harm (as measured by the Problem Gambling Severity Index), across three models containing from zero to 11 other distal predictors of harmful gambling (e.g., race/ethnicity, impulsivity, social support). Identifying as a man did not significantly improve model fit, and there were no significant interactions between masculine role norm endorsement and identifying as a man. Men and women-and-others with higher rates of masculine role norm endorsement were therefore equally likely to experience higher rates of gambling harm. This points toward gender ideology as a novel population-level risk factor for harmful gambling, that may have been missed by previous research's focus on gender identity.

This study aimed to examine the serial mediating roles of perceived social support and life satisfaction in the relationship between religiosity and online gambling addiction within the framework of Conservation of Resources (COR) theory. A total of 771 individuals (34.4% female, 65.6% male) aged between 18 and 69 years (M = 31.98, SD = 10.42) participated in the study. Data were collected using the Religiosity Scale, the Internet Gambling Addiction Scale, the Multidimensional Scale of Perceived Social Support, and the Satisfaction with Life Scale. Correlation analyses indicated that online gambling addiction was negatively associated with religiosity, perceived social support, and life satisfaction, whereas positive relationships were found among religiosity, social support, and life satisfaction. Serial mediation analysis was conducted using PROCESS Macro Model 6. The results revealed that religiosity showed a significant negative total association with online gambling addiction; however, this direct association became non-significant when mediators were included in the model. Perceived social support and life satisfaction both significantly mediated this relationship, and the serial mediation pathway was also found to be significant. The findings suggest that higher religiosity is associated with lower levels of online gambling addiction through greater perceived social support and life satisfaction. Consistent with COR theory, the results indicate that the accumulation of social and psychological resources may be associated with lower vulnerability to behavioral addictions. The study contributes to the literature by offering a resource-based and process-oriented explanation of the relationship between religiosity and online gambling addiction and provides implications for prevention and intervention programs.

Neural correlates of internet gaming disorder and gambling disorder: An fMRI Meta-Analysis.

To investigate changes in income, employment, and welfare utilization among individuals receiving addiction treatment in Greenland. We conducted a nationwide register based study using longitudinal data from the Allorfik treatment database linked with national socioeconomic registers. We included 1157 individuals aged 18-60 who had a recorded treatment episode between 2017 and 2021, retaining the first eligible episode per person. We examined annual income, employment status, and welfare utilization at four time points: the year before treatment cessation (Year -1), the year of cessation (Year 0), and the first two years after cessation (Years 1 and 2). We used generalized estimating equations to estimate changes in outcomes over time. Increases in income (13.03% in Year 1, p<0.008; 17.21% in Year 2, p=0.005) and odds of employment (Year 1: OR=1.20, p=0.033; Year 2: OR=1.25, p=0.018) were observed after treatment cessation, along with decreases in odds of welfare utilization (Year 1: OR=0.66, p≤0.001; Year 2: OR=0.57, p<0.001). This first nationwide register-based study of addiction treatment in Greenland shows small yet consistent socioeconomic improvements following treatment. While causality cannot be inferred, the findings provide important descriptive evidence from an Indigenous Arctic population and highlight the need for future studies with comparison groups.

Carlo Collodi and his gambling problem: origins of the fairy tale 'Pinocchio' - Psychiatry in literature.

Problem gambling is a serious public health issue among young adults today and the literature suggests that adverse childhood experiences may be associated with it. Additionally, difficulties in emotion regulation and self-control may contribute to the association between problem gambling and adverse childhood experiences. Sensation seeking and a family history of gambling may also influence these relationships. Hence, we examined the relationship between adverse childhood experiences and problem gambling among young adults. We analyzed the collected data from 579 young adults (18-29 years old, 67.5% male) via an online survey using a cross-sectional research design. More specifically, we tested the serial mediating roles of difficulties in emotion regulation and self-control, as well as the moderating roles of sensation seeking and a family history of gambling. We found a significant positive association between adverse childhood experiences and problem gambling. Both difficulties in emotion regulation and self-control had significant mediating effects. Sensation seeking and family history of gambling moderated the mediating effects, strengthening the pathways leading to problem gambling at higher levels of sensation seeking and in the presence of family gambling history. These findings indicate that emotion regulation and self-control are important psychological processes in explaining the relationship between adverse childhood experiences and problem gambling. They also suggest that high sensation seeking and a family history of gambling may strengthen the relationships.

Gambling consumers show low uptake and engagement with tools designed to support safer gambling practices and reduce the risk of experiencing gambling-related harms. We used co-design principles to design and develop a digital tool for safer gambling ('BetWell') to overcome known barriers to tool uptake, including a focus on gambling problems. BetWell aims to increase awareness of personal gambling expenditure and knowledge of how gambling products function to support informed decision-making about gambling. It was designed based on behavioural change theories and presents a personalised amalgamation of gambling expenditure relative to alternative spend options, and psychoeducational information via a quiz. This exploratory study assessed the perceived acceptability and usefulness of the newly designed digital tool and gathered end-user feedback to improve future prototypes. The study explored whether usability, gambling severity, financial wellbeing, gambling frequency, spend tracking, activity statement use, and the number of accounts held impacted acceptability and perceived usefulness, and the extent to which these factors independently predicted acceptability and perceived usefulness when controlling for life satisfaction, gambling satisfaction, and demographic variables. This cross-sectional study recruited 140 gambling consumers (M=41.3, SD=10.9 years) via the market research panel CRNRSTONE. Participants accessed and engaged with BetWell and completed an online survey to share their perceptions towards the tool. The overall acceptability (M=32/40, SD=5.2) and perceived usefulness (M=20/25, SD=3.9) of the tool were considered 'good' and 'useful', respectively by participants. Individuals with higher gambling severity scores were more likely to perceive the tool as useful than those of the lower risk categories. Individuals with higher financial wellbeing were more likely to perceive the tool as useful and acceptable compared to those in lower financial wellbeing categories. Higher usability scores corresponded with higher tool acceptability. Previous efforts to monitor and track gambling spend was associated with acceptability and perceived usefulness. Gambling frequency and the number of gambling accounts held were not related to acceptability and perceived usefulness. Qualitative feedback included participant identified suggestions for improvements such as a need for interactive elements, a more detailed view of gambling expenditure, automation of activity statement upload functionality, more challenging and positively framed quiz content, and an emphasis on data security. The study provides preliminary support for the acceptability and perceived usefulness of a newly developed tool to increase awareness of gambling expenditure and knowledge on how gambling products function, providing directions for future improvements to the tool.

Problem gambling among sexual and gender diversity (SGD) populations has received increasing attention in research. While the literature shows that these populations are more likely than others to experience addiction and mental health issues, little is known about gambling among them. In our online survey (n=1519), a group of SGD participants reported problematic gambling practices. The present study, conducted as part of a broader mixed-methods study on gambling among SGD populations, aimed to gather qualitative data to gain insight into why problem gambling seemed high in our online survey. This qualitative descriptive study was conducted via semi-structured individual interviews with voluntary participants who gamble and were from sexually diverse populations across Canada (n=23). A primarily inductive approach with a deductive component was employed to conduct a thematic analysis of the collected data. Participants shared their thoughts on specific difficulties faced by SGD populations and gambling. These included themes such as gambling as a coping mechanism for SGD-related struggles, a lack of visibility and awareness of gambling issues and help resources, seeking a sense of community and belonging through gambling and other addictive behaviours and a minor theme regarding perspectives on risk-taking. Other contextual influences included the COVID-19 pandemic, online gambling and financial needs. This study adds to the existing knowledge of problem gambling among SGD populations by providing a qualitative perspective of sexually diverse participants on the issue. It also provides support for the minority stress framework as a potential reason why people from SGD populations might be at a higher risk of problem gambling.

ABSTRACT Online sports betting has become a profitable segment of the global gambling industry, with young men identified as the demographic most likely to engage in online sports betting and at risk of gambling problems. Despite its prominence, limited qualitative research has explored young men’s experiences with online sports betting, and even less has examined parents’ perspectives, who may influence their child’s betting. We interviewed 16 young men (aged 18–24) and 11 parents to investigate attitudes toward sports betting, factors influencing engagement, parental strategies for addressing betting, and suggestions for support and reform. Thematic analysis revealed mixed attitudes. Parents largely emphasized the risks, while young men acknowledged the appeal and potential harms. Key influences on engagement included peer dynamics, marketing, and the accessibility of betting apps. The role of family gambling history was complex, having protective and risk-enhancing effects. Open communication with children and highlighting the risks of betting were common parental strategies. Participants recommended reforms to advertising, spending limits, and targeted educational content. Integrating perspectives from young men and parents of young men, this study highlights the multiple factors shaping young men’s sports betting behaviors and underscores the need for targeted, evidence-based support for young men and their families.

BackgroundIn the digital era, iGaming has become a rapidly expanding phenomenon that generates complex behavioral patterns and increases the risk of problematic gambling. The integration of technologies such as Artificial Intelligence of Things and the Internet of Behavior enables a shift from reactive to preventive approaches in public health protection.ObjectiveThis study combines clinical practice, AI, machine learning and the Internet of Behavior concept to analyze player behavior patterns and develop machine learning models for early detection of addiction risk through behavioral markers.MethodsBehavioral data were collected from an online game supplier operating through 52 operators in Republika Srpska, Croatia, Romania, Brazil, Somalia, and Mali. Psychiatric expertise and clinical experience were applied to identify harmful behavioral markers, which served as inputs for training MLP neural networks. Models trained per country classified player behavior into recreational, risky, and problematic categories.ResultsThe analysis included 109,418 players across three continents, aggregating 5,135,179,510 online slot game bets. Results revealed significant cross-country variation in risky and problematic gambling, shaped by socio-economic, cultural, and regulatory factors.ConclusionThe integration of AI-driven behavioral analysis with psychiatric insight provides a robust framework for early risk detection and personalized interventions supporting responsible gaming.

The United Kingdom (UK) and Dutch governments have recently implemented mandatory financial risk (affordability) assessments for online gambling as a harm prevention measure. Assessments should trigger at a level of gambling expenditure that strikes a balance between harm prevention (most at-risk consumers should surpass the threshold) and liberty preservation (most no-/lower-risk consumers should gamble below it), yet little empirical research exists to guide threshold setting. We aimed to demonstrate how research can inform the harm-prevention, liberty-preservation trade-off in this context and evaluate the UK's proposed implementation of financial risk assessments. We reanalysed a dataset that combines self-reported Problem Gambling Severity Index (PGSI) scores and open banking data from consumers who gamble (n = 424) to (1) simulate the impact of the UK's rolling 30-day £150 net-deposit (deposits minus withdrawals) threshold for financial risk assessments, and (2) identify optimal threshold values for these assessments under different circumstances. Participants were UK residents who had gambled in the past year, recruited via Prolific in April 2024. Participants completed a survey containing the PGSI and agreed to provide their past 12 months' banking records. Over 12 months, two-thirds of at-risk (PGSI ≥1) and nearly half of no-/lower-risk participants crossed the UK's £150 threshold [area under the curve = 0.66, 95% confidence intervals (CIs) = 0.62-0.71], demonstrating a greater emphasis on harm prevention over liberty preservation. Increasing the value to £186.9 (95% CIs = £69.5-£401.7) slightly improved this balance, although £150 remained within the range of appropriate values. Optimising for harm prevention in our sample required lowering the threshold to £39.0 (95% CIs = £29.6-£58.8), while emphasising liberty preservation increased it to £716.5 (95% CIs = £508.5-£990.9). We found that using a more conservative definition of risk (≥2 PGSI harms) resulted in higher thresholds, and lower thresholds may be appropriate for younger adults (<30 years). Finally, our findings suggest that thresholds based on spending with all operators-rather than single operators as implemented in the UK-may be better able to differentiate at-risk from no-/lower-risk consumers, although the added benefit of this approach in our sample was marginal and further research is needed to confirm its value. The United Kingdom's £150 net-deposit threshold for financial risk assessments for online gambling may place more emphasis on harm prevention than liberty preservation. This study provides a methodological template for guiding the implementation of financial risk assessments for online gambling. Because our sample is not representative of the broader UK gambling population, our specific threshold estimates should be treated as provisional.

Difficulties in emotion regulation involving both positive and negative emotional states are central to gambling disorder. This study developed and validated the Emotional Gambling Scale (EGS), a measure designed to assess the extent to which specific emotions trigger gambling urges. The initial 55-item EGS used a five-point Likert scale. Following item analysis, 30 items were removed due to limited variability, extreme non-normality, or low item-total correlations, resulting in a final 25-item scale. The final version was administered to 371 Spanish-speaking individuals with recent gambling experience (mean age = 28.5, SD = 11.6; 54.4% male). Factor structure was examined using exploratory (EFA) and confirmatory factor analysis (CFA). Internal consistency was evaluated via Cronbach's alpha and omega coefficients. Construct validity was assessed through correlations with gambling severity (NODS), gambling-related cognitions (GRCS-S), impulsivity (UPPS-P), anxiety and depression (HADS), and quality of life (QLI). Sampling adequacy was excellent (KMO = 0.93), and Bartlett's test of sphericity was significant, χ²(300) = 11,633.47, p < .001. EFA supported a two-factor structure comprising Positive Emotions (15 items) and Negative Emotions (10 items), explaining 70.8% of the variance. The factors were moderately correlated (r = .58). CFA supported the adequacy of the two-factor model, χ²(274) = 947.80, CFI = 0.993, TLI = 0.993, RMSEA = 0.082, and SRMR = 0.070. Standardized factor loadings ranged from 0.75 to 0.93. Internal consistency was excellent for both Positive Emotions (α = 0.96, ω = 0.97) and Negative Emotions (α = 0.94, ω = 0.96). Both subscales showed significant associations with gambling severity, gambling-related cognitions, impulsivity, anxiety, depressive symptoms, and quality of life. The EGS appears to be a reliable and valid measure of emotional triggers for gambling urges. Findings support the distinction between positive and negative emotion-driven behavior while also suggesting the presence of a broader emotional gambling vulnerability dimension.

Technological advances and regulatory changes have substantially expanded access to sports wagering in the United States, raising concerns about gambling behaviors among collegiate athletes. Since 2004, the National Collegiate Athletic Association (NCAA) has conducted a large-scale survey every four years to monitor gambling behaviors among student-athletes. The present study examined trends in gambling among NCAA student-athletes over a twenty-year period. Data were drawn from five waves of the NCAA National Study on Collegiate Wagering conducted in 2004, 2008, 2012, 2016, and 2024. Across these cohorts, more than 100,000 student-athletes completed anonymous surveys assessing gambling participation, sports wagering behaviors, attitudes toward gambling, and problem gambling severity. Gambling activities were measured using the Gambling Activities Questionnaire, and gambling severity was assessed using DSM-IV-TR criteria for pathological gambling. Descriptive analyses were used to examine trends across survey years. Overall gambling participation declined over time, with increasing proportions of non-gamblers and decreasing rates of social gambling among both men and women. Rates of at-risk and probable pathological gambling remained low and relatively stable. Male student-athletes consistently reported higher gambling participation and sports wagering than females. Notable shifts included increases in fantasy sports betting, parlay bets, live in-game betting, and prop bets, often conducted through mobile platforms. Although overall gambling participation has declined, evolving forms of sports wagering and greater accessibility through online platforms present new challenges. Continued prevention, education, and responsible gambling policies are needed to protect student-athletes and preserve the integrity of college sports.

Impairments in cognitive and emotional control are widely implicated in both behavioral and substance-related addictive behaviors. However, it remains unclear whether problem gambling severity and nicotine use risk are characterized by distinct neurobehavioral profiles. The present study investigated differences in cognitive emotion regulation, impulsivity, inhibitory control, and risky decision-making among individuals with elevated problem gambling severity, individuals with elevated nicotine use risk, and healthy controls. To enhance the generalizability of existing findings, 450 participants (150 per group) were recruited in Iran, representing a non-Western cultural context, in 2024. Data were collected using validated Persian versions of the Problem Gambling Severity Index (PGSI), Fagerström Test for Nicotine Dependence (FTND), Barratt Impulsiveness Scale (BIS), Cognitive Emotion Regulation Questionnaire (CERQ), Balloon Analogue Risk Task (BART), and Go/No-Go Task. Participants with elevated problem gambling severity demonstrated significantly higher impulsivity, greater use of maladaptive cognitive emotion regulation strategies, and poorer inhibitory control relative to both participants with elevated nicotine use risk and healthy controls. In contrast, participants with elevated nicotine use risk exhibited greater risky decision-making and selective impulsivity compared with healthy controls. Although some impairments overlapped across the two addiction-related groups, the findings indicated partially distinct neurobehavioral profiles. Specifically, elevated problem gambling severity was more strongly associated with maladaptive cognitive emotion regulation and inhibitory control deficits, whereas elevated nicotine use risk was characterized primarily by heightened risk-taking tendencies. These findings contribute to a more differentiated understanding of heterogeneity across addictive behaviors and may support the development of more targeted prevention and intervention approaches tailored to specific neurobehavioral profiles.

The widely cited estimate that there are approximately 'six others' affected per person with problem gambling implies, when projected to the population level, a count of affected others that is highly inconsistent with prevalence data - likely due to some combination of biased reporting and network clustering that inflates relationship counts relative to unique individuals. By reconciling conflicting reports from gamblers and those they harm, and explicitly modelling network clustering-where the same people are often harmed by multiple gamblers-we estimate that, at the population level, approximately 4.7 people are affected for every person with problem gambling. Correcting this population-level overestimate does not eliminate the prevention paradox: low- and moderate-risk gamblers still account for the majority (70%) of all vectors of harm transmission in the population, despite lower reconciled fan-out than problem gamblers. We also find that nearly one in four affected others are themselves at-risk gamblers due to network effects, experiencing roughly double the exposure of non-gamblers. Our reconciliation of the available evidence confirms that the transmission of gambling harm concentrates in dense social networks (including families) rather than dispersing randomly. The edge-conservation framework we develop can be updated as new data becomes available, and applies broadly to any behavioural harm that propagates through social networks.

Real-world evidence on outpatient program participation and time to treatment discontinuation (treatment retention) in patients with gambling disorder in Japan remains limited. In this study, we characterized baseline clinical and sociodemographic profiles of outpatients receiving care for gambling disorder and described patterns of engagement, including treatment retention, in a group program. We retrospectively enrolled outpatients with gambling disorder who first visited Tarumi Hospital between April 2019 and December 2023 and followed them up until December 2024. Program participation referred to attendance at a structured cognitive behavioral therapy (CBT)-based group program designed as 24 sessions over 1 year, provided in addition to usual outpatient care. The primary analysis used a Cox proportional hazard analysis, with program participation as a time-dependent covariate; a 30-day landmark analysis was used to evaluate retention after day 30 among patients retained in the program for at least 30 days. Abstinence at the final observation was defined as a self report of no gambling in the preceding 2 weeks and was compared between the program participation and non-participation groups among patients who gambled at baseline. The program was initiated for 82 patients within 30 days of their first hospital visit, and 55 patients did not participate in the program. By day 30, retention was higher in the participation group than in the non-participation group (89.0% vs. 45.5%). Program participation was associated with a lower estimated hazard of discontinuation (hazard ratio = 0.64, 95% confidence interval 0.40-1.03; p = 0.067), but the estimate was imprecise and compatible with no difference. Among patients retained beyond day 30, retention after day 30 did not differ between groups (log-rank p = 0.886). Abstinence was higher in the participation group than in the non-participation group among patients who discontinued treatment within 3 months but not among those who continued treatment for ≥ 3 or ≥ 6 months. Early participation in a structured CBT-based program may be associated with a longer observed retention duration, with divergence occurring within 30 days. Strengthening clinical contact soon after the first visit may be a practical priority; prospective studies with standardized severity and motivational measures are warranted.

A loved one's addiction to substance use (alcohol or drugs), gambling, or screen use (e.g. gaming, social media) has significant impact on the quality of life of concerned significant others (CSOs), affecting various aspects of their daily lives. As a result, CSOs implement a range of coping strategies to deal with their loved one's addiction and to try to preserve their personal and family well-being. Several studies have focused on the strategies used by CSOs, but none have provided a comprehensive overview of CSO's experiences of coping across substance use, gambling, or screen-related addiction contexts. A scoping review was conducted to provide a comprehensive overview of the coping strategies used by CSOs of adults whose loved ones experience substance use, gambling, or screen-related addiction. It also sought to extend the previous mapping of coping strategies among CSOs of individuals with gambling problems developed by Côté et al. (2018), by broadening its scope to include substance use and screen-related addictions. To do so, a systematic search was conducted across six databases: PsycINFO, Medline, Psychology and Behavioral Sciences Collection, SocIndex, Cinahl Complete, and Health and Psychosocial Instruments. Among the 64 included studies, most focused on CSOs of individuals with substance use (64%) or gambling (26%), with fewer addressing co-occurring substance use and gambling (6%) and screen-related addiction (3%). Findings indicate that CSOs rely on a broad range of coping strategies aimed at either influencing the loved one's addiction-related behaviours or enhancing personal, couple, or family well-being, alongside emerging strategies not previously captured in existing frameworks. Despite some nuances, the results reveal a trend toward uniformity in coping strategies used by CSOs in substance use and gambling contexts. Evidence on coping strategies used by CSOs in screen-related addiction remains more limited, and comparability with substance use and gambling contexts is less established. CSOs demonstrate active engagement in managing the impacts of addiction through coping strategies that address both the recovery process of their loved ones and the preservation of family and relational well-being, highlighting their central role in the broader addiction context. Not applicable.

ABSTRACT Gambling can result in benefits and harm, yet their relationship and underlying predictors remain inadequately understood. Using data from the Finnish Gambling 2023 population survey (N = 5,977), this study examines to what extent Finnish gamblers self-report gambling as beneficial or harmful. We examined associations between sociodemographic and gambling behavior-related variables and harms and benefits across three domains: relationships, health, and finance. Binary logistic regression models were used. The majority of respondents evaluated their gambling as having neither benefits nor harms for health (93.1%), finances (85.2%), and relationships (90.8%), respectively. While examining the extremes of the rating scale, 10.2% rated their gambling financially harmful while 4.6% perceived it as beneficial. Conversely, from the perspective of health and, particularly, relationships, gambling was rated more beneficial than harmful. Deviations from neutrality, positive and negative, were most common among those with frequent and at-risk gambling based on Problem Gambling Severity Index (PGSI) scores. Findings suggest that experiencing benefits from gambling is associated with experiencing harms and having higher PGSI scores. Although these findings describe co-occurring self-reported evaluations rather than directional or causal relationships, our results support the view that gambling is an atypical consumer product, inherently risky even when perceived as beneficial to the individual.

The widely adopted functional definition of gambling-related harm implies a three-part pathway: gambling engagement gives rise to harmful consequences, which in turn reduce health and wellbeing. This pathway has not previously been tested in general-population data. A population-weighted Australian analytic sample (N=4,001) was used to test whether this structure holds empirically. A risk-weighted gambling involvement index was derived from form-specific frequencies, with greater weight given to forms most strongly associated with gambling problems. Weighted mediation models showed that gambling harms statistically accounted for the observed association between gambling involvement and reduced wellbeing: indirect effects through harms were consistently negative and robust to demographic adjustment, while direct effects of gambling involvement were essentially zero once harms were included. The pattern held for both an expanded 26-item harm composite and the shorter 10-item gambling harms screen (GHS-10), and was clearest for life satisfaction and mental wellbeing. These results provide the first cross-sectional pathway-based support for the structure implied by this definition in representative population data. As a corollary, they support the construct validity of direct harm screens, which behave as expected of measures occupying the harm position in this pathway. Population-level effect sizes were modest, reflecting the concentration of harm burden in a minority of gamblers, but the wellbeing deficit among those reporting harms was substantial.

Successfully resolving self-control conflicts requires individuals to integrate information about the hedonic value of a temptation with its impact on distant goals. Functional neuroimaging research demonstrates that cue-related activity in the brain's reward system predicts self-control failures ranging from weight gain and drug use to gambling disorders. Despite this work, it remains unclear what components of the decision-making process are associated with neural cue-reactivity. The present study integrates eye-tracking and computational modeling of food choices using the attentional Drift Diffusion Model with neural measures of food cue-reactivity in a sample of chronic dieters. Our results show that activity to tempting food cues in the nucleus accumbens and orbitofrontal cortex is associated with an attentional bias towards unhealthy food items during a food choice task. Moreover, functional and structural connectivity between the brain's reward system and a prefrontal region implicated in response inhibition, were associated with a reduction in the drift rate for unhealthy food items and with the ability to maintain healthy items in mind even when gaze is directed towards unhealthy food items. Together, these findings help elucidate the relationship between neural cue-reactivity and dietary decision-making and suggest attentional biases as one mechanism through which cue-reactivity is associated with self-control failure.