Gambling disorder is associated with reduced sensitivity to expected value during risky choice

Abstract

Background and aimsIndividuals with gambling disorder display increased levels of risk-taking, but it is not known if it is associated with an altered subjective valuation of gains and/or losses, perception of their probabilities, or integration of these sources of information into expected value.MethodsParticipants with gambling disorder (n = 48) were compared with a healthy comparison group (n = 35) on a two-choice lottery task that involved either gains-only or losses-only gambles. On each trial, two lotteries were displayed, showing the associated probability and magnitude of the possible outcome for each. On each trial, participants chose one of the two lotteries, and the outcome was revealed.ResultsChoice behaviour was highly sensitive to the expected value of the two gambles in both the gain and loss domains. This sensitivity to expected value was attenuated in the group with gambling disorder. The group with gambling disorder used both probability and magnitude information less, and this impairment was greater for probability information. By contrast, they used prior feedback (win vs loss) to inform their next choice, despite the independence of each trial. Within the gambling disorder group, problem gambling severity and trait gambling-related cognitions independently predicted reduced sensitivity to expected value. The majority of observed effects were consistent across both gain and loss domains.Discussion and ConclusionsOur results provide a thorough characterization of decision processes in gain and loss domains in gambling disorder, and place these problems in the context of theoretical constructs from behavioural economics.

Problem Gambling ‘Fuelled on the Fly’

“…From an economic perspective, to decide whether and how much to gamble, people need to integrate probabilistic information (probability and reward magnitude) under conditions of risk (where this information is known-e.g., with a roulette wheel) or uncertainty (where this information is not known-e.g., sports betting) [37]. Accordingly, as prospect theory [12,13] is the most influential descriptive theory of decision-making under risk and uncertainty, and caters for individual difference in probability and value weighting, it has been used as a tool to explore problem gambling.…”

“…Problem gambling is a general term used widely in research to encompass compulsive gambling, addictive gambling, and gambling disorder [38]. In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gambling disorder is regarded as a behavioural addiction which has a prevalence of approximately 0.2% to 0.3% in the general population, and is associated with 'continued gambling in the face of mounting losses, often at the detriment of financial, social and occupational obligations' [37] (p. 1).…”

Heart rate variability and interoceptive accuracy predict impaired decision-making in Gambling Disorder

“…Moreover, trait individual differences in cardiac perception have been linked to a number of cognitive and affective phenomena, including time perception, anxiety and depressive symptoms, emotional reactivity and memory, alexithymia, as well as intuitive decision-making (Verdejo-Garcia et al, 2012). Of note, several of these dimensions are affected in subjects with GD (Bibby & Ross, 2017;Di Nicola, Pepe et al, 2020;Limbrick-Oldfield et al, 2020;Pettorruso et al, 2019;Rogier & Velotti, 2018), consistent with a key role of interoceptive processes in addictive disorders.…”

Phenotype of Gambling Disorder Patients with Lotteries as a Preferred Form of Gambling

“…Lottery gambling is relatively inexpensive to play compared to other gambling activities, and it offers attractive jackpot prizes (the odds of winning are very low, but under-estimated by most players). The available studies suggest that lottery players are distinct from nonplayers (Limbrick-Oldfield et al, 2021), that addicted lottery gamblers could exhibit a phenotype different from individuals with other gambling types (McGrath et al, 2018), and that different clusters can be identified among treatment-seeking patients who report problems related to lottery gambling (Challet-Bouju et al, 2015;Granero, Jimenez-Murcia, et al, 2020;Granero, León-Vargas, et al, 2020). But little research has been devoted to lottery tickets playing compared to other gambling forms, and only a few studies focus on the aspects of this gambling activity with the aim to identify its underlying profile/s, its specific risk factors, and the concrete clinical expressions and consequences.…”