The Relationship Between Stress and Motivation in Pathological Gambling: a Focused Review and Analysis

Abstract

This article reviews key findings on stress, motivation, and pathological gambling (PG). Environmental and dispositional sources of stress that promote PG are described, along with effects of acute stressors on risk-based decisionmaking. Gambling itself has stress-like physiological effects, activating norepinephrine (NE), cortisol (CORT), and, in PG subjects, dopamine (DA). Chronic exposure to gambling could evoke neuroadaptations in these systems, and motivation to gamble in PG subjects may partly reflect an effort to restore homeostasis. Alpha-2 NE receptors tonically inhibit, and alpha-1 NE receptors augment, striatal DA release and hypothalamic-pituitary axis-mediated CORT response. Gambling-induced dysregulation of this circuitry, coupled with environmental and dispositional stressors, may lead to allostasis, sensitization, and disturbances in cognitive function that promote further gambling. Interventions that mitigate stress may therefore deter onset and restore control over compulsive motivation to gamble in individuals with PG.

Relationship between attention-deficit hyperactivity disorder symptoms and problem gambling: A mediation analysis of influential factors among 7,403 individuals from the UK

“…This study included several mediating variables [marital status ( Botterill et al., 2016 ; Harpin, 2005 ), employment ( Feigelman et al., 1995 ; Harpin, 2005 ), smoking status ( McClernon & Kollins, 2008 ; Petry & Oncken, 2002 ), alcohol dependence ( del Pino-Gutiérrez et al., 2017 ; Wilens, 2004 ), drug use ( Wareham & Potenza, 2010 ; Wilens, 2004 ), IQ ( Biederman et al., 2012 ; Rai et al., 2014 ), common mental disorders (CMDs; depressive episode and/or anxiety disorders) ( Becker et al., 2015 ; Clarke, 2006 ; Davidsson et al., 2017 ), BPD traits ( Matthies & Philipsen, 2014 ; Oliva et al., 2017 ), perceived stress and the number of stressful life events ( Biback & Zack, 2015 ; Vrijsen et al., 2017 ), and impulsivity ( Hodgins & Holub, 2015 ; Miller et al., 2010 )], which may be associated with or be the consequence of ADHD, and also be the cause of gambling problems. Sociodemographic variables.…”

“…In addition, there has been some literature showing that ADHD is strongly associated with mental disorders and BPD ( Becker, Langberg, Evans, Girio-Herrera, & Vaughn, 2015 ; Davidsson et al., 2017 ; Matthies & Philipsen, 2014 ), while some authors have suggested that these disorders might be key players in the subsequent onset of gambling addiction ( Clarke, 2006 ; Oliva et al., 2017 ). Finally, stressful life events and stress are frequently found in people with ADHD ( Vrijsen et al., 2017 ), and they are often considered as strong motivations for gambling ( Biback & Zack, 2015 ).…”

The Conceptual Framework of Harmful Gambling: A revised framework for understanding gambling harm

“…Subjective well-being tends to decrease as risk levels for harmful gambling increase (Hilbrecht & Mock, 2019;Tang & Oei, 2011). People with gambling problems experience more stress (Biback & Zack, 2015), which contributes to negative feelings of well-being.…”

Cued for risk: Evidence for an incentive sensitization framework to explain the interplay between stress and anxiety, substance abuse, and reward uncertainty in disordered gambling behavior

“…Similar to drugs of abuse, there is evidence suggesting that stress may render individuals more vulnerable to gambling behavior and associated reward cues (Biback & Zack, 2015). A recent study by Green and colleagues investigated the relationship between post-traumatic stress symptoms and gambling problems.…”