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Problem gamblers share deficits in impulsive decision-making with alcohol-dependent individuals

  1. Andrew J. Lawrence1,2,
  2. Jason Luty3,
  3. Nadine A. Bogdan4,
  4. Barbara J. Sahakian1,5,
  5. Luke Clark1,2,*

Article first published online: 6 MAY 2009

DOI: 10.1111/j.1360-0443.2009.02533.x

Issue

Addiction

Addiction

Volume 104, Issue 6, pages 1006–1015, June 2009

Additional Information

How to Cite

Lawrence, A. J., Luty, J., Bogdan, N. A., Sahakian, B. J. and Clark, L. (2009), Problem gamblers share deficits in impulsive decision-making with alcohol-dependent individuals. Addiction, 104: 1006–1015. doi: 10.1111/j.1360-0443.2009.02533.x

Author Information

  1. 1

    Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK,

  2. 2

    Department of Experimental Psychology, University of Cambridge, Cambridge, UK,

  3. 3

    Southend Community Drug and Alcohol Service, South Essex Partnership NHS Trust, Essex, UK,

  4. 4

    Derwent Centre, North Essex Partnership Foundation Trust, Harlow, Essex, UK and

  5. 5

    Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK

*Luke Clark, Behavioural and Clinical Neuroscience Institute, Department of Experimental Psychology, University of Cambridge, Downing Street, Cambridge CB2 3EB, UK. E-mail: lc260@cam.ac.uk

Publication History

  1. Issue published online: 6 MAY 2009
  2. Article first published online: 6 MAY 2009
  3. Submitted 11 June 2008; initial review completed 25 September 2008; final version accepted 9 January 2009

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Keywords:

  • Addiction;
  • alcohol;
  • decision-making;
  • impulsivity;
  • pathological gambling;
  • prefrontal cortex;
  • risk-taking;
  • vulnerability

ABSTRACT

Aims  Problem gambling has been proposed to represent a ‘behavioural addiction’ that may provide key insights into vulnerability mechanisms underlying addiction in brains that are not affected by the damaging effects of drugs. Our aim was to investigate the neurocognitive profile of problem gambling in comparison with alcohol dependence. We reasoned that shared deficits across the two conditions may reflect underlying vulnerability mechanisms, whereas impairments specific to alcohol dependence may reflect cumulative effects of alcohol consumption.

Design  Cross-sectional study.

Setting  Out-patient addiction treatment centres and university behavioural testing facilities.

Participants  A naturalistic sample of 21 male problem and pathological gamblers, 21 male alcohol-dependent out-patients and 21 healthy male control participants.

Measurements  Neurocognitive battery assessing decision-making, impulsivity and working memory.

Findings  The problem gamblers and alcohol-dependent groups displayed impairments in risky decision-making and cognitive impulsivity relative to controls. Working memory deficits and slowed deliberation times were specific to the alcohol-dependent group.

Conclusions  Gambling and alcohol-dependent groups shared deficits in tasks linked to ventral prefrontal cortical dysfunction. Tasks loading on dorsolateral prefrontal cortex were selectively impaired in the alcohol-dependent group, presumably as a consequence of long-term alcohol use.

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