Gambling-related psychological predictors and moderators of attentional bias among electronic gaming machine players.

Abstract

Objective: Attentional biases (ABs) have been shown to develop in the context of substance use disorders. Relatively less focus has been paid toward the development of ABs in behavioral addictions such as gambling disorder (GD). Furthermore, the psychological predictors and moderators of AB in GD remain unknown. The present study addressed these empirical gaps. Methods: Fifty-two non-GD electronic gaming machine (EGM) players, 25 GD-EGM players, and 61 non-gamblers completed measures of gamblingrelated behaviors and cognitions (problem gambling severity, cravings, expectancies, motives) and substance use and mental health (alcohol use severity, depression symptoms). The relationships between these constructs and AB for EGM images were then assessed using a free-viewing eye-tracking paradigm. Results: Non-GD EGM players and GD-EGM players attended to EGM images significantly more than neutral images (with the largest AB for the EGM players with GD). For all EGM players, gambling expectancies regarding the negative emotional impact of gambling and alcohol use severity were associated with greater AB. For non-GD EGM players only, AB was moderated by the anticipation aspect of gambling craving and the self-enhancement aspect of gambling expectancies. Conclusion: The results provide further evidence that ABs develop in the context of excessive gambling and are associated with gambling and psychological variables. The findings support the incentive-salience theory of ABs in gambling and provide a rationale for the development of AB modification programs in the treatment of gambling disorder. Given the predominantly white sample, our results may not generalize to individuals of other ethnicities. Public Health Significance StatementThis study shows that individuals with gambling disorder are more likely to attend to gamblingrelated cues than individuals without gambling disorder. Positive expectations associated with gambling and greater alcohol use are related to increases in the time spent attending to gamblingrelated images.

Affective impulsivity moderates the relationship between disordered gambling severity and attentional bias in electronic gaming machine (EGM) players

“…The eligibility criteria were as follows: (1) age between 18 and 60, (2) regularly gambled on EGMs, defined as betting on EGMs once per month (at minimum) for the past three months, (3) had never sought treatment for a gambling disorder, either in the past or currently, (4) no intention to quit gambling in the next 30 days, and (5) no reported color blindness. The 85 individuals who participated in the laboratory visit were part of a larger study investigating gambling-related predictors of AB (see Kim et al., 2021 ).…”

“…Hierarchical multiple regression models were used to determine whether facets of impulsivity that correlated with AB remained statistically significant ( P < 0.05) when controlling for PGSI scores, age, and gender. As PGSI scores are known to be positively correlated with both impulsivity and AB (e.g., Ioannidis et al., 2019 ; Kim et al., 2021 ), controlling for PGSI scores in these analyses ensured that any associations between measures of impulsivity and AB were not due to higher PGSI scores. Similarly, age and gender are associated with impulsivity, such that men and those of younger age have higher levels of impulsivity ( Chamorro et al., 2012 ; Cross, Copping, & Campbell, 2011 ), and thus controlling for these variables in the regression analyses was important.…”

“…Previous studies have shown that, like substance use disorders, disordered gambling can result in an AB for gambling-related stimuli ( Hønsi, Mentzoni, Molde, & Pallesen, 2013 ). For example, a recent study reported that individuals who gamble on electronic gaming machine (EGMs) preferentially attend to EGM stimuli compared to non-EGM stimuli, unlike non-EGM players ( Kim et al., 2021 ). The presence and strength of ABs in gambling may have important clinical implications because they have been shown to increase cravings and the risk of relapse for substance use disorders ( Field, 2005 ; Field, Munafò, & Franken, 2009 ) and may also have similar effects among people with a gambling disorder.…”

“…This is because the gambling-related cues have taken on an incentive-salience and thus are more likely to result in attentional engagement ( Berridge & Robinson, 2016 ), which leads to the activation of the dopamine reward system and results in heightened approach behaviors. The incentive-salience is more likely to occur when the addictive behavior is engaged in repeatedly and thus is more likely to develop among those experiencing disordered gambling ( Berridge & Robinson, 2016 ; Kim et al., 2021 ). As such, the incentive-sensitization theory predicts that ABs for gambling-related cues will be heightened among individuals with disordered gambling.…”

“…There is a growing literature on AB and gambling, and several studies have reported associations between AB and severity of gambling ( Ciccarelli, Griffiths, Cosenza, Nigro, & D'Olimpio, 2020 ; Kim et al., 2021 ), as well as associations between AB and gambling-related measures such as the frequency of gambling, attitudes, beliefs, expectancies, and cravings ( Grant & Bowling, 2015 ; Kim et al., 2021 ). In addition, associations between AB and depression, alcohol use, and stress have been reported ( Ciccarelli et al., 2019 ; McGrath et al., 2020 ; Kim et al., 2021 ). It should be noted that not all studies have observed these relationships.…”