Patologiczny hazard – Patofizjologia i mechanizm

Patologiczny hazard
Patofizjologia i mechanizm

Patologiczny hazard (Gambling Disorder) to zaburzenie uznane w DSM-5 za uzależnienie behawioralne, charakteryzujące się niekontrolowanym impulsem do hazardu mimo negatywnych konsekwencji. Neurobiologicznie wiąże się z dysfunkcją układu nagrody, zwłaszcza szlaków dopaminergicznych mezolimbicznych, z kluczową rolą jądra półleżącego (nucleus accumbens). U osób z tym zaburzeniem obserwuje się zmniejszoną aktywność kory przedczołowej brzuszno-przyśrodkowej oraz zmiany w receptorach dopaminowych D2/3, szczególnie D3, których ekspresja koreluje z nasileniem objawów. Mechanizmy tolerancji i zmiennego wzmacniania, a także zaangażowanie układów noradrenergicznego, serotoninergicznego, opioidowego, kortyzolowego i glutaminianergicznego, podtrzymują kompulsywne zachowania hazardowe. Leki dopaminergiczne, takie jak pramipeksol, ropinirol i aripiprazol, mogą indukować lub nasilać patologiczny hazard poprzez nadaktywację układu nagrody.

Patologiczny hazard – Patomechanizm

Neurobiologiczne podłoże patologicznego hazardu
Mechanizm uzależnienia w patologicznym hazardzie
Zaburzenia neurotransmisji
Mechanizmy psychologiczne w patologicznym hazardzie
Czynniki genetyczne i środowiskowe
Współwystępowanie z innymi zaburzeniami
Zaburzenia uczenia się w patologicznym hazardzie

Konsekwencje patologicznego hazardu
Leczenie patologicznego hazardu

Psychoterapia
Farmakoterapia

Wnioski i przyszłe kierunki badań

Kolejne rozdziały

Patologiczny hazard – Patomechanizm

Patologiczny hazard (ang. Compulsive gambling, Gambling Disorder) to zaburzenie charakteryzujące się niemożnością kontrolowania impulsów do uprawiania hazardu pomimo negatywnych konsekwencji w różnych obszarach życia. W najnowszej klasyfikacji DSM-5 zaburzenie to zostało przeklasyfikowane z kategorii zaburzeń kontroli impulsów do kategorii uzależnień behawioralnych, co odzwierciedla podobieństwa neurobiologiczne z uzależnieniami od substancji psychoaktywnych.¹² Zmiana ta oparta jest na licznych badaniach naukowych, które wykazały istotne podobieństwa w ekspresji klinicznej, pochodzeniu mózgowym, współchorobowości, fizjologii i leczeniu.³

Neurobiologiczne podłoże patologicznego hazardu

Patologiczny hazard wiąże się z aktywacją układu nagrody w mózgu, podobnie jak ma to miejsce w przypadku uzależnień od substancji psychoaktywnych. Mechanizm ten obejmuje głównie szlaki dopaminergiczne układu mezolimbicznego, przy czym jądro półleżące (nucleus accumbens) odgrywa kluczową rolę w rozwoju uzależnienia.¹ Kiedy osoba uprawia hazard, w jej mózgu uwalnia się dopamina – neuroprzekaźnik odpowiedzialny za uczucie przyjemności i podniecenia.² To właśnie działanie dopaminy na układ nagrody w mózgu sprawia, że hazard może stać się uzależniający.³

Badania neuroobrazowe wykazały, że u osób z patologicznym hazardem występują zmiany w działaniu obszarów mózgu związanych z podejmowaniem decyzji, kontrolą impulsów i przetwarzaniem nagrody, w tym kory przedczołowej brzuszno-przyśrodkowej, prążkowia brzusznego i obszarów limbicznych.⁴ Osoby uzależnione od hazardu wykazują zwiększoną łączność z układem nagrody i zmniejszoną aktywność kory przedczołowej, co może tłumaczyć trudności w kontrolowaniu impulsów.⁵

W badaniach z wykorzystaniem techniki PET z użyciem ligandu [11C]-rakloprydu, antagonisty receptorów D2/3, który wiąże się głównie w prążkowiu, wykazano zmiany w przekaźnictwie dopaminergicznym u patologicznych hazardzistów.⁶ Szczególną rolę odgrywają receptory dopaminowe D3, których ekspresja koreluje z nasileniem objawów uzależnienia od hazardu.⁷

Mechanizm uzależnienia w patologicznym hazardzie

Wraz z regularnym uprawianiem hazardu dochodzi do zmian w funkcjonowaniu układu nagrody w mózgu. W miarę postępu uzależnienia osoba staje się mniej wrażliwa na działanie dopaminy (rozwija się tolerancja), co prowadzi do potrzeby coraz intensywniejszego i częstszego hazardu w celu osiągnięcia tego samego poziomu pobudzenia i przyjemności.⁸ Zjawisko to przypomina mechanizmy tolerancji obserwowane w uzależnieniach od substancji.⁹

Model niedoboru nagrody sugeruje, że osoby podatne na uzależnienie mogą mieć pierwotnie osłabioną aktywność układu nagrody w mózgu, co skłania je do angażowania się w różne aktywności stymulujące ten układ, takie jak hazard czy używanie substancji psychoaktywnych.¹⁰ Badania wskazują, że głównym motywem dla osób zmagających się z uzależnieniem od hazardu jest rekompensowanie braku aktywności układu nagrody i pozytywnych odczuć, a nie same pieniądze.¹¹

Warto zauważyć, że niepewność co do wygranej aktywuje przekaźnictwo dopaminergiczne w sposób patologiczny, co może wyjaśniać uzależniające właściwości hazardu.¹² Zjawisko zmiennego wzmacniania, gdzie nagrody są nieprzewidywalne i przerywane, odgrywa kluczową rolę w podtrzymywaniu zachowań hazardowych.¹³

Zaburzenia neurotransmisji

W patofizjologię uzależnienia od hazardu zaangażowanych jest wiele systemów neuroprzekaźnikowych, a nie tylko układ dopaminergiczny. Badania wskazują na rolę następujących układów:¹⁴

Noradrenergicznego – przyczyniającego się do pobudzenia i podniecenia
Serotoninergicznego – związanego z kontrolą impulsów
Dopaminergicznego – odpowiadającego za nagradzające i wzmacniające aspekty
Opioidowego – związanego z przyjemnością/pragnieniami
Kortyzolowego – odpowiadającego za reakcję na stres
Glutaminianergicznego – wpływającego na funkcje poznawcze, w tym elastyczność poznawczą

¹⁵

Niektóre leki oddziałujące na te układy mogą zwiększać ryzyko rozwoju patologicznego hazardu. Dotyczy to szczególnie agonistów dopaminy stosowanych w leczeniu choroby Parkinsona, takich jak pramipeksol i ropinirol, a także modulatora dopaminy – aripiprazolu.¹⁶ Leki te mogą prowadzić do patologicznej nadaktywacji dopaminergicznego układu nagrody i wzmocnienia, co jest jednym z możliwych mechanizmów zwiększania zachowań hazardowych.¹⁷

Mechanizmy psychologiczne w patologicznym hazardzie

Obok mechanizmów neurobiologicznych, w rozwoju i podtrzymywaniu uzależnienia od hazardu istotną rolę odgrywają również mechanizmy psychologiczne, które wpływają na procesy poznawcze, emocjonalne i behawioralne.¹⁸

Zniekształcenia poznawcze odgrywają kluczową rolę w podtrzymywaniu uzależnienia od hazardu, ponieważ zmieniają sposób postrzegania przez jednostkę zdolności do kontrolowania lub przewidywania wyników. Do najważniejszych zniekształceń poznawczych należą:¹⁹

Iluzja kontroli – błędne przekonanie, że można wpłynąć na wynik losowych zdarzeń, np. rzucania kośćmi czy kręcenia kołem ruletki
Złudzenie gracza – błędne przekonanie, że wynik poprzednich zdarzeń hazardowych wpływa na przyszłe rezultaty
Prawie trafienia – sytuacje, gdy hazardzista prawie wygrywa, ale jednak przegrywa (np. dwa z trzech pasujących symboli na automacie do gry)

²⁰

Czynniki emocjonalne również napędzają uzależnienie od hazardu:²¹

Wiele osób używa hazardu jako nieprzystosowawczego mechanizmu radzenia sobie w celu zarządzania negatywnymi emocjami, takimi jak stres, lęk czy depresja
Osoby z uzależnieniem od hazardu często wykazują zwiększoną wrażliwość na nagrody, co oznacza, że są bardziej podatne na natychmiastowe nagrody i ekscytację, jakie oferuje hazard
Z czasem zachowania hazardowe mogą stać się automatyczne i utrwalone, prowadząc do nawykowych wzorców zachowań podobnych do uzależnień od substancji

²²

Mechanizmy behawioralne związane są również z problemami z kontrolą impulsów, gdzie osoby dotknięte tym zaburzeniem mają trudności z oparciem się pokusie hazardu, nawet gdy wiedzą, że jest to szkodliwe.²³ Badania metaanalityczne wykazały, że zaburzenia hazardowe wiążą się z istotnymi zaburzeniami w hamowaniu motorycznym i uwagowym, dyskontowaniu i zadaniach podejmowania decyzji.²⁴

Czynniki genetyczne i środowiskowe

Patologiczny hazard, podobnie jak inne uzależnienia, ma złożoną etiologię obejmującą czynniki genetyczne i środowiskowe. Badania wskazują, że uzależnienie od hazardu ma tendencję do występowania rodzinnie, co sugeruje komponent genetyczny.²⁵ Szacuje się, że rozwój zaburzeń hazardowych w około 50% wynika z czynników genetycznych i w 50% z czynników środowiskowych.²⁶

Osoby z uzależnieniem od hazardu częściej wykazują następujące cechy osobowości lub zachowania:²⁷

Impulsywność
Poszukiwanie doznań
Kompulsywność
Trudności z podejmowaniem decyzji i planowaniem
Szybkie zmiany nastroju (niestabilność afektywna)

²⁸

Badania nad polimorfizmami genów kodujących czynniki neurotroficzne (NTF) wykazały ich związek z ryzykiem rozwoju zaburzeń hazardowych. Interakcja między tymi wariantami genetycznymi a innymi cechami biopsychologicznymi może przewidywać większe nasilenie uzależnienia od hazardu.²⁹ Dysfunkcje stwierdzone w tych wariantach genetycznych mogą mieć implikacje endokrynologiczne, ponieważ ekspresja odpowiednich endogennych ligandów byłaby zmieniona, co wpływałoby na prawidłową sygnalizację w mózgu.³⁰

Współwystępowanie z innymi zaburzeniami

Patologiczny hazard często współwystępuje z innymi zaburzeniami psychicznymi. Badania wykazały, że osoby z zaburzeniami psychicznymi są 17 razy bardziej narażone na rozwój problemów hazardowych.³¹ Najczęściej współwystępujące zaburzenia to:

Zaburzenia osobowości – występują u około połowy osób ze zdiagnozowanym uzależnieniem od hazardu (najczęściej występuje antyspołeczne zaburzenie osobowości)³²
Zaburzenia używania substancji – występują u około jednej trzeciej osób z kompulsywnym hazardem³³
Zaburzenia afektywne i lękowe – wysoka współchorobowość podkreśla znaczenie zintegrowanego leczenia zaburzeń hazardowych i ich współwystępujących problemów³⁴
PTSD – badania wskazują, że do 34% osób z zaburzeniami hazardowymi cierpi również na zespół stresu pourazowego³⁵
Zaburzenia obsesyjno-kompulsyjne (OCD) – badania wskazują na znaczące nakładanie się między uzależnieniem od hazardu a OCD, przy czym wiele osób doświadcza objawów obu zaburzeń jednocześnie³⁶

Zarówno patologiczny hazard, jak i OCD wiążą się z zaburzeniami równowagi dopaminy – neuroprzekaźnika regulującego zachowania poszukiwania nagrody.³⁷ Wspólne cechy tych zaburzeń obejmują trudności z natrętnym myśleniem, rytualnymi zachowaniami i sztywnością poznawczą.³⁸

Zaburzenia uczenia się w patologicznym hazardzie

W uzależnieniu od hazardu występują istotne zaburzenia uczenia się ze wzmocnień. Badania z użyciem funkcjonalnego rezonansu magnetycznego (fMRI) wykazały nieprawidłowości w przetwarzaniu błędów predykcji nagrody w patologicznym hazardzie.³⁹

U osób z patologicznym hazardem w porównaniu z osobami zdrowymi stwierdzono:

Wyższy współczynnik uczenia się dla wyników lepszych niż oczekiwane
Niższy współczynnik uczenia się dla wyników gorszych niż oczekiwane
Zwiększone kodowanie pozytywnych błędów przewidywania nagrody w przedniej części wyspy mózgu⁴⁰

Te ustalenia wyjaśniają mechanizmy neuronalne przetwarzania nagrody, które są zmienione w patologicznym hazardzie, dostarczając potencjalnego wyjaśnienia behawioralnej nieelastyczności w tym zaburzeniu.⁴¹ Asymetryczna wrażliwość na wyniki lepsze i gorsze niż oczekiwane w uczeniu się opartym na nagrodzie może regulować, przynajmniej częściowo, nieprawidłowe zachowania kompulsywne w tym zaburzeniu.⁴²

Konsekwencje patologicznego hazardu

Patologiczny hazard może prowadzić do poważnych konsekwencji zdrowotnych. Obejmują one stres finansowy, rozpad związków, przemoc domową, choroby psychiczne i samobójstwa. Skutki uzależnienia od hazardu mogą utrzymywać się przez całe życie i przenosić się międzypokoleniowo.⁴³

Problemy ze zdrowiem psychicznym związane z patologicznym hazardem obejmują:

Zwiększony poziom lęku, depresji i stresu⁴⁴
Poczucie wstydu, winy i bezradności⁴⁵
Obniżoną jakość życia w wielu obszarach, od niestabilności zawodowej i trudności finansowych po izolację społeczną i zmniejszoną satysfakcję z życia⁴⁶

Problemy ze zdrowiem fizycznym związane z patologicznym hazardem to m.in.:

Bóle głowy
Problemy żołądkowo-jelitowe
Wysokie ciśnienie krwi
Zmęczenie⁴⁷
Schorzenia wynikające ze stresu, takie jak nadciśnienie, wrzody trawienne i migreny⁴⁸

Leczenie patologicznego hazardu

Leczenie patologicznego hazardu powinno uwzględniać zarówno mechanizmy neurobiologiczne, jak i psychologiczne. Najskuteczniejsze podejścia terapeutyczne obejmują:

Psychoterapia

Psychoterapia jest główną metodą leczenia uzależnienia od hazardu:

Terapia poznawczo-behawioralna (CBT) – koncentruje się na zmianie zniekształconych wzorców myślenia związanych z hazardem, takich jak iluzja kontroli i złudzenie gracza⁴⁹
Wywiad motywacyjny – technika terapeutyczna pomagająca pacjentom w zidentyfikowaniu motywacji do zmiany i zwiększeniu pewności siebie w zakresie zdolności do zmiany⁵⁰
Terapia psychodynamiczna – pomaga zrozumieć głębsze motywy hazardu⁵¹
Terapia grupowa – zapewnia wsparcie społeczne i dzielenie się doświadczeniami z innymi osobami zmagającymi się z podobnymi problemami⁵²
Terapia rodzinna – pomaga naprawić relacje z bliskimi, które mogły ucierpieć z powodu uzależnienia od hazardu⁵³

Farmakoterapia

Chociaż obecnie FDA nie zatwierdza żadnych leków specyficznie do leczenia zaburzeń hazardowych, niektóre leki wykazują obiecujące wyniki w badaniach klinicznych:

Antagoniści opioidowi (np. naltrekson) – mogą zmniejszać głód hazardu i nasilenie problemów hazardowych⁵⁴⁵⁵
Leki przeciwdepresyjne – szczególnie selektywne inhibitory wychwytu zwrotnego serotoniny (SSRI), mogą pomóc w leczeniu objawów kompulsywnego hazardu, zwłaszcza gdy współwystępuje on z depresją lub lękiem⁵⁶
Stabilizatory nastroju – wykazały pewne obiecujące wyniki w badaniach⁵⁷
Escitalopram – może pomóc zmniejszyć lęk i nasilenie problemów hazardowych u osób ze współwystępującymi zaburzeniami lękowymi i hazardowymi⁵⁸

Warto zauważyć, że podobnie jak w przypadku uzależnień od substancji, patologiczny hazard jest zaburzeniem przewlekłym, które ma tendencję do pogarszania się bez leczenia. Nawet przy odpowiednim leczeniu, nawroty są powszechne. Jednak przy właściwym leczeniu osoby z uzależnieniem od hazardu mogą osiągnąć dobrą kontrolę nad swoim życiem.⁵⁹

Wnioski i przyszłe kierunki badań

Badania nad neurobiologicznymi mechanizmami patologicznego hazardu znacznie się rozwinęły w ostatniej dekadzie, ale wciąż istnieje wiele niejasności. Przyszłe kierunki badań powinny koncentrować się na:

Lepszym zrozumieniu mechanizmów molekularnych leżących u podstaw związku między lekami dopaminergicznymi a zaburzeniami hazardowymi⁶⁰
Badaniu różnic płciowych w mechanizmach patofizjologicznych patologicznego hazardu⁶¹
Rozwoju bardziej ukierunkowanych i skutecznych interwencji farmakologicznych⁶²
Analizie wpływu reklam hazardowych na aktywację obszarów mózgu związanych z nagrodą, pamięcią i funkcjami wykonawczymi⁶³
Badaniu skuteczności polityk odpowiedzialnego hazardu w promowaniu samokontroli⁶⁴

Głębsze zrozumienie złożonej patofizjologii patologicznego hazardu, a także lepsze poznanie czynników biologicznych leżących u podstaw kluczowych cech klinicznych tego zaburzenia (np. genetyki) i ich modulującego oddziaływania z innymi zmiennymi biopsychospołecznymi, może ułatwić identyfikację profili klinicznych patologicznego hazardu o różnych implikacjach terapeutycznych, np. w zakresie nasilenia zaburzenia.⁶⁵

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

Materiały źródłowe

#1 Pathological Choice: The Neuroscience of Gambling and Gambling Addiction
https://pmc.ncbi.nlm.nih.gov/articles/PMC3858640/
Gambling is pertinent to neuroscience research for at least two reasons. First, gambling is a naturalistic and pervasive example of risky decision making, and thus gambling games can provide a paradigm for the investigation of human choice behavior and irrationality. Second, excessive gambling involvement (i.e., pathological gambling) is currently conceptualized as a behavioral addiction, and research on this condition may provide insights into addictive mechanisms in the absence of exogenous drug effects. […] An international program of research over the past decade has revealed multiple similarities between pathological gambling and the substance use disorders, including neurobiological overlap. […] This process culminated in the recent reclassification of pathological gambling (now to be called Gambling Disorder) into the addictions category of the DSM5.
#1
https://link.springer.com/article/10.1007/s40290-022-00453-9
Problematic gambling has been suggested to be a possible consequence of dopaminergic medications used mainly in neurological conditions, i.e. pramipexole and ropinirole, and possibly by one antipsychotic compound, aripiprazole. […] The neurobiology of GD involves the reward and reinforcement system, based mainly on mesocorticolimbic dopamine projections, with the nucleus accumbens being a crucial area for developing addictions to substances and behaviors. […] The addictive properties of gambling can perhaps be explained by the reward uncertainty that activates dopamine signaling in a pathological manner. […] A causal relationship between the medications and GD seems likely, but the molecular mechanisms behind this association have not been fully described yet. […] The dopamine agonists pramipexole and ropinirole, and the dopamine modulator aripiprazole, are associated with an increased risk of developing problematic gambling.
#2 Neurobiology of Gambling Behaviors
https://pmc.ncbi.nlm.nih.gov/articles/PMC3803105/
For many, gambling is a recreational activity that is performed periodically without ill effects, but for some, gambling may interfere with life functioning. A diagnostic entity, pathological gambling, is currently used to define a condition marked by excessive and problematic gambling. […] Multiple neurotransmitter systems (norepinephrine, serotonin, dopamine, opioid and glutamate) and brain regions (ventral striatum, ventromedial prefrontal cortex, insula, among others) have been implicated in gambling and pathological gambling. […] Given the recently proposed changes to PG, this article will review the neurobiology of gambling and PG within the context of this changing landscape and will discuss future directions for research, with a view towards translating improved neurobiological understandings into better prevention and treatment strategies.
#2 The Science Behind Gambling
https://www.responsiblegambling.org/for-the-public/about-gambling/the-science-behind-gambling/
When you gamble, your brain releases dopamine, the feel-good neurotransmitter that makes you feel excited. […] Research conducted by Brain Connections explores how gambling can spiral from an enjoyable pastime into an addiction. When the brains rewards system becomes altered by problem gambling, new habits form that become hard to break. This can lead an individual to feel out of control. […] Research has shown that some people, such as those with an underactive brain reward system, may be genetically predisposed for thrill-seeking behaviours and impulsivity. […] Studies looking into these biological factors reveal differences in brain regions that are involved in decision-making. This can mean a difference in how individuals may process reward information, control impulses and weigh risk.
#3 Psychiatry.org – What is Gambling Disorder?
https://www.psychiatry.org/patients-families/gambling-disorder/what-is-gambling-disorder
Gambling disorder is identified by a pattern of repeated and ongoing betting and wagering that continues despite creating multiple problems in several areas of an individuals life. […] Gambling can change parts of the brain that are involved with experiencing reward or excitement. Treatment for gambling disorder can slowly help reverse these pathways to normal brain functioning prior to gambling. […] In the DSM-5, gambling disorder has been placed in a new category on behavioral addictions. This reflects research findings showing that gambling disorder is similar to substance-related disorders in clinical expression, brain origin, comorbidity, physiology and treatment.
#3 How Gambling Affects Your Brain | Gateway Foundation
https://www.gatewayfoundation.org/blog/how-gambling-affects-brain/
Compulsive gambling affects about 5 million U.S. residents. Consistent compulsive gambling can quickly lead to a gambling addiction, also known as pathological gambling. […] the way that gambling affects your brain chemistry can make it challenging to quit. […] Compulsive gambling shows signs of measurable changes in your brain chemistry. As a behavioral addiction, gambling addiction is closely connected with how the brains reward system functions. […] the effect that gambling has on your brains levels of dopamine a chemical messenger that causes feelings of pleasure is what makes gambling so addicting. […] Hitting the jackpot releases dopamine, generating exceptionally good feelings each time a gambler wins. […] Once a gambling addiction reaches this point, people will struggle to stop placing bets. Since gambling triggers the same dopamine release as using a drug, compulsive gamblers can also experience withdrawal symptoms when they stop.
#4 Neurobiology of Gambling Behaviors
https://pmc.ncbi.nlm.nih.gov/articles/PMC3803105/
These findings suggest that brain circuits, particularly those involving ventral prefrontal, ventral striatal and limbic regions, may contribute importantly to reward-related decision-making that drive gambling behaviors and underlie PG. […] While the past decade has witnessed a significant advance in our understanding of the neurobiology of gambling and PG, there remain many poorly understood aspects.
#5 How Gambling Affects Your Brain | Gateway Foundation
https://www.gatewayfoundation.org/blog/how-gambling-affects-brain/
Scientists found that those with a gambling or substance use disorder experience increased connectivity to the reward system and decreased activity to the prefrontal cortex. […] The reduced activity in the prefrontal cortex may also explain why those with a gambling disorder tend to have more difficulty controlling their impulses than other people. […] These findings indicate that individuals with problematic gambling behavior may have differences in their prefrontal cortex functioning, causing them to struggle more when making decisions about immediate rewards vs. later rewards and the consequences. […] The reward deficiency model proposes that most people prone to addiction have underactive brain reward systems, which draws them to engage in various reward-stimulating activities like gambling or using a substance. […] […] These findings suggest that the primary interest for those battling a gambling addiction is making up for the lack of reward system activity and positive feelings, not the money itself.
#6 Pathological Choice: The Neuroscience of Gambling and Gambling Addiction
https://pmc.ncbi.nlm.nih.gov/articles/PMC3858640/
The current article aims to provide a concise overview of recent developments in our understanding of decision making during gambling and the relevance of these processes to problem gambling. […] We then consider the underlying neural mechanisms, distinguishing neurochemical substrates and neuroanatomy. […] Dopamine has been a prime candidate for investigation of neurochemical abnormalities in pathological gamblers, given its established roles in both drug addiction and rewarded behavior. […] The most direct approach for quantifying dopamine transmission in human brain is PET imaging of dopamine ligands, of which the most widely studied is [11C]-raclopride, a D2/3 receptor antagonist that binds predominantly in the striatum. […] Recent studies have used this ligand in pathological gamblers.
#7 Pathological Choice: The Neuroscience of Gambling and Gambling Addiction
https://pmc.ncbi.nlm.nih.gov/articles/PMC3858640/
This association suggests that D3 expression is relevant to symptom severity in problem gambling, and as an addiction phenotype, it may be a useful marker for risk. […] Rodent models have also provided a means of examining the neurochemistry of gambling, implicating dopamine and serotonin influences. […] Such results imply concurrent regulation of choice behavior on the rat Gambling Task by multiple monoaminergic systems, consistent with human data. […] Studies of patients with pathological gambling are also beginning to provide clues about the mechanisms involved in addiction.
#8 Gambling Disorder (Gambling Addiction): What It Is & Symptoms
https://my.clevelandclinic.org/health/diseases/17881-gambling-disorder-gambling-addiction
Over time, gambling changes your brain chemistry, and you become desensitized to its effects. You then need to gamble more to produce the same effect. […] Gambling disorder tends to run in families, which suggests a genetic link. […] Several studies show that people with gambling disorder are more likely to have extremes of the following personality traits or behaviors: Impulsivity, Sensation-seeking, Compulsivity, Difficulties with decision-making and planning, Rapid shifts in mood (affective instability). […] The U.S. Food and Drug Administration currently doesnt approve any medications to help treat gambling disorder. But several types of psychotherapy can help. […] Therapy can help you: Gain control over your gambling, Handle stress in a healthy manner, Find other ways to spend your time, Better manage your finances, Heal relationships with loved ones, Maintain recovery and avoid triggers, Address any other mental health conditions that may be affecting your gambling behaviors.
#9 Gambling Disorder (Gambling Addiction): What It Is & Symptoms
https://my.clevelandclinic.org/health/diseases/17881-gambling-disorder-gambling-addiction
Gambling disorder (gambling addiction) is a mental health condition characterized by recurrent, maladaptive gambling behavior that causes you clinical stress. […] The American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders (DSM-5) considers gambling disorder as a behavioral addiction. In fact, its currently the only behavioral addiction the DSM-5 recognizes. In certain ways, gambling disorder resembles substance use disorder. They both change your brain chemistry and can have features of withdrawal and tolerance. […] Gambling affects the reward center of your brain. […] Gambling can send massive surges of dopamine through your brain, too. But instead of motivating you to do the things you need to do to survive (like eat and work), such massive dopamine levels can have damaging effects on your thoughts, feelings and behavior.
#10 How Gambling Affects Your Brain | Gateway Foundation
https://www.gatewayfoundation.org/blog/how-gambling-affects-brain/
Scientists found that those with a gambling or substance use disorder experience increased connectivity to the reward system and decreased activity to the prefrontal cortex. […] The reduced activity in the prefrontal cortex may also explain why those with a gambling disorder tend to have more difficulty controlling their impulses than other people. […] These findings indicate that individuals with problematic gambling behavior may have differences in their prefrontal cortex functioning, causing them to struggle more when making decisions about immediate rewards vs. later rewards and the consequences. […] The reward deficiency model proposes that most people prone to addiction have underactive brain reward systems, which draws them to engage in various reward-stimulating activities like gambling or using a substance. […] […] These findings suggest that the primary interest for those battling a gambling addiction is making up for the lack of reward system activity and positive feelings, not the money itself.
#11 How Gambling Affects Your Brain | Gateway Foundation
https://www.gatewayfoundation.org/blog/how-gambling-affects-brain/
Scientists found that those with a gambling or substance use disorder experience increased connectivity to the reward system and decreased activity to the prefrontal cortex. […] The reduced activity in the prefrontal cortex may also explain why those with a gambling disorder tend to have more difficulty controlling their impulses than other people. […] These findings indicate that individuals with problematic gambling behavior may have differences in their prefrontal cortex functioning, causing them to struggle more when making decisions about immediate rewards vs. later rewards and the consequences. […] The reward deficiency model proposes that most people prone to addiction have underactive brain reward systems, which draws them to engage in various reward-stimulating activities like gambling or using a substance. […] […] These findings suggest that the primary interest for those battling a gambling addiction is making up for the lack of reward system activity and positive feelings, not the money itself.
#12
https://link.springer.com/article/10.1007/s40290-022-00453-9
Problematic gambling has been suggested to be a possible consequence of dopaminergic medications used mainly in neurological conditions, i.e. pramipexole and ropinirole, and possibly by one antipsychotic compound, aripiprazole. […] The neurobiology of GD involves the reward and reinforcement system, based mainly on mesocorticolimbic dopamine projections, with the nucleus accumbens being a crucial area for developing addictions to substances and behaviors. […] The addictive properties of gambling can perhaps be explained by the reward uncertainty that activates dopamine signaling in a pathological manner. […] A causal relationship between the medications and GD seems likely, but the molecular mechanisms behind this association have not been fully described yet. […] The dopamine agonists pramipexole and ropinirole, and the dopamine modulator aripiprazole, are associated with an increased risk of developing problematic gambling.
#13 Gambling Addiction | The Psychological Mechanisms
https://cpdonline.co.uk/knowledge-base/mental-health/psychological-mechanisms-behind-gambling-addiction/
Near misses occur when a gambler comes close to winning but falls just short, such as when a slot machine shows two out of three matching symbols. […] Gambling addiction is also driven by emotional factors, as individuals often turn to gambling as a way to regulate their emotions or escape from psychological distress. […] Many individuals use gambling as a maladaptive coping mechanism to manage negative emotions such as stress, anxiety or depression. […] Individuals with gambling addiction often exhibit heightened reward sensitivity, meaning they are more responsive to the immediate rewards and excitement that gambling offers. […] Over time, gambling behaviours can become automatic and ingrained, leading to habitual patterns of behaviour in the same way as drug addictions. […] The variable reinforcement schedule in gambling, where rewards are unpredictable and intermittent, plays a key role in maintaining gambling behaviour.
#14 Neurobiology of Gambling Behaviors
https://pmc.ncbi.nlm.nih.gov/articles/PMC3803105/
Multiple neurochemical systems have been implicated in gambling and PG. Adrenergic systems have been hypothesized to contribute to arousal and excitement, serotonin to impulse control, dopamine to rewarding and reinforcing aspects, opioids to pleasure/urges, cortisol to stress responsiveness, and glutamate to cognitive functioning including cognitive flexibility. […] Arguably the most empirically validated form of pharmacotherapy for PG involves opioid antagonists, although these appear efficacious for only a portion of individuals with PG and have not been examined for long-term efficacy. […] Differences in brain function relating to multiple cognitive domains (cognitive control, decision-making, reward/loss and near-miss processing, delay and probabilistic discounting, reversal learning, alternation learning, and risk-taking) have all been linked to PG or problem-gambling severity.
#15 Neurobiology of Gambling Behaviors
https://pmc.ncbi.nlm.nih.gov/articles/PMC3803105/
Multiple neurochemical systems have been implicated in gambling and PG. Adrenergic systems have been hypothesized to contribute to arousal and excitement, serotonin to impulse control, dopamine to rewarding and reinforcing aspects, opioids to pleasure/urges, cortisol to stress responsiveness, and glutamate to cognitive functioning including cognitive flexibility. […] Arguably the most empirically validated form of pharmacotherapy for PG involves opioid antagonists, although these appear efficacious for only a portion of individuals with PG and have not been examined for long-term efficacy. […] Differences in brain function relating to multiple cognitive domains (cognitive control, decision-making, reward/loss and near-miss processing, delay and probabilistic discounting, reversal learning, alternation learning, and risk-taking) have all been linked to PG or problem-gambling severity.
#16
https://link.springer.com/article/10.1007/s40290-022-00453-9
Problematic gambling has been suggested to be a possible consequence of dopaminergic medications used mainly in neurological conditions, i.e. pramipexole and ropinirole, and possibly by one antipsychotic compound, aripiprazole. […] The neurobiology of GD involves the reward and reinforcement system, based mainly on mesocorticolimbic dopamine projections, with the nucleus accumbens being a crucial area for developing addictions to substances and behaviors. […] The addictive properties of gambling can perhaps be explained by the reward uncertainty that activates dopamine signaling in a pathological manner. […] A causal relationship between the medications and GD seems likely, but the molecular mechanisms behind this association have not been fully described yet. […] The dopamine agonists pramipexole and ropinirole, and the dopamine modulator aripiprazole, are associated with an increased risk of developing problematic gambling.
#17
https://link.springer.com/article/10.1007/s40290-022-00453-9
The pathological over-activation of the dopaminergic reward and reinforcement system is one possible mechanism for dopaminergic drugs to increase gambling behavior. […] The correlation between dopaminergic drugs and increased rates of GD is beginning to be an established consensus. […] Dopaminergic therapy is additionally used as a treatment in restless legs syndrome, fibromyalgia, and pituitary adenomas, and also correlates with an impairment of impulse control in these conditions. […] The proposed mechanism of action for aripiprazole is its stabilizing effect on dopamine levels, acting as a partial agonist. […] Dopaminergic medications may further increase the risk of GD in patients with Parkinson’s disease. […] Overall, there seems to be evidence for a direct connection between GD and dopaminergic signaling alterations in the ventral striatum and some afferent and efferent areas, but as mentioned above, there are also negative findings and the molecular mechanisms remain to be discovered.
#18 Gambling Addiction | The Psychological Mechanisms
https://cpdonline.co.uk/knowledge-base/mental-health/psychological-mechanisms-behind-gambling-addiction/
Gambling addiction, also known as gambling disorder, is characterised by persistent and recurrent problematic gambling behaviour that leads to significant impairment or distress. […] The development and maintenance of gambling addiction are driven by complex psychological mechanisms that influence an individuals cognitive, emotional and behavioural processes. […] Cognitive distortions play a role in maintaining gambling addiction. This is because they alter how individuals perceive their ability to control or predict outcomes. […] The illusion of control is a cognitive bias where individuals believe they can influence the outcome of random events, such as rolling dice or spinning a roulette wheel. […] The gamblers fallacy refers to the mistaken belief that the outcome of previous gambling events affects future results.
#19 Gambling Addiction | The Psychological Mechanisms
https://cpdonline.co.uk/knowledge-base/mental-health/psychological-mechanisms-behind-gambling-addiction/
Gambling addiction, also known as gambling disorder, is characterised by persistent and recurrent problematic gambling behaviour that leads to significant impairment or distress. […] The development and maintenance of gambling addiction are driven by complex psychological mechanisms that influence an individuals cognitive, emotional and behavioural processes. […] Cognitive distortions play a role in maintaining gambling addiction. This is because they alter how individuals perceive their ability to control or predict outcomes. […] The illusion of control is a cognitive bias where individuals believe they can influence the outcome of random events, such as rolling dice or spinning a roulette wheel. […] The gamblers fallacy refers to the mistaken belief that the outcome of previous gambling events affects future results.
#20 Gambling Addiction | The Psychological Mechanisms
https://cpdonline.co.uk/knowledge-base/mental-health/psychological-mechanisms-behind-gambling-addiction/
Gambling addiction, also known as gambling disorder, is characterised by persistent and recurrent problematic gambling behaviour that leads to significant impairment or distress. […] The development and maintenance of gambling addiction are driven by complex psychological mechanisms that influence an individuals cognitive, emotional and behavioural processes. […] Cognitive distortions play a role in maintaining gambling addiction. This is because they alter how individuals perceive their ability to control or predict outcomes. […] The illusion of control is a cognitive bias where individuals believe they can influence the outcome of random events, such as rolling dice or spinning a roulette wheel. […] The gamblers fallacy refers to the mistaken belief that the outcome of previous gambling events affects future results.
#21 Gambling Addiction | The Psychological Mechanisms
https://cpdonline.co.uk/knowledge-base/mental-health/psychological-mechanisms-behind-gambling-addiction/
Near misses occur when a gambler comes close to winning but falls just short, such as when a slot machine shows two out of three matching symbols. […] Gambling addiction is also driven by emotional factors, as individuals often turn to gambling as a way to regulate their emotions or escape from psychological distress. […] Many individuals use gambling as a maladaptive coping mechanism to manage negative emotions such as stress, anxiety or depression. […] Individuals with gambling addiction often exhibit heightened reward sensitivity, meaning they are more responsive to the immediate rewards and excitement that gambling offers. […] Over time, gambling behaviours can become automatic and ingrained, leading to habitual patterns of behaviour in the same way as drug addictions. […] The variable reinforcement schedule in gambling, where rewards are unpredictable and intermittent, plays a key role in maintaining gambling behaviour.
#22 Gambling Addiction | The Psychological Mechanisms
https://cpdonline.co.uk/knowledge-base/mental-health/psychological-mechanisms-behind-gambling-addiction/
Near misses occur when a gambler comes close to winning but falls just short, such as when a slot machine shows two out of three matching symbols. […] Gambling addiction is also driven by emotional factors, as individuals often turn to gambling as a way to regulate their emotions or escape from psychological distress. […] Many individuals use gambling as a maladaptive coping mechanism to manage negative emotions such as stress, anxiety or depression. […] Individuals with gambling addiction often exhibit heightened reward sensitivity, meaning they are more responsive to the immediate rewards and excitement that gambling offers. […] Over time, gambling behaviours can become automatic and ingrained, leading to habitual patterns of behaviour in the same way as drug addictions. […] The variable reinforcement schedule in gambling, where rewards are unpredictable and intermittent, plays a key role in maintaining gambling behaviour.
#23 Gambling Addiction | The Psychological Mechanisms
https://cpdonline.co.uk/knowledge-base/mental-health/psychological-mechanisms-behind-gambling-addiction/
Gambling addiction is often linked to issues with impulse control, where individuals struggle to resist the temptation to gamble, even when they know it is harmful. […] The psychological mechanisms behind gambling addiction contribute significantly to the persistence and escalation of the disorder. […] Cognitive distortions, emotional regulation issues and ingrained behavioural patterns interact to create a self-reinforcing cycle of addiction. […] These cognitive, emotional and behavioural mechanisms do not operate in isolation; rather, they reinforce each other in a feedback loop that perpetuates gambling addiction. […] The psychological mechanisms that drive gambling addiction have significant consequences for individuals mental health, social functioning and financial stability.
#24 Impulsivity in Gambling Disorder and problem gambling: a meta-analysis | Neuropsychopharmacology
https://www.nature.com/articles/s41386-019-0393-9
Gambling Disorder is a prevalent psychiatric condition often linked to dysfunction of cognitive domains regulating impulsive behavior. […] This meta-analysis indicates heightened impulsivity across a range of cognitive domains in Gambling Disorder. […] The concept of impulsivity is central to understanding Gambling Disorder and related addictions, and was highlighted as an important overarching construct in a recent Delphi analysis. […] Impulsivity refers to behaviors or acts that are unduly hasty, risky, and inappropriate, leading to negative outcomes. […] Recent models of impulsivity highlight its complex, multifactorial nature, and the need to consider not only its behavioral manifestations but also underlying brain-based and psychological mechanisms. […] Gambling Disorder was associated with significant impairments in motor and attentional inhibition, discounting, and decision-making tasks.
#25 Gambling Disorder (Gambling Addiction): What It Is & Symptoms
https://my.clevelandclinic.org/health/diseases/17881-gambling-disorder-gambling-addiction
Over time, gambling changes your brain chemistry, and you become desensitized to its effects. You then need to gamble more to produce the same effect. […] Gambling disorder tends to run in families, which suggests a genetic link. […] Several studies show that people with gambling disorder are more likely to have extremes of the following personality traits or behaviors: Impulsivity, Sensation-seeking, Compulsivity, Difficulties with decision-making and planning, Rapid shifts in mood (affective instability). […] The U.S. Food and Drug Administration currently doesnt approve any medications to help treat gambling disorder. But several types of psychotherapy can help. […] Therapy can help you: Gain control over your gambling, Handle stress in a healthy manner, Find other ways to spend your time, Better manage your finances, Heal relationships with loved ones, Maintain recovery and avoid triggers, Address any other mental health conditions that may be affecting your gambling behaviors.
#26 Gambling Disorder > Fact Sheets > Yale Medicine
https://www.yalemedicine.org/conditions/gambling-disorder
Excessive gambling can drain finances, ruin personal and professional relationships, and harm the gamblers mental health. Gambling disorder affects about 1% of Americans who cant stop, despite the consequences. […] Yale research is working to understand the connection between genetics and gambling disorders. Its estimated that a gambling disorders development is 50 percent due to genetic factors and 50 percent due to environmental factors. […] A 2008 study showed that people with psychiatric disorders are 17 times more likely to develop gambling problems. […] People with a gambling disorder often feel guilt or shame and may experience such withdrawal symptoms as restlessness and irritability when attempting to stop gambling. […] Certain opioid antagonists, which may reduce cravings for alcohol, have been found in randomized clinical trials to be superior to placebo in the treatment of gambling disorders. The antidepressant escitalopram may help decrease anxiety and problem-gambling severity in people with co-occurring anxiety and gambling disorders.
#27 Gambling Disorder (Gambling Addiction): What It Is & Symptoms
https://my.clevelandclinic.org/health/diseases/17881-gambling-disorder-gambling-addiction
Over time, gambling changes your brain chemistry, and you become desensitized to its effects. You then need to gamble more to produce the same effect. […] Gambling disorder tends to run in families, which suggests a genetic link. […] Several studies show that people with gambling disorder are more likely to have extremes of the following personality traits or behaviors: Impulsivity, Sensation-seeking, Compulsivity, Difficulties with decision-making and planning, Rapid shifts in mood (affective instability). […] The U.S. Food and Drug Administration currently doesnt approve any medications to help treat gambling disorder. But several types of psychotherapy can help. […] Therapy can help you: Gain control over your gambling, Handle stress in a healthy manner, Find other ways to spend your time, Better manage your finances, Heal relationships with loved ones, Maintain recovery and avoid triggers, Address any other mental health conditions that may be affecting your gambling behaviors.
#28 Gambling Disorder (Gambling Addiction): What It Is & Symptoms
https://my.clevelandclinic.org/health/diseases/17881-gambling-disorder-gambling-addiction
Over time, gambling changes your brain chemistry, and you become desensitized to its effects. You then need to gamble more to produce the same effect. […] Gambling disorder tends to run in families, which suggests a genetic link. […] Several studies show that people with gambling disorder are more likely to have extremes of the following personality traits or behaviors: Impulsivity, Sensation-seeking, Compulsivity, Difficulties with decision-making and planning, Rapid shifts in mood (affective instability). […] The U.S. Food and Drug Administration currently doesnt approve any medications to help treat gambling disorder. But several types of psychotherapy can help. […] Therapy can help you: Gain control over your gambling, Handle stress in a healthy manner, Find other ways to spend your time, Better manage your finances, Heal relationships with loved ones, Maintain recovery and avoid triggers, Address any other mental health conditions that may be affecting your gambling behaviors.
#29 Underlying Mechanisms Involved in Gambling Disorder Severity: A Pathway Analysis Considering Genetic, Psychosocial, and Clinical Variables
https://www.mdpi.com/2072-6643/15/2/418
Gambling Disorder (GD) has a complex etiology that involves biological and environmental aspects. From a genetic perspective, neurotrophic factors (NTFs) polymorphisms have been associated with the risk of developing GD. The aim of this study was to assess the underlying mechanisms implicated in GD severity by considering the direct and mediational relationship between different variables including genetic, psychological, socio-demographic, and clinical factors. […] We found that the interaction between these genetic variants and other different biopsychological features predicted a higher severity of GD. On the one hand, the presence of haplotype block 2, interrelated with haplotype block 3, was linked to a more dysfunctional personality profile and a worse psychopathological state, which, in turn, had a direct link with GD severity.
#30 Underlying Mechanisms Involved in Gambling Disorder Severity: A Pathway Analysis Considering Genetic, Psychosocial, and Clinical Variables
https://www.mdpi.com/2072-6643/15/2/418
The current study described the presence of complex interactions between biopsychosocial variables previously associated with the etiopathogenesis and severity of GD, while also supporting the involvement of genetic variants from the NTF family. […] The dysfunctions found in these genetic variants may have endocrine implications since the expression of the corresponding endogenous ligands would be altered and would therefore imply changes in normal brain signaling cross-talk. […] These findings support the involvement of the NTF family in the pathophysiology of GD at both genetic and endocrine levels. […] A deeper knowledge about the complex pathophysiology of GD, as well as a better understanding of the biological factors underlying core clinical features in GD (e.g., genetics) and their modulatory interaction with other biopsychosocial variables could facilitate the identification of GD profiles with distinctive clinical implications in terms of, for example, the severity of the disorder.
#31 Gambling Disorder > Fact Sheets > Yale Medicine
https://www.yalemedicine.org/conditions/gambling-disorder
Excessive gambling can drain finances, ruin personal and professional relationships, and harm the gamblers mental health. Gambling disorder affects about 1% of Americans who cant stop, despite the consequences. […] Yale research is working to understand the connection between genetics and gambling disorders. Its estimated that a gambling disorders development is 50 percent due to genetic factors and 50 percent due to environmental factors. […] A 2008 study showed that people with psychiatric disorders are 17 times more likely to develop gambling problems. […] People with a gambling disorder often feel guilt or shame and may experience such withdrawal symptoms as restlessness and irritability when attempting to stop gambling. […] Certain opioid antagonists, which may reduce cravings for alcohol, have been found in randomized clinical trials to be superior to placebo in the treatment of gambling disorders. The antidepressant escitalopram may help decrease anxiety and problem-gambling severity in people with co-occurring anxiety and gambling disorders.
#32 Gambling in psychopathology | EBSCO Research Starters
https://www.ebsco.com/research-starters/psychology/gambling-psychopathology
Risk factors for developing compulsive gambling include a parental history of gambling problems, alcohol and tobacco use, and membership in a minority. […] The most common comorbid conditions with compulsive gambling are a personality disorder, which occurs in about half of those diagnosed (antisocial personality disorder is the most frequently found), and substance use disorder, which occurs in about one-third of individuals who compulsively gamble. […] Theories explaining the development of compulsive gambling are multivariate and address a range of factors, including biological, environmental, and parental. Studies during the first decade of the twenty-first century suggest a biological foundation for compulsive gambling. The neurotransmitters serotonin and dopamine are implicated, as are endorphins.
#33 Gambling in psychopathology | EBSCO Research Starters
https://www.ebsco.com/research-starters/psychology/gambling-psychopathology
Risk factors for developing compulsive gambling include a parental history of gambling problems, alcohol and tobacco use, and membership in a minority. […] The most common comorbid conditions with compulsive gambling are a personality disorder, which occurs in about half of those diagnosed (antisocial personality disorder is the most frequently found), and substance use disorder, which occurs in about one-third of individuals who compulsively gamble. […] Theories explaining the development of compulsive gambling are multivariate and address a range of factors, including biological, environmental, and parental. Studies during the first decade of the twenty-first century suggest a biological foundation for compulsive gambling. The neurotransmitters serotonin and dopamine are implicated, as are endorphins.
#34 Pathological gambling | The BMJ
https://www.bmj.com/content/357/bmj.j1593/rr-0
Pathological gambling shows similarities with substance abuse, but there is only a partial overlap in diagnostic criteria. However, the etiology of this behavior is poorly understood. Genetic, environmental and biological factors can cause some different types of addiction. Deficiencies in norepinephrine, serotonin and dopamine dysregulation might also contribute. […] Dopamine agonist treatment was associated with pathological gambling, may relate to stimulation of dopamine receptors in the limbic system. […] There is a high comorbidity with affective, anxiety and personality disorders. This highlights the importance of integrated treatments of gambling disorders and its comorbidity.
#35 Gambling Addiction: Resources, Statistics, and Hotlines | University of Nevada, Reno
https://onlinedegrees.unr.edu/blog/gambling-addiction-resources/
Studies indicate that up to 34% of people with gambling disorder also suffer from post-traumatic stress disorder (PTSD), according to Verywell Mind. These individuals were also more likely to experience issues like depression, anxiety and substance abuse. […] Several peripheral factors may influence a change in their behavior that could lead to gambling addiction, even if theyre dependable and responsible individuals, per the Mental Health Foundation. These factors can include peer pressure; personality traits, such as being competitive or easily bored; or being introduced to gambling at a young age. In rare cases, certain medications may cause a side effect that could spur compulsive behaviors, such as gambling.
#36 The Relationship Between Gambling Addiction and Obsessive-Compulsive Disorder – Immunize Nevada
https://immunizenevada.org/the-relationship-between-gambling-addiction-and-obsessive-compulsive-disorder/
The intersection of gambling addiction and obsessive-compulsive disorder (OCD) highlights a complex relationship between two conditions that share underlying psychological and neurological mechanisms. Both disorders involve difficulties with intrusive thoughts, ritualistic behaviors, and cognitive inflexibility, leading to overlapping symptoms and challenges in diagnosis and treatment. […] These shared traits suggest that gambling addiction and OCD may arise from similar dysfunctions in brain circuits responsible for decision-making, reward processing, and impulse control. […] Research indicates a significant overlap between gambling addiction and OCD, with many individuals experiencing symptoms of both disorders simultaneously. […] Studies suggest that people with OCD are more likely to engage in compulsive gambling compared to the general population.
#37 The Relationship Between Gambling Addiction and Obsessive-Compulsive Disorder – Immunize Nevada
https://immunizenevada.org/the-relationship-between-gambling-addiction-and-obsessive-compulsive-disorder/
The shared neurological and psychological underpinnings of gambling addiction and OCD provide insight into their co-occurrence. […] Both conditions are linked to imbalances in dopamine, a neurotransmitter that regulates reward-seeking behaviors. […] Cognitive inflexibility is particularly evident in the inability to break free from rituals or compulsions despite negative outcomes. […] Additionally, psychological factors such as stress, trauma, and anxiety exacerbate both gambling addiction and OCD. […] Effective treatment for individuals with co-occurring gambling addiction and OCD requires a comprehensive approach that addresses both conditions simultaneously. […] Understanding the nuanced connections between gambling addiction and OCD is essential for providing targeted support and improving outcomes for affected individuals.
#38 The Relationship Between Gambling Addiction and Obsessive-Compulsive Disorder – Immunize Nevada
https://immunizenevada.org/the-relationship-between-gambling-addiction-and-obsessive-compulsive-disorder/
The intersection of gambling addiction and obsessive-compulsive disorder (OCD) highlights a complex relationship between two conditions that share underlying psychological and neurological mechanisms. Both disorders involve difficulties with intrusive thoughts, ritualistic behaviors, and cognitive inflexibility, leading to overlapping symptoms and challenges in diagnosis and treatment. […] These shared traits suggest that gambling addiction and OCD may arise from similar dysfunctions in brain circuits responsible for decision-making, reward processing, and impulse control. […] Research indicates a significant overlap between gambling addiction and OCD, with many individuals experiencing symptoms of both disorders simultaneously. […] Studies suggest that people with OCD are more likely to engage in compulsive gambling compared to the general population.
#39 Individuals with problem gambling and obsessive-compulsive disorder learn through distinct reinforcement mechanisms | PLOS Biology
https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3002031
Obsessive-compulsive disorder (OCD) and pathological gambling (PG) are accompanied by deficits in behavioural flexibility. […] In reinforcement learning, this inflexibility can reflect asymmetric learning from outcomes above and below expectations. […] Here, we examine evidence for asymmetric reward-learning in OCD and PG by leveraging model-based functional magnetic resonance imaging (fMRI). […] Compared with healthy controls (HC), OCD patients exhibited a lower learning rate for worse-than-expected outcomes, which was associated with the attenuated encoding of negative reward prediction errors in the dorsomedial prefrontal cortex and the dorsal striatum. […] PG patients showed higher and lower learning rates for better- and worse-than-expected outcomes, respectively, accompanied by higher encoding of positive reward prediction errors in the anterior insula than HC.
#40 Individuals with problem gambling and obsessive-compulsive disorder learn through distinct reinforcement mechanisms | PLOS Biology
https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3002031
Obsessive-compulsive disorder (OCD) and pathological gambling (PG) are accompanied by deficits in behavioural flexibility. […] In reinforcement learning, this inflexibility can reflect asymmetric learning from outcomes above and below expectations. […] Here, we examine evidence for asymmetric reward-learning in OCD and PG by leveraging model-based functional magnetic resonance imaging (fMRI). […] Compared with healthy controls (HC), OCD patients exhibited a lower learning rate for worse-than-expected outcomes, which was associated with the attenuated encoding of negative reward prediction errors in the dorsomedial prefrontal cortex and the dorsal striatum. […] PG patients showed higher and lower learning rates for better- and worse-than-expected outcomes, respectively, accompanied by higher encoding of positive reward prediction errors in the anterior insula than HC.
#41 Individuals with problem gambling and obsessive-compulsive disorder learn through distinct reinforcement mechanisms | PLOS Biology
https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3002031
These findings elucidate the neural computations of reward-learning that are altered in OCD and PG, providing a potential account of behavioural inflexibility in those mental disorders. […] One influential explanation suggests that behavioural inflexibility can reflect perseveration independent of the outcomes of decisions. […] An alternative account posits that inflexibility reflects asymmetric RL, i.e., overlearning from better-than-expected outcomes and underlearning from worse-than-expected outcomes. […] In this study, we hypothesised that neural computations underlying RL are altered in OCD and PG. […] Both OCD and PG are associated with altered processing of reward and loss information in a number of brain regions, including the striatum, mPFC, adjacent anterior cingulate cortex (ACC), and insula.
#42 Individuals with problem gambling and obsessive-compulsive disorder learn through distinct reinforcement mechanisms | PLOS Biology
https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3002031
In contrast, in the avoidance trials, there was no evidence for differences in key parameter values between the OCD/PG and HC groups. […] Our findings are consistent with the possibility that asymmetric sensitivity to better- and worse-than-expected outcomes in reward-learning regulates, at least in part, abnormal compulsive behaviours in these disorders.
#43
https://www.who.int/news-room/fact-sheets/detail/gambling
Gambling can lead to serious harms to health. These include financial stress, relationship breakdown, family violence, mental illness and suicide. The legacy of gambling harm can endure throughout ones life and transmit intergenerationally. […] Gambling disorder is described alongside substance use disorders in both the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM 5), and the International Classification of Diseases, eleventh revision (ICD 11). The ICD-11 describes three diagnostic requirements: […] Gambling harm also occurs well below clinical thresholds. Signs of harm include the diversion of money from essential household spending. This can lead to food insecurity, housing problems and difficulties accessing healthcare and education. […] The commercialization of gambling in many countries which also drives normalization is increasing the incidence of gambling harm. Sponsorship or other association with popular sporting leagues, and the colocation of gambling products in social settings, are key mechanisms.
#44 Recognising Problem Gambling: Signs and Symptoms
https://cpdonline.co.uk/knowledge-base/mental-health/problem-gambling/
Problem gambling is a compulsive or uncontrollable urge to gamble, despite the negative impact on various aspects of life, including mental health, finances, relationships and responsibilities. This behaviour often persists even when the individual recognises its harmful consequences, which indicates the individual has a lack of control over their urge to gamble. […] Problem gambling can have far-reaching effects on an individuals life and well-being. The financial stress of compulsive gambling often leads to debt, which can increase anxiety, stress and depression. Emotionally, problem gambling can contribute to feelings of shame, guilt and helplessness. […] Problem gambling is often associated with high levels of stress, anxiety and depression. The continuous worry over financial losses, coupled with feelings of guilt and shame, can lead to a decline in mental well-being.
#45 Recognising Problem Gambling: Signs and Symptoms
https://cpdonline.co.uk/knowledge-base/mental-health/problem-gambling/
Problem gambling is a compulsive or uncontrollable urge to gamble, despite the negative impact on various aspects of life, including mental health, finances, relationships and responsibilities. This behaviour often persists even when the individual recognises its harmful consequences, which indicates the individual has a lack of control over their urge to gamble. […] Problem gambling can have far-reaching effects on an individuals life and well-being. The financial stress of compulsive gambling often leads to debt, which can increase anxiety, stress and depression. Emotionally, problem gambling can contribute to feelings of shame, guilt and helplessness. […] Problem gambling is often associated with high levels of stress, anxiety and depression. The continuous worry over financial losses, coupled with feelings of guilt and shame, can lead to a decline in mental well-being.
#46 Recognising Problem Gambling: Signs and Symptoms
https://cpdonline.co.uk/knowledge-base/mental-health/problem-gambling/
Anxiety and depression are particularly common among individuals with gambling issues, as gambling may initially be used as a coping mechanism for negative emotions. However, as gambling behaviour escalates, it often exacerbates these underlying mental health issues, leading to a vicious cycle of emotional distress and dependency on gambling. […] The intense stress often associated with problem gambling can result in physical health issues, including headaches, gastrointestinal problems, high blood pressure and fatigue. […] Problem gambling can reduce quality of life across multiple areas, from career instability and financial distress to social isolation and reduced life satisfaction. […] Gambling addiction can put significant strain on families and often leads to mistrust, resentment and frustration.
#47 Recognising Problem Gambling: Signs and Symptoms
https://cpdonline.co.uk/knowledge-base/mental-health/problem-gambling/
Anxiety and depression are particularly common among individuals with gambling issues, as gambling may initially be used as a coping mechanism for negative emotions. However, as gambling behaviour escalates, it often exacerbates these underlying mental health issues, leading to a vicious cycle of emotional distress and dependency on gambling. […] The intense stress often associated with problem gambling can result in physical health issues, including headaches, gastrointestinal problems, high blood pressure and fatigue. […] Problem gambling can reduce quality of life across multiple areas, from career instability and financial distress to social isolation and reduced life satisfaction. […] Gambling addiction can put significant strain on families and often leads to mistrust, resentment and frustration.
#48 Pathological Gambling (312.21) | Abnormal Psychology
https://courses.lumenlearning.com/atd-herkimer-abnormalpsych/chapter/pathological-gambling-312-21/
Pathological gambling (PG) involves being unable to resist the impulse to gamble. […] After some time, the individual may feel compelled to take higher risks to produce the desired level of excitement. […] Compulsive gamblers are more prone to medical conditions that are brought about by stress such as hypertension, peptic ulcers, and migraine headaches. […] Compulsive gambling can be confused with bipolar disorder, which sometimes accompanies compulsive gambling. […] This impulse-control disorder is more common among men than women. […] Pathological gambling typically begins in adolescence for boys and later in life for girls. […] Environmental stressors or depression may increase the frequency of gambling. […] Treatment for compulsive gambling includes inpatient outpatient programs, residential care, halfway houses, behavior modification, individual and group therapy, and traditional psychoanalysis.
#49 Gambling Addiction | The Psychological Mechanisms
https://cpdonline.co.uk/knowledge-base/mental-health/psychological-mechanisms-behind-gambling-addiction/
The psychological toll of gambling addiction is severe. Individuals frequently experience heightened levels of anxiety, depression and stress. […] Gambling addiction impairs cognitive functioning, leading to difficulties with decision-making, problem-solving and impulse control. […] Effective treatment for gambling addiction requires addressing the cognitive, emotional and behavioural mechanisms that perpetuate the disorder. […] Cognitive-behavioural therapy is a primary treatment modality for gambling addiction. […] CBT targets the erroneous beliefs and thought processes that sustain gambling addiction, such as the illusion of control and the gamblers fallacy. […] Understanding these psychological mechanisms is critical for developing effective treatment and prevention strategies.
#50 Gambling Disorder (Gambling Addiction): What It Is & Symptoms
https://my.clevelandclinic.org/health/diseases/17881-gambling-disorder-gambling-addiction
Specific types of therapy for gambling disorder include: Cognitive behavioral therapy (CBT), Motivational interviewing, Psychodynamic therapy, Group therapy, Family therapy. […] The prognosis (outlook) for gambling disorder depends on a few factors, like its severity, if you get treatment, if you have other mental health conditions. […] Unfortunately, less than 10% of people with gambling disorder seek professional treatment. Many try to fix it themselves. Know that therapy with a mental health professional can help manage the condition.
#51 Gambling Disorder (Gambling Addiction): What It Is & Symptoms
https://my.clevelandclinic.org/health/diseases/17881-gambling-disorder-gambling-addiction
Specific types of therapy for gambling disorder include: Cognitive behavioral therapy (CBT), Motivational interviewing, Psychodynamic therapy, Group therapy, Family therapy. […] The prognosis (outlook) for gambling disorder depends on a few factors, like its severity, if you get treatment, if you have other mental health conditions. […] Unfortunately, less than 10% of people with gambling disorder seek professional treatment. Many try to fix it themselves. Know that therapy with a mental health professional can help manage the condition.
#52 Gambling Disorder (Gambling Addiction): What It Is & Symptoms
https://my.clevelandclinic.org/health/diseases/17881-gambling-disorder-gambling-addiction
Specific types of therapy for gambling disorder include: Cognitive behavioral therapy (CBT), Motivational interviewing, Psychodynamic therapy, Group therapy, Family therapy. […] The prognosis (outlook) for gambling disorder depends on a few factors, like its severity, if you get treatment, if you have other mental health conditions. […] Unfortunately, less than 10% of people with gambling disorder seek professional treatment. Many try to fix it themselves. Know that therapy with a mental health professional can help manage the condition.
#53 Gambling Disorder (Gambling Addiction): What It Is & Symptoms
https://my.clevelandclinic.org/health/diseases/17881-gambling-disorder-gambling-addiction
Specific types of therapy for gambling disorder include: Cognitive behavioral therapy (CBT), Motivational interviewing, Psychodynamic therapy, Group therapy, Family therapy. […] The prognosis (outlook) for gambling disorder depends on a few factors, like its severity, if you get treatment, if you have other mental health conditions. […] Unfortunately, less than 10% of people with gambling disorder seek professional treatment. Many try to fix it themselves. Know that therapy with a mental health professional can help manage the condition.
#54 Compulsive gambling Information | Mount Sinai – New York
https://www.mountsinai.org/health-library/diseases-conditions/compulsive-gambling
Compulsive gambling is being unable to resist impulses to gamble. This can lead to severe money problems, job loss, crime or fraud, and damage to family relationships. […] People with compulsive gambling have a hard time resisting or controlling the impulse to gamble. The brain is reacting to this impulse in the same manner it reacts to a person addicted to alcohol or illegal drugs. […] In people who develop compulsive gambling, occasional gambling leads to a gambling habit. Stressful situations can worsen gambling problems. […] Treatment options include: Cognitive behavioral therapy (CBT). […] A few studies have been done on medicines for treating compulsive gambling. Early results suggest that antidepressants and opioid antagonists (naltrexone) may help treat the symptoms of compulsive gambling. However, it is not yet clear which people will respond to medicines.
#55 Neurobiology of Gambling Behaviors
https://pmc.ncbi.nlm.nih.gov/articles/PMC3803105/
Multiple neurochemical systems have been implicated in gambling and PG. Adrenergic systems have been hypothesized to contribute to arousal and excitement, serotonin to impulse control, dopamine to rewarding and reinforcing aspects, opioids to pleasure/urges, cortisol to stress responsiveness, and glutamate to cognitive functioning including cognitive flexibility. […] Arguably the most empirically validated form of pharmacotherapy for PG involves opioid antagonists, although these appear efficacious for only a portion of individuals with PG and have not been examined for long-term efficacy. […] Differences in brain function relating to multiple cognitive domains (cognitive control, decision-making, reward/loss and near-miss processing, delay and probabilistic discounting, reversal learning, alternation learning, and risk-taking) have all been linked to PG or problem-gambling severity.
#56 Compulsive gambling Information | Mount Sinai – New York
https://www.mountsinai.org/health-library/diseases-conditions/compulsive-gambling
Compulsive gambling is being unable to resist impulses to gamble. This can lead to severe money problems, job loss, crime or fraud, and damage to family relationships. […] People with compulsive gambling have a hard time resisting or controlling the impulse to gamble. The brain is reacting to this impulse in the same manner it reacts to a person addicted to alcohol or illegal drugs. […] In people who develop compulsive gambling, occasional gambling leads to a gambling habit. Stressful situations can worsen gambling problems. […] Treatment options include: Cognitive behavioral therapy (CBT). […] A few studies have been done on medicines for treating compulsive gambling. Early results suggest that antidepressants and opioid antagonists (naltrexone) may help treat the symptoms of compulsive gambling. However, it is not yet clear which people will respond to medicines.
#57 Gambling in psychopathology | EBSCO Research Starters
https://www.ebsco.com/research-starters/psychology/gambling-psychopathology
Individuals who compulsively gamble show impulsivity, an inability to delay gratification, and higher levels of physiological arousal, such as increased heart rate while gambling. […] Treatment for compulsive gambling can take a variety of forms. One effective method is cognitive behavior therapy, which focuses on changing patterns of thought and cognition related to gambling impulses. […] Psychopharmacological treatments for gambling including selective serotonin reuptake inhibitors (SSRIs), opioid antagonists, and mood stabilizers also have shown some promise.
#58 Gambling Disorder > Fact Sheets > Yale Medicine
https://www.yalemedicine.org/conditions/gambling-disorder
Excessive gambling can drain finances, ruin personal and professional relationships, and harm the gamblers mental health. Gambling disorder affects about 1% of Americans who cant stop, despite the consequences. […] Yale research is working to understand the connection between genetics and gambling disorders. Its estimated that a gambling disorders development is 50 percent due to genetic factors and 50 percent due to environmental factors. […] A 2008 study showed that people with psychiatric disorders are 17 times more likely to develop gambling problems. […] People with a gambling disorder often feel guilt or shame and may experience such withdrawal symptoms as restlessness and irritability when attempting to stop gambling. […] Certain opioid antagonists, which may reduce cravings for alcohol, have been found in randomized clinical trials to be superior to placebo in the treatment of gambling disorders. The antidepressant escitalopram may help decrease anxiety and problem-gambling severity in people with co-occurring anxiety and gambling disorders.
#59 Compulsive gambling Information | Mount Sinai – New York
https://www.mountsinai.org/health-library/diseases-conditions/compulsive-gambling
Like alcohol or substance use disorder, compulsive gambling is a long-term disorder that tends to get worse without treatment. Even with treatment, it’s common to start gambling again (relapse). However, people with compulsive gambling can do very well with the right treatment. […] Exposure to gambling may increase the risk of developing compulsive gambling. Limiting exposure may be helpful for people who are at risk. Intervention at the earliest signs of compulsive gambling may prevent the disorder from getting worse.
#60
https://link.springer.com/article/10.1007/s40290-022-00453-9
The pathological over-activation of the dopaminergic reward and reinforcement system is one possible mechanism for dopaminergic drugs to increase gambling behavior. […] The correlation between dopaminergic drugs and increased rates of GD is beginning to be an established consensus. […] Dopaminergic therapy is additionally used as a treatment in restless legs syndrome, fibromyalgia, and pituitary adenomas, and also correlates with an impairment of impulse control in these conditions. […] The proposed mechanism of action for aripiprazole is its stabilizing effect on dopamine levels, acting as a partial agonist. […] Dopaminergic medications may further increase the risk of GD in patients with Parkinson’s disease. […] Overall, there seems to be evidence for a direct connection between GD and dopaminergic signaling alterations in the ventral striatum and some afferent and efferent areas, but as mentioned above, there are also negative findings and the molecular mechanisms remain to be discovered.
#61 Contribution of sex on the underlying mechanism of the gambling disorder severity | Scientific Reports
https://www.nature.com/articles/s41598-020-73806-6
Significant increasing prevalences have been observed in gambling disorder (GD) in the last decades. This study analyzed the underlying mechanisms of the gambling severity with path analysis (implemented through Structural Equation Modeling, SEM), and assessed the potential moderator effect of the patients sex. Results obtained in two separate SEM (for men and women) revealed differences in the direct effects and the mediational links. Among the male subsample, higher GD severity was directly related to the higher cognitive bias and the younger age of onset of the problematic gambling, while impulsivity levels and age of onset achieved an indirect effect on the disordered gambling mediated by the cognitive bias. Among females, GD severity was directly increased by younger age of onset, higher cognitive bias and lower self-directedness, while lower socioeconomic positions, and higher levels in harm avoidance achieved an indirect effect on the gambling severity mediated also by the distortions related to the gambling activity. These results provide new empirical evidence for a better understanding of the GD etiology, suggesting that the underlying complex links mediating the GD severity are strongly related to the patients sex. The evaluation of the role of the variables involved in the pathways explaining GD severity grades taking sex into account seems essential to determine prospective treatments taking into account the idiosyncrasy of each group. The aim of the study was to assess, through pathways analysis, the underlying mechanisms of GD severity, considering the direct and indirect (mediational) effects between a broad set of variables including sociodemographic, personality, and other clinical measurements, and to value the potential role of patient sex as a moderator variable. To our knowledge, this is the first study examining differences in the pathways that explain the gambling severity between males and females in a clinical based sample. The resulting path model for males showed two variables directly related to gambling severity; higher cognitive bias and younger age of onset. In the case of females, a third variable was included, with a lower self-directedness level also directly related to gambling severity. Overall, the SEM tested in the current study supported the idea of the existence of different mediational paths underlying mechanisms of gambling severity according to sex. The global predictive capacity of the resulting paths was higher for the female subgroup (50% vs 30%).
#62 Neurobiology of Gambling Behaviors
https://pmc.ncbi.nlm.nih.gov/articles/PMC3803105/
These findings suggest that brain circuits, particularly those involving ventral prefrontal, ventral striatal and limbic regions, may contribute importantly to reward-related decision-making that drive gambling behaviors and underlie PG. […] While the past decade has witnessed a significant advance in our understanding of the neurobiology of gambling and PG, there remain many poorly understood aspects.
#63 Effects of advertising on problem gambling: Neural-cue reactivity as a possible underlying mechanism – Garcia-Castro et al 2022a – Scipedia
https://www.scipedia.com/public/Garcia-Castro_et_al_2022a
Problem gambling has recently been reclassified as a non-substance-associated behavioral addiction. […] Although the effects of advertising on gambling behavior have been explored since the second half of the twentieth century, there is a lack of research regarding its underlying mechanisms. […] Advertisements in various formats may act both as a precipitating factor and as a maintenance factor for the gambling disorder, changing both attitudes and beliefs about gambling. […] Activation of brain areas related to reward, such as accumbens nucleus, to memory, such as hippocampus or amygdala, and to executive functions could be the underlying mechanism of this effect. […] Also, ads promoting responsible gambling do not appear to be effective in reducing behavior or encouraging self-control, but the available evidence is scarce.
#64 Effects of advertising on problem gambling: Neural-cue reactivity as a possible underlying mechanism – Garcia-Castro et al 2022a – Scipedia
https://www.scipedia.com/public/Garcia-Castro_et_al_2022a
In addition, the available evidence questions the effectiveness of responsible gambling policies to promote self-control in this population, as well as to reduce the negative impact of this disorder, so future research on neural-cue reactivity to gambling-related stimuli may serve to improve the design of advertising strategies that increase the impact of these messages.
#65 Underlying Mechanisms Involved in Gambling Disorder Severity: A Pathway Analysis Considering Genetic, Psychosocial, and Clinical Variables
https://www.mdpi.com/2072-6643/15/2/418
The current study described the presence of complex interactions between biopsychosocial variables previously associated with the etiopathogenesis and severity of GD, while also supporting the involvement of genetic variants from the NTF family. […] The dysfunctions found in these genetic variants may have endocrine implications since the expression of the corresponding endogenous ligands would be altered and would therefore imply changes in normal brain signaling cross-talk. […] These findings support the involvement of the NTF family in the pathophysiology of GD at both genetic and endocrine levels. […] A deeper knowledge about the complex pathophysiology of GD, as well as a better understanding of the biological factors underlying core clinical features in GD (e.g., genetics) and their modulatory interaction with other biopsychosocial variables could facilitate the identification of GD profiles with distinctive clinical implications in terms of, for example, the severity of the disorder.