Impaired metacognitive capacities in individuals with problem gambling

Impaired insight into behavior may be one of the clinical characteristics of pathological gambling. In the present study, we tested whether the capacity to evaluate accurately the quality of one's own decisions during a non-gambling task was impaired in problem gamblers. Twenty-five problem gamblers and 25 matched healthy participants performed an artificial grammar-learning paradigm, in which the quality of choice remains uncertain throughout the task. After each trial of this task, participants had to indicate how confident they were in the grammaticality judgements using a scale ranging from 1 (low confidence) to 7 (high confidence). Results showed that (i), problem gamblers' performance on the grammaticality test was lower than controls'; (ii) there was a significant correlation between grammaticality judgments and confidence for control participants, which indicates metacognitive insight and the presence of conscious knowledge; (iii) this correlation was not significant in problem gamblers, which suggests a disconnection between performance and confidence in this group. These findings suggest that problem gamblers are impaired in their metacognitive abilities on a non-gambling task, which suggests that compulsive gambling is associated with poor insight as a general factor. Clinical interventions tailored to improve metacognition in gambling could be a fruitful avenue of research in order to prevent pathological gambling.