Acute stress response dysfunction in problem gambling (PG) and relationships with features of addiction

Individuals with problem gambling (PG) report high stress which contributes to the onset and maintenance of gambling problems. However, few studies examine acute physiological and subjective stress responses and draw comparisons to features of addiction, such as heightened gambling urges and impulsivity. The purpose of this study is to examine the acute stress response through multiple physiological biomarkers, self-reported mood, and gambling urges in those with PG (n = 21) relative to healthy controls (HCs; n = 21). Furthermore, we test the relationship between impulsivity and acute stress processing within groups. Salivary cortisol (sC) and salivary alpha-amylase (sAA) were collected, and participants completed self-report assessments of mood disturbances and gambling urges at baseline and three times following acute psychosocial stress exposure. Results revealed consistently elevated mood disturbances, while reactive sC concentrations appeared blunted in PG. Conversely, sAA responded to stress similarly between groups. Interactions between markers were identified within PG and HC groups during stress reactivity, but were enhanced in PG participants during stress recovery. While gambling urges did not increase in response to acute stress in PG, they were associated with trait impulsivity. Overall, our study demonstrates chronic stress effects in PG through acute physiological dysregulation and elevated subjective negative mood. PG participants report a high desire to gamble, but state changes in gambling urges are unaffected by acute stress exposure. Additionally, trait-level impulsivity is associated with state features of PG, potentially contributing to gambling maintenance. This study addresses our limited understanding of stress processing in PG and has implications for neurobiological processes underlying its effects.