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Published on: November 9, 2019
Neurocognitive Deficits Associated with Gambling Behavior: A Systematic Review and Meta-analysis of Executive
Yashita Ahluwalia1, Parvender Singh Negi1, Swarndeep Singh2
1National Drug Dependence Treatment Center (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India.
Purpose Of The Review:
This systematic review and meta-analysis examined whether gambling behavior is associated with neurocognitive deficits across executive function, decision-making, delay discounting, and reward sensitivity, and whether these deficits support the dual-process model of addiction.
Collection And Analysis Of Data:
PubMed, Scopus, Embase, and Web of Science were searched on September 1, 2024. Observational studies including individuals with gambling behavior identified using Diagnostic and Statistical Manual of Mental Disorders (DSM)/International Classification of Diseases (ICD) criteria and/or standardized screening instruments were eligible. Risk of bias (ROB) was assessed using the Joanna Briggs Institute (JBI) checklist (cross-sectional studies). Random-effects meta-analyses using Hedges' g were conducted in R software, with heterogeneity, publication bias, leave-one-out sensitivity, subgroup, and meta-regression analyses.
Results:
Of 12,488 records, 76 studies (n = 5362) met eligibility for the review, and 35 (n = 2822) were included in the meta-analysis. Across 15 random-effects meta-analyses (k = 02-12; n = 38-562; I 2 = 0%-94.1%), the largest deficits were observed in inhibitory control on the Stroop task (ST) under gambling (g = 1.91; p < .05) and neutral conditions (g = 1.83; p < .05), followed by delay discounting (area under the curve [AUC]: g = -1.07; p < .001; discounting parameter: g = 0.45; p < .01), cognitive flexibility on the probabilistic reversal learning test (g = -0.51; p < .05) and Intra/Extra-Dimensional Set Shift Task (g = 0.72; p < .001), and working memory on the Trail Making Test-B (TMT-B) (g = 0.59; p < .05). Decision-making impairments were partially supported by qualitative evidence, while no consistent deficits were observed in planning ability or reward sensitivity.
Conclusions:
Findings indicate impairments in controlled and automatic processes, partially supporting the dual-process model of gambling disorder; however, heterogeneity and task-specific effects warrant caution.
