Emotion regulation is described as an important mediator factor in one of the "pathways model" of Gambling Disorder; emotional vulnerability is proposed as a determining factor combined with ecological factors, conditioning processes and cognitive models, which are the factors underlying the development and maintenance of dependent behaviour.
It has been widely demonstrated that an alteration in the processing of emotions can influence the decision-making processes. It is not clear whether emotions can be considered as a key factor leading to "good" or "bad" decisions, instead, it would be useful, to investigate the relationship between circumstances and emotions by considering them as a guide for human behaviour.
The study sample will consist of individuals affected by Gambling Disorder (GD) and Healthy Control (HC). All subjects in this study will be assessed for emotion regulation, decision-making, mood disorders, addiction characteristics and addictive behaviours. A specific decision-making task will be created assessing the relationship between emotions and decision-making processes.
The primary aim of the study is to investigate the relationship between mood disorder and the emotion regulation in GD, thus the concurrent aim is to investigate whether the emotional dysregulation can influence decision making performance.
The study will evaluate any variability in the magnitude of the effects among different tasks and questionnaires and the impact of direct relationship between emotions and their influence on the decision-making processes.
The project proposal could represent an advancement through the development of a task to improve the knowledge on emotion regulation in GD, by taking in account the role of individual differences. The knowledge currently available on this specific topic comes mainly from functional magnetic resonance imaging studies.
Different studies have used cue-exposure paradigms in nicotine, alcohol and cocaine dependence reporting increased ventral prefrontal, insular, amygdala, striatal, and thalamic activity, brain regions associated with emotion processing and motivational behaviour. To assess the influence of emotional stimuli in the GD, van Holst et al.,(2012), have evaluated GD during the execution of an adapted fMRI "go/no-go" paradigm with affective images (positive, negative and neutral) and images related to the gambling. The GD group made fewer errors when testing with positive or gambling associated images than the HC, although they were slower during all trial phases. The study shows that the emotional stimuli associated with gambling are more salient for GD than for HC, and, in addition, the GD's seem to perform similarly to HC during the trials with neutral images. However, positive and game-related stimuli seem to facilitate response inhibition in GD, as demonstrated by less specific brain activity and lower behavioural errors. These results suggest that some motivational processes do not necessarily interfere with cognitive functions but, instead, can often improve the performance. Through fMRI studies, in which gambling films were shown to GD, anomalies in the frontal lobes and in both subcortical and cortical circuits that project to the frontal cortex were found; in addition, a decreased activity of the orbital-frontal cortex and the ventro-medial prefrontal cortex was found (Conversano et al.,2012). It has been widely demonstrated that an alteration of specific neural circuits critical to the processing of emotions, can develop more advantageous decisions than normal subjects when faced with the types of positive-expected value gambles. These findings support the possibility of risk behaviours that are central to emotions (Loewenstein et al.,2001). Risky decision-making is largely a cognitive process that integrates the desirability of different possible outcomes with their probabilities.
However, there are few studies in literature that investigate the direct relationship between emotions and their influence on the decision-making processes.
Stems from these premises the idea of developing a behavioural task that can evaluate the influence of emotional stimuli on decision- making processes and in particular the risk-taking decisions. Specifically, the task will investigate reaction time (RT) and different types of betting choices.
References:
Crockford,D.N.,Goodyear,B.,Edwards, J., Quickfall, J., & el-Guebaly, N. (2005). Cue-induced brain activity in pathological gamblers. Biological psychiatry.
Cunningham-Williams,R.M.,Cottler,L.B.,Compton 3rd, W.M.,& Spitznagel,E.L.(1998). Taking chances: problem gamblers and mental health disorders--results from the St. Louis Epidemiologic Catchment Area Study. American journal of public health. Gilovich,T.,Griffin,D.,& Kahneman,D.(Eds.). (2002). Heuristics and biases: The psychology of intuitive judgment. Cambridge university press.
Goudriaan,A.E.,De Ruiter,M.B.,Van Den Brink,W.,Oosterlaan,J.,& Veltman,D.J.(2010). Brain activation patterns associated with cue reactivity and craving in abstinent problem gamblers, heavy smokers and healthy controls: an fMRI study. Addiction biology. Gratz,K.L.,& Roemer,L.(2004). Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. J. Psychopathol. Behav. Assess.
Hewig,J.,Kretschmer,N., Trippe, R. H., Hecht,H., Coles,M. G., Holroyd, C. B., & Miltner, W. H. (2010). Hypersensitivity to reward in problem gamblers. Biological psychiatry.
Kober,H.,Bolling,D.,(2014). Emotion regulation in substance use disorders. Handbook of emotion regulation.Guilford, New York, NY. Krawczyk,D.C.(2002). Contributions of the prefrontal cortex to the neural basis of human decision making. Neuroscience & Biobehavioral Reviews.
Lawrence,A.J.,Luty,J.,Bogdan,N.A.,Sahakian,B.J., & Clark,L.(2009). Impulsivity and response inhibition in alcohol dependence and problem gambling. Psychopharmacology.
Leeman,R.F.,&Potenza,M.N.(2012). Similarities and differences between pathological gambling and substance use disorders: A focus on impulsivity and compulsivity. Psychopharmacology.
Lister,J.J.,Milosevic,A., & Ledgerwood,D.M.(2015). Psychological characteristics of problem gamblers with and without mood disorder. The Canadian Journal of Psychiatry.
Loewenstein,G.F.,Weber,E.U.,Hsee,C.K.,&Welch,N.(2001). Risk as feelings. Psychological bulletin.
Lumley,M.A.,&Roby,K.J.(1995). Alexithymia and pathological gambling. Psychotherapy and psychosomatics.