Challenges of gaming disorder: Suggestions from a public health perspective [open-access article].

Introduction: Based on the results from numerous studies and discussions by expert groups organised by the WHO, gaming disorder is recognised as a mental disorder and is listed in the chapter of mental, behavioural and neurodevelopmental disorders in the recently released International Classification of Diseases, 11th Version (ICD-11). Gaming disorder, gambling disorder and substance use disorder belong to the same category of mental disorder. This change will help improve the public’s awareness and understanding of gaming disorder. Meanwhile, it will encourage related research and develop scientific and effective interventions for the purpose of negative consequences reduction. Short article available online

Reference: Zhao, M., & Hao., W. (2019). Challenges of gaming disorder: Suggestions from a public health perspective. General Psychiatry, 32(e100086). doi: 10.1136/gpsych-2019-100086


The Iowa Gambling Task: A review of the historical evolution, scientific basis, and use in functional neuroimaging [open-access article].

Abstract: The Iowa Gambling Task (IGT) provides a framework to evaluate an individual decision-making process through a simulated card game where the risks and rewards vary by the decks chosen. Participants are expected to understand the logic behind the allocation of gains and losses over the course of the test and adapt their pattern of choices accordingly. This review explores the scientific work on studying problem gambling via the IGT while employing neuroimaging techniques. We first concentrate on the historical evolution of the IGT as a mechanism for studying gamblers’ behavioral patterns. Our research will also discuss the prefrontal cortex as this region of the brain is most affected by changes in behavioral patterns. In this review, we describe a number of features that may be useful in investigating decision-making patterns that lead to gambling addiction. We discuss the evidence base to date including experiments involving gambling behavior in different groups of participants (e.g., males and females, adults and minors, patients and controls) and alterations to experiment conditions that provide more thorough understanding of thought patterns in potential gamblers. We conclude that psychological testing combined with functional imaging provide powerful tools to further examine the relationships between functional impairment of the brain and a person’s ability to objectively anticipate the end results of their decisions. Article available online

Reference: Aram, S., Levy, L., Patel, J.B., Anderson, A.A., Zaragoza, R., Dashtestani, H., Chowdhry, F.A., Gandjbakhche, A., & Tracy, J. K. (2019). The Iowa Gambling Task: A review of the historical evolution, scientific basis, and use in functional neuroimaging. SAGE Open.

Integrating psilocybin and existential-humanistic psychotherapy for pathological gambling treatment: a new perspective [open-access article].

Abstract: In the last years, the debate on the use of psychedelics in psychotherapeutic settings has intensified, attracting a lot of interest and attention from the scholarly community as well as from clinicians and paving the way for new therapeutic paradigms. Besides classical addictions and addictive behaviors, there exist forms of addictions, the so-called new addictions or behavioral addictions, whose characterization is not linked so much to substances but to widespread and socially accepted activities such as games, shopping, internet use, sex, love relationships, work and exercises, physical activities or sports.
Among the various addictions, the gambling disorder is the first form of behavioral addictions officially recognized by the DSM-V, in accordance with a wealth of neurobiological and clinical data showing the activation in patients of the gratification systems (especially dopamine).
Orthos, as intensive residential intervention program envisaging a non-moralistic approach to gambling, can be combined with the administration of psilocybin, a substance characterized by a very low potential for abuse, modulating brain areas and networks affected by addictive behaviors. Therefore, our proposal would be to start treating behavioral addictions combining psilocybin administration with existential-humanistic psychotherapy, like Orthos. Article available online

Reference: Raymondo, S., & Firenzuoli, F. (2019). Integrating psilocybin and existential-humanistic psychotherapy for pathological gambling treatment: a new perspective. Cosmos and History: The Journal of Natural and Social Philosophy, 15(1), 228–236.

The interplay between chasing behavior, time perspective, and gambling severity: An experimental study [open-access article].

Background and aims: Chasing refers to continued gambling in an attempt to recoup previous losses and is one of the diagnostic criteria for gambling disorder. However, research on the topic is still in its infancy. This study investigated whether chasing behavior mediates the relationship between time perspective and gambling severity.
Methods: Nonproblem gamblers (N = 26) and problem gamblers (N = 66) with the same demographic features (age and gender) were compared on the Consideration of Future Consequences and a computerized task assessing chasing. The Italian South Oaks Gambling Screen was used to discriminate participants in terms of gambling severity.
Results: Significant correlations were found relating to gambling severity, chasing, and time perspective. More specifically, the results showed that problem gamblers reported more chasing and a foreshortened time horizon. Chasers, compared to nonchasers, were found to be more oriented to the present. Regression analysis showed that male gender, present-oriented time perspective, and chasing were good predictors of gambling severity. Finally, to clarify if present orientation was on the path from chasing to gambling severity or if chasing was the mediator of the impact of present orientation on gambling severity, a path analysis was performed. The results indicated that present orientation had a direct effect on gambling severity and mediated the relationship between chasing and gambling involvement.
Conclusion: The findings support the exacerbating role of chasing in gambling disorder and for the first time show the relationship of time perspective, chasing, and gambling severity among adults. Article available online

Reference: Ciccarelli, M., Cosenza, M., Griffiths, M.D., D’Olimpio. F., & Nigro, G. (2019). The interplay between chasing behavior, time perspective, and gambling severity: An experimental study. Journal of Behavioral Addictions. DOI: 10.1556/2006.8.2019.29

Big five personality traits and alcohol, nicotine, cannabis, and gambling disorder comorbidity [subscription access article].

Abstract: The Diagnostic and Statistical Manual of Mental Disorders (DSM; 5th ed.) reassignment of gambling disorder as an addictive disorder alongside the substance-related addictive disorders encourages research into their shared etiologies. The aims of this study were to examine: (a) the associations of Big Five personality dimensions with alcohol, nicotine, cannabis, and gambling disorders, (b) the comorbidity between these disorders, (c) the extent to which common personality underpinnings explain comorbidity, (d) whether results differed for men and women, and (e) the magnitude of personality differences corresponding to the 4 disorders. Participants were 3,785 twins and siblings (1,365 men, 2,420 women; Mage = 32 years, range = 21–46 years) from the Australian Twin Registry who completed psychiatric interviews and Big Five personality inventories. The personality profile of high neuroticism, low agreeableness, and low conscientiousness was associated with all 4 addictive disorders. All but 1 of the pairwise associations between the disorders were significant. After accounting for Big Five traits, the associations were attenuated to varying degrees but remained significant. The results were generally similar for men and women. The results suggest that the Big Five traits of neuroticism, agreeableness, and conscientiousness are associated with the general propensity to develop an addictive disorder and may in part explain their co-occurrence; however, they may be more broadly associated with the propensity for any psychiatric disorder. The effect sizes of the personality associations suggest that the diagnosis of gambling disorder as operationalized by the DSM may be more severe than the other addictive disorders. Calibration of the diagnosis of gambling disorder to the other addictive disorders may be warranted. Article available from APA PsycNET $11.95

Reference: Dash, Genevieve F., Slutske, Wendy S., Martin, Nicholas G., Statham, Dixie J., Agrawal, Arpana, & Lynskey, Michael T. (2019). Big Five Personality Traits and Alcohol, Nicotine, Cannabis, and Gambling Disorder Comorbidity. Psychology of Addictive Behaviors, (16 May).

Problem gambling and psychiatric comorbidity—risk and temporal sequencing among women and men: Results from the Swelogs Case–Control Study [open-access article].

Abstract: It is well known that many problem gamblers also suffer from other psychiatric conditions. However, knowledge regarding the temporal sequencing of the conditions is lacking, as well as insight in possible gender specific patterns. The aim of this study was to examine the risk for psychiatric comorbidity among problem gamblers compared to non-problem gamblers in the general Swedish population, as well as the age of onset and the temporal sequencing of problem gambling and the comorbid psychiatric conditions among lifetime problem gamblers. A case–control study nested in the Swelogs cohort was used. For both the female and the male problem gamblers, the risk for having had a lifetime psychiatric condition was double or more than double compared to the controls. Having experienced anxiety or depression before gambling onset, constituted a risk for developing problem gambling for the women but not for the men. Further, the female cases initiated gambling after their first period of anxiety, depression and problems with substances, and problem gambling was the last condition to evolve. Opposite this, the male cases initiated gambling before any condition evolved, and depression and suicidal events emerged after problem gambling onset. There were large differences in mean age of onset between the female cases and their controls, this was not the case for the males. Gender specific patterns in the association between problem gambling and psychiatric comorbidity, as well as in the development of problem gambling needs to be considered in treatment planning as well as by the industry in their advertising. Article available online

Reference: Sundqvist, K. & Rosendahl, I. (2019).Problem gambling and psychiatric comorbidity—risk and temporal sequencing among women and men: Results from the Swelogs Case–Control Study. Journal of Gambling Studies. Retrieved from

The treatment of gambling disorder: A comprehensive (socio-psychological-neurobiological) explanation and therapy model?

Available online working paper made available via the Social Science Open Access Repository.

Summary: In this theoretical work, we present the clinical picture of pathological gambling, an etiological explanatory model and resulting therapeutic implications. Social, psychological and physiological factors are included. The “addiction model” also distinguishes between factors relevant to the onset and continuation of disturbed gambling behavior. Multifactorial causes must be postulated in the “entry phase” of the behavior. During the actual “addiction phase“, the self-perpetuating disturbed gambling behavior is characterized by a strong mental dependence and a nearly autonomously triggered addiction behavior (loss of control) associated with structural changes in the deeper brain areas of the „reward system“. There is an “irresistible urge” to continue gambling, upheld not least by a dominance of gambling behavior in the reward system and the accompanying dysfunction of this area of the brain.

At the beginning of therapy, the focus lies on the addictive behavior itself. The symptoms that developed last are the ones that are first incorporated into the therapy consideration, whereby the therapeutic goals are to be set in a certain order: (a) Motivation, withdrawal symptoms after the patient stopped gambling, (b) insight into the disease (do not deny further) and its acceptance, (c) consolidation of the abstinence through a treatment of the causes of disease development. Dependence means not having sufficient alternatives. The reconstruction of the reward system and the development of a wide range of varied alternatives are an important prerequisite for avoiding relapse and achieving a balanced and satisfied way of life. Eliminating the dominance of gambling in the reward system and strongly anchoring the desired potently rewardable alternatives in behavior is associated with significant psychological and physiological resistance. The adrenaline rush of gambling is not easily compensated and cannot be replaced with lukewarm water or realistic thinking. Problems of implementing desired behavioral changes have not yet been sufficiently taken into account and there is a lack of necessary research. Are there any obligatory treatment factors? Full article

Reference: Bachmann, M., Bachmann, A.A., & Frensemeier, S. (2019). The treatment of gambling disorder: A comprehensive (socio-psychological-neurobiological) explanation and therapy model? Retrieved from ssoar-61824-8