Neurocognitive dysfunction in strategic and non-strategic gamblers

ObjectiveIt has been theorized that there may be subtypes of pathological gambling, particularly in relation to the main type of gambling activities undertaken. Whether or not putative pathological gambling subtypes differ in terms of their clinical and cognitive profiles has received little attention.MethodSubjects meeting DSM-IV criteria for pathological gambling were grouped into two categories of preferred forms of gambling - strategic (e.g., cards, dice, sports betting, stock market) and non-strategic (e.g., slots, video poker, pull tabs). Groups were compared on clinical characteristics (gambling severity, and time and money spent gambling), psychiatric comorbidity, and neurocognitive tests assessing motor impulsivity and cognitive flexibility.ResultsSeventy-seven subjects were included in this sample (45.5% females; mean age: 42.7 ± 14.9) which consisted of the following groups: strategic (n = 22; 28.6%) and non-strategic (n = 55; 71.4%). Non-strategic gamblers were significantly more likely to be older, female, and divorced. Money spent gambling did not differ significantly between groups although one measure of gambling severity reflected more severe problems for strategic gamblers. Strategic and non-strategic gamblers did not differ in terms of cognitive function; both groups showed impairments in cognitive flexibility and inhibitory control relative to matched healthy volunteers.ConclusionThese preliminary results suggest that preferred form of gambling may be associated with specific clinical characteristics but are not dissociable in terms of cognitive inflexibility and motor impulsivity.

► Non-strategic gamblers were significantly older, female, and divorced. ► Pathological gamblers had impairments in cognitive flexibility and inhibition. ► Cognitive function did not differ between strategic and non-strategic gamblers. ► Preferred gambling type might be more related to specific clinical characteristics.