To play or not to play: A personal dilemma in pathological gambling

• We investigated changes in loss aversion and personality traits between pathological gamblers (PG) and non-PG (NG).
• We used true PG, at the earlier (ETG) and later stage (LTG) of clinical treatment.
• LTG showed a lower willingness to gamble and a higher loss aversion than ETG and NG.
• Both LTG and ETG scored higher than NG in personality traits related to impulsivity.
• Only changes in loss aversion are associated with the time course of pathology.

Research has shown that healthy people would rather avoid losses than gamble for even higher gains. On the other hand, research on pathological gamblers (PGs) demonstrates that PGs are more impaired than non-pathological gamblers in choice under risk and uncertainty. Here, we investigate loss aversion by using a rigorous and well-established paradigm from the field of economics, in conjunction with personality traits, by using self-report measures for PGs under clinical treatment. Twenty pathological gamblers, at the earlier and later stages of clinical treatment, were matched to 20 non-gamblers (NG). They played a “flip coin task” by deciding across 256 trials whether to accept or reject a 50–50 bet with a variable amount of gains and losses. They completed questionnaires aimed at assessing impulsivity. Compared to NG, pathological gamblers, specifically those in the later stages of therapy, were more loss averse and accepted a lower number of gambles with a positive expected value, whereas their impulsivity traits were significantly higher. This study shows for the first time that changes in loss aversion, but not in personality traits, are associated with the time course of pathology. These findings can be usefully employed in the fields of both gambling addiction and decision-making.