Compulsivity-related neurocognitive performance deficits in gambling disorder: A systematic review and meta-analysis

• Published in: Neuroscience and biobehavioral reviews 2018-01, Vol.84, p.204-217
• Main Authors: van Timmeren, Tim, Daams, Joost G., van Holst, Ruth J., Goudriaan, Anna E.
• Format: Article
• Language: English
• Subjects: Addiction; Cognitive flexibility; Cognitive switching; Contingency learning; Dimensional psychiatry; Executive functions; Intra-extra dimensional set-shift; Pathological gambling; Reversal learning; Stroop task; Trail making task; Wisconsin card sorting task
• ISSN: 0149-7634; 1873-7528
• DOI: 10.1016/j.neubiorev.2017.11.022

•Compulsivity is thought to be a central construct of gambling disorder.•However, it is unclear if this is reflected by aberrant compulsivity-related neurocognitive functioning.•To synthesize research evidence, we conducted a systematic review and meta-analysis.•We identified 30 studies testing compulsivity-related neuropsychological functions.•Meta-analyses revealed performance deficits in individuals with gambling disorder vs healthy controls. Compulsivity is a core feature of addictive disorders, including gambling disorder. However, it is unclear to what extent this compulsive behavior in gambling disorder is associated with abnormal compulsivity-related neurocognitive functioning. Here, we summarize and synthesize the evidence for compulsive behavior, as assessed by compulsivity-related neurocognitive tasks, in individuals with gambling disorder compared to healthy controls (HCs). A total of 29 studies, comprising 41 task-results, were included in the systematic review; 32 datasets (n = 1072 individuals with gambling disorder; n = 1312 HCs) were also included in the meta-analyses, conducted for each cognitive task separately. Our meta-analyses indicate significant deficits in individuals with gambling disorder in cognitive flexibility, attentional set-shifting, and attentional bias. Overall, these findings support the idea that compulsivity-related performance deficits characterize gambling disorder. This association may provide a possible link between impairments in executive functions related to compulsive action. We discuss the practical relevance of these results, their implications for our understanding of gambling disorder and how they relate to neurobiological factors and other ‘disorders of compulsivity’.