Decision-making during gambling: an integration of cognitive and psychobiological approaches
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Department of Experimental Psychology, Behavioural and Clinical Neuroscience Institute, University of Cambridge
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Downing Street, Cambridge CB2 3EB
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UK
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Decision-making during gambling: an
integration of cognitive and
psychobiological approaches
Luke Clark*
Gambling is a widespread form of entertainment that may afford unique insights into the interaction
between cognition and emotion in human decision-making. It is also a behaviour that can become
harmful, and potentially addictive, in a minority of individuals. This article considers the status of
two dominant approaches to gambling behaviour. The cognitive approach has identified a number
of erroneous beliefs held by gamblers, which cause them to over-estimate their chances of winning.
The psychobiological approach has examined case-control differences between groups of
pathological gamblers and healthy controls, and has identified dysregulation of brain areas linked to reward
and emotion, including the ventromedial prefrontal cortex (vmPFC) and striatum, as well as
alterations in dopamine neurotransmission. In integrating these two approaches, recent data are discussed
that reveal anomalous recruitment of the brain reward system (including the vmPFC and ventral
striatum) during two common cognitive distortions in gambling games: the near-miss effect and
the effect of personal control. In games of chance, near-misses and the presence of control have
no objective influence on the likelihood of winning. These manipulations appear to harness a
reward system that evolved to learn skill-oriented behaviours, and by modulating activity in this
system, these cognitive distortions may promote continued, and potentially excessive, gambling.
1. INTRODUCTION
The term gambling refers to a form of entertainment
where a wager, typically a sum of money, is placed
on the uncertain prospect of a larger monetary
outcome. As a form of recreation, gambling has been
widespread for several centuries, and across many
cultures (Raylu & Oei 2004b). The 2007 British
Gambling Prevalence Survey found that 68 per cent
of respondents reported gambling at least once in the
past year, and 48 per cent reported gambling on
games other than the state lottery (Wardle et al.
2007). To economists and psychologists, the
popularity of gambling represents an enduring paradox, as the
vast majority of gamblers are well aware of the popular
saying the house always wins. This refers to the fact
that gambling odds are carefully arranged to ensure a
steady profit for the bookmaker, casino or slot machine;
something that can only be achieved at the expense of the
gambler. In economic terms, the expected value of
gambling is negative, such that an accumulating debt is
inevitable over a large number of trials. Thus, the
widespread tendency to accept such gambles may provide
some useful insights into the mechanisms of human
irrationality. However, in addition to the financial
considerations, it is probable that gambling is also
One contribution of 12 to a Theme Issue Rationality and emotions.
motivated by cognitive and emotional factors.
Unpredictable monetary wins are a potent form of positive
reinforcement that strengthen the instrumental response.
Gambling is associated with physiological arousal that is
manifested in heart rate increases and elevated cortisol
levels (Anderson & Brown 1984; Meyer et al. 2004).
Environmental cues (e.g. flashing lights, the chime of
coins) that are associated with this arousal become
conditioned stimuli via Pavlovian processes. Gambling may
also serve to alleviate unpleasant states of boredom,
anxiety or low mood (i.e. negative reinforcement).
These emotional learning mechanisms will play a key
role in shaping gambling behaviour (Blaszczynski &
Nower 2002).
Gambling is also a behaviour that can spiral out of
control in some individuals. As gambling becomes
excessive, there are observable harms including debt,
illegal activity and interpersonal conflict. In its most
extreme form, pathological gambling is a recognized
psychiatric diagnosis in the Diagnostic and statistical
manual, version 4 (text revision) (DSM-IV-TR;
American Psychiatric Association 2000), with a
prevalence of around 1 per cent (Petry et al. 2005). The
severity of gambling involvement is thought to lie on
a continuum, and the label of problem gambling
is used to denote the less severe form. The US
prevalence of problem gambling is estimated
between 1 and 4 per cent (Shaffer et al. 1999; Welte
et al. 2002).
320 L. Clark Review. Decision-making during gambling
The current psychiatric system places pathological
gambling within the impulse control disorders, a
heterogeneous rag-bag of conditions that also includes
kleptomania (compulsive stealing) (...truncated)