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Personality and Individual Differences 52 (2012) 390–394

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Personality and Individual Differences

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Effects of , sensitivity, and cognitive style on Pathological symptoms among frequent players ⇑ Vance V. MacLaren , Jonathan A. Fugelsang, Kevin A. Harrigan, Michael J. Dixon

Department of Psychology, University of Waterloo, Problem Gambling Lab, 200 University Avenue West, Waterloo, Ontario, Canada N2L 3G1 article info abstract

Article history: Pathological Gambling (PG) is the inability to resist recurrent urges to gamble excessively despite harmful Received 30 April 2011 consequences to the gambler or others. A cognitive-behavioral Pathways Model of PG (Blaszczynski & Received in revised form 10 October 2011 Nower, 2002) suggests individual differences in rash impulsivity and reward sensitivity, together with a Accepted 26 October 2011 cognitive style that promotes poor decision making, as risk factors. These individual differences were exam- Available online 17 November 2011 ined in a community sample of experienced slot machine players (N = 100), who were classified into Low, Moderate, and Problem gambling groups according to the Problem Gambling Severity Index (Ferris & Wyn- Keywords: ne, 2001). There were significant group differences on rash impulsivity as measured by the Eysenck Impul- Gamblers sivity scale, and on reward sensitivity as measured by the BIS/BAS Drive scale. For cognitive style, there were Pathological Gambling Pathways Model differences on Actively Openminded Thinking (AOT), but not the Rational Experiential Inventory. Hierarchi- Cognitive style cal regression analyses found that impulsivity and AOT predicted severity of PG, but that AOT mediated the Impulsivity effect of BAS Drive. A thinking style that promotes erroneous cognition may correlate with PG, but individ- Reinforcement sensitivity ual differences in rash impulsivity and reward-seeking play a more critical role in the etiology of PG. The individual characteristics of Pathological Gamblers are similar to those of people with Substance Use Disorders. Ó 2011 Elsevier Ltd. All rights reserved.

1. Introduction losses. This is due to faulty decision making that leads to desperate ‘‘chasing’’ of lost money: Pathological Gambling (PG) is the inability to resist recurrent urges to gamble excessively despite harmful consequences to the As the frequency of gambling increases, strong biased and dis- gambler or others. The most influential account of the phenome- torted cognitive schemas appear. These schemas shape beliefs non is the Pathways Model of Problem and Pathological Gambling surrounding attribution, personal skill and control over out- (Blaszczynski & Nower, 2002). According to this theory, ‘‘Operant come, biased evaluations, erroneous perceptions, superstitious conditioning occurs when intermittent wins delivered on a vari- thinking and probability theory. The potency and pervasiveness able ratio produce states of arousal often described as equivalent of distorted and irrational cognitive belief structures strengthen to a drug induced high.’’, and once the habit of gambling is ac- with increasing levels of involvement in gambling (p. 491). quired, ‘‘Attempts to resist completing the habit provoke a state of aversive arousal experienced as a drive, compulsion or urge to Thus, the Pathways Model proposes two distinct phases of PG: an carry out the behavior.’’ (p. 491). This learning mechanism implies acquisition phase marked by habit formation through conditioning, that clinical PG symptoms should be increased among people who and a maintenance phase characterized by irrational decision-mak- gamble frequently, who are motivated strongly by the excitement ing. The focus of the present paper is on individual differences in per- of winning, and who have weak control over their compulsion to sonality and cognitive style that may elevate vulnerability to clinical gamble excessively. Disinhibition of the gambling habit involves PG symptoms among people who gamble frequently. It was pre- both reward seeking and rash impulsivity, and in this regard the dicted that PG symptoms would be positively correlated with re- Pathways Model is consistent with the 2-Component Approach ward sensitivity and impulsivity because those traits should to Reinforcing Substances model of (Gullo, Ward, Dawe, facilitate acquisition, and be negatively correlated with a rational Powell, & Jackson, 2011). cognitive style necessary for effective decision-making. The Pathways Model also proposes a complex set of cognitive mechanisms that promote persistent gambling despite recurring 1.1. The personality of Pathological Gamblers

⇑ Corresponding author. Tel.: +1 (519) 888 4567x37181. The personality of Pathological Gamblers is characterized by E-mail address: [email protected] (V.V. MacLaren). Negative Affective and Disinhibitory traits, including facets of

0191-8869/$ - see front matter Ó 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.paid.2011.10.044 V.V. MacLaren et al. / Personality and Individual Differences 52 (2012) 390–394 391 impulsivity (MacLaren, Fugelsang, Harrigan, & Dixon, 2011). This than nonproblem gamblers on a subset of 8 items from the REI Ra- combination may form an externalizing dimension of psychopa- tional scale. The Pathological Gamblers also scored higher on the thology (Markon, Krueger, & Watson, 2005; Widiger, 2011) that Eysenck Impulsivity scale (I7; Eysenck, Pearson, Easting, & Allsopp, may be expressed as PG, as Substance Use Disorders (Kotov, Ga- 1985), and lower on the Consideration of Future Consequences mez, Schmidt, & Wilson, 2010), and in other behaviors that reflect scale (CFC; Strathman, Gleicher, Boninger, & Edwards, 1994), Antisocial or Borderline features (Samuel & Widiger, 2008). These which measures delay nondiscounting. meta-analytic findings are consistent with the Pathways Model in its assertion of a specific subtype of ‘‘Antisocial Impulsivist’’ 1.3. The present study Pathological Gambler with elevated risk compared to those who are merely ‘‘Behaviorally Conditioned’’ but without personality Rash impulsivity and reward sensitivity are separate traits (Milosevic & Ledgerwood, 2010). (Cross, Copping, & Campbell, 2011) that have independent effects Impulsive antisociality is a dimension of psychopathy (Ross, on PG (Loxton et al., 2008). Although Toplak et al. (2007) found ef- Benning, Patrick, Thompson, & Thirston, 2009), which reflects the fects of cognitive style and rash impulsivity, the placement of re- maladjustment of brain systems that control learning to seek re- ward sensitivity within the constellation of cognitive style and wards and to fear punishments (Corr, 2010; Fowles, 1988; Lykken, impulsive traits has not been characterized among frequent gam- 1995). According to the Reinforcement Sensitivity Theory of per- blers. We examined rash impulsivity and reward sensitivity along sonality (RST; Gray & McNaughton, 2000), the neuropsychological with cognitive style as predictors of PG symptoms in a community substrate of excessive reward seeking is the Behavioral Approach sample of people who were at risk for PG because they play slot System (BAS), which consists of the mesolimbic and mesocortical machines frequently. dopaminergic systems (Gray & McNaughton, 2000). The Fight- Flight-Freeze and Behavioral Inhibition Systems (BIS) mediate affective and behavioral responses to threat and response conflict, 2. Method and include the amygdala and septo-hippocampal structures. Exposure to unusually powerful sources of reward (e.g. winning 2.1. Participants large prizes) may sensitize the BAS and feedback positively into a compulsive pattern of (Koob & Le Moal, 2008; Participants were 50 men and 50 women aged 19–82 years Robinson & Berridge, 2000). (M = 38.7, SD = 15.96). They were recruited using advertisements Reward sensitivity is a critical component of disinhibition in PG. on a local classified advertisements website that requested ‘‘expe- In student samples, BAS Drive (Carver & White, 1994) correlates rienced slots players who gamble at least twice a month’’. To insure positively with time and money spent gambling (O’Connor, Stew- equivalent numbers of men and women with Low, Moderate, and art, & Watt, 2009), and Sensitivity to Reward (Torrubia, Avila, Mol- Problem gambling symptoms, 29 community respondents who to, & Caseras, 2001) correlates positively with PG symptoms had recently participated in a separate experiment in our lab were (Mercer & Eastwood, 2010). Clinical studies of Pathological Gam- invited to also be in the present study. According to scores on the blers have found higher BAS (Goudriaan, Oosterlaan, deBeurs, & PGSI, the sample included 33 Low gamblers, 33 Moderate gam- van den Brink, 2006), and Sensitivity to Reward (Loxton, Nguyen, blers, and 34 Problem gamblers. Casey, & Dawe, 2008) compared to nonpathological gamblers. In experimental studies, high BAS predicts risky decision-making 2.2. Procedure (Franken & Muris, 2005; Suhr & Tsanadis, 2007) in the Iowa Gam- bling Task (Bechara, Damasio, Damasio, & Lee, 1999) and on a com- All procedures were approved by the University of Waterloo Of- puterized dice game (Kim & Lee, 2011), as well as higher wagers on fice of Research Ethics. After reading a detailed explanation of the simulated slot machines (Brunborg, Johnsen, Mentzoni, Molde, & study and signing a declaration of informed consent, participants Pallesen, 2011; Demaree, DeDonno, Burns, & Everhart, 2008). individually completed self-report measures of PG symptoms, per- sonality and cognitive style. Participants also played a slot machine 1.2. The cognition of Pathological Gamblers for up to 40 min, but results of the slot machine task will be reported elsewhere. Participants were paid $20, plus a bonus of up to $60 Distorted cognitions are common among Pathological Gamblers depending on their performance on the slot machine task. In debrief- (Joukhador, MacCallum, & Blaszczynski, 2003). They may easily re- ing, participants were given a pamphlet explaining the symptoms of call wins because of an availability heuristic (Tversky & Kahneman, PG, and those with CPGI scores indicating Moderate or Problem 1974a), they may fail to deliberately weigh the probability of win- gambling were given brochures from two local addiction treatment ning against the risk of losing (Fletcher, Marks, & Hine, 2011), and service providers and encouraged to seek treatment. they may misattribute winning to personal skill because they have an illusion of control (Langer, 1975). Reliance on such cognitive heuristics and biases is a trait-like characteristic (Epstein, Pacini, 2.3. Materials Denes-Raj, & Heier, 1996) that is separate from general cognitive ability (West, Toplak, & Stanovich, 2008). Cognitive style ranges 2.3.1. Problem Gambling Severity Index from a rational, logical and fact-based thinking style to one that The PGSI (Ferris & Wynne, 2001) is widely used in the clinical is intuitive, emotional and heuristic. Cognitive style can be mea- assessment of PG. The 9 items concerned the following PG symp- sured using the Rational Experiential Inventory (REI; Pacini & Ep- toms: exceeding spending limits, increasing expenditures, chasing stein, 1999), or the Actively Openminded Thinking test (AOT; losses, incurring debt or selling possessions, self-identification as a Stanovich & West, 2008). problem gambler, criticism from others about gambling, feelings of The role played by cognitive style in PG has been directly tested guilt, health problems from gambling, and financial insufficiency. in two studies. Emond and Marmurek (2010) found that Patholog- Items were rated on a 4-point Likert scale: never (0), sometimes ical Gamblers had higher scores on a measure of erroneous gam- (1), most of the time (2), almost always (3). Missing scores were gi- bling cognitions and lower scores on the REI Rational scale than ven a value of 0 (0.7% of questions). Participants were classified nonproblem gamblers. Toplak, Liu, MacPherson, Toneatto, and into one of three levels of gambling severity according to their total Stanovich (2007) found lower scores among Pathological Gamblers scores: those with a score of 0–2 were classified as ‘Low’ gamblers, 392 V.V. MacLaren et al. / Personality and Individual Differences 52 (2012) 390–394 those with a score of 3–7 as ‘Moderate’ gamblers, and those with a There were complex intercorrelations among the personality score of 8–27 as ‘Problem’ gamblers. Cronbach’s a was .90. and cognitive style scales. To examine their unique contributions to PG severity, the continuous PGSI scores were regressed onto 2.3.2. Eysenck Impulsivity questionnaire age and sex, followed by the 10 scales. The overall regression equa- 2 tion was significant, (F(12,81) = 4.38, p < .001, R = .39), with I7 The Eysenck Impulsivity scale, version 7 (I7; Eysenck et al., 1985) is a widely used measure of rash impulsiveness. The 19 (b = .43, t = 3.51, p = .001), and AOT (b = À.32, t = 3.33, p=.001) items were endorsed by circling Yes or No. Total scores were di- accounting for unique variance. The only other predictor that ap- vided by the number of scored items to eliminate missing values proached significance was BAS Drive (b = .21, t = 1.81, p=.074). Be- (0.3% of questions). Cronbach’s a was .85. cause of the high degree of intercorrelation among the measures of personality and cognitive style, two secondary regression analyses were carried out to test for mediation effects. 2.3.3. BIS/BAS scales To examine the possible mediation of other predictors by AOT, The BIS/BAS scales (Carver & White, 1994) measure the sensitiv- we repeated the above regression analysis, but did not include AOT ity of behavioral approach and avoidance systems. The BAS items as a predictor. PGSI was regressed onto age and sex, followed by measure Reward Responsiveness (5 items), Drive (4 items), and the remaining 9 scales. This second regression equation was signif- Funseeking (4 items). In keeping with revised RST (McNaughton 2 icant, F(11,82) = 3.35, p=.001, R = .31), with I7 (b = .48, t = 3.66, & Corr, 2008), the BIS scale was divided into separate subscales p < .001) and BAS Drive (b = .28, t = 2.38, p=.020) accounting for measuring Fear (4 items) and Anxiety (3 items) following Heym, unique variance. Because both Drive and AOT correlate signifi- Ferguson, and Lawrence (2008). Items were rated on a 4-point Lik- cantly with each other and with PGSI, and because Drive was a sig- ert scale: (1) strongly disagree, (2) disagree, (3) agree, (4) strongly nificant predictor of PGSI only when AOT was not simultaneously agree. Total scores were divided by the number of scored items to entered, it appears that the nonsignificant effect of Drive on PGSI eliminate missing values (1.4% of questions). Cronbach’s for Re- a in the first regression was due to mediation of its effect by AOT ward, Drive, Funseeking, Fear and Anxiety was .82, .85, .91, .59, (Baron & Kenny, 1986). Together with the null effects of REI Ra- and .64, respectively. tional, this pattern indicates that the hypothesized contribution of cognitive style to PG is not supported. 2.3.4. Rational Experiential Inventory We similarly tested for mediation effects involving impulsivity. The REI (Pacini & Epstein, 1999) measures analytical-rational Here PGSI was regressed onto age and sex, followed by the remaining and intuitive-experiential cognitive styles. The 20 items of each 9 scales. This third equation was significant (F(11,82) = 3.21, dimension were rated on 5-point Likert scales: (1) definitely not p=.001, R2 = .30), with only AOT (b = À.36, t = 3.49, p=.001) true of myself, (2) somewhat not true of myself, (3) may be true accounting for unique variance. The only other predictor that ap- or not true of me, (4) somewhat true of myself, (5) definitely true proached significance was BAS Drive (b = .23, t = 1.89, p=.062). This of myself. Total scores were divided by the number of scored items shows that the effect of I7 on PGSI in the first regression did not medi- to eliminate missing values (2.2% of questions). Cronbach’s a of the ate the effect of any of the other variables. Rational and Experiential scales was .92 and .95 respectively.

2.3.5. Actively Openminded Thinking test 4. Discussion The AOT (Stanovich & West, 2008) measures the tendency to- ward novel versus conservative thinking and is conceptually simi- Individual differences in traits representing approach motiva- lar to the REI Rational scale. The 41 items were rated on 6-point tion (i.e. BAS Drive) and (i.e. I7) systems were Likert scales ranging from (1) disagree strongly to (6) agree the best predictors of clinical PG symptoms among frequent slot strongly. Total scores were divided by the number of scored items machine gamblers. This is consistent with the 2-CARS model of to eliminate missing values (1.3% of questions). Cronbach’s a was personality characteristics (Gullo et al., 2011) that may reflect .91. neurobiological mechanisms of addiction (George & Koob, 2010). The Negative Affective and Disinhibitory traits of Pathological Gamblers (MacLaren et al., 2011) are similar to those who have 2.3.6. Consideration of future consequences scale Substance Use Disorders (Kotov et al., 2010), and there appear to The CFC (Strathman et al., 1994) is a self-report measure of de- be common biological substrates that support these addictive dis- lay nondiscounting in which respondents consider distant versus orders (van Holst, van den Brink, Veltman, & Goudriaan, 2010; Zack immediate consequences of potential behaviors. The 12 items were & Poulos, 2009). rated on a 5-point Likert scale: (1) extremely uncharacteristic of The Pathways Model suggests a central role for poor critical me, (2) uncharacteristic of me, (3) somewhat characteristic of thinking (i.e. low REI Rational or AOT scores) in the maintenance me, (4) characteristic of me, (5) extremely characteristic of me. To- of PG behavior, but the results of the present study call this crucial tal scores were divided by the number of scored items to eliminate element of the theory into question. We found null effects of REI Ra- missing values (0.8% of questions). Cronbach’s a was .84. tional, and a spurious effect of AOT that was due to its mediation of BAS Drive. As for delay nondiscounting, the CFC scale appears to 3. Results have tapped a well-established role of impulsivity in PG, since it

was negatively correlated with I7 and those scales had an inverse As shown in Table 1, the Problem group had higher I7 and lower pattern of correlations with other measures. The lack of an effect AOT scores than the Low and Moderate groups. The Problem group of REI Rational, which is contrary to the findings of Emond and Mar- also had higher BAS Drive than the Low group. Importantly, the murek (2010) and Toplak et al. (2007), might have been due to range groups did not differ on the REI Rational scale. As shown in Table restriction caused by the inclusion of only high frequency slot ma-

2, continuous PGSI scores were correlated positively with I7, BAS chine gamblers in our sample. The correlation between REI Rational Drive and Funseeking, and BIS Fear. PGSI scores were also corre- and PG might also be attenuated because REI Rational correlates lated negatively with CFC and AOT, but not with REI Rational. negatively with Neuroticism (Pacini & Epstein, 1999), which is ele- The null results for REI Rational are contrary to predictions from vated in PG (MacLaren et al., 2011) and is conceptually related to the Pathways Model. BIS (Smillie, Pickering, & Jackson, 2006). In our sample, REI Rational V.V. MacLaren et al. / Personality and Individual Differences 52 (2012) 390–394 393

Table 1 Characteristics of Low, Moderate, and Problem gamblers.

Gambling severity group Low Moderate Problem FpSignificant contrasts PGSI 1.03 (0.81) 4.24 (1.35) 12.97 (4.15) 182.97 <.001 L < M; L < P; M < P

I7 0.34 (0.22) 0.39 (0.22) 0.60 (0.22) 9.88 <.001 L < P; M < P CFC 3.20 (0.49) 3.20 (0.56) 3.01 (0.56) 1.24 .295 BAS Reward 3.28 (0.38) 3.28 (0.35) 3.41 (0.44) 0.50 .607 BAS Drive 2.39 (0.59) 2.57 (0.58) 2.94 (0.72) 4.06 .020 L < P BAS Funseeking 2.79 (0.44) 2.89 (0.56) 3.06 (0.61) 0.87 .422 BAS Total 2.86 (0.34) 2.95 (0.37) 3.17 (0.52) 2.62 .078 BIS Fear 2.75 (0.52) 2.86 (0.38) 2.94 (0.64) 1.05 .354 BIS Anxiety 2.76 (0.45) 2.70 (0.55) 2.89 (0.49) 1.38 .257 BIS Total 2.75 (0.44) 2.77 (0.44) 2.91 (0.50) 1.26 .288 REI Rational 3.51 (0.56) 3.64 (0.66) 3.41 (0.65) 1.06 .351 REI Experiential 3.52 (0.54) 3.61 (0.53) 3.50 (0.56) 0.77 .467 AOT 4.31 (0.50) 4.19 (0.47) 3.82 (0.55) 8.39 <.001 L > P; M > P

Note: Oneway ANCOVAs were conducted with age and sex as covariates. Significant contrasts are Bonferroni corrected t tests between among Low (L), Moderate (M), and Problem (P) groups with overall p < .05.

Table 2 Correlations among predictors of problem gambling severity scores.

Predictors of PGSI gambling severity 12345678910 1. PGSI ** 2. I7 .47 3. CFC À.21* À.40** 4. BAS Reward .16 .29* À.12 5. BAS Drive .33** .36** À.13 .52** 6. BAS Funseeking .24* .58** À.27* .51** .50** 7. BIS Fear .22* .24* À.11 .29** .18 .16 8. BIS Anxiety .17 .10 À.01 .36** .10 .03 .63** 9. REI Rational À.14 À.40** .46** .06 .03 À.12 À.21* À.26** 10. REI Experiential À.04 .00 .02 .09 .01 .14 À.13 À.09 .14 11. AOT À.39** À.21* .28* À.07 À.23* À.01 À.22* À.17 .25* .16

* p < .05. ** p < .001. was negatively correlated with both subscales of BIS and with I7, something understandable to them. Gambling behavior acquired which may have contributed to the null effects of REI Rational on on a variable reinforcement schedule typical of slot machines, PGSI. Sensitivity to both reward and punishment may be important where the occurrence and magnitude of wins are both unpredict- in PG, as gamblers derive arousal not only from the anticipation of able, is likely to be persistent no matter what gamblers may think winning, but also from the fear of losing (McNaughton & Corr, 2009). (Skinner, 1953). To our knowledge, there is insufficient evidence Pathological Gamblers often have a bizarre understanding of that erroneous gambling cognitions precede and cause Pathological the games they play and why they play them. These cognitions Gambling. The present study has shown that Pathological Gam- are often situational and individual gamblers may simultaneously blers do not inherently tend toward faulty thinking. Happily, the hold beliefs that are not logically coherent. For instance, a gambler lack of a deficiency in cognitive style among Pathological Gamblers might continue betting after a series of losing outcomes and accept suggests that cognitive-behavioral interventions should be no less the gambler’s fallacy, the belief that a winning outcome must be effective for PG than for other forms of psychopathology. imminent because the preceding series of losses is unlikely to con- tinue even though the outcomes are independent (Tversky & Kahn- Acknowledgment eman, 1974b). Alternatively, a gambler might continue betting after a series of winning outcomes and accept the hot hand fallacy, This research was supported by the Ontario Problem Gambling the belief that winning outcomes will continue because they are on Research Center. a lucky streak (Gilovich, Vallone, & Tversky, 1985). By carefully observing the betting behavior of casino roulette players, Sundali and Croson (2006) found that the same players who act according References to one such fallacy are also likely to accept the other fallacy if they have different outcomes. The sad reality is that gamblers persist Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research – Conceptual, strategic, and statistical because they crave the reward associated with winning, or at least considerations. Journal of Personality and Social Psychology, 51, 1173–1182. a temporary respite from the punishment of recurring losses Bechara, A., Damasio, H., Damasio, A. R., & Lee, G. P. (1999). Different contributions (McNaughton & Corr, 2009). Their wish that a win is due or that of the human amygdala and ventromedial prefrontal cortex to decision-making. Journal of Neuroscience, 19, 5473–5481. they are on a winning streak is immaterial to the fact that all Blaszczynski, A., & Nower, L. (2002). A pathways model of problem and pathological games of chance are structured around a variable schedule of rein- gambling. Addiction, 97, 487–499. forcement, with winnings that average less than the wagers. Brunborg, G. S., Johnsen, B. H., Mentzoni, R. A., Molde, H., & Pallesen, S. (2011). Individual differences in evaluative conditioning and reinforcement sensitivity Superstitious beliefs may be created by Pathological Gamblers affect bet-size during gambling. Personality and Individual Differences, 50, who are desperate to attribute their incongruous behavior to 729–734. 394 V.V. MacLaren et al. / Personality and Individual Differences 52 (2012) 390–394

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