Luck, come here! Automatic approach tendencies toward gambling cues in moderate- to high-risk gamblers

Abstract

Background and aims Similar to substance addictions, reward-related cognitive motivational processes, such as selec-tive attention and positive memory biases, have been found in disordered gambling. Despite findings that individuals withsubstance use problems are biased to approach substance-related cues automatically, no study has yet focused on auto-matic approach tendencies for motivationally salient gambling cues in problem gamblers. We tested if moderate- tohigh-risk gamblers show a gambling approach bias and whether this bias was related prospectively to gambling behaviourand problems. Design Cross-sectional assessment study evaluating the concurrent and longitudinal correlates of gam-bling approach bias in moderate- to high-risk gamblers compared with non-problem gamblers. Setting Online studythroughout the Netherlands. Participants Twenty-six non-treatment-seeking moderate- to high-risk gamblers and 26non-problem gamblers community-recruited via the internet. Measurements Two onlineassessment sessions 6 monthsapart, including self-report measures of gambling problems and behaviour (frequency, duration and expenditure) and thegambling approach avoidance task, with stimuli tailored to individual gambling habits. Findings Relative to non-problem gamblers, moderate- to high-risk gamblers revealed a stronger approach bias towards gambling-related stimulithan neutral stimuli (P= 0.03). Gambling approach bias was correlated positively with past-month gambling expenditureat baseline (P= 0.03) and with monthly frequency of gambling at follow-up (P= 0.02). In multiple hierarchical regres-sions, baseline gambling approach bias predicted monthly frequency positively (P= 0.03) and total duration of gamblingepisodes (P= 0.01) 6 months later, but not gambling problems or expenditure. Conclusions In the Netherlands, relativeto non-problem gamblers, moderate- to high-risk gamblers appear to have a stronger tendency to approach rather than toavoid gambling-related pictures compared with neutral ones. This gamblingapproach bias is associated concurrently withpast-month gambling expenditure and duration of gambling and has been found to predict persistence in gambling behaviour over time.