Executive functioning in Asian pathological gamblers

Two decades of neuropsychological research on predominantly Caucasian problem gamblers has unveiled significantly poorer performance on several domains of executive functioning (EF) relative to healthy controls. However, contradictory findings are widespread and evidence that pathological gamblers (PGs) are 'impaired' remains inconclusive. The study examined multiple facets of EF in 30 male, PGs seeking outpatient treatment in Singapore and 30 matched controls. CANTAB® tests of planning and organization/problem-solving, set-shifting, working memory and reflection impulsivity, were administered alongside the Barratt Impulsiveness Scale, Cognitive Failures Questionnaire and Dysexecutive Questionnaire. No significant group differences were found on any of the EF performance parameters, with performance falling in the healthy, unimpaired range for both groups. PGs did, however, report significantly greater impulsivity, everyday cognitive failures and symptoms of the dysexecutive syndrome. Exploratory analysis on a subgroup of PGs addicted to non-strategic gambling activities revealed poorer EF performance than among those addicted to strategic gambling activities. The findings suggest an absence of EF deficits despite higher trait impulsivity in Asian, predominantly strategic PGs. Hence, psychological interventions such as CBT and treatment approaches that emphasize the use of self-monitoring and informed decision-making to reduce impulsive behaviours should be suited to this population.