Executive Functioning in Gambling Disorder: Cognitive Profiles and Associations with Clinical Outcomes

Gambling disorder shares neurobiological and clinical symptoms with substance use disorders; however, it remains unclear if they share executive functioning deficits that compromise gambling treatments. In this review article, findings from the resurgence in clinical and cognitive neuroscience studies in the past 3 years are considered and their role in clinical decision-making re-appraised. In contrast to early findings, novel studies are suggestive of preserved general executive functions (i.e. working memory, planning, rule shifting), but lend further support for deficits of response inhibition, reward-related switching and value-based decision-making, although evidence of their impact on treatment outcome remains limited. The hallmark characteristic of disordered gambling “cognitive impulsivity” may reflect an underlying core alteration in value coding. Increased attention to wins and blunted attention to losses may serve to maintain maladaptive gambling behaviours (e.g. loss chasing), thus the effectiveness of interventions targeting faulty brain value systems (e.g. cognitive bias modification) warrants investigation with this population.