Emotional Divergence Across Gambling Severity: A Multimodal Study Combining Behavior and Resting-State fMRI

Objective To investigate the relationship between gambling severity and emotional experience during gambling, and its neural basis. Methods Behavioral assessments were conducted on 111 participants (using the Problem Gambling Severity Index (PGSI) to assess severity and the The Positive and Negative Affect Schedule (PANAS) to assess emotions during gambling). Subsequently, 34 participants (low-risk group: PGSI ≤ 4, n = 15; high-risk group: PGSI > 4, n = 19) underwent resting-state functional magnetic resonance imaging (fMRI) scans. Results Behavioral level: PGSI's impact on emotional experience exhibited a threshold effect at a score of 4. No significant association was found within the low-risk group (PGSI ≤ 4), whereas within the high-risk group (PGSI > 4), emotional experience significantly worsened as PGSI increased. Emotional dominance: Significant positive emotional dominance was observed when PGSI < 8. At PGSI ≥ 8, this dominance weakened and disappeared, but negative emotional dominance did not emerge. Neural level: The high-risk group exhibited significantly reduced functional connectivity in the left frontopolar cortex/paracingulate gyrus (BA10). Brain-behavior relationship: A significant positive correlation between functional connectivity in this brain region and emotional experience was observed only in the low-risk group; this association disappeared in the high-risk group, indicating a "decoupling" between brain function and behavior. Conclusion A PGSI score of 4 is a critical behavioral threshold for the deterioration of emotional experience during gambling. This transition is associated with reduced functional integrity of the left prefrontal emotion regulation network and its decoupling from behavior, and the emotional deterioration does not shift to a state dominated by negative emotion.