Reaction to near misses and full losses in individuals experiencing gambling problems

Near misses are negative gambling outcomes that are close to the desired win. Previous research has shown that individuals experiencing gambling problems (PG) cognitively process these events differently than normal controls. Especially reward-related brain areas have been shown to exhibit abnormal activation patterns in PG. The current study aims at investigating group differences between individuals experiencing gambling problems and normal controls during near misses and full loss experiences. It also tests risky decisions immediately after these gambling outcomes as revealed by fMRI methods using a “wheel-of-fortune” paradigm. Additionally, behavioral measures were taken. Group differences were observed in prefrontal areas that have previously been associated with reward, conflict, and response inhibition, as well as in the amygdala and in the putamen. While individuals experiencing gambling problems consistently showed stronger brain responses to the feedback categories of full losses compared to near misses, controls showed the opposite pattern. During decisions to continue gambling or quit a trial, PGs showed stronger brain responses in reward-related orbitofrontal areas and reported a stronger urge to gamble on. Gambling scores measured by questionnaires corroborated this specific activation pattern in decisions to gamble on. Taken together, the results might indicate that individuals experiencing gambling problems experience enhanced conflict, impaired inhibition, and increased reward anticipation after near misses.