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Chunk #40 — IMPULSIVITY AND DECISION-MAKING IN PATHOLOGICAL GAMBLING

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Recent research on impulsivity in individuals with drug use and mental health disorders: implications for alcoholism.
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In imaging terms, deciding to keep chase losses in an attempt to recover previous losses was associated with increased activity in the ventromedial prefrontal cortex (along the gyrus rectus) on the left, with further peaks in the subgenual cingulate cortex bilaterally (area 25). There is extensive evidence that neural activity in ventromedial prefrontal cortex codes the expectation of reward (Galvan et al., 2005; Knutson et al., 2005). It has also been argued that this activity reflects the representation of reward values for goal-directed actions (Hampton et al., 2006). The subgenual cingulate cortex has also been implicated in the aspects of reward processing, including the representation of strong appetitive states such as hunger (Tataranni et al., 1999), suggesting that this cortical area is also involved in the incentive-motivational aspects of chasing losses. Clinical research indicates that loss-chasing is sustained by the persistent, undeterred belief that winning outcomes are imminent (Ladouceur et al., 1996; Lesieur, 1977). Campbell-Meiklejohn and colleagues (2008)’s fMRI findings provide at least some evidence to support this claim.