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Chunk #30 — 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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absolutely no useful information to guide ongoing play. Clark and colleagues (2009) devised a computerized slot-machine task that allowed the comparison of monetary wins, near-misses (where the reel stopped one position from the payline), and “full-misses.” Subjective ratings showed that near-misses were experienced as aversive (more unpleasant than full-misses) but increased the desire to continue with the game. In a second group of subjects who played the task during an fMRI scan, near-misses were observed to activate the ventral striatum, insula, medial prefrontal cortex that responded to monetary wins. Neuronal response to near-misses in the insula cortex predicted subjective effects of near-misses to encourage further play, and also predicted individual differences on a questionnaire measure of cognitive distortions (Clark et al., 2009).