Gambling-Related Psychological Predictors and Moderators of Attentional Bias Among Electronic Gaming Machine Players

Objective: Attentional biases (ABs) have been shown to develop in the context of substance use disorders. Relatively less focus has been paid toward the development of ABs in behavioral addictions such as gambling disorder (GD). Furthermore, the psychological predictors and moderators of AB in GD remain unknown. The present study addressed these empirical gaps. Methods: Fifty-two non-GD electronic gaming machine (EGM) players, 25 GD-EGM players, and 61 non-gamblers completed measures of gambling-related behaviors and cognitions (problem gambling severity, cravings, expectancies, motives) and substance use and mental health (alcohol use severity, depression symptoms). The relationships between these constructs and AB for EGM images were then assessed using a free-viewing eye-tracking paradigm. Results: Non-GD EGM players and GD-EGM players attended to EGM images significantly more than neutral images (with the largest AB for the EGM players with GD). For all EGM players, gambling expectancies regarding the negative emotional impact of gambling and alcohol use severity were associated with greater AB. For non-GD EGM players only, AB was moderated by the anticipation aspect of gambling craving and the self-enhancement aspect of gambling expectancies. Conclusion: The results provide further evidence that ABs develop in the context of excessive gambling and are associated with gambling and psychological variables. The findings support the incentive-salience theory of ABs in gambling and provide a rationale for the development of AB modification programs in the treatment of gambling disorder. Given the predominantly white sample, our results may not generalize to individuals of other ethnicities. Public Health Significance Statement This study shows that individuals with gambling disorder are more likely to attend to gambling-related cues than individuals without gambling disorder. Positive expectations associated with gambling and greater alcohol use are related to increases in the time spent attending to gambling-related images.