Neuropsychology in GD: old and new directions

Understanding the neuropsychological features in GD has implications for highlighting addictive mechanisms in the absence of potentially neurotoxic effects of drugs. Several recent meta-analyses both within GD groups as well as across addictive disorders are clarifying broad and unique characteristics through more careful control of demographic and comorbid features. Several neuropsychological studies are also beginning to highlight aspects of self-awareness in GD, including metacognition and interoceptive processes and how they may relate to cognitive distortions and decision-making. Neuropsychological features of gambling products, including ‘near-misses’ and ‘losses disguised as wins’, tap into contextual effects and conditioned win responses and serve as a type of nudging behaviour. More broadly, investigating the neuropsychology of GD and gambling features can help us understand how reward, risk and uncertainty affect the decision-making process.