Presentations March 2015

[email protected] Problem gambling is substantially comorbid with attention-deficit hyperactivity disorder (ADHD). Elucidation of the underlying link between these two conditions is likely to catalyze novel strategies for treatment and diagnosis of gambling problems. In this study, a simplified computerized version of the Iowa Gambling Task (IGT) was used to assess differences in reinforcement-driven choice adaptation among subjects with pathological gambling and/or ADHD. The task contained two choice options with different net payouts over the session; a ‘good bet’ that resulted in a win of +50 points on 60% of trials (and -50 points on 40%), and a ‘bad bet’ that resulted in +100 points on 40% of the trials (and -100 points on 60%). We quantified subjects’ preference for the good bet over the session. Both the control subjects (p = 0.01) and medicated ADHD nongamblers (p < 0.001) significantly increased the proportion of good bets over the 400 trials of the session, indicating that they were able to acquire and use knowledge of the reward outcomes to obtain a positive financial outcome. This contrasts previous studies indicating impairment of subjects with ADHD on variants of the IGT task. Subjects with problem gambling performed worse than controls or ADHD nongamblers (both medicated and unmedicated) but better than our limited sample (n=4) of unmedicated ADHD gamblers. The results indicate that ADHD additionally impairs reinforcement-driven choice adaptation in subjects with problem gambling, but that medicated ADHD nongamblers are not different than controls. These data highlight the need for studies of ADHD in gambling and other decision tasks to screen for problem gambling to avoid confounding altered decision processes related to problem gambling with those related to ADHD alone.