Nordic Psychology, 2007, 59 (4) 347-361 ARTICLE

An overview of cognitive
mechanisms in pathological
gambling
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LINE HOLVIN JACOBSEN Dept. of Psychosocial Science

ANN KRISTIN KNUDSEN University of Bergen
EMMELINE KROGH Norway
STÅLE PALLESEN &
HELGE MOLDE

This paper presents an overview of the literature published on “cognitive biases” and gambling
from 1960 till the present day. Typical cognitive biases are an individual’s irrational beliefs,
cognitive distortions and erroneous perceptions about his or her ability to influence, control
or predict the outcome of a chance event; these appear to be important for the maintenance
of gambling related behaviour. Overall, the research suggests that cognitive factors are impor-
tant in developing gambling addiction, but may be less important when gambling becomes
habitual or regulated by automatic processes. Regardless of whether the behaviour is explained
by reinforcement, needs or cognitive theories, it is still unclear why some individuals gamble
more than others.

Corresponding author: Helge Molde, Department of Psychosocial Science, University of Bergen,

Norway, Christiesgt. 12, PO Box 7800, N-5020 Bergen, NORWAY. Email: Helge.Molde@psysp.
uib.no. Tel.: +47 55 58 86 82. Fax: +47 55 58 98

Introduction
Gambling could be defined as “any kind of allocation of stakes which involves
possessions of material value in an event with uncertain outcome where ran-
domness of different degree decides the results” (Bolen & Boyd, 1968).
The last 10-15 years have seen a wave of gambling liberalisation throughout
the western world. The gambling industry is now considered part of the enter-
tainment industry, thus giving rise to wider social acceptance and availability of
gambling activities. Consequently, the problems associated with gambling have
also increased over the same period (Molde et al., 2004).
Norwegian gambling policy has ranked among the most liberal in Europe in
recent years. In 2005, total revenue from the Norwegian money gaming and
lottery market was € 5,01 billion (The Norwegian Gaming and Foundation
Authority, 2006) which means that on average, every Norwegian spent € 1100 on
gaming. In real terms, 10% of the population accounted for 54% of this amount
(Lund & Norlund, 2003). Nationwide, a substantial part of the revenue comes
 348 Line Holvin Jacobsen et al. NP, 2007 (4)

from gaming machines, which in 2005 accounted for € 3,3 billion of the total
takings (The Norwegian Gaming and Foundation Authority, 2006).

The prevalence of gambling problems in Norway

In June 2005 the Norwegian Gaming and Foundation Authority published a
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national survey entitled “Gambling and gambling problems in Norway” (this

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article is in Norwegian entitled “Pengespill og pengespillproblemer i Norge”),

concluding that 1.4% of the Norwegian population, or 50 000 people, have or
have had serious gambling problems (The Norwegian Gaming and Foundation
Authority, 2003a). A NOVA report entitled “Entertainment with a tang” (this
article is in Norwegian entitled ”Underholdning med bismak”), also published
in 2003, found that 3.2% of Norwegian teenagers between the ages of 13 and
19 experience problems associated with gambling (The Norwegian Gaming
and Foundation Authority, 2003b). In other words, the pathological gambling
problem in Norway is substantial, and most of those who experience these
problems point to gaming machines as the main culprits. In a meta analysis of
119 international studies it was concluded that more young people than adults
and more men than women are pathological gamblers, and that the prevalence
of pathological gamblers has increased over the last 20 years (Shaffer, Hall, &
Vanderbilt, 1999).
Increased focus on the problems associated with gambling has led the
Norwegian government to put forward an action plan for prevention and reduc-
tion of problem gambling. According to the Action Plan, published in April
2005 (The Norwegian Gaming and Foundation Authority, 2005), 0.5% of the
government’s annual revenue (€ 1,44 million in 2005) from Norsk Tipping (Norsk
Tipping is Norway’s leading games company, owned by the Norwegian state) will
be used to put the plan into action. These funds are sat aside to improve research,
information, treatment and prevention of gambling problems. By introducing
the Action Plan, the government commits to an intention of taking the problems
associated with gambling seriously, and trying to reduce them. In July 2006 a
ban on using money notes in Norwegian gaming machines was introduced, and
the government has decided that the current gaming machines will be removed
from the market by July 1st 2007. The government has applied to EFTA for permis-
sion to establish a government monopoly on the operation of gaming machines,
and this application has been approved. However the new machines cannot be
introduced until 2008, at the earliest (The Norwegian Gaming and Foundation
Authority, 2006).
 NP, 2007 (4) An overview of cognitive mechanisms in pathological gambling 349

Diagnosing and approaches to pathological gambling

Pathological gambling has been considered a diagnosis in DSM since 1980.
Table 1 gives the diagnostic criteria for pathological gambling according to
DSM-IV. The literature uses several different terms for pathological gambling,
e.g. “pathological gambling passion”, “gambling addiction”, “pathological
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gambling disorders” and “problem gamblers”. Pathological gambling must

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be distinguished from social gambling and professional gambling which do

not meet the full criteria for pathological gambling (American Psychiatric
Association, 2000). Shaffer et al. (1999) also draws a line between problem
gamblers and pathological gamblers; pathological gamblers are those who meet
the established diagnostic criteria for gambling, e.g. at least 5 out of the 10
criteria in DSM-IV, while problem gamblers experience some problems, but fail
to meet the diagnostic criteria. Gambling problems are usually accounted for
by the use of questionnaires (e.g., SOGS-R) or standardised clinical interviews,
and based on this material it is possible to distinguish between different risk
groups according to whether the individuals are developing gambling problems,
problem gamblers or pathological gamblers.
The ”chasing” of losses is often considered an important stage in the develop-
ment of pathological gambling, and is also one of the DSM-IV diagnostic crite-
ria for pathological gambling (Breen & Zuckerman, 1999; Molde et al., 2004;
Toneatto, 1999). ”Chasing” is defined as continued gambling to recover one’s
losses, either in the same gambling session or by returning later, often with an
increased wager, usually causing the gambler to suffer even greater losses. The
chase normally ends only when all options for financing the chase have been
exhausted (O’Connor & Dickerson, 2003). In other words, pathological gamblers
have difficulties ending the game, regardless of whether they win or lose.
Historically, a number of different approaches have provided causal explana-
tions for developing and maintaining gambling behaviour. The first theories trying
to account for pathological gambling were put forward by psychoanalysts who
explained gambling as an expression of neuroses (Greenson, 1947; Hattinger,
1914), guilt and self punishment (Freud, 1928), and as a rebellion against author-
ity figures and principles of reality (Bergler, 1957). According to the disease model
(Blume, 1988), pathological gambling is caused by physiological predispositions,
with stages of characteristic symptoms. Still others see pathological gambling
as general addiction behaviour and a phenomenon which helps the individual
avoid psychological discomfort (Jacobs, 1986) or gives the individual positive
experiences. Viewed from a learning perspective, the prize won is considered
positive reinforcement for the gambling behaviour (Skinner, 1953), and random
and uncertain reinforcements can lead to maintenance of gambling behaviour.
 350 Line Holvin Jacobsen et al. NP, 2007 (4)

Table 1.
Diagnostic criteria for 312.31 Pathological Gambling according to DSM-IV

A. Persistent and recurrent maladaptive gambling behaviour is indicated by five (or more)
of the following criteria.

The individual:
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1. is preoccupied with gambling (e.g. preoccupied with reliving past gambling experi-
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ences, handicapping or planning the next venture, or thinking of ways to get money
with which to gamble)
2. needs to gamble with increasing amounts of money in order to achieve the desired
excitement
3. has repeated unsuccessful efforts to control, cut back, or stop gambling
4. is restless or irritable when attempting to cut down or stop gambling
5. gambles as a way of escaping from problems or of relieving a dysphoric mood (e.g.,
feelings of helplessness, guilt, anxiety, depression)
6. after losing money gambling, often returns another day to get even (“chasing”
one’s losses)
7. lies to family members, therapist, or others to conceal the extent of involvement
with gambling
8. has committed illegal acts such as forgery, fraud, theft or embezzlement to finance
gambling
9. has jeopardized or lost a significant relationship, job, or educational or career
opportunity because of gambling
10. relies on others to provide money to relieve a desperate financial situation caused
by gambling

B. Manic Episodes give no better accounts of gambling behaviour.

Furthermore, in recent years scholars have been looking at the gambling environ-
ment and the structural characteristics of the gambling devices (e.g. noise and
light), and these have been included as explanatory factors for the development
and maintenance of gambling behaviour (Griffiths, 1996; Griffiths & Parke,
2003; Griffiths, 1999). Personality variables like impulsiveness and sensation
seeking have also been given explanatory value (Breen & Zuckerman, 1999),
together with underlying physiological factors such as arousal in the gambling
situation (Zuckerman, 1984) or impulsiveness due to deficits in the functions of
the frontal lobes (Cavedini, Riboldi, Keller, D’Annucci, & Bellodi, 2002). This
paper, however, will focus on cognitive models of pathological gambling, and
will examine the association between cognition and pathological gambling.
Research has demonstrated that cognitive factors play a role in the develop-
ment and maintenance of gambling problems (Ladouceur & Walker, 1996). This
paper will particulary focus on the cognitive processes and errors which appear
 NP, 2007 (4) An overview of cognitive mechanisms in pathological gambling 351

to contribute to the development and maintenance of gambling behaviour. This

overview is based on articles about cognition and gambling published between
1960 and the present day, found through literature searches in PsychInfo, Bibsys
and ISIweb of Science.

Cognitive bias and decision-making tendencies in

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pathological gamblers
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“Cognitive biases” are an individual’s irrational beliefs, cognitive distortions

and erroneous perceptions about his or her ability to influence, control or
predict the outcome of a chance event. A number of scholars, among them
Ladouceur & Walker (1996), have focused on cognitive phenomena associated
with pathological gambling, such as illusions of causality, correlations and
control, superstitions and “gamblers fallacy” (Ladouceur & Walker, 1996). These
phenomena could be central to our understanding of some of the decision-
making and behaviour displayed by pathological gamblers. Especially two types
of cognitive errors are prominent: (i) the gambler believes that he or she can
influence the outcome of the unpredictable, (ii) the outcome is believed to be
more predictable than it really is (Ladouceur, 2004).
Cognitive biases represent a common element in human decision-making. In
the context of pathological gambling, it is particularly interesting to study which
types of cognitive biases are the most dominant, and their respective frequencies.
It is assumed that the different decision deficits may influence individuals in a
manner which causes distorted perception with regard to the actual likelihood of
winning (Tversky & Kahneman, 1974). Studies indicate that there are dissimilari-
ties between the different groups of pathological gamblers. These dissimilarities
may well relate to specific gambling activities, such as gambling on horses and
lotteries. Cognitive biases and the maintenance of gambling-related behaviour
could result from different erroneous inferences with regard to the heuristics of
representativness, correlation and causality, as well as accessibility.
The “think – aloud” paradigm has been used as a method in association
with studies into the variety of decision-making errors and irrational thinking in
gambling situations. Gaboury and Ladouceur (1989) developed the technique,
which is based on a process through which the participant verbalizes all of his/
her thoughts during the actual gambling activity. The main objective is to reduce
the participants’ censorship of what he/she thinks is irrelevant information. The
methodical procedure also involves making participants talk continually, never
stopping to think about phrasing or sentence structure. Studies that make use
of the “think – aloud” paradigm have given us useful information regarding the
role that cognitive biases and distortions play in gambling-related behaviour
 352 Line Holvin Jacobsen et al. NP, 2007 (4)

and pathology. The study conducted by Gaboury and Ladouceur (1989) showed
that more than 70% of the individuals with gambling problems who verbalized
their thoughts during gambling, would reveal erroneous interpretations referring
to prediction and control over games based on randomness. Results from this
study demonstrate that a typical problem for a pathological gambler could be
to comprehend the aspect of chance, or to take the factor of randomness into
consideration in gambling situations.
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Illusion of control
Different types of cognitive errors may contribute to the illusion of control
among pathological gamblers. The false impression of control may be asso-
ciated with attribution errors. Fundamental attribution error can be defined
as a tendency to exaggerate the effect of either internal or external factors in
different circumstances. Consequently, this type of attribution error is of signi-
ficant importance when seeking to explain how pathological gamblers make
attributions in gambling situation. The studies of Langer (1975), and Wagenaar
and Keren (1988) demonstrate that in the case of predictions with a positive
outcome, it is more likely that an individual will attribute these to dispositional
factors. Cantinotti, Ladouceur and Jacques (2004) established, in their study
of attribution in gamblers, that a high level of knowledge about the gambling
activity (e.g. gambling on horses) can give gamblers mistaken confidence in
his/her ability to predict the outcome. Subsequently, this belief is associated
with strengthening the illusion of control. In contrast, the individual will often
attribute the reason for loss and failure to misfortune or other situational and
external factors (Petry, 2002).

Availability and selectivity in information processing

Decision-making and calculation of probability are often based upon availa-
ble information and selective processing. Availability, in this context, refers to
the ease with which examples of an exact event may be imagined (Tversky
& Kahneman, 1974). Availability is associated with the ability to recall and
is dependent on the situation’s novelty, familiarity and vividness (Helstrup &
Kaufmann, 2000)
Pathological gamblers tend to have a higher probability of recalling episodes
of winning than incidents of loss (Ecole Normale Supérieure, 2005). As a result,
gamblers allow themselves to be convinced they do not lose money, simply
because they are able to forget their losses. This will give them a mistaken impres-
sion of winning more often. In addition, studies have confirmed the assumption
 NP, 2007 (4) An overview of cognitive mechanisms in pathological gambling 353

that gamblers often recall winnings better than losses (Rachlin, 1990).
McCusker and Getting (1997) used a stroop task1 to compare pathological
gamblers to their spouses and a control group. They found that pathological gam-
blers had a longer reaction time with respect to game-related words than the other
two groups, and they took this as evidence of attention distortions in pathological
gamblers. Their other findings also indicated that pathological gamblers have
cognitive biases that occur with game-related words in implicit memory tasks.
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A study carried out by Atkins and Sharpe (2004) indicated that, compared to
the control group, pathological gamblers have a significantly faster reaction time
when naming positive words relating to gambling. This supports their hypothesis
that pathological gamblers are hyper attentive to positive outcomes, and hypo
attentive to negative outcomes. These results confirm earlier findings (Boyer &
Dickerson, 2003), that people with problem behaviour(s) have a longer reaction
time with respect to words that relate to their problem area.

The effect of early experiences on decision-making

Probability estimation can be influenced by so-called “early big wins.” It is
assumed that recent big payouts, which the gambler has experienced as signifi-
cantly positive, may influence subsequent gambling activity. Whether or not the
actual winnings are considered “big”, is relative to the gambler’s general stake.
Research on factors that influence and contribute to erroneous decision-making,
has proved that “early wins” and “near misses”2 (broadly defined, near misses
are failures that come close to being successful) have considerable impact on
the pathological gambler’s subsequent decision-making in gambling-related
situations. It is a widespread hypothesis that early wins in a gambling career
will contribute to the development of an expectancy of winning. In turn, this
is assumed to change the gambler’s understanding of control and increase his/
her resistance to extinction of the behaviour. In fact, these assumptions could
also be viewed as predisposal factors for later pathological gambling activities
(Custer & Milt, 1985). Despite the fact that this anticipation has been incorpo-
rated into theories of gambling addiction (Griffiths, 1996), only two empirical
studies have been carried out. The first found no significant differences in per-
severance between the “big win present” and the “big win absent” conditions
(Kassinove & Schare, 2001). The lack of a significant effect could be the result of

1 In a stroop task the participant is asked to name the colour of a word. The stroop task is
seen as a reliable measurement of attention.
2 Different authors use the terms “near win”, “near loss” or “near miss” to describe the
phenomen of failures that come close to being successful. We have chosen to use the term
“near miss” in this article.
 354 Line Holvin Jacobsen et al. NP, 2007 (4)

a number of minor procedural variables that may have prevented observation of

the influence of a big win. In the second study, different kinds of variables were
taken into consideration and controlled for. Results from this study (Weatherly,
Sauter, & King, 2004) established that the effect of a “big win” is present, but
that participants who experienced their big win in the first trial would find it
easier to stop gambling at the first opportunity, than participants who were
presented with a big win in the fifth trial.
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The results from these two studies seem to question the idea that an immedi-
ate early win triggers subsequent pathological gambling, yet they also suggest
that a big win at an early stage of a “gambling career” will have an effect on
later pathology. Studies of this type appear to demonstrate that reinforcement
mechanisms have significant impact on the maintenance of gambling behaviour,
and that randomized wins will be more resistant to extinction. Nevertheless,
it is possible that a big win could influence the development of illusions with
respect to control, coping and superstition (Molde et al., 2004).

Heuristics of representativeness
Judgements of probability are often based on so-called representative heuristics.
Decision-making errors and errors of probability estimation may thus result from
minimal use of base rate3, population size and misconceptions of randomness
(Helstrup & Kaufmann, 2000). In accordance with gambling behaviour, the fact
that a gambler has won a particular number of times may make this individual
believe he or she has a winning tendency rather than the wins being considered
the result of randomness. A big payout from a particular machine could result
in an assumption that this is a “winning machine”, when, in fact, it is based on
a randomized system (Petry, 2002). In these cases neither base rate nor the law
of big numbers4 is taken into consideration in the gambling activity.

The illusion of causality and correlation

The assumption that events are related when they in fact are not, is called the
illusion of correlation. Studies have shown that after several losses, pathological
gamblers gamble more heavily and more convincingly because they confuse
independent outcomes with dependent outcomes (Breen, Kruedelbach, &
Walker, 2001). One example of false perception is “ if I lose four times in a row,

3 Base rate is normally not taken into consideration in decision-making. Base rate can be
defined as the frequency of any given action or outcome in a large population.
4 The Law of Big Numbers indicates that the larger the sample you draw from a population,
the closer its average will be to the population average
 NP, 2007 (4) An overview of cognitive mechanisms in pathological gambling 355

surely I will win next time” (Ladouceur et al., 2003). According to Ladouceur
and Walker (1996), gamblers will develop convictions that encourage them to
continue gambling, even when they expect a negative outcome. These false
convictions lead gamblers to believe they can control random events (Sylvain,
Ladouceur, & Boisvert, 1997). The illusion of causality and correlation must be
understood as part of the gambler fallacy phenomenon because it contributes
to the development and persistence of gambling behaviour.
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“Gambler fallacy” is a phenomenon which involves cognition and decision-

making errors based on the heuristics of representativeness. Gambler fallacy can
be defined as “the belief that a successful outcome is due after a run of bad luck,
or more generally, the belief that a series of independent trials with the same out-
come will soon be followed by the opposite outcome”(Plous, 1993 p.113). This
can lead to a state of mind in which previous experiences can be used to predict
future outcomes, e.g. a chain of losses can be used as a predictor for success if
randomness is considered a self-correcting phenomenon. This phenomenon is of
course prominent in pathological gamblers (Ladouceur, Sylvain, Letarte, Giroux,
& Jacques, 1998; Ladouceur & Walker, 1996), and is seen as a result of the ran-
domness element being denied or excluded from consideration.
In a study conducted by Ladouceur and Dubè (1997) participants were asked to
generate a random sequence of 100 heads and tails. Results showed that most of
the participants based their next selection based on previous ones. The results also
showed a general tendency to balance the sequences (50:50 ratios). Interestingly,
the findings of this study demonstrated a tendency for participants to deny their
irrational thinking and refuse to admit to having behaved irrationally.
Research demonstrates that being in a gambling situation seems to impact sig-
nificantly on the gamblers’ cognition. Both pathological and occasional gamblers
demonstrate faulty perception during gambling activities. Studies conducted by
Gaboury and Ladouceur (1989) have shown that participants expressed a higher
level of erroneous perception and verbalization during gambling. Furthermore,
individuals demonstrated a more rational perception of gambling before and after
a gambling session. In a study carried out by Caron and Ladouceur (2003) they
found that pathological gamblers expressed a more significant conviction that
their erroneous perceptions were right, than occasional gamblers. This convic-
tion seemed to increase during gambling sessions among pathological gamblers,
while the opposite tendency was found in the control group. This may all be
seen to prove that prior knowledge about randomness is not sufficient to protect
individuals with gambling problems against the occurrence of cognitive biases
while gambling (Benhsain, Taillefer, & Ladouceur, 2004).
 356 Line Holvin Jacobsen et al. NP, 2007 (4)

Superstition
The illusion of causality and correlation can lead to various forms of supersti-
tious beliefs in the pathological gambler. For instance, they may believe they
can control the outcome of random events by using verbal and non-verbal
gestures(Henslin, 1967; King, 1990). Superstitious beliefs are also demonstrated
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through the various rituals performed by gamblers. These include the carrying
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of particular objects for good luck; intuition; belief in “hot” and “cold” num-
bers; and other ritual behaviours considered to affect the outcome (Ladouceur,
Paquet, & Dubè, 1996; Toneatto, 1999). For example, studies have shown that
we throw the dice hard when we wish to obtain high numbers and we throw
them softly when we wish to obtain small numbers (Henslin, 1967; Reith,
1999). The one study that has examined the differences in superstitious thinking
between pathological and non-pathological gamblers, concluded that patho-
logical gamblers show significantly higher levels of superstitious thinking in
gambling situations than non-pathological gamblers (Joukhador, Blaszczynski,
& Maccallum, 2004).

Chasing
Chasing is not normally defined as a cognitive phenomenon, but erroneous per-
ception bounded in heuristics of representativeness could help us explain this
behaviour. Chasing has been seen as associated with impaired control. Studies
have confirmed a distinction between chasing within a session and chasing
on return at a later time, and the findings demonstrate that the correlation is
strongest for chasing within sessions (O’Connor & Dickerson, 2003). Surveys on
pathological gamblers show that chasing is normal after big wins as well as after
losses. The gambler appears to feel forced to continue playing and to double the
stake. The need to continue playing has been hypothesised to involve different
cognitive biases. Further research will therefore be necessary to increase our
understanding of the circumstances and variables which promote and contain
chasing behaviour (O’Connor & Dickerson, 2003).

The effect of a “near miss”

A “near miss” can be defined as a special form of failure in attaining one’s goal
that is perceived as almost succeeding (Henslin, 1967). The gambler does not
perceive himself to be constantly losing, but to be constantly on the verge of
winning (Griffiths, 1996;Griffiths, 1999). It is assumed that this situation triggers
many of the same psychological mechanisms as a real win situation (Parke &
 NP, 2007 (4) An overview of cognitive mechanisms in pathological gambling 357

Griffiths, 2004) such as the experience of reward, arousal, excitement, luck etc.
The fact that the “near miss” effect contributes to the persistence of gambling
was demonstrated, along with other factors, in a study carried out by Cote,
Caron, Aubert, Desrochers and Ladouceur in 2003. The subjects in the “near
miss” group gambled 33% more than the subjects in the control group. All the
subjects were non-gamblers (Cote, Caron, Aubert, Desrochers, & Ladouceur,
2003).
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Studies have indicated that a moderate number of near misses gives the great-
est effect on the persistence of gambling; the “near miss” effect follows a reverse
u-curve. In a study conducted by Kassinove and Schares (2001), there was no
significant difference between the effects of a 15% and 45% rate of “near miss”
occurrence, while the effect of a 30% rate of “near miss” occurrence led to the
greatest persistence of gambling behaviour.
This persistent gambling behaviour may be explained by cognitive theories
which suggest that gamblers interpret a near miss to be evidence of their abil-
ity to control the outcome of the gamble, an ability that can be acquired (Reid,
1986). In these types of cases, a near miss can be perceived as confirmation of
the gambler’s increasing ability to control the outcome, thereby motivating him
to continue gambling. The gambler develops an expectation that a win is bound
to arrive soon (Cote, Caron, Aubert, Desrochers, & Ladouceur, 2003). Cognitive
theories may explain the “near miss” effect in isolation but cannot explain why
it is manifested in a reverse u-curve. According to learning theories, the near
miss can become a conditioned stimulus which functions as a signal of gain,
and which will therefore lead to the same joy and persistence of gambling as a
real win. Reinforcement studies (Skinner, 1953) may explain why a 30% rate of
“near miss” occurrence is the optimal for the persistence of gambling behaviour:
at 45%, the “near miss” occurrence rate prevents the near miss from becoming a
conditioned stimulus because it is not followed by sufficient gains, while at 15%,
the rate of occurrence does not sufficiently expose the subjects to near misses
to establish a conditioned stimulus. Learning theory and cognitive theory both
offer an explanation for the effect of near misses and it is therefore necessary to
conduct further research before it is possible to decide which of the two theories
provide the best comprehension of the phenomenon.

Discussion
Since the early 1980s, there has been quite a lot of research on gambling
behaviour and pathological gambling, first of all because pathological gambling
became a diagnosis in DSM III in 1980 (National Research Counsil, 1999).
Secondly because there was an increase in the number of problem gamblers
 358 Line Holvin Jacobsen et al. NP, 2007 (4)

during this period. Most studies emphasised cognitive and personality variables,
possibly because personality psychology and cognitive psychology have been
the two most acclaimed psychological disciplines during this period (Eber &
Shaffer, 2000).
Research has shown that cognitive factors play a significant role in gambling
behaviour (Ladouceur & Walker, 1996). However, scholars like Fantino (2005)
and Delfabbro and Winefield (2000) suggest that while cognitive factors may
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be important in developing gambling addiction, they may not necessarily be

important when gambling becomes habitual or regulated by automatic processes.
Although the studies have yielded significant results with respect to the type and
frequency of the pathological gambler’s biases, they have failed to provide us with
evidence of a causal relationship that would explain the reasons why individuals
develop a gambling problem. May et al.(2005) have pointed out the shortcom-
ings of the cognitive model as the only theory offered for explaining gambling
behaviour. Social and psychological explanations alone cannot account for this
complex behaviour. Regardless of whether the behaviour is explained by rein-
forcement, needs or cognitive theories, it is still unclear why some individuals
gamble more than others (Molde et al., 2004)
Future research should seek to study a number of complex variables within the
same study. The development of theories and models should therefore be based
on data from cognitive, biological and physiological research as well as person-
ality studies (Sharpe, 2002). Sharpe and Tarrier (among others) have developed
a cognitive behavioural model which may be used as a tool for pathological
gambling studies (Sharpe & Tarrier, 1993). With this type of approach, it is pos-
sible to combine both genetic and environmental factors. Sharpe points out that
pathological gambling may be associated with genetic vulnerability, impulse
control, the attitudes and habits of one’s family, availability, problem solving abili-
ties, former gambling history, reinforcement mechanisms and personality traits as
well as tendencies in human cognition (Sharpe, 2002).
Comparisons between studies of cognition and pathological gambling pose
several difficulties. There is no consistency with respect to the use of notions
and definitions within the field. Different measurement devices are used in dif-
ferent studies and the operationalizing may well differ between different studies
(Pallesen, Mitsem, Kvale, Johnsen, & Molde, 2005). Furthermore, there is a need
for longitudinal studies, both of an experimental and a clinical kind. We still
have insufficient knowledge about what causes some individuals in a risk group
to develop a gambling problem while others do not (O’Connor & Dickerson,
2003).
Laboratory studies on gambling are often criticized for low external validity.
Subjects do not play with their own money; the stakes are usually lower than what
 NP, 2007 (4) An overview of cognitive mechanisms in pathological gambling 359

would be the case in real life, and the surroundings are artificial. This weakens
the face validity and gives rise to questions about the generalisation of the results.
Both non-gamblers and pathological gamblers show irrational thinking in gam-
bling situations, albeit of different kinds and strengths. Only very few studies have
adequately compared these two groups. There may also be differences within the
gambler group (Griffiths, 1996) which are not picked up by the studies. Perhaps
that which applies to the frequent gamblers does not apply to the less frequent
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gamblers, and vice versa. Differences within the group may be due to different
types of gambling activities (Kyngdon & Dickerson, 1999). Some of the problems
within research on gambling may therefore be a result of the fact that pathological
gamblers have been viewed as a homogenous group.
In terms of methodology, it is necessary to ascertain the nature of the correct
control group. It should be debated whether pathological gambling should still
be diagnosed as an impulse control disorder, or if it is better described as a
dependency disorder. How one defines pathological gambling has an impact on
the nature of the correct control group. Pathological gamblers share a number
of characteristics with other clinical groups, including patients with dependency
and impulse disorders as well as the “normal” group. The use of different patient
groups for control may be a helpful tool in mapping the specific and shared char-
acteristics of the gambler and control groups, as well as in mapping co-morbidity
(Petry, 2002; Sharpe, 2002).

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