Purpose of the Review: This systematic review and meta-analysis examined whether gambling behavior is associated with neurocognitive deficits across executive function, decision-making, delay discounting, and reward sensitivity, and whether these deficits support the dual-process model of addiction. Collection and Analysis of Data: PubMed, Scopus, Embase, and Web of Science were searched on September 1, 2024. Observational studies including individuals with gambling behavior identified using Diagnostic and Statistical Manual of Mental Disorders (DSM)/International Classification of Diseases (ICD) criteria and/or standardized screening instruments were eligible. Risk of bias (ROB) was assessed using the Joanna Briggs Institute (JBI) checklist (cross-sectional studies). Random-effects meta-analyses using Hedges’ g were conducted in R software, with heterogeneity, publication bias, leave-one-out sensitivity, subgroup, and meta-regression analyses. Results: Of 12,488 records, 76 studies ( n = 5362) met eligibility for the review, and 35 ( n = 2822) were included in the meta-analysis. Across 15 random-effects meta-analyses ( k = 02–12; n = 38–562; I 2 = 0%–94.1%), the largest deficits were observed in inhibitory control on the Stroop task (ST) under gambling ( g = 1.91; p < .05) and neutral conditions ( g = 1.83; p < .05), followed by delay discounting (area under the curve AUC: g = −1.07; p < .001; discounting parameter: g = 0.45; p < .01), cognitive flexibility on the probabilistic reversal learning test ( g = −0.51; p < .05) and Intra/Extra-Dimensional Set Shift Task ( g = 0.72; p < .001), and working memory on the Trail Making Test–B (TMT-B) ( g = 0.59; p < .05). Decision-making impairments were partially supported by qualitative evidence, while no consistent deficits were observed in planning ability or reward sensitivity. Conclusions: Findings indicate impairments in controlled and automatic processes, partially supporting the dual-process model of gambling disorder; however, heterogeneity and task-specific effects warrant caution.
Ahluwalia et al. (Sun,) studied this question.