Work

Decision-making and implicit associations in internet gaming disorder, gambling disorder and alcohol use disorder - A comparative study on treatment-seeking patients

Year: 2026

Type: article

Abstract: BACKGROUND AND AIMS: Previous studies suggest that altered implicit and explicit cognitive processes in individuals with substance-related and behavioral addictions influence the development and maintenance of these disorders. Based on the Interaction of Person-Affect-Cognition-Execution model, the present research project investigates how disorder-specific implicit cognitions contribute to the development and persistence of addictive behaviors. METHODS: The study involved 103 treatment-seeking patients with Internet Gaming Disorder, Gambling Disorder, or Alcohol Use Disorder. In addition, 40 healthy participants served as a control group. Implicit addiction-related cognitions were assessed using a modified Implicit Association Test. Decision-making processes in response to addiction-related imagery were assessed using a modified Iowa Gambling Task, which was supplemented by addiction-specific and addiction-unspecific stimuli. RESULTS: Patients with Internet Gaming Disorder showed significantly stronger positive implicit associations with gaming-related cues than patients with Gambling Disorder, Alcohol Use Disorder, and healthy controls in the Implicit Association Test. In the Iowa Gambling Task, patients with Gambling Disorder achieved the lowest total profits and selected significantly fewer advantageous decks than healthy controls and patients with Alcohol Use Disorder. CONCLUSIONS: The findings indicate disorder-specific cognitive patterns in both substance-related and behavioral addictions. Internet Gaming Disorder was characterized by stronger positive implicit associations, whereas Gambling Disorder showed significantly poorer decision-making performance. These results suggest distinct underlying cognitive mechanisms and highlight the relevance of tailored therapeutic interventions.

Source: Comprehensive Psychiatry

DOI: 10.1016/j.comppsych.2026.152753

Authors: N. Dominick, M.E. Beutel, O. Tüscher, S. Steins-Loeber, K. Wölfling

Institutions: University Medical Center of the Johannes Gutenberg University Mainz, University Hospital in Halle, University of Bamberg

Language: English

Topic: Gambling Behavior and Treatments

Subfield: Clinical Psychology

Field: Psychology

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,470