Acute psychosocial stress responses in problem gambling and associations with features of addiction

Abstract

Background: Persistent stress contributes to the onset and maintenance of problem gambling (PG), increasing risks for physiological disturbances. However, minimal research examines acute stress effects and relationships with PG features such as impulsivity or gambling urges. Purpose: The current study examines multiple facets of acute subjective and physiological stress responses in PG. Stress effects on gambling urges and relationships with impulsivity are also explored. Methods: A PG (n=21) and healthy control (HC; n=21) group were exposed to acute psychosocial stress. Saliva samples were collected while participants completed self-report measures of mood and gambling urges. Gambling urges, salivary cortisol (sC), salivary alpha-amylase (sAA), and subjective stress reactivity and recovery were compared within and between groups from baseline up to an hour following stress. Relationships between trait impulsivity, gambling urges, and all aspects of the acute stress response were examined. Results: The PG group showed blunted sC reactivity but reported heightened mood disturbances compared to HCs, while sAA levels did not differ between groups. Within PG and HC groups, sAA had a more rapid acute stress onset than sC, but between-marker differences were pronounced in PG. Self-reported gambling urges were high among PG participants but remained relatively unchanged following acute stress. Impulsivity was positively associated with gambling urges, however, it was not correlated with the acute stress response. Conclusions: This study provides a novel and wide-ranging assessment of the acute stress response in PG, for which research is currently limited. These results indicate that high stress in PG contributes to multi-faceted alterations of the acute stress response relative to HCs. Self-reported gambling urges are elevated and associated with greater trait impulsivity in PG but are unaffected by acute stress exposure. Our findings provide insight into acute stress processing dysfunction in PG and have implications for potential harms, such as increased suicide risk.