Does craving increase gambling severity? The role of attentional bias

Background: Although previous studies have investigated the role of attentional bias in gambling, the inconsistent findings and the paucity of research require further investigations, as well as the examination of the interrelationships between attentional bias, subjective craving, and gambling severity. Methods: The present study comprised 80 male gamblers, aged between 18 and 64 years. Participants carried out a modified version of the Posner Task to assess attentional bias and completed the South Oaks Gambling Screen (SOGS) and the Gambling Craving Scale (GACS) to assess the severity of gambling involvement and the subjective gambling-related craving, respectively. Results: Regression analyses showed that craving and facilitation bias at 500 ms are significant predictors of gambling severity. The path analysis indicated that craving predicted gambling severity not only directly, but also indirectly via attentional bias for gambling stimuli. Limitations: The recruitment of male participants and the not-matched gambling stimuli to the preferred gambling activity limit the present results. Conclusions: The present findings shed light on the interrelationships between craving, attentional bias, and problem gambling, demonstrating that craving is indirectly associated with problem gambling via attentional bias: higher levels of craving make gamblers more responsive to gambling cues, leading to attentional bias, which, in turn, motivate gamblers to bet, contributing to problematic gambling.