![]() ![]() ![]() Theories on substance-related addiction (reward deficiency hypotheses, incentive-sensitization theory, impaired response inhibition and salience attribution (I-RISA) ) stress the role of the prefrontal cortex and the mesolimbic reward system (especially the ventral striatum) in the development and maintenance of addictive behavior. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gambling disorder is classified under “substance-related and addictive disorders.” Because this disorder shares clinical characteristics, as well as common cognitive and personality features, neurobiologic processes, and genetic vulnerability, with substance use disorders, it has been considered a behavioral addiction. Gambling disorder is a psychiatric disorder characterized by maladaptive and excessive gambling behavior. This review focuses on brain imaging studies of reward and loss processing, with an emphasis on loss avoidance and aversion as well as brain volume and functional connectivity in gambling disorder. However, only a few studies on brain structure and functional connectivity in gambling disorder have been performed so far. Because the brain is a complex network, investigation of alterations in functional connectivity has gained interest among gambling disorder researchers in order to get a more complete picture of functional brain changes in people with gambling disorder. Because gambling disorder might be considered an addiction in its “pure” form, i.e., without the influence of a drug of abuse, investigating brain volume changes in people with this behavioral addiction is an important task for neuroimaging researchers in exploring the neural signatures of addiction. Therefore, special forms of reward (i.e., gain/loss) processing, such as the processing of loss avoidance and loss aversion, have just recently attracted attention among gambling disorder researchers. ![]() However, the gambling disorder symptom “chasing one’s losses” is the only criterion absent from substance use disorder. Gambling disorder recently was reclassified under the category “substance-related and addictive disorders.” With regard to the diagnostic criteria, it overlaps a great deal with substance use disorder, i.e., loss of control, craving/withdrawal, and neglect of other areas of life. ![]()
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