Neurobehavioral Heterogeneity in Problem Gambling Severity and Nicotine Use Risk: Divergent Profiles of Cognitive and Emotional Control.

Abstract

Impairments in cognitive and emotional control are widely implicated in both behavioral and substance-related addictive behaviors. However, it remains unclear whether problem gambling severity and nicotine use risk are characterized by distinct neurobehavioral profiles. The present study investigated differences in cognitive emotion regulation, impulsivity, inhibitory control, and risky decision-making among individuals with elevated problem gambling severity, individuals with elevated nicotine use risk, and healthy controls. To enhance the generalizability of existing findings, 450 participants (150 per group) were recruited in Iran, representing a non-Western cultural context, in 2024. Data were collected using validated Persian versions of the Problem Gambling Severity Index (PGSI), Fagerström Test for Nicotine Dependence (FTND), Barratt Impulsiveness Scale (BIS), Cognitive Emotion Regulation Questionnaire (CERQ), Balloon Analogue Risk Task (BART), and Go/No-Go Task. Participants with elevated problem gambling severity demonstrated significantly higher impulsivity, greater use of maladaptive cognitive emotion regulation strategies, and poorer inhibitory control relative to both participants with elevated nicotine use risk and healthy controls. In contrast, participants with elevated nicotine use risk exhibited greater risky decision-making and selective impulsivity compared with healthy controls. Although some impairments overlapped across the two addiction-related groups, the findings indicated partially distinct neurobehavioral profiles. Specifically, elevated problem gambling severity was more strongly associated with maladaptive cognitive emotion regulation and inhibitory control deficits, whereas elevated nicotine use risk was characterized primarily by heightened risk-taking tendencies. These findings contribute to a more differentiated understanding of heterogeneity across addictive behaviors and may support the development of more targeted prevention and intervention approaches tailored to specific neurobehavioral profiles.