2013 Addiction Research and Theory, June 2013; 21(3): 216–226 Copyright ß 2013 Informa UK Ltd. ISSN: 1606-6359 print/1476-7392 online DOI: 10.3109/16066359.2012.705399 Neuropsychological performance, impulsivity, symptoms of ADHD, and Cloninger’s personality traits in pathological gambling Donald W. Black 1 , Megan M. Smith 1 , Kelsie T. Forbush 2 , Martha C. Shaw 1 , Brett A. McCormick 1 , David J. Moser 1 , & Jeff M. Allen 1 1 Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA 52242, USA, and 2 Department of Psychology, Purdue University, West Lafayette, IN 47907, USA (Received 12 September 2011; revised 12 June 2012; accepted 18 June 2012) Pathological gambling (PG) is a prevalent public health problem associated with fronto-temporal dysfunction and maladaptive personality traits. To further test these associations, we assessed neuro- psychological performance in pathological gamblers (PGs) and controls. We also examined selected personality characteristics and symptoms of atten- tion deficit hyperactivity disorder (ADHD). Subjects were recruited from the community. All received a comprehensive neuropsychological battery, the ADHD Rating Scale, and personality measures including the Barratt Impulsiveness Scale and a version of the Temperament and Character Inventory. People with DSM-IV PG (n ¼ 54) and controls (n ¼ 65) were comparable in age, sex, and education level. PGs were more likely to have comorbid lifetime mood, anxiety, and substance use disorders; antisocial personality disorder; and other impulse control disorders. PGs performed signifi- cantly worse on the Wisconsin Card Sort Test-64 perseverative responses subscale and the Trails B test; they also had lower performance and full scale IQs. PGs had elevated levels of depression, ADHD symptoms, trait impulsivity, novelty seeking, and harm avoidance, but lower levels of reward depen- dence. High levels of self-reported impulsivity or ADHD symptoms in PGs did not predict worse neuropsychological performance. We conclude that PGs performed worse than controls on two measures of executive function and had lower IQs. They also had more psychiatric comorbidity, higher levels of trait impulsivity and ADHD symptoms, and both novelty seeking and harm-avoidance, but lower levels of reward-dependence. This study does not support the notion that there is a pattern of neuropsychological deficits associated with high levels of impulsivity or ADHD symptoms in PGs. Keywords: Pathological gambling, neuropsychology, personal- ity, impulsivity, ADHD INTRODUCTION Pathological gambling (PG) is a prevalent public health problem associated with depression, substance misuse, domestic violence, crime, and suicide (Kessler et al., 2008; NORC, 1999; Petry & Kiluk, 2002; Shaw et al., 2007). Presently classified as an impulse control disorder, it has been proposed that PG be reclassified as a ‘‘behavioral addiction’’ in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders expected to be published in 2013 (APA, 1994; http//:www.dsm5, accessed March 17, 2012). Several lines of evidence suggest that PG is a neuropsychiatric disorder. Family and twin studies have shown the disorder to be familial with high heritability (Black, Monahan, Temkit, & Shaw, 2006; Eisen et al., 1998). Neuroimaging studies suggest the presence of functional disturbances among pathologi- cal gamblers (PGs) in specific subcortical frontal regions (Crockford, Goodyear, Edwards, Quickfall, & el-Guebaly, 2005; Potenza et al., 2003). Lastly, neu- ropsychological research suggests that PGs have impaired executive functioning (e.g., cognitive flexi- bility, decision-making) attributed to disturbances in fronto-temporal circuitry (Cavedini, Riboldi, Keller, D’Annucci, & Bellodi, 2002; Forbush et al., 2008; Goudriaan, Oosterlaan, deBeurs, & van den Brink, 2006; Rugle & Melamed, 1993). Bechara (2003) has Correspondence: D. W. Black, Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, 500 Newton Road, Iowa City, IA 52242, USA. Tel: 319.353.4431. Fax: 319.353.3003. E-mail: donald-black@uiowa.edu 216