Metacognition deficits and impulsivity in Parkinson's Disease patients with and without gambling behavior: a pilot study

Introduction: Impaired metacognition and impulsivity are critical factors in pathological gambling behavior subsistence. This study aims at jointly exploring metacognitive skills and impulsivity levels in subgroups of Parkinson's Disease (PD) patients with different gambling status. Method: 48 PD participants were divided into three subgroups: PD Gamblers (PDG), PD patients with a previous history of gambling and PD controls. Impulsivity was assessed by the Barratt Impulsiveness Scale. After performing the Iowa Gambling Task (IGT), patients filled in a self-report measure to assess their metacognitive strategies. Results: Findings highlighted that PDG showed higher levels of impulsivity than PD controls as reflected by clinical scales and behavioral measure. Also, PDG displayed a worse performance at IGT although they stated to use an efficacious strategy, suggesting then an erroneous metacognitive representation. Conclusions: Overall findings proposed that high levels of impulsivity combined with an explicit metacognitive bias on self-efficacy could intervene in the persistence of pathological gambling behavior in PD patients.