Poker, Skills and Associated Problems (PERHAPS)

Poker, Skills and Associated Problems (PERHAPS). Controlled Experimental Single Centre Study of Poker Players: Study of the Cognitive Mechanisms Underlying Poker Skills and of the Specificity of Poker-related Problems

The PERHAPS project aims to fill two gaps in the scientific literature: on the one hand, studying the clinical and cognitive particularities of poker-related problems, and on the other hand, studying poker skill as a combination of multiple cognitive and emotional abilities. The underlying clinical aim is to develop a cognitive remediation therapy program dedicated to pathological gamblers.

Study Overview

• Status: Completed
• Conditions: Pathological Gambling
• Intervention / Treatment: Behavioral: cognitive, emotional and clinical assessment

Detailed Description

In the literature, although compulsive poker players undoubtedly share similarities with the compulsive gamblers of other gambling games, clinicians have observed significant specificities in these patients, in terms of personality profile, gaming practices and associated troubles. These specificities could influence the effectiveness of treatment and prevention strategies in many ways. However, there are very few studies focused on the specific poker-related problems, particularly compared to other practices.

Furthermore, skill at poker has often been treated as a unique and general ability. This binary vision is now considered widely insufficient and most researchers recommend exploring the individual cognitive abilities at play in poker skill. To the investigators knowledge, no study has done this to date.

Consequently, the PERHAPS project aims to fill two gaps in the scientific literature: on the one hand, studying the clinical and cognitive particularities of poker-related problems, and on the other hand, studying poker skill as a combination of multiple cognitive and emotional abilities.

Three profiles of poker players will be studied, depending on their gambling practices and whether or not they are addicted: a control group of 30 non-poker players, a group of 30 expert unproblematic poker players, and a group of 30 pathological poker players.

The three groups will be compared with one another on:

• Cognitive and emotional abilities (for expert players) or deficits (for pathological gamblers)
• Clinical particularities of poker-related problems

Secondarily (ancillary study), pathological poker gamblers will be compared with pathological gamblers of other gambling games (pure chance games n=30 and quasi-skill games n=30).

The PERHAPS project aims to improve knowledge of gambling addiction, particularly as regards poker, in order to optimise prevention and care strategies. The clinical aim is especially to construct a cognitive remediation therapy program. It also intends to discuss the legal framework applied to poker under the gambling regulation.

• Study Type: Interventional
• Enrollment (Actual): 113
• Phase: Not Applicable

Contacts and Locations

Study Locations

• France
  • Nantes, France, 44093
    • CHU de Nantes

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 59 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• 18-59 years
• good understanding of French, literate
• correct level of vision and hearing
• specific inclusion criteria for each group include frequency and length of poker practice, DSM-5 doagnostic criteria for gambling disorder

Exclusion Criteria:

• protected adults
• important cognitive deficit (assessed by the MMSE)
• psychotic syndrome whole life
• other psychiatric disorders (mood disorders, anxiety disorders) and addictive disorders (disorders related to the use of alcoholic or other substances, excluding nicotine) that are present and not stabilized
• unstable endocrine disorders
• significant neurological disorders (such as head injuries (except mild), neurodegenerative diseases, unbalanced epilepsy, mental retardation, etc.)
• psychoactive use (before participation)
• color blindness
• cardiac disorders
• electronic implants

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: non-poker players; (control group)	Behavioral: cognitive, emotional and clinical assessment; Cognitive and emotional assessment: Posner paradigm applied to emotional information (attention and emotional perception abilities), the modified Wisconsin Card Sorting Test (mental flexibility), the Hayling Sentence Completion Task (verbal inhibition), the Go - No Go test (motor inhibition) and the expressive suppression method (facial expression inhibition) Clinical assessment: gambling course and habits, level of cognitive distortions, control attribution (locus of control), social phobia, motivation for gambling, impulsivity, co-addictions, coping and gambling related-damage
Other: expert unproblematic poker players; (comparator)	Behavioral: cognitive, emotional and clinical assessment; Cognitive and emotional assessment: Posner paradigm applied to emotional information (attention and emotional perception abilities), the modified Wisconsin Card Sorting Test (mental flexibility), the Hayling Sentence Completion Task (verbal inhibition), the Go - No Go test (motor inhibition) and the expressive suppression method (facial expression inhibition) Clinical assessment: gambling course and habits, level of cognitive distortions, control attribution (locus of control), social phobia, motivation for gambling, impulsivity, co-addictions, coping and gambling related-damage
Other: pathological poker players; (comparator)	Behavioral: cognitive, emotional and clinical assessment; Cognitive and emotional assessment: Posner paradigm applied to emotional information (attention and emotional perception abilities), the modified Wisconsin Card Sorting Test (mental flexibility), the Hayling Sentence Completion Task (verbal inhibition), the Go - No Go test (motor inhibition) and the expressive suppression method (facial expression inhibition) Clinical assessment: gambling course and habits, level of cognitive distortions, control attribution (locus of control), social phobia, motivation for gambling, impulsivity, co-addictions, coping and gambling related-damage

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
attention and emotional perception performances	Modified Posner paradigm Performances will be compared between pathological poker players and non-poker players (to identify cognitive deficits in pathological players compared to baseline level) and between pathological poker players and expert unproblematic poker players (to identify cognitive deficits in pathological players compared to a gambler level)	only one assessment so at baseline
mental flexibility performances	Wisconsin Test (M-WCST) Performances will be compared between pathological poker players and non-poker players (to identify cognitive deficits in pathological players compared to baseline level) and between pathological poker players and expert unproblematic poker players (to identify cognitive deficits in pathological players compared to a gambler level)	only one assessment so at baseline
inhibition performances	Evaluation of inhibition at verbal level: Hayling sentence Completion Task Performances will be compared between pathological poker players and non-poker players (to identify cognitive deficits in pathological players compared to baseline level)	only one assessment so at baseline
inhibition performances	Evaluation of inhibition at motor level : Go-No Go Task Performances will be compared between pathological poker players and non-poker players (to identify cognitive deficits in pathological players compared to baseline level)	only one assessment so at baseline
inhibition performances	Evaluation of inhibition et expressive level : suppressive expression method Performances will be compared between pathological poker players and non-poker players (to identify cognitive deficits in pathological players compared to baseline level)	only one assessment so at baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
gambling course and habits	Standardized maintenance grid. The interview allows you to explore gambling habits, possible abstinence periods, different games the game of choice, current practice, damage and the quality of shoring, and resources.	only one assessment so at baseline
control attribution (locus of control)	three-dimensional control location scale of Levenson (IPAH)	only one assessment so at baseline
level of cognitive distortions,	clinical questionnaires : Gambling Related Cognitions Scale (GRCS)	only one assessment so at baseline
level of social phobia	clinical questionnaires : social phobia questionnaire Leibowitz,	only one assessment so at baseline
motivation for gambling	clinical questionnaires : Gambling motivation questionnaire Reasons Questionnaire (GMQ)	only one assessment so at baseline
impulsivity profile	clinical questionnaires : Impulsive Behavior Scale	only one assessment so at baseline
psychiatric and addictive comorbidities	clinical questionnaires : Mini International Neuropsychiatric Interview (MINI)	only one assessment so at baseline
coping and gambling related-damage	clinical questionnaires : COPE Brief Questionnaire	only one assessment so at baseline

Collaborators and Investigators

• Sponsor: Nantes University Hospital

Study record dates

Study Major Dates

• Study Start (Actual): September 27, 2016
• Primary Completion (Actual): March 23, 2021
• Study Completion (Actual): March 23, 2021

Study Registration Dates

• First Submitted: October 6, 2015
• First Submitted That Met QC Criteria: October 27, 2015
• First Posted (Estimate): October 28, 2015

Study Record Updates

• Last Update Posted (Actual): March 30, 2021
• Last Update Submitted That Met QC Criteria: March 29, 2021
• Last Verified: March 1, 2021

More Information

Terms related to this study

• Keywords: cognitive remediation therapy; experimental study; cognitive mechanisms; poker
• Additional Relevant MeSH Terms: Mental Disorders; Disruptive, Impulse Control, and Conduct Disorders; Gambling
• Other Study ID Numbers: RC14_0036

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO