Testing Interference-based Methods to Mitigate Gambling Craving - A Multiple Single Case Design

June 27, 2019 updated by: Aurelien Cornil, Université Catholique de Louvain

Gambling craving is involved in the development, maintenance and relapse of gambling disorder. Yet, it lacks research regarding evidence-based interventions available to mitigate craving in patients displaying gambling disorder. The elaborated intrusion theory of desire (EIT) is a cognitive model of craving which offers important avenues for the development of psychological interventions, as it clearly describes the processes at play in craving experiences (e.g., mental imageries, working memory). Recent research evidenced that the elaborated intrusion theory is relevant to account for gambling craving experiences. According to this model, craving (and desire) is the result of an elaboration process where "desires thoughts" (mental images and thoughts), induced by internal (e.g., frustration) and/or external (e.g., advertisement) triggers, require attentional and cognitive resources. The principle of interference-based techniques is to move the resources allocated to the elaboration of intrusive desire thoughts to a competing task (e.g., clay modelling, competitive mental imagery, Tetris) in order to monopolize the resources underlying craving, thus preventing its elaboration and reducing its vividness and overwhelming nature. Several studies have shown the efficacy of such techniques to reduce substance-related craving. Yet, data obtained on clinical samples remain scarce.

Preliminary data have been obtained prior to this application. In order to investigate the relevance of interference-based techniques, an experimental study was conducted in community gamblers. In two conditions (19 gamblers per condition), gambling craving was first induced via a short mental imagery session and a computer-generated gambling simulation task. Then, the experimental group was asked to perform an interference task consisting of creating a vivid mental image of a bunch of keys. The control group completed a task in which they had to pop and count bubble wrap. The analyses revealed that induced craving decreases significantly in both groups. However, participants that are considered problem gamblers showed a greater decrease of their craving in the experimental condition. This previous "proof of principle" study supports that interference-based techniques are potentially promising interventions to reduce craving in problem gambling. It also warrants further research as no data is available in clinical population.

The current project consists in a pilot study aiming to test the efficacy of interference-based techniques in a sample of gambling disorder patients. The investigators decided to adopt a multiple single case design, as this methodology is ideal in the sense that it helps to understand the whole process of an interference-based intervention among a small number (10) of outpatients with a gambling disorder, without control group. Ecological Momentary Assessment will be used to allow intervention no naturally occuring craving. In addition to be easily implementable in a clinical design, this design will provide sufficient evidences before possibly, in a second time, further validation of these techniques using a randomized-control trial.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Anticipated)

7

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Switzerland
    • Vaud
      • Lausanne, Vaud, Switzerland
        • Centre du Jeu Excessif

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Outpatients from CJE
  • In therapy for a Gambling Disorder
  • French speaking
  • Signifiant gambling cravings (clinically assessed)
  • Sign an inform consent

Exclusion Criteria:

  • Comorbidities (psychosis, acute manic phase, acute depressive phase, suicidal phase, mental retardation, alcohol intoxication or other psychic state incompatible with the study)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: TREATMENT
  • Interventional Model: SEQUENTIAL
  • Masking: NONE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: Problem Gamblers
Interference
Behavioral: Interference

The principle of interference-based techniques is to move the resources allocated to the elaboration of intrusive desire thoughts to a competing task (e.g., clay modelling, competitive mental imagery, Tetris) in order to monopolize the resources underlying craving, thus preventing its elaboration and reducing its vividness and overwhelming nature. Several studies (Andrade, Pears, May, & Kavanagh, 2012; May, Andrade, Panabokke, & Kavanagh, 2010; Skorka-Brown, Andrade, Whalley, & May, 2015) have shown the efficacy of such techniques to reduce substance-related craving. Yet, data obtained on clinical samples remain scarce.

Due to the flexibility of the single case design towards each participant, the list of interference-based techniques that will be used in this study cannot be exhaustive. However, the following will be proposed to participants: Tetris (smartphone version), manipulation of a bunch of keys, manipulation of a fidget, mental imagery, reading and memorizing a text.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Gambling Craving Strength
Time Frame: 6 months
Self-reported Questionnaire: gambling Craving Experience Questionnaire Strength (g-CEQ-S; Cornil et al., in prep) with 9 items rated on a Likert scale from 0 (not at all) to 10 (extremely). It is divided in 3 subscales of 3 items each: intensity, imagery, intrusiveness.
6 months
Gambling Craving Frequency
Time Frame: 6 months
Self-reported Questionnaire: gambling Craving Experience Questionnaire Frequency (g-CEQ-F; Cornil et al., in prep) with 9 items rated on a Likert scale from 0 (not at all) to 10 (constantly). It is divided in 3 subscales of 3 items each: intensity, imagery, intrusiveness.
6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Université Catholique de Louvain

Collaborators

Centre Hospitalier Universitaire Vaudois
Cliniques universitaires Saint-Luc- Université Catholique de Louvain
University of Geneva, Switzerland
University of Luxembourg

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ANTICIPATED)

July 1, 2019

Primary Completion (ANTICIPATED)

October 30, 2019

Study Completion (ANTICIPATED)

October 30, 2019

Study Registration Dates

First Submitted

March 23, 2018

First Submitted That Met QC Criteria

April 9, 2018

First Posted (ACTUAL)

April 10, 2018

Study Record Updates

Last Update Posted (ACTUAL)

June 28, 2019

Last Update Submitted That Met QC Criteria

June 27, 2019

Last Verified

June 1, 2019

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • UCLouvain - CJE-CHUV

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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