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

NCT ID: NCT03493399

Last Updated: 2019-06-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

7 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-07-01

Study Completion Date

2019-10-30

Brief Summary

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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.

Detailed Description

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Conditions

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Gambling Disorder Gambling, Pathological Craving Gambling Gambling Problem

Keywords

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Gambling Craving Urge Desire Interference Elaborated Intrusion Theory Treatment Intervention Clinical Sample Single case

Study Design

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Intervention Model

SEQUENTIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Problem Gamblers

Interference

Group Type EXPERIMENTAL

Interference

Intervention Type BEHAVIORAL

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.

Interventions

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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.

Intervention Type BEHAVIORAL

Eligibility Criteria

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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)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Luxembourg

OTHER

Sponsor Role collaborator

Centre Hospitalier Universitaire Vaudois

OTHER

Sponsor Role collaborator

University of Geneva, Switzerland

OTHER

Sponsor Role collaborator

Cliniques universitaires Saint-Luc- Université Catholique de Louvain

OTHER

Sponsor Role collaborator

Université Catholique de Louvain

OTHER

Sponsor Role lead

Responsible Party

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Aurelien Cornil

Main Collaborator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Centre du Jeu Excessif

Lausanne, Canton of Vaud, Switzerland

Site Status

Countries

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Switzerland

Central Contacts

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Aurélien Cornil

Role: CONTACT

Phone: +3210478737

Email: [email protected]

Olivier Simon

Role: CONTACT

Email: [email protected]

Facility Contacts

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Olivier Simon

Role: primary

References

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Young MM, Wohl MJ. The Gambling Craving Scale: Psychometric validation and behavioral outcomes. Psychol Addict Behav. 2009 Sep;23(3):512-22. doi: 10.1037/a0015043.

Reference Type BACKGROUND
PMID: 19769435 (View on PubMed)

Kavanagh DJ, Andrade J, May J. Imaginary relish and exquisite torture: the elaborated intrusion theory of desire. Psychol Rev. 2005 Apr;112(2):446-67. doi: 10.1037/0033-295X.112.2.446.

Reference Type BACKGROUND
PMID: 15783293 (View on PubMed)

Cornil, A., Lopez-Fernandez, O., Devos, G., de Timary, P., Goudriaan, A. E., & Billieux, J. (2018). Exploring gambling craving through the elaborated intrusion theory of desire: a mixed methods approach. International Gambling Studies, 18(1), 1-21. https://doi.org/10.1080/14459795.2017.1368686

Reference Type BACKGROUND

May J, Andrade J, Panabokke N, Kavanagh D. Visuospatial tasks suppress craving for cigarettes. Behav Res Ther. 2010 Jun;48(6):476-85. doi: 10.1016/j.brat.2010.02.001. Epub 2010 Feb 7.

Reference Type RESULT
PMID: 20189549 (View on PubMed)

Andrade J, Pears S, May J, Kavanagh DJ. Use of a clay modeling task to reduce chocolate craving. Appetite. 2012 Jun;58(3):955-63. doi: 10.1016/j.appet.2012.02.044. Epub 2012 Feb 24.

Reference Type RESULT
PMID: 22369958 (View on PubMed)

Skorka-Brown J, Andrade J, Whalley B, May J. Playing Tetris decreases drug and other cravings in real world settings. Addict Behav. 2015 Dec;51:165-70. doi: 10.1016/j.addbeh.2015.07.020. Epub 2015 Jul 26.

Reference Type RESULT
PMID: 26275843 (View on PubMed)

Cornil, A., & Billieux, J. (2017). OP-15. Using interference-based intervention to block gambling craving: A proof of principle study. Journal of Behavioral Addictions, 6 (Suppl.1), 9.

Reference Type RESULT

Other Identifiers

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UCLouvain - CJE-CHUV

Identifier Type: -

Identifier Source: org_study_id