Poker, Skills and Associated Problems

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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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

Conditions
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Pathological Gambling

Intervention / Treatment
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* Behavioral: cognitive, emotional and clinical assessment


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 59 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

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


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: non-poker players<br>(control group) | Behavioral: cognitive, emotional and clinical assessment<br>* 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<br>|
| Other: expert unproblematic poker players<br>(comparator) | Behavioral: cognitive, emotional and clinical assessment<br>* 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<br>|
| Other: pathological poker players<br>(comparator) | Behavioral: cognitive, emotional and clinical assessment<br>* 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<br>|

What is the study measuring?
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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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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experimental study, cognitive mechanisms, poker, cognitive remediation therapy