Clinical trial NCT03493399: Testing Interference-based Methods to Mitigate Gambling Craving - A Multiple Single Case Design
Official title: Testing Interference-based Methods to Mitigate Gambling Craving - A Multiple Single Case Design
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Gambling Disorder
Gambling, Pathological
Craving
Gambling
Gambling Problem
Keywords: Gambling
Craving
Urge
Desire
Interference
Elaborated Intrusion Theory
Treatment
Intervention
Clinical Sample
Single case
Lead sponsor: Université Catholique de Louvain
Sponsor class: OTHER
Collaborators: name: University of Luxembourg
name: Centre Hospitalier Universitaire Vaudois
name: University of Geneva, Switzerland
name: Cliniques universitaires Saint-Luc- Université Catholique de Louvain
First posted: 2018-04-10
Enrollment: 7
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Intervention model: SEQUENTIAL
Primary purpose: TREATMENT

Brief summary: 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.


Eligibility criteria: 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)

Primary outcomes:
measure: Gambling Craving Strength
timeFrame: 6 months
measure: Gambling Craving Frequency
timeFrame: 6 months
Secondary outcomes:
Other outcomes:
Locations:
city: Lausanne
country: Switzerland
facility: Centre du Jeu Excessif
state: Vaud
Study officials:
References:
citation: 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.
citation: 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.
citation: 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
citation: 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.
citation: 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.
citation: 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.
citation: 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.