Interference-based methods to mitigate gambling craving: a proof-of-principle pilot study

Figures & data

Table 1. Selection of studies that use interference-based methods

Study	Target	Participants	Interference-based tasks and control conditions (CC)	Results
Kemps et al. (2005)	Induced chocolate craving	Chocolate cravers or not cravers, female university students	Dynamic visual noise Irrelevant speech	Reduction of craving and vividness Dynamic visual noise more effective than irrelevant speech
Steel et al. (2006)	Induced food craving	Food deprived or not-deprived female University students	Dynamic visual noise	Reduction of vividness and intensity of craving
May et al. (2010) 4 experiments	Induced cigarette craving	Smokers (>10 cigarettes/day) recruited in a University (staff and students)	Auditory mental imagery Visual mental imagery	Reduction of craving in visual condition but not in auditory condition
			Auditory mental imagery and dynamic visual noise Visual mental imagery	Reduction of craving in both conditions among deprived individuals
			Auditory mental imagery Visual mental imagery	Interruption of the increase of craving in visual imagery condition but not in auditory imagery condition
			Clay modeling Backwards counting (CC)	Interruption of the increase of craving in clay modeling condition but not in backwards counting condition
Knäuper et al. (2011)	Naturally occurring food or drink craving	University staff and students	Pleasant imagery Backwards alphabet (CC)	Reduction of craving Pleasant imagery more effective than reciting the backwards alphabet condition
Andrade, May et al. (2012) 2 experiments	Induced chocolate craving	Chocolate lovers recruited from university staff and students	Clay modeling Backwards counting (CC)	Reduction of craving in clay modeling Clay modeling as effective as backwards counting
			Clay modeling Backwards counting (CC)	Reduction of the strength and the vividness of craving in Clay modeling condition Clay modeling more effective than backwards counting
Kemps and Tiggemann (2013)	Naturally occurring food craving	Female university students with food cravings (7/week)	Dynamic visual noise	Reduction of the intensity of food craving Dynamic visual noise more effective than no intervention
Skorka-Brown et al. (2014)	Naturally occurring food, drink, caffeine, or nicotine craving	University students	Puzzle video game Tetris Load screen (CC)	Reduction of the strength and vividness of craving in Tetris condition Tetris more effective than load screen
Skorka-Brown et al. (2015)	In real world, drugs, drink, food, or activities craving	University students	Puzzle video game Tetris No task (CC)	Reduction of the strength and vividness of craving in Tetris condition Tetris more effective than simple monitoring
Schumacher et al. (2018)	Naturally occurring food craving	Female university students with food cravings (1/day)	Mental imagery Cognitive defusion (CC)	Reduction of the frequency and intensity of craving Mental imagery as effective as cognitive defusion
Dodds et al. (2019) 2 experiments	Naturally occurring food, drink, caffeine, nicotine, alcohol, or unspecified craving	University students and the nearby city dwellers	Puzzle video game Tetris Corsi block task Digit span task (CC)	Reduction of intensity, vividness, and intrusiveness but no difference across tasks
			Corsi block task Video watching (CC)	Reduction of intensity, vividness and intrusiveness more important in the task involving visuospatial working memory (Corsi block)

The lines separate experiments from one study.

Table 2. Demographics and gambling preferences

	Experiment 1 n = 38	Experiment 2 n = 38
Education
Primary	1	1
Secondary	17	21
Bachelor	5	6
Master	15	10
Occupation
Employee	8	10
Self-employed	2	3
Unemployed	1	1
Student	24	22
Retired	1	1
Other^a	2	1
Gambling preferences
Scratch cards	68.42%	55.26%
Lottery	60.53%	57.89%
Betting	39.47%	47.37%
Slot machines	18.42%	18.42%
Poker	10.53%	13.16%
Online poker	7.89%	7.89%
Other^b	2.63%	5.26%

^aVolunteer, mutual fund, integration allowance

^bBlackjack, roulette

Figure 1. Experimental design for both experiments. DASS-21 = Depression, Anxiety and Stress Scales; g-CEQ-S = gambling Craving Experience Questionnaire – Strength form, at baseline (Base), pre-intervention (Pre), and post-intervention (Post). Pictograms are license-free or Noun Project creations (Joseph Elsbernd, Nikita Kozin, corpus delicti, and Magicon)

Table 3. Characteristics and reliability of scales used

Questionnaire	Author (year)	Number and Type of Items	Response Format	Composite reliability (CR) of scale or subscales in experiment 1 and experiment 2
Gambling Craving Experience Questionnaire – Frequency (g-CEQ-F)	Cornil et al. (2019)	9 items distributed on 3 subscales (intensity, imagery and intrusiveness)	10-point Likert scale from 1 (not at all) to 10 (constantly)^a	Range from .88 to .95 and from .79 to .91
Gambling Craving Experience Questionnaire – Strength (g-CEQ-S)	Cornil et al. (2019)	9 items distributed on 3 subscales (intensity, imagery and intrusiveness)	10-point Likert scale from 1 (not at all) to 10 (extremely)^a	Range^b from .86 to .95 and from .84 to .94
Problem Gambling Severity Index	Ferris and Wynne (2001)	9 items	4-point Likert scale: 0 (never), 1 (sometimes), 2 (most of the time), 3 (almost always)	.78 and .86
Short Plymouth Sensory Imagery Questionnaire	Andrade et al. (2014)	21 items distributed on 7 subscales (vision, sound, smell, taste, touch, body, emotion)	11-point Likert scale ranging from 0 (no image at all) to 10 (as vivid as real life)	Range from .64 to .94 and from .66 to .92
Short UPPS-P Impulsive Behavior Scale	Billieux et al. (2012)	20 items distributed on 5 subscales (negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking)	4-point Likert scale: 1 (I agree strongly), 2 (I agree somewhat), 3 (I disagree somewhat), 4 (I disagree strongly)	Range from .78 to .91 and from .68 to .92
Depression, Anxiety and Stress Scales	Lovibond and Lovibond (1995)	21 items distributed on 3 subscales (depression, anxiety and stress)	4-point Likert scale: 0 (did not apply to me at all), 1 (applied to some degree, or some of the time), 2 (applied to me to a considerable degree or a good part of time), 3 (applied to me very much or most of the time)	Range from .87 to .91 and from .66 to .84

^aThe g-CEQ-F and -S were validated after these studies in a version with an 11-point Likert scale ranging from 0 (not at all) to 10 (constantly or extremely).

^bThe CR range takes each administration of the g-CEQ-S into account

Table 4. Paired samples t-tests between g-CEQ-S subscales at T1 (baseline) and at T2 (post-induction) and between g-CEQ-S subscales at T2 and at T3 (post-intervention)

			T1		T2
			M	SD	M	SD	t(37)	p	d
Experiment 1	g-CEQ-S	Intensity	12.45	7.91	17.84	8.09	6.87	<.001	1.11
(n = 38)		Imagery	11.76	7.84	18.68	8.53	7.63	<.001	1.24
		Intrusiveness	8.58	6.50	12.47	7.62	3.92	<.001	.64
Experiment 2	g-CEQ-S	Intensity	13.55	5.44	18.95	6.39	5.56	<.001	.90
(n = 38)		Imagery	14.03	7.07	19.55	7.45	6.21	<.001	1.01
		Intrusiveness	11.26	6.87	16.18	7.21	5.82	<.001	.94
			T2		T3
			M	SD	M	SD	t(37)	p	d
Experiment 1	g-CEQ-S	Intensity	17.84	8.09	11.45	6.88	−7.32	<.001	−1.19
(n = 38)		Imagery	18.68	8.53	11.76	7.39	−6.49	<.001	−1.05
		Intrusiveness	12.47	7.62	8.13	6.10	−3.96	<.001	−.64
Experiment 2	g-CEQ-S	Intensity	18.95	6.39	15.21	5.86	−5.69	<.001	−.92
(n = 38)		Imagery	19.55	7.45	14.92	8.49	−5.95	<.001	−.97
		Intrusiveness	16.18	7.21	12.34	7.14	−4.82	<.001	−.78

g-CEQ-S = gambling Craving Experience Questionnaire – Strength.

Figure 2. Mean ratings of each g-CEQ-S subscale at T2 (post-induction) and T3 (post-intervention) for Experiment 1 and Experiment 2. Error bars represent standard error of the mean. g-CEQ-S = gambling Craving Experience Questionnaire – Strength form. Error bars represent standard error of the mean. g-CEQ-S = gambling Craving Experience Questionnaire – Strength form

Table A1. Independent samples t-tests between experimental and control conditions

	Experiment 1			Experiment 2
	Statistic	Mean difference	Benjamini-Hochberg Adjusted p	Statistic	Mean difference	Benjamini-Hochberg Adjusted p
Sex	1.73		.99	1.73		.57
Age	1.24	4.89	.88	−1.79	−6.58	.48
short Psi-Q Vision	.44	.63	.88	1.23	2.79	.61
short Psi-Q Sound	−.37	−1.11	.86	1.43	2.47	.55
short Psi-Q Smell	.75	1.42	.79	1.02	2.58	.55
short Psi-Q Taste	.56	1.32	.82	1.21	3.16	.61
short Psi-Q Touch	−.40	−.79	.87	.55	1.16	.75
short Psi-Q Body	−.94	−1.58	.84	1.49	2.21	.56
short Psi-Q Emotion	.09	.16	.97	.67	.95	.71
g-CEQ-F Intensity	.11	.26	1.00	−.50	−1.11	.74
g-CEQ-F Imagery	.06	.11	.96	−.94	−1.95	.70
g-CEQ-F Intrusiveness	.91	1.68	.74	−2.19	−3.68	.48
PGSI	.11	.11	1.00	−.90	−1.37	.68
Negative Urgency	1.58	1.53	.72	.61	.53	.73
Positive Urgency	2.35	1.74	.24	−.30	−.21	.77
Lack of Premeditation	−.56	−.42	.87	−.34	−.26	.81
Lack of Perseverance	−.91	−.68	.81	.39	.32	.80
Sensation Seeking	−.69	−.74	.80	1.50	.74	.67
DASS-21 Depression	1.41	1.95	.82	−2.37	−2.05	.56
DASS-21 Anxiety	1.73	2.37	.72	−.72	−3.21	.48
DASS-21 Stress	2.72	4.11	.24	−.72	−.79	.72
g-CEQ-SBase Intensity	.84	2.16	.75	−1.75	−3.00	.43
g-CEQ-SBase Imagery	1.01	2.58	1.00	−.90	.79	.77
g-CEQ-SBase Intrusiveness	1.00	2.11	.88	−.90	−2.00	.65

Psi-Q = Plymouth Sensory Imagery Questionnaire; g-CEQ-F = gambling Craving Experience Questionnaire – Frequency form; PGSI = Problem Gambling Severity Index; DASS-21 = short version of the Depression Anxiety and Stress Scales; g-CEQ-S_Base = gambling Craving Experience Questionnaire – Strength form at T1 (baseline). Benjamini-Hochberg procedure (Benjamini & Hochberg, 1995) was used to obtain adjusted p-values with a false discovery rate at 5% for the 24 t-tests of each experiment.

Figure B1. Mean ratings of the intensity subscale of the g-CEQ-S at T2 (pre-intervention) and T3 (post-intervention) for Experiment 2 across three categories of gambling severity. Error bars represent standard error of the mean. The sample was divided into three categories according to the Problem Gambling Severity Index scores: low severity (0–2; n = 12), medium severity (3–7; n = 13) and high severity (8–21; n = 13). g-CEQ-S = gambling Craving Experience Questionnaire – Strength form

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Data availability statement

The data described in this article are openly available in the Open Science Framework at http://doi.org/10.17605/OSF.IO/CMZGR.