Behavioral activation intervention, reward processing and youth smoking cessation

行为激活干预、奖励处理和青少年戒烟

基本信息

批准号：
8252217
负责人：
Laura MacPherson
金额：
$ 21.75万
依托单位：
UNIV OF MARYLAND, COLLEGE PARK
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-05-10 至 2014-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8252217
关键词：
21 year old Abstinence Addictive Behavior Address Adolescent Adolescent Behavior Adolescent Development Adult Affective Aftercare Age Alcohol or Other Drugs use Anxiety Disorders Area Attention Behavior Behavior Therapy Behavioral Brain Brain region Child Chronic Collaborations DA10 Data Decision Making Depressive disorder Development Effectiveness Environment Event Exhibits Focus Groups Functional Magnetic Resonance Imaging Future General Population Goals Hand Image Incidence Individual Interdisciplinary Study Intervention Investigation Life Style Literature Maintenance Manuals Maryland Mental Depression Methodology Methods Modeling Mood Disorders National Institute of Mental Health Neurobiology Neurosciences Nucleus Accumbens Outcome Paper Participant Phase Prevalence Protocols documentation Psychological reinforcement Psychophysiology Randomized Clinical Trials Relapse Research Research Personnel Rewards Risk Running Sarin Site Smoke Smoker Smoking Smoking Behavior Staging System Techniques Telephone Testing Time Training Treatment Protocols Universities Ventral Striatum Work Youth addiction adolescent smoking affective neuroscience base clinical conference depressive symptoms improved interest medical schools meetings member multidisciplinary neurobehavioral nicotine replacement novel strategies open label programs psychosocial public health relevance reinforcer response reward processing smoking cessation smoking intervention symposium theories therapy development translational approach treatment response trend young adult

项目摘要

DESCRIPTION (provided by applicant): Evidence suggests a significant percentage of adolescent regular smokers are interested in trying to quit smoking and frequently make attempts to quit, yet are unsuccessful in maintaining abstinence on their own. Despite a genuine desire to quit on the part of many adolescents, there is an increasing incidence of smoking among older adolescents that runs counter to the overall trends of smoking reduction seen in the general population. Unfortunately, psychosocial and pharmacological smoking interventions have yet to indicate clear effectiveness with youth. Moreover, depression-related vulnerabilities, particularly currently elevated depressive symptoms, are highly comorbid with smoking behavior and dramatically reduce cessation rates. As a result, new approaches to smoking cessation are needed for adolescent smokers with currently elevated depressive symptoms. Behavioral activation (BA) is an approach that may be especially relevant for youth. BA has been shown to effectively treat those with depressive disorders through reduction of depressive symptoms by increasing contact with positive reinforcing events. In its application to smoking, BA is a practical, treatment approach based on reinforcement theory that helps individuals develop a more healthy and active lifestyle to simultaneously address depressive symptoms and quit smoking. In considering key theoretical aspects of BA and its basis in reinforcement theory, the construct of reward sensitivity is of great importance. Because reward sensitivity differs greatly across individuals and different stages of development, the current application will take a translational approach. Finally, despite a strong body of work supporting the use of BA with addictions in adults, developmental considerations are critical when applying adult derived-treatment models to adolescents. The objective of the proposed project is to develop a specialized behavioral activation treatment for smoking in youth ages 18-21 with elevated depressive symptoms (BATSY). The project will take place in two phases. In the first phase, we will utilize focus groups and pilot testing with 15 youth to develop the BATSY treatment protocol. In Phase II, we will conduct an open-label trial of BATSY plus nicotine replacement therapy with 30 youth. In the context of testing this newly developed BA treatment for adolescent smokers with elevated depressive symptoms, we will use sophisticated fMRI methodology to examine the extent to which baseline reward sensitivity is associated with treatment response. To achieve these multidisciplinary goals at the integration of neurodevelopmental and neurobehavioral methods with behavioral treatment development for adolescent smokers, in line with RFA-DA-10-003, we will establish a translational collaboration of researchers from University of Maryland, NIMH, and Yale University. PUBLIC HEALTH RELEVANCE: Adolescent smokers with elevated depressive symptoms are at significant risk to develop into chronic adult smokers, yet smoking treatments specifically targeted to their needs are absent. This application represents the first effort to develop and test a specialized behavioral activation (BA) base protocol for this extremely at- risk group of youth using a translational, multidisciplinary team-building approach.

描述（由申请人提供）：证据表明，有很大一部分的青春期常规吸烟者有兴趣试图戒烟并经常尝试戒烟，但没有成功地自行戒酒。尽管许多青少年的渴望真正渴望戒烟，但年长的青少年吸烟的发生率越来越多，这与普通人群中减少吸烟的总体趋势相反。不幸的是，社会心理和药理吸烟干预措施尚未表明对青年的有效性。此外，与抑郁症相关的脆弱性，尤其是目前的抑郁症状升高，与吸烟行为高度合并，并大大降低了停止率。结果，对于目前抑郁症状升高的青少年吸烟者需要进行新的戒烟方法。行为激活（BA）是一种可能与青年特别相关的方法。 BA已被证明可以通过增加与积极加强事件的接触来有效地治疗抑郁症的人。 BA在应用吸烟的应用中是一种基于增强理论的实用治疗方法，可帮助个人发展更健康，更积极的生活方式，以同时解决抑郁症状并戒烟。在考虑BA的关键理论方面及其在增强理论中的基础时，奖励敏感性的构建非常重要。由于奖励灵敏度在个人和发展的不同阶段之间有很大的不同，因此当前的应用将采用转化方法。最后，尽管大量工作支持在成年人中使用BA和成瘾的BA，但在将成人派生的治疗模型应用于青少年时，发展方面的考虑至关重要。拟议项目的目的是开发一种专门的行为激活治疗方法，以在18-21岁的青年中吸烟，抑郁症状升高（BATSY）。该项目将分为两个阶段。在第一阶段，我们将利用焦点小组和15名青年进行试验测试来制定BATSY治疗方案。在第二阶段，我们将对BATSY和30名青年进行Batsy和Nicotine替代疗法进行开放标签试验。在测试这种新开发的对具有抑郁症状升高的青春期吸烟者的BA治疗的背景下，我们将使用复杂的fMRI方法来检查基线奖励灵敏度与治疗反应有关的程度。为了实现这些多学科目标，即与RFA-DA-10-003一致的神经发育和神经行为方法与青少年吸烟者的行为治疗开发的整合，我们将建立来自马里兰州大学，NIMH和耶鲁大学研究人员的翻译合作。公共卫生相关性：抑郁症状升高的青春期吸烟者有很大的风险将其发展成为慢性成年吸烟者，但缺乏专门针对其需求的吸烟治疗。该应用程序代表着使用转化，多学科的团队建设方法为这个极端风险的青年组开发和测试专门行为激活（BA）基础方案的首次努力。