Impulsivity In Cocaine Abusers: Relationship to Drug Taking and Treatment Outcome

可卡因滥用者的冲动：与吸毒和治疗结果的关系

• 批准号: 8694439
• 负责人: Richard W Foltin
• 金额: $ 52.77万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-15 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8694439
• 关键词: Accounting; Age; Alcohol consumption; Behavioral; Behavioral inhibition; Binge Eating; Brain; Clinical; Cocaine; Cocaine Abuse; Cocaine Users; Cognitive; Cognitive Therapy; Control Groups; Data; Decision Making; Drug usage; Economics; Ethnic Origin; Exercise; Factor Analysis; Female; Foundations; Functional Magnetic Resonance Imaging; Future; Impulsive Behavior; Impulsivity; Laboratories; Measures; Modeling; Outcome; Participant; Patient Self-Report; Personality; Personality Traits; Pharmaceutical Preparations; Play; Process; Public Health; Punishment; Research; Research Design; Rewards; Risk-Taking; Role; Smoke; Structural Models; Structure; Testing; Treatment outcome; base; clinically relevant; cocaine use; discount; discounting; high risk sexual behavior; male; neurobehavioral; neuroimaging; novel; public health relevance; relating to nervous system; response; sex; social; success; therapy development; treatment strategy

DESCRIPTION (provided by applicant): Cocaine users 1) are more impulsive based on self-report measures, 2) have more difficulty inhibiting behavioral responses, 3) make poorer decisions in decision-making tasks, and 4) discount the value of future rewards at a faster rate than non-cocaine users, suggesting that impulsivity plays a role in cocaine abuse. After collecting data on these 4 domains in current cocaine abusers (n = 200) and matched controls (n = 180), we will conduct confirmatory factor analyses testing a second-order factor model of Impulsive Choice. We hypothesize that 3 first-order latent factors (personality/behavioral inhibition, risk taking, reward/punishment value) will account for the significant relations among the measures within each factor, and a single latent second-order factor (impulsive decision-making) will account for the relationships among the 3 first-order factors. We will test the abilit of our model to predict real world cocaine use and clinical outcome. Aim 1. Obtain self-report and task-based measures of 1) impulsivity~ 2) response inhibition~ 3) decision- making~ and 4) temporal discounting in cocaine abusers and matched controls in order to examine the correlational structure among the measures and test our model of Impulsive Choice. Aim 2a. Compare the structural model and the scores for each factor between groups. We hypothesize that the 4 latent factors of our model of Impulsive Choice will be observed in both groups, but cocaine abusers will have greater scores on all factors. Aim 2b. Evaluate the predictive validity of our factors with respect to cocaine use. We hypothesize a positive relationship between our factors and current cocaine use. Aim 3. Compare the structural model and the scores for each factor between sexes. We hypothesize that the 4 latent factors of our model of Impulsive Choice will be observed in both sexes with the following rank order of factor scores: Female Cocaine Abusers > Male Cocaine Abusers > Male Controls > Female Controls. Aim 4a. Evaluate the predictive validity of our factors in 35 cocaine users with respect to neural measures of response inhibition and temporal discounting. Aim 4b. Evaluate whether the factors predict neural activity associated with decisions to smoke cocaine measured using a novel fMRI task (CNET) in 35 cocaine users. We hypothesize that our factors, with incorporation of neural measures of response inhibition and temporal discounting, will predict neural activity related to decisions to smoke cocaine and self-reported cocaine use. Aim 5. Evaluate the predictive validity of our factors with respect to treatment outcome for 100 participants for whom we will provide cognitive-behavioral treatment (CBT) for their cocaine use. We hypothesize that there will be a negative relationship between our factors and clinical outcome. Impact: A better understanding of the construct of impulsivity and which factors of impulsivity best predict clinica outcome will provide critical information to guide the development of therapies specifically targeting cognitive processes associated with those factors in drug taking.

描述（由申请人提供）：可卡因使用者 1) 根据自我报告的衡量结果更容易冲动，2) 更难以抑制行为反应，3) 在决策任务中做出较差的决定，以及 4) 对未来奖励的价值打折扣比非可卡因使用者更快，这表明冲动在可卡因滥用中发挥了作用。在收集当前可卡因滥用者 (n = 200) 和匹配对照 (n = 180) 这 4 个领域的数据后，我们将进行验证性因素分析，测试冲动选择的二阶因素模型。我们假设 3 个一阶潜在因素（个性/行为抑制、冒险、奖励/惩罚值）将解释每个因素内的度量之间的显着关系，以及一个潜在二阶因素（冲动决策）将解释 3 个一阶因素之间的关系。我们将测试我们的模型预测现实世界可卡因使用和临床结果的能力。目标 1. 获得可卡因滥用者和匹配对照的 1) 冲动 ~ 2) 反应抑制 ~ 3) 决策 ~ 和 4) 时间贴现的自我报告和基于任务的测量，以检查测量和匹配之间的相关结构。测试我们的冲动选择模型。目标 2a。比较组间结构模型和每个因素的得分。我们假设冲动选择模型的 4 个潜在因素在两组中都能观察到，但可卡因滥用者在所有因素上的得分都更高。目标 2b。评估我们的因素对可卡因使用的预测有效性。我们假设我们的因素与当前的可卡因使用之间存在正相关关系。目标 3. 比较性别之间的结构模型和每个因素的得分。我们假设我们的冲动选择模型的 4 个潜在因素将在两性中观察到，其因素得分的排序如下：女性可卡因滥用者 > 男性可卡因滥用者 > 男性对照 > 女性对照。目标 4a。评估我们的因素在 35 名可卡因使用者中关于反应抑制和时间贴现的神经测量的预测有效性。目标 4b。使用新型功能磁共振成像任务 (CNET) 对 35 名可卡因使用者进行测量，评估这些因素是否可以预测与吸食可卡因决定相关的神经活动。我们假设我们的因素，结合反应抑制和时间折扣的神经测量，将预测与吸食可卡因和自我报告的可卡因使用决定相关的神经活动。目标 5. 评估我们的因素对于 100 名参与者的治疗结果的预测有效性，我们将为这些参与者提供针对可卡因使用的认知行为治疗 (CBT)。我们假设我们的因素与临床结果之间存在负相关关系。影响：更好地理解冲动的构成以及哪些冲动因素最能预测临床结果，将为指导开发专门针对与吸毒因素相关的认知过程的疗法提供关键信息。