Sensitivity to Unpredictable Threat and Smoking Lapse Behavior

对不可预测的威胁和戒烟行为的敏感性

• 批准号: 9442942
• 负责人: Stewart Aaron Shankman
• 金额: $ 24.37万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9442942
• 关键词: Abstinence; Adopted; Adult; Affective; American; Anxiety; Anxiety Disorders; Behavior; Categories; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Clinical; Cognitive; Development; Diagnosis; Dimensions; Disease; Event-Related Potentials; Evoked Potentials; Functional disorder; Hour; Individual; Individual Differences; Knowledge; Laboratories; Measures; Modeling; National Institute of Mental Health; Outcome; Panic Disorder; Participant; Patient Self-Report; Pharmacological Treatment; Pharmacology; Physiology; Play; Process; Psychopathology; Public Health; Relapse; Research Domain Criteria; Risk; Role; Smoke; Smoker; Smoking; Smoking Behavior; Smoking Cessation Intervention; Speed; Stress; Testing; Uncertainty; Withdrawal; Withdrawal Symptom; addiction; analog; anxiety-related disorders; base; biological adaptation to stress; craving; deprivation; disability; experience; high risk; high risk population; individual patient; innovation; lens; meetings; multimodality; neuroadaptation; novel; precision medicine; premature; programs; psychosocial; smoking cessation; smoking prevalence; therapy development; trait

Project Summary Smoking is responsible for over 40% of premature deaths and disability in the US CDC. Although over 40% of the 48 million Americans that still smoke make a serious quit attempt each year, either on their own (i.e., self-guided quit) or with assistance from formal treatment, less than 5% are able to abstain from smoking for greater than 3 months. The selection hypothesis of smoking prevalence posits that smokers who are not able to quit successfully are “burdened” by specific characteristics that make it more challenging to quit. For example, those less successful in quitting smoking may be more likely to suffer from cognitive or affective vulnerabilities associated with psychiatric or other disorders. Smokers who suffer from anxiety are among the largest of these high-risk groups. Anxiety, however, is a broad construct that encompasses many mechanisms. New strategies targeting specific vulnerabilities (and not just general self-reported anxiety) are therefore needed to identify, understand, and ultimately, intervene with anxiety-prone smokers. One vulnerability for anxiety that is likely to play a role in smoking lapse behavior is sensitivity to unpredictable threat (SUT), an individual difference factor that is central to many anxiety disorders. SUT may be particularly predictive of smoking lapse as it has been proposed to be a manifestation of neuroadaptations of the stress response that has been observed across addictions. This project is therefore devoted to understanding the role of SUT in smoking lapse behavior and smoking topography (e.g., greater puff velocity, and shorter inter-puff intervals) using an innovative, multimethod assessment of sensitivity to unpredictable threat (i.e., EMG startle, evoked potentials, and self-report). The proposed project is significant from a public health standpoint because it can directly guide the development of novel psychosocial or pharmacologic smoking cessation interventions to help this and similar high-risk populations of smokers quit by targeting unique biologic vulnerability processes that result in poorer cessation outcomes. Meeting the specific aims will help validate the importance of the innovative laboratory assessment, demonstrate the importance of specific targets for assessment for at-risk smokers, and will contribute to the treatment development for smokers with anxiety and related disorders. Hence, the present project will significantly expand knowledge about the process and outcomes of smoking cessation as a function of a core biologic mechanism of dysfunction of anxiety, including the identification of specific mechanisms that impede quitting. In addition, this project will help expand the scope and usefulness of a lab assessment of relapse behavior to speed psychosocial/pharmacologic treatment development. Clinically, this approach will represent highly innovative and significant progress toward precision medicine where the selection of a smoking cessation program is tailored to the individual patient based on their attributes.

项目摘要 吸烟是美国疾病预防控制中心（CDC）超过40％的过早死亡和残疾。虽然结束了 在仍然吸烟的4800万美国人中，有40％每年都会严重退出尝试 （即自我引导的退出）或在正式治疗的帮助下，少于5％的人能够戒烟 超过3个月。吸烟流行率的选择假设认为不是 能够成功退出的特定特征“负担”，这使戒烟更具挑战性。为了 例如，那些在安静吸烟方面不太成功的人可能更有可能患有认知或情感 与精神病或其他疾病相关的漏洞。患有焦虑的吸烟者是 这些高风险群体中最大。然而，焦虑是一种涵盖许多人的广泛结构 机制。针对特定漏洞的新策略（不仅是一般自我报告的动画）是 因此，需要识别，理解并最终干预容易焦虑的吸烟者。 动画的一种脆弱性可能在吸烟失误行为中发挥作用 不可预测的威胁（SUT），这是许多焦虑症核心的个体差异因素。梅可能 特别可以预测吸烟失误，因为它被认为是神经适应的表现 在成瘾之间观察到的压力反应。因此，这个项目专门用于 了解SUT在吸烟行为和吸烟地形中的作用（例如，更大的粉扑速度， 较短的间隔间间隔）使用对不可预测的敏感性的创新，多方法评估 威胁（即EMG惊吓，引起潜力和自我报告）。拟议的项目非常重要 健康角度，因为它可以直接指导新型社会心理或药物的发展 吸烟戒烟干预措施，以帮助这种戒烟者通过靶向戒烟者戒烟 独特的生物脆弱性过程，导致停止结果较差。达到具体目标将有助于验证创新的实验室评估的重要性，证明特定目标对处于危险的吸烟者评估的重要性，并将为患有焦虑和相关疾病的吸烟者的治疗发展做出贡献。因此，本项目将显着扩大有关戒烟的过程和结果的知识，这是动画功能障碍的核心生物学机制的函数，包括鉴定妨碍安静的特定机制。此外，该项目将有助于扩大对继电器行为评估的范围和实用性，以加快心理社会/药理治疗的发展。在临床上，这种方法将代表选择吸烟的高度创新性和重大进展 戒烟计划是根据患者的属性量身定制的。