Engaging Working Memory and Distress Tolerance to Aid Smoking Cessation

调动工作记忆和抗压能力来帮助戒烟

• 批准号: 9767106
• 负责人: Michael W. Otto
• 金额: $ 20.98万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9767106
• 关键词: American; Attention; Back; Behavior Control; Biological Assay; Clinical; Cognitive; Digit structure; Emotional; Emotions; Exposure to; Face; Failure; Goals; Health behavior; Impairment; Individual; Informal Social Control; Intervention; Investigational Therapies; Knowledge; Laboratories; Link; Low income; Measures; Mindfulness Training; Modeling; Modification; Nicotine; Nicotine Withdrawal; Outcome; Persons; Population Characteristics; Process; Protocols documentation; Psychological reinforcement; Publishing; Regulation; Relapse; Research; Risk; Risk Factors; Schedule; Self-control as a personality trait; Severities; Short-Term Memory; Smoke; Smoker; Smoking; Socioeconomic Status; Stress; Therapeutic; Time; Withdrawal; Withdrawal Symptom; Work; anxiety sensitivity; base; behavior change; cigarette smoke; clinically relevant; craving; deprivation; distress tolerance; emotional behavior; evidence base; improved; innovation; low socioeconomic status; mindfulness; mindfulness intervention; negative affect; nicotine use; novel; relapse risk; resilience; smoking cessation; smoking prevalence; stress reactivity; stress resilience; stress symptom; stressor; therapy development

PROJECT SUMMARY/ABSTRACT Recent estimates indicate that both low income and educational attainment are among the strongest predictors of both smoking prevalence and continued smoking. Treatment development is limited by inadequate knowledge of the specific lapse/relapse-relevant vulnerabilities characteristic of these populations (i.e, the processes that underpin lapse/relapse). Recently, we published a comprehensive model of the way in which these cognitive and emotional vulnerabilities--lower WMC and elevated AS--represent separate liabilities for negative health behaviors and self-control lapses, particularly under conditions of stress. The interactive models we propose suggest that interventions targeting only some of these vulnerabilities will leave smokers at risk for cessation failure. Accordingly, interventions that can engage these multiple vulnerabilities have the potential to greatly benefit at-risk subsamples of smokers, such as low SES smokers. Accordingly, this project is devoted to using an experimental therapeutics approach to show: (1) that a standard mindfulness intervention, and a mindfulness intervention modified in accordance with crucial preliminary work (Mindfulness+IE), have the ability to differentially engage these triple risk mechanistic targets, and (2) that the degree to which these putative triple risk targets are engaged produces a desired change in a health behavior, using a laboratory model of smoking risk burden and lapse potential. An innovative approach for understanding risk for relapse in smokers undergoing a quit attempt is to examine candidate mechanistic targets assessed not only during nicotine use, but during the conditions smokers will face upon a cessation attempt – during nicotine deprivation windows. In particular, we intend to show the incremental value of assessments during deprivation windows, in part due to the way in which triple vulnerabilities are modified by and interact with the heightened stress and withdrawal symptoms inherent to nicotine deprivation states in smokers. We also intent to show that a novel mindfulness intervention (Mindfulness+IE) can rescue limitations of standard mindfulness interventions, by extending therapeutic gains to the modification of mechanistic targets assessed in high-stress contexts. The overall goal is to validate mechanistic targets and associated interventions for the purpose of expanding treatment options for particularly at-risk smokers.

项目概要/摘要 最近的估计表明，低收入和教育程度都是最强的 吸烟率和持续吸烟的预测因素 治疗的发展受到限制。 对这些人群的具体复发/复发相关脆弱性特征了解不足 （即支持衰退/复发的过程）。最近，我们发布了一个全面的模型。 这些认知和情感脆弱性（WMC 降低和 AS 升高）代表了单独的责任 针对不良健康行为和自我控制失误，特别是在压力条件下。 我们提出的模型仅针对其中一些脆弱性的干预措施将使吸烟者陷入困境 因此，可以针对这些多个漏洞的干预措施具有戒烟失败的风险。 因此，该项目有可能使高危吸烟者子样本（例如低社会经济地位吸烟者）受益匪浅。 致力于使用实验治疗方法来证明：（1）标准的正念 干预，以及根据重要的前期工作修改的正念干预 （正念+IE），有能力区别对待这些三重风险机制目标，并且（2） 这些假定的三重风险目标在多大程度上产生了健康行为所需的改变， 使用吸烟风险负担和戒烟潜力的实验室模型进行理解的创新方法。 尝试戒烟的吸烟者复吸的风险是检查评估的候选机械目标 不仅在尼古丁使用过程中，而且在吸烟者尝试戒烟时将面临的情况——在 特别是，我们打算展示尼古丁剥夺窗口期间评估的增量价值。 剥夺窗口，部分原因是三重漏洞被修改并与之交互的方式 我们还打算减少吸烟者尼古丁剥夺状态所固有的令人疲惫的压力和戒断症状。 表明一种新颖的正念干预（正念+IE）可以挽救标准正念的局限性 干预措施，通过将治疗收益扩展到高压力下评估的机械目标的修改 总体目标是验证机械目标和相关干预措施，以达到以下目的： 针对高危吸烟者的治疗方案。