Marijuana Use, Extinction Learning, and Exposure Therapy in Individuals with PTSD

创伤后应激障碍 (PTSD) 患者的大麻使用、消退学习和暴露疗法

• 批准号: 9267954
• 负责人: MICHELE A BEDARD-Gilligan
• 金额: $ 17.91万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-05-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9267954
• 关键词: Acoustics; Affect; Agonist; Alcohol or Other Drugs use; Amygdaloid structure; Animals; Anxiety; Anxiety Disorders; Attenuated; Basic Science; Behavioral; Biological; Blood Pressure; CNR1 gene; Cannabinoids; Chronic; Clinical; Clinical Sciences; Comorbidity; Cues; Discrimination; Dose; Drops; Extinction (Psychology); Fright; Galvanic Skin Response; Hippocampus (Brain); Human; Hydrocortisone; Impairment; Individual; Intervention; Investigation; Knowledge; Learning; Link; Marijuana; Medical; Monitor; Neurobiology; Outcome; Participant; Pathologic; Patients; Physiological; Population; Post-Traumatic Stress Disorders; Prefrontal Cortex; Process; Protocols documentation; Psychopathology; Public Health; Randomized; Recovery; Recruitment Activity; Research; Risk; Sampling; Signal Transduction; Societies; System; Testing; Therapeutic; Therapeutic Effect; Time; Translating; Trauma; Treatment Protocols; Treatment outcome; Urine; Work; brief intervention; conditioning; cost; design; emotional experience; health care service utilization; high risk; improved; innovation; learning extinction; marijuana use; marijuana user; neurobiological mechanism; novel; predictive of treatment response; public health relevance; response; symptomatic improvement; treatment response

 DESCRIPTION (provided by applicant): Following trauma exposure a substantial number of individuals will go on to develop psychopathology, such as posttraumatic stress disorder (PTSD), and many also develop co-occurring substance use, such as marijuana use. Their co-occurrence is costly to both the victim and society as a whole. The co-occurrence of PTSD and marijuana use is predictive of poorer outcome and increased drop out from PTSD treatment. Exposure therapy, a first line intervention for PTSD, is theorized to work through extinction processes, and marijuana has known effects on extinction learning. Thus, a better understanding of the relationship between marijuana and extinction learning, in both experimental and treatment contexts, can help us better understand how to best intervene with this population. This project is designed to integrate basic and clinical science to translate mechanisms of recovery from PTSD to testing an intervention in individuals with PTSD and marijuana use. We will recruit 72 individuals with PTSD and varying levels of marijuana use, 36 with current heavy marijuana use and 36 without current marijuana use, to complete a conditional discrimination and extinction task in order to understand the relationship between marijuana and fear learning in individuals with pathological fear. Following this task, participant will be randomized to either a brief 6 session imaginal exposure protocol (IE) or a standard 10 session prolonged exposure protocol (PE) to explore whether the adapted short form treatment shows increased feasibility (efficacy, reduced drop out) for individuals with co-occurring PTSD and marijuana use. We will also be able to test the link between basic fear and recovery processes by looking at the extinction task as a predictor of treatment response for individuals with and without marijuana use. This research is significant in its potential to identify a predictr of treatment response, to test an underlying mechanism of recovery for PTSD in individuals with PTSD and co-occurring marijuana use, and to test feasibility of a novel intervention for a difficul to treat population.

 描述（由适用提供）：创伤暴露后，大量的个体将继续发展精神病学，例如创伤后应激障碍（PTSD），许多人也会开发同时发生的药物使用，例如大麻使用。他们的同时发生对受害者和整个社会都是昂贵的。 PTSD和大麻使用的同时出现预测结果较差，而PTSD治疗中的掉落增加了。曝光疗法是PTSD的第一线干预措施，从理论上讲是通过扩展过程进行的，并且大麻对扩展学习具有已知影响。在实验和治疗环境中，对大麻与扩展学习之间的关系有更好的理解可以帮助我们更好地了解如何最好地干预该人群。该项目旨在整合基本和临床科学，以转化从PTSD的恢复机制，以测试对PTSD和大麻使用的人的干预。我们将招募72名具有PTSD和不同水平的大麻使用的人，36种具有当前大麻使用的人，而36人没有当前使用大麻，以完成有条件的歧视和扩展任务，以了解大麻和恐惧在患有病理恐惧中的人之间的关系。遵循此任务，参与者将被随机分配为简短的6个会话想象暴露协议（IE）或标准的10次会话延长暴露协议（PE），以探索适应性的短形式治疗方法是否显示出可行性增加（功效，降低掉落），以使患有PTSD和大麻使用的人使用。我们还将能够通过将扩展任务视为使用或不使用大麻的人的治疗反应的预测指标来测试基本恐惧和恢复过程之间的联系。研究对鉴定治疗反应的可能性很大，以测试PTSD和同时发生大麻使用的患者中PTSD恢复的潜在机制，并测试新干预的可行性，以使难以治疗的人群难以治疗。