Distress Tolerance and Smoking Cessation

痛苦耐受力和戒烟

• 批准号: 10166818
• 负责人: Merideth A. Addicott
• 金额: $ 5.13万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2021-08-20
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10166818
• 关键词: Abstinence; Address; Affect; Affective; Anterior; Arkansas; Auditory; Auditory area; Awareness; Behavior; Behavioral; Brain; Cancer Etiology; Cessation of life; Chronic; Cigarette; Cognitive Therapy; Counseling; Data; Development; Disease; Distress; Drug Addiction; Drug usage; Ecological momentary assessment; Event; Functional Magnetic Resonance Imaging; Goals; Individual; Individual Differences; Insula of Reil; Intervention; Knowledge; Malignant Neoplasms; Measures; Medical Care Costs; Middle frontal gyrus structure; Monitor; Moods; Nicotine Withdrawal; Outcome; Outcome Study; Patient Self-Report; Pharmacotherapy; Play; Productivity; Relapse; Research; Role; Seeds; Services; Smoker; Smoking; Standardization; Stress; Techniques; Testing; Therapeutic Intervention; Time; Tobacco Dependence; Tobacco smoking behavior; Tobacco use; attributable mortality; auditory feedback; base; behavioral response; cigarette craving; cigarette smoking; cognitive control; coping; cost; craving; distress tolerance; drug relapse; experience; improved; interest; neurofeedback; neuroimaging; neuromechanism; neuroregulation; new therapeutic target; nicotine replacement; novel therapeutics; personalized intervention; predictive test; public health relevance; relating to nervous system; sensory cortex; smartphone Application; smoking cessation; smoking intervention; success; targeted treatment

ABSTRACT Tobacco addiction is a costly and often fatal problem. Even with counseling and nicotine replacement therapy, most smokers relapse following a quit attempt. For many smokers, cigarette smoking is provoked by affective distress. The ability to cope with this distress and remain abstinent may depend on one's level of distress tolerance, which is the ability to persist in a goal-directed activity while experiencing physical or affective discomfort. However, a gap in knowledge exists regarding the neural mechanisms that underlie distress tolerance. Identifying these neural mechanisms and understanding individual differences in distress tolerance holds promise for the development of new therapies and the improvement of cessation success through personalized interventions. Past research has shown that cigarette cravings and other forms of affective distress activate the insula, which may be the neural hub that connects the awareness of affective distress to cognitive control regions that determine the subsequent behavioral response (e.g., smoking a cigarette to relieve cravings). However, there is a significant gap in knowledge concerning whether insula connectivity underlies real-world distress tolerance behavior in the service of smoking cessation. Lab-based measures of distress tolerance provide standardized comparisons across individuals and could be used to identify smokers who would most benefit from interventions. A complementary approach, ecological momentary assessment, can capture temporal relationships among affective distress, craving, and smoking as they occur in smoker's daily lives, in real time. The goal of this research is to test the predictive validity of lab-based measures of distress tolerance against the real-world stress/smoking relationship, and to identify neural differences within smokers that relate to distress tolerance and could predict quit outcomes (i.e., relapsed vs nonrelapsed). To address this gap in knowledge, we will investigate three aims: Aim 1) Associate lab measures of distress tolerance to insula connectivity. Aim 2) Relate lab measures of distress tolerance with real-world stress and smoking using ecological momentary assessment. Aim 3) Explore how insula connectivity relates to real-world stress and smoking. By providing clear evidence of how distress tolerance, brain connectivity, and daily stress relate to quit outcomes, this study will greatly increase our understanding of why some smokers succeed in quitting while others relapse. This research will be generalizable to other drug addictions and psychiatric conditions that are exacerbated by physical or affective distress. Successful completion of this study will inform the development of personalized smoking interventions, as well as identify neural mechanisms that can be targeted by novel therapeutic techniques.

抽象的 烟草成瘾是一个昂贵且经常致命的问题。即使接受咨询和尼古丁替代疗法， 戒烟尝试后，大多数吸烟者复发。对于许多吸烟者来说，吸烟是由情感引起的 困扰。应对这种困扰和避免的能力可能取决于一个人的困扰水平 宽容，这是在体验身体或情感的同时继续进行目标指导活动的能力 不适。但是，知识的差距存在有关痛苦基础的神经机制的差距 宽容。识别这些神经机制并了解遇险宽容的个体差异 对开发新疗法以及通过 个性化干预措施。 过去的研究表明，香烟的渴望和其他形式的情感困扰激活了岛屿， 这可能是将情感困扰意识与认知控制区域联系起来的神经枢纽 确定随后的行为反应（例如，吸烟以缓解渴望）。但是，那里 是关于岛连接是否具有现实世界中的遇险宽容的知识的重大差距 服务戒烟的行为。基于实验室的遇险公差措施提供标准化 比较个人，可以用来识别最能从中受益的吸烟者 干预措施。一种互补的方法，生态瞬时评估，可以捕捉时间 情感困扰，渴望和吸烟在吸烟者日常生活中的关系，实时。 这项研究的目的是测试基于实验室的遇险公差措施的预测有效性 现实世界的压力/吸烟关系，并确定吸烟者中与之相关的神经差异 遇险的容忍度，可以预测戒烟的结果（即复发与未划分的复发）。 为了解决知识的这一差距，我们将研究三个目标：目标1） 对岛连通性的遇险容忍。目的2）将实验室承受能力的措施与现实世界联系起来 使用生态时刻评估的压力和吸烟。目标3）探索绝缘连通性与 现实世界的压力和吸烟。通过提供明确的证据表明遇险的容忍度，大脑连通性和 每日压力与退出结果有关，这项研究将大大增加我们对某些吸烟者的理解 成功退出时，其他人复发。这项研究将推广到其他药物成瘾和 受身体或情感困扰加剧的精神病疾病。成功完成 研究将为个性化吸烟干预措施的发展提供信息，并确定神经 可以通过新颖的治疗技术靶向的机制。