Approach Bias Modification for the Treatment of Cannabis Use Disorder

项目概要/摘要 大麻使用障碍（CUD）越来越常见，但可用的治疗方法不足。迄今 没有FDA批准的药物，虽然心理干预是适度有效的，但其持久性 是有限的，禁欲率很低。研究新的CUD预防性治疗是必要的。 药物相关刺激认知加工中的偏差在药物相关刺激的发展和维持中起着重要的作用 成瘾性疾病的症状越来越多的证据表明，药物相关的自动方法的衰减 趋势提供了一种有前途的新治疗方法。接近偏差修正（ABM）涉及操纵 在计算机化任务期间，为了减弱接近偏差并减少 吸毒在最近的临床试验中，ABM在一年的随访中将酒精复发率降低了10-13%， 中边缘神经活动对酒精提示的反应，并减少尼古丁的消耗和依赖 严重性。ABM尚未在大麻使用者中进行测试。 该候选人最近完成了一项四期实验室试点研究，证明反弹道导弹培训 在非寻求治疗的成人CUD患者（N=33）中是安全、可耐受和可行的。接受ABM的参与者 显示钝大麻线索诱导的渴望，有性别修饰的ABM上的趋势， 使用大麻鉴于这些有希望的初步发现，反弹道导弹可能是现有的一个强大的辅助手段， 心理社会干预。 在拟议的职业发展奖中，候选人的目标是确定四次会议的干预是否 ABM与MET/CBT相结合可以减少大麻线索诱导的反应（目的1），并改善大麻的使用 结果（目标2）在寻求治疗的成人CUD。此外，候选人将确定是否性别 缓和ABM对线索反应性和大麻使用的影响（探索性目的）。一部小说的发展， 有效的CUD治疗将有可能帮助估计有100万使用大麻的美国人 寻求治疗的人。值得注意的是，ABM没有副作用，具有成本效益，并且可能集中针对认知障碍。 与CUD相关的机制。

PROJECT SUMMARY / ABSTRACT Cannabis use disorder (CUD) is increasingly common, yet available treatments are inadequate. To date there are no FDA-approved medications, and while psychosocial interventions are modestly effective, their durability is limited and abstinence rates are low. Investigation of novel adjunctive treatments for CUD is warranted. Biases in cognitive processing of drug-related stimuli play an important role in the development and maintenance of addictive disorders. Growing evidence suggests that attenuation of drug-related automatic approach tendencies offers a promising new treatment approach. Approach bias modification (ABM) involves manipulating stimulus-response contingencies during a computerized task in order to attenuate approach bias and reduce drug use. In recent clinical trials, ABM reduced alcohol relapse rates by 10-13% at one-year follow-up, decreased mesolimbic neural activity in response to alcohol cues, and reduced nicotine consumption and dependence severity. ABM has not yet been tested with cannabis users. The candidate recently completed a four-session laboratory-based pilot study demonstrating that ABM training is safe, tolerable, and feasible in non-treatment seeking adults with CUD (N=33). Participants receiving ABM showed blunted cannabis cue-induced craving, and there was a trend for gender modification of ABM on cannabis use. Given these promising preliminary findings, ABM may be a powerful adjunct to existing psychosocial interventions. In the proposed career development award, the candidate aims to determine if a four-session intervention combining ABM with MET/CBT can reduce cannabis cue-induced reactivity (Aim 1) and improve cannabis use outcomes (Aim 2) in treatment-seeking adults with CUD. Additionally, the candidate will determine if gender moderates the effect of ABM on cue-reactivity and cannabis use (Exploratory Aim). Development of a novel, effective treatment for CUD would have the potential to help the estimated one million cannabis using Americans that seek treatment each year. Of note, ABM has no side effects, is cost-efficient, and may focally target cognitive mechanisms associated with CUD.