A Puff Topography Biofeedback Paradigm to Reduce Stress-Precipitated Smoking Reinforcement

项目摘要/摘要 有情绪困扰的吸烟者由于各种原因特别容易受到吸烟强化的影响 导致情绪调节缺陷和奖赏处理增强的生物心理因素， 这会破坏戒烟努力。吹气的时机和强度(即吹气地形)可以滴定或 最大限度地发挥香烟的奖励作用。我们的团队已经确定了烟尘地形是吸烟的核心驱动因素 强化，尤其是在情绪不佳的吸烟者身上。尽管很大程度上被认为是一种行为 吸烟强化的表型，在吸烟行为中固有的是相应的变化 心肺参数(例如，心脏迷走神经控制，CVC)，可促进自我调节和减少 渴望。在我们的情绪困扰和吸烟的综合心理生理学模型中，我们在 吸烟者，CVC受损不仅影响生理动态平衡，还影响与成瘾相关的 过程，包括自我调节和心理所需的受损的高级认知过程 功能(例如，减少焦虑和压力)。然而，在某些时间敏感的情况下(例如，压力)， 情绪不佳的吸烟者可能会以一种增强CVC的方式吸烟，从而导致强烈的自我调节 好处，反过来又矛盾地放大了每一口烟的强化价值。因此，一种生物行为 可以改变烟幕地形和CVC的干预措施有很大的潜力降低补强价值 吸烟对情绪痛苦的高危吸烟者的影响。基于我们的生物行为框架，我们 设计了一种高度创新的生物行为范式，称为喷雾地形生物反馈训练(PTBT)，以 直接以吸烟强化的假定生物行为基础为目标(即，膨胀地形和 CVC)。PTBT利用体内监测呼吸参数(即，生物反馈)，发生在 吸烟，使吸气的速度被限制在设计的最小CVC，以减轻急性 与吸烟强化相关的自律、情绪和欲望的减少。在这张R1中，我们 提出了一种受试者之间的PTBT实验测试，以及它对喷雾地形和CVC的修正能力 在压力沉淀的吸烟期间，并反过来，减少急性吸烟强化。情绪低落 每日吸烟者(N=88，50%女性)将被随机分为PTBT组或对照组；这两组在时间和 注意力需求。参与者将在连续两天内完成两项吸烟试验，使用 PTBT/控制。第一次吸烟试验(访问1)将使参与者熟悉这项任务。第二 吸烟试验(探访2)将在实验室急性应激诱导(应激诱发吸烟)后完成 审判)。主要的研究目的是测试PTBT和对照组的效果，在以下方面：压力的急性变化- 强化吸烟(烟草需求；香烟奖励；满意度)和变化 机制(气泡持续时间、CVC)。这项高干预前研究的结果可以为后续的 开发一种新的干预策略，以改善治疗耐药人群的戒烟结果。

PROJECT SUMMARY/ABSTRACT Smokers with emotional distress are particularly vulnerable to smoking reinforcement due to various biopsychological factors that contribute to deficits in emotion regulation and heightened reward processing, which undermine cessation efforts. The timing and intensity of one's puffing (i.e., puff topography) can titrate or maximize the cigarette's rewarding effect. Our group has identified puff topography as a core driver of smoking reinforcement, especially in emotionally distressed smokers. Although largely considered a behavioral phenotype of smoking reinforcement, inherent in puffing behavior are corresponding changes in cardiorespiratory parameters (e.g., cardiac vagal control, CVC) that may promote self-regulation and reduce craving. In our integrated psychophysiological model of emotional distress and smoking, we proposed that in smokers, impaired CVC not only implicates physiological homeostasis, but also influences addiction-relevant processes, including impaired higher-order cognitive processes needed for self-regulation and psychological functioning (e.g., reduced anxiety and stress).Yet, under certain time-sensitive contexts (e.g., stress), emotionally distressed smokers may puff in a way that enhances CVC, resulting in acute self-regulatory benefits, and in turn paradoxically amplifies the reinforcing value of each puff. Thus, a bio-behavioral intervention that could modify puff topography and CVC has the strong potential to reduce the reinforcing value of cigarettes in high-risk emotionally distressed smokers. Grounded in our biobehavioral framework, we designed a highly innovative bio-behavioral paradigm, called Puff Topography Biofeedback Training (PTBT) to directly target putative bio-behavioral underpinnings of smoking reinforcement (i.e., puffing topography and CVC). PTBT leverages in vivo monitoring of respiratory parameters (i.e., biofeedback) that occurs during smoking so that puffing is constrained to a pace that is designed to minimize CVC in order to attenuate acute self-regulatory, emotional, and craving reduction associated with smoking reinforcement. In this R1, we propose a between-subjects experimental test of PTBT and its ability to modify puff topography and CVC during stress-precipitated smoking, and in turn, reduce acute smoking reinforcement. Emotionally distressed daily smokers (N=88, 50% female) will be randomized to PTBT or Control; which are matched for time and attentional demand. Participants will complete two smoking trials on two successive days using either PTBT/Control. The first smoking trial (Visit 1) will allow participants to gain familiarity with the task. The second smoking trial (Visit 2) will be completed following acute laboratory stress induction (stress-precipitated smoking trial). The primary study aims are to test the effect of PTBT vs. Control, in terms of: acute changes in stress- precipitated smoking reinforcement (tobacco demand; cigarette reward; satisfaction) and changes in mechanisms (puff duration, CVC). The results of this high pre-intervention study could inform the subsequent development of a novel intervention strategy for improving quit outcomes in a treatment-resistant population.