Smoking-Based Prevention Program for Panic Disorder

描述(由申请人提供)：当前提案的总体目标是通过一种专门的焦虑症戒烟干预措施来发展关于预防惊恐障碍(PD)的知识。这项计划将在受控随机选择预防计划的背景下，针对PD焦虑敏感性(对焦虑和与焦虑相关的感觉的恐惧)和吸烟的两个可延展性易感性因素。惊恐障碍是一种常见的、严重的和慢性的疾病，其特征是反复发作的恐慌症，并担心将来再次发作恐慌症的可能性[美国精神病学协会(APA)，1994]。在北美，吸烟是导致死亡和残疾的主要原因[疾病控制和预防中心(CDC)，1994]，在患有帕金森病或有患帕金森病风险的人中尤其常见；大约40%的帕金森病患者目前经常吸烟，超过60%的人有终生吸烟史(amering等人，1999年；Lasser等人，2000年)。有经验证据表明，吸烟和恐慌因素之间存在双向关联，这与一个正反馈循环过程一致，从而导致各种负面影响。这个问题的背景是我更广泛地认识到，尽管物质使用问题经常与恐慌和其他形式的精神病理学共存，但很少有人努力开发理论上集成的程序来针对导致这种共病的行为过程(Otto，Power，&Fischmann，出版社；Zvolensky&Schmidt，2004)。目前的建议旨在通过在受控随机选择预防计划的背景下前瞻性地评估戒烟行为和恐慌结果来开始填补现有文献中的这一空白。这项预防计划在两个地点实施，将利用认知结构调整和相互感觉暴露策略，特别侧重于减少对焦虑的恐惧和相关的焦虑过程，以(1)减少恐慌症和恐慌症的发展；以及(2)促进成功戒烟。这个恐慌性吸烟预防计划(PSPP)将把针对恐慌症预防和治疗计划开发的内部感觉暴露、认知结构调整和心理教育练习与标准的戒烟咨询结合在一起。PSPP计划将与标准的焦虑敏感性改善干预、标准的戒烟和健康信息控制条件进行比较。

DESCRIPTION (provided by applicant): The overall aim of the current proposal is to develop knowledge about the prevention of panic disorder (PD) using a specialized anxiety-smoking cessation intervention. This program will target, within the context of a controlled randomized selected prevention program, two malleable vulnerability factors for the development of PD - anxiety sensitivity (the fear of anxiety and anxiety-related sensations) and cigarette smoking. Panic disorder is a common, severe, and chronic condition characterized by recurrent panic attacks and worry about the possibility of experiencing a future panic attack [American Psychiatric Association (APA), 1994]. Cigarette smoking, the leading cause of death and disability in North America [Centers for Disease Control and Prevention (CDC), 1994], is particularly common among those with, or at risk for, developing PD; approximately 40% of individuals with PD are currently regular smokers and over 60% have a lifetime history of smoking (Amering et al., 1999; Lasser et al., 2000). There is empirical evidence that suggests bi-directional associations between smoking and panic factors, consistent with a positive feedback loop process, resulting in a variety of negative effects. This issue sits on the backdrop of me larger recognition that, although substance use problems frequently co-occur with panic and other forms of psychopathology, there has been little effort to develop theoretically-integrated programs to target behavioral processes that contribute to this comorbidity (Otto, Powers, & Fischmann, in press; Zvolensky & Schmidt, 2004). The present proposal aims to begin to fill this gap in the existing literature by prospectively evaluating quitting behavior and panic outcomes within the context of a controlled randomized selected prevention program. The prevention program, implemented across two sites, will utilize cognitive restructuring and interoceptive exposure strategies with a specific focus on reducing the fear of anxiety and related anxiety processes in order to (1) decrease the development of panic attacks and panic disorder; and (2) facilitate successful cessation. This Panic-Smoking Prevention Program (PSPP) will integrate interoceptive exposure, cognitive restructuring, and psychoeducation exercises developed for panic prevention and treatment programs with standard smoking cessation counseling. The PSPP program will be compared to a standard anxiety sensitivity amelioration intervention, standard smoking cessation, and a health information control condition.