Influence of Nicotine on Positive and Negative Affect in Smokers with PTSD

描述(由申请者提供)：这个辅导性培训奖项的目的是建立候选人的独立研究生涯，研究吸烟和创伤后应激障碍(PTSD)之间的共病。这位候选人的长期目标是找出支持患有创伤后应激障碍的吸烟者尼古丁依赖的底物，以便开发定制的治疗方法，更有效地减少这一人群的吸烟。这些目标将通过正式的教学课程、研讨会和华盛顿大学和退伍军人管理局Puget Sound Health Care System的实验室研究的实际执行来实现。尽管吸烟和创伤后应激障碍之间存在强烈的共病，但人们对这一精神人群中吸烟的维持机制知之甚少。提出了两项研究，旨在探讨吸烟对创伤后应激障碍患者的潜在影响。研究1)描述急性尼古丁给药对情景诱导的积极情绪和情景诱发的消极情绪的影响，以及2)确定尼古丁的情绪影响在患有创伤后应激障碍的吸烟者中是否比没有创伤后应激障碍的吸烟者更明显。按照平衡顺序，患有创伤后应激障碍的吸烟者(n=50)和没有创伤后应激障碍的吸烟者(n=50)将接受三种基于实验室的积极情绪诱导和三种负面情绪诱导：1)吸烟尼古丁香烟，2)吸烟非尼古丁香烟，3)喝水。对情绪诱导的积极和消极情感反应的大小将进行比较。研究2将检验在患有创伤后应激障碍的吸烟者和没有患创伤后应激障碍的吸烟者中，尼古丁剥夺对积极情绪和消极情绪的影响是否被放大。参与研究1的吸烟者将在48小时内停止吸烟，同时通过电子日记评估积极情绪、负面情绪和渴望。此外，研究2将探索两种可能影响患有创伤后应激障碍的吸烟者对尼古丁剥夺的情感反应的机制：1)依赖尼古丁调节情绪(在研究1中测量)和2)戒烟后皮质醇的变化。唾液中的cbrtisol将在两天经常吸烟和两天不吸尼古丁的情况下进行测量。相关性：吸烟是导致死亡和残疾的头号可避免原因。据估计，创伤后应激障碍影响了260万美国人，其中160万患者是吸烟者。

DESCRIPTION (provided by applicant): The purpose of this mentored training award is to establish the candidate's independent research career examining comorbidity between cigarette smoking and posttraumatic stress disorder (PTSD). The candidate's long-term goal is to identify substrates that underpin nicotine dependence in smokers with PTSD in order to develop tailored treatments that more effectively reduce smoking in this population. These goals will be accomplished through formal didactic coursework, seminars, and practical performance of a laboratory study at the University of Washington and the Veterans Administration Puget Sound Health Care System. Despite strong comorbidity between smoking and PTSD, little is known about mechanisms maintaining smoking in this psychiatric population. Two studies examining affective mechanisms potentially influencing smoking in PTSD are proposed. Study 1 will 1) characterize effects of acute nicotine administration on situationally induced positive affect and situationally induced negative affect, and 2) determine whether nicotine's mood effects are more pronounced among smokers with PTSD versus smokers without PTSD. In counterbalanced order, smokers with PTSD (n = 50) and smokers without PTSD (n = 50) will undergo three positive and three negative laboratory-based mood inductions in combination with: 1) smoking a nicotinized cigarette, 2) smoking a denicotinized cigarette, and 3) drinking water. The magnitude of positive and negative affective responses to the mood inductions will be compared. Study 2 will examine whether the effects of nicotine deprivation on positive affect and negative affect are magnified among smokers with PTSD versus smokers without PTSD. Smokers who participated in Study 1 will stop smoking for 48 hours while being assessed for positive affect, negative affect, and craving via electronic diary. In addition, Study 2 will explore two mechanisms that potentially influence affective response to nicotine deprivation among smokers with PTSD: 1) reliance on nicotine to regulate affect (measured during Study 1) and 2) changes in cortisol after quitting smoking. Salivary cbrtisol will be measured over two days of regular smoking and two days of nicotine deprivation. RELEVANCE: Cigarette smoking is the number one avoidable cause of death and disability. It is estimated that PTSD affects 2.6 million Americans, and that 1.6 million of these patients are smokers.