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

描述（由申请人提供）：本导师培训奖的目的是建立候选人的独立研究生涯，研究吸烟与创伤后应激障碍（PTSD）之间的共病。候选人的长期目标是确定PTSD吸烟者尼古丁依赖的基础，以便开发更有效地减少这一人群吸烟的量身定制的治疗方法。这些目标将通过正式的教学课程、研讨会和在华盛顿大学和退伍军人管理局普吉特海湾医疗保健系统进行的实验室研究的实际表现来实现。尽管吸烟和创伤后应激障碍之间有很强的共病性，但对精神疾病人群中维持吸烟的机制知之甚少。提出了两项研究，探讨了可能影响PTSD患者吸烟的情感机制。研究1将1)表征急性尼古丁给药对情境诱导的积极情绪和情境诱导的消极情绪的影响，2)确定尼古丁的情绪效应是否在患有PTSD的吸烟者中比在没有PTSD的吸烟者中更明显。按照平衡顺序，患有PTSD的吸烟者（n = 50）和没有PTSD的吸烟者（n = 50）将接受三种阳性和三种阴性的实验室情绪诱导，并结合：1)吸含尼古丁的香烟，2)吸去尼古丁的香烟，3)喝水。对情绪诱导的积极和消极情感反应的大小进行比较。研究2将检验尼古丁剥夺对积极影响和消极影响的影响是否在患有PTSD的吸烟者和没有PTSD的吸烟者中被放大。参与研究1的吸烟者将戒烟48小时，同时通过电子日记评估积极影响、消极影响和渴望程度。此外，研究2将探讨两种可能影响PTSD吸烟者对尼古丁剥夺的情感反应的机制：1)依赖尼古丁来调节情感（在研究1中测量）和2)戒烟后皮质醇的变化。唾液皮质醇将在正常吸烟两天和尼古丁剥夺两天的情况下进行测量。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着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.