Smoking's role in positive affect & reward regulation in depression-prone smokers

描述(由申请人提供)：在易患抑郁症的人群中，吸烟率高得不成比例，戒烟困难也更大，这表明吸烟可能在这一人群中发挥重要作用。新出现的数据指出，奖赏处理减少和积极情绪调节失调是吸烟可能会改善抑郁倾向(DP+)吸烟者的两个过程。容易抑郁的人有更少的替代增强剂，从他们环境中的天然增强剂获得的奖励更少，并且减少了积极的影响。吸烟是一种强化行为，它可以替代有限的替代强化剂，增加那些可用的强化剂的奖励，并增加积极的情绪。根据行为经济学理论，吸烟的选择取决于替代增强剂的存在，吸烟的强化价值可以根据替代方案来增强或降低。与不容易抑郁的吸烟者(DP-)相比，我们假设DP+吸烟者(1)在替代增强剂较少的情况下吸烟的相对强化价值更高，以及(2)与戒烟相比，在正常吸烟时，可用替代增强剂在积极情绪和主观奖励方面的变化更大。这些假设将在吸烟者(n=100)中进行验证，年龄在18-65岁之间，使用具有组间比较的受试者内设计(DP+吸烟者与DP吸烟者)。DP+吸烟者被定义为吸烟者，在诊断抑郁终生清单上有严重抑郁史，在流行病学研究中心抑郁量表上得16分。吸烟的相对强化价值将通过有效的吸烟选择范例来衡量。从自然环境中替代增强剂获得的积极情感和主观奖励(愉悦)的变化将通过在3天临时吸烟阶段和3天戒烟阶段(顺序平衡)的经验抽样来前瞻性地衡量。研究吸烟在DP+吸烟者的奖赏加工和积极情绪调节中的作用，可能有助于揭示DP+吸烟者独特的吸烟机制和新的戒烟治疗靶点，为DP+吸烟者提供更有效的戒烟干预措施。

DESCRIPTION (provided by applicant): The disproportionately higher smoking prevalence and greater difficulty quitting among individuals prone to depression suggests that smoking may serve an important function in this population. Emerging data point to diminished reward processing and dysregulated positive affect as two processes potentially ameliorated by smoking in depression-prone (DP+) smokers. Individuals prone to depression have fewer alternative reinforcers, derive less reward from natural reinforcers in their environment, and have diminished positive affect. Smoking is a reinforcing behavior, it can substitute for limited alternative reinforcers, enhance reward from those reinforcers that are available, and increase positive affect. According to Behavioral Economic Theory, the choice to smoke depends on the presence of alternative reinforcers and that the reinforcing value of smoking can be enhanced, or reduced, based on the alternatives. Compared to smokers not prone to depression (DP-), we hypothesize that DP+ smokers (1) have a heightened relative reinforcing value of smoking in the context of fewer alternative reinforcers, and (2) experience greater changes in positive affect and subjective reward from available alternative reinforcers when smoking as usual compared to smoking abstinence. These hypotheses will be tested in smokers (n=100), ages 18-65 years old using a within-subjects design with between-group comparisons (DP+ vs. DP- smokers). DP+ smokers are defined as smokers with a past history of major depression on the Inventory to Diagnose Depression-Lifetime and a score > 16 on the Center for Epidemiological Studies Depression scale. The relative reinforcing value of smoking will be measured with a validated smoking choice paradigm. Changes in positive affect and subjective reward (pleasure) derived from alternative reinforcers in the natural environment will be prospectively measured via Experience Sampling across a 3-day smoking ad-lib phase and a 3-day smoking abstinence phase (order counterbalanced). Investigation of the role of smoking in reward processing and positive affect regulation among DP+ smokers may illuminate unique smoking mechanisms and novel smoking cessation treatment targets to inform more effective smoking cessation interventions for DP+ smokers.