Behavioral activation intervention, reward processing and youth smoking cessation

行为激活干预、奖励处理和青少年戒烟

• 批准号: 8252217
• 负责人: Laura MacPherson
• 金额: $ 21.75万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-10 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8252217
• 关键词: 21 year old; Abstinence; Addictive Behavior; Address; Adolescent; Adolescent Behavior; Adolescent Development; Adult; Affective; Aftercare; Age; Alcohol or Other Drugs use; Anxiety Disorders; Area; Attention; Behavior; Behavior Therapy; Behavioral; Brain; Brain region; Child; Chronic; Collaborations; DA10; Data; Decision Making; Depressive disorder; Development; Effectiveness; Environment; Event; Exhibits; Focus Groups; Functional Magnetic Resonance Imaging; Future; General Population; Goals; Hand; Image; Incidence; Individual; Interdisciplinary Study; Intervention; Investigation; Life Style; Literature; Maintenance; Manuals; Maryland; Mental Depression; Methodology; Methods; Modeling; Mood Disorders; National Institute of Mental Health; Neurobiology; Neurosciences; Nucleus Accumbens; Outcome; Paper; Participant; Phase; Prevalence; Protocols documentation; Psychological reinforcement; Psychophysiology; Randomized Clinical Trials; Relapse; Research; Research Personnel; Rewards; Risk; Running; Sarin; Site; Smoke; Smoker; Smoking; Smoking Behavior; Staging; System; Techniques; Telephone; Testing; Time; Training; Treatment Protocols; Universities; Ventral Striatum; Work; Youth; addiction; adolescent smoking; affective neuroscience; base; clinical conference; depressive symptoms; improved; interest; medical schools; meetings; member; multidisciplinary; neurobehavioral; nicotine replacement; novel strategies; open label; programs; psychosocial; public health relevance; reinforcer; response; reward processing; smoking cessation; smoking intervention; symposium; theories; therapy development; translational approach; treatment response; trend; young adult

DESCRIPTION (provided by applicant): Evidence suggests a significant percentage of adolescent regular smokers are interested in trying to quit smoking and frequently make attempts to quit, yet are unsuccessful in maintaining abstinence on their own. Despite a genuine desire to quit on the part of many adolescents, there is an increasing incidence of smoking among older adolescents that runs counter to the overall trends of smoking reduction seen in the general population. Unfortunately, psychosocial and pharmacological smoking interventions have yet to indicate clear effectiveness with youth. Moreover, depression-related vulnerabilities, particularly currently elevated depressive symptoms, are highly comorbid with smoking behavior and dramatically reduce cessation rates. As a result, new approaches to smoking cessation are needed for adolescent smokers with currently elevated depressive symptoms. Behavioral activation (BA) is an approach that may be especially relevant for youth. BA has been shown to effectively treat those with depressive disorders through reduction of depressive symptoms by increasing contact with positive reinforcing events. In its application to smoking, BA is a practical, treatment approach based on reinforcement theory that helps individuals develop a more healthy and active lifestyle to simultaneously address depressive symptoms and quit smoking. In considering key theoretical aspects of BA and its basis in reinforcement theory, the construct of reward sensitivity is of great importance. Because reward sensitivity differs greatly across individuals and different stages of development, the current application will take a translational approach. Finally, despite a strong body of work supporting the use of BA with addictions in adults, developmental considerations are critical when applying adult derived-treatment models to adolescents. The objective of the proposed project is to develop a specialized behavioral activation treatment for smoking in youth ages 18-21 with elevated depressive symptoms (BATSY). The project will take place in two phases. In the first phase, we will utilize focus groups and pilot testing with 15 youth to develop the BATSY treatment protocol. In Phase II, we will conduct an open-label trial of BATSY plus nicotine replacement therapy with 30 youth. In the context of testing this newly developed BA treatment for adolescent smokers with elevated depressive symptoms, we will use sophisticated fMRI methodology to examine the extent to which baseline reward sensitivity is associated with treatment response. To achieve these multidisciplinary goals at the integration of neurodevelopmental and neurobehavioral methods with behavioral treatment development for adolescent smokers, in line with RFA-DA-10-003, we will establish a translational collaboration of researchers from University of Maryland, NIMH, and Yale University. PUBLIC HEALTH RELEVANCE: Adolescent smokers with elevated depressive symptoms are at significant risk to develop into chronic adult smokers, yet smoking treatments specifically targeted to their needs are absent. This application represents the first effort to develop and test a specialized behavioral activation (BA) base protocol for this extremely at- risk group of youth using a translational, multidisciplinary team-building approach.

描述（由申请人提供）：有证据表明，有相当大比例的青少年经常吸烟者有兴趣尝试戒烟，并经常尝试戒烟，但却不能靠自己保持戒烟。尽管许多青少年真心希望戒烟，但在年龄较大的青少年中，吸烟的发生率不断增加，这与一般人群中吸烟减少的总体趋势背道而驰。不幸的是，社会心理和药物吸烟干预尚未表明对青少年的明确有效性。此外，与抑郁相关的脆弱性，特别是目前抑郁症状的升高，与吸烟行为高度并存，并显著降低戒烟率。因此，对于目前抑郁症状加重的青少年吸烟者，需要新的戒烟方法。行为激活（BA）是一种可能与青少年特别相关的方法。BA已被证明通过增加与积极强化事件的接触来减少抑郁症状，从而有效地治疗抑郁症患者。在应用于吸烟方面，BA是一种实用的治疗方法，基于强化理论，帮助个人发展更健康和积极的生活方式，同时解决抑郁症状和戒烟。在考虑BA的关键理论方面及其在强化理论中的基础时，奖励敏感性的构建是非常重要的。由于个体和不同发展阶段的奖励敏感性差异很大，目前的应用将采取翻译方法。最后，尽管有大量的工作支持在成人成瘾中使用BA，但在将成人衍生治疗模式应用于青少年时，发展考虑是至关重要的。拟议项目的目标是开发一种专门的行为激活治疗吸烟的青少年年龄18-21抑郁症状升高（BATSY）。该项目将分两个阶段进行。在第一阶段，我们将利用焦点小组和15名青少年的试点测试来制定BATSY治疗方案。在II期，我们将对30名青少年进行BATSY加尼古丁替代疗法的开放标签试验。在测试这种新开发的BA治疗抑郁症状加重的青少年吸烟者的背景下，我们将使用复杂的功能磁共振成像方法来检查基线奖励敏感性与治疗反应的关联程度。为了实现这些多学科目标，将神经发育和神经行为方法与青少年吸烟者的行为治疗发展相结合，根据RFA-DA-10-003，我们将与马里兰大学、NIMH和耶鲁大学的研究人员建立转化合作。