Effects of repetitive smoking imagery on cue-induced craving and smoking behavior

描述（由申请人提供）：目前最好的治疗方法并不能防止大多数吸烟者在戒烟一年内复吸。虽然背景渴望随着长期戒烟而减弱，但吸烟线索引起的渴望会随着戒烟而增加，并促使吸烟复发。有充分的证据表明，体内和体外吸烟提示暴露在实验室中会使吸烟者对香烟敏感（即增加他们的渴望）。到目前为止，暗示暴露还没有涉及到吸烟者实际吸烟时通常会经历的重复的想象暴露。几十年来对感知和心理意象之间重叠的研究表明，以一种类似于实际吸烟的方式在心理上模拟吸烟，应该会导致吸烟者习惯化或减少吸烟的动机和对香烟的享乐反应。换句话说，伴随吸烟的心理意象应该引起与实际吸烟相同的反应——对香烟的习惯。使用一个经过验证的人类实验室吸烟复发模型，该研究将通过确定重复的吸烟心理模拟是否能产生习惯化，从而减少吸烟的渴望、吸烟的强化价值、香烟消费和吸烟的享乐反应（喜欢）来开辟新的领域。这些假设将在18-55岁的吸烟者（n=60）中使用2（提示：吸烟，中性）x 2（图像：重复，有限）的受试者内设计进行检验。这四个条件的顺序将被平衡。我们将探讨重复图像是否会减少吸烟线索暴露对心率和皮肤电导（线索反应性的两个生理指标）和吸烟强度（CO增加）的影响。情感机制是否部分解释了重复意象对结果的影响，也将被探讨。通过利用感知和心理意象之间的重叠，本研究将揭示一种独特的、反直觉的、便携的方法来立即管理线索诱导的渴望，而不需要线索暴露疗法的情境依赖、药物的药物状态依赖、渴望抑制的认知成本以及可能增强渴望的主流治疗策略的线索回避。如果这些假设得到支持，这些发现将表明，通过重复吸烟图像直接参与线索诱导的渴望的认知策略可能比长期策略更有效。识别新的策略，可以很容易地实施线索暴露后改变渴望和吸烟行为可能会减少吸烟的可能性和复发。

DESCRIPTION (provided by applicant): The best available treatments do not prevent the majority of smokers from relapsing within a year of cessation. While background craving subsides with extended abstinence, smoking cue-induced craving can increase with abstinence and precipitate smoking relapse. It has been well documented that in vivo and in vitro smoking cue exposure in the laboratory sensitizes smokers to cigarettes (i.e., increases their cravings). To date, cue exposure has not involved the repetitive imaginal exposure that would normally be experienced when a smoker is actually smoking. Decades of research examining the overlap between perception and mental imagery, suggests that mentally simulating smoking a cigarette in a manner analogous to actually smoking should lead to habituation or a decrease in a smoker's motivation to smoke and hedonic response to a cigarette. In other words, performing the mental imagery that would accompany smoking should evoke the same response as actually smoking - habituation to cigarettes. Using a validated human laboratory model of smoking relapse, the proposed study will break new ground by determining whether repetitive mental simulation of smoking can engender habituation thereby reducing cravings, the reinforcing value of smoking, cigarette consumption, and the hedonic response to cigarette smoking (liking). These hypotheses will be tested in smokers (n=60) ages 18-55 years old using a 2 (Cue: Smoking, Neutral) x 2 (Imagery: Repetitive, Limited) within-subjects design. The order of the four conditions will be counterbalanced. We will explore whether repetitive imagery diminishes the impact of smoking cue exposure on heart rate and skin conductance (two physiological indices of cue-reactivity) and smoking intensity (CO boost). Whether affective mechanisms account, in part, for the effects of repetitive imagery on the outcomes will also be explored. By exploiting the overlap between perception and mental imagery, the proposed study will uncover a unique, counterintuitive and portable approach to immediately manage cue-induced craving without the contextual dependency of cue exposure therapy, the drug state dependency of medication, the cognitive expense of craving suppression and the cue avoidance of mainstay treatment strategies that may potentiate craving. If the hypotheses are supported, these findings would suggest that cognitive strategies that directly engage cue-induced craving through repetitive smoking imagery may be more effective than long- standing strategies. Identification of novel strategies that can be easily implemented after cue exposure to alter craving and smoking behavior may decrease the likelihood of smoking lapse and relapse.