Reducing Smoking Cue Reactivity and Behavior via a Retrieval-Extinction Mechanism

通过检索-消除机制减少吸烟提示反应和行为

• 批准号: 8570714
• 负责人: Michael E Saladin
• 金额: $ 22.43万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-15 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8570714
• 关键词: Abstinence; Addictive Behavior; Address; Alternative Therapies; Attenuated; Back; Behavior; Behavior Therapy; Behavioral; Blood Pressure; Cigarette; Cigarette Smoker; Clinical; Control Groups; Cues; Data; Development; Drug usage; Ensure; Evaluation; Exposure to; Extinction (Psychology); Galvanic Skin Response; Goals; Heart Rate; Heroin; Hour; Individual; Intervention; Investigation; Laboratories; Late Effects; Lead; Learning; Maintenance; Measures; Memory; Modification; Monitor; Morbidity - disease rate; Neurosciences Research; Nicotine; Nicotine Dependence; Outcome; Participant; Persons; Pharmaceutical Preparations; Physiological; Population; Process; Psychological reinforcement; Public Health; Publications; Randomized; Reaction; Relative (related person); Reporting; Research; Resistance; Retrieval; Rewards; Science; Smell Perception; Smoker; Smoking; Smoking Behavior; Societies; Substance Use Disorder; Substance of Abuse; Testing; Time; Training; Treatment outcome; Update; Vision; addiction; base; brief intervention; cost effective; craving; cue reactivity; design; diaries; follow-up; improved; indexing; innovation; learned behavior; memory process; memory retrieval; mortality; nicotine patch; non-smoking; novel; public health relevance; response; smoking cessation; success; treatment effect; varenicline

DESCRIPTION (provided by applicant): Presentation of cues involved in prior learning can elicit retrieval of memory for the learning. Retrieved memories are unstable before they are reconsolidated back into long-term storage. While unstable, the memories can be altered such that behaviors previously supported by the memories are significantly altered or eradicated. Nicotine addiction is multi-determined but one major etiological factor in the initiation and maintenance of smoking behavior is memory for smoking-related learning that develops as a consequence of frequent pairings between cues (e.g., sight and smell of cigarettes) and nicotine reward. The craving and other reactions that are elicited by exposure to these conditioned cues represent a significant threat to sustained cessation. Cue exposure therapy, which involves the repeated presentation of smoking cues in the absence of nicotine reward, was developed to extinguish cue-elicited craving and reactivity. Enthusiasm for this therapy waned as research revealed that extinguished responses would often reemerge with passage of time or if a smoking lapse occurred. The proposed exploratory study developed out of a recent Science publication that reported on the effects of a novel retrieval-extinction intervention on craving an cue reactivity in detoxified heroin addicts. The retrieval-extinction intervention consisted of two sessions in which brief heroin cue presentations, designed to elicit retrieval, were followed closely in time by protracted heroin cue exposure. Remarkably, this brief intervention led to significant reductions in heroin craving and cue reactivity that were sustained for 6-months. One explanation for these finding is that the brief 'retrieval' cue exposure initiated reconsolidation, thereby opening a window of opportunity in which protracted cue exposure could update the memories with information that would lead to dampened responsiveness to heroin cues. Given these initial and impressive findings, we propose to examine the effects of two sessions of retrieval-extinction training in smokers who are making a quit attempt. Retrieval will be initiated by a brief (5-min.) video with smoking-related content and the extinction will consist of protracted (1 hr.) exposure to smoking cues. A control group receiving the same treatment except that the retrieval video will have nonsmoking/neutral content will serve to demonstrate that retrieval is a key feature of retrieval-extinction training. Effects of the training on smokin craving and cue reactivity will be assessed 1-day, 2-weeks and 4-weeks post-training. The effects of the training on indices of smoking will also be preliminarily assessed. It is expected that the smoking-cue retrieval feature of this training will result in significant and enduring reductions in craving and reactivity to smoking cues and have a favorable impact on smoking. Positive findings from this study could lead to a safe and effective behavioral intervention that will help smokers overcome the threat to cessation posed by cue-elicited craving and reactivity, and thereby reduce the burden levied against society by this most costly addiction. Additionally, this treatment could be modified to address addiction to other substances of abuse.

描述（由申请人提供）：呈现与先前学习相关的线索，可以引发学习记忆的检索。检索到的记忆在被重新整合成长期存储之前是不稳定的。虽然不稳定，但记忆可以被改变，以至于以前由记忆支持的行为被显著改变或根除。尼古丁成瘾是由多种因素决定的，但吸烟行为开始和维持的一个主要病因是与吸烟有关的学习记忆，这种记忆是由线索（例如，香烟的视觉和气味）和尼古丁奖励频繁配对而形成的。由于暴露于这些条件提示而引起的渴望和其他反应对持续戒烟构成了重大威胁。线索暴露疗法是在没有尼古丁奖励的情况下反复呈现吸烟线索，旨在消除线索引发的渴望和反应。对这种疗法的热情逐渐消退，因为研究表明，随着时间的推移或吸烟的消失，这种消失的反应经常会重新出现。这项探索性研究是根据最近的一篇《科学》杂志发表的，该杂志报道了一种新颖的提取-消失干预对戒毒海洛因成瘾者的渴望和线索反应的影响。检索-灭绝干预包括两个方面