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）：先前学习中涉及的提示的介绍可以为学习的记忆检索。在将记忆重新整合到长期存储中之前，检索的记忆是不稳定的。虽然不稳定，但可以改变记忆，以使以前由记忆支持的行为显着改变或消除。尼古丁成瘾是多确定的，但是吸烟行为的启动和维持中的一个主要病因是与吸烟有关的学习记忆，这是由于提示（例如，吸烟的视力和气味）和尼古丁奖励而频繁配对而发展的。暴露于这些条件的提示引起的渴望和其他反应代表了对持续停止的重大威胁。提示暴露疗法涉及在没有尼古丁奖励的情况下反复出现吸烟线索，以消除提示吸引的渴望和反应性。由于研究表明，对这种疗法的热情逐渐减弱，随着时间的流逝，或者如果发生吸烟失误，熄灭的反应通常会重新出现。拟议的探索性研究是根据最近的科学出版物发展而来的，该出版物报道了一种新型检索伸展干预措施对渴望在排毒海洛因成瘾者中提示反应性的影响。检索伸展干预措施由两个 简短的海洛因提示演讲（旨在引起检索）的会议紧随其后的是持久的海洛因提示暴露。值得注意的是，这种简短的干预导致海洛因渴望和提示反应性的大幅降​​低了6个月。对这些发现的一种解释是，简短的“检索”提示暴露开始了重新整合， 从而打开机会窗口，其中旷日持久的提示暴露可以通过信息来更新记忆，从而导致对海洛因提示的响应能力减弱。鉴于这些最初和令人印象深刻的发现，我们建议研究进行戒烟尝试的吸烟者的两次检索伸展训练的影响。检索将启动 通过简短的（5分钟）视频，与吸烟有关的含量和灭绝将由持久的（1小时）暴露于吸烟提示。接受相同治疗的对照组，除了检索视频将具有非吸烟/中性内容的情况下，将证明检索是检索伸展训练的关键特征。训练对烟素渴望和提示反应性的影响将在训练后1天，2周和4周评估。训练对吸烟指数的影响也将进行初步评估。预计该训练的吸烟 - 提示检索特征将导致对吸烟提示的渴望和反应性的显着降低，并对吸烟产生有利的影响。这项研究的积极发现可能导致安全有效的行为干预，这将有助于吸烟者克服提示引起的渴望和反应性施加的戒烟的威胁，从而减轻了这种最昂贵的成瘾者对社会的负担。此外，可以修改这种治疗方法以解决对其他滥用物质的成瘾。