Panic-Relevant Sensations and Smoking Motivation

描述(申请人提供)：吸烟是美国可预防死亡的主要原因，每年有近44.3万人死亡。不幸的是，戒烟率仍然很低，复发很常见。越来越多的人达成共识，认为在帮助吸烟者戒烟方面可能会取得重大进展，因为有能力开发针对吸烟者亚群体的特殊需求的新颖、专门的治疗方法，特别是那些复发风险较高的人。在这一领域有一条很有希望的研究路线，已经开始研究容易恐慌和焦虑障碍的人群，因为(A)吸烟率是非精神病人群的两倍，以及(B)有证据表明，恐慌发作和焦虑症状会显著影响戒烟成功。研究努力旨在确定将恐慌发作或焦虑状态与重新启动和维持吸烟行为联系起来的解释机制。焦虑敏感性(AS)是一种稳定的、但具有延展性的概念，是一种基于认知的跨诊断概念，被描述为焦虑、疼痛或压力等消极状态的“放大器”。研究表明，AS升高的吸烟者可能特别倾向于吸烟，以缓解或避免痛苦的身体和情绪状态(例如，焦虑、恐慌症发作)。然而，过去对AS和吸烟的研究采用描述性或相关性方法；没有直接测量吸烟行为的地形图；也没有整合急性恐慌相关状态在AS和吸烟动机(冲动、渴望和可观察到的吸烟行为)之间的关系中的作用。本研究旨在提供恐慌相关唤醒与吸烟动机之间的经验联系。据推测，实验室引起的恐慌症状将与吸烟动机的增加有因果关系，AS将缓和这一影响。为了解决这些假设，90名成年吸烟者(每天抽15支烟)将被招募参加一项实验室实验。 参与者将被随机分配到吸入单个肺活量为35%的二氧化碳[CO2]富含空气混合物或压缩室内空气(对照条件)；这种程序是一种安全且经常使用的惊恐症状的激发方法。挑战后，吸烟动机将通过自我报告的冲动以及渴望的行为指数(吸烟潜伏期)和吸烟地形(喷烟速度和喷烟间隔-由基于口罩的计算机化系统测量；临床研究支持系统测量)来评估。拟议的项目将确定增加药物使用和滥用风险的因素，这解决了国家药物滥用研究所(NIDA)预防研究目标的重点。最终，根据国家开发协会2010年战略计划，拟议的研究将(1)确定药物滥用的特征和模式，(2)了解各种因素如何影响药物滥用的各种风险因素。最后，该奖项将帮助对一位有前途的研究人员进行道德、方法和实质性培训，以满足对烟草和情感脆弱性进行翻译和创新研究的需要。

DESCRIPTION (provided by applicant): Cigarette smoking is the leading cause of preventable death in the United States, accounting for nearly 443,000 deaths annually. Unfortunately, smoking cessation rates remain low and relapse is common. There is growing consensus that significant strides in helping smokers quit will likely be found in the ability to develop novel, specialized treatments that target the particular needs of subgroups of smokers, especially those who are at higher risk for relapse. One promising line of research in this domain has begun to study panic-prone and anxiety disordered populations, given (a) rates of smoking are double to that of non-psychiatric populations and (b) evidence that panic attacks and anxiety symptoms can significantly impair quit success. Research efforts have aimed to identify explanatory mechanisms that link panic attacks or anxiety states with the re-initiation and maintenance of smoking behavior. Anxiety sensitivity (AS) is a stable, but malleable, is a cognitive-based transdiagnostic construct that has been described as an "amplifier" of negative states, such anxiety, pain, or stress. Research suggests that smokers with elevated AS may be especially prone to smoke to relieve or avoid distressing bodily and emotional states (e.g., anxiety, panic attacks). Yet, past work on AS and smoking has employed descriptive or correlational methodology; has not directly measured the topography of smoking behavior; and has not integrated the role of acute, panic-relevant states on the relation between AS and smoking motivation (urges, cravings and observable smoking behavior). The current study aims to provide the empirical link between panic-relevant arousal and smoking motivation. It is hypothesized that laboratory-induced panic symptoms will be causally related to an increase in smoking motivation and that AS will moderate this effect. To address these hypotheses, 90 adult smokers (e15 cigarettes per day) will be recruited to participate in a laboratory experiment. Participants will be randomly assigned to inhale a single vital capacity of 35% carbon dioxide [CO2]-enriched air mixture or compressed room air (control condition); this procedure is a safe and frequently used provocation method for panic symptoms. Post-challenge, smoking motivation will be evaluated by self-reported urges and behavioral indices of cravings (latency to smoking) and smoking topography (puff velocity and inter-puff interval - measured by mouthpiece-based, computerized system; Clinical Research Support System). The proposed project will identify factors that increase the risk of drug use and abuse, which addresses the focus of the National Institute of Drug Abuse (NIDA) prevention research goals. Ultimately, in accordance with NIDA's 2010 strategic plan, the proposed study will (1) identify the characteristics and patterns of drug abuse and (2) understand how factors influence the various risk factors for drug abuse. Finally, the award will aid in the ethical, methodological, and substantive training of a promising researcher to address the need for translational, innovative research on tobacco and emotional vulnerability.