Computerized Intervention for Distress Intolerance

痛苦不耐受的计算机干预

• 批准号: 9050901
• 负责人: Richard Macatee
• 金额: $ 3.86万
• 依托单位: FLORIDA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-13 至 2019-04-12
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9050901
• 关键词: Affect; Aftercare; Alcohol or Other Drugs use; Anxiety; Appointment; Behavior; Behavior Control; Cannabis; Conduct Clinical Trials; Cues; Data; Dependence; Development; Diagnosis; Distress; Electroencephalogram; Emotional; Emotions; Event-Related Potentials; Future; Individual; Intervention; Investigation; Knowledge; Laboratories; Left; Link; Literature; Measurement; Measures; Mediating; Modeling; Negative Reinforcements; Outcome; Participant; Patient Self-Report; Placebo Control; Placebo Effect; Prevention; Preventive Intervention; Process; Psychophysiology; Public Health; Publishing; Randomized; Recruitment Activity; Relapse; Reporting; Research; Risk; Risk Factors; Risk Marker; Sampling; Sampling Studies; Severities; Signal Transduction; Stress; Substance Addiction; Substance Use Disorder; Symptoms; Techniques; Technology; Time; Training; Treatment Failure; Treatment outcome; base; behavior measurement; brief intervention; comparison group; computerized; coping; cost; craving; design; emotion regulation; follow-up; high risk; indexing; intervention effect; marijuana use; marijuana use disorder; marijuana user; model development; neurophysiology; novel; novel strategies; prevent; psychosocial; public health relevance; relating to nervous system; response; stressor; substance use prevention; trait

 DESCRIPTION (provided by applicant): Given the high relapse rates following treatment of substance use disorders (SUDs), preventative approaches targeting vulnerabilities implicated in SUD development are a promising avenue for reducing their public health burden. Well-supported models of the development of SUDs implicate negative reinforcement motives and dysfunctional appraisals of internal states as mechanisms in the transition from initiation to dependence. Emerging evidence indicates that distress intolerance (DI), which refers to the tendency to negatively appraise and escape aversive emotional states, is a risk factor uniquely associated with SUDs, coping-motivated substance use, and development of substance use problems. Although affect tolerance treatments have demonstrated efficacy in reducing relapse, these investigations did not target DI generally, instead focusing upon narrower domains of distress (e.g., anxiety), nor did they assess DI explicitly as a mechanism of change. Further, existing DI treatment research has focused on preventing relapse; the effect of reducing DI on preventing development of SUDs has not been studied. The extant DI literature is also limited by exclusive reliance upon self-report and behavioral measures of the construct. It is important to identify neurophysiological markers of DI to further clarify the construct and inform future ris identification and prevention efforts. The proposed study was designed to provide incremental training to the PI in psychophysiological assessment [specifically electroencephalogram/event-related potential (EEG/ERP)], technology-based interventions, and conducting clinical trials. In the proposed study, approximately 60 individuals with elevated DI and current cannabis use will be randomized to receive either a recently piloted two-session active DI intervention or a healthy behaviors control intervention. The first specific aim of the project is to determine if DI can be reduced relative to a placebo control via this brief DI intervention. The second specific aim is to determine if individuals in the DI intervention condition report less stress-induced cannabis craving at post-treatment relative to individuals in the healthy behaviors condition. The next specific aim is to determine if individuals in the DI intervention condition will have fewer Cannabis Use Disorder symptoms/diagnoses at four month follow-up, and report lower coping-motivated cannabis use and use- related problems at one and four month follow-ups, relative to individuals in the healthy behaviors condition. Relatedly, the next aim is to determine if reductions in DI mediate the DI intervention's effect on these cannabis use outcomes. The final aim is to examine if high and low DI individuals matched for cannabis use show differential event-related potentials (ERPs) to cues signaling negative reinforcement, and to determine if the DI intervention leads to changes in these ERPs. By examining a brief treatment for DI in a substance using sample, this study will provide critical knowledge regarding how to quickly and effectively reduce DI and potentially prevent SUDs.

 描述（由申请人提供）：鉴于药物使用障碍（SUD）治疗后的高复发率，针对SUD发展中涉及的脆弱性的预防方法是减少其公共卫生负担的一种有希望的途径。充分支持的模型的发展SUDs牵连负强化动机和功能失调的评价内部状态的机制，从启动过渡到依赖。新出现的证据表明，痛苦不容忍（DI），这是指倾向于负面评价和逃避厌恶的情绪状态，是一个危险因素，唯一与SUD，应对动机的物质使用，和物质使用问题的发展。尽管情感耐受治疗已证明在减少复发方面有效，但这些研究通常不针对DI，而是集中在较窄的痛苦领域（例如，焦虑），他们也没有明确评估DI作为一种变化机制。此外，现有的DI治疗研究集中在预防复发;尚未研究减少DI对预防SUD发展的影响。现存的DI文献也受到限制，完全依赖于自我报告和行为措施的建设。重要的是要确定DI的神经生理学标志物，以进一步阐明结构，并为未来的风险识别和预防工作提供信息。拟定研究旨在为PI提供心理生理学评估[特别是脑电图/事件相关电位（EEG/ERP）]、基于技术的干预和开展临床试验方面的增量培训。在拟议的研究中，大约60名DI升高和目前使用大麻的人将被随机分配接受最近试点的两次主动DI干预或健康行为控制干预。该项目的第一个具体目标是确定通过这种简短的DI干预是否可以相对于安慰剂对照降低DI。第二个具体目标是 确定相对于健康行为条件下的个体，DI干预条件下的个体是否在治疗后报告较少的压力诱导的大麻渴望。下一个具体目标是确定DI干预条件下的个体在四个月随访时是否会有更少的大麻使用障碍症状/诊断，并在一个月和四个月随访时报告较低的应对动机大麻使用和使用相关问题，相对于健康行为条件下的个体。相关地，下一个目标是确定DI的减少是否介导DI干预对这些大麻使用结果的影响。最后的目的是检查是否匹配大麻使用的高和低DI个体显示不同的事件相关电位（ERP）信号负强化线索，并确定DI干预是否导致这些ERP的变化。通过使用样本检查物质中DI的简短治疗，本研究将提供有关如何快速有效地减少DI并潜在预防SUD的关键知识。