Personalized Feedback for Smokers with Elevated Anxiety Sensitivity

为焦虑敏感度较高的吸烟者提供个性化反馈

• 批准号: 9321585
• 负责人: Lorra Garey
• 金额: $ 3.47万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9321585
• 关键词: Address; Affective; Affective Symptoms; Alcohol abuse; Anxiety; Anxiety Disorders; Appointments and Schedules; Awareness; Behavior; Caring; Cause of Death; Cessation of life; Chronic; Cigarette; Comorbidity; Computers; Consensus; Data; Depressive Syndromes; Development; Disease; Elements; Emotional disorder; Esthesia; Etiology; Expectancy; Feedback; Fright; General Population; Health behavior; Heterogeneity; Hour; Human Resources; Intention; Intervention; Laboratories; Logistics; Maintenance; Mediating; Mental disorders; Mood Disorders; Moods; Motivation; Nature; Nicotine; Online Systems; Participant; Perception; Phase; Population; Predisposition; Preventive Intervention; Problem behavior; Process; Property; Protocols documentation; Psychopathology; Public Health; Randomized; Relapse; Reporting; Research; Risk; Risk Factors; Smoke; Smoker; Smoking; Smoking Behavior; Smoking Cessation Intervention; Subgroup; Symptoms; Thinking; Time; Tobacco Dependence; Travel; anxiety reduction; anxiety sensitivity; anxiety symptoms; behavior change; brief intervention; cigarette smoking; coping; cost; depressive symptoms; disability; expectation; experience; follow-up; high risk; improved; intervention program; medical specialties; medication compliance; motivational processes; negative affect; negative mood; normative feedback; premature; prospective; psychiatric symptom; psychologic; psychosocial; public health relevance; response; sex; smoking cessation; smoking prevalence; smoking relapse; success; willingness

 DESCRIPTION (provided by applicant): Cigarette smoking is the leading cause of death and disability in the US, contributing to over 440,000 deaths each year. Despite awareness that smoking is a 'chronic health behavior problem,' smoking rates have stabilized in the US, most notably for smokers with elevated psychiatric symptoms and disorders. Here, anxiety and depressive symptoms and syndromes are particularly important because they are the most prevalent psychiatric symptoms in the general population, remarkably comorbid with smoking, and reliably associated with smoking initiation, maintenance, and relapse. Indeed, 'affectively-vulnerable smokers' (i.e., smokers with elevated negative mood states or psychopathology) often are more nicotine dependent, experience more mood problems when quitting, smoke more to manage negative mood states, and nicotine maintains a relatively more reinforcing effect for this group. There is a general consensus that affective-vulnerable smokers require specialty care options that address their unique 'affective needs.' One promising, integrative approach to address the heterogeneity of negative affect symptoms and disorders for smoking has been to focus on underlying transdiagnostic processes that underpin affective psychopathology and the maintenance of smoking. Anxiety sensitivity (AS), the tendency to fear anxiety-related sensations, is a core transdiagnostic vulnerability factor for the etiology and maintenance of anxiety disorders and other emotional disorders, and is also related to smoking maintenance and relapse. AS is malleable in response to psychosocial interventions, making it a prime risk factor to target in prevention/intervention programs. Although some progress has been made in terms of developing highly intensive, integrated treatments that address affective vulnerability in the context of smoking cessation, no targeted efforts have focused on 'earlier phases' of the quit process (i.e., Motivation [having motivation to quit] or Precessation [thinking about and preparing for quitting] phases) for smokers with elevated AS. Moreover, as smokers infrequently use intensive treatments for smoking cessation (consistently less than 10% across studies) because of such barriers as cost, time commitments, and logistics (e.g., travel, scheduling appointments), there is a major need to develop an accessible, brief, integrated tactic to explicitly address the smoking-affective vulnerability comorbidity. By promoting 'earlier change efforts' through focused, personalized feedback for high-risk segments of the smoking population, there is a greater chance to increase sustained and successful quit behavior. The current proposal seeks to employ a computer- delivered integrated Personalized Feedback Intervention (PFI) that directly addresses smoking-AS in a personalized manner. Smokers with elevated AS (N = 130) will be randomly assigned to receive either a PFI or smoking information control (no personalized feedback) and then will be followed up to 1-month after the one- session intervention. The PFI will focus on feedback about smoking behavior, AS, and adaptive coping strategies.

 描述（由申请人提供）：吸烟是美国死亡和残疾的主要原因，每年导致超过440，000人死亡。尽管人们意识到吸烟是一种“慢性健康行为问题”，但美国的吸烟率已经稳定下来，尤其是那些精神症状和精神障碍加重的吸烟者。在这里，焦虑和抑郁症状和综合征是特别重要的，因为它们是一般人群中最常见的精神症状，与吸烟显著共病，并与吸烟开始，维持和复发可靠相关。事实上，“情感脆弱的吸烟者”（即，具有升高的负面情绪状态或精神病理学的吸烟者）通常更依赖尼古丁，在戒烟时经历更多的情绪问题，更多地吸烟以管理负面情绪状态，并且尼古丁对这一组保持相对更多的强化作用。人们普遍认为，情感脆弱的吸烟者需要专门的护理选择来满足他们独特的“情感需求”。“一种有希望的综合方法来解决吸烟的负面影响症状和障碍的异质性，一直专注于支持情感精神病理学和维持吸烟的潜在转诊断过程。焦虑敏感性（anxiety sensitivity，AS）是焦虑障碍和其他情绪障碍的一个核心转诊易感性因素，与吸烟维持和复吸有关。AS是可塑性的心理干预，使其成为预防/干预计划的主要风险因素。虽然在开发高度密集的综合治疗方面取得了一些进展，以解决戒烟背景下的情感脆弱性，但没有针对性的努力集中在戒烟过程的“早期阶段”（即，动机[有退出的动机]或进动[思考] 对于吸烟者来说，吸烟是一种享受。此外，由于成本、时间承诺和物流等障碍，吸烟者很少使用强化戒烟治疗（在研究中始终低于10%）（例如，旅行，安排约会），主要需要开发一种可访问的，简短的，综合的策略来明确解决吸烟情感脆弱性合并症。通过促进“更早 通过对吸烟人群中的高危人群进行有针对性的个性化反馈，有更大的机会增加持续和成功的戒烟行为。目前的建议旨在采用计算机提供的集成个性化反馈干预（PFI），以个性化的方式直接解决吸烟AS。AS升高的吸烟者（N = 130）将被随机分配接受PFI或吸烟信息控制（无个性化反馈），然后在一次干预后随访1个月。PFI将重点关注有关吸烟行为、AS和适应性应对策略的反馈。