Engaging Working Memory and Distress Tolerance to Aid Smoking Cessation

项目概要/摘要 最近的估计表明，低收入和教育程度都是最严重的问题 吸烟率和持续吸烟的预测因素。治疗发展受到以下因素的限制： 对这些人群特有的与复发/复发有关的具体脆弱性了解不足 (i.e支持失效/复发的过程）。最近，我们发布了一个全面的模型， 这些认知和情感上的弱点--较低的WMC和较高的AS--代表着不同的责任 消极的健康行为和自我控制的失误，特别是在压力的条件下。交互式 我们提出的模型表明，仅针对其中一些脆弱性的干预措施将使吸烟者 戒烟失败的风险。因此，能够针对这些多重脆弱性的干预措施具有 潜在的极大受益于吸烟者的风险子样本，如低SES吸烟者。因此，该项目 致力于使用实验治疗方法来表明：（1）标准的正念 干预，以及根据关键的初步工作修改的正念干预 （正念+IE），有能力区别地参与这些三重风险机制目标，以及（2） 参与这些假定的三重风险目标的程度产生健康行为的期望改变， 使用吸烟风险负担和失效潜力的实验室模型。一种创新的理解方法 正在尝试戒烟的吸烟者的复发风险是检查评估的候选机制目标 不仅在尼古丁使用期间，而且在吸烟者尝试戒烟时将面临的条件下-在 尼古丁剥夺窗特别是，我们打算显示评估的增量价值， 剥夺窗口，部分原因是三重脆弱性被修改并与之相互作用的方式。 吸烟者尼古丁剥夺状态所固有的高度压力和戒断症状。我们还打算 表明一种新的正念干预（正念+IE）可以拯救标准正念的局限性 干预措施，通过将治疗收益扩展到高压力下评估的机制目标的修改， contexts.总体目标是验证机制目标和相关干预措施， 为高危吸烟者扩大治疗选择。

PROJECT SUMMARY/ABSTRACT Recent estimates indicate that both low income and educational attainment are among the strongest predictors of both smoking prevalence and continued smoking. Treatment development is limited by inadequate knowledge of the specific lapse/relapse-relevant vulnerabilities characteristic of these populations (i.e, the processes that underpin lapse/relapse). Recently, we published a comprehensive model of the way in which these cognitive and emotional vulnerabilities--lower WMC and elevated AS--represent separate liabilities for negative health behaviors and self-control lapses, particularly under conditions of stress. The interactive models we propose suggest that interventions targeting only some of these vulnerabilities will leave smokers at risk for cessation failure. Accordingly, interventions that can engage these multiple vulnerabilities have the potential to greatly benefit at-risk subsamples of smokers, such as low SES smokers. Accordingly, this project is devoted to using an experimental therapeutics approach to show: (1) that a standard mindfulness intervention, and a mindfulness intervention modified in accordance with crucial preliminary work (Mindfulness+IE), have the ability to differentially engage these triple risk mechanistic targets, and (2) that the degree to which these putative triple risk targets are engaged produces a desired change in a health behavior, using a laboratory model of smoking risk burden and lapse potential. An innovative approach for understanding risk for relapse in smokers undergoing a quit attempt is to examine candidate mechanistic targets assessed not only during nicotine use, but during the conditions smokers will face upon a cessation attempt – during nicotine deprivation windows. In particular, we intend to show the incremental value of assessments during deprivation windows, in part due to the way in which triple vulnerabilities are modified by and interact with the heightened stress and withdrawal symptoms inherent to nicotine deprivation states in smokers. We also intent to show that a novel mindfulness intervention (Mindfulness+IE) can rescue limitations of standard mindfulness interventions, by extending therapeutic gains to the modification of mechanistic targets assessed in high-stress contexts. The overall goal is to validate mechanistic targets and associated interventions for the purpose of expanding treatment options for particularly at-risk smokers.