Engaging Working Memory and Distress Tolerance to Aid Smoking Cessation

项目摘要/摘要 最近的估计表明，低收入和受教育程度都是最高的。 吸烟流行率和持续吸烟的预测因子。治疗的发展受到以下因素的限制 对这些人群特有的具体的失误/复发的脆弱性认识不足 (即，支撑失误/复发的过程)。最近，我们发布了一个全面的模型 这些认知和情绪的脆弱性--WMC降低和AS升高--代表着独立的责任 对于消极的健康行为和自我控制失误，特别是在压力条件下。互动型 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处于 停止失败的风险。因此，能够接触到这些多个漏洞的干预措施具有 有可能极大地使吸烟者的高危亚样本受益，例如低SES吸烟者。因此，这个项目 致力于使用实验治疗学方法来证明：(1)标准的正念 干预，以及根据关键的前期工作修改的正念干预 (正念IE)，有能力差异化地接触这些三重风险机制目标，以及(2) 这些假定的三重风险目标的参与程度会在健康行为中产生所需的变化， 使用吸烟风险负担和潜伏期的实验室模型。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械目标 不仅是在尼古丁使用期间，在吸烟者试图戒烟时将面临的条件--期间 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，部分原因是三重漏洞被修改并与之交互的方式 吸烟者尼古丁缺乏状态所固有的压力和戒断症状增加。我们还打算 为了证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，通过将治疗成果扩展到修改在高应激条件下评估的机械性靶点 上下文。总体目标是验证机械性目标和相关干预措施，目的是 扩大对特别是高危吸烟者的治疗选择。

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.