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Behavioral Strategies to Reduce Stress Reactivity in Opioid Use Disorder

减少阿片类药物使用障碍应激反应的行为策略

基本信息

批准号：
9926402
负责人：
Rebecca Kathryn McHugh
金额：
$ 1.29万
依托单位：
MCLEAN HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-01 至 2020-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9926402
关键词：
Address Adult Affect Affective Anxiety Disorders Automobile Driving Basic Science Behavior Behavior Therapy Behavioral Buprenorphine Cessation of life Chronic Clinical Cognitive Cognitive Therapy Development Disease Dose Effectiveness Elements Emotions Epidemic Exhibits Galvanic Skin Response Hydrocortisone Inflammatory Informal Social Control Interleukin-6 Intervention Label Maintenance Medicine Mental Health Mental disorders Modeling Negative Reinforcements Opioid Outcome Participant Peripheral Physiological Population Post-Traumatic Stress Disorders Randomized Regulation Relapse Research Resources Science Stimulus Stress Subgroup Testing Training Translating Treatment outcome United States Woman alcohol use disorder analog behavior change behavioral tolerance biological adaptation to stress cognitive reappraisal craving design distress tolerance effective therapy emotion regulation executive function heroin use improved improved outcome innovation intervention effect men negative affect novel opioid misuse opioid overdose opioid use opioid use disorder premature prescription opioid misuse psychoeducational recruit relapse patients relapse prediction relapse risk response response biomarker stress reactivity stress reduction stress tolerance stressor treatment strategy

项目摘要

Project Summary/Abstract In response to RFA-RM-17-028, we propose to investigate the impact of behavioral strategies for reducing stress reactivity in adults with opioid use disorder. Opioid misuse has reached an epidemic level in the United States, with over 12.5 million people misusing prescription opioids and over 900,000 using heroin in 2015. In 2015, over 33,000 people died from opioid overdose, continuing the unabated escalation of deaths since the late 1990s. Although treatments such as buprenorphine maintenance have been shown to be effective for the treatment of opioid use disorder, relapse remains highly prevalent. Heightened reactivity to stress (i.e., affective and physiological response to stressors) is robustly associated with risk for relapse; however, existing treatments have little impact on stress reactivity. Accordingly, there is a clear need for novel interventions to reduce stress reactivity in those with opioid use disorder. Consistent with a mechanisms-focused experimental medicine approach to behavior change research, we propose to test the effect of brief cognitive-behavioral affect regulation interventions on (1) affective and physiological markers of reactivity to stress (target engagement), and (2) short-term behavior change (behavioral persistence in the context of stress). Participants will be randomly assigned to either a control condition or one of two brief affect regulation interventions, consisting of either an intentional affect regulation strategy (cognitive reappraisal) or an incidental affect regulation strategy (affect labeling). These two strategies have been shown to yield similar reductions in response to affective stimuli, but require different levels of cognitive resources, and thus represent two distinct approaches to reducing stress reactivity. The first aim is to determine the impact of intentional and incidental affect regulation strategies on reactivity to a stressor relative to a control condition. The second aim is to determine the association between these affect regulation strategies and behavioral tolerance to a stressor. As a secondary aim, we will investigate whether baseline (i.e., pre-intervention) levels of self-regulation are associated with the impact of these affect regulation strategies. Specifically, we will investigate whether those with self-regulatory deficits have a reduced response to affect regulation interventions and whether they respond differently to intentional vs. incidental strategies (e.g., whether those with self-regulatory deficits exhibit greater responding to an incidental affect regulation strategy, which requires fewer cognitive resources). If our hypotheses are supported, this information can be used to inform the development of a full dose of multi-session cognitive-behavioral therapy for improving outcomes among those with opioid use disorder. Critically, because of the relevance of stress reactivity across an array of psychiatric disorders (alcohol use disorder, posttraumatic stress disorder), these findings may also have implications for behavior change for other mental health conditions.

项目总结/文摘