Refinement and Pilot Testing of a Computerized Distress Tolerance Intervention with Just-In-Time Text Message Reminders for Cannabis Use Disorder

针对大麻使用障碍的实时短信提醒的计算机化应激耐受干预的完善和试点测试

• 批准号: 10681967
• 负责人: Richard Macatee
• 金额: $ 28.77万
• 依托单位: AUBURN UNIVERSITY AT AUBURN
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10681967
• 关键词: Anxiety; Behavior; Cannabis; Chronic; Classification; Control Groups; Cues; Data; Devices; Distal; Distress; Ecological momentary assessment; Emotional; Feedback; Frequencies; Harm Reduction; Health education; Heterogeneity; Imagery; Individual; Intervention; Interviewer; Learning; Link; Machine Learning; Measurement; Measures; Methods; Modification; Motivation; Outcome; Participant; Patient Self-Report; Pharmaceutical Preparations; Physiological; Physiology; Population; Prevalence; Public Health; Quality of life; Randomized; Randomized, Controlled Trials; Reporting; Risk Factors; Sampling; Severities; Shapes; Signal Transduction; Stress; Testing; Text Messaging; Time; Training; Treatment Efficacy; United States; Visual; Work; cannabis cue; comparative efficacy; computerized; cost; craving; cue reactivity; depressive symptoms; disability; distress tolerance; efficacy evaluation; efficacy testing; emotion regulation; emotional distress; follow-up; group intervention; habituation; high risk; improved; intervention cost; intervention effect; intervention refinement; long term abstinence; marijuana legalization; marijuana use; marijuana use disorder; marijuana user; negative affect; neurophysiology; novel; personalized intervention; pilot test; portability; psychoeducation; psychoeducational; psychosocial; response; secondary outcome; texting support; urinary; wearable device

Project Summary. The prevalence of daily cannabis use and Cannabis Use Disorder (CUD) has increased in the United States over the past two decades. Brief, computerized harm reduction interventions that target specific high-risk CUD populations could be an efficient approach to reducing CUD. Distress intolerance (DI), which refers to the tendency to negatively appraise and escape aversive emotional states, is a risk factor associated with stress-related cannabis use motivation and CUD severity/chronicity. Thus, a brief, accessible, low-cost intervention that reduces DI in those with CUD and elevated DI could have a significant public health impact. This proposed Stage I project aims to modify an existing two-session computerized distress tolerance intervention to optimize emotion regulation learning/generalization and test its impact on DI and cannabis use outcomes in a randomized controlled trial. Specifically, the intervention will be condensed to one-session and its imaginal exposure module will be modified to shape emotional engagement with the aim of maximizing within-session habituation, which will be signaled with a novel audio/visual cue (habituation cue). Habituation cues will then be delivered in just-in-time text message reminders triggered by naturalistic distress reported via ecological momentary assessment. After obtaining feedback on the modified Emotional Engagement Distress Tolerance Intervention in a small sample (Specific Aim 1), the intervention’s efficacy compared to a stringent, credible, time-matched health education control intervention will be tested in a randomized controlled trial in 80 cannabis users with CUD and high DI. To measure the intervention’s mechanistic target engagement (Specific Aim 2), multi-method DI assessments will be administered through four-month follow-up. To measure the intervention’s impact on cannabis use (Specific Aim 3a), stress-related cannabis use motivation (lab stress- elicited craving and neurophysiological drug cue reactivity, ecological momentary assessment of stress-elicited cannabis use) will be assessed through the intervention period. Interviewer-assessed cannabis use frequency, CUD severity, and urinary THC metabolite concentration will be measured through 4-month follow-up. Quality of life and anxiety/depression symptoms will also be measured as secondary outcomes through 4-month follow-up (Specific Aim 3b). As an exploratory aim, a wristworn device will be used to measure ambulatory physiology during a portion of the intervention period to evaluate the feasibility of detecting heightened real- world distress based on objective indicators (Specific Aim 4).Our central hypothesis is that, compared to a control intervention, the Emotional Engagement Distress Tolerance Intervention will produce superior reductions in multi-method assessments of DI, stress-related cannabis use motivation, disordered cannabis use, and psychosocial functioning. Successful completion of the proposed aims will (1) justify a subsequent Stage II trial, and (2) inform efforts to integrate the just-in-time habituation reminders with wearable technology in order to increase emotion regulation generalization opportunities and decrease participant report burden.

项目总结。每日使用大麻和大麻使用障碍（CUD）的流行率在