Distress Tolerance and Smoking Cessation

痛苦耐受力和戒烟

• 批准号: 10624427
• 负责人: Merideth A. Addicott
• 金额: $ 34.11万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-11-06 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10624427
• 关键词: Abstinence; Address; Affect; Affective; Anterior; Arkansas; Auditory; Auditory area; Awareness; Behavior; Behavior Therapy; Behavioral; Brain; Cancer Etiology; Cessation of life; Chronic; Cigarette; Cognitive; Counseling; Data; Development; Disease; Distress; Drug Addiction; Drug usage; Ecological momentary assessment; Event; Functional Magnetic Resonance Imaging; Goals; Individual; Individual Differences; Insula of Reil; Intervention; Knowledge; Malignant Neoplasms; Measures; Medical Care Costs; Middle frontal gyrus structure; Monitor; Moods; Nicotine Withdrawal; Outcome; Patient Self-Report; Pharmacotherapy; Play; Productivity; Relapse; Research; Role; Services; Smoker; Smoking; Standardization; Stress; Techniques; Testing; Therapeutic Intervention; Time; Tobacco Dependence; Tobacco smoking behavior; Tobacco use; attributable mortality; auditory feedback; behavioral response; cigarette craving; cigarette smoking; cognitive control; coping; cost; craving; distress tolerance; drug relapse; experience; improved; interest; neural; neurofeedback; neuroimaging; neuromechanism; neuroregulation; new therapeutic target; nicotine replacement; novel therapeutics; personalized intervention; public health relevance; sensory cortex; smartphone application; smoking cessation; smoking intervention; success; targeted treatment

ABSTRACT Tobacco addiction is a costly and often fatal problem. Even with counseling and nicotine replacement therapy, most smokers relapse following a quit attempt. For many smokers, cigarette smoking is provoked by affective distress. The ability to cope with this distress and remain abstinent may depend on one's level of distress tolerance, which is the ability to persist in a goal-directed activity while experiencing physical or affective discomfort. However, a gap in knowledge exists regarding the neural mechanisms that underlie distress tolerance. Identifying these neural mechanisms and understanding individual differences in distress tolerance holds promise for the development of new therapies and the improvement of cessation success through personalized interventions. Past research has shown that cigarette cravings and other forms of affective distress activate the insula, which may be the neural hub that connects the awareness of affective distress to cognitive control regions that determine the subsequent behavioral response (e.g., smoking a cigarette to relieve cravings). However, there is a significant gap in knowledge concerning whether insula connectivity underlies real-world distress tolerance behavior in the service of smoking cessation. Lab-based measures of distress tolerance provide standardized comparisons across individuals and could be used to identify smokers who would most benefit from interventions. A complementary approach, ecological momentary assessment, can capture temporal relationships among affective distress, craving, and smoking as they occur in smoker's daily lives, in real time. The goal of this research is to test the predictive validity of lab-based measures of distress tolerance against the real-world stress/smoking relationship, and to identify neural differences within smokers that relate to distress tolerance and could predict quit outcomes (i.e., relapsed vs nonrelapsed). To address this gap in knowledge, we will investigate three aims: Aim 1) Associate lab measures of distress tolerance to insula connectivity. Aim 2) Relate lab measures of distress tolerance with real-world stress and smoking using ecological momentary assessment. Aim 3) Explore how insula connectivity relates to real-world stress and smoking. By providing clear evidence of how distress tolerance, brain connectivity, and daily stress relate to quit outcomes, this study will greatly increase our understanding of why some smokers succeed in quitting while others relapse. This research will be generalizable to other drug addictions and psychiatric conditions that are exacerbated by physical or affective distress. Successful completion of this study will inform the development of personalized smoking interventions, as well as identify neural mechanisms that can be targeted by novel therapeutic techniques.

抽象的 烟草成瘾是一个代价高昂且往往致命的问题。即使有咨询和尼古丁替代疗法， 大多数吸烟者在尝试戒烟后会复吸。对于许多吸烟者来说，吸烟是由情感因素引起的。 苦恼。应对这种痛苦并保持禁欲的能力可能取决于一个人的痛苦程度 宽容，是在经历身体或情感的同时坚持以目标为导向的活动的能力 不适。然而，关于造成痛苦的神经机制存在知识空白 宽容。识别这些神经机制并了解应激耐受力的个体差异 通过以下方式有望开发新疗法并提高戒烟成功率 个性化干预。 过去的研究表明，对香烟的渴望和其他形式的情感困扰会激活岛叶， 这可能是连接情感困扰意识和认知控制区域的神经中枢 确定随后的行为反应（例如，吸烟以缓解烟瘾）。然而，有 关于岛叶连通性是否是现实世界的遇险承受能力的基础，在知识上存在重大差距 为戒烟服务的行为。基于实验室的应激耐受性测量提供了标准化 个人之间的比较，可用于识别最能受益的吸烟者 干预措施。一种补充方法，即生态瞬时评估，可以捕获时间 实时了解吸烟者日常生活中发生的情感困扰、渴望和吸烟之间的关系。 本研究的目的是测试基于实验室的应激耐受性测量的预测有效性 现实世界的压力/吸烟关系，并识别吸烟者中与以下相关的神经差异 痛苦耐受性并可以预测戒烟结果（即复发与未复发）。 为了解决这一知识差距，我们将研究三个目标： 目标 1) 关联实验室测量 对岛叶连接的应激耐受性。目标 2) 将实验室的抗压能力与现实世界联系起来 使用生态瞬时评估来评估压力和吸烟。目标 3) 探索岛叶连接性与 现实世界的压力和吸烟。通过提供明确的证据来证明应激耐受性、大脑连接性和 日常压力与戒烟结果相关，这项研究将极大地加深我们对为什么有些吸烟者 成功戒烟，而其他人却旧病复发。这项研究将推广到其他药物成瘾和 因身体或情感困扰而加剧的精神疾病。顺利完成本次 研究将为个性化吸烟干预措施的发展提供信息，并确定神经网络 可以通过新的治疗技术来靶向的机制。