Distress Tolerance and Adolescent Smoking Cessation

描述(申请人提供)：证据表明，相当大比例的青少年日常吸烟者有兴趣尝试戒烟，经常尝试戒烟，但未能成功维持戒烟。目前的复发模型很少关注青少年戒烟的机制，尽管人们普遍认为青少年日常吸烟者更有可能是成年吸烟者。成人吸烟文献中关于早逝的一个很有希望的新理论是痛苦耐受性。根据这一理论，一个人对不适的反应比不适本身的严重程度更重要。与其把重点放在戒烟过程中发生的情感和身体症状的严重性上，不如检查一下围绕着一个人对这些症状的反应的因素可能更有希望。这项提议的目的是支持候选人发展技能，以便在青少年戒烟领域进行以患者为导向的研究。职业发展计划包括获得关于青少年吸烟的生物行为和情感因素、复发现象和基础研究的培训。马里兰大学学院园区是一个智力激发的环境，拥有极好的资源，有助于候选人成功实现她的培训目标。首席导师卡尔·勒尤兹博士和布朗、梅梅尔斯坦、达尔和斯特朗博士(共同导师)分别是实验精神病理学、吸烟复发、青少年吸烟、青少年情感调节和统计学方面的专家。本研究的主要目的是考察戒烟前情绪和行为变量对60名尝试戒烟的青少年日常吸烟者再次吸烟和再次吸烟的影响。参与者将完成对烟草和其他物质使用、抑郁症状、情绪、焦虑敏感性、个性和尼古丁依赖的评估；以及四项实验室挑战程序：(A)心算、(B)镜像追踪、(C)屏息和(D)冷压力任务。从基线开始，戒烟当天，以及第7、14、21和28天，参与者将接受烟草使用、情绪和戒断症状的评估。我们将检验对挑战程序的行为反应性对首次吸烟失效和复发的存活率的影响。预计K23项目的结果将增加关于易感因素在青少年吸烟失败和复发中所起作用的基本知识，并将对青少年吸烟的新的痛苦耐受疗法产生直接影响。

DESCRIPTION (provided by applicant): Evidence suggests a significant percentage of adolescent daily smokers are interested in trying to quit smoking, frequently make attempts to quit, yet are unsuccessful in maintaining abstinence. Current models of relapse devote scant attention to mechanisms involved in adolescent smoking cessation despite widespread acceptance that adolescent daily smokers are more likely to be adult smokers. A promising new theory of early lapse from the adult smoking literature is distress tolerance. According to this theory, how one responds to discomfort is more important than severity of discomfort itself. Instead of focusing on severity of affective and physical symptoms occurring in the cessation process, examining factors surrounding how one reacts to these symptoms may be more promising. The objective of this proposal is to support the candidate's development of skills to perform patient-oriented research in the area of adolescent smoking cessation. The career development plan consists of obtaining training in biobehavioral and affective factors in adolescent smoking, relapse phenomena, and basic research. The University of Maryland College Park is an intellectually stimulating environment with superb resources for the candidate's successful achievement of her training goals. Dr. Carl Lejuez, the primary mentor, and Drs. Brown, Mermelstein, Dahl, and Strong (co mentors) are each experts in experimental psychopathology, smoking relapse, adolescent smoking, adolescent affect regulation, and statistics, respectively. The primary research aim is to examine the influence of pre-quit emotional and behavioral variables on lapse and relapse to smoking among 60 adolescent daily smokers undergoing a quit attempt. Participants will complete assessments of tobacco and other substance use, depressive symptoms, mood, anxiety sensitivity, personality, and nicotine dependence; and four laboratory challenge procedures: (a) mental arithmetic, (b) mirror tracing, (c) breath-holding, and (d) the cold pressortask. Beginning at baseline, quit day, and at days 7,14, 21, and 28, participants will be assessed for tobacco use, mood, and withdrawal symptoms. We will examine effects of behavioral reactivity to the challenge procedures on survival to first cigarette lapse and relapse. It is expected the results of this K23 project will increase basic knowledge about the role of vulnerability factors in adolescent smoking lapse and relapse, and will have direct implications for novel distress tolerance treatments for adolescent smoking.