(PQA3) Smartphone delivered attentional bias modification training for smokers

描述(申请人提供)：接受一线治疗的吸烟者中，超过70%的人在6个月内复发。因此，替代和补充戒烟疗法是必要的。鉴于它在治疗焦虑和酒精障碍方面的成功，一种由计算机提供的干预措施--注意偏见修正(ABM)--已被提出用于治疗尼古丁依赖。ABM减少了对吸烟线索的注意偏差(AB)，这种偏见是随着时间的推移而发展起来的，这是吸烟线索在动机上变得强烈突出的条件作用过程的结果。针对吸烟者的ABM已经尝试过，但收效甚微。到目前为止，我们已经确定了吸烟ABM方法的三个缺点：(1)现有的吸烟ABM研究仅依赖于单一的实验室培训环节，没有对该技术影响AB和吸烟行为相关神经生物学机制的潜力进行现实和可推广的评估；(2)没有发表的吸烟ABM研究评估ABM对AB的普适性，即在多种环境下经历的AB，跨多种方式的AB，以及长期改变AB；(3)以前没有研究探讨ABM在一线戒烟治疗中的潜在附加益处。此应用程序的目标是确定智能手机交付的、家庭内ABM的可行性，以减少AB对吸烟线索的影响，并在短期和长期内改变吸烟行为。参与者将是250名寻求治疗的吸烟者，他们将在完成ABM(AB远离吸烟线索并走向中性线索)或假训练2周后接受8周的NRT。本研究的第一个目的是确定家庭ABM对AB的影响，第二个目的是确定家庭ABM对吸烟行为的影响。这个项目的意义是一种新的非药物干预，使寻求治疗的吸烟者的AB和吸烟行为正常化，可用作一线戒烟治疗的辅助手段。该项目的创新如下：1)我们将是第一个使用智能手机进行多节n家庭ABM培训的公司，这将提供最大限度地发挥ABM对吸烟者自然环境影响的潜力；2)我们将首次结合一线戒烟疗法(NRT)评估ABM的影响；3)我们将是第一个直接评估ABM在AB上的概括性的研究，使用多个模式测量，包括使用ERP方法的中枢神经系统变化指标，其高空间分辨率是检查RT无法复制的早期注意过程的理想选择；4)通过使用多个会话，我们将能够评估AB随时间的变化轨迹，以确定ABM训练的最佳次数。我们预计，我们的研究将通过确定一种创新的低成本干预措施来改变寻求治疗的吸烟者的AB和吸烟行为，从而对戒烟治疗产生积极影响，这将为未来的戒烟临床试验提供一条有前景的新途径。

DESCRIPTION (provided by applicant): More than 70% of smokers who receive first-line therapies relapse within 6 months. Thus, alternative and complementary smoking-cessation therapies are needed. Given its success in treating anxiety and alcohol disorders, Attentional bias modification (ABM), a computer-delivered intervention, has been proposed to treat nicotine dependence. ABM reduces the attentional bias (AB) towards smoking cues that develops over time as a result of conditioning processes through which smoking cues become strongly motivationally salient. ABM with smokers has been attempted, but with limited success. We have identified three weaknesses with the smoking ABM approaches to date: (1) Existing smoking ABM studies have relied on only a single laboratory training session, falling short of a realistic and generalizable assessment of the technique's potential to influence neurobiological mechanisms associated with AB and smoking behavior; (2) No published smoking ABM study has evaluated the generalizability of ABM to AB experienced in multiple environments, to AB across multiple modalities, and to alter AB in the long-term; (3) No previous study has examined the potential additive benefits of ABM on first-line smoking cessation therapy. The objective of this application is to determine the feasibility of smartphone-delivered, in-home ABM to reduce AB to smoking cues and to modify smoking behavior in the short- and long-term. Participants will be 250 treatment-seeking smokers, who will receive 8 weeks of NRT after completing either ABM (AB away from smoking cues and toward neutral cues) or sham training daily for 2 weeks. The first aim of this study is to identify the impact of in- home ABM on AB and the second aim is to identify the impact of in-home ABM on smoking behavior. The significance of this project is a new non-pharmacological intervention that normalizes AB and smoking behavior in treatment-seeking smokers that can be used as an adjunct to first-line cessation therapies. The innovations of this project are as follows: 1) we will be the first to administer multiple-session n-home ABM training using smartphones which offers the potential of maximizing ABM's effects to smokers' naturalistic environments; 2) we will be the first to evaluate the impact of ABM in conjunction with a first-line smoking cessation therapy (NRT); 3) we will be the first study to directly assess the generalizability of ABM on AB measured using multiple modalities, including central nervous system indicators of changes using ERP methodology, which its high spatial resolution is ideal for examining early attentional processes that RT cannot duplicate and 4) by using multiple sessions, we will be able to assess trajectories of change in AB over time to determine the optimum number of ABM training sessions. We anticipate that our study will have a positive impact on smoking cessation treatment by identifying an innovative low-cost intervention that alters AB and smoking behavior in treatment-seeking smokers, which would suggest a promising new avenue for future smoking cessation clinical trials.