Cognitive-Affective Substrates of Smoking: Targets for Maternal Behavior Change

 描述(由申请人提供)：Suena Massey医学博士是一名董事会认证的精神病学家，拥有成瘾医学的额外资格，她建议重新提交以患者为导向的研究职业发展奖(K23)的重新提交申请，该奖项的标题是：产前吸烟行为变化的心理机制。基于她与怀孕和非怀孕药物滥用者的临床工作，梅西博士的目标是为一个独立的研究项目奠定基础，该项目旨在研究怀孕期间成功戒烟的女性的心理特征，以此为基础确定与戒烟相关的可改变因素，并将其作为未来干预的目标。为了实现这一长期目标，在这项K23研究中，她将结合对大量表型特征的社区样本中现有数据的分析，以及对产前吸烟模式的最先进的纵向重复前瞻性测量，以及一项新的先导性研究。这一战略最大限度地发挥了K奖研究的影响，同时提供了必要的教学培训和与产前队列进行独立研究的日常指导经验。具体地说，她将研究怀孕期间戒烟的女性和没有对产前吸烟进行过抽样的产前队列的女性之间同理心的差异(R01 DA023653；PI：L.Wakschlag)。在这些结果的指导下，她将进行一项试点研究，开发一种用于评估怀孕期间同理心的多水平电池，并为其在未来用于产前戒烟的大规模研究提供初步证据。作为对这些科学目标的补充，培训目标是：(1)在多层次建模、随机效应回归和创建潜在变量方面发展复杂的分析技能；(2)在包括直接评估在内的多层次共情测量方面获得专业知识；以及(3)获得干预发展方面的培训。梅西博士杰出的导师团队包括首席导师、医学博士凯瑟琳·威斯纳和共同导师Lauren Wakschlag博士，以及顾问Daniel Mroczek博士(统计学人格研究)、Michael Fleming医学博士(干预发展)、Jordan Grafman博士(认知神经科学博士)和William Grobman医学博士(产科)。如果如假设的那样，产前戒烟与同理心能力独立相关，那么旨在提高孕期同理心的干预措施可以显著提高戒烟率，减少产前尼古丁的暴露。增强孕期行为改变的独特动机有可能中断破坏性的代际风险传递，同时为母亲带来直接的健康益处。

 DESCRIPTION (provided by applicant): Suena Massey, MD is a board-certified Psychiatrist with additional qualifications in Addiction Medicine who proposes the resubmission application for the Mentored Patient-Oriented Research Career Development Award (K23) entitled, Psychological Mechanisms in Prenatal Smoking Behavior Change. Based on her clinical work with pregnant and non-pregnant substance abusers, Dr. Massey aims to build a foundation for an independent program of research on the psychological characterization of women who successfully quit smoking during pregnancy as a basis for identifying modifiable factors linked to cessation that can be targets for future interventions. To accomplish this long term goal, in this K23 study, she will combine analysis of extant data in a large phenotypically characterized community sample with state-of-the-art longitudinal repeated prospective measurement of prenatal smoking patterns with a new pilot study. This strategy maximizes impact of the K-award study while providing necessary didactic training and mentored experience in the day-to-day conduct of independent research with a prenatal cohort. Specifically, she will examine differences in empathy between women who quit smoking during pregnancy and women who do not drawing on a prenatal cohort oversampled for prenatal smoking (R01 DA023653; PI: L. Wakschlag). Guided by these results, she will conduct a pilot study to develop a multi-level battery for assessing empathy in pregnancy and provide preliminary evidence for its utility for use in future large scale studies of prenatal smoking cessation. Complementing these scientific aims, training goals are to: (1) develop sophisticated analytic skills in multi-level modeling, random-effects regression, and creation of latent variables; (2) acquire depth of expertise in multi-level measurement of empathy including direct assessments, and (3) acquire training in intervention development. Dr. Massey's outstanding mentorship team includes Lead Mentor, Katherine Wisner, MD, MS, and Co-Mentor Lauren Wakschlag, PhD, and Advisors Daniel Mroczek, PhD (Statistician, Personality Research), Michael Fleming, MD (Intervention Development), Jordan Grafman, PhD (Cognitive Neuroscience), and William Grobman, MD (Obstetrics). If prenatal smoking cessation is independently related to empathic capacity as hypothesized, interventions aimed at increasing empathy during pregnancy can significantly improve smoking cessation rates and reduce prenatal exposures to nicotine. Enhancing the unique motivation for behavior change during pregnancy holds the potential to interrupt a devastating intergenerational transmission of risk, while yielding immediate health benefits for mothers.