Impulsivity In Cocaine Abusers: Relationship to Drug Taking and Treatment Outcome

描述（由申请人提供）：可卡因使用者1）基于自我报告措施更冲动，2）更难以抑制行为反应，3）在决策任务中做出更差的决定，4）以比非可卡因使用者更快的速度贴现未来奖励的价值，这表明冲动在可卡因滥用中起作用。在当前可卡因滥用者（n = 200）和匹配的对照组（n = 180）中收集这4个领域的数据后，我们将进行验证性因素分析，测试冲动选择的二阶因素模型。我们假设，3个一阶潜在因素（人格/行为抑制，冒险，奖励/惩罚值）将解释每个因素内的措施之间的显着关系，和一个潜在的二阶因素（冲动决策）将解释3个一阶因素之间的关系。我们将测试我们的模型预测真实的世界可卡因使用和临床结果的能力。目标1.获得可卡因滥用者和配对对照者的1）冲动性、2）反应抑制、3）决策、4）时间折扣的自我报告和任务测量，以检验测量之间的相关结构，并检验我们的冲动选择模型。目标2a。比较各组之间的结构模型和每个因素的得分。我们假设我们的冲动选择模型的4个潜在因素在两组中都可以观察到，但可卡因滥用者在所有因素上的得分都更高。目标2b。评估我们的因素对可卡因使用的预测有效性。我们假设我们的因素和当前可卡因使用之间存在正相关关系。目标3。比较性别间的结构模型和各因子得分。我们假设，我们的冲动选择模型的4个潜在因素将在两种性别中观察到，其因素得分的等级顺序如下：女性可卡因滥用者>男性可卡因滥用者>男性对照>女性对照。目标4a。评估我们的因素在35可卡因用户的反应抑制和时间折扣的神经措施的预测有效性。目标4 b。评估是否因素预测神经活动与决定吸烟可卡因测量使用一种新的功能磁共振成像任务（CNET）在35可卡因用户。我们假设，我们的因素，结合神经措施的反应抑制和时间折扣，将预测神经活动相关的决定吸烟可卡因和自我报告的可卡因使用。目标5。评估我们的因素对100名参与者的治疗结果的预测有效性，我们将为他们的可卡因使用提供认知行为治疗（CBT）。我们假设我们的因素和临床结果之间存在负相关。影响：更好地理解冲动性的结构以及冲动性的哪些因素最能预测临床结果，将为指导开发专门针对与吸毒因素相关的认知过程的疗法提供关键信息。

DESCRIPTION (provided by applicant): Cocaine users 1) are more impulsive based on self-report measures, 2) have more difficulty inhibiting behavioral responses, 3) make poorer decisions in decision-making tasks, and 4) discount the value of future rewards at a faster rate than non-cocaine users, suggesting that impulsivity plays a role in cocaine abuse. After collecting data on these 4 domains in current cocaine abusers (n = 200) and matched controls (n = 180), we will conduct confirmatory factor analyses testing a second-order factor model of Impulsive Choice. We hypothesize that 3 first-order latent factors (personality/behavioral inhibition, risk taking, reward/punishment value) will account for the significant relations among the measures within each factor, and a single latent second-order factor (impulsive decision-making) will account for the relationships among the 3 first-order factors. We will test the abilit of our model to predict real world cocaine use and clinical outcome. Aim 1. Obtain self-report and task-based measures of 1) impulsivity~ 2) response inhibition~ 3) decision- making~ and 4) temporal discounting in cocaine abusers and matched controls in order to examine the correlational structure among the measures and test our model of Impulsive Choice. Aim 2a. Compare the structural model and the scores for each factor between groups. We hypothesize that the 4 latent factors of our model of Impulsive Choice will be observed in both groups, but cocaine abusers will have greater scores on all factors. Aim 2b. Evaluate the predictive validity of our factors with respect to cocaine use. We hypothesize a positive relationship between our factors and current cocaine use. Aim 3. Compare the structural model and the scores for each factor between sexes. We hypothesize that the 4 latent factors of our model of Impulsive Choice will be observed in both sexes with the following rank order of factor scores: Female Cocaine Abusers > Male Cocaine Abusers > Male Controls > Female Controls. Aim 4a. Evaluate the predictive validity of our factors in 35 cocaine users with respect to neural measures of response inhibition and temporal discounting. Aim 4b. Evaluate whether the factors predict neural activity associated with decisions to smoke cocaine measured using a novel fMRI task (CNET) in 35 cocaine users. We hypothesize that our factors, with incorporation of neural measures of response inhibition and temporal discounting, will predict neural activity related to decisions to smoke cocaine and self-reported cocaine use. Aim 5. Evaluate the predictive validity of our factors with respect to treatment outcome for 100 participants for whom we will provide cognitive-behavioral treatment (CBT) for their cocaine use. We hypothesize that there will be a negative relationship between our factors and clinical outcome. Impact: A better understanding of the construct of impulsivity and which factors of impulsivity best predict clinica outcome will provide critical information to guide the development of therapies specifically targeting cognitive processes associated with those factors in drug taking.