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)根据自我报告测量更冲动，2)更难以抑制行为反应，3)在决策任务中做出更差的决策，4)比非可卡因使用者更快地贴现未来奖励的价值，这表明冲动在可卡因滥用中起作用。在收集现有可卡因滥用者（n = 200）和匹配对照（n = 180）的这4个领域的数据后，我们将进行验证性因素分析，以检验冲动选择的二阶因素模型。我们假设三个一阶潜在因素（人格/行为抑制、风险承担、奖罚价值）将解释每个因素内的措施之间的显著关系，而一个潜在的二阶因素（冲动决策）将解释三个一阶因素之间的关系。我们将测试我们的模型预测真实世界可卡因使用和临床结果的能力。目的1。获取可卡因滥用者和匹配对照的1)冲动性~ 2)反应抑制~ 3)决策~和4)时间折扣的自我报告和基于任务的测量，以检验测量之间的相关结构和检验我们的冲动选择模型。目标2。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存在，但可卡因滥用者在所有因素上的得分都更高。目标2 b。评估我们的因素对可卡因使用的预测有效性。我们假设这些因素与目前的可卡因使用之间存在正相关关系。目标3。比较结构模型和性别之间每个因素的得分。我们假设我们的冲动选择模型的4个潜在因素将在男女中观察到，因子得分的排名顺序如下：女性可卡因滥用者>男性可卡因滥用者>男性对照者>女性对照者。目标4。评估我们的因素对35名可卡因使用者的反应抑制和时间折扣的神经测量的预测有效性。目标4 b。用一种新的功能磁共振成像任务（CNET）对35名可卡因使用者进行测量，评估这些因素是否能预测与吸食可卡因决定相关的神经活动。我们假设我们的因素，结合反应抑制和时间折扣的神经测量，将预测与吸烟可卡因和自我报告可卡因使用决定相关的神经活动。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关系。影响：更好地理解冲动的结构和冲动的哪些因素最能预测临床结果，将为指导治疗的发展提供关键信息，特别是针对与这些因素相关的认知过程的治疗。

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.