CUE REACTIVITY IN DUAL ALCOHOL AND NICOTINE ADDICTION

它已被充分记录，有一个高比率的共同发病率 酒精中毒和尼古丁依赖之间的联系越来越多的证据支持 条件反射机制在两种形式的成瘾中的重要作用 行为 具体来说，酗酒者和吸烟者往往表现出某些 在面对环境和 内感受性刺激与先前的 吸毒 这种现象通常被称为线索反应， 已经提出了几个理论模型来解释这一点 反应性 考虑到酗酒者中吸烟率很高， 可以想象，吸烟暗示或尼古丁戒断可能促进 对酒精的渴望 未能解释这种关系， 酒精治疗可能适得其反，并可能导致增加 复发的风险。 这项拟议中的研究将检查线索反应的模式， 目前对尼古丁上瘾的酗酒者以及比较 仅酒精组、仅尼古丁组和非依赖性对照组。 研究1将需要制定和实证验证一套 与酒精相关的图像脚本，将被使用，结合 先前开发的与吸烟相关的图像脚本和视觉线索 酒精和尼古丁，在随后的两个线索反应性研究。在 研究2，这些形象和视觉线索将在 线索反应性评估的单独阶段，沿着标准化 愉快的、中性的和不愉快的线索作为情感控制。 反应性将在三个一般响应域（即， 口头报告，心理生理和行为），并将包括 评估惊吓眨眼反射和相关测量 线索反应性的信息处理模型（即，反应时间）。 在研究3中，所有受试者都是尼古丁依赖性酗酒者， 评估将发生在尼古丁的三个水平之一， 不同受试者组的退出。 结果应该会有所改善 我们对尼古丁和酒精之间强烈联系的理解 成瘾，并将对这种双重治疗产生影响 成瘾

It has been well documented that there is a high rate of co-morbidity between alcoholism and nicotine dependence. Increasing evidence supports an important role for conditioning mechanisms in both forms of addictive behavior. Specifically, alcoholics and smokers tend to display certain patterns of responding when confronted with environmental and interoceptive stimuli that have been reliably associated with previous drug taking. This phenomenon is often termed cue reactivity, and several theoretical models have been forwarded to account for this reactivity. Given the high rate of smoking among alcoholics, it is conceivable that smoking cues or nicotine withdrawal may promote cravings for alcohol. The failure to account for this relationship in alcohol treatment may be counterproductive and may lead to an increased risk for relapse. The proposed research will examine patterns of cue reactivity among alcoholics who are currently addicted to nicotine, as well as comparison groups of alcohol-only, nicotine-only, and non-dependent controls. Study 1 will entail development and empirical validation of a set of alcohol-relevant imagery scripts that will be used, in combination with previously developed smoking- relevant imagery scripts and visual cues for alcohol and nicotine, in two subsequent cue reactivity studies. In Study 2, these imaginal and visual cues will be presented during separate phases of a cue reactivity assessment, along with standardized pleasant, neutral, and unpleasant cues as affective controls. Reactivity will be indexed across three general responses domains (i.e., verbal report, psychophysiological, and behavioral), and will include assessment of the startle eye blink reflex and a measure related to information processing models of cue reactivity (i.e., reaction time). In Study 3, all subjects will be nicotine-dependent alcoholics, and the assessment will occur during one of the three levels of nicotine withdrawal for separate groups of subjects. The results should improve our understanding of the strong association between nicotine and alcohol addiction, and will have implications for the treatment of this dual addiction.