CONTEXTUAL CONTROL OF CRAVING FOR ALCOHOL

上下文（即，背景线索）在调节获得性行为中起着至关重要的作用。在过去的20年里，研究人员广泛研究了外部环境对巴甫洛夫条件反射消退的影响。这一研究领域的最新进展对我们如何进行线索暴露治疗有直接影响，但尚未纳入线索暴露研究和酗酒者的治疗。本申请旨在通过调查最近的消退性能的理论模型（其已在实验室动物研究中得到支持）是否适用于酗酒者中酒精提示反应的消退来填补该空白。具体来说，拟议的研究是一个初步的测试，在寻求治疗的酗酒者的渴望和酒精线索反应的措施的影响。受试者将是210名寻求治疗的酗酒者，并随机分配到六个实验组之一，这些实验组在灭绝后评估背景方面有所不同。使用平衡设计，将比较组1至组4，以测试消退后评估背景是否影响对酒精饮料线索的反应性更新。包括第5组和第6组以测试与消退情境配对的线索（即消退线索）的存在是否可以在后测试期间降低渴望和酒精线索反应性，以及设计用于增加该线索的显著性（即消退线索）的程序是否可以在后测试期间降低渴望和酒精线索反应性。第6组）将进一步增强这种效果。将第5组和第6组与四组设计中的第2组进行比较。该项目的短期目标是将当代学习理论的最新发现应用于旨在减少酗酒者对酒精的渴望和酒精暗示反应的研究。长期目标是开发进行线索暴露治疗的替代方法，通过进一步降低酒精线索反应性和增加恢复饮酒和重度饮酒的潜伏期，增强线索暴露治疗效果的推广并改善治疗结果。总之，这项研究代表了研究的纲领性路线的第一步，在该路线中，首先在人类临床样本中测试基础实验室研究开发的理论，然后用于开发新的行为干预。

Context (i.e., background cues) has long been known to play a vital role in modulating acquired behavior. During the past 20 years, researchers have extensively studied the effects of external context upon the extinction of Pavlovian conditioning. Recent advances in this line of research, which have direct implications for how we conduct cue exposures treatment, have yet to be incorporated into cue exposure research and treatment for alcoholics. The present application is designed to fill that void by investigating whether a recent theoretical model of extinction performance, which has been supported in laboratory animal studies, will apply to the extinction of alcohol cue responses in alcoholics. Specifically, the proposed study represents an initial test of the effect of context on measures of craving and alcohol cue reactivity in treating-seeking alcoholics. Subjects will be 210 alcoholics seeking treatment and randomly assigned to one of six experimental groups that vary with regard to the post-extinction assessment context. Using a counter-balanced design, Groups 1 through 4 will be compared to test if post-extinction assessment context affects renewal of reactivity to alcohol beverage cues. Groups 5 and 6 are included to test if the presence of a cue (i.e, extinction cue) that was paired with the extinction context can reduce craving and alcohol cue reactivity during the post-test and whether a procedure designed to increase the saliency of this cue (i.e., Group 6) will further enhance this effect. Groups 5 and 6 will be compared to Group 2 from the four group design. The short-term goal of this project is to apply recent findings from contemporary learning theory to research aimed at reducing craving and alcohol cue reactivity in alcoholics. The long-term goal is to develop alternative methods of conducting cue exposure treatment that will enhance the generalization of cue exposure treatment effects and improve treatment outcomes by further reducing alcohol cue reactivity and increasing the latency of return to drinking and heavy drinking. In summary, this study represents the first step in a programmatic line of research in which a theory developed with basic laboratory research is first tested in a human clinical sample, and then used to develop a new behavioral intervention.