CONTEXTUAL CONTROL OF CRAVING FOR ALCOHOL

长期以来，语境(即背景线索)在调节后天习得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亡的影响。这一系列研究的最新进展对我们如何进行线索暴露治疗有直接影响，但尚未纳入对酗酒者的线索暴露研究和治疗。本申请旨在通过调查最近的消光性能理论模型是否适用于酗酒者的酒精提示反应消退来填补这一空白，该模型已在实验室动物研究中得到支持。具体地说，这项拟议的研究代表了环境对寻求治疗的酗酒者的渴求和酒精线索反应性测量的影响的初步测试。受试者将是210名寻求治疗的酗酒者，并随机分配到六个试验组中的一个，这些试验组根据灭绝后评估环境的不同而有所不同。使用平衡设计，将对第1组到第4组进行比较，以测试灭绝后评估环境是否影响对酒精饮料线索的反应性更新。第5组和第6组被包括在内，以测试在后测期间，与消退背景配对的线索(即，消退线索)的存在是否可以减少渴求和酒精线索的反应性，以及旨在增加该线索的显著程度的程序(即，组6)是否会进一步增强这一效果。组5和组6将与四组设计中的组2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的渴求和酒精线索反应性的研究。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重新饮酒和大量饮酒的潜伏期，增强线索暴露治疗效果的普遍性，并改善治疗结果。总而言之，这项研究代表了程序性研究路线的第一步，在该研究中，通过基础实验室研究开发的理论首先在人类临床样本中进行测试，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.