Negative affect in relapse: Withdrawal and treatment medication

描述：（申请人的描述）在过去的20年中，已经开发了许多戒烟治疗。 不幸的是，这些措施并没有导致同期戒烟率显著上升。 一个障碍，以理性为基础的方法来治疗吸烟是，我们知道很少有效的治疗工作。 拟议中的研究将使用电子日记（ED;掌上电脑）来收集关于被认为介导有效戒烟治疗效果的变量的细粒度、几乎实时的信息。 此外，最近的研究表明，情感/退缩的紧张性变化有力地预测复发;该项目将允许对这种关系进行敏感的测试。在这项研究中，390名有戒烟动机的吸烟者将被随机分为三组。 在安非他酮组中，吸烟者将尝试在安非他酮药物治疗（150 mg b.i.d.）的帮助下戒烟。在联合条件下，吸烟者将接受安非他酮药物治疗，并将参加包括已知疗效的治疗元素（即，社会支持和应对技能培训）。最后一组吸烟者将被分配至安慰剂组;这些受试者将不参加小组会议，并将接受安慰剂药物治疗。 所有受试者将使用ED收集有关冲动、戒断、负面影响、吸烟率等的实时信息-在戒烟日期前的4天内和戒烟尝试的前8周内。该研究设计允许对理论上突出的变量（例如负面影响、退缩、压力源、诱惑和冲动）的短期事件和长期趋势进行敏感的描述性和预测性检查。 它还允许测试调解，以确定是否安非他酮药物治疗和/或咨询工作，通过修改的时间，频率，趋势，和/或严重程度的这些变量。

DESCRIPTION: (Applicant's Description) Numerous smoking cessation treatments have been developed over the past 20 years. Unfortunately, these have not led to a notable increase in cessation rates over the same period. One impediment to a rational, empirically-based approach to smoking treatment is that we know very little about how effective treatments work. The proposed research will use Electronic Diaries (EDs; palmtop computers) to gather fine-grained, virtually real-time information on variables thought to mediate the effects of efficacious smoking cessation treatments. In addition, recent research suggests that tonic change in affect/withdrawal powerfully predicts relapse; this project will permit sensitive tests of this relation. In this research, 390 smokers motivated to quit will be randomized to one of three groups. In the Bupropion group, smokers will attempt to quit smoking with the aid of bupropion pharmacotherapy (150 mg b.i.d.). In the Combined condition, smokers will receive bupropion pharmacotherapy and will participate in group therapy sessions comprising therapeutic elements of known efficacy (i.e., social support and coping-skills training). A final group of smokers will be assigned to a Placebo condition; these subjects will not attend group sessions and will be given placebo pharmacotherapy. All subjects will use EDs to collect real-time information about urges, withdrawal, negative affect, smoking rates, etc -- during a 4-day period prior to the quit date and for the first 8 weeks of the cessation attempt. The study design allows for sensitive descriptive and predictive examinations of both short-term episodes and longer-term trends in theoretically prominent variables such as negative affect, withdrawal, stressors, temptations, and urges. It also permits tests of mediation to determine whether bupropion pharmacotherapy and/or counseling work through modifying the timing, frequency, trends, and/or severity of such variables.