Virtual Reality Skills Training: Nicotine Dependence

描述(由申请人提供)：在第一阶段试验中成功证明了虚拟现实线索暴露(VRCE)用于吸烟的可行性后，我们提出在传统认知行为应对技能计划的基础上开发一种针对尼古丁依赖的虚拟现实技能培训(VRST)治疗方案。VRST将计算机图形与感官输入设备相结合，包括：跟踪设备、可视头盔显示器(HMD)和旨在让参与者沉浸在计算机生成的虚拟环境中的定向音频。针对尼古丁依赖的VRST将在安全、保密和受控的实验室或办公室治疗环境中，将VR的元素与特定的药物线索、环境、与药物相关的社交互动和其他相关刺激相结合。VRST结合视频图像和对复杂线索的暴露将扩展传统的线索暴露(反应性)方法，并将提供与传统治疗方法相比的明显优势。这个项目的重点是开发另外七个VRST场景，将计算机生成的图像和视频图像结合起来，描述吸烟提示(例如香烟包装、烟灰缸、燃烧的香烟)和吸烟的社交互动(例如在社交环境中被提供一支香烟，与吸烟者一起乘坐汽车，接近人们吸烟的建筑物入口处)。此外，还将编写VRST治疗手册。VRST的可行性和有效性将在一项针对吸烟者的临床试点研究中进行测试。100名尼古丁依赖吸烟者从市中心哮喘诊所招募，将被随机分为VRST+尼古丁替代疗法(NRT)或仅NRT(NRTO)。一项为期10周的治疗试验将比较VRST+NRT和NRTO在治疗和随访(1、2、3和6个月)期间的香烟消耗量、共同水平和戒烟率。此外，所有参与者将在基线、第4周和第10周使用VRCE评估线索反应性(渴望和生理)。该项目的总体目标是开发和测试针对尼古丁依赖吸烟者的VRST戒烟方法。长期目标是开发和测试VRST，并开发负担得起的交钥匙VRST系统，该系统将用于药物滥用项目、个人治疗师、医院和尼古丁和其他滥用药物的成瘾研究人员的商业使用。

DESCRIPTION (provided by applicant): After successfully demonstrating the feasibility of virtual reality cue exposure (VRCE) for smoking in a phase I trial, we proposed to develop a virtual reality skills training (VRST) treatment for nicotine dependence based on traditional cognitive behavioral coping skills programs. VRST combines computer graphics with sensory input devices including: tracking devices, visual head mounted displays (HMD), and directional audio designed to immerse a participant in a computer-generated virtual environment. VRST for nicotine dependence will combine the elements of VR with specific drug cues, environments, drug related social interactions, and other associated stimuli in the safe, confidential and controlled lab or office treatment setting. VRST combining video images and exposure to complex cues will expand traditional cue-exposure (reactivity) approaches and will offer distinct advantages over traditional treatment approaches. This project focuses on the development of seven additional VRST scenarios combining both computer generated and video images depicting smoking cues (e.g. cigarette packages, ash trays, burning cigarette) and smoking social interactions (e.g. being offered a cigarette in a social context, riding in a car with a smoker, approaching a building entrance where people are smoking). In addition, a VRST treatment manual will be developed. The feasibility and efficacy of VRST will be tested in a clinical pilot study with cigarette smokers. One hundred nicotine dependent smokers recruited from and urban inner city asthma clinic and will be randomized to either VRST + nicotine replacement therapy (NRT) or NRT only (NRTO). A ten week treatment trial will compare VRST+NRT versus NRTO on cigarette consumption, co-levels, and cessation rates across treatment and follow up (1, 2, 3, & 6 months) time periods. In addition, all participants will be assessed for cue reactivity (craving and physiological) at baseline, week 4 and week 10 using VRCE. The overarching aim of this project is to develop and test VRST cessation approach for nicotine dependent cigarette smokers. The long-term goal is to develop and test the VRST, and develop affordable turnkey, VRST systems that will be commercially available to substance abuse programs, individual therapists, hospitals, and drug addiction researchers for nicotine and other drugs of abuse.