Smoking-Based Prevention Program for Panic Disorder

描述(由申请人提供)：目前修订的(第三次提交)提案的总体目标是利用专门的焦虑症戒烟干预措施发展关于预防恐慌症发作和恐慌症(PD)的知识。这项计划将在受控预防计划的背景下，针对导致帕金森病焦虑敏感性(对焦虑和与焦虑相关的感觉的恐惧)和吸烟的两个可延展性易损性因素。这项在两个网站实施的预防计划将利用认知结构调整和相互感觉暴露策略，重点放在减少焦虑的恐惧上，以(1)减少恐慌症和恐慌症的发展；以及(2)促进成功戒烟。恐慌和吸烟因素都是寻求改变与这两种结果相关的风险过程的综合干预的主要理论兴趣。值得注意的是，医学研究所关于预防科学的报告(Mrazek&Haggerty，1994)以及最近的NIMH关于在精神疾病中使用烟草和戒烟的工作组(Riley，2005)建议，这种“双重”关注是治疗共病问题的理想策略。具体地说，这个恐慌性吸烟计划(PSP)将把针对恐慌预防和治疗计划开发的内部感觉暴露、认知结构调整和心理教育练习与标准的戒烟咨询结合起来。为了解决PSP中与焦虑相关的部分的有效性，该计划将与只包含与吸烟相关的PSP(SP)部分的计划进行比较。这种方法的目的是确定PSP干预相对于当代戒烟计划的有效性。主要目的是检查吸烟-恐慌综合计划中心理脆弱因素(焦虑敏感性)和行为风险因素(吸烟)减少的效果，该计划旨在减少恐慌性精神病理学的发展，并促进戒烟。

DESCRIPTION (provided by applicant): The overall aim of the current revised (third submission) proposal is to develop knowledge about the prevention of panic attacks and panic disorder (PD) using a specialized anxiety-smoking cessation intervention. This program will target, within the context of a controlled prevention program, two malleable vulnerability factors for the development of PD - anxiety sensitivity (the fear of anxiety and anxiety-related sensations) and cigarette smoking. The prevention program, implemented across two sites, will utilize cognitive restructuring and interoceptive exposure strategies with a specific focus on reducing the fear of anxiety in order to (1) decrease the development of panic attacks and panic disorder; and (2) facilitate successful cessation. Both panic and smoking factors are of primary theoretical interest to an integrative intervention that seeks to modify risk processes relevant to both outcomes. It is noteworthy that this "dual" focus has been recommended as an ideal strategy by the Institute of Medicine report on prevention science (Mrazek & Haggerty, 1994) as well as the recent NIMH Workgroup on Tobacco Use and Cessation in Psychiatric Disorders (Riley, 2005) for comorbid problems. Specifically, this Panic-Smoking Program (PSP) will integrate interoceptive exposure, cognitive restructuring, and psychoeducation exercises developed for panic prevention and treatment programs with standard smoking cessation counseling. To address the efficacy of the anxiety-related components of PSP, the program will be compared to a program consisting only of the smoking-related components of PSP (SP). This approach is aimed at establishing the efficacy of the PSP intervention relative to a contemporary smoking-cessation program. The primary aims focus on examining the effects of reductions in a psychological vulnerability factor (anxiety sensitivity) and a behavioral risk factor (smoking) in an integrated smoking-panic program designed to decrease the development of panic psychopathology and to facilitate smoking cessation.