Smoking-Based Prevention Program for Panic Disorder

描述（由申请人提供）：当前修订（第三次提交）提案的总体目标是使用专门的焦虑-戒烟干预来开发有关预防惊恐发作和惊恐障碍（PD）的知识。该计划将在受控预防计划的背景下针对PD发展的两个可塑性脆弱性因素-焦虑敏感性（对焦虑和焦虑相关感觉的恐惧）和吸烟。在两个研究中心实施的预防计划将利用认知重建和内感受性暴露策略，特别关注减少对焦虑的恐惧，以（1）减少惊恐发作和惊恐障碍的发展;（2）促进成功戒烟。恐慌和吸烟的因素是主要的理论兴趣的综合干预，旨在修改相关的风险过程，这两个结果。值得注意的是，这种“双重”关注已被医学研究所关于预防科学的报告（Mrazek & Haggerty，1994）以及最近NIMH关于精神疾病中烟草使用和戒烟工作组（Riley，2005）推荐为共病问题的理想策略。具体来说，这个恐慌吸烟计划（PSP）将整合内感受性暴露，认知重建和心理教育练习开发的恐慌预防和治疗计划与标准的戒烟咨询。为了说明PSP的焦虑相关成分的疗效，将该计划与仅由PSP（SP）的吸烟相关成分组成的计划进行比较。该方法旨在确定PSP干预相对于当代戒烟计划的有效性。主要目的集中在检查减少心理脆弱性因素（焦虑敏感性）和行为风险因素（吸烟）的综合吸烟恐慌计划，旨在减少恐慌精神病理学的发展，促进戒烟的影响。

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.