Smoking's role in positive affect & reward regulation in depression-prone smokers

描述（由申请人提供）：抑郁症易感人群中不成比例的高吸烟率和更大的戒烟困难表明吸烟可能在这一人群中起重要作用。新出现的数据表明，在抑郁倾向（DP+）吸烟者中，吸烟可能会改善奖励加工减少和积极影响失调这两个过程。易患抑郁症的个体可选择强化物较少，从环境中自然强化物获得的奖励较少，积极影响减弱。吸烟是一种强化行为，它可以替代有限的替代强化物，增强现有强化物的奖励，增加积极影响。根据行为经济学理论，吸烟的选择取决于是否存在替代强化物，并且吸烟的强化值可以根据替代物的存在而增强或降低。与不容易抑郁的吸烟者（DP-）相比，我们假设DP+吸烟者(1)在替代强化物较少的情况下，吸烟的相对强化值更高；(2)与戒烟相比，在正常吸烟时，可获得的替代强化物在积极影响和主观奖励方面的变化更大。这些假设将在18-65岁的吸烟者（n=100）中进行检验，使用受试者内设计和组间比较（DP+ vs DP-吸烟者）。DP+吸烟者被定义为在抑郁症诊断量表中有严重抑郁症病史的吸烟者，并且在流行病学研究中心抑郁量表中得分为bbb16。吸烟的相对强化值将用一个经过验证的吸烟选择范式来测量。积极影响和主观奖励（愉悦）的变化来源于自然环境中的替代强化物，将通过体验抽样在为期3天的自由吸烟阶段和为期3天的戒烟阶段（秩序平衡）进行前瞻性测量。研究吸烟在DP+吸烟者的奖励加工和积极情绪调节中的作用，可能会揭示独特的吸烟机制和新的戒烟治疗目标，为DP+吸烟者提供更有效的戒烟干预措施。

DESCRIPTION (provided by applicant): The disproportionately higher smoking prevalence and greater difficulty quitting among individuals prone to depression suggests that smoking may serve an important function in this population. Emerging data point to diminished reward processing and dysregulated positive affect as two processes potentially ameliorated by smoking in depression-prone (DP+) smokers. Individuals prone to depression have fewer alternative reinforcers, derive less reward from natural reinforcers in their environment, and have diminished positive affect. Smoking is a reinforcing behavior, it can substitute for limited alternative reinforcers, enhance reward from those reinforcers that are available, and increase positive affect. According to Behavioral Economic Theory, the choice to smoke depends on the presence of alternative reinforcers and that the reinforcing value of smoking can be enhanced, or reduced, based on the alternatives. Compared to smokers not prone to depression (DP-), we hypothesize that DP+ smokers (1) have a heightened relative reinforcing value of smoking in the context of fewer alternative reinforcers, and (2) experience greater changes in positive affect and subjective reward from available alternative reinforcers when smoking as usual compared to smoking abstinence. These hypotheses will be tested in smokers (n=100), ages 18-65 years old using a within-subjects design with between-group comparisons (DP+ vs. DP- smokers). DP+ smokers are defined as smokers with a past history of major depression on the Inventory to Diagnose Depression-Lifetime and a score > 16 on the Center for Epidemiological Studies Depression scale. The relative reinforcing value of smoking will be measured with a validated smoking choice paradigm. Changes in positive affect and subjective reward (pleasure) derived from alternative reinforcers in the natural environment will be prospectively measured via Experience Sampling across a 3-day smoking ad-lib phase and a 3-day smoking abstinence phase (order counterbalanced). Investigation of the role of smoking in reward processing and positive affect regulation among DP+ smokers may illuminate unique smoking mechanisms and novel smoking cessation treatment targets to inform more effective smoking cessation interventions for DP+ smokers.