Effects of repetitive smoking imagery on cue-induced craving and smoking behavior

描述(由申请人提供)：现有的最佳治疗方法不能防止大多数吸烟者在戒烟一年内复发。虽然背景渴望随着戒烟时间的延长而减弱，但吸烟线索诱导的渴望会随着戒烟而增加，并加速吸烟复发。已经有充分的文件证明，在体内和体外暴露在实验室的吸烟线索会使吸烟者对香烟敏感(即增加他们的渴望)。到目前为止，线索暴露还没有涉及吸烟者实际吸烟时通常会经历的重复想象暴露。数十年来对感知和心理想象之间重叠的研究表明，以类似于实际吸烟的方式在精神上模拟吸烟应该会导致烟民的习惯性或烟民吸烟动机和对香烟的享乐反应的减少。换句话说，进行伴随吸烟的心理想象应该会引起与实际吸烟相同的反应--对香烟的习惯。利用经过验证的人体吸烟复发实验室模型，这项拟议的研究将开辟新的领域，通过确定重复的吸烟心理模拟是否可以产生习惯性，从而减少对吸烟的渴望、吸烟的强化价值、香烟消费和对吸烟的享乐反应(喜欢)。这些假设将在18-55岁的吸烟者(n=60)中使用2(线索：吸烟，中性)x 2(意象：重复，有限)受试者内设计进行验证。这四个条件的顺序将被平衡。我们将探索重复图像是否会减少吸烟线索暴露对心率和皮肤电导(线索反应性的两个生理指标)和吸烟强度(CO Boost)的影响。情感机制是否在一定程度上解释了重复想象对结果的影响，也将被探讨。通过利用知觉和心理意象之间的重叠，这项拟议的研究将揭示一种独特的、反直觉的和便携的方法来立即管理线索诱导的渴望，而不需要线索暴露疗法的上下文依赖、药物的药物状态依赖、抑制渴望的认知成本以及可能加剧渴望的主流治疗策略的线索回避。如果假设得到支持，这些发现将表明，通过重复的吸烟意象直接参与线索诱导的渴望的认知策略可能比长期存在的策略更有效。识别新的策略，这些策略可以在线索暴露后很容易地实施来改变渴望和吸烟行为，可能会降低吸烟失误和复发的可能性。

DESCRIPTION (provided by applicant): The best available treatments do not prevent the majority of smokers from relapsing within a year of cessation. While background craving subsides with extended abstinence, smoking cue-induced craving can increase with abstinence and precipitate smoking relapse. It has been well documented that in vivo and in vitro smoking cue exposure in the laboratory sensitizes smokers to cigarettes (i.e., increases their cravings). To date, cue exposure has not involved the repetitive imaginal exposure that would normally be experienced when a smoker is actually smoking. Decades of research examining the overlap between perception and mental imagery, suggests that mentally simulating smoking a cigarette in a manner analogous to actually smoking should lead to habituation or a decrease in a smoker's motivation to smoke and hedonic response to a cigarette. In other words, performing the mental imagery that would accompany smoking should evoke the same response as actually smoking - habituation to cigarettes. Using a validated human laboratory model of smoking relapse, the proposed study will break new ground by determining whether repetitive mental simulation of smoking can engender habituation thereby reducing cravings, the reinforcing value of smoking, cigarette consumption, and the hedonic response to cigarette smoking (liking). These hypotheses will be tested in smokers (n=60) ages 18-55 years old using a 2 (Cue: Smoking, Neutral) x 2 (Imagery: Repetitive, Limited) within-subjects design. The order of the four conditions will be counterbalanced. We will explore whether repetitive imagery diminishes the impact of smoking cue exposure on heart rate and skin conductance (two physiological indices of cue-reactivity) and smoking intensity (CO boost). Whether affective mechanisms account, in part, for the effects of repetitive imagery on the outcomes will also be explored. By exploiting the overlap between perception and mental imagery, the proposed study will uncover a unique, counterintuitive and portable approach to immediately manage cue-induced craving without the contextual dependency of cue exposure therapy, the drug state dependency of medication, the cognitive expense of craving suppression and the cue avoidance of mainstay treatment strategies that may potentiate craving. If the hypotheses are supported, these findings would suggest that cognitive strategies that directly engage cue-induced craving through repetitive smoking imagery may be more effective than long- standing strategies. Identification of novel strategies that can be easily implemented after cue exposure to alter craving and smoking behavior may decrease the likelihood of smoking lapse and relapse.