Daily-Level Analysis of Ovarian Hormones, Smoking, and Anxiety

项目总结/摘要 有明确的证据表明，在保持吸烟方面存在性别差异，例如，女性与男性相比， 更容易受到香烟的增强价值的影响（即，尼古丁强化），并且不太成功 在戒烟方面。卵巢激素（雌激素、孕激素）是一种生物学机制，可能与此有关 对女性尼古丁的强化作用雌二醇似乎增强尼古丁敏感性，而孕酮 降低了它的价值。此外，雌二醇和孕酮水平较低可能会增加 负面情绪增加，情绪调节能力差。因此，雌二醇和孕酮的频繁波动 在月经周期期间，可能会导致间歇性的负面影响加剧和身体不适。 痛苦，并耗尽适应性情绪调节能力，这可能使妇女特别容易受到伤害， 尼古丁强化然而，现有的研究很少测量女性在怀孕期间的卵巢激素。 周期（仅1 - 4次），这限制了对周期内卵巢激素波动的了解的准确性 因为它与吸烟有关。此外，迄今为止还没有研究检查吸烟卵巢癌的性质。 焦虑性精神病理学女性吸烟者的激素水平。这是令人惊讶的，因为女性是男性的两倍。 与男性相比更容易患焦虑症。此外，焦虑症与尼古丁有关 强化和较低的退出成功。两个特定的焦虑脆弱性因素已经被强烈地联系在一起 焦虑敏感性（AS：对焦虑和身体感觉的恐惧）和痛苦 不容忍（DI：一个人的感知或行为能力，以承受痛苦状态。对于某些女性（即， AS或DI升高）在她们的月经周期中可能有特定的时间，由于E2和P的波动， 他们更容易受到尼古丁强化的影响。拟议的研究是一项观察性受试者内试验 72名生理上的女性吸烟者（年龄18 - 40岁），月经周期正常（25 - 35天），未被 荷尔蒙避孕药在一个完整的月经周期的过程中，每天收集唾液样本， 直接评估孕酮和雌二醇，并将与每日生态瞬时评估配对 (EMA)在自然环境中，女性“实时”报告了情绪和尼古丁强化的情况。 主要目的是检查唾液中雌二醇和孕酮的每日波动， 女性完整的月经周期及其对日常（a）情绪过程和（B）尼古丁的影响 加固.第二个目的是研究焦虑脆弱性（AS和DI）的调节作用。 另一个探索性的目的是探索情绪过程是否介导卵巢功能与卵巢功能之间的联系。 激素和尼古丁强化。这项研究有可能改善治疗决策， 女性吸烟者在她们的月经周期前后，包括在她们的月经周期什么时候进行干预，具体有哪些类型 需要干预，以及最需要具体干预的人（例如，女性焦虑症 脆弱性）。

PROJECT SUMMARY/ABSTRACT There is clear evidence of sex-disparity in the maintenance of smoking, such that women compared to men, are more vulnerable to the reinforcing value of cigarettes (i.e., nicotine reinforcement) and are less successful in quitting smoking. Ovarian hormones (estradiol, progesterone) are a biological mechanism that may account for nicotine reinforcement in women. Estradiol appears to enhance nicotine sensitivity, while progesterone decreases its rewarding value. Additionally, lower levels of estradiol and progesterone may increase risk for heighted negative affect and poor emotion regulation. Thus, frequent fluctuations in estradiol and progesterone during the menstrual cycle may contribute to intermittent periods of exacerbated negative affect and somatic distress, and deplete adaptive emotion regulation abilities, which may make women especially vulnerable to nicotine reinforcement. However, existing studies infrequently measure ovarian hormones during a women’s cycle (only 1-4 times), which limits precision in knowledge about fluctuations in ovarian hormones within-cycle as it relates to smoking. Additionally, no studies to date have examined the nature of smoking-ovarian hormones among female smokers with anxiety psychopathology. This is surprising given women are twice as likely to have an anxiety disorder compared to men. Additionally, anxiety disorders are linked to nicotine reinforcement and lower quit success. Two specific anxiety vulnerability factors that have been robustly linked to anxiety-smoking comorbidity are anxiety sensitivity (AS: fear of anxiety and bodily sensations) and distress intolerance (DI: one’s perceived or behavioral incapacity to withstand distress states. For certain women (i.e., elevated AS or DI) there may be specific times during their menstrual cycle when, due to fluctuating E2 and P, they are more vulnerable to nicotine reinforcement. The proposed study is an observational within-subjects test of 72 biologically female smokers (ages 18-40) with a normal menstrual cycle (25-35 days), not altered by hormonal contraceptive. Over the course of a full menstrual cycle, daily saliva samples will be collected to directly assess progesterone and estradiol, and will be paired with daily ecological momentary assessment (EMA) of emotion and nicotine reinforcement reported in “real-time” from women in their natural environments. The primary aim is to examine daily fluctuations in salivary estradiol and progesterone over the course of a women’s complete menstrual cycle and its effect on daily (a) emotional processes and (b) nicotine reinforcement. The secondary aim is to examine the role moderating role of anxiety vulnerability (AS and DI). An additional exploratory aim is to explore whether emotional processes mediate the link between ovarian hormones and nicotine reinforcement. This study has the potential to improve treatment decision-making for female smokers around their menstrual cycle, including when in their cycle to intervene, what specific type of intervention is needed, and for whom specific intervention is most needed (e.g., women with anxiety vulnerability).