Phenotypic Markers for Smoking Cessation: Impulsive Choice and Impulsive Action

描述(由申请人提供)：戒烟的表型标记：冲动的选择和冲动的行动本申请涉及广泛的挑战领域(01)：行为、行为改变和预防，以及特定的高优先级挑战主题01-AA-101确定积极行为改变的表型标记。这项拟议的项目将在吸烟者行为变化的两个表型标记物中收集有关时间增长模式的新信息，这些吸烟者试图通过个人戒烟咨询和尼古丁含片治疗戒烟。该项目还将生成关于饮酒与尝试戒烟的个人冲动选择和行动措施之间的关联的实时数据。延迟折扣是指吸烟者记录的延迟奖励的贬值，特别是在戒烟急性期。延迟折扣对吸烟者试图戒烟的瞬时决定具有重要但以前未被探索的影响，即吸烟者必须就现在戒烟的价值做出决定，尽管戒烟不适和强烈的渴望，以在多年后获得健康益处。拟议的项目将检查掌上电脑在戒烟尝试前7天和戒烟尝试的前21天每天评估的延迟折扣的日常波动，并将探索延迟折扣与随后禁欲之间的关系。受试者还将在研究中完成三次基于实验室的标准延迟折扣任务(戒烟前一周，目标戒烟日，戒烟后三周)，这将被评估为未来戒酒的预测因素。还将检查可能解释延迟折扣随时间变化的变量，如酒精使用、情感状态、吸烟机会或戒烟对健康益处的确定性。除了冲动性选择的延迟折扣措施外，拟议的项目还将管理一项评估冲动行动的任务，即去不去任务要求个人能够抑制强势反应，这一能力与戒烟明显相关。当出现围棋刺激时，受试者被指示轻击一个键，而当信号不存在时，受试者被指示停止反应。到目前为止，在退出尝试的过程中还没有收集到关于冲动行为的实时数据。这个项目将产生关于冲动行为变化的新信息，以及在试图抑制过度学习的吸烟行为期间与这种变化相关的因素(例如，饮酒、渴望)。该项目的受试者内部纵向设计将产生关于冲动选择和冲动行为的变化的新知识，以及在辅助行为改变尝试期间这些结构之间的关联。该项目还将产生关于冲动和情感状态的实时行为测量、环境背景、实时评估的行为(包括饮酒)和随后的禁欲之间的关系的新信息。拟议的研究可能有助于确定成功变化或风险的认知标记，这些标记可能会在未来的干预措施中成为目标。这项拟议的研究将把成瘾研究与认知心理学和行为经济学结合起来，填补我们在理解可能影响吸烟行为的决策和行为动态变化方面的一个重要空白。追踪戒烟过程中对立即与延迟奖励和冲动行为的偏好，可能有助于我们识别成功戒烟的标志，并与包括酒精在内的其他滥用物质有关。

DESCRIPTION (provided by applicant): Phenotypic Markers for Smoking Cessation: Impulsive Choice and Impulsive Action This application addresses broad Challenge Area (01): Behavior, Behavioral Change, and Prevention and specific high-priority Challenge Topic 01-AA-101 Identifying Phenotypic Markers for Positive Behavior Change. The proposed project will gather new information about temporal growth patterns in two phenotypic markers of behavior change among smokers engaged in an attempt to quit smoking with individual smoking cessation counseling and nicotine lozenge treatment. The project will also generate real time data about the associations between alcohol use and measures of impulsive choice and action in individuals attempting to stop smoking. Delay discounting is a devaluing of delayed rewards that has been documented in smokers, particularly during acute periods of withdrawal. Delay discounting has important but previously unexplored implications for momentary decisions that smokers attempting to quit must make regarding the value of abstaining now, despite withdrawal discomfort and powerful cravings, to reap health benefits years later. The proposed project will examine day-to-day fluctuations in delay discounting assessed daily by palmtop computer in the 7 days preceding a quit attempt and the first 21 days of a quit attempt and will explore relations between delay discounting and subsequent abstinence. Subjects will also complete a standard, laboratory-based delay discounting task three times in the study (one week pre-quit, on the target quit day, and 3 weeks post-quit) which will be assessed as predictors of later abstinence. Variables that may account for changes in delay discounting over time, such as alcohol use, affective states, access to cigarettes, or perceived certainty of health benefits of quitting, will be examined as well. In addition to the delay discounting measure of impulsive choice, the proposed project will also administer a task assessing impulsive action, Go-no go tasks require that individuals be able to inhibit prepotent responses, an ability with clear relevance for smoking cessation. Subjects are instructed to tap a key when a go stimulus appears and to withhold the response when the signal is not present. To date, real-time data regarding impulsive action have not been collected during the course of a quit attempt. This project will generate new information about changes in impulsive action and factors associated with such changes (e.g., alcohol use, craving) during an attempt to inhibit over-learned smoking behavior. The within-subjects longitudinal design of the proposed project will generate new knowledge about change in impulsive choice and impulsive action, and the associations between these constructs over time, during an assisted behavior change attempt. The project will also generate new information about relations between real-time behavioral measures of impulsivity and affective states, environmental contexts, behaviors (including alcohol use) assessed in real time, and subsequent abstinence. The proposed research may help identify cognitive markers of successful change or risk that could be targeted in future interventions. The proposed research will combine addiction research with cognitive psychology and behavioral economics to fill an important gap in our understanding about dynamic changes in decisions and behaviors that may influence smoking behavior. Tracking preference for immediate versus delayed rewards and impulsive action during an attempt to quit smoking and may help us identify markers of successful cessation with implications for other substances of abuse, including alcohol.