Development of Positive Psychotherapy for Smoking Cessation

描述(由申请人提供)：情绪障碍一直被认为与不良的戒烟效果有关，因此可能是戒烟治疗干预的重要目标。然而，结合了针对抑郁症的认知行为疗法或情绪管理干预的戒烟计划，主要针对负面情绪和抑郁症状，并未被证明对大多数吸烟者有效，在戒烟期间或戒烟后似乎也没有改善情绪。鉴于这些发现，再加上更多的数据表明，积极情绪低落可能会阻碍戒烟，在戒烟期间改善情绪的另一种方法仍然是必要的。积极心理治疗(PPT)为抑郁症的传统认知行为治疗提供了一种新的创新选择，并被发现能迅速而有意义地增加幸福感和积极情绪，减少抑郁症状。PPT和相关干预措施植根于积极心理学领域，专注于个人力量的来源，增强幸福感和积极情绪，而不是关注缺陷和负面情绪。这种方法可能是戒烟的理想方法，允许参与者增加他们对积极情绪的体验，建立应对压力的心理和社会资源，并培养出较少的愤世嫉俗和敌意认知，所有这些都可能导致更好的吸烟结果。此外，PPT对幸福的关注，而不是抑郁症状，可能会增加其对吸烟者的吸引力，并鼓励更多地参与治疗。该项目的主要目标是开发一种用于戒烟的PPT(PPT-S)的手工改编，并获得该干预措施的效果大小估计，与在积极影响水平较低的吸烟者中进行标准戒烟治疗相比。还将审查治疗效果的潜在调解人。该项目将分两个阶段进行。在第一阶段(治疗开发的1a阶段)，研究人员将最终完成PPT-S手册，并在15名低积极影响吸烟者中进行试点。在第二阶段(1b阶段)，研究人员将进行一项初步的随机临床试验(N=60)，以与标准戒烟治疗相比，在26周的随访中检查PPT-S的可行性、可接受性和有效性。这两种治疗方法都将在六周内分六次进行，并将包括提供经皮尼古丁贴片。这项1b阶段研究的效应大小估计将为未来进行大规模、II阶段随机临床试验的应用提供基础。这个项目代表了积极心理学这一新兴领域在成瘾治疗领域的重大创新应用，这是一种可以极大地丰富成瘾研究和理论的交叉受精。最终，研究人员预计，这项研究计划可能会产生一种明确、有效的干预措施，可以很容易地传播，并适用于寻求戒烟治疗的广泛吸烟者。 与公共健康相关：该项目寻求开发一种戒烟治疗，它包含了积极心理疗法的核心要素，这种治疗方法植根于积极心理学领域，侧重于增强幸福感和积极情绪，并建立个人优势。该项目将对这种新开发的疗法与传统戒烟疗法相比提高戒烟率和改善戒烟期间情绪的能力进行初步测试。如果有效，这种治疗方法可以很容易地应用于戒烟治疗计划，并可以通过增加戒烟率显著改善公众健康。

DESCRIPTION (provided by applicant): Mood disturbance has been linked consistently to poor smoking cessation outcomes and therefore may be an important target for intervention in smoking cessation treatment. However, smoking cessation programs incorporating cognitive behavioral therapy for depression or mood management interventions, which primarily focus on negative mood and depressive symptoms, have not proven effective for the majority of smokers and do not appear to improve mood during or after smoking cessation. Given these findings, combined with additional data indicating that low positive mood may impede smoking cessation, an alternative approach to enhancing moods during smoking cessation is still needed. Positive psychotherapy (PPT) offers a new and innovative alternative to traditional cognitive behavioral therapy for depression and has been found to yield rapid and meaningful increases in happiness and positive affect and decreases in depressive symptoms. Rooted in the field of positive psychology, PPT and related interventions focus on sources of individual strength and on enhancing well-being and positive emotions rather than focusing on deficits and negative emotion. Such an approach may be ideal for smoking cessation, allowing participants to increase their experience of positive emotions, build psychological and social resources for coping with stress, and develop less cynical and hostile cognitions, all of which may lead to better smoking outcomes. Furthermore, the focus of PPT on well-being, as opposed to depressive symptoms, may increase its breadth of appeal to smokers and encourage greater engagement with treatment. The primary objectives of this project are to develop a manualized adaptation of PPT for smoking cessation (PPT-S) and to obtain an effect size estimate for this intervention compared to standard smoking cessation treatment among smokers with low levels of positive affect. Potential mediators of treatment effects also will be examined. The project will take place in two phases. During the first phase (Stage 1a of treatment development), investigators will finalize the PPT-S manual and pilot it with 15 low positive affect smokers. In the second phase (Stage 1b), investigators will conduct a preliminary randomized clinical trial (N = 60) to examine the feasibility, acceptability, and efficacy of PPT-S over 26 weeks of follow up in comparison to a standard smoking cessation treatment. Both treatments will be delivered in individual six sessions over six weeks, and will include provision of transdermal nicotine patch. The effect size estimates from this Stage 1b research will provide the foundation for a future application to conduct a large-scale, Stage II, randomized clinical trial. This project represents a significant and innovative application of the burgeoning field of positive psychology to the field of addictions treatment, a cross-fertilization that could substantially enrich addictions research and theory. Ultimately, the investigators expect that this program of research could result in a well-specified, efficacious intervention that could be readily disseminated and be applicable to a broad range of smokers seeking cessation treatment. PUBLIC HEALTH RELEVANCE: This project seeks to develop a smoking cessation treatment that incorporates central elements of Positive Psychotherapy, a treatment approach that is rooted in the field of positive psychology and that focuses on enhancing well-being and positive emotions and on building upon personal strengths. The project will provide a preliminary test of the ability of this newly developed treatment to increase rates of smoking abstinence and to improve moods during smoking cessation in comparison to a traditional smoking cessation treatment program. If effective, such a treatment approach could be readily applied in smoking cessation treatment programs and could significantly improve public health by increasing rates of smoking cessation.