Bradford Daniel E, Curtin John J, Piper Megan E
Department of Psychology, University of Wisconsin-Madison.
Center for Tobacco Research and Intervention.
J Abnorm Psychol. 2015 Feb;124(1):128-36. doi: 10.1037/abn0000007.
Most smokers attempting to quit will relapse, even when using evidence-based cessation treatment. This illustrates the need for better understanding of the relapse process to thereby improve cessation treatments. Although the impact of stress sensitivity on relapse is clear, little research has precisely examined stress reactivity in addicted individuals. Further, most research on relapse focuses on affect surrounding self-administration, and does not address potentially important preconsumption processes such as anticipation of use. We examined the effects of anticipation and actual smoking on stress reactivity in 34 deprived smokers withdrawn for 24 hr and 37 nondeprived smokers, with 37 nonsmoker controls. Using a cued shock stressor task, we measured stress reactivity via startle potentiation and self-reported anxiety. After completing the task once, smokers anticipated smoking a cigarette resting in front of them while they completed the task a second time. Smokers then smoked before completing the task a third and final time. Nonsmokers anticipated and drank water as a control. Anticipation of smoking significantly attenuated both startle potentiation and self-reported anxiety to shock cues for deprived smokers relative to nondeprived smokers. Smokers' stress reactivity was not reduced by smoking beyond the prior effect of anticipation. These results suggest that anticipation, rather than actual drug consumption, may drive the primary reinforcing effect of reduced stress reactivity in smoking. Future research is needed to understand this effect of anticipation on drug use and to determine whether anticipation would make an effective intervention target for addiction and other psychopathology that exhibits increased stress sensitivity.
大多数试图戒烟的吸烟者都会复吸,即使使用基于证据的戒烟治疗方法。这表明需要更好地理解复吸过程,从而改进戒烟治疗。尽管压力敏感性对复吸的影响很明显,但很少有研究精确地考察成瘾个体的应激反应性。此外,大多数关于复吸的研究都集中在与自我给药相关的情绪上,而没有涉及潜在重要的消费前过程,如对使用的预期。我们研究了预期和实际吸烟对34名已戒烟24小时的戒断吸烟者、37名未戒断吸烟者以及37名不吸烟对照组的应激反应性的影响。使用线索性电击应激任务,我们通过惊跳增强和自我报告的焦虑来测量应激反应性。在完成一次任务后,吸烟者在第二次完成任务时预期会吸食放在他们面前的香烟。然后吸烟者在第三次也是最后一次完成任务前吸烟。不吸烟者预期并喝水作为对照。相对于未戒断吸烟者,预期吸烟显著减弱了戒断吸烟者对电击线索的惊跳增强和自我报告的焦虑。吸烟并没有进一步降低吸烟者的应激反应性,其应激反应性并未超过预期的先前效果。这些结果表明,预期而非实际药物消费可能驱动了吸烟中应激反应性降低的主要强化作用。未来需要进行研究,以了解预期对药物使用的这种影响,并确定预期是否会成为成瘾和其他表现出压力敏感性增加的精神病理学的有效干预靶点。