Department of Clinical Psychology, Institute of Psychology, University of Siegen, Adolf-Reichwein-Str. 2a, D-57068, Siegen, Germany.
Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.
Psychopharmacology (Berl). 2022 Jan;239(1):105-121. doi: 10.1007/s00213-021-06058-5. Epub 2022 Jan 11.
Recently, experimental paradigms have been developed to strengthen automatic avoidance or inhibitory responses for smoking cues. However, these procedures have not yet been directly compared regarding their effectiveness and mechanisms of action.
This study compared the effects of avoidance vs. inhibitory training as an add-on to a brief smoking cessation intervention. The standard Approach-Avoidance-Task (AAT) was adapted for both training types and control conditions.
One hundred twenty-four smokers attended behavioral counseling for smoking cessation and were thereafter randomized to one of four training conditions: avoidance-AAT, sham-avoidance-AAT, inhibition-AAT, sham-inhibition-AAT. During a 2-week training period including five training sessions, smokers in the avoidance-AAT trained to implicitly avoid all smoking-related cues, while smokers in the inhibition-AAT trained to implicitly inhibit behavioral response to smoking cues. During sham training, no such contingencies appeared. Self-report and behavioral data were assessed before and after training. Cigarette smoking and nicotine dependence were also assessed at 4- and 12-week follow-ups.
At posttest, avoidance training was more effective in reducing daily smoking than inhibition training. However, this difference was no longer evident in follow-up assessments. All training conditions improved other smoking- and health-related outcomes. Neither training changed smoking-related approach biases or associations, but approach biases for smoking-unrelated pictures increased and Stroop interference decreased in all conditions. Smoking devaluation was also comparable in all groups.
Avoidance training might be slightly more effective in reducing smoking than inhibitory training. Overall, however, all four training types yielded equivalent therapy and training effects. Hence, a clear preference for one type of training remains premature.
最近，已经开发出一些实验范式来强化对吸烟线索的自动回避或抑制反应。然而，这些程序在其有效性和作用机制方面尚未直接进行比较。
本研究比较了回避与抑制训练作为简短戒烟干预的附加手段的效果。标准的接近回避任务（AAT）被改编为两种训练类型和对照条件。
124 名吸烟者参加了戒烟行为咨询，然后随机分为 4 种训练条件之一：回避-AAT、假回避-AAT、抑制-AAT、假抑制-AAT。在包括 5 次训练的 2 周训练期间，回避-AAT 组的吸烟者被训练以隐式回避所有与吸烟相关的线索，而抑制-AAT 组的吸烟者则被训练以隐式抑制对吸烟线索的行为反应。在假训练期间，没有出现这种条件。在训练前后评估自我报告和行为数据。在 4 周和 12 周随访时还评估了吸烟和尼古丁依赖。
在测试后，回避训练在减少每日吸烟量方面比抑制训练更有效。然而，在随访评估中，这种差异不再明显。所有训练条件都改善了其他与吸烟和健康相关的结果。两种训练都没有改变与吸烟相关的接近偏差或关联，但在所有条件下，与吸烟无关的图片的接近偏差增加，Stroop 干扰减少。所有组的吸烟贬值也相当。
回避训练在减少吸烟量方面可能比抑制训练稍有效。然而，总体而言，所有四种训练类型都产生了等效的治疗和训练效果。因此，对一种训练类型的明确偏好仍然不成熟。
