A placebo-controlled randomized trial of D-cycloserine augmentation of cue exposure therapy for smoking cessation

Recent studies underscore the importance of studying d-cycloserine (DCS) augmentation under conditions of adequate cue exposure treatment (CET) and protection from reconditioning experiences. In this randomized trial, we evaluated the efficacy of DCS for augmenting CET for smoking cessation under these conditions.

Sixty-two smokers attained at least 18 hours abstinence following 4 weeks of smoking cessation treatment and were randomly assigned to receive a single dose of DCS (n=30) or placebo (n=32) prior to each of two sessions of CET. Mechanistic outcomes were self-reported cravings and physiologic reactivity to smoking cues. The primary clinical outcome was 6-week, biochemically-verified, continuous tobacco abstinence.

DCS, relative to placebo, augmentation of CET resulted in lower self-reported craving to smoking pictorial and in vivo cues (d = 0.8 to 1.21) in a relevant subsample of participants who were reactive to cues and free from smoking-related reconditioning experiences. Select craving outcomes were correlated with smoking abstinence, and DCS augmentation was associated with a trend toward a higher continuous abstinence rate (33% vs. 13% for placebo augmentation).

DCS augmentation of CET can significantly reduce cue-induced craving, supporting the therapeutic potential of DCS augmentation when applied under appropriate conditions for adequate extinction learning.     

Electrophysiological modulations of exogenous attention by intervening events

The present study used event related potentials (ERPs) in a spatial cueing procedure to investigate the stages of processing influenced by intervening events presented between cues and targets, when they produce maximal behavioural modulations (i.e., facilitation in the absence of the intervening event, and inhibition of return – IOR, when the intervening event is presented). Our data challenge the traditional orienting–reorienting hypothesis, leading to alternative explanations of cueing effects that are beyond the orienting of attention. Peripheral cues always produced a detection cost (reflected in a reduced amplitude of the P100 component for cued as compared to uncued trials), independently on the behavioural effect that was measured. In contrast, facilitation was associated to modulations of later-stage components, such as N100, Nd, and P300. The N2pc component, usually associated to spatial selection, was the only component reflecting opposite and significant modulations associated to the behavioural effect. The present results suggest that facilitation and IOR can arise from changes at different stages of processing. We propose that the perceptual detection cost (reflected on the P100), and the hindered spatial selection (reflected on the N2pc) at the cued location determine the IOR effect at least in discrimination tasks, while the contribution of the later-stage components, beside attentional processes, determines other facilitatory effects of cueing, which altogether determine the behavioural effect that is measured.     

Distraction and reappraisal efficiency on immediate negative emotional responses: role of trait anxiety

Background and Objectives: Emotion regulation involves attempts to influence emotion unfolding and may target experiential, expressive and physiological responses. Several strategies can be used, such as reappraisal (re-evaluating the emotional situation to reduce its emotional meaning) or distraction (turning the attention toward non-emotional aspects of the situation). Previous research on these regulation strategies produced contrasting results regarding their efficiency and we hypothesize that this could be due to individual differences such as trait anxiety.

Design and Methods: Participants (N?=?77) were confronted with negative pictures and we examined the differential emotional reactivity according to trait anxiety, followed by a comparison of the efficiency of reappraisal and distraction in reducing emotional responses.

Results: Results show that trait anxiety has no impact on reactivity at the experiential and expressive levels, but has an impact at the physiological level, where high anxiety individuals show increased cardiac orienting effect, as well as higher skin conductance and respiratory rate. Regarding regulation, reappraisal and distraction successfully reduce emotional experience and expressivity, but not physiological arousal.

Conclusions: Such contrasting results involve that high trait anxiety individuals might benefit from the use of other kinds of strategies than reappraisal and distraction, some that may successfully target physiological responses.