背景性渴求与事件性渴求:区分心理渴求对尼古丁成瘾的不同作用路径

大量研究发现心理渴求机制的紊乱是尼古丁成瘾的核心机制之一。线索暴露是探索心理渴求与尼古丁成瘾关系的重要研究范式。但最近研究者提出该范式较难区分事件性渴求与背景性渴求,导致无法清楚定位渴求在尼古丁成瘾中扮演的角色。通过对以往文献的回顾,对不同成瘾概念、作用机制和生理基础进行对比分析,认为事件性渴求与背景性渴求两者在维持成瘾行为上的确存在不同的作用路径。未来研究应改进实验范式,分别探讨两种心理渴求与尼古丁成瘾的内在联系,完善心理渴求与尼古丁成瘾的关系模型,为尼古丁成瘾的治疗和干预等方法提供一定的理论依据。     

用药动作线索诱发海洛因戒断者的镜像神经活动:一项fMRI研究

相关线索能够诱发药物依赖者的心理渴求,而健康人不会对相关线索产生心理渴求。15名海洛因成瘾者和12名没有任何物质滥用的健康被试参与实验,收集了他们在观看相关线索与对照线索时的脑神经活动。结果发现,药物线索能够诱发戒断者更多脑区的活动,包括扣带回和楔前叶。两组被试在对照动作线索刺激诱发作用下,其颞叶、顶叶均出现了较为一致的活动。在用药动作线索诱发作用下,戒断组双侧颞中回、双侧顶下小叶、左侧顶上小叶和右侧额下回显示出显著活动,并且与对照动作线索激活脑区一致;健康组被试除枕叶-颞叶联合区外,没有出现显著的脑区活动。以上结果表明,用药动作线索诱发了海洛因戒断者颞中回、顶下小叶、额下回等镜像神经系统的活动,这些脑区对不同类型的相关线索十分敏感,它们可能通过对用药动作的心理模拟,参与了用药动作线索的快速自动化加工。     

Exposure to negative emotional cues and alcohol cue reactivity with alcoholics: a preliminary investigation

Fifty-one male and female inpatient alcoholics received cue exposure treatment involving in vivo exposure to alcohol cues and imaginal exposure to individualized high-risk drinking situations involving negative emotional cues. At post-test, self-report measures of urge to drink alcohol and negative emotional states were obtained during an alcohol cue reactivity assessment. Contrary to our hypothesis, greater exposure to negative emotional cues during treatment was associated with greater urge and negative emotional responses at post-test. In addition, greater duration of exposure to negative emotional cues predicted greater attention to alcohol-related stimuli and thoughts about drinking during the post-test. Implications for future research in this area include extending the duration of exposure to negative emotional cues in order to establish the optimal exposure durations within which a majority of individuals achieve clinically significant reductions in their urge to drink alcohol.     

Pilot study of the effects of a workplace smoking ban on indices of smoking,cigarette craving,stress and other health behaviours

Abstract

Worksite smoking bans provide an ideal opportunity to examine the effects of enforced smoking restrictions on not only smoking behaviour, but also other health behaviours. This pilot study examines the short term effects of a such a ban on self-reported smoking behaviour, carbon monoxide and plasma cotinine levels and a number of other appetitive behaviours. The total number of cigarettes smoked on a working day and the number smoked just during working hours both declined following the introduction of a ban. Although the carbon monoxide levels of smokers during working hours demonstrated a similar trend to self-reported smoking, smokers' cotinine levels tended to increase, following an initial decrease following the ban. These data are suggestive of a compensatory process and a change in smoking topography, probably outside working hours. Measures of stress and craving also appeared to be affected by the introduction of smoking restrictions.     

镜像神经系统—研究药物依赖行为的新靶点

镜像神经是近年来认知与大脑神经科学研究中崭新的课题,大量实验证实了镜像神经元(系统)参与到了多种心理能力的发展与进化之中。目前有研究发现,吸烟相关线索会激活尼古丁成瘾者大脑相应的动作脑区,而该区域也正是人类镜像神经区域,这意味着镜像神经在相关线索激发的心理渴求中可能扮演了重要角色。该实验结果有重要的意义,动作计划脑区的神经线索反应为发展可靠的依赖行为的生物学标记提供了另一个新目标,不仅开发了一个新型的依赖行为的理论模型,还为把神经科学的研究发现运用到实践应用打下了良好的基础。     

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.