Projects & Publications
There has been increasing interest in developing interventions that directly target attentional processes. In attentional re-training (AR), cognitive experimental paradigms are re-designed so that they can actually modify (rather than simply measure) attentional processes. AR has been shown to have clinically significant effects in anxiety and addictive disorders. Hitherto, researchers have administered AR in the laboratory or over the internet. We propose to administer AR on a Smart Phone multiple times per day. The Specific Aims are to examine whether AR (delivered on a Smart Phone) can 1) reduce attentional bias to smoking-related stimuli in smokers wishing to quit; 2) reduce self-reported craving in smokers wishing to quit; and 3) reduce smoking in smokers wishing to quit. This study is funded by NCI.
African American cigarette smokers have higher rates of lung cancer and lower rates of cigarette smoking cessation compared to Whites. African American smokers also live in communities that have a disproportionately high number of tobacco cues and advertisements (compared to White smokers). Studies suggest that exposure to smoking cues can promote smoking and undermine cessation attempts. While it is difficult to modify the number of smoking cues in the environment, it may be possible to reduce attention to those cues ('attentional bias') through a cognitive task. This procedure is termed Attentional Retraining (AR). In AR, smokers are trained to automatically attend away from smoking cues. This training should reduce exposure to smoking cues, and therefore reduce craving. In this randomized controlled trial we will investigate the efficacy of AR using a modified dot probe task. We will recruit sixty African American smokers from the Washington, D.C. area. Participants will be randomly assigned to an AR condition or a Control condition. We hypothesize that, over time, AR will 1) reduce attentional bias to smoking cues, and 2) reduce craving in response to a stimulus containing both smoking and neutral cues. We will also explore the effects of AR on smoking behavior. This study is funded by the American Lung Association.
Alcohol Relapse Project
The study is designed to assess the natural history of temptations and lapses in treated alcohol dependent patients. Similar to Project Cognition, we use computerized reaction tasks (such as the Stroop Task and the Implicit Association Test) to assess implicit processes. Fifty Dutch alcohol dependent patients who recently finished their inpatient rehabilitation program will carry around Personal Digital Assistants (PDA) for four weeks. We are assessing stress, positive and negative affect, craving, and trait mindfulness. This study is being run by Dr. Tim Schoenmakers and Michelle Snelleman at IVO in Rotterdam, the Netherlands. The Project Coordinator is Edwin Szeto. This study is funded by IVO.
Cognitive Enhancers for Treatment of Addiction
Interventions that boost executive function may improve treatment outcomes in the addictions. In a collaboration with Dr. Mehmet Sofuoglu at Yale University, in this NIDA-funded study we will examine the safety and efficacy of galantamine as a treatment for nicotine addiction. This study will use EMA methods to evaluate the effect of the medication. The results of this study may lead to development of a novel treatment for smoking cessation. This study is funded by NIDA.
Brief Mindfulness-based Meditation Intervention
The purpose of this behavioral research study was to evaluate the effect of mindfulness meditation on thoughts and emotions related to smoking. Prior research has shown that mindfulness training can influence smokers' withdrawal symptoms, tobacco dependence, and smoking. This study investigated if a self-administered, brief version of mindfulness training will influence attention, perspective towards negative emotions, positive and negative emotions, and smoking. Participants carried around PDAs for two weeks, during which time they completed subjective and cognitive assessments. The Project Coordinator is Aimee Ruscio.
The majority of smokers are motivated to quit. However, most quit attempts end in failure. Many relapses occur in the first few days. It is therefore important to understand the mechanisms underlying relapse to smoking, so that more effective interventions can be developed. Most research on the psychological processes underlying relapse has used questionnaire (self-report) measures. In this completed study, we used computerized reaction time tasks, derived from experimental cognitive psychology, to assess processes ("implicit processes") that may not be captured by self-report. Two-hundred and forty adult smokers wishing to quit were enrolled in a smoking cessation study. All participants attended five laboratory sessions. At each session, they completed a battery of cognitive and questionnaire assessments. Some participants carried around a hand-held computer for one week. The study focused on smokers who wanted to quit without using nicotine replacement or other medications. Participants were provided with counseling. We sought to evaluate the clinical and theoretical utility of the implicit cognitive measures. For example, data collected in this study may identify individuals who are at high risk for an early relapse. This study was funded by NIDA.