Behavioral Activation Intervention, Reward Processing, and Youth Smoking Cessation
| Status: | Completed |
|---|---|
| Conditions: | Smoking Cessation |
| Therapuetic Areas: | Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 18 - 21 |
| Updated: | 4/2/2016 |
| Start Date: | April 2010 |
| End Date: | April 2013 |
| Contact: | Laura MacPherson, PhD |
| Email: | lmacpherson@psyc.umd.edu |
| Phone: | 301-405-7895 |
Evidence suggests a significant percentage of adolescent regular smokers are interested in
trying to quit smoking and frequently make attempts to quit, yet are unsuccessful in
maintaining abstinence on their own. Despite a genuine desire to quit on the part of many
adolescents, there is an increasing incidence of smoking among older adolescents that runs
counter to the overall trends of smoking reduction seen in the general population.
Unfortunately, psychosocial and pharmacological smoking interventions have yet to indicate
clear effectiveness with youth. Moreover, depression-related vulnerabilities, particularly
currently elevated depressive symptoms, are highly comorbid with smoking behavior and
dramatically reduce cessation rates. As a result, new approaches to smoking cessation are
needed for adolescent smokers with currently elevated depressive symptoms. Thus the
objective of the present study is to develop a specialized behavioral activation treatment
for smoking in youths ages 18-21 with elevated depressive symptoms. In the first phase we
utilize focus groups and pilot testing with 15 youths to develop the behavioral activation
smoking treatment for youth (BATSY). In Phase II, we will conduct an open-label trial of
BATSY plus nicotine replacement therapy with 30 youths who will also take part in a
neuroimaging protocol examining reward sensitivity. Participants will be followed over 26
weeks post-quit date.
trying to quit smoking and frequently make attempts to quit, yet are unsuccessful in
maintaining abstinence on their own. Despite a genuine desire to quit on the part of many
adolescents, there is an increasing incidence of smoking among older adolescents that runs
counter to the overall trends of smoking reduction seen in the general population.
Unfortunately, psychosocial and pharmacological smoking interventions have yet to indicate
clear effectiveness with youth. Moreover, depression-related vulnerabilities, particularly
currently elevated depressive symptoms, are highly comorbid with smoking behavior and
dramatically reduce cessation rates. As a result, new approaches to smoking cessation are
needed for adolescent smokers with currently elevated depressive symptoms. Thus the
objective of the present study is to develop a specialized behavioral activation treatment
for smoking in youths ages 18-21 with elevated depressive symptoms. In the first phase we
utilize focus groups and pilot testing with 15 youths to develop the behavioral activation
smoking treatment for youth (BATSY). In Phase II, we will conduct an open-label trial of
BATSY plus nicotine replacement therapy with 30 youths who will also take part in a
neuroimaging protocol examining reward sensitivity. Participants will be followed over 26
weeks post-quit date.
This will be a Open-label trial to examine the efficacy of behavioral activation treatment
for smoking-youths (BATSY). After completing a focus group phase and pilot study phase of
BATSY with 15 youths, we will recruit 30 adolescent smokers with elevated depressive
symptoms between the ages of 18-21 into the open-label trial of the the BATSY treatment. All
participants in the open-label trial will receive 8 weeks of transdermal nicotine patch in
addition to the BATSY intervention. Participants will also undergo an fMRI session including
a behavioral task assessing reward sensitivity prior to commencement of the BATSY
intervention. We intend to examine both abstinence and relapse outcomes. In addition we will
examine to what extent depressive symptoms and reward sensitivity prior to quit date will
correspond with improved smoking cessation outcomes over time.
for smoking-youths (BATSY). After completing a focus group phase and pilot study phase of
BATSY with 15 youths, we will recruit 30 adolescent smokers with elevated depressive
symptoms between the ages of 18-21 into the open-label trial of the the BATSY treatment. All
participants in the open-label trial will receive 8 weeks of transdermal nicotine patch in
addition to the BATSY intervention. Participants will also undergo an fMRI session including
a behavioral task assessing reward sensitivity prior to commencement of the BATSY
intervention. We intend to examine both abstinence and relapse outcomes. In addition we will
examine to what extent depressive symptoms and reward sensitivity prior to quit date will
correspond with improved smoking cessation outcomes over time.
Inclusion Criteria:
- between 18 and 21 years of age
- a regular smoker for at least 6 months
- currently smoking an average of at least 5 cigarettes per day
- want to quit smoking
- report current elevated depressive symptoms
Exclusion Criteria:
- current Axis I disorder
- psychoactive substance dependence (excluding nicotine dependence) within the past 6
months
- current use of psychotropic medication or participation in any form of psychotherapy
- a history of significant medical condition (e.g., cardiovascular , neurological,
gastrointestinal), pregnancy and/or breast feeding, or other systemic illness
- limited mental competency [Mini Mental State Examination score < 23] and/or the
inability to give informed, voluntary, written consent to participate
- current use of any pharmacotherapy for smoking cessation not provided by the
researchers during the quit attempt
Additional fMRI Exclusion criteria:
- cerebrovascular disease
- high blood pressure
- diabetes
- use of psychotropic medications in 3 weeks prior to participation in fMRI protocol
- exposure to extreme trauma
- lifetime history of mania, psychosis, or pervasive developmental disorder,
- being ambidextrous or left handed
- any metal implants, heart pacemaker, permanent retainer
- tattoos containing metal dyes
- claustrophobia.
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