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Reinforcer Pathology and Response to Contingency Management for Smoking Cessation

机译：强化物病理学和应急响应管理戒烟

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The recognition of the interplay between cigarette demand and impulsivity as a proxy of reinforcer pathology (RP) has prompted studies that assess these 2 constructs. Scarce research has examined their interrelation within clinical contexts. This secondary analysis sought to identify different types of treatment-seeking smokers based on cigarette demand and delay discounting and examine their differential response to contingency management (CM). The dataset included 305 participants (68% female) receiving either a cognitive-behavioral treatment (CBT) or CBT + CM. A cluster analysis based on the bifactorial structure of a cigarette purchase task (i.e., psychological inertia and persistence) and delay discounting (base-10 logarithmic transformation of the area under the curve) was conducted. Clusters were compared in abstinence rates at posttreatment and 6-month follow-up. Two RP subgroups emerged. Cluster 1 (n = 128) and Cluster 2 (n = 177). which were interpreted as "individuals with excessive tobacco valuation" and "steep discounters," respectively. At 8 weeks, the percentage of abstinent individuals was higher in those in Cluster 2 compared to those in Cluster 1 (76.3% vs. 61%; chi(2) = 8.291, p = .004, phi = .16). The nonsignificant effect of treatment condition on cessation outcomes indicated that both clusters equally benefited from CBT or CBT + CM. Support was reached for the generalizability of CBT and CM irrespective of patients' RP subtype. The fact that CM did not enhance abstinence outcomes beyond those obtained with CBT alone, underscores the need to evaluate the effect of innovative treatment procedures tailored to these RP phenotypes.
机译：承认烟之间的相互作用需求和冲动作为强化物的代理病理学(RP)促使研究评估这两个结构。他们的相互关系在临床环境。这二次分析试图识别不同类型的寻求治疗的吸烟者基于卷烟需求和延迟折扣并检查它们的微分响应应急管理(CM)。305名参与者(68%的女性)接收认知行为治疗(CBT)或CBT +厘米。基于bifactorial集群分析购买香烟的任务的结构(例如,心理惯性和持久性)和延迟折扣(八进制数数对数变换曲线下的面积)。集群在禁欲率进行比较治疗后6个月随访。子组出现。集群2 (n = 177)。“个人过度烟草估价”分别和“陡峭的折扣店,”。周,节制个人的百分比在集群的高2相比这些集群1(76.3%比61%;8.291, p = 04,φ= 16)。影响治疗的停止条件结果表明,两种集群同样得益于CBT或CBT +厘米。伸手CBT的普遍性和厘米不管病人的RP亚型。厘米不提高禁欲的结果除了同CBT,下划线需要评估创新的影响治疗程序根据这些RP表型。

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