Treatments for drug abuse continue to be characterized by high rates of post-cessation relapse. It appears that patients often do not persist much beyond treatment in executing the effortful behaviors required to maintain drug abstinence or to recover from an initial slip. Treatments may benefit from basic theory and research on effort and persistence. One theory, Learned Industriousness (LI; Eisenberger, 1992), offers a parsimonious explanation of individual differences in drug cessation and relapse based on individuals' learning history. The theory posits that individuals with a history of receiving reinforcement for high levels of performance will be more likely to expend high effort in general, across tasks, compared with individuals with a history of reinforcement for low performance. Moreover, LI can be increased through effort training. Thus, LI theory also suggests possible techniques for improving both initial cessation and long-term abstinence. This Stage 1 Type A project will test the causal role of LI in cessation of drug abuse, using nicotine dependence as a convenient model, and begin the development of a behavioral smoking-cessation treatment based on the enhancement of patients' LI. Three studies are proposed. The first study will test if task persistence (a measure of LI) predicts quitting success among patients in a standard smoking cessation program. We hypothesize that subjects' pretreatment persistence on two frustrating tasks will predict success at quitting smoking and maintaining abstinence. Affirmative results would extend our previous finding of a concurrent association between effortful performance and substance use. The second study will test if effort training improves smokers' ability to abstain from smoking in a laboratory analog of cessation and relapse. Current smokers will be randomly assigned to receive high- or low-effort training. They will then be asked to abstain from smoking for the next six days. (A random half of all subjects will smoke 5 cigarettes after the second day, as an analog of an initial """"""""lapse."""""""") We hypothesize that subjects who receive high-effort training--reinforcement for displaying effortful and persistent behaviors--will show greater ability to abstain from smoking during this time period than subjects who receive low-effort training. This would demonstrate a causal role of LI in smoking cessation and also suggest that effort training has potential value in improving outcomes of substance abuse treatments. The third study will begin the development of an intervention that includes effort training in a manner that is acceptable to patients and therapists. We will experiment with treatment formats and develop a preliminary treatment manual. Together, these studies will form the basis for subsequent Stage 1 Type B and Stage 2 therapy-development projects.
