1
|
Zvolensky MJ, Shepherd JM, Clausen BK, Robison J, Cano MÁ, de Dios M, Correa-Fernández V. Posttraumatic stress and probable post traumatic stress disorder as it relates to smoking behavior and beliefs among trauma exposed hispanic persons who smoke. J Behav Med 2024; 47:581-594. [PMID: 38409553 DOI: 10.1007/s10865-024-00480-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/09/2024] [Indexed: 02/28/2024]
Abstract
There has been little scientific effort to evaluate the associations between cigarette smoking and cessation-related constructs and exposure to traumatic events, posttraumatic stress, and Posttraumatic Stress Disorder (PTSD) symptoms among Hispanic persons who smoke in the United States (US). Such trauma-related factors may pose unique difficulties for Hispanic persons who smoke and possess a desire to quit. As such, the present investigation sought to fill this gap in the literature and examine posttraumatic stress and probable PTSD in terms of their relations with several clinically significant smoking constructs among trauma-exposed Hispanic persons who smoke from the United States. Participants included 228 Spanish-speaking Hispanic persons who endorsed prior traumatic event exposure and smoked combustible cigarettes daily (58.3% female, Mage= 32.1 years, SD = 9.65). Results indicated that posttraumatic stress symptoms were related to increased cigarette dependence, perceived barriers for smoking cessation, and more severe problems when trying to quit with effect sizes ranging from small to moderate in adjusted models. Additionally, Hispanic persons who smoke with probable PTSD compared to those without probable PTSD showcased a statistically effect for perceived barriers for cessation (p < .008) and a severity of problems when trying to quit (p < .001). No effect was evident for cigarette dependence after alpha correction. Overall, the present study offers novel empirical evidence related to the role of posttraumatic stress symptoms and PTSD among Hispanic persons who smoke in the US. Such findings highlight the need to expand this line of research to better understand the role of posttraumatic stress and PTSD among Hispanic persons who smoke which can inform smoking cessation treatments for Hispanic persons who smoke experiencing trauma-related symptomology.
Collapse
Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA.
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- HEALTH Institute, University of Houston, Houston, TX, USA.
| | - Justin M Shepherd
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA
| | - Bryce K Clausen
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA
| | - Jillian Robison
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA
| | - Miguel Ángel Cano
- Peter O'Donnell Jr. School of Public Health, The University of Texas Southwestern Medical Center, Dallas, USA
| | - Marcel de Dios
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, USA
| | | |
Collapse
|
2
|
Shevorykin A, Hyland BM, Robles D, Ji M, Vantucci D, Bensch L, Thorner H, Marion M, Liskiewicz A, Carl E, Ostroff JS, Sheffer CE. Tobacco use, trauma exposure and PTSD: a systematic review. Health Psychol Rev 2024:1-32. [PMID: 38711288 DOI: 10.1080/17437199.2024.2330896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/11/2024] [Indexed: 05/08/2024]
Abstract
Tobacco use remains one of the most significant preventable public health problems globally and is increasingly concentrated among vulnerable groups, including those with trauma exposure or diagnosed with PTSD. The goal of this systematic review was to update and extend previous reviews. Of the 7224 publications that met the initial criteria, 267 were included in the review. Summary topic areas include conceptual frameworks for the relation between trauma or PTSD and tobacco use; associations between trauma exposure or PTSD and tobacco use; number and type of trauma exposures and tobacco use; PTSD symptoms and tobacco use; Treatment-related studies; and the examination of causal relations. Evidence continues to indicate that individuals exposed to trauma or diagnosed with PTSD are more likely to use tobacco products, more nicotine dependent and less likely to abstain from tobacco even when provided evidence-based treatments than individuals without trauma. The most commonly cited causal association proposed was use of tobacco for self-regulation of negative affect associated with trauma. A small proportion of the studies addressed causality and mechanisms of action. Future work should incorporate methodological approaches and measures from which we can draw causal conclusions and mechanisms to support the development of viable therapeutic targets.
Collapse
Affiliation(s)
- Alina Shevorykin
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Bridget M Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Daniel Robles
- Department of Psychology, Faculty of Science, University of Alberta, Edmonton, Canada
| | - Mengjia Ji
- Department of Psychology, The City College of New York (CUNY), New York, NY, USA
| | - Darian Vantucci
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Lindsey Bensch
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Hannah Thorner
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Matthew Marion
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Amylynn Liskiewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Ellen Carl
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Jamie S Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| |
Collapse
|
3
|
Ricci M, Pozzi G, Caraglia N, Chieffo DPR, Polese D, Galiuto L. Psychological Distress Affects Performance during Exercise-Based Cardiac Rehabilitation. Life (Basel) 2024; 14:236. [PMID: 38398745 PMCID: PMC10890595 DOI: 10.3390/life14020236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/29/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND It is known that psychosocial distress affects the morbidity and mortality of patients with cardiovascular disease of every age. The aim of this study was to produce novel information on how psychological distress can influence cardiovascular performance in patients after cardiac surgery undergoing multidisciplinary cardiac rehabilitation. METHODS Patients (n = 57) admitted after cardiac surgery for valvular or coronary disease underwent, within 5 days of admission, the Symptom Checklist-90-Revised (SCL-90-R) self-report questionnaire to measure psychiatric symptoms and the 12-item General Health Questionnaire (GHQ-12) to assess the level of psychological distress. The Positive Symptom Distress Index (PSDI) was measured to indicate the amplitude of symptom distress. Cardiovascular performance was assessed by a 6 min walking test (6MWT) at admission and discharge, and oxygen consumption (VO2 max) was derived. RESULTS Within the SCL-90-R score, somatic symptoms (47.4%), depressive and anxiety symptoms (36.8% and 33.3%, respectively), symptoms of phobic anxiety (21.1%), and psychoticism (24.6%) were over-represented. As for the GHQ-12, 75.4% of the sample reported an abnormally negative perception of their health status. An inverse correlation was shown between the variation in 6MWT and SCL depression (p = 0.048), PSDI (p = 0.022), and the GHQ-12 (p = 0.040). Similarly, an inverse correlation was shown between the variation in the VO2 max, GHQ-12 (p = 0.041), and the PSDI (p = 0.023). CONCLUSIONS Post-cardiac surgery cardiac rehabilitation was associated with increased symptoms of psychological discomfort, as compared with the general population. The amplitude of psychological distress, depression, and hostility are associated with limited improvement in performance. These data strengthen the need for psychological support during cardiac rehabilitation programs.
Collapse
Affiliation(s)
- Marta Ricci
- Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, 00189 Rome, Italy;
- UOC of Cardiology, Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Gino Pozzi
- Department of Psychiatry, Fondazione Policlinico A. Gemelli-IRCCS, Catholic University, 00153 Rome, Italy;
| | - Naike Caraglia
- Clinical Psychology Unit, Fondazione Policlinico A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.C.); (D.P.R.C.)
- Memory Clinic, Foundation Policlinico A. Gemelli-IRCCS, 00168 Rome, Italy
| | - Daniela P. R. Chieffo
- Clinical Psychology Unit, Fondazione Policlinico A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.C.); (D.P.R.C.)
| | - Daniela Polese
- UOD of Childhood Neuropsychiatry, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy;
- Department of Neuroscience, Mental Health and Sensory Organs NESMOS, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Leonarda Galiuto
- Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, 00189 Rome, Italy;
- UOC of Cardiology, Sant’Andrea University Hospital, 00189 Rome, Italy
| |
Collapse
|
4
|
Wang X, Chen Y, Dong J, Ge J, Liu X, Liu J. Neurobiology of Stress-Induced Nicotine Relapse. Int J Mol Sci 2024; 25:1482. [PMID: 38338760 PMCID: PMC10855331 DOI: 10.3390/ijms25031482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/15/2024] [Accepted: 01/19/2024] [Indexed: 02/12/2024] Open
Abstract
Tobacco smoking is the leading cause of preventable death and disease. Although there are some FAD-approved medicines for controlling smoking, the relapse rate remains very high. Among the factors that could induce nicotine relapse, stress might be the most important one. In the last decades, preclinical studies have generated many new findings that lead to a better understanding of stress-induced relapse of nicotine-seeking. Several molecules such as α3β4 nicotinic acetylcholine receptor, α2-adrenergic receptors, cannabinoid receptor 1, trace amine-associated receptor 1, and neuropeptide systems (corticotropin-releasing factor and its receptors, dynorphine and kappa opioid receptor) have been linked to stress-induced nicotine relapse. In this review, we discuss recent advances in the neurobiology, treatment targets, and potential therapeutics of stress-induced nicotine relapse. We also discuss some factors that may influence stress-induced nicotine relapse and that should be considered in future studies. In the final section, a perspective on some research directions is provided. Further investigation on the neurobiology of stress-induced nicotine relapse will shed light on the development of new medicines for controlling smoking and will help us understand the interactions between the stress and reward systems in the brain.
Collapse
Affiliation(s)
| | | | | | | | | | - Jianfeng Liu
- Institute of Brain Science and Advanced Technology, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Medicine, Wuhan University of Science and Technology, Wuhan 430065, China (Y.C.); (J.D.)
| |
Collapse
|
5
|
Johnstad PG. Unhealthy behaviors associated with mental health disorders: a systematic comparative review of diet quality, sedentary behavior, and cannabis and tobacco use. Front Public Health 2024; 11:1268339. [PMID: 38249418 PMCID: PMC10797041 DOI: 10.3389/fpubh.2023.1268339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/14/2023] [Indexed: 01/23/2024] Open
Abstract
Background There are well-established literatures documenting the associations between mental disorders and unhealthy behaviors such as poor diet quality, sedentary behavior, and cannabis and tobacco use. Few studies have attempted to understand the respective findings in light of each other, however. Objective The purpose of this review was to assemble comparable data for each behavior-disorder association and assess the associations in terms of their overall strength. The review aimed to include a representative, but not exhaustive, range of studies that would allow for explorative comparisons. Methods Eligible studies were identified via Pubmed searches and citation searching, restricted to publications no older than 2015 written in English. To obtain comparable data, only studies that reported findings as odds ratios were included, and risk of bias related to study samples, behavioral measurement disparities, and control variables was assessed via sensitivity analyses. Findings for each disorder were compared on the basis of different measures of central tendency. Results From 3,682 records, 294 studies were included. The review found evidence of associations between each of the four unhealthy behaviors and psychosis, depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD), while personality disorder was only investigated in relation to cannabis and tobacco use. In overall comparison, the associations were generally of similar strength, and only the association between cannabis use and personality disorder was exceptional in terms of being significantly stronger than its counterparts across disorders and across behaviors. Analyses of bias risk identified some influence from behavioral measurement disparities and lack of adequate statistical control, but findings were generally robust across a range of sensitivity analyses. Conclusion This explorative and comparative review found that poor diet quality, sedentary behavior, and cannabis and tobacco use are about equally strongly associated with a range of different mental disorders. Given the general nature of these associations, we should probably understand them to reflect a general and shared etiology. However, the findings in this review should be regarded as tentative until confirmed by more comprehensive investigations.
Collapse
|
6
|
Jones-Patten A, Shin SS, Nyamathi A, Bounds D. "Cigarettes play the equalizer": discrimination experiences and readiness to quit cigarette smoking among African Americans experiencing homelessness: a qualitative analysis. Addict Sci Clin Pract 2024; 19:1. [PMID: 38163885 PMCID: PMC10759568 DOI: 10.1186/s13722-023-00432-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Approximately 70-80% of people experiencing homelessness in the United States use tobacco. Smoking cessation programs specifically for this population have been found to be less effective for African American participants. The purpose of this study was to explore discrimination experiences and their impact on smoking habits and readiness to quit cigarette smoking while experiencing homelessness. METHODS In the qualitative phase of this mixed methods study, five focus groups were conducted for African Americans residing in a homeless shelter in Skid Row, Los Angeles, CA. Using a semi-structured interview guide, we asked participants about discrimination experiences, how smoking habits were impacted by these experiences, and tools needed to successfully abstain from cigarette smoking. Qualitative descriptive content analysis was used to explore discrimination experiences and its association with readiness to quit cigarette smoking. RESULTS Of the 17 participants, 14 (82.4%) were male, and the average age was 46.8 years. Using a qualitative In Vivo coding method, three themes were revealed: "Experiencing Discrimination while Black", "The Psychosocial Fabric-Why Quitting Cigarette Smoking is a Challenge", and "The Lesser of Two Evils-Choosing to Smoke over More Harmful Options." Participants discussed working in the blue-collar workforce while Black, identifying as a double minority, smoking to cope with stress, early exposure to cigarettes, smoking being a central part of one's belonging to a group, and the legality of cigarette smoking. DISCUSSION Our findings show that African Americans experiencing homelessness (1) may experience discrimination in multiple settings, regardless of housing status, (2) could have grown up around cigarette smoking and remain surrounded by it while experiencing homelessness, and (3) may experience a calming effect with smoking, which slows some from reacting negatively to adverse situations. CONCLUSION Barriers to successfully abstaining from smoking are multifactorial among African Americans experiencing homelessness and should be addressed individually. Future research should explore the cultural tailoring of interventions that support cessation efforts unique to minoritized populations to improve smoking cessation programs offered to this population.
Collapse
Affiliation(s)
- Alexandria Jones-Patten
- Columbia University School of Nursing, Center for Research On People of Color, 560 W 168Th St, New York, NY, 10032, USA.
- Columbia University Irving Medical Center New York, New York, NY, USA.
| | - Sanghyuk S Shin
- Irvine School of Nursing Berk Hall, University of California, 802 West Peltason Drive, Irvine, CA, 92617, USA
| | - Adeline Nyamathi
- Irvine School of Nursing Berk Hall, University of California, 802 West Peltason Drive, Irvine, CA, 92617, USA
| | - Dawn Bounds
- Irvine School of Nursing Berk Hall, University of California, 802 West Peltason Drive, Irvine, CA, 92617, USA
| |
Collapse
|
7
|
Russell A, Filec S, Serper M, Opsasnick L, Batio S, O'Conor RM, Curtis L, Kwasny M, Benavente JY, Wismer G, Bonham M, Zheng P, Lovett R, Arvanitis M, Ladner DP, McCaffery K, Linder JA, Bailey SC, Wolf MS. Impact of COVID-19 on the capacity to self-manage health and chronic conditions. PEC INNOVATION 2023; 2:100163. [PMID: 37197693 PMCID: PMC10167781 DOI: 10.1016/j.pecinn.2023.100163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 05/07/2023] [Accepted: 05/08/2023] [Indexed: 05/19/2023]
Abstract
Objective To investigate well-being, lifestyle behaviors, self-management capacity and healthcare utilization among adults with chronic conditions at the outbreak of the COVID-19 pandemic. Methods Data was collected from two interviewer-administered telephone surveys conducted between March 27 - May 22, 2020. Participants were patients at Chicago-area clinics. Self-report and validated measures were used for study-related outcomes. Results A total of 553 participants (age range 23-88) completed data collection at both timepoints. One in five (20.7%) participants experienced stress due to the coronavirus most or all the time and rates of negative well-being were high (WHO-5 Index mean = 58.7%). Almost a quarter (22.3%) engaged in hazardous drinking and 79.7% reported insufficient physical activity. Nearly one in four participants (23.7%) avoided seeking medical care due to worry about COVID-19. In multivariable analyses, greater COVID-19 related stress was associated with less physical activity, lower self-efficacy, greater difficulty managing health and medications, and delays in seeking medical care due to the coronavirus. Conclusions Mental well-being, lifestyle behaviors, self-management capacity, and healthcare utilization were impacted in the months following the COVID outbreak. Innovation These findings suggest health systems should implement proactive measures for detecting and treating emotional and behavioral COVID-related concerns.
Collapse
Affiliation(s)
- Andrea Russell
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr., 10th Floor, Chicago, IL, United States of America
| | - Sarah Filec
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr., 10th Floor, Chicago, IL, United States of America
| | - Marina Serper
- Hospital of the University of Pennsylvania, Philadelphia, PA, United States of America
| | - Lauren Opsasnick
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr., 10th Floor, Chicago, IL, United States of America
| | - Stephanie Batio
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr., 10th Floor, Chicago, IL, United States of America
| | - Rachel M. O'Conor
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr., 10th Floor, Chicago, IL, United States of America
| | - Laura Curtis
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr., 10th Floor, Chicago, IL, United States of America
| | - Mary Kwasny
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr., 10th Floor, Chicago, IL, United States of America
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Julia Yoshino Benavente
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr., 10th Floor, Chicago, IL, United States of America
| | - Guisselle Wismer
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr., 10th Floor, Chicago, IL, United States of America
| | - Morgan Bonham
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr., 10th Floor, Chicago, IL, United States of America
| | - Pauline Zheng
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr., 10th Floor, Chicago, IL, United States of America
| | - Rebecca Lovett
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr., 10th Floor, Chicago, IL, United States of America
| | - Marina Arvanitis
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr., 10th Floor, Chicago, IL, United States of America
| | - Daniela P. Ladner
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | | | - Jeffrey A. Linder
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr., 10th Floor, Chicago, IL, United States of America
| | - Stacy Cooper Bailey
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr., 10th Floor, Chicago, IL, United States of America
| | - Michael S. Wolf
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr., 10th Floor, Chicago, IL, United States of America
| |
Collapse
|
8
|
Barrett BW, Meanley S, Brennan-Ing M, Haberlen SA, Ware D, Detels R, Friedman MR, Plankey MW. The Relationship Between Posttraumatic Stress Disorder and Alcohol Misuse and Smoking Among Aging Men Who Have Sex With Men: No Evidence of Exercise or Volunteering Impact. J Aging Health 2023:8982643231215475. [PMID: 37976419 PMCID: PMC11288306 DOI: 10.1177/08982643231215475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVES To determine if the association between posttraumatic stress disorder (PTSD) and substance use (alcohol misuse or smoking tobacco) is mediated/moderated by exercise or volunteering among aging (≥40 years) men who have sex with men (MSM), and if this mediation/moderation differs by HIV serostatus. METHODS Multicenter AIDS Cohort Study data were used. Three datasets with PTSD measured during different time periods (10/1/2017-3/31/2018, 898 men; 4/1/2018-9/30/2018, 890 men; 10/1/2018-3/31/2019, 895 men) were analyzed. Longitudinal mediation analyses estimated the mediation effect of exercise and volunteering on the outcomes. RESULTS Nine percent of MSM had evidence of PTSD. There was no statistically significant mediation effect of exercise or volunteering regardless of substance use outcome. The odds of smoking at a future visit among MSM with PTSD were approximately double those of MSM without PTSD. Results did not differ by HIV serostatus. DISCUSSION There is a particular need for effective smoking cessation interventions for aging MSM with PTSD.
Collapse
Affiliation(s)
- Benjamin W. Barrett
- Department of Epidemiology, Bloomberg School of Public
Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Steven Meanley
- Department of Family and Community Health, University of
Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Mark Brennan-Ing
- Brookdale Center for Healthy Aging, Hunter College, The
City University of New York, New York, New York, USA
| | - Sabina A. Haberlen
- Department of Epidemiology, Bloomberg School of Public
Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Deanna Ware
- Department of Medicine, Georgetown University Medical
Center, Washington, District of Columbia, USA
| | - Roger Detels
- Department of Epidemiology, Fielding School of Public
Health, University of California, Los Angeles, Los Angeles, California, USA
| | - M. Reuel Friedman
- Department of Urban-Global Public Health, School of Public
Health, Rutgers University, Newark, New Jersey, USA
| | - Michael W. Plankey
- Department of Medicine, Georgetown University Medical
Center, Washington, District of Columbia, USA
| |
Collapse
|
9
|
Lin SY, Cheng X, Rossheim ME, Gress D, Cuellar AE, Cheskin L, Xue H. Associations between use of specific social media sites and electronic cigarette use among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2217-2224. [PMID: 34469259 DOI: 10.1080/07448481.2021.1965149] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To examine dose-response associations between use of specific social media sites and the use of electronic cigarettes (e-cigarettes) and traditional cigarettes. METHODS This was a cross-sectional study of 298 first-year college students enrolled in the fall 2019 semester at a large state university. Heckman selection and Probit model were used to estimate associations between use of specific social media sites and e-cigarette/traditional cigarette use. RESULTS Each additional hour per day spent on Snapchat was associated with a 4.61% increase in the probability of lifetime e-cigarette use. In addition, among current e-cigarette users, more time spent on Snapchat was associated with more frequent e-cigarette use (marginal effects: 0.13, p = 0.001). Facebook, Twitter, Snapchat and Instagram were not associated with traditional cigarette smoking. CONCLUSION Snapchat was the only major social media platform associated with both lifetime and current e-cigarette use.
Collapse
Affiliation(s)
- Shuo-Yu Lin
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Xiaolu Cheng
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Matthew E Rossheim
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Dustin Gress
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Alison Evans Cuellar
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Lawrence Cheskin
- Department of Nutrition and Food Studies, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Hong Xue
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| |
Collapse
|
10
|
Kostev K, Smith L, Haro JM, Konrad M, Koyanagi A, Jacob L. Is There an Association between Post-Traumatic Stress Disorder and the Incidence of Chronic Low Back Pain? J Clin Med 2023; 12:5753. [PMID: 37685820 PMCID: PMC10488514 DOI: 10.3390/jcm12175753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/29/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Preliminary research suggests post-traumatic stress disorder (PTSD) is a risk factor for chronic low back pain (CLBP). However, this literature displays some limitations. Therefore, this study aimed to investigate the association between PTSD and the 10-year cumulative incidence of CLBP in adults from Germany. METHODS The present retrospective cohort study included adults diagnosed with PTSD in 1 of 1284 general practices in Germany in 2005-2020 (index date). Individuals without PTSD were matched to those with PTSD (1:1) using a propensity score based on age, sex, index year, duration of follow-up, and the mean number of consultations during follow-up. In patients without PTSD, the index date was a randomly selected visit date. RESULTS There were 60,664 patients included in the study. After adjusting for frequent comorbidities, there was a positive but non-significant association between PTSD and incident CLBP in the overall population (HR = 1.07, 95% CI = 0.99-1.15). Nonetheless, the relationship between PTSD and CLBP was statistically significant in the age group >60 years (HR = 1.24, 95% CI = 1.05-1.46). CONCLUSIONS Conversely to previous research, PTSD was not associated with incident CLBP in this large German sample. Further longitudinal studies are warranted to corroborate these findings before drawing any firm conclusions.
Collapse
Affiliation(s)
- Karel Kostev
- Epidemiology, IQVIA, 60549 Frankfurt, Germany
- University Clinic of Philipps University, 35037 Marburg, Germany
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain
| | - Marcel Konrad
- Health & Social, FOM University of Applied Sciences for Economics and Management, 45127 Frankfurt am Main, Germany
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain
- Université Paris Cité, AP-HP, Lariboisière-Fernand Widal Hospital, Physical Medicine and Rehabilitation Department, 75010 Paris, France
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, 75010 Paris, France
| |
Collapse
|
11
|
Winslow VA, Jagai JS, Makelarski JA, Wroblewski KE, Lindau ST, Vu M. Social Risk and Smoking Among Women Smokers Early in the COVID-19 Pandemic: The Role of Mental Health. J Womens Health (Larchmt) 2023; 32:960-969. [PMID: 37379463 PMCID: PMC10510694 DOI: 10.1089/jwh.2023.0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023] Open
Abstract
Background: We examined patterns of smoking in relation to health-related socioeconomic vulnerability (HRSV) among U.S. women early in the pandemic and whether mental health symptoms mediated these relationships. Materials and Methods: Data were obtained from the April 2020 National U.S. Women's Health COVID-19 Study (N = 3200). Among current smokers, adjusted odds of increased smoking since the start of the pandemic (vs. same or less) by incident and worsening HRSVs were modeled. Structural equation modeling was used to assess anxiety, depression, and traumatic stress symptoms as mediators of the relationship between six HRSVs (food insecurity; housing, utilities, and transportation difficulties; interpersonal violence; financial strain) and increased smoking early in the pandemic. Results: Nearly half (48%) of current smokers reported increased smoking since the pandemic started. Odds of increased smoking were higher among women with incident financial strain (aOR = 2.0, 95% CI 1.2-3.3), incident food insecurity (aOR = 2.9, 95% CI 1.7-5.1), any worsening HRSV (aOR = 2.2, 95% CI 1.5-3.0), and worsening food insecurity (aOR = 1.9, 95% CI 1.3-3.0). Anxiety symptoms were a significant, partial mediator of the relationship between increased smoking and any worsening HRSVs (proportion mediated = 0.17, p = 0.001) and worsening food insecurity (0.19, p = 0.023), specifically. Depression symptoms were a significant, partial mediator of the relationship between increased smoking and any worsening HRSVs (0.15, p = 0.004) and incident financial strain (0.19, p = 0.034). Traumatic stress was not a significant mediator of any tested relationship. Conclusions: Anxiety and depression symptoms partially explain the relationship between rising socioeconomic vulnerability and increased smoking among women early in the pandemic. Addressing HRSVs and mental health may help reduce increased smoking during a public health crisis.
Collapse
Affiliation(s)
- Victoria A. Winslow
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, USA
| | - Jyotsna S. Jagai
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, USA
| | - Jennifer A. Makelarski
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, USA
| | - Kristen E. Wroblewski
- Department of Public Health Sciences, The University of Chicago, Chicago, Illinois, USA
| | - Stacy Tessler Lindau
- Department of Obstetrics and Gynecology and Medicine-Geriatrics and Palliative Medicine, The University of Chicago and The University of Chicago Comprehensive Cancer Center, Chicago, Illinois, USA
| | - Milkie Vu
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA
| |
Collapse
|
12
|
Jin Y, Xu S, Luo X, Wang Y, Li J, Liang B, Li H, Wang X, Sun X, Wang Y. A network approach to the symptom-level associations between smoking and posttraumatic stress disorder (PTSD) among young adults exposed to childhood sexual abuse. J Glob Health 2023; 13:04037. [PMID: 37350563 PMCID: PMC10288921 DOI: 10.7189/jogh.13.04037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
Background Previous empirical literature has examined the associations between childhood sexual abuse (CSA) exposure, posttraumatic stress disorder (PTSD), and smoking. However, few studies examined symptom-level associations between smoking and PTSD among CSA victims. Thus, the aims of this study were 1) to explore symptom-level associations between smoking and PTSD among combustible cigarette (CC) and electronic cigarette (EC) users exposed to CSA and 2) to compare the differences manifested in two network structures between EC and CC users with CSA experiences. Methods This cross-sectional study covers all 63 universities and colleges in Jilin province, China, from October 26 to November 18, 2021. A total of 117 769 students participated in this study, while 3479 young adults were exposed to CSA (3.62%, 95% CI = 3.50%-3.73%). Childhood sexual abuse, PTSD, and smoking symptoms were measured using the Childhood Trauma Questionnaire-Short Form (CTQ-SF), 10-item Trauma Screening Questionnaire (TSQ-10), and the 6-item Fagerstrom Test for Nicotine Dependence (FTND-6), respectively. In addition, network analysis was applied to analyse psychopathological symptoms between EC and CC users with CSA experiences. Both the edges and centralities were computed, and the network properties were compared among the two groups. Results Four symptoms of PTSD (i.e. emotional cue reactivity, hypervigilance, nightmares, and difficulty concentrating) were both central and bridge symptoms between PTSD and smoking among EC and CC users with CSA experiences. Moreover, compared with CC users with CSA, there were significantly stronger associations between "nightmares" - "difficulty with restrictions" and "irritability / anger" - "more during wake up" among young EC users with CSA. Conclusions The four symptoms (i.e. emotional cue reactivity, hypervigilance, nightmares, and difficulty concentrating) were keystones for treatments or interventions targeting these CSA victims with PTSD and smoking symptoms. Increasing efforts should be taken to restrict morning smoking among EC users with CSA. In addition, target interventions and strategies founded on these core symptoms and associations should be implemented to relieve the comorbid PTSD and smoking in EC and CC users with CSA experiences.
Collapse
Affiliation(s)
- Yu Jin
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, China
- Department of Population, Resources, and Environment, Northeast Asian Studies College, Jilin University, Changchun, China
- China Center for Aging Studies and Social-Economic Development, Jilin University, Changchun, China
| | - Xianyu Luo
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Yinzhe Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Jiaqi Li
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China, South China Normal University, Guangzhou, China
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Beixiang Liang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China, South China Normal University, Guangzhou, China
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Hui Li
- School of Public Health, Jilin University, Changchun, China
| | - Xiaofeng Wang
- Northeast Asian Research Center, Jilin University, Changchun, China
| | - Xi Sun
- Department of Population, Resources, and Environment, Northeast Asian Studies College, Jilin University, Changchun, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China, South China Normal University, Guangzhou, China
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| |
Collapse
|
13
|
Logue MW, Miller MW, Sherva R, Zhang R, Harrington KM, Fonda JR, Merritt VC, Panizzon MS, Hauger RL, Wolf EJ, Neale Z, Gaziano JM. Alzheimer's disease and related dementias among aging veterans: Examining gene-by-environment interactions with post-traumatic stress disorder and traumatic brain injury. Alzheimers Dement 2023; 19:2549-2559. [PMID: 36546606 PMCID: PMC10271966 DOI: 10.1002/alz.12870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/03/2022] [Accepted: 10/17/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) confer risk for Alzheimer's disease and related dementias (ADRD). METHODS This study from the Million Veteran Program (MVP) evaluated the impact of apolipoprotein E (APOE) ε4, PTSD, and TBI on ADRD prevalence in veteran cohorts of European ancestry (EA; n = 11,112 ADRD cases, 170,361 controls) and African ancestry (AA; n = 1443 ADRD cases, 16,191 controls). Additive-scale interactions were estimated using the relative excess risk due to interaction (RERI) statistic. RESULTS PTSD, TBI, and APOE ε4 showed strong main-effect associations with ADRD. RERI analysis revealed significant additive APOE ε4 interactions with PTSD and TBI in the EA cohort and TBI in the AA cohort. These additive interactions indicate that ADRD prevalence associated with PTSD and TBI increased with the number of inherited APOE ε4 alleles. DISCUSSION PTSD and TBI history will be an important part of interpreting the results of ADRD genetic testing and doing accurate ADRD risk assessment.
Collapse
Affiliation(s)
- Mark W Logue
- National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Boston University Chobanian & Avedisian School of Medicine, Biomedical Genetics, Boston, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Mark W Miller
- National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Richard Sherva
- Boston University Chobanian & Avedisian School of Medicine, Biomedical Genetics, Boston, Massachusetts, USA
| | - Rui Zhang
- National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Kelly M Harrington
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Jennifer R Fonda
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Victoria C Merritt
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Matthew S Panizzon
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, California, USA
- Division of Aging, Harvard Medical School, Brigham & Women's Hospital, Boston, Massachusetts, USA
| | - Richard L Hauger
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, California, USA
| | - Erika J Wolf
- National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Zoe Neale
- National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - J Michael Gaziano
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, USA
- Division of Aging, Harvard Medical School, Brigham & Women's Hospital, Boston, Massachusetts, USA
| |
Collapse
|
14
|
Florescu C, Ciobanu P, Hădăreanu DR, Gheorman V, Mustafa ER, Glodeanu AD, Bunescu MG, Mită A, Dinescu VC. The Interplay between Conventional Cardiovascular Risk Factors and Health-Related Quality of Life in a Cohort of Working Young and Middle-Aged Adults: A Prospective Study. LIFE (BASEL, SWITZERLAND) 2022; 12:life12122132. [PMID: 36556497 PMCID: PMC9782771 DOI: 10.3390/life12122132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
Psychosocial and work stress, socioeconomic status, and environmental health directly impact the onset and progression of cardiovascular diseases, irrespective of sex or conventional cardiovascular risk factors (cCRFs). On the other hand, the impact of cCRFs on health-related quality of life (HRQoL) is not well known, and the psychological socioeconomic environmental somatic health interaction is often neglected. Accordingly, we aimed to: (i) compare the self-reported HRQoL using the WHOQOL-BREF questionnaire between healthy subjects and those with cCRFs; and (ii) evaluate the interplay between HRQoL, cCRFs, and cardiovascular treatment adherence. We prospectively included 90 working adults (46 healthy and 44 with cCRFs age- and sex-matched adults) evaluated by clinical examination, 12-leads electrocardiography, and transthoracic echocardiography as part of a cardiovascular diseases screening program, that also filled in the WHOQOL-BREF questionnaire. Subjects with CRFs were less satisfied with their own individual health. The presence and the number of CRFs, as well as the need for cardiovascular treatment and the number of drugs taken correlated with reduced scores at the majority of HRQoL domains. The results in the social relationships domain were the best predictor of cardiovascular treatment adherence. Finally, the results of all HRQoL domains were strongly correlated to each other demonstrating the psychological socioeconomic environmental somatic health interaction.
Collapse
Affiliation(s)
- Cristina Florescu
- Department of Cardiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 2 Petru Rares St., 200349 Craiova, Romania
- Filantropia Clinical Hospital, 200516 Craiova, Romania
| | - Petre Ciobanu
- Department of Cardiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 2 Petru Rares St., 200349 Craiova, Romania
- Filantropia Clinical Hospital, 200516 Craiova, Romania
| | - Diana Ruxandra Hădăreanu
- Clinical Emergency County Hospital of Craiova, 1 Tabaci St., 200642 Craiova, Romania
- Correspondence:
| | - Veronica Gheorman
- Clinical Emergency County Hospital of Craiova, 1 Tabaci St., 200642 Craiova, Romania
| | - Edme Roxana Mustafa
- Department of Cardiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 2 Petru Rares St., 200349 Craiova, Romania
- Clinical Emergency County Hospital of Craiova, 1 Tabaci St., 200642 Craiova, Romania
| | - Adina Dorina Glodeanu
- Filantropia Clinical Hospital, 200516 Craiova, Romania
- Department of Internal Medicine, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, 2 Petru Rares St., 200349 Craiova, Romania
| | - Marius Gabriel Bunescu
- Clinical Emergency County Hospital of Craiova, 1 Tabaci St., 200642 Craiova, Romania
- Department of Health Promotion and Occupational Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 2 Petru Rares St., 200349 Craiova, Romania
| | - Adrian Mită
- Filantropia Clinical Hospital, 200516 Craiova, Romania
- Department of Medical Semiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 2 Petru Rares St., 200349 Craiova, Romania
| | - Venera Cristina Dinescu
- Clinical Emergency County Hospital of Craiova, 1 Tabaci St., 200642 Craiova, Romania
- Department of Health Promotion and Occupational Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 2 Petru Rares St., 200349 Craiova, Romania
| |
Collapse
|
15
|
Boozary LK, Frank-Pearce SG, Alexander AC, Sifat MS, Kurien J, Waring JJ, Ehlke SJ, Businelle MS, Ahluwalia JS, Kendzor DE. Tobacco use characteristics, treatment preferences, and motivation to quit among adults accessing a day shelter in Oklahoma City. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 5:100117. [PMID: 36844157 PMCID: PMC9949321 DOI: 10.1016/j.dadr.2022.100117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/07/2022] [Accepted: 11/04/2022] [Indexed: 11/08/2022]
Abstract
Background Smoking rates are exceptionally high among adults experiencing homelessness (AEH). Research is needed to inform treatment approaches in this population. Methods Participants (n=404) were adults who accessed an urban day shelter and reported current smoking. Participants completed surveys regarding their sociodemographic characteristics, tobacco and substance use, mental health, motivation to quit smoking (MTQS), and smoking cessation treatment preferences. Participant characteristics were described and compared by MTQS. Results Participants who reported current smoking (N=404) were primarily male (74.8%); White (41.4%), Black (27.8%), or American Indian/Alaska Native (14.1%) race; and 10.7% Hispanic. Participants reported a mean age of 45.6 (SD=11.2) years, and they smoked an average of 12.6 (SD=9.4) cigarettes per day. Most participants reported moderate or high MTQS (57%) and were interested in receiving free cessation treatment (51%). Participants most frequently selected the following options as among the top 3 treatments that offered the best chance of quitting: Nicotine replacement therapy (25%), money/gift cards for quitting (17%), prescription medications (17%), and switching to e-cigarettes (16%). Craving (55%), stress/mood (40%), habit (39%), and being around other smokers (36%) were frequently identified as the most challenging aspects of quitting. Low MTQS was associated with White race, lack of religious participation, lack of health insurance, lower income, greater cigarettes smoked per day, and higher expired carbon monoxide. Higher MTQS was associated with sleeping unsheltered, cell phone ownership, higher health literacy, more years of smoking, and interest in free treatment. Discussion Multi-level, multi-component interventions are needed to address tobacco disparities among AEH.
Collapse
Affiliation(s)
- Laili Kharazi Boozary
- Department of Psychology, Cellular and Behavioral Neurobiology, University of Oklahoma, Norman OK 73019
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Summer G. Frank-Pearce
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Adam C. Alexander
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Munjireen S. Sifat
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Jasmin Kurien
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Joseph J.C. Waring
- Bloomberg School of Public of Health, Johns Hopkins University, Baltimore, MD, United States
| | - Sarah J. Ehlke
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Michael S. Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Jasjit S. Ahluwalia
- School of Public Health, Behavioral and Social Sciences, Brown University, Providence, RI, United States
| | - Darla E. Kendzor
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| |
Collapse
|
16
|
Guadagnoli L, Mashimo H, Lo WK. Assessment of Post-traumatic Stress Disorder Among Objective Esophageal Motility and Reflux Phenotypes in Symptomatic Veterans. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09920-6. [PMID: 36378471 DOI: 10.1007/s10880-022-09920-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2022] [Indexed: 11/16/2022]
Abstract
Prior research suggests post-traumatic stress disorder (PTSD) is associated with the development of esophageal symptoms. We aimed to evaluate the prevalence of PTSD in veterans with esophageal symptoms, and assess for differences in objective esophageal motility and reflux classifications. Consecutive veterans reporting esophageal symptoms (e.g., dysphagia and reflux) underwent clinical evaluation with standard reflux and motility testing. Relevant demographic, mental health, and clinical esophageal information was gathered. Patients were classified into "PTSD" and "Non-PTSD" groups based on the documentation of a clinician-confirmed diagnosis of PTSD in the medical chart. Of the 273 consecutive veterans (89% men, mean age: 62 years) that met inclusion criteria for the study, 34% had a clinician-confirmed diagnosis of PTSD. Differences existed between PTSD and non-PTSD groups on smoking, bipolar disorder, depression, ADHD, and opiate use. However, no differences existed in objectively determined motility or reflux phenotypes. While PTSD was highly prevalent among our sample of symptomatic veterans, the presence of PTSD was not associated with differences in motility classifications and reflux phenotypes. These findings are consistent with recent research in psychogastroenterology, which suggests psychological processes are important to consider across esophageal classifications.
Collapse
|
17
|
Bajor LA, Balsara C, Osser DN. An evidence-based approach to psychopharmacology for posttraumatic stress disorder (PTSD) - 2022 update. Psychiatry Res 2022; 317:114840. [PMID: 36162349 DOI: 10.1016/j.psychres.2022.114840] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 01/04/2023]
Abstract
Algorithms for posttraumatic stress disorder were published by this team in 1999 and 2011. Developments since then warrant revision. New studies and review articles from January 2011 to November 2021 were identified via PubMed and analyzed for evidence supporting changes. Following consideration of variations required by special patient populations, treatment of sleep impairments remains as the first recommended step. Nightmares and non-nightmare disturbed awakenings are best addressed with the anti-adrenergic agent prazosin, with doxazosin and clonidine as alternatives. First choices for difficulty initiating sleep include hydroxyzine and trazodone. If significant non-sleep PTSD symptoms remain, an SSRI should be tried, followed by a second SSRI or venlafaxine as a third step. Second generation antipsychotics can be considered, particularly for SSRI augmentation when PTSD-associated psychotic symptoms are present, with the caveat that positive evidence is limited and side effects are considerable. Anti-adrenergic agents can also be considered for general PTSD symptoms if not already tried, though evidence for daytime use lags that available for sleep. Regarding other pharmacological and procedural options, e.g., transcranial magnetic stimulation, cannabinoids, ketamine, psychedelics, and stellate ganglion block, evidence does not yet support firm inclusion in the algorithm. An interactive version of this work can be found at www.psychopharm.mobi.
Collapse
Affiliation(s)
- Laura A Bajor
- James A. Haley VA Hospital, Tampa, FL, United States; University of South Florida Morsani School of Medicine, Tampa, FL, United States; VA Boston Healthcare System and Harvard South Shore Psychiatry Residency Training Program, Brockton, MA, United States.
| | - Charmi Balsara
- HCA Healthcare East Florida Division GME/HCA FL Aventura Hospital, United States
| | - David N Osser
- VA Boston Healthcare System and Harvard South Shore Psychiatry Residency Training Program, Brockton, MA, United States
| |
Collapse
|
18
|
Nizio P, Smit T, Matoska CT, Chavez J, Tullos EA, Garey L, Vujanovic AA, Zvolensky MJ. Trauma exposure and smoking outcomes: The indirect effects of anxious and depressive symptoms. Addict Behav 2022; 134:107409. [PMID: 35717891 DOI: 10.1016/j.addbeh.2022.107409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 11/01/2022]
Abstract
With a direct link between traumatic stress and poor smoking outcomes established, there is a clinically important need to identify underlying, targetable mechanisms that maintain these relations. The present study employed a parallel mediation model to assess the competing explanatory significance of four distinct facets of depression and anxiety (general anxiety, anxious arousal, general depression, and anhedonic depression) in the relation between traumatic load and perceived barriers for quitting smoking, severity of psychosomatic problems experienced when attempting to quit smoking in the past, and negative reinforcement expectancies related to smoking among 98 adult trauma-exposed daily smokers (Mage = 44.64, SD = 10.66). Results showed that only general anxiety symptoms, when controlling for the competing facets of depression and anxiety, had a statistically significant indirect effect on the relation between traumatic load and all smoking processes, such that general anxiety symptoms significantly, indirectly influenced the relation between traumatic load and barriers for smoking cessation (ab = 0.95, 95% CI [0.163, 0.2.14]), smoking quit problems (ab = 0.07, 95% CI [0.009, 0.165]), and negative reinforcement smoking expectancies (ab = 0.16, 95% CI [0.025, 0.399]). Anxious arousal demonstrated an indirect effect for trauma load on only negative reinforcement smoking expectancies (ab = -0.15, 95% CI [-0.345, -0.023]). The current findings highlight the potential importance of general anxiety symptoms as a targetable mechanism for smoking cessation treatments for trauma-exposed smokers.
Collapse
Affiliation(s)
- Pamella Nizio
- Department of Psychology, University of Houston, United States
| | - Tanya Smit
- Department of Psychology, University of Houston, United States
| | | | | | - Emily A Tullos
- Department of Psychiatry, The University of Texas MD Anderson Cancer Center, United States
| | - Lorra Garey
- Department of Psychology, University of Houston, United States
| | | | - Michael J Zvolensky
- Department of Psychology, University of Houston, United States; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, United States; HEALTH Institute, University of Houston, United States.
| |
Collapse
|
19
|
Konjevod M, Sáiz J, Nikolac Perkovic M, Nedic Erjavec G, Tudor L, Uzun S, Kozumplik O, Barbas C, Zarkovic N, Pivac N, Strac DS. Plasma lipidomics in subjects with combat posttraumatic stress disorder. Free Radic Biol Med 2022; 189:169-177. [PMID: 35918015 DOI: 10.1016/j.freeradbiomed.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/18/2022] [Indexed: 11/18/2022]
Abstract
Posttraumatic stress disorder (PTSD) is complex neuropsychiatric disorder triggered by a traumatic event and characterized by the symptoms that represent large burden to patients, as well as to society. Lipidomic approach can be applied as a useful tool for discovery of novel diagnostic, prognostic and therapeutic lipid biomarkers of various disorders, whose etiology is complex and still unknown, including PTSD. Since changes in the levels of lipid metabolites might indicate impairments in various metabolic pathways and cellular processes, the aim of this lipidomic study was to determine altered levels of lipid compounds in PTSD. The study enrolled 235 male patients with combat PTSD and 241 healthy male control subjects. Targeted lipidomic analysis of plasma samples was conducted using reverse-phase liquid chromatography coupled with mass spectrometry. Lipids that have been analyzed belong to the group of ceramides, cholesterol esters, diacylglycerols, lysophosphatidylcholines, lysophosphatidylethanolamines, phosphatidylcholines, phosphatidylethanolamines, sphingomyelins and triglycerides. The levels of fifteen lipid compounds were found to be significantly different between PTSD patients and healthy control subjects, including four phosphatidylcholines, two phosphatidylethanolamines, five sphingomyelins, two cholesterol esters and two ceramides. The lipid metabolites whose levels significantly differed between patients with PTSD and control subjects are associated with various biological processes, including impairments of membrane integrity and function, mitochondrial dysfunction, inflammation and oxidative stress. As these processes might be associated with development and progression of PTSD, altered lipid compounds represent potential biomarkers that could facilitate the diagnosis of PTSD, prediction of the disease, as well as identification of novel treatment approaches in PTSD.
Collapse
Affiliation(s)
- Marcela Konjevod
- Ruder Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000, Zagreb, Croatia; Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanizacion Monteprincipe, 28660, Boadilla del Monte, Spain
| | - Jorge Sáiz
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanizacion Monteprincipe, 28660, Boadilla del Monte, Spain.
| | - Matea Nikolac Perkovic
- Ruder Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000, Zagreb, Croatia
| | - Gordana Nedic Erjavec
- Ruder Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000, Zagreb, Croatia
| | - Lucija Tudor
- Ruder Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000, Zagreb, Croatia
| | - Suzana Uzun
- Department for Biological Psychiatry and Psychogeriatrics, University Psychiatric Hospital Vrapce, Bolnicka Cesta 32, 10000, Zagreb, Croatia; School of Medicine, University of Zagreb, Salata 2, 10 000, Zagreb, Croatia; Faculty of Education and Rehabilitation Studies, University of Zagreb, University Campus Borongaj, Borongajska Cesta 83f, 10000, Zagreb, Croatia
| | - Oliver Kozumplik
- Department for Biological Psychiatry and Psychogeriatrics, University Psychiatric Hospital Vrapce, Bolnicka Cesta 32, 10000, Zagreb, Croatia; Faculty of Education and Rehabilitation Studies, University of Zagreb, University Campus Borongaj, Borongajska Cesta 83f, 10000, Zagreb, Croatia
| | - Coral Barbas
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanizacion Monteprincipe, 28660, Boadilla del Monte, Spain
| | - Neven Zarkovic
- Ruder Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000, Zagreb, Croatia
| | - Nela Pivac
- Ruder Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000, Zagreb, Croatia.
| | - Dubravka Svob Strac
- Ruder Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000, Zagreb, Croatia.
| |
Collapse
|
20
|
Sara JDS, Toya T, Ahmad A, Clark MM, Gilliam WP, Lerman LO, Lerman A. Mental Stress and Its Effects on Vascular Health. Mayo Clin Proc 2022; 97:951-990. [PMID: 35512885 PMCID: PMC9058928 DOI: 10.1016/j.mayocp.2022.02.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/24/2022] [Accepted: 02/08/2022] [Indexed: 01/13/2023]
Abstract
Coronary artery disease continues to be a major cause of morbidity and mortality despite significant advances in risk stratification and management. This has prompted the search for alternative nonconventional risk factors that may provide novel therapeutic targets. Psychosocial stress, or mental stress, has emerged as an important risk factor implicated in a higher incidence of cardiovascular events, and although our understanding of this far ranging and interesting phenomenon has developed greatly over recent times, there is still much to be learned regarding how to measure mental stress and how it may impact physical health. With the current coronavirus disease 2019 global pandemic and its incumbent lockdowns and social distancing, understanding the potentially harmful biological effects of stress related to life-changing events and social isolation has become even more important. In the current review our multidisciplinary team discusses stress from a psychosocial perspective and aims to define psychological stress as rigorously as possible; discuss the pathophysiologic mechanisms by which stress may mediate cardiovascular disease, with a particular focus to its effects on vascular health; outline existing methods and approaches to quantify stress by means of a vascular biomarker; outline the mechanisms whereby psychosocial stressors may have their pathologic effects ultimately transduced to the vasculature through the neuroendocrine immunologic axis; highlight areas for improvement to refine existing approaches in clinical research when studying the consequences of psychological stress on cardiovascular health; and discuss evidence-based therapies directed at reducing the deleterious effects of mental stress including those that target endothelial dysfunction. To this end we searched PubMed and Google Scholar to identify studies evaluating the relationship between mental or psychosocial stress and cardiovascular disease with a particular focus on vascular health. Search terms included "myocardial ischemia," "coronary artery disease," "mental stress," "psychological stress," "mental∗ stress∗," "psychologic∗ stress∗," and "cardiovascular disease∗." The search was limited to studies published in English in peer-reviewed journals between 1990 and the present day. To identify potential studies not captured by our database search strategy, we also searched studies listed in the bibliography of relevant publications and reviews.
Collapse
Key Words
- cad, coronary artery disease
- cbt, cognitive behavioral therapy
- cvd, cardiovascular disease
- fmd, flow-mediated dilatation
- il, interleukin
- mi, myocardial infarction
- ms, mental stress
- msimi, mental stress induced myocardial ischemia
- pat, peripheral arterial tonometry
- ped, peripheral endothelial dysfunction
- pet, positron emission tomography
- rh, reactive hyperemia
- ses, socioeconomic status
- tnf, tumor necrosis factor
- vsmc, vascular smooth muscle cells
Collapse
Affiliation(s)
| | - Takumi Toya
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Ali Ahmad
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Wesley P Gilliam
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Lliach O Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Amir Lerman
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
| |
Collapse
|
21
|
Kapfhammer HP. [Comorbidity of posttraumatic stress disorder and addiction from a biopsychosocial perspective]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2022; 36:1-18. [PMID: 33439473 PMCID: PMC8916999 DOI: 10.1007/s40211-020-00384-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/16/2020] [Indexed: 11/18/2022]
Abstract
Posttraumatic stress disorder and substance use disorder often co-occur within the health care system. Their comorbidity is associated with more serious acute clinical symptomatology, more frequent hospital admissions in state of emergency and significantly lower chances of improvement by psychological and pharmacological treatment. Their comorbidity contributes to dramatically unfavourable courses of illness as regards all biopsychosocial levels. The survey presented will discuss empirical findings from various perspectives: general epidemiology, substance use disorder as risk factor of trauma and PTSD, trauma and PTSD as risk factor of SUD, neurobiological effects of SUD converging towards neurobiology of PTSD, shared common factors of genetics/epigenetics, personality traits, and early developmental stress and trauma. The main focus of analysis will be put on processes that are intrinsically linked to the development and course of both disorders.
Collapse
Affiliation(s)
- Hans-Peter Kapfhammer
- Universitätsklinik für Psychiatrie und Psychotherapeutische Medizin, Medizinische Universität Graz, Auenbruggerplatz 31, 8036, Graz, Österreich.
| |
Collapse
|
22
|
Riley ED, Delucchi K, Rubin S, Weiser SD, Vijayaraghavan M, Lynch K, Tsoh JY. Ongoing tobacco use in women who experience homelessness and unstable housing: A prospective study to inform tobacco cessation interventions and policies. Addict Behav 2022; 125:107125. [PMID: 34673360 DOI: 10.1016/j.addbeh.2021.107125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/30/2021] [Accepted: 09/23/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Tobacco use is common in people who experience homelessness. However, despite biological differences in use by sex and lower quit rates in women, research in homeless and unstably housed (HUH) women is sparse. We identified correlates of use specific to this population, with the goal of informing tobacco cessation programs tailored for HUH women. METHODS We conducted a prospective study among HUH women recruited from San Francisco homeless shelters, street encampments, free meal programs and low-income hotels. Between June 2016 and January 2019, study participants completed six monthly interviews to examine factors associated with tobacco use, defined as urinary cotinine >10 pg/mL or self-reported prior 30-day use. RESULTS Among 245 participants, 40% were Black, the median age was 53, 75% currently used tobacco and 89% had ≥one 24-hour quit attempt in the prior year. Tobacco use was more common in women with PTSD (66% vs. 48%) and depression (54% vs. 35%) compared to women without these conditions. Adjusted odds of tobacco use decreased significantly with increasing age (OR/5 yrs: 0.81; 95% CI:0.68, 0.96) and increased with an increasing number of additional substances used (OR: 2.52; 95% CI: 1.88, 3.39). CONCLUSION Outside of a treatment setting and within a community-recruited sample population composed of HUH women, the number of additional substances used is a primary correlate of ongoing tobacco use. Tailored cessation interventions that prioritize the issue of multiple substance use, and public health policies that allocate funding to address it, may increase tobacco cessation in this population.
Collapse
|
23
|
Barroso-Hurtado M, Suárez-Castro D, Martínez-Vispo C, Becoña E, López-Durán A. Smoking Cessation Apps: A Systematic Review of Format, Outcomes, and Features. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11664. [PMID: 34770178 PMCID: PMC8583115 DOI: 10.3390/ijerph182111664] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 11/16/2022]
Abstract
Smoking cessation interventions are effective, but they are not easily accessible for all treatment-seeking smokers. Mobile health (mHealth) apps have been used in recent years to overcome some of these limitations. Smoking cessation apps can be used in combination with a face-to-face intervention (FFSC-Apps), or alone as general apps (GSC-Apps). The aims of this review were (1) to examine the effects of FFSC-Apps and GSC-Apps on abstinence, tobacco use, and relapse rates; and (2) to describe their features. A systematic review was conducted following the internationally Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Of the total 6016 studies screened, 24 were included, of which nine used GSC-Apps and 15 FFSC-Apps. Eight studies reported significant differences between conditions in smoking cessation outcomes, with three of them being in favor of the use of apps, and two between different point-assessments. Concerning Apps features, most GSC-Apps included self-tracking and setting a quit plan, whereas most of the FFSC-Apps included self-tracking and carbon monoxide (CO) measures. Smartphone apps for smoking cessation could be promising tools. However, more research with an adequate methodological quality is needed to determine its effect. Nevertheless, smartphone apps' high availability and attractiveness represent a great opportunity to reach large populations.
Collapse
Affiliation(s)
- María Barroso-Hurtado
- Smoking and Addictive Disorders Unit, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (D.S.-C.); (C.M.-V.); (E.B.); (A.L.-D.)
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Daniel Suárez-Castro
- Smoking and Addictive Disorders Unit, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (D.S.-C.); (C.M.-V.); (E.B.); (A.L.-D.)
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Carmela Martínez-Vispo
- Smoking and Addictive Disorders Unit, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (D.S.-C.); (C.M.-V.); (E.B.); (A.L.-D.)
| | - Elisardo Becoña
- Smoking and Addictive Disorders Unit, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (D.S.-C.); (C.M.-V.); (E.B.); (A.L.-D.)
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Ana López-Durán
- Smoking and Addictive Disorders Unit, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (D.S.-C.); (C.M.-V.); (E.B.); (A.L.-D.)
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| |
Collapse
|
24
|
Ibrahim C, Le Foll B, Hassan AN. The effect of nicotine dependence on the risk of developing post-traumatic stress disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Nicotine Tob Res 2021; 24:719-727. [PMID: 34734244 DOI: 10.1093/ntr/ntab229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 10/04/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND It is evident that an association between smoking and post-traumatic stress disorder (PTSD) exists, but research is lacking in establishing the directionality of the relationship. METHODS We used longitudinal data from wave I (2001-2002) and II (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Individuals with nicotine dependence (ND) were matched to individuals without ND using propensity score matching to estimate the risk of developing PTSD after trauma. We also matched smokers (with or without ND) to lifetime non-smokers to estimate their risk of developing PTSD after trauma. Lastly, we conducted a mediation analysis on the effect of ND severity on PTSD symptoms. RESULTS Individuals with ND (n = 1,514) were more likely to develop PTSD (OR: 1.59; 95%CI: 1.09-2.32; p = 0.017) compared to individuals without ND (n = 6,047). Smokers (regardless of ND status) (n = 2,335) compared to non-smokers (n = 5,226) had no significant effect on risk of PTSD (p = 0.26). Withdrawal was found to be a mediator of the effect of ND severity on PTSD symptoms. CONCLUSION ND, but not smoking status, increases a smoker's risk of developing PTSD. This provides information that could aid in preventive strategies for individuals with ND who are exposed to trauma. IMPLICATIONS This study provides evidence in a national representative sample of adults in the U.S. that nicotine dependence may increase one's risk of developing PTSD after exposure to trauma. It also shows the directionality of the association between smoking and PTSD. Lastly, it demonstrates that withdrawal may be the link to the association between nicotine dependence and PTSD. We hope that with these findings, preventative strategies are put in place for smokers who are dependent and are exposed to trauma, such that they do not develop PTSD.
Collapse
Affiliation(s)
- Christine Ibrahim
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Addictions Division, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Ahmed N Hassan
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Addictions Division, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
25
|
Smits JAJ, Zvolensky MJ, Rosenfield D, Brown RA, Otto MW, Dutcher CD, Papini S, Freeman SZ, DiVita A, Perrone A, Garey L. Community-based smoking cessation treatment for adults with high anxiety sensitivity: a randomized clinical trial. Addiction 2021; 116:3188-3197. [PMID: 34033178 PMCID: PMC10091508 DOI: 10.1111/add.15586] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/02/2021] [Accepted: 05/12/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS People with anxiety disorders are more likely to smoke and less likely to succeed when they try to quit. Anxiety sensitivity may underlie both phenomena, such that people with high anxiety sensitivity react to interoceptive distress by avoidance. This study aimed to test the efficacy of an exercise program that induced interoceptive distress and thereby created tolerance to this distress in a safe environment. DESIGN, SETTING AND PARTICIPANTS Randomized clinical trial at four YMCA branches in Austin, Texas, USA. Participants [n = 150; 130 (86.7%) white; 101 (67.3%) female; meanage = 38.6, standard deviation (SD)age = 10.4] were adult, daily smokers with high anxiety sensitivity motivated to quit smoking, who reported no regular moderate-intensity exercise. INTERVENTIONS Participants were assigned a YMCA personal trainer who guided them through a 15-week intervention aerobic exercise program. Participants assigned to the personalized intervention trained at 60-85% of their heart rate reserve (HRR), whereas participants assigned to the control intervention trained at 20-40% of their HRR. Participants in both groups received standard behavioral support and nicotine replacement therapy. MEASUREMENTS The primary outcome was biologically verified 7-day point prevalence abstinence (PPA) at 6-month follow-up. FINDINGS Sixty-one per cent of participants were available at the 6-month follow-up. PPA at 6 months was higher in the personalized intervention than the control intervention [27.6 versus 14.8%; odds ratio (OR) = 2.20, 95% confidence interval (CI) = 1.28, 3.80, P = 0.005], assuming missing at random. Anxiety sensitivity declined in both groups with no evidence that this differed between groups. CONCLUSIONS An exercise program of high intensity increased abstinence from smoking in people with high anxiety sensitivity, but may not have done so by reducing anxiety sensitivity.
Collapse
Affiliation(s)
- Jasper A J Smits
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | | | - David Rosenfield
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
| | - Richard A Brown
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Michael W Otto
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Christina D Dutcher
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Santiago Papini
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Slaton Z Freeman
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Annabelle DiVita
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Alex Perrone
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
| |
Collapse
|
26
|
Salas J, Gebauer S, Gillis A, van den Berk-Clark C, Schneider FD, Schnurr PP, Friedman MJ, Norman SB, Tuerk PW, Cohen BE, Lustman PJ, Scherrer JF. Increased Smoking Cessation among Veterans with Large Decreases in Posttraumatic Stress Disorder Severity. Nicotine Tob Res 2021; 24:178-185. [PMID: 34477205 DOI: 10.1093/ntr/ntab179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/01/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND Improvement in posttraumatic stress disorder (PTSD) is associated with better health behavior such as better medication adherence and greater use of nutrition and weight loss programs. However, it is not known if reducing PTSD severity is associated with smoking cessation, a poor health behavior common in patients with PTSD. METHODS Veterans Health Affairs (VHA) medical record data (2008 to 2015) were used to identify patients with PTSD diagnosed in specialty care. Clinically meaningful PTSD improvement, was defined as ≥20 point PTSD Checklist (PCL) decrease from the first PCL ≥ 50 and the last available PCL within 12 months and at least 8 weeks later. The association between clinically meaningful PTSD improvement and smoking cessation within 2-years after baseline among 449 smokers was estimated in Cox proportional hazard models. Entropy balancing controlled for confounding. RESULTS On average, patients were 39.4 (SD=12.9) years of age, 86.6% were male and 71.5% were white. We observed clinically meaningful PTSD improvement in 19.8% of participants. Overall, 19.4% quit smoking in year 1 and 16.6% in year 2. More patients with vs. without clinically meaningful PTSD improvement stopped smoking (n=36, cumulative incidence=40.5% vs. 111, cumulative incidence=30.8%; respectively). After controlling for confounding, patients with vs. without clinically meaningful PTSD improvement were more likely to stop smoking within 2-years (HR=1.57; 95%CI:1.04-2.36). CONCLUSIONS Patients with clinically meaningful PTSD improvement were significantly more likely to stop smoking. Further research should determine if targeted interventions are needed or whether improvement in PTSD symptoms is sufficient to enable smoking cessation. IMPLICATIONS Patients with PTSD are more likely to develop chronic health conditions such as heart disease and diabetes. Poor health behaviors, including smoking, partly explain the risk for chronic disease in this patient population. Our results demonstrate that clinically meaningful PTSD improvement is followed by greater likelihood of smoking cessation. Thus, PTSD treatment may enable healthier behaviors and reduce risk for smoking related disease.
Collapse
Affiliation(s)
- Joanne Salas
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis MO. 63104, United States.,Harry S. Truman Veterans Administration Medical Center. Columbia, MO, United States
| | - Sarah Gebauer
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis MO. 63104, United States.,Harry S. Truman Veterans Administration Medical Center. Columbia, MO, United States
| | - Auston Gillis
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis MO. 63104, United States
| | - Carissa van den Berk-Clark
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis MO. 63104, United States
| | - F David Schneider
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Paula P Schnurr
- National Center for PTSD and Department of Psychiatry, Geisel School of Medicine at Dartmouth, United States
| | - Matthew J Friedman
- National Center for PTSD and Department of Psychiatry, Geisel School of Medicine at Dartmouth, United States
| | - Sonya B Norman
- National Center for PTSD and Department of Psychiatry, University of California San Diego, United States
| | - Peter W Tuerk
- Sheila C. Johnson Center for Clinical Services, Department of Human Services, University of Virginia, Charlottesville, VA. United States
| | - Beth E Cohen
- Department of Medicine, University of California San Francisco School of Medicine and San Francisco VAMC, United States
| | - Patrick J Lustman
- Department of Psychiatry, Washington University School of Medicine, St. Louis MO. and The Bell Street Clinic Opioid Addiction Treatment Programs, VA St. Louis Healthcare System, St. Louis, MO, United States
| | - Jeffrey F Scherrer
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis MO. 63104, United States.,Harry S. Truman Veterans Administration Medical Center. Columbia, MO, United States
| |
Collapse
|
27
|
Budenz A, Klein A, Prutzman Y. The Relationship Between Trauma Exposure and Adult Tobacco Use: Analysis of the National Epidemiologic Survey on Alcohol and Related Conditions (III). Nicotine Tob Res 2021; 23:1716-1726. [PMID: 33848342 PMCID: PMC8562326 DOI: 10.1093/ntr/ntab057] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 04/12/2021] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Previous research has examined cigarette smoking in trauma exposed populations. However, the relationships between trauma exposure and use of other tobacco products (eg, cigars, e-cigarettes) and specific trauma exposure characteristics that may be associated with tobacco use are understudied. AIMS AND METHODS Using the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (N = 36 151 adults), we conducted weighted bivariate analyses of tobacco use among participants with no trauma exposure, trauma exposure, and trauma exposure with post-traumatic stress disorder (trauma + PTSD), stratified by tobacco product use. We also performed weighted logistic regressions testing relationships between trauma exposure and tobacco use, controlling for behavioral health (BH) conditions (mood, anxiety, substance use, personality disorders) and sociodemographics. RESULTS Approximately 44% of participants had experienced trauma; 6% experienced trauma + PTSD. Trauma exposed participants had a higher prevalence of tobacco use (30%--46% vs. 22%) and poly-tobacco use (34%--35% vs. 28%) than unexposed participants. Cigarettes were the most used tobacco product; trauma + PTSD (19%), and trauma (15%) participants had a higher prevalence of e-cigarette use than unexposed participants (11%). Trauma exposure was associated with current tobacco use (AOR = 1.36 trauma + PTSD; 1.23 trauma) (but not former use), particularly among participants exposed to violence/abuse (AOR = 1.23). Personality and substance use disorders were strongly associated with current and former tobacco use. CONCLUSIONS Trauma exposure, PTSD, and experiences of violence/abuse are associated with current tobacco use. BH conditions may also play a role in current and former tobacco use. Recognizing and addressing trauma exposure and BH conditions among tobacco users may improve cessation rates in these populations. IMPLICATIONS This study contributes to research on tobacco use disparities in behavioral health populations by providing a comprehensive examination of tobacco use in trauma exposed individuals. Prior research has examined cigarette smoking, but not other tobacco product use in these populations. This study presents findings on multiple tobacco use behaviors (tobacco product, poly-tobacco use, cessation attempts) in trauma exposed populations and characteristics of trauma exposure (severity, type of traumatic event) associated with tobacco use. These findings underscore the importance of further examining the implications of trauma exposure for tobacco use and of screening and addressing trauma in cessation treatment.
Collapse
Affiliation(s)
- Alexandra Budenz
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Amanda Klein
- Center for Chronic Disease Prevention and Control Prevention and Health Promotion Administration, Maryland Department of Health, Timonium, MD, USA
| | - Yvonne Prutzman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| |
Collapse
|
28
|
Piirtola M, Kaprio J, Baker TB, Piasecki TM, Piper ME, Korhonen T. The associations of smoking dependence motives with depression among daily smokers. Addiction 2021; 116:2162-2174. [PMID: 33629475 PMCID: PMC8274496 DOI: 10.1111/add.15390] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/16/2020] [Accepted: 12/23/2020] [Indexed: 12/14/2022]
Abstract
AIMS To investigate how strongly smoking dependence and smoking dependence motives are associated with depressive symptoms among daily smokers and if these associations are independent of measured confounders and shared familial factors. DESIGN Cross-sectional individual-based and within-pair analyses. SETTING Fourth wave of the population-based Finnish Twin Cohort conducted in 2011. PARTICIPANTS 918 daily smokers born 1945-1957 (48% men), mean age 59.5 years including 38 twin pairs discordant for depression. MEASUREMENTS Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale with a cut off value ≥20 for depression. Smoking dependence was assessed using the Fagerström Test for Cigarette Dependence (FTCD) and smoking dependence motives with three subscales from the multi-dimensional Brief Wisconsin Inventory of Smoking Dependence Motives (WISDM): primary dependence motives (PDM), affective enhancement (AE), and Taste. Logistic regressions, using standardized scores of independent variables and adjusted for multiple confounders with correction for sampling as twin pairs, were used in the individual-based analyses. Conditional logistic regression was used to control for shared familial factors in discordant twin pairs. FINDINGS Prevalence of depression was 18% (n = 163: 61 [14%] in men, n = 102 [22%] in women). Higher smoking dependence measured by the FTCD (OR 1.45; 95% CI 1.20, 1.75), and dependence motives measured by the PDM (1.56; 1.30, 1.87) and the AE (1.54; 1.28, 1.85) were associated with higher odds of depression. The associations remained after adjusting for individual confounders, except for neuroticism, which attenuated all associations. FTCD, PDM, and AE showed associations with depression within depression-discordant monozygotic pairs, suggesting an association independent of familial factors. CONCLUSIONS Depression appears to be associated with smoking dependence and smoking dependence motives related to heavy, automatic use and use to regulate affective states. The associations appear to be confounded or mediated by neuroticism but are independent of shared familial influences.
Collapse
Affiliation(s)
- Maarit Piirtola
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO. Box 20, 00014 University of Helsinki, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO. Box 20, 00014 University of Helsinki, Helsinki, Finland; Department of Public Health, University of Helsinki, Po. Box 20, 20014 University of Helsinki, Helsinki, Finland
| | - Timothy B. Baker
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1930 Monroe Street, Madison, WI 53711 -2059, United States
| | - Thomas M. Piasecki
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO 65211, United States
| | - Megan E. Piper
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1930 Monroe Street, Madison, WI 53711 -2059, United States
| | - Tellervo Korhonen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO. Box 20, 00014 University of Helsinki, Helsinki, Finland
| |
Collapse
|
29
|
Kearns NT, Blumenthal H, Contractor AA, Aston ER, Metrik J. Effect of trauma-related stress after alcohol consumption on perceived likelihood of negative consequences and willingness to drive. Addict Behav 2021; 117:106836. [PMID: 33529850 PMCID: PMC7956021 DOI: 10.1016/j.addbeh.2021.106836] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 01/06/2021] [Accepted: 01/13/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Alcohol-related motor vehicle crashes are a major preventable cause of death in the United States. One potential factor that may modulate the influence of alcohol on driving-related cognitions and decision-making is trauma-related stress. Indeed, in addition to compelling research indicating that both acute trauma-related stress and acute alcohol consumption may independently affect driving-related risky decision-making, there is reason to believe that the combination of these antecedents may have an exacerbating effect. METHODS The current study evaluated the influence of induction of acute trauma-related stress (via script-driven imagery) after alcohol consumption (0.06% Breath Alcohol Concentration [BrAC]) on driving-related cognitions - perceived likelihood of negative consequences and willingness to drive - among 25 trauma-exposed (currently symptomatic) adult drinkers from the community (M = 24.08; 36.0% female). RESULTS Participants who were acutely exposed to trauma-related stress after alcohol consumption evidenced lower perceived likelihood of being pulled over by a police officer (ηp2 = 0.38, large effect size) and lower perceived likelihood of getting in an accident (ηp2 = 0.17, medium-to-large effect size) relative to participants exposed to a neutral cue; conversely, participants exposed to trauma-related stress after alcohol consumption evidenced greater willingness to drive (d = 1.16, large effect size) than participants exposed to a neutral cue. CONCLUSIONS Generally, findings suggest that individuals with a trauma history that are acutely exposed to trauma-related stressors (e.g., reminders of their traumatic experience) may be particularly vulnerable to poorer driving-related decision-making after alcohol consumption. Results provide a meaningful target for the development of intoxicated driving prevention and intervention efforts geared specifically for individuals with trauma history.
Collapse
Affiliation(s)
- Nathan T Kearns
- Brown University, School of Public Health, Center for Alcohol and Addiction Studies, 121 S. Main St., Providence, RI 02912, USA.
| | - Heidemarie Blumenthal
- University of North Texas, Department of Psychology, 1155 Union Circle, Denton, TX 76201, USA.
| | - Ateka A Contractor
- University of North Texas, Department of Psychology, 1155 Union Circle, Denton, TX 76201, USA.
| | - Elizabeth R Aston
- Brown University, School of Public Health, Center for Alcohol and Addiction Studies, 121 S. Main St., Providence, RI 02912, USA.
| | - Jane Metrik
- Brown University, School of Public Health, Center for Alcohol and Addiction Studies, 121 S. Main St., Providence, RI 02912, USA.
| |
Collapse
|
30
|
Nedic Erjavec G, Nikolac Perkovic M, Tudor L, Uzun S, Kovacic Petrovic Z, Konjevod M, Sagud M, Kozumplik O, Svob Strac D, Peraica T, Mimica N, Havelka Mestrovic A, Zilic D, Pivac N. Moderating Effects of BDNF Genetic Variants and Smoking on Cognition in PTSD Veterans. Biomolecules 2021; 11:biom11050641. [PMID: 33926045 PMCID: PMC8146493 DOI: 10.3390/biom11050641] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/15/2021] [Accepted: 04/24/2021] [Indexed: 12/21/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is frequently associated with cognitive disturbances and high prevalence of smoking. This study evaluated cognition in war veterans with PTSD and control subjects, controlled for the effect of smoking and brain derived neurotrophic factor (BDNF) rs6265 and rs56164415 genotypes/alleles. Study included 643 male war veterans with combat related PTSD and 120 healthy controls. Genotyping was done by real time PCR. Cognitive disturbances were evaluated using the Positive and Negative Syndrome Scale (PANSS) cognition subscale and the Rey-Osterrieth Complex Figure (ROCF) test scores. Diagnosis (p < 0.001), BDNF rs56164415 (p = 0.011) and smoking (p = 0.028) were significant predictors of the cognitive decline in subjects with PTSD. BDNF rs56164415 T alleles were more frequently found in subjects with PTSD, smokers and non-smokers, with impaired cognition, i.e., with the higher PANSS cognition subscale scores and with the lower ROCF immediate recall test scores. Presence of one or two BDNF rs56164415 T alleles was related to cognitive decline in PTSD. The T allele carriers with PTSD had advanced cognitive deterioration in smokers and nonsmokers with PTSD, and worse short-term visual memory function. Our findings emphasize the role of the BDNF rs56164415 T allele and smoking in cognitive dysfunction in war veterans with PTSD.
Collapse
Affiliation(s)
- Gordana Nedic Erjavec
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, 10000 Zagreb, Croatia; (G.N.E.); (M.N.P.); (L.T.); (M.K.); (D.S.S.)
| | - Matea Nikolac Perkovic
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, 10000 Zagreb, Croatia; (G.N.E.); (M.N.P.); (L.T.); (M.K.); (D.S.S.)
| | - Lucija Tudor
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, 10000 Zagreb, Croatia; (G.N.E.); (M.N.P.); (L.T.); (M.K.); (D.S.S.)
| | - Suzana Uzun
- Department for Biological Psychiatry and Psychogeriatrics, University Psychiatric Hospital Vrapce, 10090 Zagreb, Croatia; (S.U.); (Z.K.P.); (O.K.); (N.M.)
- School of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Zrnka Kovacic Petrovic
- Department for Biological Psychiatry and Psychogeriatrics, University Psychiatric Hospital Vrapce, 10090 Zagreb, Croatia; (S.U.); (Z.K.P.); (O.K.); (N.M.)
- School of Medicine, The University of Zagreb, 10000 Zagreb, Croatia;
| | - Marcela Konjevod
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, 10000 Zagreb, Croatia; (G.N.E.); (M.N.P.); (L.T.); (M.K.); (D.S.S.)
| | - Marina Sagud
- School of Medicine, The University of Zagreb, 10000 Zagreb, Croatia;
- Department of Psychiatry, University Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Oliver Kozumplik
- Department for Biological Psychiatry and Psychogeriatrics, University Psychiatric Hospital Vrapce, 10090 Zagreb, Croatia; (S.U.); (Z.K.P.); (O.K.); (N.M.)
- School of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Dubravka Svob Strac
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, 10000 Zagreb, Croatia; (G.N.E.); (M.N.P.); (L.T.); (M.K.); (D.S.S.)
| | - Tina Peraica
- Department of Psychiatry, University Hospital Dubrava, 10000 Zagreb, Croatia;
| | - Ninoslav Mimica
- Department for Biological Psychiatry and Psychogeriatrics, University Psychiatric Hospital Vrapce, 10090 Zagreb, Croatia; (S.U.); (Z.K.P.); (O.K.); (N.M.)
- School of Medicine, The University of Zagreb, 10000 Zagreb, Croatia;
| | | | | | - Nela Pivac
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, 10000 Zagreb, Croatia; (G.N.E.); (M.N.P.); (L.T.); (M.K.); (D.S.S.)
- Correspondence: ; Tel.: +385-145-712-07
| |
Collapse
|
31
|
Post-traumatic stress disorder and its association with stroke and stroke risk factors: A literature review. Neurobiol Stress 2021; 14:100332. [PMID: 34026954 PMCID: PMC8122169 DOI: 10.1016/j.ynstr.2021.100332] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 03/27/2021] [Accepted: 04/20/2021] [Indexed: 12/19/2022] Open
Abstract
Stroke is a major cause of mortality and disability globally that has multiple risk factors. A risk factor that has recently gained more attention is post-traumatic stress disorder (PTSD). Literature searches were carried out for updated PTSD information and for the relationship between PTSD and stroke. The review was divided into two sections, one exploring PTSD as an independent risk factor for stroke, with a second concentrating on PTSD's influence on stroke risk factors. The study presents accumulating evidence that shows traumatic stress predicts stroke and is also linked to many major stroke risk factors. The review contributes knowledge to stroke aetiology and acts as a reference for understanding the relationship between PTSD and stroke. The information presented indicates that screening and identification of traumatic experience would be beneficial for directing stroke patients to appropriate psychological and lifestyle interventions. In doing so, the burden of stroke may be reduced worldwide.
Collapse
|
32
|
Buhelt LP, Pisinger C, Andreasen AH. Smoking and stress in the general population in Denmark. Tob Prev Cessat 2021; 7:27. [PMID: 33860112 PMCID: PMC8040741 DOI: 10.18332/tpc/132712] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/22/2021] [Accepted: 01/22/2021] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The social pressure placed on smokers today might potentially lead to an increasing level of stress. We investigated if the proportion of persons with high stress level had increased over time more in smokers than in non-smokers. METHODS Data were obtained from repeated cross-sectional surveys of The Capital Region Health Survey conducted in 2010, 2013 and 2017. Survey data were weighted for survey design and non-response, and linked to national register data. Cohens Perceived Stress Scale (PSS-10) score was used. Logistic regression analyses, based on 136608 citizens’ self-reports, were adjusted for sex, age, education level, employment, and alcohol intake (and loneliness, in analysis investigating the associations between tobacco consumption and high stress level). RESULTS A significantly higher proportion of citizens reported a high stress level in 2017 compared with 2010 and 2013 but there was not a greater increase in smokers than in non-smokers. Daily smoking men had 69% higher odds of reporting perceived high stress level and daily smoking women had 36% higher odds, than never smokers of the same sex. There was a significant trend between higher daily tobacco consumption and a higher proportion of smokers with high stress level. CONCLUSIONS The increase in high stress level over time occurred independently of smoking status. Daily smokers had the highest odds of perceived high stress level, and a higher daily tobacco consumption was associated with a higher proportion of smokers with high stress level. Smoking cessation programs should, to a higher degree, consider implementing stress-coping elements to prevent relapse.
Collapse
Affiliation(s)
- Lone P Buhelt
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Charlotta Pisinger
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,Danish Heart Foundation, Copenhagen, Denmark.,Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne H Andreasen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| |
Collapse
|
33
|
Levine GN, Cohen BE, Commodore-Mensah Y, Fleury J, Huffman JC, Khalid U, Labarthe DR, Lavretsky H, Michos ED, Spatz ES, Kubzansky LD. Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association. Circulation 2021; 143:e763-e783. [PMID: 33486973 DOI: 10.1161/cir.0000000000000947] [Citation(s) in RCA: 238] [Impact Index Per Article: 79.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
As clinicians delivering health care, we are very good at treating disease but often not as good at treating the person. The focus of our attention has been on the specific physical condition rather than the patient as a whole. Less attention has been given to psychological health and how that can contribute to physical health and disease. However, there is now an increasing appreciation of how psychological health can contribute not only in a negative way to cardiovascular disease (CVD) but also in a positive way to better cardiovascular health and reduced cardiovascular risk. This American Heart Association scientific statement was commissioned to evaluate, synthesize, and summarize for the health care community knowledge to date on the relationship between psychological health and cardiovascular health and disease and to suggest simple steps to screen for, and ultimately improve, the psychological health of patients with and at risk for CVD. Based on current study data, the following statements can be made: There are good data showing clear associations between psychological health and CVD and risk; there is increasing evidence that psychological health may be causally linked to biological processes and behaviors that contribute to and cause CVD; the preponderance of data suggest that interventions to improve psychological health can have a beneficial impact on cardiovascular health; simple screening measures can be used by health care providers for patients with or at risk for CVD to assess psychological health status; and consideration of psychological health is advisable in the evaluation and management of patients with or at risk for CVD.
Collapse
|
34
|
Estey D, Platt J, Goodwin RD, Weinberger AH. Relationship of trauma exposure and PTSD to cigarette smoking prevalence, frequency, and quantity: Data from a nationally representative sample of U.S. adults. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2020; 13:231-239. [PMID: 33252969 DOI: 10.1037/tra0000991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Individuals with Post-Traumatic Stress Disorder (PTSD) smoke cigarettes at much higher prevalences than the general population. Less is known about PTSD and other smoking behaviors (e.g., smoking quantity and frequency) or about smoking among individuals who experience trauma. OBJECTIVE To examine differences in cigarette smoking behaviors among adults in the United States (a) with no exposure to trauma or PTSD, (b) with trauma but no PTSD, and (c) with PTSD. METHODS Data came from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions-II (NESARC-II, 2004-2005) and included demographics, PTSD diagnoses, traumatic events, and smoking behaviors. Odds ratios and group differences in smoking prevalence and behaviors based on PTSD diagnoses and exposure to traumatic experiences were calculated. RESULTS Traumatic events and PTSD diagnoses were both associated with greater smoking prevalences than persons without trauma or PTSD. Individuals with PTSD who smoke were more likely to report daily smoking than those without PTSD who smoke (Cohen's d = 0.19). Cigarette users with either trauma or PTSD smoked more cigarettes per day than cigarette users without trauma or PTSD (Cohen's d = 0.35). US adults with trauma exposure or PTSD have higher smoking prevalences and more intense smoking behaviors than those without PTSD or trauma. CONCLUSION Trauma or PTSD may each serve as a clinical indicator of increased risk of cigarette smoking-related health problems and prompt the implementation of targeted interventions to reduce the harms of smoking. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- David Estey
- Ferkauf Graduate School of Psychology, Yeshiva University
| | | | | | | |
Collapse
|
35
|
Peltzer K, Pengpid S. Tobacco use and associated mental symptoms and health risk behaviours amongst individuals 15 years or older in South Africa. S Afr J Psychiatr 2020; 26:1499. [PMID: 33240550 PMCID: PMC7669997 DOI: 10.4102/sajpsychiatry.v26.i0.1499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 08/05/2020] [Indexed: 11/01/2022] Open
Abstract
Background Tobacco use may deteriorate mental health and increase health risk behaviours. Aim The aim of this investigation was to identify associations between tobacco use and mental illness symptoms and health risk behaviours in individuals 15 years or older in South Africa. Setting Community-based national population sample in South Africa. Methods Cross-sectional data were analysed from the 'South African National Health and Nutrition Examination Survey (SANHANES-1) 2012', using a sample of 15 310 individuals 15 years or older (median age 33 years). Measures included information on tobacco use, sociodemographic factors, mental symptoms and health risk behaviour. Results Compared to non-tobacco users, daily tobacco users were associated with psychological distress and post-traumatic stress disorder (PTSD) in adjusted logistic regression analysis, and with sleeping problems in unadjusted analysis. Past tobacco use, less than daily, and daily tobacco use were highly associated with a drinking problem. In terms of dietary variables, less than daily and daily tobacco use increased the odds of inadequate fruit intake and salty food intake, and daily tobacco use decreased the odds of fast food consumption. Past tobacco use, less than daily, and daily tobacco use were inversely associated with physical inactivity, and daily tobacco use was associated with not always washing hands before eating. Conclusions The study showed that compared to non-tobacco users, daily tobacco users had significantly poorer mental health (psychological distress and PTSD) and increased odds for several health risk behaviours (drinking problem, inadequate fruit intake, salty food consumption and not always washing hands before eating) as compared to non-tobacco users.
Collapse
Affiliation(s)
- Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa
| | - Supa Pengpid
- Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa.,ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
| |
Collapse
|
36
|
The Role of Anxiety Sensitivity in the Relation Between Pain Intensity with Substance Use and Anxiety and Depressive Symptoms Among Smokers with Chronic Pain. Int J Behav Med 2020; 27:668-676. [PMID: 32588345 DOI: 10.1007/s12529-020-09914-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The additive effect of experiencing chronic pain in the context of nicotine addiction places smokers with chronic pain at elevated risk for experiencing physical and mental health problems. Isolating factors that explain linkages between pain and health-related outcomes among smokers with chronic pain is an important next step. Therefore, the current study examined the explanatory role of anxiety sensitivity in relations between pain intensity and current opioid misuse, severity of opioid dependence, tobacco-related problems, and anxiety/depressive symptoms. METHOD Participants were 187 (Mage = 39.02, SD = 9.94, 74.9% female) daily smokers with chronic pain who completed a battery of self-report measures on pain experience, anxiety sensitivity, tobacco and opioid use, and anxiety/depression symptoms. Indirect effect analyses were conducted to examine anxiety sensitivity as a mediator of the relations between pain intensity and health-related outcomes. RESULTS A significant indirect effect emerged for pain intensity, through anxiety sensitivity, on opioid misuse (ab = 0.83, SE = 0.24, 95% CI [0.39, 1.34], CSE = 0.17), severity of opioid dependence (ab = 0.17, SE = 0.05, 95% CI [0.08, 0.26], CSE = 0.16), tobacco use problems (ab = 0.16, SE = 0.06, 95% CI [0.07, 0.28], CSE = 0.11), and anxiety/depressive symptoms (ab = 0.20, SE = 0.06, 95% CI [0.10, 0.31], CSE = 0.19). CONCLUSION The current investigation highlights the potential importance of anxiety sensitivity in terms of the experience of pain with severity of substance use and anxiety/depressive symptoms among smokers with chronic pain.
Collapse
|
37
|
Mahoney CT, Zweig IR, Marx BP, Keane TM. Cross-lagged effects of posttraumatic stress disorder symptom severity and cigarette smoking among OEF/OIF/OND veterans. Depress Anxiety 2020; 37:1118-1126. [PMID: 32851756 PMCID: PMC9020073 DOI: 10.1002/da.23091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/13/2020] [Accepted: 07/29/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Veterans with posttraumatic stress disorder (PTSD) are known to smoke cigarettes at elevated levels in comparison to both veterans without PTSD and civilians. This study aims to elucidate how cigarette smoking and PTSD symptoms interact over time. MATERIALS AND METHODS This study examined the directionality and strength of the relationship between average daily cigarette smoking and PTSD symptom severity across three (T1-T3) time points in a large cohort (N = 851) of male and female Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn returning veterans who were either current or former smokers at T1 (mean age = 37.56; standard deviation = 10.10). We used cross-lagged panel analyses to evaluate their temporal relations. RESULTS The analyses indicated that PTSD symptom severity at T1 significantly predicted cigarette smoking at T2, and this predictive association was maintained from T2 to T3. Conversely, smoking at T1 and T2 did not predict PTSD symptom severity at T2 and T3, respectively. Although effect sizes were small, PTSD symptom severity was cross-sectionally related to smoking at T1 and T2, but not T3. In addition, when analyses were examined by gender, the same results were found except these associations were stronger for women than for men cross-sectionally. CONCLUSION Our findings provide some evidence of a longitudinal association between PTSD symptom severity and tobacco use and highlight potential targets of intervention.
Collapse
Affiliation(s)
- Colin T. Mahoney
- Behavioral Science Division, National Center for PTSD, Boston, Massachusetts
| | | | - Brian P. Marx
- Behavioral Science Division, National Center for PTSD, Boston, Massachusetts
| | - Terence M. Keane
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts,Correspondence Brian P. Marx, Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130,
| |
Collapse
|
38
|
Trindade Fortes J, Giordani Cano F, Alcoforado Miranda V, Chung Kang H, Fontenelle LF, Mendlowicz MV, Garcia-Rosa ML. PTSD Predicts Smoking Cessation Failure in a Trauma-Exposed Population. J Dual Diagn 2020; 16:392-401. [PMID: 32643580 DOI: 10.1080/15504263.2020.1786615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The objective of the study was to investigate whether a diagnosis of posttraumatic stress disorder (PTSD; full or partial) or specific PTSD symptom clusters predicted failure in quitting smoking in a trauma-exposed population. Methods: Participants were 310 smokers who attempted quitting smoking, either successfully (quitters, n = 213) or not (relapsers, n = 97), who lived in slums and were attending a family doctor program. Measurements included a general questionnaire covering sociodemographic characteristics, clinical status and life habits, and the Posttraumatic Stress Disorder Checklist - Civilian Version. Differences in sociodemographic, clinical and lifestyle characteristics between quitters and relapsers were compared using a chi-square test. Because of the small sample size, full and partial PTSD were collapsed into a single category. Results: Significant differences (p ≤ .15) between quitters and relapsers were found in age, body mass index (BMI), income, alcohol consumption, and in the presence of full/partial PTSD diagnosis and of all three symptom clusters separately. Four logistic regression models predicting smoking cessation were modeled to control for confounding factors and included as independent variables a full/partial PTSD diagnosis and the three posttraumatic symptom clusters. The avoidance/numbing cluster presented the strongest association with relapse status (ORa 2.04, 95% CI [1.15, 3.63], p = .015), followed by the full/partial PTSD (ORa 1.80, 95% CI [1.04, 3.14], p = .038). The re-experiencing and the hyperarousal clusters were non-significantly associated with smoking cessation (ORa 1.34, 95% CI [0.80, 2.31], ns and ORa 1.65, 95% CI [0.96, 2.84], ns, respectively). Conclusions: Full/partial PTSD and posttraumatic symptom clusters uniquely predict risk for smoking relapse and thus may be a useful therapeutic target in trauma-exposed smokers.
Collapse
Affiliation(s)
| | - Fabiola Giordani Cano
- Department of Psychiatry and Mental Health, Universidade Federal Fluminense, Niteroi, Brazil
| | | | - Hye Chung Kang
- Department of Psychiatry and Mental Health, Universidade Federal Fluminense, Niteroi, Brazil
| | - Leonardo F Fontenelle
- Department of Psychiatry and Mental Health, Universidade Federal Fluminense, Niteroi, Brazil.,School of Psychological Sciences, Monash University, Melbourne, VIC, Australia.,Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mauro Vitor Mendlowicz
- Department of Psychiatry and Mental Health, Universidade Federal Fluminense, Niteroi, Brazil.,Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Luiza Garcia-Rosa
- Department of Psychiatry and Mental Health, Universidade Federal Fluminense, Niteroi, Brazil
| |
Collapse
|
39
|
Kearns NT, Contractor AA, Weiss NH, Blumenthal H. Coping strategy utilization among posttraumatic stress disorder symptom severity and substance use co-occurrence typologies: A latent class analysis. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2020; 13:929-939. [PMID: 32897090 DOI: 10.1037/tra0000964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE There is a lack of research on primary prevention of posttraumatic stress disorder (PTSD) symptoms and substance use among trauma-exposed populations. To guide the development of more effective prevention efforts, the current study sought to identify underlying coping mechanisms that impact PTSD-substance use co-occurrence. METHOD A person-centered analytic approach (latent class analysis) examined PTSD-substance use co-occurrence typologies (classes) and identified theoretically adaptive (e.g., active coping) and maladaptive (e.g., denial) coping strategies that differentiated between classes among a sample of 1,270 trauma-exposed participants (Mage = 20.71, 73.5% female, 45.7% White). RESULTS Latent class analysis identified five distinct typologies, reflective of extant epidemiological and etiological work. Generally, behavioral disengagement and self-blame coping increased the likelihood of being in more severe PTSD-illicit substance use (e.g., cocaine) comorbidity classes. Positive reframing and planning differentiated between low and moderate illicit substance typologies with moderate PTSD severity. Venting, acceptance, and self-distraction differentiated between asymptomatic and moderate PTSD severity typologies with low illicit substance use. CONCLUSIONS Findings identify general coping strategies associated with increased likelihood of being in more severe comorbidity typologies, as well as several unique coping strategies associated with risk of transitioning between low/moderate PTSD and illicit substance use classes. Relevant interventions (e.g., trauma psychoeducation, guilt-reduction therapy, psychological first aid) that may be targets for future prevention-oriented work are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
|
40
|
Stefanovics EA, Potenza MN, Pietrzak RH. Smoking, obesity, and their co-occurrence in the U.S. military veterans: results from the national health and resilience in veterans study. J Affect Disord 2020; 274:354-362. [PMID: 32469827 DOI: 10.1016/j.jad.2020.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 01/24/2020] [Accepted: 04/09/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Smoking and obesity are major public health concerns, though little is known about the mental and physical health burden of co-occurring obesity and smoking. METHODS Using a nationally representative sample of U.S. military veterans, we examined the prevalence of mental and physical co-morbidities, physical and mental functioning, and quality of life between obese only; smoking only; and obese smokers. RESULTS Among current smokers, 31.7% were obese; among obese veterans, 16.4% were current smokers; and in the total sample, 5.4% were obese and current smokers. Relative to the obese-only group, obese smokers were more likely to be younger, male, non-white, non-married, unemployed and VA-served, and have lower household incomes. These also reported higher levels of perceived stress and trauma and were more likely to endorsed current suicidal ideation and lifetime suicide attempts (odds ratio [OR]=2.0), medical (2.3<=OR<=3.9) and psychiatric (1.5<=OR<=2.9) comorbidities, and lower overall health status and quality of life. Compared to the smoking-only group, obese smokers were more likely to endorse current suicidal ideation (OR=2.0) and nicotine dependence (OR=1.5), and reported poorer physical health and overall quality of life. Analyses were adjusted for sociodemographic and military characteristics. LIMITATIONS The cross-sectional study design precludes causal inference. CONCLUSIONS These findings suggest that co-occurring obesity and smoking is associated with substantial mental and physical health burden in U.S. veterans. Collectively, they underscore the importance of multicomponent interventions targeting, obesity, smoking, and co-occurring issues, such as trauma and internalizing disorders, in this population.
Collapse
Affiliation(s)
- Elina A Stefanovics
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.; U.S. Department of Veteran Affairs New England Mental Illness Research and Education Clinical Center (MIRECC), Connecticut Healthcare System, West Haven, CT, USA..
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.; Department of Neuroscience and Child Study Center, Yale University School of Medicine, New Haven, CT, USA.; Connecticut Council on Problem Gambling, Connecticut Council on Problem Gambling, Wethersfield, CT, USA.; Connecticut Mental Health Center, New Haven, CT, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| |
Collapse
|
41
|
Mu W, Narine K, Farris S, Lieblich S, Zang Y, Bredemeier K, Brown L, Foa E. Trauma-related cognitions predict treatment response in smokers with PTSD: Evidence from cross-lagged panel analyses. Addict Behav 2020; 108:106376. [PMID: 32413581 DOI: 10.1016/j.addbeh.2020.106376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 02/21/2020] [Accepted: 02/26/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Compared to smokers without posttraumatic stress disorders (PTSD), smokers with PTSD smoke more heavily and are less successful in quitting smoking. However, limited research has examined the cognitive pathways underlying this heightened comorbidity. The current study is the first to simultaneously model the cross-sectional and lagged relationships between trauma-related cognitions and cigarette smoking, as well as between trauma-related cognitions and PTSD severity, in smokers with comorbid PTSD receiving treatment. METHOD Participants (n = 142) were seeking treatment for smoking cessation and PTSD as part of a randomized controlled trial of varenicline and smoking cessation counseling with or without adjunctive Prolonged Exposure (varenicline + PE vs. varenicline only) (Foa et al., 2017). Data were available for both baseline and end-of-treatment assessments of trauma cognitions severity of cigarette smoking and PTSD symptoms. We conducted both cross-sectional and lagged analysis to simultaneously examine the bidirectional relationship from trauma cognitions and 1) cigarette smoking and 2) PTSD symptoms. RESULTS Trauma cognitions (specifically, negative beliefs about the self and the world) were significantly associated with cigarette/day at the end of treatment for participants who received varenicline only. However, baseline trauma cognitions did not predict post-treatment cigarettes/day. Baseline trauma cognitions (specifically negative beliefs about the self and world) were associated with PTSD severity at both baseline and end of treatment; furthermore, these negative cognitions at baseline positively and prospectively predicted end-of-treatment PTSD severity, but not vice versa. Wald tests revealed that there were no treatment effects on these cross-lagged relationships. Conclusions These findings provide novel empirical support for the importance of addressing trauma-related cognitions in the smoking cessation treatment efforts for patients with comorbid PTSD and cigarette smoking.
Collapse
|
42
|
Schneider M, Schwerdtfeger A. Autonomic dysfunction in posttraumatic stress disorder indexed by heart rate variability: a meta-analysis. Psychol Med 2020; 50:1937-1948. [PMID: 32854795 PMCID: PMC7525781 DOI: 10.1017/s003329172000207x] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/20/2020] [Accepted: 05/27/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Changes in autonomic nervous system (ANS) function have been observed in a variety of psychological disorders, including posttraumatic stress disorder (PTSD). Analysis of heart rate variability (HRV) provides insight into the functioning of the ANS. Previous research on PTSD found lower HRV in PTSD patients compared to controls, indicating altered sympathetic and parasympathetic activity, but findings are inconsistent. The purpose of this meta-analysis was to examine differences in HRV indices between individuals with PTSD and healthy controls at baseline and during stress. METHODS The included primary studies present an aggregate of studies analyzing different HRV indices. Examined HRV indices were standard deviation of the normalized NN-intervals (SDNN), root mean square of successive differences (RMSSD), low-frequency (LF) and high-frequency (HF) spectral components, LF/HF ratio, and heart rate (HR). Moderating effects of study design, HRV and PTSD assessment, and sample characteristics were examined via subgroup-analyses and meta-regressions. RESULTS Random-effects meta-analyses for HRV parameters at rest revealed significant group differences for RMSSD and HF-HRV, suggesting lower parasympathetic activity in PTSD. The aggregated effect size for SDNN was medium, suggesting diminished total variability in PTSD. A small effect was found for LF-HRV. A higher LF/HF ratio was found in the PTSD sample as compared to controls. Individuals with PTSD showed significantly higher HR. During stress, individuals with PTSD showed higher HR and lower HF-HRV, both indicated by small effect sizes. CONCLUSIONS Findings suggest that PTSD is associated with ANS dysfunction.
Collapse
|
43
|
Mathew AR, Yang E, Avery EF, Crane MM, Lange-Maia BS, Lynch EB. Trauma exposure, PTSD symptoms, and tobacco use: Does church attendance buffer negative effects? JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:2364-2374. [PMID: 32789875 PMCID: PMC7654728 DOI: 10.1002/jcop.22420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 06/03/2020] [Accepted: 07/13/2020] [Indexed: 06/11/2023]
Abstract
Traumatic stress and posttraumatic stress disorder (PTSD) are overrepresented in urban African American communities, and associated with health risk behaviors such as tobacco use. Support and resources provided by churches may reduce trauma-related health risks. In the current study, we assessed weekly church attendance as a moderator of relations between (a) traumatic event exposure and probable PTSD, and (b) probable PTSD and tobacco use. Data were drawn from a health surveillance study conducted in seven churches located in Chicago's West Side. Participants (N = 1015) were adults from churches as well as the surrounding community. Trauma exposure was reported by 62% of participants, with 25% of those who experienced trauma reporting probable PTSD. Overall, more than one-third of participants (37.2%) reported current tobacco use. As compared with non-weekly church attendance, weekly church attendance was associated with a lower likelihood of PTSD (odds ratio [OR] = 0.41; 95% confidence interval [CI] = 0.26-0.62; p < .0001) and lower tobacco use overall (OR = 0.22; 95% CI = 0.16-0.30; p < .0001), but did not moderate the effect of trauma exposure on risk of PTSD, or the effect of PTSD on tobacco use. Findings support church attendance as a potential buffer of trauma-related stress.
Collapse
Affiliation(s)
- Amanda R. Mathew
- Department of Preventive Medicine, Rush University Medical Center
| | - Eric Yang
- Center for Community Health Equity, Rush University Medical Center
| | | | - Melissa M. Crane
- Department of Preventive Medicine, Rush University Medical Center
| | - Brittney S. Lange-Maia
- Department of Preventive Medicine, Rush University Medical Center
- Center for Community Health Equity, Rush University Medical Center
| | - Elizabeth B. Lynch
- Department of Preventive Medicine, Rush University Medical Center
- Center for Community Health Equity, Rush University Medical Center
| |
Collapse
|
44
|
Kheirallah KA, Cobb CO, Alsulaiman JW, Alzoubi A, Hoetger C, Kliewer W, Mzayek F. Trauma exposure, mental health and tobacco use among vulnerable Syrian refugee youth in Jordan. J Public Health (Oxf) 2020; 42:e343-e351. [PMID: 31742341 DOI: 10.1093/pubmed/fdz128] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/15/2019] [Accepted: 09/10/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Little is known about tobacco use among youth exposed to armed conflicts, or the influence of trauma on tobacco use in this context. This study examined patterns of smoking by tobacco product and gender among Syrian refugee youth living in host communities in Jordan and assessed the associations of post-traumatic stress disorder (PTSD) and depression symptoms, trauma exposure and social support with current smoking status in boys and girls. METHODS Syrian refugee students (mean [standard deviation] age = 14.9 [1.33] years) were identified through the public school system. Data were collected using an online Arabic questionnaire that included questions about demographics, trauma exposure, current smoking (cigarette and waterpipe), PTSD, depression and perceived social support. Logistic regression was used to assess the adjusted effects of independent variables on current smoking status. RESULTS One in 7 boys and one in 14 girls were current smokers, with boys reporting greater tobacco use than girls. Among boys, current smokers reported significantly higher family member loss and lower perceived family social support than nonsmokers; among girls, current smokers also reported significantly higher family member loss as well as greater PTSD symptoms and lower perceived significant other/special person social support. CONCLUSIONS Tobacco use is established among this vulnerable group. The findings highlight the potential role of psychosocial support for tobacco prevention and cessation strategies.
Collapse
Affiliation(s)
- Khalid A Kheirallah
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid 21110, Jordan
| | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA 23284-2018, USA
| | - Jomana W Alsulaiman
- Department of Pediatrics, Faculty of Medicine, Yarmouk University, Irbid 21110, Jordan
| | - Abdallah Alzoubi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid 21110, Jordan
| | - Cosima Hoetger
- Department of Psychology, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA 23284-2018, USA
| | - Wendy Kliewer
- Department of Psychology, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA 23284-2018, USA
| | - Fawaz Mzayek
- Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis School of Public Health, Memphis, TN 38152, USA
| |
Collapse
|
45
|
Osborne MT, Shin LM, Mehta NN, Pitman RK, Fayad ZA, Tawakol A. Disentangling the Links Between Psychosocial Stress and Cardiovascular Disease. Circ Cardiovasc Imaging 2020; 13:e010931. [PMID: 32791843 DOI: 10.1161/circimaging.120.010931] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Stress is a pervasive component of the human experience. While often considered an adversity to be ignored, chronic stress has important pathological consequences, including cardiovascular disease (CVD). Stress also increases the prevalence and severity of several CVD risk factors, including hypertension, diabetes mellitus, and obesity. Yet even after adjustment, stress' attributable CVD risk is similar to those risk factors, suggesting it is a particularly potent contributor. Nevertheless, there has been insufficient study of mechanisms linking stress to CVD or of methods to attenuate stress' pathological impact. This review covers the current concepts of how stress impacts CVD and emerging approaches to mitigate stress-attributable CVD risk.
Collapse
Affiliation(s)
- Michael T Osborne
- Cardiology Division (M.T.O., A.T.), Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Cardiovascular Imaging Research Center, Departments of Medicine and Imaging (M.T.O., A.T.), Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Lisa M Shin
- Department of Psychiatry (L.M.S., R.K.P.), Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Department of Psychology, Tufts University, Boston, MA (L.M.S.)
| | - Nehal N Mehta
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, Bethesda, MD (N.N.M.)
| | - Roger K Pitman
- Department of Psychiatry (L.M.S., R.K.P.), Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Zahi A Fayad
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (Z.A.F.)
| | - Ahmed Tawakol
- Cardiology Division (M.T.O., A.T.), Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Cardiovascular Imaging Research Center, Departments of Medicine and Imaging (M.T.O., A.T.), Massachusetts General Hospital and Harvard Medical School, Boston, MA
| |
Collapse
|
46
|
Hammett PJ, Japuntich SJ, Sherman SE, Rogers ES, Danan ER, Noorbaloochi S, El-Shahawy O, Burgess DJ, Fu SS. Proactive tobacco treatment for veterans with posttraumatic stress disorder. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2020; 13:114-122. [PMID: 32614201 DOI: 10.1037/tra0000613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Individuals with posttraumatic stress disorder (PTSD) smoke at higher rates compared to the general population and experience significant barriers to initiating cessation treatment. Proactive outreach addresses these barriers by directly engaging with smokers and facilitating access to treatment. The objective of the present study was to evaluate a proactive outreach intervention for increasing rates of treatment utilization and abstinence among veteran smokers with and without PTSD. METHOD This is a secondary analysis of a randomized controlled trial conducted from 2013 to 2017 that demonstrated the effectiveness of proactive outreach among veterans using Veterans Affairs mental health care services. Electronic medical record data were used to identify participants with (n = 355) and without (n = 1,583) a diagnosis of PTSD. Logistic regressions modeled cessation treatment utilization (counseling, nicotine replacement therapy [NRT], and combination treatment) and abstinence (7-day point prevalence and 6-month prolonged at 6- and 12-month follow-ups) among participants randomized to proactive outreach versus usual care in the PTSD and non-PTSD subgroups, respectively. RESULTS Compared to usual care, proactive outreach increased combined counseling and NRT utilization among participants with PTSD (odds ratio [OR] = 26.25, 95% confidence interval [3.43, 201.17]) and without PTSD (OR = 10.20, [5.21, 19.98]). Proactive outreach also increased 7-day point prevalence abstinence at 12 months among participants with PTSD (OR = 2.62, [1.16, 5.91]) and without PTSD (OR = 1.61, [1.11, 2.34]). CONCLUSIONS Proactive outreach increased treatment utilization and abstinence among smokers with and without PTSD. Smokers with PTSD may need additional facilitation to initiate cessation treatment but are receptive when it is offered proactively. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Steven S Fu
- VA HSR&D Center for Care Delivery and Outcomes Research
| |
Collapse
|
47
|
Boals A, Contractor AA, Blumenthal H. The utility of college student samples in research on trauma and posttraumatic stress disorder: A critical review. J Anxiety Disord 2020; 73:102235. [PMID: 32464542 DOI: 10.1016/j.janxdis.2020.102235] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 03/18/2020] [Accepted: 05/05/2020] [Indexed: 12/20/2022]
Abstract
There is a widespread notion of the 'college sophomore problem' in social science research that posits that college student samples are samples of convenience with little generalizability to the general population. To address this concern, we conducted a critical review of the literature on college student samples in trauma research. Specifically, we reviewed how college student samples differ from non-college samples in four key areas of trauma research: (1) exposure rates to potentially traumatic events (PTEs), (2) prevalence of posttraumatic stress disorder (PTSD) symptoms, (3) factor structure of PTSD symptoms, and (4) PTSD's relation with common markers, correlates, and consequences. Lastly, we discussed the value and advantages of using college student samples in trauma research. Results of the critical review indicated similar trends of trauma-related findings (Points 1-4) between college student samples and both U.S. nationally collected and treatment-seeking samples; specifically, we identified a comparable lifetime PTE exposure rate, comparable rates of PTSD, a comparable factor structure of PTSD symptoms, and a comparable pattern of associations between PTSD symptoms and post-trauma markers/correlates/consequences. Although trauma-exposed college student samples are biased in some key areas, they may be no more biased than other commonly used trauma samples (e.g. epidemiological, treatment-seeking). Results of this critical review highlight the need to re-examine potentially unfounded biases on the part of the trauma research community, as well as the need to consider advantages of using college student samples in trauma research.
Collapse
|
48
|
Determinants of Increased Tobacco Consumption Following a Major Disaster. Disaster Med Public Health Prep 2020; 15:20-24. [PMID: 32183911 DOI: 10.1017/dmp.2019.160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Experience of a major disaster can potentially impact on tobacco consumption. Our objective was to explore the determinants of increasing tobacco consumption after the Great East Japan Earthquake (GEJE). METHODS We conducted a cross-sectional study using data from the Miyagi Prefectural Health Survey 2014: a total of 2632 people were randomly selected from residents aged ≥20 years in Miyagi, Japan. Of 2443 respondents (response rate = 92.8%), 551 current smokers (411 men) were included in the analysis. Odds ratios (OR) and 95% confidence interval (CI) for increasing tobacco consumption were calculated using multivariable logistic regression models including variables of age, sex, disaster-related job status change, education status, self-rated health, and age at smoking initiation. RESULTS After adjustments for all variables, significantly higher ORs for increasing tobacco consumption after the GEJE were observed in women (OR = 1.87; 95% CI = 1.10-3.15), 20-39 years old (OR = 5.18; 95% CI = 2.28-11.75), 40-59 years old (OR = 3.97; 95% CI = 1.76-8.94) and respondents who had lost their jobs (OR = 3.42; 95% CI = 1.06-11.05) than the counterpart categories. CONCLUSIONS This study found 3 determinants of increasing tobacco consumption after a major disaster: being a woman, being of working age, and experiencing disaster-related job loss.
Collapse
|
49
|
Walsh K, Gilmore AK, Schumacher JA, Coffey SF, Frazier PA, Ledray L, Acierno R, Ruggiero KJ, Kilpatrick DG, Resnick HS. Post-sexual assault cigarette smoking: Findings from a randomized clinical trial of a video-based intervention. Addict Behav 2020; 100:106121. [PMID: 31622944 DOI: 10.1016/j.addbeh.2019.106121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/23/2019] [Accepted: 09/04/2019] [Indexed: 10/26/2022]
Abstract
Sexual assault (SA) is associated with elevated risk for cigarette smoking. The current study tested whether a brief video intervention delivered in the emergency department was effective at reducing smoking following SA. Participants were 233 girls and women (age 15+) who received a SA medical forensic examination (SAMFE) and were randomized to one of three conditions: 1) Prevention of Post-Rape Stress (PPRS), a brief video designed to reduce post-SA psychopathology; 2) Pleasant Imagery and Relaxation Information (PIRI), an active control video involving relaxation training; and 3) treatment as usual (TAU). Among those who participated at baseline, 154 participants completed at least one follow-up at 1.5, 3, and 6 months after the SAMFE. Participants reported the number of days of smoking and the average number of cigarettes smoked per day in the two weeks prior to the sexual assault as well as in the two weeks prior to each follow-up. Two-thirds (68.8%) of participants smoked prior to the SA or during any follow-up. One-fifth of participants who did not smoke prior to the SA smoked at one or more follow-ups. Smoking declined on average over follow-up although TAU was associated with increased initial smoking compared to PPRS; PPRS and PIRI did not differ. SA contributes to increases in smoking and the PPRS, a brief and cost-effective video-based intervention delivered during the SAMFE, can protect against increases in post-SA smoking. Trial registration: NCT01430624.
Collapse
|
50
|
Dallery J, Raiff BR, Grabinski MJ, Marsch LA. Technology-Based Contingency Management in the Treatment of Substance-Use Disorders. Perspect Behav Sci 2019; 42:445-464. [PMID: 31976444 PMCID: PMC6768925 DOI: 10.1007/s40614-019-00214-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Contingency management is one of the most efficacious interventions to promote drug abstinence. Contingency management has traditionally been delivered in person so that clinicians could confirm drug abstinence and provide access to additional therapeutic services. Now, new technologies not only permit remote confirmation of abstinence, but also remote delivery of incentives. We discuss several technology-based tools to assess substance use, and new ways to deliver contingency management to promote tobacco, alcohol, and cannabis abstinence. These new tools have the potential to dramatically increase access while maintaining high levels of treatment fidelity. Technology-based methods also allow arranging group contingencies that harness online communities, and they permit targeting multiple health-risk behaviors with a combination of sensor-based technologies. Overall, there are unprecedented opportunities to link technology with contingency management to promote drug abstinence.
Collapse
Affiliation(s)
- Jesse Dallery
- Department of Psychology, University of Florida, PO Box 112250, Gainesville, FL 32611 USA
| | | | | | - Lisa A. Marsch
- The Geisel School of Medicine, Dartmouth College, Hanover, NH USA
| |
Collapse
|