An experimental investigation of the functional relationship between social phobia and cigarette smoking

Associations between anxiety symptoms and barriers to smoking cessation among African Americans who smoke cigarettes daily

BACKGROUND

African Americans who smoke cigarettes and experience heightened anxiety symptoms may have low quit smoking rates. Identifying which particular barriers to cessation are associated with specific types of anxiety symptoms in African Americans could inform cessation treatments for this population. This cross-sectional, correlational study examined associations of anxiety-related symptoms and distinct barriers to cessation among non-treatment-seeking African Americans who smoke cigarettes daily.

METHODS

African Americans who smoke (N = 536) enrolled in a clinical research study on individual differences in tobacco addiction between 2013 and 2017 completed self-report measures of anxiety-related symptoms (i.e., social anxiety, panic, and posttraumatic intrusions) and types of barriers to cessation (i.e., addiction-related, social-related, and affect-related barriers). Linear regression models tested associations of anxiety symptoms with cessation barriers with and without adjusting for age, sex, depressive symptoms, and nicotine dependence.

RESULTS

All anxiety-related symptoms were associated with each cessation barrier (βs = 0.240-0.396). After covariate adjustment, panic and trauma-related symptoms were not associated with cessation barriers, and the strength of association of social anxiety with external barriers was reduced but remained significant (β = 0.254).

CONCLUSION

Symptoms of social anxiety, but not trauma or panic-related symptoms, may play a unique, but modest, role in certain barriers to cessation in non-treatment-seeking African Americans who smoke cigarettes over. Further research is needed to uncover why African Americans who smoke and have anxiety might experience these barriers, and how future interventions can mitigate these obstacles.

Analysis of E-mental health research: mapping the relationship between information technology and mental healthcare

BACKGROUND

E-mental healthcare is the convergence of digital technologies with mental health services. It has been developed to fill a gap in healthcare for people who need mental wellbeing support that may not otherwise receive psychological treatment. With an increasing number of e-mental healthcare and research, this study aimed to investigate the trends of an e-mental health research field that integrates interdisciplinary fields and to examine the information technologies is being used in mental healthcare. To achieve the research objectives, bibliometric analysis, information extraction, and network analysis were applied to analyze e-mental health research data.

METHODS

E-mental health research data were obtained from 3663 bibliographic records from the Web of Science (WoS) and 3172 full-text articles from PubMed Central (PMC). The text mining techniques used for this study included bibliometric analysis, information extraction, and visualization.

RESULTS

The e-mental health research topic trends primarily involved e-health care services and medical informatics research. The clusters of research comprised 16 clusters, which refer to mental sickness, e-health, diseases, information technology (IT), and self-management. The information extraction analysis revealed a triple relation with IT and biomedical domains. Betweenness centrality was used as a measure of network graph centrality, based on the shortest path to rank the important entities and triple relation; nodes with higher betweenness centrality had greater control over the network because more information passes through that node. The IT entity-relations of "mobile" had the highest score at 0.043466. The top pairs were related to depression, mobile health, and text message.

CONCLUSIONS

E-mental related publications were associated with various research fields, such as nursing, psychology, medical informatics, computer science, telecommunication, and healthcare innovation. We found that trends in e-mental health research are continually rising. These trends were related to the internet of things (IoT) and mobile applications (Apps), which were applied for mental healthcare services. Moreover, producing AI and machine learning for e-mental healthcare were being studied. This work supports the appropriate approaches and methods of e-mental health research that can help the researcher to identify important themes and choose the best fit with their own survey work.

Anxiety in social interactions and nicotine dependence in nicotine-dependent men: The role of metacognitions about smoking

Anxiety in social interactions is an important factor in cigarette use and nicotine dependence. Metacognitions about smoking have been found to predict smoking behavior and may help understand the relationship between anxiety in social interactions and nicotine dependence. In the current study, we evaluated the direct effect of anxiety in social interactions on nicotine dependence and its indirect effect through metacognitions (controlling for anhedonia and depression) in nicotine-dependent men (n = 388). Participants completed measures of anxiety in social interactions [the Social Interaction Anxiety Scale (SIAS)], anhedonia [the Snaith HamiltonPleasure Scale (SHAPS)], metacognitions about smoking [e.g., theMetacognitions aboutSmoking Questionnaire (MSQ)] nicotine dependence [the Fagerström Test for Nicotine Dependence (FTND)], and clinical factors related to smoking including depressive symptoms [e.g., the Beck Depression Inventory-II (BDI-II)]. As expected, after controlling for depressive symptoms and anhedonia, anxiety in social interactions indirectly affected nicotine dependence through negative metacognitions about smoking, but not positive metacognitions. These findings are discussed in relation to the metacognitive model of addictive behaviors.

The Role of Anxiety in Smoking Onset, Severity, and Cessation-Related Outcomes: a Review of Recent Literature

PURPOSE OF REVIEW

Anxiety is one of the most common mental health conditions globally and co-occurs with smoking at a markedly high rate. The present review offers a narrative overview of the most recent research on the role of anxiety in smoking onset, maintenance, and cessation-related outcomes. Additionally, given the rise in electronic cigarette use, we review the emerging literature on the influence of anxiety on e-cigarette use.

RECENT FINDINGS

Evidence across studies varied as to the role of anxiety or anxiety symptoms in smoking behavior. The most consistent findings suggested that those with anxiety are more likely to be a smoker, supporting a high rate of co-occurrence across these conditions. Less consistent evidence was observed for the association between anxiety and onset, indicators of severity, and cessation outcomes. Although there is robust evidence for an association between smoking and anxiety, there were considerable discrepancies for the precise role of anxiety in smoking onset, severity, and cessation outcomes. Future work utilizing more sophisticated methodologies is needed to identify causal relations as well as putative moderators and mediators of the anxiety-smoking relation.

Cigarette craving and stressful social interactions: The roles of state and trait social anxiety and smoking to cope

BACKGROUND

Previous research indicates that social anxiety (SA) is a risk factor for the maintenance and relapse of smoking behaviors. However, little is known about the mechanisms underlying this relationship. The current study tested the effects of state and trait levels of SA as well as smoking to cope with symptoms of SA on craving during a social stressor task in abstinent conditions.

METHODS

Participants (n = 60) were daily smokers, aged 18-30. Participants attended two sessions: a baseline session and a second session, wherein they engaged in a social stressor task while deprived from nicotine for 24 h. Subjective ratings of cigarette craving and state levels of SA were assessed six times throughout the task. Data were analyzed via multilevel modeling.

RESULTS

Both trait SA and some forms of smoking to cope with symptoms of SA were more likely to predict increased craving during times of high, relative to low, social stress. Further, individuals with higher state SA, greater smoking to cope behaviors, and those who experience greater relief of social distress by smoking experienced greater craving throughout the task. These effects remained after controlling for nicotine dependence, withdrawal symptoms, depression, and other symptoms of anxiety and stress. Smoking to cope with symptoms of SA did not moderate the relationship between state SA and craving.

CONCLUSIONS

Smokers high in SA (state and trait) and smoking to cope with symptoms of SA may be at risk for continued smoking and relapse because of the intensity of cravings they experience during stressful social situations.

Differential prevalence of established risk factors for poor cessation outcomes among smokers by level of social anxiety

BACKGROUND AND OBJECTIVES

Despite clear associations between social anxiety (SA), high prevalence of smoking, and cessation failure, little is known about factors contributing to these relationships. Moreover, the extent to which smokers with moderate SA represent an at-risk group of smokers is also unknown. This study examined the extent to which established risk factors for poor cessation (eg, sociodemographic, smoking history, mental health comorbidity) are prevalent among smokers with low, moderate, and high levels of SA.

METHODS

Participants (N = 2,637) were adult smokers from a web-based smoking cessation trial. Nineteen characteristics considered risk factors for poor cessation outcomes were assessed at baseline. Those associated with social anxiety were subsequently compared by SA level.

RESULTS

Regression models indicated that 10/19 risk factors were associated with SA. Compared to smokers with low SA, those with moderate and high SA endorsed 4/10 and 10/10 risk factors as more prevalent or severe, respectively. Compared to smokers with low SA, High SA was associated with greater sociodemographic risk factors, while both moderate and high SA was associated with more severe mental health symptoms.

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE

Smokers with moderate and high levels of SA endorse more risk factors for poor cessation outcomes than those with low levels of SA, particularly mental health symptoms. These factors may help explain the differential smoking outcomes of socially anxious smokers. Results suggest that smokers with both moderate and high levels of SA would likely benefit from cessation interventions that address and consider these risk factors. (Am J Addict 2017;26:176-182).

Depressive Symptoms and Cigarette Demand as a Function of Induced Stress

INTRODUCTION

Depressed smokers may disproportionately value cigarettes as compared to other reinforcers in the context of increases in negative affect (NA). Thus, cigarette demand may be an important construct for understanding the relationship between depression, NA change, and tobacco use. The aim of the current study was to examine the interaction between depressive symptoms and change in NA as a function of induced mood as a predictor of cigarette demand.

METHODS

Participants included 73 young adult daily smokers (41.70% female, 73.60% White, age M (SD) = 19.70 (1.15)) who attended two experimental sessions: one stress and one neutral. During each session, participants completed ratings of depressive symptoms, NA, and cigarette demand.

RESULTS

We examined the predictive utility of depressive symptoms, change in NA as a result of a stressor, and the interaction between depressive symptoms and NA change on demand indices. Separate models were constructed by session. Results indicated significant interactive effects between depressive symptoms and change in NA for predicting intensity, breakpoint, and P max during the stress session. Specifically, change in NA moderated the relationship between depression and demand indices such that among individuals high in NA change, depressive symptoms were positively related to P max and breakpoint, whereas among individuals low in NA change, depressive symptoms were positively related to intensity.

CONCLUSIONS

When exposed to stress, cigarettes may become more valuable for individuals with depressive symptoms.

IMPLICATIONS

This study contributes to the literature attempting to understand the complex relationships between depression, stress-related changes in NA, and tobacco use. This study suggests that one mechanism that may be important to the relationship between depression and tobacco use is cigarette demand. Specifically, for individuals with elevated depressive symptoms, certain aspects of cigarette demand may be higher (intensity, breakpoint, and P max) when exposed to stress, which may contribute to tobacco use being maintained over time.

Risk-Taking Propensity in Older Adolescents: Internalizing Symptoms, Gender, and Negative Reinforcement

OBJECTIVE

Engagement in risk behaviors, including substance use, risky sex, and violence, tends to increase throughout adolescence into young adulthood. One motivational process that may underlie risk behaviors during adolescence is negative reinforcement. Moreover, gender and internalizing symptoms (e.g., depression and anxiety) may both convey risk for negative reinforcement-based risk taking. Along these lines, the aims of the current study were to (a) examine gender differences in negative reinforcement-based risk-taking propensity and (b) examine internalizing symptoms as a moderator of the relationship between gender and negative reinforcement-based risk-taking propensity.

METHOD

Participants included 103 youth between the ages of 18 and 21 (50.49% female, age M(SD) = 19.41(1.06)) who were recruited from a large Mid-Atlantic university between September 2013 and November 2014. Participants completed self-report assessments of internalizing symptomatology and a computerized behavioral analog assessment of negative reinforcement-based risk-taking propensity.

RESULTS

Results indicated that, overall, female older adolescents were riskier under conditions of negative reinforcement than male older adolescents. In addition, internalizing symptoms significantly moderated the relationship between gender and negative reinforcement-based risk-taking propensity such that the relationship between gender and negative reinforcement-based risk-taking propensity was nonsignificant at high levels of internalizing symptoms, and female gender was significantly positively predictive of heightened negative reinforcement-based risk-taking propensity at low levels of internalizing symptoms.

CONCLUSIONS

Thus, although female youth overall were riskier, the predictive utility of gender for negative reinforcement-based risk taking may be most relevant at low levels of internalizing symptoms. Results are discussed in terms of implications for future prevention and intervention.

A Review of Impact of Tobacco Use on Patients with Co-occurring Psychiatric Disorders

Consumption of tobacco has been a worldwide problem over the past few decades due to the highly prevalent tobacco-attributable complications. Tobacco use has also been found to be more prevalent in patients with psychiatric disorders. Therefore, we conducted this review about the impact of tobacco use on co-occurring psychiatric disorders. Various facets of this interaction between tobacco use among those with co-occurring psychiatric disorders have been explored. It has been found that people with psychiatric disorders have a higher chance of currently smoking tobacco and lesser chance of cessation. Tobacco use and mental disorders continue to share a complex relationship that has been further evolving after the change in the pattern of tobacco use and also the advent of newer modalities of treatment. However, at the same time, it is believed that cessation of smoking may lead to improvement in the symptoms of mental illness.

Health behaviors and personality in burnout: a third dimension

The high prevalence of burnout among healthcare professionals warrants a thorough examination aimed at improving the current understanding of its predictors and preventive measures. Cecil et al. have underscored the alarming prevalence of burnout among medical students and assessed its association with demographic, lifestyle, and behavioral factors. Of interest, health behaviors were found to be predictive of burnout. The study suggests certain behaviors (such as high physical activity) to be protective, and thus, calls for their establishment early in college life to prevent the development of this professionally-disabling mental state. Although the adoption of advisable health behaviors may independently reduce the risk of burnout, recognition of the existence and influence of closely related factors allows for an enhanced understanding and a greater precision for any conclusions to be made. Personality, through deductive and inductive reasoning, is likely to exert significant influence on both the student's behavior and his/her susceptibility to burnout. Thus, with personality representing--in and of itself--a principal model for prediction of burnout risk, controlling for personality traits when addressing health behaviors' influence per se on burnout is essential.