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Nizio P, Clausen B, Businelle MS, Ponton N, Jones AA, Redmond BY, Buckner JD, Obasi EM, Zvolensky MJ, Garey L. Mobile Intervention to Address Cannabis Use Disorder Among Black Adults: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e52776. [PMID: 38373037 PMCID: PMC10912995 DOI: 10.2196/52776] [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] [Received: 09/14/2023] [Revised: 12/21/2023] [Accepted: 12/29/2023] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND African American or Black (hereafter referred to as Black) adults who use cannabis use it more frequently and are more likely to meet criteria for cannabis use disorder (CUD) than both White and Hispanic or Latin individuals. Black adults may be more apt to use cannabis to cope with distress, which constitutes a false safety behavior (FSB; a behavior designed to reduce psychological distress in the short term). Although FSB engagement can perpetuate the cycle of high rates of CUD among Black individuals, limited work has applied an FSB elimination treatment approach to Black adults with CUD, and no previous work has evaluated FSB reduction or elimination in the context of a culturally tailored and highly accessible treatment developed for Black individuals. OBJECTIVE This study aims to develop and pilot-test a culturally tailored adaptive intervention that integrates FSB reduction or elimination skills for cannabis reduction or cessation among Black adults with probable CUD (Culturally Tailored-Mobile Integrated Cannabis and Anxiety Reduction Treatment [CT-MICART]). METHODS Black adults with probable CUD (N=50) will complete a web-based screener, enrollment call, baseline assessment, 3 daily ecological momentary assessments (EMAs) for 6 weeks, and a follow-up self-report assessment and qualitative interview at 6 weeks after randomization. Participants will be randomized into 1 out of the 2 conditions after baseline assessment: (1) CT-MICART+EMAs for 6 weeks or (2) EMAs only for 6 weeks. RESULTS The enrollment started in June 2023 and ended in November 2023. Data analysis will be completed in March 2024. CONCLUSIONS No culturally tailored, evidence-based treatment currently caters to the specific needs of Black individuals with CUD. This study will lay the foundation for a new approach to CUD treatment among Black adults that is easily accessible and has the potential to overcome barriers to treatment and reduce practitioner burden in order to support Black individuals who use cannabis with probable CUD. TRIAL REGISTRATION ClinicalTrials.gov NCT05566730; https://clinicaltrials.gov/study/NCT05566730. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52776.
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Affiliation(s)
| | | | - Michael S Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | | | - Ava A Jones
- University of Houston, Houston, TX, United States
| | | | | | | | | | - Lorra Garey
- University of Houston, Houston, TX, United States
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2
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Elsaid S, Wang R, Kloiber S, Le Foll B, Hassan AN. Motivations for Cannabis Use in Individuals with Social Anxiety Disorder (SAD). Brain Sci 2023; 13:1698. [PMID: 38137146 PMCID: PMC10741773 DOI: 10.3390/brainsci13121698] [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] [Received: 10/31/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
Social anxiety disorder (SAD) is a debilitating psychiatric condition. Consequently, it is common for those affected to resort to cannabis to cope with their symptoms. The primary objective of this study was to understand the differences between motivations for cannabis use in adults with and without SAD. We employed convergent, mixed methods to collect the data. Twenty-six individuals (age: 27.9 ± 7.3 years; 54% female) with and twenty-six (age: 27.4 ± 6.7 years; 50% female) without SAD were administered Marijuana Motives Measure (MMM). Motivations to initiate, continue, and maintain cannabis use were assessed in 12/26 participants in both groups using in-depth interviews. Cannabis weekly consumption was 3.8-fold and frequency 1.3-fold higher in the SAD group. Coping (F = 10.02; p <0.001; η2 = 0.46) and social (F = 2.81; p = 0.036; η2 = 0.19) motivations were also higher in the SAD group, after controlling for age, sex, and current CUD. The need to cope with symptoms of SAD may have been the driving force for repeated cannabis consumption. Psychoeducational programs educating children about the risk of using cannabis to cope with SAD should be implemented in vocational settings early on.
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Affiliation(s)
- Sonja Elsaid
- Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada; (S.E.); (R.W.); (A.N.H.)
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada;
| | - Ruoyu Wang
- Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada; (S.E.); (R.W.); (A.N.H.)
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Stefan Kloiber
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada;
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada; (S.E.); (R.W.); (A.N.H.)
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada;
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
- Department of Family and Community Medicine, Toronto, ON M5G 1V7, Canada
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, ON L9M 1G3, Canada
- Addictions Division, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
| | - Ahmed N. Hassan
- Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada; (S.E.); (R.W.); (A.N.H.)
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada;
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
- Addictions Division, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
- Department of Psychiatry, King Abdulaziz University, Jeddah 22254, Saudi Arabia
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3
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Buckner JD, Zvolensky MJ, Scherzer CR. Alcohol-Related Problems Among Black Adults: the Role of False Safety Behaviors. J Racial Ethn Health Disparities 2023; 10:987-992. [PMID: 35320510 DOI: 10.1007/s40615-022-01286-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/08/2022] [Accepted: 03/12/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Black adults who consume alcohol experience negative alcohol-related outcomes, indicating a need for culturally sensitive research aimed at identifying malleable psychological factors that may play a role in drinking related problems to inform prevention and treatment. One such factor is false safety behavior (FSB), which reflects behaviors geared toward decreasing anxiety short term but that maintains or increases anxiety long term. Although emerging data indicate that FSBs are related to substance use in predominantly White samples, no known studies have tested whether these behaviors are related to drinking behaviors among Black individuals. METHODS Participants were 163 Black undergraduate who endorsed current (past-month) alcohol use and completed an online survey. RESULTS FSB use frequency was robustly positively related to alcohol-related problems, even after controlling for peak eBAC, anxiety, depression, and relevant demographic variables. Anxiety was indirectly related to alcohol-related problems via more frequent FSB use. CONCLUSIONS Nearly all Black individuals who consume alcohol report using FSB to manage anxiety. More frequent FSB use is robustly related to more alcohol-related problems and may play an important role in the relation of anxiety with alcohol-related problems among Black individuals who endorse current alcohol use.
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Affiliation(s)
- Julia D Buckner
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA, 70803, USA.
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Caroline R Scherzer
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA, 70803, USA
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4
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Abstract
Anxiety is among the most prevalent psychiatric conditions, yet little attention has been paid to whether putative cognitive vulnerability factors related to anxiety in predominantly White samples are related to anxiety among Black individuals. Yet, given less mental health service utilization and greater experience of some life stressors, Black persons may be especially at risk for using false safety behaviors (FSB; designed to decrease anxiety in the short term, but are associated with more longer-term mental health problems). We tested whether non-Hispanic/Latin Black persons (n = 133) reported greater FSB use than non-Hispanic/Latin White participants (n = 844) as well as whether FSB use was related to more mental health problems among Black participants. Data were collected online among undergraduates. Black participants did endorse more frequent FSB use, especially FSB-Avoidance and FSB-Body Sensations. Results indicate that among Black participants, FSB use was related to more anxiety, depression, and suicidal thoughts and behaviors. FSB may be an important behavioral vulnerability factor related to anxiety and associated mental health problems among Black young adults.
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Affiliation(s)
- Julia D Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA.,Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Health Institute, University of Houston, Houston, TX, USA
| | - Mara L Ferrie
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Paige E Morris
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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5
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Phillips KT, Prince MA, Phillips MM, Lalonde TL, Stein MD. Momentary patterns of alcohol and cannabis co-use in college students: Assessing the temporal association with anxiety. CANNABIS (RESEARCH SOCIETY ON MARIJUANA) 2022; 5:42-58. [PMID: 35938093 PMCID: PMC9355455 DOI: 10.26828/cannabis/2022.01.005] [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] [Indexed: 06/15/2023]
Abstract
Using ecological momentary assessment (EMA), we assessed momentary patterns of alcohol and cannabis co-use in college students and whether state-level and baseline reports of anxiety varied based on type of substance(s) consumed. Students (N=109) reporting regular cannabis use completed a baseline assessment and two-week signal-contingent EMA, with three random prompts/day. At each EMA instance, we categorized instances of substance "usage" as: 1) no use, 2) cannabis-only, 3) alcohol-only, or 4) co-use of alcohol and cannabis (i.e., reports of alcohol and cannabis use within the same prompt). Using temporal sequenced data, we explored how state-level anxiety varied before and after usage type using multiple multilevel structural equation models (MSEMs) and whether baseline factors (general anxiety, social anxiety, and sex) influenced the relation between usage type and state-level anxiety. Participants were 63.3% White, 58.7% female, used cannabis near-daily, and commonly reported co-use. Models examining whether usage type predicted subsequent state-level anxiety were predominantly significant, with the majority of relationships being more pronounced for participants with higher baseline general anxiety. In examining whether momentary state-level anxiety predicted usage type, in instances when participants reported higher levels of momentary anxiety, they were more likely to report no use compared to co-use and cannabis-only, with sex moderating some of the relationships. Social anxiety did not moderate any of the within-person associations between state-level anxiety and usage type. This study provides preliminary evidence that report of momentary anxiety varies based on substance type. Future research is needed to establish co-use related synergistic effects and correlates.
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Affiliation(s)
- Kristina T. Phillips
- Center for Integrated Health Care Research (CIHR), Kaiser Permanente Hawai’i, 501 Alakawa St., Suite 201, Honolulu, HI 96817
| | - Mark A. Prince
- Department of Psychology, 1876 Campus Delivery, Colorado State University, Fort Collins, CO 80523
| | - Michael M. Phillips
- Office of Public Health Studies, University of Hawai’i, 1960 East-West Road, Honolulu, HI 96822
| | - Trent L. Lalonde
- Colorado Department of Human Services, 1575 Sherman St., Denver, CO 80203
| | - Michael D. Stein
- School of Public Health, Boston University, 715 Albany Street, Boston, MA 02118
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Zamboni L, Centoni F, Fusina F, Mantovani E, Rubino F, Lugoboni F, Federico A. The Effectiveness of Cognitive Behavioral Therapy Techniques for the Treatment of Substance Use Disorders: A Narrative Review of Evidence. J Nerv Ment Dis 2021; 209:835-845. [PMID: 34698698 DOI: 10.1097/nmd.0000000000001381] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
ABSTRACT Substance use disorders (SUDs) are characterized by a recurrent and maladaptive use of drugs and/or alcohol. Cognitive behavioral therapies (CBTs) comprise different types of interventions: traditional CBT and the more recent "third wave" behavior therapies, such as acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), mindfulness-based cognitive therapy (MBCT), and schema therapy (ST). We searched English-language articles published between 2014 and present. This review includes randomized controlled trials (RCTs), quasi-RCTs, pilot studies, and reviews of CBTs for SUDs available on PubMed. Results seem to indicate that CBT and MBCT are effective interventions for SUDs; however, the studies showed a high degree of heterogeneity, so no exhaustive conclusions could be outlined at this time. ACT and DBT in SUD management are limited to few studies and results are therefore inconclusive.
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Affiliation(s)
| | - Francesco Centoni
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital
| | | | - Elisa Mantovani
- Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona
| | - Francesca Rubino
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital
| | - Fabio Lugoboni
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital
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7
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Cannabis use among US adults with anxiety from 2008 to 2017: The role of state-level cannabis legalization. Drug Alcohol Depend 2020; 214:108163. [PMID: 32707516 DOI: 10.1016/j.drugalcdep.2020.108163] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 06/18/2020] [Accepted: 06/20/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cannabis use is more common among adults with anxiety. Cannabis legalization is occurring rapidly across the United States (US) and individuals may use cannabis to cope with anxiety. This study investigated whether cannabis use across the US has changed differentially by anxiety status and by state cannabis legalization for medical (MML) and/or recreational use (RML). METHODS Public and restricted-use data from the 2004 to 2017 National Survey on Drug Use and Health, an annual cross-sectional, nationally representative survey of US individuals, were analyzed. The prevalence of past-30-day cannabis use by anxiety status in 2017 was estimated among respondents ages ≥18 (n = 42,554) by sociodemographics and state-level cannabis law. Weighted logistic regressions with continuous year as the predictor for the linear time trend were used to examine the time trends in cannabis use by anxiety and cannabis law status from 2004 to 2017 (total combined analytic sample n = 398,967). RESULTS Cannabis use was consistently two to three times higher among those with high anxiety compared to those with some or no anxiety and was higher in states with RML compared to MML or no MML/RML. Cannabis use has increased over time among those with and without anxiety overall, in MML states, and in states without MML/RML; with a faster increase in cannabis use among those with high anxiety compared to lower anxiety in states with MML. CONCLUSIONS Cannabis use is increasing among American adults overall, yet is disproportionately common among Americans with anxiety especially among those residing in states where cannabis has been legalized.
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8
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Hammond CJ, Chaney A, Hendrickson B, Sharma P. Cannabis use among U.S. adolescents in the era of marijuana legalization: a review of changing use patterns, comorbidity, and health correlates. Int Rev Psychiatry 2020; 32:221-234. [PMID: 32026735 PMCID: PMC7588219 DOI: 10.1080/09540261.2020.1713056] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Decriminalization, medicalization, and legalization of cannabis use by a majority of U.S. states over the past 25 years have dramatically shifted societal perceptions and use patterns among Americans. How marijuana policy changes have affected population-wide health of U.S. youth and what the downstream public health implications of marijuana legalization are topics of significant debate. Cannabis remains the most commonly used federally illicit psychoactive drug by U.S. adolescents and is the main drug for which U.S. youth present for substance use treatment. Converging evidence indicates that adolescent-onset cannabis exposure is associated with short- and possibly long-term impairments in cognition, worse academic/vocational outcomes, and increased prevalence of psychotic, mood, and addictive disorders. Odds of negative developmental outcomes are increased in youth with early-onset, persistent, high frequency, and high-potency Δ-9-THC cannabis use, suggesting dose-dependent relationships. Cannabis use disorders are treatable conditions with clear childhood antecedents that respond to targeted prevention and early intervention strategies. This review indicates that marijuana policy changes have had mixed effects on U.S. adolescent health including potential benefits from decriminalization and negative health outcomes evidenced by increases in cannabis-related motor vehicle accidents, emergency department visits, and hospitalizations. Federal and state legislatures should apply a public health framework and consider the possible downstream effects of marijuana policy change on paediatric health.
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Affiliation(s)
- Christopher J. Hammond
- Division of Child & Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland;,Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, Maryland;,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland;,Corresponding Author address: Christopher Hammond, MD PhD, Johns Hopkins Bayview, 5500 Lombard Street, Baltimore, MD 21224, , Phone: 410-550-0048
- Fax: 410-550-0030
| | - Aldorian Chaney
- Division of Child & Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland;,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Brian Hendrickson
- Division of Child & Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland;,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Pravesh Sharma
- Department of Psychiatry, Mayo Clinic Health System and University of Wisconsin-Eau Claire, Eau Claire, WI
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9
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Short NA, Schmidt NB. Developing and Testing a Novel, Computerized Insomnia and Anxiety Intervention to Reduce Safety Aids Among an at-Risk Student Sample: A Randomized Controlled Trial. Behav Ther 2020; 51:149-161. [PMID: 32005332 DOI: 10.1016/j.beth.2019.05.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 05/21/2019] [Accepted: 05/24/2019] [Indexed: 11/16/2022]
Abstract
Anxiety and insomnia disorders are two of the most common and costly mental health conditions. They are frequently comorbid, but current treatments do not target both. To streamline treatment, we developed a computerized intervention targeting a transdiagnostic factor, safety aids (cognitive or behavioral strategies used to cope with distress that paradoxically exacerbate symptoms). We conducted a randomized controlled trial to determine the acceptability and efficacy of this brief one-session intervention. Young adult undergraduates (N = 61) with elevated subclinical anxiety and insomnia were randomized to receive the anxiety-insomnia intervention or a physical health control condition. Participants were followed for 1 month and completed self-report measures. Analyses indicated that participants found the intervention acceptable, credible, and engaging. Analyses revealed the active intervention reduced sleep- and anxiety-related safety aids, with medium to large effect sizes. Findings suggest that targeting safety aids for anxiety and insomnia is acceptable and effective in reducing the target mechanism, safety aids, as well as worry. Future research should replicate these findings within a clinical sample and with a longer-term follow-up.
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Affiliation(s)
- Nicole A Short
- Florida State University; Medical University of South Carolina
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10
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Buckner JD, Zvolensky MJ, Lewis EM. Smoking and social anxiety: the role of false safety behaviors. Cogn Behav Ther 2019; 49:374-384. [PMID: 31847703 DOI: 10.1080/16506073.2019.1696396] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Despite the negative health consequences associated with smoking, most smokers find it difficult to quit. This is especially true for smokers with elevated social anxiety. One factor that may play a role in maintaining smoking with elevated anxiety is false safety behavior (FSB), behaviors geared toward decreasing anxiety short-term but that maintain or increase anxiety long-term. The present study tested whether FSB explained the relation of social anxiety severity with smoking among 71 current smokers. Avoidance-related FSB was the only type of FSB related to cigarettes smoked per day (CPD) and it was robustly related to more CPD. Further, social anxiety was related to CPD indirectly via FSB-Avoidance. Findings suggest that more frequent use of avoidance behaviors to manage anxiety may maintain smoking and may partially explain the high rates of smoking among those with elevated social anxiety. Thus, FSB may be a promising target in smoking cessation interventions, especially among those with elevated social anxiety.
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Affiliation(s)
- Julia D Buckner
- Department of Psychology, Louisiana State University , LA, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston , Houston, TX, USA.,Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center , Houston, TX, USA
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11
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Buckner JD, Zvolensky MJ, Walukevich-Dienst K, Lewis EM, Dean KE, Zielinski MH. Integrated Cognitive Behavioral Therapy for Anxiety and Smoking Cessation. Clin Case Stud 2019. [DOI: 10.1177/1534650119859094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Smokers suffer from high rates of anxiety disorders, presumably because some individuals with anxiety disorders rely on smoking as a maladaptive attempt to manage anxiety. Cognitive behavioral therapy (CBT) is an efficacious smoking cessation treatment, yet outcomes are worse for patients with elevated anxiety. The integration of CBT for smoking cessation with False Safety Behavior Elimination Therapy (FSET) may be useful with anxious smoking cessation patients, as smoking to manage anxiety and associated negative affect can be targeted as a false safety behavior (i.e., behavior aimed at decreasing anxiety in the short-term but which may maintain or exacerbate it in the long-term). Here, we describe the integrated treatment, Treatment for Anxiety and Smoking Cessation (TASC), and the successful use of it with two smoking cessation patients—one with comorbid generalized anxiety disorder (GAD) and one with clinically elevated social anxiety that did not meet diagnostic threshold for an anxiety disorder. Data support the feasibility of TASC as a viable approach to smoking cessation treatment for patients with comorbid anxiety disorder and with elevated anxiety that does not meet diagnostic threshold. Future controlled trials are now warranted to further evaluate the intervention.
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Affiliation(s)
- Julia D. Buckner
- Louisiana State University, Baton Rouge, LA, USA
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Michael J. Zvolensky
- University of Houston, Houston, TX, USA
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | | | | | - Mark H. Zielinski
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
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12
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Zvolensky MJ, Mayorga NA, Garey L. Worry, anxiety sensitivity, and electronic cigarettes among adults. Psychiatry Res 2018; 269:321-327. [PMID: 30173037 PMCID: PMC10034964 DOI: 10.1016/j.psychres.2018.08.087] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/22/2018] [Accepted: 08/24/2018] [Indexed: 12/27/2022]
Abstract
Although electronic cigarette (e-cigarette) use is now a common substance use behavior, there is little understanding of the individual difference factors related to e-cigarette use beliefs and dependence. The present investigation sought to test a theoretically-driven model of anxiety sensitivity as an explanatory element in a worry-e-cigarette beliefs and dependence model. Participants included 558 adult e-cigarette users (51.4% female; 35.2 years, SD = 10.1) who were nationally recruited via an online survey system. Participants completed a single survey that assessed their mood and e-cigarette behavior and beliefs. Results supported a statistically significant indirect pathway for worry in relation to perceived benefits of e-cigarettes, e-cigarette positive outcome expectancies, and e-cigarette dependence via anxiety sensitivity; effect sizes were small. The indirect effects were evident when accounting for several theoretically relevant covariates (sex, income, education, concurrent cigarette use, and neuroticism). This study provides the first empirical evidence of the role of anxiety sensitivity in the relation between worry and e-cigarette use beliefs and behavior, which may represent a novel intervention target.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX 77204, USA; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Health Institute, University of Houston, Houston, TX, USA.
| | - Nubia A Mayorga
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX 77204, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX 77204, USA
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13
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Short NA, Schmidt NB. A Multimethod Examination of the Effect of Insomnia Symptoms on Anxious Responding to a Social Stressor. Behav Ther 2018; 49:323-330. [PMID: 29704963 PMCID: PMC5937274 DOI: 10.1016/j.beth.2017.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 11/09/2017] [Accepted: 11/09/2017] [Indexed: 10/18/2022]
Abstract
A growing number of studies identify insomnia symptoms as a potential risk factor for the development of anxiety disorders. However, little research has examined potential mechanisms through which insomnia could confer increased risk for anxiety. A separate line of literature suggests sleep is necessary for adaptive emotional and behavioral responding to stressors, a potential mechanism linking insomnia symptoms to anxiety risk. To test whether insomnia symptoms affect emotional and behavioral responding to an anxiety-relevant stressor, the current study recruited a sample of 99 undergraduates with varying levels of insomnia symptoms. Participants completed self-report and psychophysiological measures before, during, and after an impromptu speech task. Results indicated that, after covarying for negative affectivity, increased insomnia symptoms were significantly associated with elevated anticipatory anxiety and skin conductance response prior to the speech, and increased skin conductance response, emotion regulation difficulties, and safety aid use during the speech. Taken together, results provide evidence for the notion that insomnia symptoms are associated with maladaptive emotional and behavioral responding to an anxiety-relevant stressor.
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14
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Buckner JD, Zvolensky MJ, Businelle MS, Gallagher MW. Direct and indirect effects of false safety behaviors on cannabis use and related problems. Am J Addict 2017; 27:29-34. [PMID: 29280237 DOI: 10.1111/ajad.12659] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 10/23/2017] [Accepted: 11/29/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND AND OBJECTIVES In light of increasing rates of cannabis use and use-related problems, efforts to understand malleable psychological vulnerability factors related to use and related problems remain important as they can inform prevention and treatment efforts. Recent data indicate that false safety behaviors (FSB; ie, behaviors that may be effective in decreasing anxiety in the short-term, but can maintain and even exacerbate anxiety in the long-term) are related to cannabis problem severity. Thus, an important next step is to identify factors implicated in the relation between FSB and cannabis use behavior. The current study tested whether FSB were uniquely related to cannabis use problems and high-risk cannabis use motives. We also tested whether FSB were indirectly related to cannabis outcomes via high-risk motives. METHOD The sample consisted of 349 current (69.6% female) cannabis-using undergraduates who completed an online survey. RESULTS FSB was robustly related to cannabis-related problems and cannabis use motives (ie, coping and availability) after controlling for anxiety and cannabis use frequency. FSB was indirectly related to cannabis problems via coping and availability motives and to cannabis use frequency via coping motives. DISCUSSION AND CONCLUSIONS Results add to a growing literature indicating that FSB are related to cannabis problem severity and extend this work by identifying mechanisms underlying this relationship. SCIENTIFIC SIGNIFICANCE Data indicate that FSB may be an under recognized, yet clinically important, vulnerability factor related to cannabis use problems. (Am J Addict 2018;27:29-34).
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Affiliation(s)
- Julia D Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, Texas.,Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael S Businelle
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.,Oklahoma Tobacco Research Center, Stephenson Cancer Center, Oklahoma City, Oklahoma
| | - Matthew W Gallagher
- Department of Psychology, University of Houston, Houston, Texas.,Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, Texas
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