The indirect effect of panic disorder on smoking cognitions via difficulties in emotion regulation

Easing Panic: The Effect of an Online Psychoeducational Program on Panic Symptoms, Anxiety, and Quality of Life Among People Experiencing Panic Attacks

Panic attacks (PAs) are intense episodes of anxiety with severe physical symptoms that can impair an individual's social and occupational functions. Psychoeducation, a structured educational intervention, aims to improve various health aspects, including mental disorders. Delivering psychoeducation via the Internet can overcome barriers to accessing mental health treatment. This study examined the effectiveness of online psychoeducation on panic symptoms, anxiety, and quality of life (QOL) among people experiencing PAs. In this quasi-experimental design, 157 participants with PAs were recruited, and 136 eligible participants were allocated to treatment and control groups. The treatment group received an eight-session online psychoeducational program over 8 weeks, while the control group received reading materials. Outcome variables, including panic symptoms, anxiety, and QOL, were measured at baseline, 1-week post-intervention, and at 8-week follow-up using the Panic Disorder Dimensional (PD-D) scale, the Generalized Anxiety Disorder (GAD-7) scale, and the World Health Organization Quality of Life-BREF (WHOQOL-BREF), respectively. In the treatment group, the split-plot ANOVA showed a significant reduction in panic symptoms [F(1, 98) = 18.86, p < 0.01] and anxiety [F(1, 98) = 18.241, p < 0.01] compared to the control group. However, the intervention did not significantly affect QOL [F(1, 98) = 0.278, MSE = 153.007, p > 0.05]. The online psychoeducational program effectively reduced panic symptoms and anxiety levels but did not significantly impact QOL. Internet-based interventions, including psychoeducation, can improve access to mental health treatment, potentially reducing the treatment gap and enhancing overall mental health outcomes.

Emotional dysregulation in relation to substance use and behavioral addictions: Findings from five separate meta-analyses

Background/objective

Emotional dysregulation (ED) is a transdiagnostic variable underlying various psychiatric disorders, including addictive behaviors (ABs). This meta-analysis examines the relationship between ED and ABs (alcohol, tobacco, cannabis, gambling, and gaming), and indicators of AB engagement (frequency, quantity/time of use, severity, and problems).

Method

Searches were conducted in PubMed, Scopus, WoS, and PsycINFO. Five separate meta-analysis were run using random-effects models. Moderators (age, sex, continental region, and sample type; community vs. clinical), and publication bias were evaluated.

Results

A total of 189 studies (N = 78,733; 51.29 % women) were identified. ED was significantly related to all ABs. Problems and severity indicators exhibited the largest effects (r's .118-.372, all p <.023). There were larger effect sizes for cannabis problems (r = .372), cannabis severity (r = .280), gaming severity (r = .280), gambling severity (r = .245), gambling problems (r = .131), alcohol problems (r = .237), alcohol severity (r = .204), and severity of nicotine dependence (r = .118). Lack of impulse control exhibited some of the largest effects in relation to ABs. Clinical samples of cannabis users vs. community-based exhibited larger magnitude of associations.

Conclusions

Interventions targeting ABs should address lack of strategies and impulsive behaviors as an emotion regulation strategy specifically, as it is a common risk factor for ABs.

Internet-Based Cognitive-Behavioral Therapy for Individuals Experiencing Panic Attacks: A Scoping Literature Review

Panic attacks (PAs) are prevalent and highly comorbid with various physical and psychological disorders. Cognitive-behavioral therapy (CBT) is a well-established psychosocial intervention. Internet-delivered CBT (ICBT) presents a promising avenue to overcome barriers and provide evidence-based support to those in need. The current scoping review aimed to systematically map the existing literature and identify knowledge gaps regarding the impact of ICBT on outcome measures for individuals experiencing PAs. The PRISMA guidelines for scoping reviews were used. A total of 3,044 records were retrieved, and 18 studies from 2013 to 2023 were ultimately included in the analysis. ICBT demonstrated effectiveness as a psychosocial intervention for improving panic symptoms and anxiety in individuals with PAs. However, the impact of ICBT on quality of life (QOL) remains inconclusive. All studies included in this review focused on assessing the severity of panic symptoms, with limited emphasis on measuring QOL. This scoping review holds significant implications for research and practice. However, further addressing the research needs identified in this review will enhance our understanding and improve treatment outcomes for PAs. [Journal of Psychosocial Nursing and Mental Health Services, 62(4), 9-15.].

Emotion dysregulation, transdiagnostic vulnerabilities, and e-cigarette expectancies in a young adult sample

OBJECTIVE

Use of e-cigarettes is more common among youth with psychological distress. Negative affect reduction outcome expectancies (beliefs about ability of a product to reduce unpleasant emotional states) and emotional transdiagnostic vulnerabilities (maladaptive responses to emotional states common to multiple forms of emotional psychopathology) are both positively related to tobacco susceptibility and use. However, it is unclear if expectancies mediate the effects between emotional issues and use.

METHOD

College students aged 18 to 24 (N = 216; 79.6% female; 36.6% African American) completed an online survey with measures on e-cigarette negative affect reduction outcome expectancies (ENAROE), e-cigarette use, and the following emotional transdiagnostic vulnerabilities (ETV): difficulties in emotion regulation, distress tolerance (DT), positive/negative urgency, and positive/negative affect.

RESULTS

In individual predictor path analysis models, ENAROE mediated the relationship between ETVs and e-cigarette use. Expectancies (ENAROE) mediated 47.3% of the total relationship between positive urgency and use. Significant effects were found for a comprehensive model, in which negative urgency was related to higher ENAROE (b = 0.47, 95% BCCI [0.04, 0.96]), controlling for all other transdiagnostic vulnerabilities. Higher positive urgency was related to an increased likelihood of current use.

CONCLUSIONS

This study provides a novel examination of expectancies as a potential mediator for current e-cigarette use via emotional vulnerabilities. Negative Affect Reduction outcome expectancies mediated the relationship between vulnerabilities and e-cigarette use, indicating that the association between positive urgency and e-cigarette use may be explained partially though emotional expectancies. Thus, expectancies are important targets for prevention and further ETV research.

The effects of emotion dysregulation and negative affect on urge to smoke and nicotine dependence: The different roles of metacognitions about smoking

Evidence has shown that smoking is a self-regulatory strategy to relieve negative affect and that metacognitions about smoking may play a role in addictive behaviors. Therefore, the present research was designed to examine the direct and indirect roles of emotion dysregulation and negative affect in predicting urge to smoke and nicotine dependence via metacognitions about smoking. In a cross-sectional study, 450 nicotine-dependent men completed measures of urge to smoke, nicotine dependence, metacognitions about smoking, negative affect, and emotion dysregulation. The results showed that both emotion dysregulation and negative affect had indirect effects on urge to smoke via positive metacognitions about smoking as well as on nicotine dependence via negative metacognitions about smoking. The findings suggest that metacognitions about smoking have different roles in different patterns of nicotine use so that positive and negative metacognitions have important roles respectively in urge to smoke and nicotine dependence in smokers with high emotion dysregulation and negative affect. This study also adds to the literature on the metacognitive theoretical framework of addictive behaviors supporting the use of Metacognitive Therapy interventions in smoking cessation.

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.

The psychometric properties of the Persian version of the metacognitions about Smoking Questionnaire among smokers

OBJECTIVES

It has been shown that smoking may be affected by metacognitions. This study aimed to evaluate the factor structure, reliability and validity of the Persian version of the Metacognitions about Smoking Questionnaire (MSQ) among a sample of Iranian male smokers.

METHODS

When the English to Persian translation of the MSQ was performed, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were completed according to the four-factor solution of the original MSQ. Three hundred male treatment-seeking smokers (mean age = 41.37, SD = 15.90) filled out the Persian-translated version of the MSQ, the Smoking Effects Questionnaire (SEQ), and the Nicotine Dependence Syndrome Scale (NDSS).

RESULTS

The results of EFA revealed that the Persian version of the MSQ had a four-factor structure named positive metacognitions about cognitive regulation (PM-CR), positive metacognitions about emotional regulation (PM-ER), negative metacognitions about uncontrollability (NM-U), and negative metacognitions about cognitive interference (NM-CI). The findings of CFA also indicated that the four-factor structure of the Persian version of the MSQ had appropriate fit. Validity and reliability of the Persian version of the MSQ were found to be good. Negative metacognitions about smoking predicted nicotine dependence over and above smoking outcome expectancies. Positive metacognitions about emotion regulation explained daily cigarette use independent of smoking outcome expectancies.

CONCLUSIONS

The findings suggested that the Persian version of the MSQ had adequate psychometric properties among Iranian male treatment-seeking smokers.

Emotion dysregulation and smoking among treatment-seeking smokers

INTRODUCTION

There has been increased scholarly interest in advancing the study of emotion dysregulation and substance use. However, there is limited study of emotion dysregulation in the context of smoking. The current study examined the emotion dysregulation global construct and sub facets in relation to negative affect reduction expectancies, coping motives, perceived barriers for quitting, and the severity of problems experienced during quit attempts.

METHOD

Treatment seeking smokers (n=469; 48.2% female, M_age=36.59, SD=13.58) enrolled in a smoking cessation trial and completed baseline measures of smoking cognitions and emotion dysregulation.

RESULTS

Results indicated that the emotion dysregulation global score was significantly associated with each of the smoking dependent variables. Additionally, difficulty accessing emotion regulation strategies and difficulty engaging in goal-directed behavior were significantly associated with the dependent variables.

CONCLUSION

Overall, this is the first study to evaluate relations between multidimensional facets of emotion dysregulation and clinically relevant smoking variables. Emotion dysregulation may be an important treatment target for changing smoking.