Trauma-related cognitions predict treatment response in smokers with PTSD: Evidence from cross-lagged panel analyses

Tobacco use, trauma exposure and PTSD: a systematic review

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.

Effects of current treatments for trauma survivors with posttraumatic stress disorder on reducing a negative self-concept: a systematic review and meta-analysis

Background: A negative self-concept is characterised by dysfunctional cognitions about the self and has been suggested to be a key factor involved in the development and maintenance of posttraumatic stress disorder (PTSD). In addition, the current definitions of PTSD according to DSM-5 and the new ICD-11 diagnosis of Complex PTSD (CPTSD) include aspects of negative self-concept in their diagnostic criteria. Objective: The aim of this meta-analysis was to synthesise the currently available evidence on the effects of psychological interventions for PTSD on negative self-concept. Methods: PubMed, PsychINFO, PSYNDEX, PTSDpubs and Cochrane Library were searched for randomised controlled trials (RCTs) of psychological treatments for PTSD symptoms in adults, published up to February 2021. A systematic review and meta-analysis were conducted, with risk of bias assessed by the Cochrane Risk of Bias Assessment Tool. Results: A total of 25 RCTs (N = 2585) were included in the meta-analysis. Results showed that psychological interventions significantly improve a negative self-concept with a moderate to large controlled effect size (k = 30, g = 0.67, 95% CI [0.31, 1.02], p < .001) at post-treatment. Heterogeneity between studies was large but could not be accounted for by moderators included in the current analysis, i.e. different types of interventions (e.g. with vs. without a cognitive restructuring component, trauma-focused vs. not). Conclusions: Current treatments for PTSD are effective in reducing a negative self-concept. However, more research is needed to identify moderators of this effect and identify interventions that are most effective for reducing negative self-concept.

How Can E-Cigarette Fear Appeals Improve the Perceived Threat, Fear, Anger, and Protection Motivation of Young People

The lack of awareness regarding the risks of e-cigarettes and the misleading business propaganda caused an increase in the popularity of e-cigarettes among young people. The effective communication of the risks associated with e-cigarettes is an important part of current work to control their usage, and the use of fear appeals is an effective method to achieve good control. Based on the Extended Parallel Process Model (EPPM) and Appraisal-Tendency Framework (ATF), this article presents a 2 × 2 control experiment to test the impact of fear appeals on the perception of risk, emotions, and behavioral motivation of young people aged 35 and less. A total of 333 valid samples of adolescents and young adults were included to investigate the different response paths to fear appeals among young people of different age, sex and smoking history. The results show that high-threat, high-efficacy fear appeals are able to: (1) significantly increase young people's perception of the e-cigarette-associated threats, (2) trigger fear and anger amongst young people, and (3) stimulate their self-protection motivation. Fear appeals do not have an impact on young people's perception of efficacy, regardless of their level of threat and efficacy. High fear appeals can also increase young people's perception of threat, which in turn enhances their anger and protection motivation. Furthermore, while this type of fear appeal can enhance young women's perception of efficacy, it cannot enhance the perception of e-cigarette risks in adolescents, young men and young smokers, regardless of their level of threat and efficacy. Young non-smokers have a higher perception of the risks involved in the use of e-cigarettes compared with young smokers.