1
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He X, Ji J, Pei Z, Luo Z, Fang S, Liu X, Lei Y, Yan H, Guo L. Anxiety and depression status in patients with idiopathic pulmonary fibrosis and outcomes of nintedanib treatment: an observational study. Ann Med 2024; 56:2323097. [PMID: 38581666 PMCID: PMC11000612 DOI: 10.1080/07853890.2024.2323097] [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: 10/08/2023] [Accepted: 02/21/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND Anxiety and depression are common comorbidities in idiopathic pulmonary fibrosis (IPF) that impair health-related quality of life. However, there is a lack of studies focusing on the mental disorder of IPF after antifibrotic treatment and their related predictive factors. METHODS Patients with an initial diagnosis of IPF were enrolled. Data on demographics, lung function, Generalized Anxiety Disorder-7 (GAD-7) Scale, Patient Health Questionnaire 9 (PHQ-9), Patient Health Questionnaire-15 (PHQ-15), and St. George's Respiratory Questionnaire total score(SGRQ-T) were collected. Changes in anxiety, depression, somatic symptoms, and quality of life scores before and after nintedanib treatment were compared, and the related predictive factors were analyzed. RESULTS A total of 56 patients with a first diagnosis of IPF were enrolled, with 42 and 35 patients suffering from anxiety and depression, respectively. The GAD-7, PHQ-9, PHQ-15, and SGRQ scores were higher in the anxiety and depression groups. SGRQ total score (SGRQ-T) [OR = 1.075, 95%CI= (1.011, 1.142)] was an independent predictor of IPF combined with anxiety (p < 0.05); SGRQ-T [OR = 1.080, 95%CI= (1.001, 1.167)] was also an independent predictor of IPF combined with depression (p < 0.05). After treatment, GAD-7, PHQ-9, PHQ-15, and SGRQ scores decreased (p < 0.05). ΔSGRQ-T significantly affected ΔGAD-7 (β = 0.376, p = 0.009) and ΔPHQ-9 (β = 0.329, p = 0.022). CONCLUSION Anxiety and depression in IPF patients are closely related to somatic symptoms, pulmonary function, and quality of life. The SGRQ-T score is of great value for assessing anxiety and depression in patients with IPF. Short-term treatment with nintedanib antifibrotic therapy can alleviate anxiety and depression in IPF patients.
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Affiliation(s)
- Xing He
- Department of Pulmonary and Critical Care Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
- Department of Pulmonary and Critical Care Medicine, Cheng Du Qing Cheng Mt. Hospital, Chongzhou City, Chengdu, Sichuan Province, China
| | - Jiaqi Ji
- Department of Pulmonary and Critical Care Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Zongmin Pei
- Department of Psychosomatic Medicine, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), Chengdu, Sichuan Province, China
| | - Zeli Luo
- Department of Critical Care Medicine, Wenjiang District People's Hospital, Chengdu, Sichuan Province, China
| | - Siyu Fang
- Department of Pulmonary and Critical Care Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Xiaoqin Liu
- Department of Pulmonary and Critical Care Medicine, Cheng Du Qing Cheng Mt. Hospital, Chongzhou City, Chengdu, Sichuan Province, China
| | - Yan Lei
- Department of Pulmonary and Critical Care Medicine, Cheng Du Qing Cheng Mt. Hospital, Chongzhou City, Chengdu, Sichuan Province, China
| | - Haiying Yan
- Department of Pulmonary and Critical Care Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
- Department of Pulmonary and Critical Care Medicine, Cheng Du Qing Cheng Mt. Hospital, Chongzhou City, Chengdu, Sichuan Province, China
| | - Lu Guo
- Department of Pulmonary and Critical Care Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
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Sabbagh HJ, Abdelaziz W, Quritum M, AlKhateeb NA, Abourdan J, Qureshi N, Qureshi S, Hamoud AHN, Mahmoud N, Odeh R, Al-Khanati NM, Jaber R, Balkhoyor AL, Shabi M, Folayan MO, Alade O, Gomaa N, Alnahdi R, Mahmoud NA, El Wazziki H, Alnaas M, Samodien B, Mahmoud RA, Abu Assab N, Saad S, Alhachim SG, El Tantawi M. Cigarettes' use and capabilities-opportunities-motivation-for-behavior model: a multi-country survey of adolescents and young adults. Front Public Health 2022; 10:875801. [PMID: 35937229 PMCID: PMC9353685 DOI: 10.3389/fpubh.2022.875801] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/27/2022] [Indexed: 01/08/2023] Open
Abstract
The use of cigarettes among adolescents and young adults (AYA) is an important issue. This study assessed the association between regular and electronic-cigarettes use among AYA and factors of the Capability-Motivation-Opportunity-for-Behavior-change (COM-B) model. A multi-country survey was conducted between August-2020 and January-2021, Data was collected using the Global-Youth-Tobacco-Survey and Generalized-Anxiety-Disorder-7-item-scale. Multi-level logistic-regression-models were used. Use of regular and electronic-cigarettes were dependent variables. The explanatory variables were capability-factors (COVID-19 status, general anxiety), motivation-factors (attitude score) and opportunity-factors (country-level affordability scores, tobacco promotion-bans, and smoke free-zones) controlling for age and sex. Responses of 6,989-participants from 25-countries were used. Those who reported that they were infected with COVID-19 had significantly higher odds of electronic-cigarettes use (AOR = 1.81, P = 0.02). Normal or mild levels of general anxiety and negative attitudes toward smoking were associated with significantly lower odds of using regular-cigarettes (AOR = 0.34, 0.52, and 0.75, P < 0.001) and electronic-cigarettes (AOR = 0.28, 0.45, and 0.78, P < 0.001). Higher affordability-score was associated with lower odds of using electronic-cigarettes (AOR = 0.90, P = 0.004). Country-level-smoking-control policies and regulations need to focus on reducing cigarette affordability. Capability, motivation and opportunity factors of the COM-B model were associated with using regular or electronic cigarettes.
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Affiliation(s)
- Heba Jafar Sabbagh
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- *Correspondence: Heba Jafar Sabbagh
| | - Wafaa Abdelaziz
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Maryam Quritum
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | | - Joud Abourdan
- Medical Faculty, Istanbul Medipol University, Istanbul, Turkey
| | - Nafeesa Qureshi
- City Quay Dental Practice and Implant Centre, Dundee, Scotland
| | - Shabnum Qureshi
- Department of Education, University of Kashmir, Srinagar, India
| | | | - Nada Mahmoud
- Faculty of Dentistry, National Ribat University, Khartoum, Sudan
| | - Ruba Odeh
- College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Nuraldeen Maher Al-Khanati
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Rawiah Jaber
- General Courses, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Mohammed Shabi
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Omolola Alade
- Department of Preventive and Community Dentistry, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Noha Gomaa
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Raqiya Alnahdi
- Department of Dental Surgery, Oman Dental College, Muscat, Oman
| | | | - Hanane El Wazziki
- Laboratory of Cereal Plant Pathology, National Institute for Argonomic Research, Settat, Morocco
| | - Manal Alnaas
- Division of Imaging Science and Technology, School of Medicine, University of Dundee, Dundee, Scotland
| | - Bahia Samodien
- Western Cape Education Department, Cape Town, South Africa
| | | | | | | | | | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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3
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Powers JM, LaRowe LR, Lape EC, Zvolensky MJ, Ditre JW. Anxiety sensitivity, pain severity and co-use of cigarettes and e-cigarettes among adults with chronic pain. J Behav Med 2021; 44:392-401. [PMID: 33675503 PMCID: PMC11163874 DOI: 10.1007/s10865-021-00210-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 02/18/2021] [Indexed: 12/20/2022]
Abstract
Anxiety sensitivity (fear of potential negative consequences of anxiety-related symptoms/sensations) has been identified as a transdiagnostic factor in comorbid pain and nicotine dependence and evidence suggests that anxiety sensitivity may be indirectly associated with nicotine use via greater pain severity. Therefore, this study tested the hypothesis that anxiety sensitivity is associated with cigarette and e-cigarette use/co-use directly and indirectly via greater pain severity. Participants included 273 online survey respondents with chronic musculoskeletal pain (34% female; Mage = 32.9). Anxiety sensitivity was positively associated with cigarette smoking, e-cigarette use and cigarette/e-cigarette co-use (ps < .05). Furthermore, anxiety sensitivity was indirectly and positively associated with cigarette smoking, e-cigarette use and co-use via greater chronic pain severity. Pain severity may play an important role in associations between anxiety sensitivity and nicotine dependence and prospective research should examine temporal/causal effects of anxiety sensitivity in relation to pain severity and nicotine/tobacco use.
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Affiliation(s)
- Jessica M Powers
- Department of Psychology, Syracuse University, Syracuse, NY, 13244, USA
| | - Lisa R LaRowe
- Department of Psychology, Syracuse University, Syracuse, NY, 13244, USA
| | - Emma C Lape
- Department of Psychology, Syracuse University, Syracuse, NY, 13244, USA
| | | | - Joseph W Ditre
- Department of Psychology, Syracuse University, Syracuse, NY, 13244, USA.
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4
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Mayorga NA, Rogers AH, Smit T, Garey L, Zvolensky MJ. Evaluating the psychometric properties of the e-cigarette barriers to cessation scale. Cogn Behav Ther 2021; 50:492-508. [PMID: 33910485 DOI: 10.1080/16506073.2021.1901773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Evidence suggests that electronic cigarette (e-cigarette) users have difficulty quitting e-cigarettes. The Electronic Cigarette Barriers to Cessation Scale (E-BCS) was developed to assess barriers to cessation among e-cigarette users. Yet, no work has evaluated the psychometric properties of the E-BCS. The current study utilized data from two independent samples of adult e-cigarette users to evaluate the psychometric properties and structure of the E-BCS. In Study 1, competing models of the E-BCS were evaluated, and initial construct validity and reliability were explored using data from 599 adult e-cigarettes users (52.3% female, Mage = 35.16 years, SD = 10.30). Results supported a unidimensional structure for the E-BCS comprised of 18 items. In Study 2, the unidimensional structure of the 18-item E-BCS and construct validity were evaluated among a sample of 516 current e-cigarette using adults (52.3% female; Mage = 34.74, SD = 11.37). Results confirmed the unidimensional structure, measurement invariance across sex, and construct validity across related e-cigarette behavior constructs and psychopathology for the E-BCS. These findings suggest that the E-BCS is a potentially useful clinical instrument for measuring barriers that may interfere with e-cigarette cessation.
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Affiliation(s)
- Nubia A Mayorga
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Andrew H Rogers
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, 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
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5
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Mayorga NA, Chavez J, Garey L, Otto MW, Zvolensky MJ. Affective Vulnerability Across Non-Daily and Daily Electronic Cigarette Users. Behav Med 2021; 47:51-59. [PMID: 31361573 DOI: 10.1080/08964289.2019.1644282] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Electronic cigarette (e-cigarette) use has risen exponentially since its initial introduction. The widespread and growing use of these novel products has prompted increased research to evaluate use from a nuanced perspective that considers patterns and antecedents of use. Specifically, research has identified sociodemographic characteristics related to varying levels of e-cigarette use frequency. Yet, limited research has investigated broad-based psychological factors related to frequent and infrequent e-cigarette use. The current study sought to address this clinically relevant research gap within a cross sectional design. Several affective vulnerability states were evaluated, including anxiety sensitivity, anxious arousal, general distress, and anhedonia across 566 (51.1% female, Mage = 35.3 years, SD = 10.1) non-daily and daily past month, adult e-cigarette users. Results demonstrated that in comparison to non-daily e-cigarette users, daily users evinced significantly higher levels of anxiety sensitivity, anxiety sensitivity cognitive concerns, anxiety sensitivity social concerns, anxiety sensitivity physical concerns, anxious arousal, and general distress. No significant differences were found for anhedonic depression. Overall, the current study provides initial and novel empirical evidence that certain affective vulnerability constructs related to anxiety may be more strongly endorsed by daily e-cigarette users. Importantly, this work adds to evolving, but underdeveloped, e-cigarette models by highlighting the need to consider anxiety-related constructs when evaluating e-cigarette use patterns and behavior.
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Affiliation(s)
| | | | - Lorra Garey
- Department of Psychology, University of Houston
| | - Michael W Otto
- Department of Psychology & Brain Sciences, Boston University
| | - Michael J Zvolensky
- Department of Psychology, University of Houston.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center.,HEALTH Institute, University of Houston
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6
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Prevalence and Epidemiological Profile of Smokers in the Psychiatric Population and General Population: Smokers in Psychiatric Population. J Addict Nurs 2020; 31:E13-E24. [PMID: 32868617 DOI: 10.1097/jan.0000000000000353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study aims to estimate the prevalence of smokers living in Brazil who use outpatient and hospital psychiatric services and outpatient services in primary health care services. It also aims to identify the sociodemographic and clinical factors associated with current smoking in these samples. This is a cross-sectional study with 378 participants from a Brazilian city: P1, persons from the mental health outpatient service; and P2, persons from the psychiatric hospital; P3, general population from the primary healthcare center. A Poisson multiple regression model for current smoking was adjusted. The prevalence of smokers was greater in the psychiatric population than those in the primary health care population (mental health outpatient service = 27%, psychiatric hospital = 60.3%, primary healthcare center = 19%). Current smoking is associated with younger groups (15-29 years old: PRadjusted = 3.35; 30-39 years old: PRadjusted = 2.28), Roman Catholicism (PRadjusted = 1.60), not having a religion (PRadjusted = 2.45), severe psychiatric illness (PRadjusted = 3.04), anxiety disorders/other disorders (PRadjusted = 3.96), and the previous and current use of alcohol (PRadjusted = 2.27 and 2.25, respectively) and illicit substances (PRadjusted = 1.81 and 2.00, respectively). In conclusion, the independent factors associated with current smoking are age, religion, psychiatric diagnosis, and use of alcohol/illicit substances.
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7
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Guillot CR, Blackledge SM, Douglas ME, Cloutier RM, Liautaud MM, Pang RD, Kirkpatrick MG, Leventhal AM. Indirect Associations of Anxiety Sensitivity with Tobacco, Alcohol, and Other Drug Use Problems Through Emotional Disorder Symptoms in Adolescents. Behav Med 2020; 46:161-169. [PMID: 31039083 PMCID: PMC6821558 DOI: 10.1080/08964289.2019.1573797] [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] [Indexed: 12/25/2022]
Abstract
Theoretically, anxiety sensitivity-fear of anxiety symptoms-enhances perception of and emotional reactivity to autonomic arousal and mental distress, thereby increasing negative affect and motivation to use substances for negative reinforcement. Because no prior study of adolescents has tested if anxiety sensitivity is indirectly associated with substance use problems through symptoms of emotional disorders (i.e., disorders involving high levels of negative affect), the current cross-sectional study examined this theoretical pathway. Participants included ninth-grade students from 10 different high schools in the Los Angeles metropolitan area (N = 3005; 54.3% female). Self-report measures of anxiety sensitivity, emotional disorder symptoms, tobacco dependence, and alcohol and other drug problems were administered. Controlling for sex, race/ethnicity, parental education, school, and impulsiveness, we tested the associations of anxiety sensitivity with tobacco, alcohol, and other drug use problems as well as the indirect effects of anxiety sensitivity on each domain of substance use problems through emotional disorder symptoms. Anxiety sensitivity was associated with more severe tobacco dependence and greater alcohol problems and other drug problems, and anxiety sensitivity further was indirectly associated with all three domains of substance use problems through emotional disorder symptoms. Current findings suggest that adolescents high in anxiety sensitivity tend to experience emotional disorder symptoms, which may increase risk for substance use problems. Interventions that target anxiety sensitivity and enhance negative-affect coping skills may assist in preventing and reducing adolescent substance use problems.
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Affiliation(s)
- Casey R. Guillot
- Department of Psychology, University of North Texas, Denton, TX,Corresponding author: Casey Guillot, PhD, University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX 76203-5017; Tel: 1-940-369-8426; Fax: 1-940-565-4682;
| | - Sabrina M. Blackledge
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | | | | | - Madalyn M. Liautaud
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Raina D. Pang
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | | | - Adam M. Leventhal
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA,Department of Psychology, University of California, Los Angeles, CA
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8
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Oliveira RMD, Santos JLF, Furegato ARF. Prevalence and smokers' profile: comparisons between the psychiatric population and the general population. Rev Lat Am Enfermagem 2019; 27:e3149. [PMID: 31038640 PMCID: PMC6528629 DOI: 10.1590/1518-8345.2976.3149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 02/07/2019] [Indexed: 11/21/2022] Open
Abstract
Objectives: to identify the prevalence of smokers between the psychiatric population and
the general population; to compare the personal, socio-demographic and
clinical profile of smokers and non-smokers in the psychiatric population
and the general population; to compare the reasons for smoking of these two
population groups. Method: this is a cross-sectional descriptive-analytical epidemiological study with
378 patients from three services: Ambulatory Mental Health, Psychiatric
Hospital, and Basic Health Unit. Interviews were conducted with three
questionnaires. The Chi-square and Kruskal-Wallis tests were applied. Results: in the total of the 378 participants, 67% were women and 69% were over 40
years old. There was a higher prevalence of smokers among men, young people,
illiterates, singles and with more than one government benefit. Smokers
prevailed among schizophrenics, chronic patients, who used ≥ 3 psychotropic
drugs and had a history of ≥ 4 psychiatric hospitalizations and/or suicide
attempts. The main reason for smoking was the improvement of negative
feelings. Conclusion: the prevalence of smokers is higher in the psychiatric population (especially
among severely ill patients) and among men, young people, unmarried and with
socioeconomic losses. The main reason for smoking is tension/relaxation
relief. This study provides nurses and other professionals with knowledge
capable of subsidizing the planning of smoking interventions in the
Brazilian population.
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Affiliation(s)
| | | | - Antonia Regina Ferreira Furegato
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
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9
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Guillot CR, Blumenthal H, Zvolensky MJ, Schmidt NB. Anxiety sensitivity components in relation to alcohol and cannabis use, motives, and problems in treatment-seeking cigarette smokers. Addict Behav 2018; 82:166-173. [PMID: 29544169 DOI: 10.1016/j.addbeh.2018.03.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 02/06/2018] [Accepted: 03/06/2018] [Indexed: 12/14/2022]
Abstract
Anxiety sensitivity (AS)- fear of anxiety symptoms and their potential negative consequences-has been implicated in the development of substance use problems and motivation to use substances for coping with distress, though the AS components (physical, cognitive, and social concerns) have not been studied extensively in relation to alcohol- and cannabis-related variables. In a cross-sectional design, self-report measures of AS and alcohol and cannabis use, motives, and problems were administered to 364 treatment-seeking cigarette smokers with a history of alcohol and cannabis use. In both adjusted and unadjusted analyses, linear regression models indicated that AS cognitive concerns are related to cannabis-use conformity motives, alcohol-use coping motives, and alcohol problems; AS physical and cognitive concerns are related to greater cannabis problems specifically in males; and AS social concerns are associated with greater social, coping, enhancement, and conformity drinking motives. AS cognitive and physical concerns were also related to greater alcohol and cannabis problems, respectively, in subsamples limited to 214 current alcohol users and 170 current cannabis users. Together with prior work, current findings suggest that it may be beneficial to focus more on addressing AS cognitive concerns in individuals with tobacco-alcohol problem comorbidity, whereas it may be beneficial to focus on addressing both AS physical and cognitive concerns in males with tobacco-cannabis problem comorbidity. In addition, cigarette smokers high in AS social concerns may benefit from relaxation training to lessen their social anxiety as well as behavioral activation to enhance their positive affect.
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10
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Zvolensky MJ, Garey L, Allan NP, Farris SG, Raines AM, Smits JAJ, Kauffman BY, Manning K, Schmidt NB. Effects of anxiety sensitivity reduction on smoking abstinence: An analysis from a panic prevention program. J Consult Clin Psychol 2018; 86:474-485. [PMID: 29683703 PMCID: PMC6022361 DOI: 10.1037/ccp0000288] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Scientific evidence implicates anxiety sensitivity (AS) as a risk factor for poor smoking cessation outcomes. Integrated smoking cessation programs that target AS may lead to improved smoking cessation outcomes, potentially through AS reduction. Yet, little work has evaluated the efficacy of integrated smoking cessation treatment on smoking abstinence. The present study prospectively examined treatment effects of a novel AS reduction-smoking cessation intervention relative to a standard smoking cessation intervention on smoking abstinence. METHOD Participants (N = 529; 45.9% male; Mage = 38.23, SD = 13.56) included treatment-seeking smokers who received either a 4-session integrated anxiety-reduction and smoking cessation intervention (Smoking Treatment and Anxiety Management Program; [STAMP]) or a 4-session standard smoking cessation program (SCP). The primary aims focused on examining the effects of STAMP on (a) AS reduction during treatment, (b) early and late smoking point prevalence abstinence, and (c) the mechanistic function of AS reduction on treatment effects across early and late smoking abstinence. RESULTS Results indicated a significantly greater decline in AS in STAMP relative to SCP (B = -.72, p < .001). Treatment condition did not significantly directly predict early or late abstinence. However, the effect of STAMP on early abstinence was significantly mediated by reductions in AS (indirect = .16, 95% CI [.02, .40]). CONCLUSIONS Findings provide evidence for the efficacy of a novel, integrated anxiety and smoking cessation treatment to reduce AS. Moreover, the meditation pathway from STAMP to early abstinence through reductions in AS suggest that AS is a clinically important mechanism of change for smoking cessation treatment and research. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - Samantha G Farris
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | | | - Jasper A J Smits
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin
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11
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Kotlyar M, Chau HT, Thuras P. Effects of smoking and paroxetine on stress-induced craving and withdrawal symptoms. JOURNAL OF SUBSTANCE USE 2018; 23:655-659. [PMID: 31768127 DOI: 10.1080/14659891.2018.1489008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background When smokers relapse, many cite stressful circumstances as the cause. Most smoking cessation medications do not prevent stress induced increases in craving and withdrawal symptom severity; however the effect of smoking prior to stress exposure on symptom severity is unclear. Methods We examined how smoking a cigarette immediately prior to a stressful task affects craving and withdrawal symptom severity by analyzing data from a double-blind, crossover study assessing paroxetine's effects on the physiological response to the combination of stress and smoking. Measures were obtained prior to and following smoking / stress exposure and following a subsequent 30 minute period at two laboratory sessions (i.e., after one month each of paroxetine and placebo). Results Among study completers (n=63), severity of craving decreased from the beginning of the session to immediately following the smoking / stress exposure (p<0.01) and severity of smoking urges decreased from the beginning to the end of the laboratory session (p<0.001). Withdrawal symptoms were less severe while taking paroxetine vs. placebo (p<0.05) but no treatment x time effects were observed. Conclusions Additional research is needed to identify interventions that could similarly decrease stress induced craving in order to determine if smoking cessation rates can be increased.
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Affiliation(s)
- Michael Kotlyar
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota; 308 Harvard Street SE, Minneapolis, MN 55455.,Department of Psychiatry, University of Minnesota
| | - Hannah T Chau
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota; 308 Harvard Street SE, Minneapolis, MN 55455
| | - Paul Thuras
- Department of Psychiatry, University of Minnesota.,Minneapolis VA Health Care System
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12
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Yuan M, Guo X, Li X, Chen X, Wang C, Li Y. The moderating role of regulatory emotional self-efficacy on smoking craving: An ecological momentary assessment study. Psych J 2017; 7:5-12. [PMID: 29171689 DOI: 10.1002/pchj.188] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/27/2017] [Accepted: 08/01/2017] [Indexed: 01/30/2023]
Abstract
Emotion is presumed as a major reason for smoking, but this hypothesis needs support from data with high ecological validity. Regulatory emotional self-efficacy (RESE) is key for emotion regulation, therefore RESE is likely to moderate the relationship between emotional states and smoking. The present study used the ecological momentary assessment (EMA) to record the levels of pleasure, arousal, and smoking craving in 33 male current smokers' daily lives, and examined the moderating effect of RESE in the prediction relationship between emotion and craving. The results showed that either end of the pleasure dimension, namely the high positive or high negative affect, predicted higher smoking craving. A similar pattern was also discovered in the arousal dimension, in which either of the activation and deactivation ends predicted higher smoking craving. Moreover, the prediction of negative affect on smoking craving was weakened by higher RESE, especially by the higher self-efficacy in managing negative emotions. In conclusion, smoking craving is closely related with immediate emotional states, and RESE reveals promising value in the reduction of smoking behavior. We discuss the possibility of expanding the RESE frame.
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Affiliation(s)
- Ming Yuan
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Science, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xucheng Guo
- School of Public Administration, Hunan Normal University, Changsha, China
| | - Xi Li
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Science, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xijing Chen
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Science, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Chunguang Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Science, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.,Beijing Educational Correction Bureau, Beijing, China
| | - Yonghui Li
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Science, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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13
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Demonstration of an Integrated Treatment for Smoking Cessation and Anxiety Symptoms in People With HIV: A Clinical Case Study. COGNITIVE AND BEHAVIORAL PRACTICE 2017. [DOI: 10.1016/j.cbpra.2016.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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14
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Kopel LS, Petty CR, Gaffin JM, Sheehan WJ, Baxi SN, Kanchongkittiphon W, Fu C, Gold DR, Phipatanakul W. Caregiver stress among inner-city school children with asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2017; 5:1132-1134.e3. [PMID: 28433340 DOI: 10.1016/j.jaip.2017.02.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 02/03/2017] [Accepted: 02/21/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Lianne S Kopel
- Division of Respiratory Medicine, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Carter R Petty
- Clinical Research Center, Boston Children's Hospital, Boston, Mass
| | - Jonathan M Gaffin
- Division of Respiratory Diseases, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - William J Sheehan
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass
| | - Sachin N Baxi
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass
| | - Watcharoot Kanchongkittiphon
- Department of Pediatrics, Children's Hospital of Michigan, Detroit, Mich; Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chunxia Fu
- Division of Respiratory Epidemiology, Channing Laboratory, Brigham and Women's Hospital, Boston, Mass
| | - Diane R Gold
- Division of Respiratory Epidemiology, Channing Laboratory, Brigham and Women's Hospital, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Wanda Phipatanakul
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass.
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15
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Powers MB, Davis ML, Kauffman BY, Baird SO, Zvolensky M, Rosenfield D, Marcus BH, Church TS, Frierson G, Otto MW, Smits JAJ. Anxiety sensitivity and smoking variability among treatment seeking smokers. ADDICTIVE DISORDERS & THEIR TREATMENT 2016; 15:136-142. [PMID: 27672353 PMCID: PMC5034872 DOI: 10.1097/adt.0000000000000075] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Anxiety sensitivity (AS) is associated with poor smoking cessation outcomes. One reason may be that smokers with high AS smoke differently (i.e., to manage negative affect and uncomfortable bodily sensations) than other smokers, leading to stronger addiction (due to an affect/sensation based and thereby highly variable rather than a regular smoking routine). Thus, we examined the relationship between AS and smoking variability in a group of treatment-seeking smokers. METHODS Participants (N = 136; 52.2% female; Mage = 44.19 years, SD = 11.29) were daily smokers with elevated AS (AS≥20 on the Anxiety Sensitivity Index 16-item at prescreen) recruited as part of a larger randomized controlled trial for smoking cessation. Most participants were Caucasian (73%), educated (with 76% attending some college), unmarried (73%), and employed full-time (56%). They smoked, on average, 17 cigarettes per day. RESULTS Consistent with prediction, a regression analysis of baseline assessments and a longitudinal analysis with multilevel modeling (MLM) both showed higher AS was associated with greater variability in cigarettes smoked per day while controlling for gender, age, ethnicity, and income. CONCLUSIONS This finding encourages investigation of how AS might interact with clinical strategies using a fixed smoking taper as part of quit attempts.
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Affiliation(s)
- Mark B. Powers
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| | - Michelle L. Davis
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| | - Brooke Y. Kauffman
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| | - Scarlett O. Baird
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| | - Michael Zvolensky
- Department of Psychology, University of Houston, Houston, TX
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - David Rosenfield
- Department of Psychology, Southern Methodist University, Dallas, TX
| | - Bess H. Marcus
- Department of Family Medicine and Public Health, University of California, San Diego, CA
| | | | | | - Michael W. Otto
- Department of Psychological and Brain Sciences, Boston University, Boston, MA
| | - Jasper A. J. Smits
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
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16
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Lemieux A, Olson L, Nakajima M, Schulberg L, al'Absi M. Life adversity is associated with smoking relapse after a quit attempt. Addict Behav 2016; 60:71-7. [PMID: 27100471 DOI: 10.1016/j.addbeh.2016.03.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 01/25/2016] [Accepted: 03/29/2016] [Indexed: 11/18/2022]
Abstract
Multiple cross-sectional studies have linked adverse childhood events and adult adversities to current smoking, lifetime smoking, and former smoking. To date, however, there have been no direct observational studies assessing the influence of adversities on smoking relapse. We prospectively followed 123 participants, 86 of whom were habitual smokers, from pre-quit ad libitum smoking to four weeks post-quit. Thirty-seven non-smokers were also tested in parallel as a comparison group. Subjects provided biological samples for confirmation of abstinence status and self-report history of adversities such as abuse, neglect, family dysfunction, incarceration, and child-parent separation. They also completed mood and smoking withdrawal symptom measures. The results indicated that within non-smokers and smokers who relapsed within the first month of a quit attempt, but not abstainers, females had significantly higher adversity scores than males. Cigarette craving, which was independent from depressive affect, increased for low adversity participants, but not those with no adversity nor high adversity. These results demonstrate that sex and relapse status interact to predict adversity and that craving for nicotine may be an important additional mediator of relapse. These results add further support to the previous cross-sectional evidence of an adversity and smoking relationship. Further studies to clarify how adversity complicates smoking cessation and impacts smoking behaviors are warranted.
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Affiliation(s)
- Andrine Lemieux
- University of Minnesota Medical School, Duluth, MN, United States
| | - Leif Olson
- University of Minnesota Medical School, Duluth, MN, United States
| | | | - Lauren Schulberg
- University of Minnesota Medical School, Duluth, MN, United States
| | - Mustafa al'Absi
- University of Minnesota Medical School, Duluth, MN, United States; Department of Psychiatry, University of Minnesota, Twin Cities, Minneapolis, MN, United States; Department of Family Medicine and Community Health, University of Minnesota, Twin Cities, Minneapolis, MN, United States.
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17
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Otto MW, Eastman A, Lo S, Hearon BA, Bickel WK, Zvolensky M, Smits JAJ, Doan SN. Anxiety sensitivity and working memory capacity: Risk factors and targets for health behavior promotion. Clin Psychol Rev 2016; 49:67-78. [PMID: 27611632 DOI: 10.1016/j.cpr.2016.07.003] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 06/03/2016] [Accepted: 07/25/2016] [Indexed: 11/15/2022]
Abstract
Understanding the nature and influence of specific risk profiles is increasingly important for health behavior promotion. The purpose of this article is to document the value of two factors-anxiety sensitivity (AS) and working memory capacity (WMC)-for enhancing risk for the initiation and/or maintenance of a range of negative health behaviors. AS is a distress-related risk factor that potentiates avoidance/coping motivations for negative health behaviors. Stress provides the conditions for negative somatic and affective states, and AS amplifies the aversiveness of these experiences and correspondingly hinders adaptive functioning. In contrast, low WMC is hypothesized to exert its effect by decreasing the capacity to filter out current temptations, attenuating a focus on longer-term goals and impairing the application of relevant coping skills at times of stress. In this review, we provide conceptual models for the separate roles of high AS and low WMC in negative health behaviors, review the influence of these factors on specific health behavior exemplars (eating behaviors/obesity, physical activity, smoking, alcohol use, and sleep promotion), provide preliminary evidence for their value as independent treatment targets for health-behavior promotion, and encourage specific research directions in relation to these variables.
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Affiliation(s)
- Michael W Otto
- Department of Psychological and Brain Sciences, Boston University, USA.
| | - Abraham Eastman
- Department of Psychological and Brain Sciences, Boston University, USA
| | - Stephen Lo
- Department of Psychological and Brain Sciences, Boston University, USA
| | | | - Warren K Bickel
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, USA
| | - Michael Zvolensky
- University of Houston, USA; The University of Texas MD Anderson Cancer Center, USA
| | - Jasper A J Smits
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, USA
| | - Stacey N Doan
- Department of Psychology, Claremont McKenna College, USA
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18
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Martínez-Vispo C, Becoña E. La sensibilidad a la ansiedad y el consumo de tabaco: una revisión. ANSIEDAD Y ESTRES-ANXIETY AND STRESS 2016. [DOI: 10.1016/j.anyes.2016.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Parkerson HA, Asmundson GJG. The role of pain intensity and smoking expectancies on smoking urge and behavior following experimental pain induction. Drug Alcohol Depend 2016; 164:166-171. [PMID: 27234659 DOI: 10.1016/j.drugalcdep.2016.05.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 05/05/2016] [Accepted: 05/09/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Contemporary models of pain and smoking posit a cyclical relationship wherein smoking reduces pain in the short term but, ultimately, serves to exacerbate it in the long term. Such models were influenced by initial experimental findings suggesting situational pain is sufficient to increase smoking-urge and behavior. The initial experimental findings have not yet been replicated and potential mediating smoking motives and anxiety variables have not been explored. METHODS The current investigation was designed with the aims of exploring whether (a) electrical heat-pain is sufficient to increase smoking-urge, (b) pain intensity, anxiety sensitivity, and smoking expectancies for pain relief account for variance in post-pain smoking-urge, and (c) individuals are more likely to smoke following a pain experience. RESULTS Participants in the heat-pain condition (n=16) reported greater smoking-urge than those in the no-pain control condition (n=16). In the heat-pain condition, approximately 31% of variance in smoking-urge was accounted for by the belief that smoking would help with pain coping or relief. Anxiety sensitivity and pain intensity ratings were not significant predictors of smoking-urge. Significantly more individuals in the heat-pain condition attempted to smoke (100%) after the pain manipulation than those in the no-pain control condition (62.5%). CONCLUSIONS Acute heat-pain increases smoking-urge and behavior, especially for individuals with expectancies that smoking will help with pain coping. Pain and pain-related smoking expectancies may serve as barriers to smoking cessation for those experiencing pain. Findings provide support for smoking cessation interventions strategies aimed at pain management and challenging smoking expectancies for pain coping/relief.
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Affiliation(s)
- Holly A Parkerson
- Department of Psychology, University of Regina, Regina, Saskatchewan S4S 0A2, Canada, Canada.
| | - Gordon J G Asmundson
- Department of Psychology, University of Regina, Regina, Saskatchewan S4S 0A2, Canada, Canada
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20
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Jawinski P, Mauche N, Ulke C, Huang J, Spada J, Enzenbach C, Sander C, Hegerl U, Hensch T. Tobacco use is associated with reduced amplitude and intensity dependence of the cortical auditory evoked N1-P2 component. Psychopharmacology (Berl) 2016; 233:2173-2183. [PMID: 26983415 DOI: 10.1007/s00213-016-4268-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 03/02/2016] [Indexed: 10/22/2022]
Abstract
RATIONALE Tobacco use is linked to cerebral atrophy and reduced cognitive performance in later life. However, smoking-related long-term effects on brain function remain largely uncertain. Previous studies suggest that nicotine affects serotonergic signaling, and the intensity dependence (alias loudness dependence) of the auditory evoked N1-P2 potential has been proposed as a marker of serotonergic neurotransmission. OBJECTIVE In the present study, we assesed the effects of chronic smoking on amplitude and intensity dependence of the auditory evoked N1-P2 potential. METHODS Subjects underwent a 15-min intensity dependence of auditory evoked potentials (IAEP) paradigm. From N = 1739 eligible subjects (40-79 years), we systematically matched current smokers, ex-smokers, and never-smokers by sex, age, alcohol and caffeine consumption, and socioeconomic status. Between-group differences and potential dose-dependencies were evaluated. RESULTS Analyses revealed higher N1-P2 amplitudes and intensity dependencies in never-smokers relative to ex- and current smokers, with ex-smokers exhibiting intermediate intensity dependencies. Moreover, we observed pack years and number of cigarettes consumed per day to be inversely correlated with amplitudes in current smokers. CONCLUSIONS According to the IAEP serotonin hypothesis, our results suggest serotonin activity to be highest in current smokers, intermediate in ex-smokers, and lowest in never-smokers. To our knowledge, the present study is the first providing evidence for a dose-dependent reduction in N1-P2 amplitudes. Further, we extend prior research by showing reduced amplitudes and intensity dependencies in ex-smokers even 25 years, on average, after cessation. While we can rule out several smoking-related confounders to bias observed associations, causal inferences remain to be established by future longitudinal studies.
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Affiliation(s)
- Philippe Jawinski
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany. .,Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany. .,Depression Research Center of the German Depression Foundation, Leipzig, Germany.
| | - Nicole Mauche
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Christine Ulke
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Depression Research Center of the German Depression Foundation, Leipzig, Germany
| | - Jue Huang
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Janek Spada
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany.,Depression Research Center of the German Depression Foundation, Leipzig, Germany
| | - Cornelia Enzenbach
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Christian Sander
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany.,Depression Research Center of the German Depression Foundation, Leipzig, Germany
| | - Ulrich Hegerl
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany.,Depression Research Center of the German Depression Foundation, Leipzig, Germany
| | - Tilman Hensch
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
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21
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Guillot CR, Leventhal AM, Raines AM, Zvolensky MJ, Schmidt NB. Anxiety sensitivity facets in relation to tobacco use, abstinence-related problems, and cognitions in treatment-seeking smokers. Addict Behav 2016; 56:30-5. [PMID: 26802790 DOI: 10.1016/j.addbeh.2016.01.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 01/09/2016] [Accepted: 01/11/2016] [Indexed: 01/15/2023]
Abstract
Anxiety sensitivity (AS)--fear of anxiety-related experiences--has been implicated in smoking motivation and maintenance. In a cross-sectional design, we examined AS facets (physical, cognitive, and social concerns) in relation to tobacco use, abstinence-related problems, and cognitions in 473 treatment-seeking smokers. After controlling for sex, race, age, educational attainment, hypertension status, and neuroticism, linear regression models indicated that AS physical and cognitive concerns were associated with tobacco dependence severity (β=.13-.14, p<.01), particularly the severity of persistent smoking regardless of context or time of day (β=.14-.17, p<.01). All three AS facets were related to more severe problems during past quit attempts (β=.23-.27, p<.001). AS cognitive and social concerns were related to negative affect reduction smoking motives (β=.14, p<.01), but only the social concerns aspect of AS was related to pleasurable relaxation smoking motives and positive and negative reinforcement-related smoking outcome expectancies (β=.14-.17, p<.01). These data suggest that AS physical and cognitive concerns are associated with negative reinforcement-related smoking variables (e.g., abstinence-related problems), whereas the social concerns aspect of AS is associated with positive and negative reinforcement-related smoking variables. Together with past findings, current findings can usefully guide AS-oriented smoking cessation treatment development and refinement.
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22
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Smits JAJ, Zvolensky MJ, Davis ML, Rosenfield D, Marcus BH, Church TS, Powers MB, Frierson GM, Otto MW, Hopkins LB, Brown RA, Baird SO. The Efficacy of Vigorous-Intensity Exercise as an Aid to Smoking Cessation in Adults With High Anxiety Sensitivity: A Randomized Controlled Trial. Psychosom Med 2016; 78:354-64. [PMID: 26513517 PMCID: PMC4844851 DOI: 10.1097/psy.0000000000000264] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES High anxiety sensitivity predicts poor smoking cessation outcomes. Aerobic exercise reduces anxiety sensitivity and aspects of the risk conferred by anxiety sensitivity. In the current study, we examined whether exercise can aid smoking cessation in adults with high anxiety sensitivity. METHODS Participants were sedentary and low-activity adult daily smokers (n = 136) with elevated prescreen anxiety sensitivity. Participants received 15 weeks of standard smoking cessation treatment (ST; cognitive behavioral therapy plus nicotine replacement therapy). In addition, participants were simultaneously randomized to 15 weeks of either an exercise intervention (ST + EX; n = 72) or a wellness education control condition (ST + CTRL; n = 64). Self-reported smoking abstinence was assessed weekly during the intervention, at the end of treatment (10 weeks after the target quit date), and at 4 and 6 months after the target quit date. Abstinence was verified by expired carbon monoxide readings and saliva cotinine. RESULTS Results indicated that point prevalence abstinence (PPA) and prolonged abstinence (PA) rates were significantly higher for ST + EX than for ST + CTRL at each of the major end points among persons with high anxiety sensitivity (PPA: b = -0.91, standard error [SE] = 0.393, t(1171) = -2.33, p = .020; PA: b = -0.98, SE = 0.346, t(132) = -2.84, p = .005), but not among those with low anxiety sensitivity (PPA: b = -0.23, SE = 0.218, t(1171) = -1.06, p = .29; PA: b = -0.31, SE = 0.306, t(132) = -1.01, p = .32). CONCLUSIONS The present results suggest that exercise facilitates the odds of quit success for smokers with high levels of anxiety sensitivity and therefore may be a useful therapeutic tactic for this high-risk segment of the smoking population. TRIAL REGISTRATION ClinicalTrials.gov, NCT01065506.
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Affiliation(s)
- Jasper A. J. Smits
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center
| | - Michelle L. Davis
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin
| | | | - Bess H. Marcus
- Department of Family & Preventive Medicine, University of California at San Diego
| | | | - Mark B. Powers
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin
| | | | - Michael W. Otto
- Department of Psychology, Boston University; Department of Psychological and Brain Sciences, Boston University
| | | | | | - Scarlett O. Baird
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin
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23
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Pohjola V, Rekola A, Kunttu K, Virtanen JI. Association between dental fear and oral health habits and treatment need among University students in Finland: a national study. BMC Oral Health 2016; 16:26. [PMID: 26922793 PMCID: PMC4769491 DOI: 10.1186/s12903-016-0179-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 02/12/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND First-year university students are in a new, independent life situation, which may affect health behaviour, including oral health habits. The aim of this study was to evaluate the association between dental fear and oral health habits, while considering the simultaneous effects of attitude toward food and treatment need at dental check-ups. METHODS The data (n = 8514) for this national cross-sectional study were collected from health registers of Finnish Student Health Service. As part of health examination all first-year university students in Finland were sent an electronic questionnaire asking about general, psychological and oral health, and health habits. Dental fear was measured by the question: "How afraid are you of visiting a dentist?" (reply alternatives: "Not at all", "Somewhat" and "Very"). Chi-square tests and Multiple logistic regression analyses were used to determine the associations between dental fear and oral health habits (tooth brushing, tobacco use, frequency of eating and drinking, eating habits and interval between dental check-ups) as well as attitude to food and treatment need at dental check-ups while controlling for age, gender, general mood and feelings in social situations. RESULTS Of the oral health habits, tooth brushing and tobacco use were associated with dental fear. Those who brushed their teeth once a day or less often or used tobacco regularly were more likely to have high dental fear than those who brushed their teeth twice a day or more often or used tobacco occasionally or not at all. Students who reported not having a normal attitude to food were more likely to have high dental fear than were those reporting normal attitude to food, but the frequency of eating and drinking was not associated with dental fear. Students who reported needing treatment frequently or at every dental check-up were more likely to have high dental fear than those who reported rarely or never needing treatment. CONCLUSION Those students with high dental fear seem to be at risk of having poor oral health habits and abnormal attitude to food, which may increase the risk of deterioration of oral health and the need for treatment. Dental teams should make efforts in helping fearful patients to find motivation for good oral health habits.
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Affiliation(s)
- Vesa Pohjola
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland. .,Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
| | - Aino Rekola
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | | | - Jorma I Virtanen
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland. .,Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
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24
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Langdon KJ, Farris SG, Øverup CS, Zvolensky MJ. Associations Between Anxiety Sensitivity, Negative Affect, and Smoking During a Self-Guided Smoking Cessation Attempt. Nicotine Tob Res 2015; 18:1188-95. [PMID: 26553948 DOI: 10.1093/ntr/ntv253] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 10/28/2015] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Anxiety sensitivity (AS), defined as the extent to which individuals believe anxiety and internal sensations have harmful consequences, is associated with the maintenance and relapse of smoking. Yet, little is known about how AS interplays with negative affect during the quit process in terms of smoking behavior. To address this gap, the current study examined the dynamic interplay between AS, negative affect, and smoking lapse behavior during the course of a self-guided (unaided) quit attempt. METHODS Fifty-four participants (33.3% female; M age = 34.6, SD = 13.8) completed ecological momentary assessment procedures, reporting on negative affect and smoking status via a handheld computer device, three times per day for the initial 14 days of the self-guided cessation attempt. RESULTS As expected, a significant interaction was observed, such that participants characterized by high levels of AS were at a higher risk of smoking on days when negative affect was high (relative to low). Results also revealed a significant interaction between AS and daily smoking lapse behavior in terms of daily change in negative affect. Participants characterized by high levels of AS reported significant increases in same-day negative affect on days when they endorsed smoking relative to days they endorsed abstinence. CONCLUSIONS This study provides novel information about the nature of AS, negative affect, and smoking behavior during a quit attempt. Results suggest there is a need for specialized intervention strategies to enhance smoking outcome among this high-risk group that will meet their unique "affective needs." IMPLICATIONS The current study underscores the importance of developing specialized smoking cessation interventions for smokers with emotional vulnerabilities.
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Affiliation(s)
- Kirsten J Langdon
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, MA; Department of Psychiatry, Boston University School of Medicine, Boston, MA;
| | - Samantha G Farris
- Department of Psychology, University of Houston, Houston, TX; Department of Psychiatry, Alpert Medical School of Brown University, Providence, RI
| | - Camilla S Øverup
- School of Psychology, Fairleigh Dickinson University, Teaneck, NJ
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX; Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX
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25
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Cambiaghi M, Grosso A, Renna A, Concina G, Sacchetti B. Acute administration of nicotine into the higher order auditory Te2 cortex specifically decreases the fear-related charge of remote emotional memories. Neuropharmacology 2015; 99:577-88. [PMID: 26319210 PMCID: PMC4710760 DOI: 10.1016/j.neuropharm.2015.08.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 08/19/2015] [Accepted: 08/21/2015] [Indexed: 01/10/2023]
Abstract
Nicotine elicits several behavioural effects on mood as well as on stress and anxiety processes. Recently, it was found that the higher order components of the sensory cortex, such as the secondary auditory cortex Te2, are essential for the long-term storage of remote fear memories. Therefore, in the present study, we examined the effects of acute nicotine injection into the higher order auditory cortex Te2, on the remote emotional memories of either threat or incentive experiences in rats. We found that intra-Te2 nicotine injection decreased the fear-evoked responses to a tone previously paired with footshock. This effect was cue- and dose-specific and was not due to any interference with auditory stimuli processing, innate anxiety and fear processes, or with motor responses. Nicotine acts acutely in the presence of threat stimuli but it did not determine the permanent degradation of the fear-memory trace, since memories tested one week after nicotine injection were unaffected. Remarkably, nicotine did not affect the memory of a similar tone that was paired to incentive stimuli. We conclude from our results that nicotine, when acting acutely in the auditory cortex, relieves the fear charge embedded by learned stimuli. Nicotine reliefs fear memories. Nicotine acts on long-term memories. Nicotine modulates memory in auditory cortex.
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Affiliation(s)
- Marco Cambiaghi
- Rita Levi-Montalcini Department of Neuroscience, University of Turin, Corso Raffaello 30, I-10125 Turin, Italy.
| | - Anna Grosso
- Rita Levi-Montalcini Department of Neuroscience, University of Turin, Corso Raffaello 30, I-10125 Turin, Italy.
| | - Annamaria Renna
- Rita Levi-Montalcini Department of Neuroscience, University of Turin, Corso Raffaello 30, I-10125 Turin, Italy.
| | - Giulia Concina
- Rita Levi-Montalcini Department of Neuroscience, University of Turin, Corso Raffaello 30, I-10125 Turin, Italy.
| | - Benedetto Sacchetti
- Rita Levi-Montalcini Department of Neuroscience, University of Turin, Corso Raffaello 30, I-10125 Turin, Italy; National Institute of Neuroscience, Italy.
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Jardin C, Bakhshaie J, Schmidt NB, Sharp C, Zvolensky M. Examination of smoking inflexibility as a mechanism linking anxiety sensitivity and severity of smoking behavior. Am J Addict 2015; 24:374-81. [DOI: 10.1111/ajad.12203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 01/07/2015] [Accepted: 01/11/2015] [Indexed: 12/17/2022] Open
Affiliation(s)
- Charles Jardin
- Department of Psychology; University of Houston; Houston Texas
| | - Jafar Bakhshaie
- Department of Psychology; University of Houston; Houston Texas
| | - Norman B. Schmidt
- Department of Psychology; Florida State University; Tallahassee Florida
| | - Carla Sharp
- Department of Psychology; University of Houston; Houston Texas
- Adolescent Treatment Program; The Menninger Clinic; Houston Texas
| | - Michael Zvolensky
- Department of Psychology; University of Houston; Houston Texas
- Department of Behavioral Sciences; University of Texas MD Anderson Cancer Center; Houston Texas
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Anderson SM, Brunzell DH. Anxiolytic-like and anxiogenic-like effects of nicotine are regulated via diverse action at β2*nicotinic acetylcholine receptors. Br J Pharmacol 2015; 172:2864-77. [PMID: 25625469 DOI: 10.1111/bph.13090] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 12/19/2014] [Accepted: 01/19/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND AND PURPOSE Nicotine dose-dependently activates or preferentially desensitizes β2 subunit containing nicotinic ACh receptors (β2*nAChRs). Genetic and pharmacological manipulations assessed effects of stimulation versus inhibition of β2*nAChRs on nicotine-associated anxiety-like phenotype. EXPERIMENTAL APPROACH Using a range of doses of nicotine in β2*nAChR subunit null mutant mice (β2KO; backcrossed to C57BL/6J) and their wild-type (WT) littermates, administration of the selective β2*nAChR agonist, 5I-A85380, and the selective β2*nAChR antagonist dihydro-β-erythroidine (DHβE), we determined the behavioural effects of stimulation and inhibition of β2*nAChRs in the light-dark and elevated plus maze (EPM) assays. KEY RESULTS Low-dose i.p. nicotine (0.05 mg·kg(-) 1) supported anxiolysis-like behaviour independent of genotype whereas the highest dose (0.5 mg·kg(-1) ) promoted anxiogenic-like phenotype in WT mice, but was blunted in β2KO mice for the measure of latency. Administration of 5I-A85380 had similar dose-dependent effects in C57BL/6J WT mice; 0.001 mg·kg(-1) 5I-A85380 reduced anxiety on an EPM, whereas 0.032 mg·kg(-1) 5I-A85380 promoted anxiogenic-like behaviour in both the light-dark and EPM assays. DHβE pretreatment blocked anxiogenic-like effects of 0.5 mg·kg(-1) nicotine. Similarly to DHβE, pretreatment with low-dose 0.05 mg·kg(-1) nicotine did not accumulate with 0.5 mg·kg(-1) nicotine, but rather blocked anxiogenic-like effects of high-dose nicotine in the light-dark and EPM assays. CONCLUSIONS AND IMPLICATIONS These studies provide direct evidence that low-dose nicotine inhibits nAChRs and demonstrate that inhibition or stimulation of β2*nAChRs supports the corresponding anxiolytic-like or anxiogenic-like effects of nicotine. Inhibition of β2*nAChRs may relieve anxiety in smokers and non-smokers alike.
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Affiliation(s)
- S M Anderson
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - D H Brunzell
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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Farris SG, Leventhal AM, Schmidt NB, Zvolensky MJ. Anxiety sensitivity and pre-cessation smoking processes: testing the independent and combined mediating effects of negative affect-reduction expectancies and motives. J Stud Alcohol Drugs 2015; 76:317-25. [PMID: 25785807 PMCID: PMC5374482 DOI: 10.15288/jsad.2015.76.317] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 09/09/2014] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Anxiety sensitivity appears to be relevant in understanding the nature of emotional symptoms and disorders associated with smoking. Negative-reinforcement smoking expectancies and motives are implicated as core regulatory processes that may explain, in part, the anxiety sensitivity-smoking interrelations; however, these pathways have received little empirical attention. METHOD Participants (N = 471) were adult treatment-seeking daily smokers assessed for a smoking-cessation trial who provided baseline data; 157 participants provided within-treatment (pre-cessation) data. Anxiety sensitivity was examined as a cross-sectional predictor of several baseline smoking processes (nicotine dependence, perceived barriers to cessation, severity of prior withdrawal-related quit problems) and pre-cessation processes including nicotine withdrawal and smoking urges (assessed during 3 weeks before the quit day). Baseline negative-reinforcement smoking expectancies and motives were tested as simultaneous mediators via parallel multiple mediator models. RESULTS Higher levels of anxiety sensitivity were related to higher levels of nicotine dependence, greater perceived barriers to smoking cessation, more severe withdrawal-related problems during prior quit attempts, and greater average withdrawal before the quit day; effects were indirectly explained by the combination of both mediators. Higher levels of anxiety sensitivity were not directly related to pre-cessation smoking urges but were indirectly related through the independent and combined effects of the mediators. CONCLUSIONS These empirical findings bolster theoretical models of anxiety sensitivity and smoking and identify targets for nicotine dependence etiology research and cessation interventions.
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Affiliation(s)
| | - Adam M. Leventhal
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California
- Department of Psychology, University of Southern California, Los Angeles, California
| | - Norman B. Schmidt
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, Texas
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Anxiety sensitivity and negative urgency: a pathway to negative reinforcement-related smoking expectancies. J Addict Med 2015; 8:189-94. [PMID: 24662369 DOI: 10.1097/adm.0000000000000017] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Anxiety sensitivity--fear of anxiety symptoms--may increase motivation to smoke by influencing the development of cognitive expectations regarding smoking's negative reinforcing effects; yet, the nature and mechanisms of this pathway are unclear. We hypothesized that relations between anxiety sensitivity and negative reinforcement-related smoking expectancies would be mediated by negative urgency, that is, a trait tendency to act impulsively during negative affect. METHODS In a cross-sectional design, we administered self-report measures of anxiety sensitivity, negative urgency, and negative reinforcement-related smoking outcome and abstinence expectancies to 205 smokers (≥10 cigarettes/d, 34% female, M age = 44.4 years). RESULTS Anxiety sensitivity was associated with stronger expectancies that smoking alleviates negative affect (β = 0.30; P < 0.0001) and smoking abstinence exacerbates aversive withdrawal symptoms (β = 0.24; P = 0.0004). Negative urgency partially mediated the relation between anxiety sensitivity and both types of negative reinforcement-related smoking expectancies (βs ≥ 0.057; Ps ≤ 0.007). Results remained significant after statistically controlling for anxiety and nicotine dependence symptoms. CONCLUSIONS Smokers high in anxiety sensitivity tend to display negative urgency, which in turn is related to greater expectations of negative reinforcement consequences of smoking and smoking abstinence. Treatments that mitigate fear of anxiety symptoms and the tendency to act impulsively in response to negative affect (eg, interoceptive exposure, distress tolerance skills training, and mindfulness training) may be particularly useful in assisting with smoking cessation for high-anxiety sensitivity smokers.
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Leventhal AM, Zvolensky MJ. Anxiety, depression, and cigarette smoking: a transdiagnostic vulnerability framework to understanding emotion-smoking comorbidity. Psychol Bull 2015; 141:176-212. [PMID: 25365764 PMCID: PMC4293352 DOI: 10.1037/bul0000003] [Citation(s) in RCA: 349] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Research into the comorbidity between emotional psychopathology and cigarette smoking has often focused upon anxiety and depression's manifest symptoms and syndromes, with limited theoretical and clinical advancement. This article presents a novel framework to understanding emotion-smoking comorbidity. We propose that transdiagnostic emotional vulnerabilities-core biobehavioral traits reflecting maladaptive responses to emotional states that underpin multiple types of emotional psychopathology-link various anxiety and depressive psychopathologies to smoking. This framework is applied in a review and synthesis of the empirical literature on 3 transdiagnostic emotional vulnerabilities implicated in smoking: (a) anhedonia (Anh; diminished pleasure/interest in response to rewards), (b) anxiety sensitivity (AS; fear of anxiety-related sensations), and (c) distress tolerance (DT; ability to withstand distressing states). We conclude that Anh, AS, and DT collectively (a) underpin multiple emotional psychopathologies, (b) amplify smoking's anticipated and actual affect-enhancing properties and other mechanisms underlying smoking, (c) promote progression across the smoking trajectory (i.e., initiation, escalation/progression, maintenance, cessation/relapse), and (d) are promising targets for smoking intervention. After existing gaps are identified, an integrative model of transdiagnostic processes linking emotional psychopathology to smoking is proposed. The model's key premise is that Anh amplifies smoking's anticipated and actual pleasure-enhancing effects, AS amplifies smoking's anxiolytic effects, and poor DT amplifies smoking's distress terminating effects. Collectively, these processes augment the reinforcing properties of smoking for individuals with emotional psychopathology to heighten risk of smoking initiation, progression, maintenance, cessation avoidance, and relapse. We conclude by drawing clinical and scientific implications from this framework that may generalize to other comorbidities.
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Affiliation(s)
- Adam M Leventhal
- Department of Psychology, Keck School of Medicine, University of Southern California
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31
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Olvera H, Bakhshaie J, Garey L, Jardin C, Schmidt NB, Zvolensky MJ. The role of anxiety sensitivity in the relation between trait worry and smoking behavior. Nicotine Tob Res 2014; 17:682-9. [PMID: 25367093 DOI: 10.1093/ntr/ntu233] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 10/22/2014] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Smoking and anxiety disorders frequently co-occur. Trait worry is a core symptom of anxiety disorders. While research suggests worry processes may be important to certain smoking behaviors, the mechanisms explicating these relations remain unknown. METHOD The current study examined anxiety sensitivity (AS) as a potential mediator for the relation between trait worry and number of years being a daily smoker, latency to first cigarette of the day, smoking rate, heaviness of smoking, and nicotine dependence among treatment-seeking daily smokers (N = 376; 47% female; M age = 37.76, SD = 13.46). RESULTS Consistent with prediction, AS significantly mediated the relations between trait worry and the studied smoking variables. CONCLUSION The present findings suggest it may be useful to clinically address AS among worry-prone, treatment-seeking daily smokers in order to address smoking behavior.
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Affiliation(s)
| | - Jafar Bakhshaie
- Department of Psychology, University of Houston, Houston, TX;
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX
| | - Charles Jardin
- Department of Psychology, University of Houston, Houston, TX
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX; Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX
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Zvolensky MJ, Farris SG, Leventhal A, Schmidt NB. Anxiety sensitivity mediates relations between emotional disorders and smoking. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2014; 28:912-920. [PMID: 25222178 PMCID: PMC4244904 DOI: 10.1037/a0037450] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Research has documented consistent and robust relations between emotional disorders (i.e., depressive and anxiety disorders) and smoking. Yet, it is presently unclear whether anxiety sensitivity--the fear of aversive internal anxiety states--accounts for the relations between emotional disorders and various smoking processes, including nicotine dependence, perceived barriers to smoking cessation, and severity of problematic symptoms during past cessation attempts. Participants (N = 465) were treatment-seeking daily tobacco smokers recruited as part of a larger tobacco-cessation study. Baseline (pretreatment) data were utilized. Emotional disorders were assessed via clinical diagnostic interview; self-report measures were used to assess anxiety sensitivity and 3 criterion variables: nicotine dependence, barriers to smoking cessation, and severity of problematic symptoms while quitting in past attempts. Emotional disorders were predictive of higher levels of nicotine dependence, greater perceived barriers to cessation, and greater severity of problematic symptoms while attempting to quit in the past; each of these relations were accounted for by the indirect effect of anxiety sensitivity. The present findings suggest that anxiety sensitivity may be an important transdiagnostic construct in explicating the nature of the relations between emotional disorders and various smoking processes.
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Affiliation(s)
- Michael J. Zvolensky
- University of Houston, Department of Psychology
- The University of Texas MD Anderson Cancer Center, Department of Behavioral Science
| | | | - Adam Leventhal
- Department of Psychology, University of Southern California
- Department of Preventive Medicine, University of Southern California Keck School of Medicine
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An Anxiety Sensitivity Reduction Smoking-Cessation Program for Spanish-Speaking Smokers (Argentina). COGNITIVE AND BEHAVIORAL PRACTICE 2014. [DOI: 10.1016/j.cbpra.2013.10.005] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Zvolensky MJ, Farris SG, Schmidt NB, Smits JAJ. The role of smoking inflexibility/avoidance in the relation between anxiety sensitivity and tobacco use and beliefs among treatment-seeking smokers. Exp Clin Psychopharmacol 2014; 22:229-237. [PMID: 24490706 PMCID: PMC4112514 DOI: 10.1037/a0035306] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Recent scholarly attention has focused on explicating the nature of tobacco use among anxiety-vulnerable smokers. Anxiety sensitivity (fear of aversive internal anxiety states) is a cognitive-affective individual difference factor related to the development and maintenance of anxiety symptoms and disorders and various smoking processes. The present study examined the cross-sectional associations between anxiety sensitivity and a range of cognitive and behavioral smoking processes, and the mediating role of the tendency to respond inflexibly and with avoidance in the presence of smoking-related distress (i.e., avoidance and inflexibility to smoking [AIS]) in such relations. Participants (n = 466) were treatment-seeking daily tobacco smokers recruited as part of a larger tobacco cessation study. Baseline (pretreatment) data were utilized. Self-report measures were used to assess anxiety sensitivity, AIS, and 4 criterion variables: barriers to smoking cessation, quit attempt history, severity of problematic symptoms reported in past quit attempts, and mood-management smoking expectancies. Results indicated that anxiety sensitivity was indirectly related to greater barriers to cessation, greater number of prior quit attempts and greater mood-management smoking expectancies through the tendency to respond inflexibly/avoid to the presence of distressing smoking-related thoughts, feelings, and internal sensations; but not severity of problems experienced while quitting. The present findings suggest AIS may be an explanatory mechanism between anxiety sensitivity and certain smoking processes.
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Affiliation(s)
- Michael J. Zvolensky
- University of Houston, Department of Psychology
- The University of Texas MD Anderson Cancer Center, Department of Behavioral Science
| | | | | | - Jasper A. J. Smits
- University of Texas at Austin, Department of Psychology and Institute for Mental Health Research
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The association of dehydroepiandrosterone and dehydroepiandrosterone sulfate with anxiety sensitivity and electronic diary negative affect among smokers with and without posttraumatic stress disorder. J Clin Psychopharmacol 2013; 33:556-60. [PMID: 23771199 PMCID: PMC3896952 DOI: 10.1097/jcp.0b013e3182968962] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Posttraumatic stress disorder (PTSD) is associated with increased smoking initiation, maintenance, and relapse. Dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS) are neurosteroids that have been associated with mood measures as well as smoking status, and nicotine is associated with increased DHEA and DHEAS levels. Given the difficulties with mood experienced by smokers with PTSD, the purpose of the current study was to evaluate the association between negative affect and anxiety sensitivity with DHEA and DHEAS levels. Ninety-six smokers with and without PTSD provided blood samples for neurosteroid analyses and completed self-report measures of anxiety sensitivity and electronic diary ratings of negative affect. As expected, PTSD smokers reported higher levels of anxiety sensitivity (F(1,94) = 20.67, partial η2 = 0.18, P < 0.0001) and negative affect (F(1,91) = 7.98, partial η2 = 0.08, P = 0.006). After accounting for age and sex, DHEAS was significantly inversely associated with both anxiety sensitivity (F(3,92) = 6.97, partial η2 = 0.07, P = 0.01) and negative affect (F(3,87) = 10.52, partial η2 = 0.11, P = 0.002) across groups. Effect sizes indicated that these effects are moderate to high. No significant interactions of diagnosis and DHEA(S) levels with mood measures were detected. Given that nicotine is known to elevate DHEA(S) levels, these results suggest that DHEAS may serve as a biomarker of the association between mood and nicotine among smokers. Implications for the results include (1) the use of DHEAS measurement across time and across quit attempts and (2) the potential for careful use of DHEA supplementation to facilitate abstinence during smoking cessation.
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36
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Rosenbaum DL, White KS. The Role of Anxiety in Binge Eating Behavior: A Critical Examination of Theory and Empirical Literature. Health Psychol Res 2013; 1:e19. [PMID: 26973904 PMCID: PMC4768578 DOI: 10.4081/hpr.2013.e19] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 01/03/2013] [Accepted: 01/04/2013] [Indexed: 11/23/2022] Open
Abstract
The purpose of this manuscript is to expand the understanding of binge eating by reviewing the role of aspects of negative affect. Specifically, this paper will present evidence for further investigation of the bearing that anxiety may have in binge eating development and maintenance. A comprehensive review of the literature regarding the relation of binge eating and anxiety was performed. Valuable contributions have been made to the binge eating literature regarding some aspects of negative affect (i.e., depression); however, outside of bulimia nervosa studies, much of the theoretical and empirical binge eating research to date has not directly addressed the role of anxiety. Research supports expansion of investigations of negative emotionality and binge eating to include specific study of anxiety. Greater inclusivity and specificity in the unique contributions of various negative emotions may further the development of temporal models and intervention efforts.
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Affiliation(s)
- Diane L Rosenbaum
- Department of Psychology, University of Missouri - Saint Louis , St. Louis, MO, USA
| | - Kamila S White
- Department of Psychology, University of Missouri - Saint Louis , St. Louis, MO, USA
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Gender differences in attitudes impeding colorectal cancer screening. BMC Public Health 2013; 13:500. [PMID: 23706029 PMCID: PMC3672022 DOI: 10.1186/1471-2458-13-500] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 04/08/2013] [Indexed: 01/13/2023] Open
Abstract
Background Colorectal cancer screening (CRCS) is the only type of cancer screening where both genders reduce risks by similar proportions with identical procedures. It is an important context for examining gender differences in disease-prevention, as CRCS significantly reduces mortality via early detection and prevention. In efforts to increase screening adherence, there is increasing acknowledgment that obstructive attitudes prevent CRCS uptake. Precise identification of the gender differences in obstructive attitudes is necessary to improve uptake promotion. This study randomly sampled unscreened, screening - eligible individuals in Ontario, employing semi-structured interviews to elicit key differences in attitudinal obstructions towards colorectal cancer screening with the aim of deriving informative differences useful in planning promotions of screening uptake. Methods N = 81 participants (49 females, 32 males), 50 years and above, with no prior CRCS, were contacted via random-digit telephone dialing, and consented via phone-mail contact. Altogether, N = 4,459 calls were made to yield N = 85 participants (1.9% response rate) of which N = 4 participants did not complete interviews. All subjects were eligible for free-of-charge CRCS in Ontario, and each was classified, via standard interview by CRCS screening decision-stage. Telephone-based, semi-structured interviews (SSIs) were employed to investigate gender differences in CRCS attitudes, using questions focused on 5 attitudinal domains: 1) Screening experience at the time of interview; 2) Barriers to adherence; 3) Predictors of Adherence; 4) Pain-anxiety experiences related to CRCS; 5) Gender-specific experiences re: CRCS, addressing all three modalities accessible through Ontario’s program: a) fecal occult blood testing; b) flexible sigmoidoscopy; c) colonoscopy. Results Interview transcript analyses indicated divergent themes related to CRCS for each gender: 1) bodily intrusion, 2) perforation anxiety, and 3) embarrassment for females and; 1) avoidant procrastination with underlying fatalism, 2) unnecessary health care and 3) uncomfortable vulnerability for males. Respondents adopted similar attitudes towards fecal occult blood testing, flexible sigmoidoscopy and colonoscopy, and were comparable in decision stage across tests. Gender differences were neither closely tied to screening stage nor modality. Women had more consistent physician relationships, were more screening-knowledgeable and better able to articulate views on screening. Men reported less consistent physician relationships, were less knowledgeable and kept decision-making processes vague and emotionally distanced (i.e. at ‘arm’s length’). Conclusions Marked differences were observed in obstructive CRCS attitudes per gender. Females articulated reservations about CRCS-associated distress and males suppressed negative views while ambiguously procrastinating about the task of completing screening. Future interventions could seek to reduce CRCS-related stress (females) and address the need to overcome procrastination (males).
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Moylan S, Gustavson K, Karevold E, Øverland S, Jacka FN, Pasco JA, Berk M. The impact of smoking in adolescence on early adult anxiety symptoms and the relationship between infant vulnerability factors for anxiety and early adult anxiety symptoms: the TOPP Study. PLoS One 2013; 8:e63252. [PMID: 23696803 PMCID: PMC3655993 DOI: 10.1371/journal.pone.0063252] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2012] [Accepted: 03/30/2013] [Indexed: 11/18/2022] Open
Abstract
Cigarette smoking is increased in people with trait anxiety and anxiety disorders, however no longitudinal data exist illuminating whether smoking in adolescence can influence the developmental trajectory of anxiety symptoms from early vulnerability in infancy to adult anxiety expression. Using The Tracing Opportunities and Problems in Childhood and Adolescence (TOPP) Study, a community-based cohort of children and adolescents from Norway who were observed from the age of 18 months to age 18-19 years, we explored the relationship between adolescent smoking, early vulnerability for anxiety in infancy (e.g. shyness, internalizing behaviors, emotional temperaments) and reported early adult anxiety. Structural equation modeling demonstrated that adolescent active smoking was positively associated with increased early adulthood anxiety (β = 0.17, p<0.05), after controlling for maternal education (proxy for socioeconomic status). Adolescent anxiety did not predict early adult smoking. Adolescent active smoking was a significant effect modifier in the relationship between some infant vulnerability factors and later anxiety; smoking during adolescence moderated the relationship between infant internalizing behaviors (total sample: active smokers: β = 0.85, p<0.01, non-active smokers: ns) and highly emotional temperament (total sample: active smokers: β = 0.55, p<0.01,non-active smokers: ns), but not shyness, and anxiety in early adulthood. The results support a model where smoking acts as an exogenous risk factor in the development of anxiety, and smoking may alter the developmental trajectory of anxiety from infant vulnerability to early adult anxiety symptom expression. Although alternative non-mutually exclusive models may explain these findings, the results suggest that adolescent smoking may be a risk factor for adult anxiety, potentially by influencing anxiety developmental trajectories. Given the known adverse health effects of cigarette smoking and significant health burden imposed by anxiety disorders, this study supports the importance of smoking prevention and cessation programs targeting children and adolescence.
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Affiliation(s)
- Steven Moylan
- School of Medicine, Deakin University, Geelong, Victoria, Australia.
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Concern-induced negative affect is associated with the occurrence and content of mind-wandering. Conscious Cogn 2013; 22:442-8. [PMID: 23466878 DOI: 10.1016/j.concog.2013.01.012] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 01/27/2013] [Accepted: 01/30/2013] [Indexed: 11/20/2022]
Abstract
Previous research has shown that the content and frequency of mind-wandering episodes--the occurrence of thoughts that are both stimulus-independent and task-unrelated--are closely related to an individual's future-related concerns. Whether this relationship is shaped by the affective changes that are usually associated with future-related concerns still remains unclear, however. In this study, we induced the anticipation of a negatively valenced event and examined whether the ensuing affective changes were related to the occurrence and content of mind-wandering during an unrelated attentional task. We found that the increase in negative affect following concern induction predicted the general frequency of mind-wandering episodes. Furthermore, mind-wandering episodes specifically directed at the induced concern were related to a lower decrease in negative affect during the attentional task. These results suggest that the negative emotional impact of future-related concerns is an important factor to be taken into consideration for the subsequent occurrence of mind-wandering episodes, which might in turn be involved in the maintenance of negative affect over time.
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Wong M, Krajisnik A, Truong L, Lisha NE, Trujillo M, Greenberg JB, Kahler CW, Zvolensky MJ, Leventhal AM. Anxiety sensitivity as a predictor of acute subjective effects of smoking. Nicotine Tob Res 2012; 15:1084-90. [PMID: 23144083 DOI: 10.1093/ntr/nts208] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Anxiety sensitivity (i.e., AS; the degree to which one believes that anxiety and its related sensations are harmful) is a stable trait that is associated with habitual smoking. Yet, the mechanisms linking AS and smoking are unclear. A promising hypothesis is that high-AS individuals are more sensitive to the acute subjective reinforcing effects of smoking and are, therefore, more prone to tobacco dependence. This study examined trait AS as a predictor of several subjective effects of cigarette smoking. METHODS Adult non-treatment-seeking smokers (N = 87; 10+ cigarettes/day) completed a measure of AS during a baseline session. Prior to a subsequent experimental session, participants were asked to smoke normally before their appointment. At the outset of that visit, each participant smoked a single cigarette of their preferred brand in the laboratory. Self-report measures of affect and cigarette craving were completed before and after smoking, and post-cigarette subjective effect ratings were provided. RESULTS AS predicted greater increases in positive affect from pre- to post-cigarette (β = .30, p = .006) as well as greater smoking satisfaction and psychological reward (β = .23 to .48, ps < .03). Each of these effects remained statistically significant after adjusting for anxiety symptom severity. AS did not predict the degree of negative affect and craving suppression or post-cigarette aversive effects. CONCLUSIONS These findings suggest that positive reinforcement mechanisms may be particularly salient etiological processes that maintain smoking in high-AS individuals.
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Affiliation(s)
- Matthew Wong
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
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Individual differences in amygdala reactivity following nicotinic receptor stimulation in abstinent smokers. Neuroimage 2012; 66:585-93. [PMID: 23110878 DOI: 10.1016/j.neuroimage.2012.10.043] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 10/06/2012] [Accepted: 10/08/2012] [Indexed: 11/22/2022] Open
Abstract
Hyperactive amygdala functioning may underlie emotional dysregulation during smoking abstinence and represents one neurobiological target for pharmacological cessation aids. Available pharmacotherapies (e.g., nicotine replacement and varenicline) aid only a subset of individuals with smoking cessation and therefore elucidating the neurobiological impact of these medications is critical to expedite improved interventions. In a fMRI study employing a within-subject, double-blind, placebo-controlled design, we assessed task performance and amygdala functioning during an emotional face matching paradigm following administration of nicotine and varenicline to 24 abstinent smokers and 20 nonsmokers. All participants underwent ~17days of varenicline and placebo pill administration and were scanned, on different days under each condition, wearing a transdermal nicotine or placebo patch. During the amygdala reactivity paradigm, nicotinic acetylcholine receptor (nAChR) stimulation by nicotine and varenicline decreased reaction time (RT) in abstinent smokers but not in nonsmokers. When considering all smokers as a single homogenous group, no drug-induced effects on amygdala reactivity were detected. However, in an exploratory analysis we parsed participants into subgroups according to individual differences in the propensity to demonstrate stable performance augmentation following nAChR stimulation (stable RT-improvers [SI] vs. variable RT-improvers [VI]). Using this exploratory approach, drugs appeared to modulate amygdala reactivity in only one smoker subgroup but not in either nonsmoker subgroup. Specifically, in the SI-smoker cohort abstinence-induced elevated amygdala reactivity was down-regulated by nAChR stimulation. In contrast, varenicline and nicotine did not modulate amygdala functioning in the VI-smoker cohort who displayed moderate levels of amygdala reactivity in the absence of drug administration. These results suggest that pharmacotherapies most robustly dampened amygdala functioning in smokers appearing susceptible to abstinence-induced effects. Such findings provide a step towards fractionating the smoker phenotype by discrete neurobiological characteristics.
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Tamam MO, Bagcioglu E, Mulazimoglu M, Tamam L, Ozpacaci T. Evaluation of anxiety and depression in patients prior to myocardial perfusion scintigraphy. Int J Psychiatry Clin Pract 2012; 16:93-7. [PMID: 22136214 DOI: 10.3109/13651501.2011.631017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE In myocardial perfusion scintigraphy (MPS) negative results indicate coronary artery diseases which might cause prominent anxiety and other psychological reactions. The aim of this study was to determine anxiety and depression levels of patients prior to MPS procedures. METHODS The Hospital Anxiety Depression Scale(HADS) and the State and Trait Anxiety Inventory I and II were used to evaluate the anxiety and depression levels of the patients. Descriptive analyses and independent sample t-test were used for statistical assessment. RESULTS The mean score of HADS-anxiety score prior to MPS was 8.1 ± 4.2, whereas the mean HADS depression score was 6.1 ± 3.7. The mean state anxiety score prior to MPS was 39.7 ± 10.6 and the mean trait anxiety score was 45.02 ± 9.1. HAD and state and trait anxiety scores were found to be significantly higher in female patients than male patients and non-smoker patients than smoker patients. Other risk factors such as having bypass operation, myocardial infarction, hypercholesterolemia, diabetes and hypertension were not related to depression and anxiety scores. CONCLUSION The results in this study suggest a role for MPS as a risk factor for higher state anxiety. The MPS procedures might lead to an increase in anxiety levels of patients which is possibly associated with anticipation anxiety felt during waiting period and expectation life-threatening.
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Affiliation(s)
- Muge Oner Tamam
- Department of Nuclear Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey.
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Kobiella A, Ulshöfer DE, Vollmert C, Vollstädt-Klein S, Bühler M, Esslinger C, Smolka MN. Nicotine increases neural response to unpleasant stimuli and anxiety in non-smokers. Addict Biol 2011; 16:285-95. [PMID: 20731637 DOI: 10.1111/j.1369-1600.2010.00237.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Studies in smokers suggest that nicotine might exert anxiolytic, stress-dampening and mood-enhancing effects and beneficially influences neural processing of affective information. Regarding non-smokers, results are inconsistent, and no data exist on the effect of nicotine on neural emotion processing. We applied functional magnetic resonance imaging (fMRI) to assess the influence of nicotine on brain activation during processing of emotional stimuli in 31 non-smokers with a maximum lifetime cigarette consumption of 20 cigarettes. Participants were subjected to two fMRI scans with event-related presentations of images taken from the International Affective Picture System, receiving nicotine (2 mg) and placebo gums in a double-blinded, randomized cross-over design. Furthermore, subjective affect was assessed. Nicotine increased brain activity in response to unpleasant stimuli in the amygdala, anterior cingulate cortex (ACC) and basal ganglia, whereas processing of pleasant stimuli was not altered. Psychophysiological interaction (PPI) analyses revealed that nicotine increased connectivity between the amygdala and the perigenual ACC (pACC) during processing of unpleasant stimuli and decreased connectivity between those structures during processing of pleasant stimuli. Participants reported higher state anxiety under nicotine than placebo. A single dose of nicotine acted as a stressor in non-smokers, leading to increased anxiety and neural activation elicited by unpleasant stimuli as well as altered connectivity within the amygdala-pACC circuit. Besides the possibility that reactions to nicotine may differ between non-smokers and smokers due to tolerance and neuroadaptive processes that occur during prolonged nicotine use, a priori differences in smokers and non-smokers might potentially explain diverse effects of nicotine on affect and emotional reactivity.
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Affiliation(s)
- Andrea Kobiella
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Keinan-Boker L, Enav T, Rozentraub T, Shohat T. Changes in smoking habits of smokers under bombing by rockets. J Public Health (Oxf) 2011; 33:55-62. [DOI: 10.1093/pubmed/fdq099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Perkins KA, Karelitz JL, Giedgowd GE, Conklin CA, Sayette MA. Differences in negative mood-induced smoking reinforcement due to distress tolerance, anxiety sensitivity, and depression history. Psychopharmacology (Berl) 2010; 210:25-34. [PMID: 20217051 PMCID: PMC2882096 DOI: 10.1007/s00213-010-1811-1] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 02/18/2010] [Indexed: 10/19/2022]
Abstract
RATIONALE Negative mood increases smoking reinforcement and may do so to a greater degree in smokers vulnerable to negative mood dysregulation. METHODS Adult smokers (N = 71) without current depression were randomly assigned to one of two smoking conditions (nicotine or denic cigarettes, presented blind) maintained across all sessions. Subjects completed one neutral mood session and four negative mood induction sessions. Negative mood inductions included one each of the following: 1) overnight smoking abstinence, 2) challenging computer task, 3) public speech preparation, 4) watching negative mood slides. In each session, subjects took 4 puffs on their assigned cigarette, rated it for "liking" (reward), and then smoked those cigarettes ad libitum (reinforcement) during continued mood induction. Affect was assessed intermittently before and after smoking. Differences in responses were examined as functions of self-reported history of major depression and levels of distress tolerance and anxiety sensitivity. RESULTS Smoking reinforcement, but not reward or negative affect relief, was greater in all sessions in those with a history of depression and greater after overnight abstinence in those with lower distress tolerance. Reward and affect relief, but not reinforcement, were greater during speech preparation among those high in anxiety sensitivity. CONCLUSIONS Low distress tolerance may enhance acute smoking reinforcement due to abstinence, while depression history may broadly increase acute smoking reinforcement regardless of mood. Neither smoking reward nor affect help explain these individual differences in smoking reinforcement.
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Affiliation(s)
- Kenneth A. Perkins
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA 15213, USA
| | - Joshua L. Karelitz
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA 15213, USA
| | - Grace E. Giedgowd
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA 15213, USA
| | - Cynthia A. Conklin
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA 15213, USA
| | - Michael A. Sayette
- Department of Psychology, University of Pittsburgh, 3137 Sennott Square, Pittsburgh, PA 15261, USA
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