1
|
Wei L. Commentary on "The Role of Emotion Differentiation in the Association Between Momentary Affect and Tobacco/Nicotine Craving in Young Adults". Nicotine Tob Res 2024; 26:402-403. [PMID: 37589540 DOI: 10.1093/ntr/ntad154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Indexed: 08/18/2023]
Affiliation(s)
- LienChung Wei
- Department of Addiction Psychiatry, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan City, Taiwan (ROC)
| |
Collapse
|
2
|
Runyan JD, Vermilya S, St Pierre M, Brooks NW, Fowler A, Brewer T. A mixed methods experience sampling study of a posttraumatic growth model for addiction recovery. Sci Rep 2024; 14:3511. [PMID: 38383566 PMCID: PMC10881473 DOI: 10.1038/s41598-024-53740-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 02/04/2024] [Indexed: 02/23/2024] Open
Abstract
Problematic substance use and addiction is a growing crisis in the United States. As a result, identifying factors that effectively promote addiction recovery is, currently, of particular societal importance. Informed by evidence that-while addiction can be perpetuated by stress-related impulsivity and decreased self-regulation-perceived social support is protective against addiction, we test a model for addiction recovery as a form of posttraumatic growth (PTG), focused specifically on close relationships and personal strength-two domains of PTG. In an initial study, we found that perceived social support and impulsivity predicted number of relapses in individuals in a substance use disorder recovery program. Using experience sampling, we then observed that experiencing a stressful event predicted impulsive behavior. However, experiencing closeness with others-a domain of PTG-was directly associated with perceived social support, and both predicted positive emotional states, which were, in turn, inversely associated with experiencing a stressful event. Further, when experiencing a stressful event, personal strength-also a domain of PTG-was inversely associated with impulsive behavior and was predicted by both perceived social support and positive emotional states. Finally, in a follow-up experiment, we found that an ecological momentary intervention targeting perceived social support decreased impulsivity and increased self-regulation-an aspect of personal strength-in a dose-dependent fashion. Taken together, our findings: (1) support a PTG model for recovery; (2) provide evidence for processes by which close supportive relationships are protective against addiction and relapse; and (3) indicate that self-regulation is responsive to a short in-the-moment perceived social support intervention. We suggest that these findings support the theory that addiction is a social disease in the sense that close personal interactions and supportive relationships: (a) buffer against stress-related impulsivity, thereby protecting against addiction and relapse; and (b) increase personal strength, thereby decreasing the probability of impulsive-including addictive-behavior and promoting recovery.
Collapse
|
3
|
Cleveland HH, Knapp KS, Cleveland MJ, Deneke E, Bunce SC. Using ecological momentary assessments of negative affect and craving during residential opioid use disorder treatment to predict patients' relapse to substance use. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 146:208931. [PMID: 36880896 PMCID: PMC10127152 DOI: 10.1016/j.josat.2022.208931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 09/13/2022] [Accepted: 12/30/2022] [Indexed: 04/27/2023]
Abstract
BACKGROUND Negative affect (NA) and craving are often independently examined as precipitators of relapse among individuals with substance use disorders, including opioid use disorder (OUD). Recent ecological momentary assessment (EMA) research has revealed that NA and craving frequently co-occur within individuals. Yet we know little about the general patterns of, and variability in, within-person associations between NA and craving, as well as whether the nature and degree of within-person NA-craving coupling predicts post-treatment time-to-relapse. METHODS Seventy-three patients (77 % male, Mage = 30.10, Range = 19-61) in residential treatment for OUD took part in a 12-day, 4× daily smartphone-based EMA study. Linear mixed-effects models tested within-person, day-level associations between self-reported NA and craving during treatment. The study used Person-specific slopes (i.e., average within-person NA-craving coupling for each participant) estimated from the mixed-effects model in survival analyses with Cox proportional hazards regression models to determine if between-person differences in the within-person coupling predicted post-treatment time-to-relapse (operationalized as the return to problematic use of any substance except tobacco), and whether this prediction was similar across patients' average levels of NA and craving intensity. The study monitored relapse through a combination of hair samples and reports from patients or alternative contacts via a voice response system twice a month for up to 120 days or more following discharge. RESULTS Among the 61 participants with time-to-relapse data, those with stronger positive within-person NA-craving coupling on average during residential OUD treatment had a lower hazard of relapsing (slower time to relapse) post-treatment than participants with weaker NA-craving slopes. The significant association held after controlling for interindividual differences in age, sex, and average levels of NA and craving intensity. Average NA and craving intensity did not moderate the association between NA-craving coupling and time-to-relapse. CONCLUSIONS Interindividual differences in average within-person, day-level NA-craving coupling during residential treatment predict OUD patients' post-treatment time-to-relapse.
Collapse
Affiliation(s)
- H Harrington Cleveland
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States.
| | - Kyler S Knapp
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States; Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, United States.
| | - Michael J Cleveland
- Department of Human Development, Washington State University, Pullman, WA, United States.
| | - Erin Deneke
- Caron Treatment Centers, Wernersville, PA, United States.
| | - Scott C Bunce
- Department of Psychiatry, The Pennsylvania State University, Hershey, PA, United States.
| |
Collapse
|
4
|
Neurobiology and Mechanisms of Nicotine Addiction. Respir Med 2023. [DOI: 10.1007/978-3-031-24914-3_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
|
5
|
Parnarouskis L, Leventhal AM, Ferguson SG, Gearhardt AN. Withdrawal: A key consideration in evaluating whether highly processed foods are addictive. Obes Rev 2022; 23:e13507. [PMID: 36196649 PMCID: PMC9786266 DOI: 10.1111/obr.13507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 07/04/2022] [Accepted: 09/20/2022] [Indexed: 12/30/2022]
Abstract
Researchers are currently debating whether theories of addiction explain compulsive overeating of highly processed (HP) foods (i.e., industrially created foods high in refined carbohydrates and/or fat), which contributes to obesity and diet-related disease. A subset of individuals consumes HP foods with behavioral phenotypes that mirror substance use disorders. Withdrawal, the emergence of aversive physical and psychological symptoms upon reduction or cessation of substance use, is a core component of addiction that was central to historical debates about other substances' addictive potential (e.g., nicotine and cocaine). However, no one has systematically considered evidence for whether HP foods cause withdrawal, which represents a key knowledge gap regarding the utility of addiction models for understanding compulsive overeating. Thus, we reviewed evidence for whether animals and humans exhibit withdrawal when reducing or eliminating HP food intake. Controlled experimental evidence indicates animals experience HP food withdrawal marked by neural reward changes and behaviors consistent with withdrawal from other addictive substances. In humans, preliminary evidence supports subjective withdrawal-like experiences. However, most current human research is limited to retrospective recall. Further experimental research is needed to evaluate this construct. We outline future research directions to investigate HP food withdrawal in humans and consider potential clinical implications.
Collapse
Affiliation(s)
| | - Adam M Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Stuart G Ferguson
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Ashley N Gearhardt
- Department of Psychology, The University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
6
|
Tonkin SS, Colder C, Mahoney MC, Swan GE, Cinciripini P, Schnoll R, George TP, Tyndale RF, Hawk LW. Evaluating Treatment Mechanisms of Varenicline: Mediation by Affect and Craving. Nicotine Tob Res 2022; 24:1803-1810. [PMID: 35639828 PMCID: PMC9596996 DOI: 10.1093/ntr/ntac138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/17/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Negative reinforcement models posit that relapse to cigarette smoking is driven in part by changes in affect and craving during the quit attempt. Varenicline may aid cessation by attenuating these changes; however, this mediational pathway has not been formally evaluated in placebo-controlled trials. Thus, trajectories of negative affect (NA), positive affect (PA), and craving were tested as mediators of the effect of varenicline on smoking cessation. AIMS AND METHODS Secondary data analysis was conducted on 828 adults assigned to either varenicline or placebo in a randomized controlled trial for smoking cessation (NCT01314001). Self-reported NA, PA, and craving were assessed 1-week pre-quit, on the target quit day (TQD), and 1 and 4 weeks post-TQD. RESULTS Across time, NA peaked 1-week post-quit, PA did not change, and craving declined. Less steep rises in NA (indirect effect 95% CI: .01 to .30) and lower mean craving at 1-week post-quit (CI: .06 to .50) were mediators of the relationship between varenicline and higher cessation rates at the end of treatment. PA was associated with cessation but was not a significant mediator. CONCLUSIONS These results partially support the hypothesis that varenicline improves smoking cessation rates by attenuating changes in specific psychological processes and supported NA and craving as plausible treatment mechanisms of varenicline. IMPLICATIONS The present research provides the first evidence from a placebo-controlled randomized clinical trial that varenicline's efficacy is due, in part, to post-quit attenuation of NA and craving. Reducing NA across the quit attempt and craving early into the attempt may be important treatment mechanisms for effective interventions. Furthermore, post-quit NA, PA, and craving were all associated with relapse and represent treatment targets for future intervention development.
Collapse
Affiliation(s)
- Sarah S Tonkin
- Department of Psychology, University at Buffalo, State University of New York, Buffalo, NY, USA.,Department of Psychiatry, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Craig Colder
- Department of Psychology, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Martin C Mahoney
- Departments of Internal Medicine and Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Gary E Swan
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Paul Cinciripini
- Department of Behavioral Science MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Robert Schnoll
- Department of Psychiatry and Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Tony P George
- Departments of Psychiatry, Pharmacology & Toxicology, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Rachel F Tyndale
- Departments of Psychiatry, Pharmacology & Toxicology, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Larry W Hawk
- Department of Psychology, University at Buffalo, State University of New York, Buffalo, NY, USA
| |
Collapse
|
7
|
Castaldelli-Maia JM, Nesoff ED, Lima DR, Sanchez ZM, Martins SS. The first day of smoking abstinence is more challenging for women than men: A meta-analysis and meta-regression across 12 low- and middle-income countries. Addict Behav 2022; 128:107234. [PMID: 35007914 DOI: 10.1016/j.addbeh.2021.107234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/24/2021] [Accepted: 12/29/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Maintained abstinence during the first 24 h of a quit attempt is a critical predictor of long-term smoking cessation. Little is known about sex differences in the very early abstinence period, particularly in the context of low- and middle-income countries (LMICs) with varying anti-smoking policies and female smoking prevalences. We examined female sex effects on one-day relapse in a cross-national sample from 12 LMICs. METHODS Data from the Global Adult Tobacco Survey (2008-2012) included nationally representative samples from 12 LMICs restricted to smokers with ≥ 1 quit attempt in the past 12 months (n = 16,576). We ran adjusted logistic regression models for female sex effects on one-day relapse, adjusting for nine individual-level demographics (e.g., age, education, age at smoking initiation) and smoking cessation variables (e.g., exposure to health warnings, receipt of counseling). We then conducted a meta-analysis adjusted for national-level and policy measures through meta-regression (e.g., cigarette consumption per capita, percent of cigarette box covered with warning labels). RESULTS One-day relapse prevalence varied across countries (2.7-13.6%). The odds of one-day relapse were significantly higher for women than for men in six countries (adjusted for nine individual-level sociodemographic variables), and there were no significant sex differences in the remaining six countries. Result remained significant after meta-regressions for national-level tobacco consumption and policy measures. Sensitivity analyses showed that the odds of one-day relapse for women remained significant when excluding countries with both higher and lower relative rates of female smoking. Larger warning labels on cigarette packs were associated with reduced odds of one-day relapse among women. CONCLUSION The first day of a quit attempt is more challenging for women than men in LMICs. Tailored interventions incorporating national policies, in addition to counseling and pharmacotherapy, could play an essential role in supporting women during the initial abstinence phase of smoking cessation in LMICs.
Collapse
Affiliation(s)
- João M Castaldelli-Maia
- Department of Psychiatry, Medical School, University of São Paulo, Brazil; Department of Neuroscience, Medical School, ABC Health University Center, Brazil; Department of Epidemiology, Mailman School of Public Health, Columbia University, US.
| | - Elizabeth D Nesoff
- Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Danielle R Lima
- Department of Psychiatry, Medical School, University of São Paulo, Brazil
| | - Zila M Sanchez
- Department of Preventive Medicine, Medical School, Universidade Federal de São Paulo, Brazil
| | - Silvia S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, US
| |
Collapse
|
8
|
Meredith LR, Grodin EN, Montoya AK, Miranda R, Squeglia LM, Towns B, Evans C, Ray LA. The effect of neuroimmune modulation on subjective response to alcohol in the natural environment. Alcohol Clin Exp Res 2022; 46:876-890. [PMID: 35362101 PMCID: PMC10460619 DOI: 10.1111/acer.14821] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/28/2022] [Accepted: 03/18/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Despite the promising implications for novel immune therapeutics, few clinical trials have tested these therapies to date. An understanding of how immune pharmacotherapies influence complex alcohol use disorder (AUD) profiles, including subjective response to alcohol, is very limited. Initial findings show that ibudilast, a neuroimmune modulator, reduces rates of heavy drinking and measures of alcohol craving. METHODS This study is a secondary analysis of a 2-week clinical trial of ibudilast that enrolled a nontreatment-seeking sample with AUD. Eligible participants (N = 52) were randomized to receive ibudilast or matched placebo and completed daily diary assessments (DDAs) during the 2-week period. Each morning, participants reported on their mood and craving levels both before and during the previous day's drinking episode, as well as stimulation and sedation levels during the previous day's drinking episode. Multilevel models were used to compare the effects of ibudilast and placebo on subjective alcohol response. Exploratory analyses tested whether ibudilast moderated the relationship between daily stimulation/sedation and alcohol intake and whether withdrawal-related dysphoria moderated ibudilast's effects on subjective response. RESULTS Ibudilast did not significantly alter mean levels of stimulation or sedation (p's > 0.05). It did, however, moderate the effect of daily stimulation on drinking (p = 0.045). Ibudilast attenuated alcohol-induced increases in craving compared with placebo (p = 0.047), but not other subjective response measures. Ibudilast significantly tempered daily alcohol-induced changes in urge to drink and positive mood only among individuals without withdrawal-related dysphoria. CONCLUSIONS Ibudilast's effects on subjective alcohol responses appear to be nuanced and perhaps most salient for individuals drinking for positive reinforcement as distinguished from those who drink to feel normal. Consistent with previous findings, reductions in alcohol craving may represent a primary mechanism of ibudilast's effects on drinking. The ecologically valid nature of DDAs provide a clinically useful window into how individuals experience alcohol's effects while taking ibudilast.
Collapse
Affiliation(s)
| | - Erica N. Grodin
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Amanda K. Montoya
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Robert Miranda
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
- E. P. Bradley Hospital, Riverside, RI, USA
| | - Lindsay M. Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Brandon Towns
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Christopher Evans
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Lara A. Ray
- Department of Psychology, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| |
Collapse
|
9
|
Sharbin GK, Rash CJ. Characterizing nicotine withdrawal in smokers experiencing homelessness. J Subst Abuse Treat 2022; 138:108748. [DOI: 10.1016/j.jsat.2022.108748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/28/2021] [Accepted: 02/14/2022] [Indexed: 11/30/2022]
|
10
|
Cleveland HH, Knapp KS, Brick TR, Russell MA, Gajos JM, Bunce SC. Effectiveness and Utility of Mobile Device Assessment of Subjective Craving during Residential Opioid Dependence Treatment. Subst Use Misuse 2021; 56:1284-1294. [PMID: 34057031 PMCID: PMC8370391 DOI: 10.1080/10826084.2021.1921808] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Craving is a dynamic state that is both theoretically and empirically linked to relapse in addiction. Static measures cannot adequately capture the dynamic nature of craving, and research has shown that these measures are limited in their capacity to link craving to treatment outcomes. Methods: The current study reports on assessments of craving collected 4x-day across 12 days from 73 patients in residential treatment for opioid dependence. Analyses investigated whether the within-person assessments yielded expected across- and within-day variability, whether levels of craving changed across and within days, and, finally, whether individual differences in craving variability predicted post-residential treatment relapse. Results: Preliminary analyses found acceptable levels of data entry compliance and reliability. Consistent with expectations, craving varied both between (46%) and within persons, with most within-person variance (over 40%) existing within days. Other patterns that emerged indicated that, on average, craving declined across the 12-days of assessment, and was generally strongest at mid-day. Analyses also found that patients' person-level craving variability predicted post-treatment relapse, above and beyond their mean levels of craving. Conclusion: Analyses support the reliability, sensitivity, and potential utility of the 4x-day, 12-day assessment protocol for measuring craving during residential treatment.
Collapse
Affiliation(s)
- H Harrington Cleveland
- Human Development & Family Studies, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Kyler S Knapp
- Human Development & Family Studies, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Timothy R Brick
- Human Development & Family Studies, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Michael A Russell
- Human Development & Family Studies, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Jamie M Gajos
- Department of Human Development and Family Studies, University of Alabama, Tuscaloosa, Alabama, USA
| | - Scott C Bunce
- Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| |
Collapse
|
11
|
Lydon-Staley DM, Cornblath EJ, Blevins AS, Bassett DS. Modeling brain, symptom, and behavior in the winds of change. Neuropsychopharmacology 2021; 46:20-32. [PMID: 32859996 PMCID: PMC7689481 DOI: 10.1038/s41386-020-00805-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/19/2020] [Accepted: 07/22/2020] [Indexed: 02/08/2023]
Abstract
Neuropsychopharmacology addresses pressing questions in the study of three intertwined complex systems: the brain, human behavior, and symptoms of illness. The field seeks to understand the perturbations that impinge upon those systems, either driving greater health or illness. In the pursuit of this aim, investigators often perform analyses that make certain assumptions about the nature of the systems that are being perturbed. Those assumptions can be encoded in powerful computational models that serve to bridge the wide gulf between a descriptive analysis and a formal theory of a system's response. Here we review a set of three such models along a continuum of complexity, moving from a local treatment to a network treatment: one commonly applied form of the general linear model, impulse response models, and network control models. For each, we describe the model's basic form, review its use in the field, and provide a frank assessment of its relative strengths and weaknesses. The discussion naturally motivates future efforts to interlink data analysis, computational modeling, and formal theory. Our goal is to inspire practitioners to consider the assumptions implicit in their analytical approach, align those assumptions to the complexity of the systems under study, and take advantage of exciting recent advances in modeling the relations between perturbations and system function.
Collapse
Affiliation(s)
- David M Lydon-Staley
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Eli J Cornblath
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Neuroscience Graduate Group, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Ann Sizemore Blevins
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Danielle S Bassett
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Department of Electrical & Systems Engineering, School of Engineering & Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Department of Physics & Astronomy, College of Arts & Sciences, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- The Santa Fe Institute, Santa Fe, NM, 87501, USA.
| |
Collapse
|
12
|
Gunter R, Szeto E, Suh S, Kim Y, Jeong SH, Waters A. Associations between affect, craving, and smoking in Korean smokers: An ecological momentary assessment study. Addict Behav Rep 2020; 12:100301. [PMID: 33364310 PMCID: PMC7752717 DOI: 10.1016/j.abrep.2020.100301] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 07/23/2020] [Accepted: 08/28/2020] [Indexed: 10/25/2022] Open
Abstract
Cigarette smoking remains the largest cause of preventable death in the United States and worldwide. In South Korea and other Asian countries, a large proportion of males smoke, increasing the need to examine cigarette smoking in these populations. Research suggests that the association between positive affect and negative affect, and between affect and craving, may differ across cultures, and that it is useful to examine these associations using Ecological Momentary Assessment (EMA). South Korean smokers (N = 20, Mean Age = 21.15, 25% female) completed baseline questionnaires and downloaded an EMA app which prompted 4 random assessments (RAs) each day for 1-week. At each assessment, participants responded to items assessing momentary negative affect (NA) and positive affect (PA), craving, and number of cigarettes smoked since the previous EMA assessment. Linear mixed models (LMMs) were used to analyze EMA data (544 assessments), separating out between- and within- subject associations. There was a significant positive association between positive affect and negative affect at the between-subjects level. Both positive affect and negative affect were significantly positively associated with craving at between-subjects and within-subject levels. Craving was associated with subsequent smoking behavior at the within-subjects level. Overall, results suggest that associations between positive affect and negative affect may be different in South Korean smokers than in Western smokers, and that there are robust associations between both negative and positive affect and craving.
Collapse
Affiliation(s)
- R.G. Gunter
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - E.H. Szeto
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - S. Suh
- Department of Psychology, Sungshin Women’s University, Seoul, Republic of Korea
| | - Y. Kim
- Department of Preventive Medicine, University of Southern California, CA, USA
| | - S-H. Jeong
- School of Media & Communication, Korea University, Seoul, Republic of Korea
| | - A.J. Waters
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| |
Collapse
|
13
|
Knapp KS, Bunce SC, Brick TR, Deneke E, Cleveland HH. Daily associations among craving, affect, and social interactions in the lives of patients during residential opioid use disorder treatment. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2020; 35:609-620. [PMID: 33090811 DOI: 10.1037/adb0000612] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study captured the interrelationships among craving, negative affect, and positive and negative social exchanges in the daily lives of patients in residential treatment for opioid use disorders (OUDs). METHOD Participants were 73 patients (77% male), age 19 to 61 (Mage = 30.10, SDage = 10.13) in residential treatment for OUD. Participants completed a smartphone-based survey 4 times per day for 12 consecutive days that measured positive and negative social exchanges (Test of Negative Social Exchange), negative affect (PA-NA scales), and craving (frequency and intensity). Within-person, day-level associations among daily positive and negative social exchanges, negative affect, and craving were examined using multilevel modeling. RESULTS Daily negative social exchanges (M = 1.44, SD = 2.27) were much less frequent than positive social exchanges (M = 6.59, SD = 4.00) during residential treatment. Whereas negative social exchanges had a direct association with same-day craving (β = 0.08; 95% CI = 0.01, 0.16, ΔR2 = 0.01), positive social exchanges related to craving indirectly via moderation of the within-person negative affect-craving link (β = -0.01; 95% CI = -0.01, -0.001, ΔR2 = 0.002). Positive social exchanges decoupled the same-day linkage between negative affect and craving on days when individuals had at least four more positive social exchanges than usual. CONCLUSIONS These results indicate that both negative affect and negative social exchanges are uniquely related to craving on a daily basis, and that extra positive social interactions can reduce the intraindividual coupling of negative affect and craving during residential treatment for OUD. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
|
14
|
Conti AA, Tolomeo S, Steele JD, Baldacchino AM. Severity of negative mood and anxiety symptoms occurring during acute abstinence from tobacco: A systematic review and meta-analysis. Neurosci Biobehav Rev 2020; 115:48-63. [PMID: 32454051 DOI: 10.1016/j.neubiorev.2020.04.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 01/20/2023]
Abstract
This review was conducted with the following goals: To quantify the severity of mood and anxiety symptoms emerging during acute abstinence from tobacco (1). To explore sex differences related to the experience of specific symptoms (2). To investigate the early time course of symptoms (3). A meta-analysis was performed from 28 studies assessing mood and anxiety symptoms during the earliest phases of tobacco abstinence (up to 24 hrs post-quit) conducted from 1999 to 2019. Results revealed a significant (p < 0.0001) increase in 'anxiety', 'anger/irritability', 'depressed mood /sadness', and composite negative affect ('NA') in the 24 hours following smoking cessation. The largest effect size was detected for 'anxiety' (0.63). A qualitative analysis was performed to investigate sex differences and the time course of the specific symptoms. Results indicated that female smokers may experience worse mood symptoms compared to male smokers and that these symptoms may emerge within 3 hrs post-quit. Smoking cessation programs should implement sex-tailored interventions in order to improve their effectiveness, while future research should focus on alternative methods of nicotine administration.
Collapse
Affiliation(s)
- A A Conti
- University of St Andrews, School of Medicine, Division of Population and Behavioural Science, UK
| | - S Tolomeo
- National University of Singapore (NUS), Department of Psychology, Singapore
| | - J D Steele
- University of Dundee, School of Medicine, Division of Imaging Science and Technology, UK
| | - A M Baldacchino
- University of St Andrews, School of Medicine, Division of Population and Behavioural Science, UK.
| |
Collapse
|
15
|
Masiero M, Lucchiari C, Maisonneuve P, Pravettoni G, Veronesi G, Mazzocco K. The Attentional Bias in Current and Former Smokers. Front Behav Neurosci 2019; 13:154. [PMID: 31354446 PMCID: PMC6637300 DOI: 10.3389/fnbeh.2019.00154] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/24/2019] [Indexed: 11/29/2022] Open
Abstract
Attentional bias has been defined as the propensity of a person to allocate selective attention automatically to salient cues (Field and Powell, 2007). In the case of smoking, this bias implies that smokers are implicitly attracted by smoking-related stimuli, which produce behavioral, memory, and emotional effects (Volkow et al., 2006; Giardini et al., 2009). In more detail, scientific evidence pointed out that smoking is strongly supported by attentional bias that activates craving and urgency to smoke a cigarette. However, poor and conflicting data are available regarding the role of this cognitive bias on former smokers. The main aim of this study is to explore the occurrence of the attentional bias on of both current and former smokers, also with the aim to identify associations with behavioral, psychological and cognitive characteristic of participants. We collected data on 245 current, volunteers (male 50.6%; female 49.4%) aged 54.81 (SD = 14.352, range = 18–63), divided in current smokers (98), former smokers (102) and non-smokers (45). A combination of neuropsychology tests (Emotional Smoke Stroop Task and Go/no-Go task), and standardized questionnaires [Behavioral Inhibition System-Behavioral Approach System (BIS-BAS), Fagerström Test for Nicotine Dependence (FTND), Barratt Impulsiveness Scale, Motivational questionnaire] were used to assess the attentional bias, psychological variables, and smoking-related characteristics. Responses at the Emotional Smoke Stroop task revealed that current and former smokers are actually slower than non-smokers are when facing smoking cues, while performances at other Stroop conditions and at the Go/no-Go task are not statistically different. These results confirmed the occurrence of the attentional bias in current smokers, and above all points out that the same effect is present in former smokers. We found only small and selective correlations between attentional bias and psychological variables (e.g., impulsiveness and inhibition). In particular, impulsivity is not directly associated with the AB intensity. Also, smoking characteristics (e.g., years of smoking and dependence level) and the length of the period of abstinence do not seem to modulate implicit cognition of smoking cue. Our data support the idea that the attentional bias may be considered relevant in sustaining smoking and favoring relapse.
Collapse
Affiliation(s)
- Marianna Masiero
- Department of Biomedical and Clinical Sciences (DIBIC), Luigi Sacco, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (IEO), IRCSS, Milan, Italy
| | | | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, European Institute of Oncology (IEO), IRCSS, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (IEO), IRCSS, Milan, Italy.,Department of Oncology and Emato-Oncology (DIPO), University of Milan, Milan, Italy
| | - Giulia Veronesi
- Division of Thoracic and General Surgery, Humanitas Research Hospital, Rozzano, Italy
| | - Ketti Mazzocco
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (IEO), IRCSS, Milan, Italy.,Department of Oncology and Emato-Oncology (DIPO), University of Milan, Milan, Italy
| |
Collapse
|
16
|
Singh NB, Björling EA. A review of EMA assessment period reporting for mood variables in substance use research: Expanding existing EMA guidelines. Addict Behav 2019; 94:133-146. [PMID: 30712774 DOI: 10.1016/j.addbeh.2019.01.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 01/03/2019] [Accepted: 01/23/2019] [Indexed: 10/27/2022]
Abstract
Ecological Momentary Assessment (EMA) is an increasingly popular approach in substance use research for capturing reliable, in-situ, self-reported information about fluctuating variables, such as mood, over time. Current EMA guidelines do not sufficiently address the reporting of assessment periods (e.g., right now, past 30 min). Given the importance of time in EMA studies, variation and ambiguity in assessment period reporting risks misinterpretation of procedures and findings. The following study reviewed the methodological reporting of EMA assessment periods in substance use research. A search conducted in PsychINFO and PubMed using the terms "ecological momentary assessment" OR "EMA" AND "mood" AND "substance use" yielded 36 unique search results. The references of these results were hand searched and resulted in 126 additional studies. After deleting duplicates and applying inclusion criteria, 56 studies were included in the review. Review of these studies illustrated (1) variability and ambiguity in study assessment periods (2) within-study incongruence between assessment period descriptions and associated EMA prompts, (3) and a large temporal range of retrospective assessment periods across studies. Each of these findings are illustrated and discussed using examples from the literature. From these examples, assessment period reporting guidelines are proposed to improve EMA reporting clarity. Such improvements will facilitate increased synthesis of EMA research and position future researchers to investigate the validity and reliability of EMA data captured with different lengths of retrospection.
Collapse
|
17
|
Predictors of craving and substance use among patients with alcohol, tobacco, cannabis or opiate addictions: Commonalities and specificities across substances. Addict Behav 2018; 83:123-129. [PMID: 29428330 DOI: 10.1016/j.addbeh.2018.01.041] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 01/25/2018] [Accepted: 01/31/2018] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Craving has been proposed as a major contributor to addiction relapse and the influence of mood on craving and substance use has been extensively documented. However, information is lacking concerning the extent to which the magnitude of these effects may vary according to different types of substances. The aim of the present study was to compare the prospective links between emotions, craving and substance use in four groups of patients beginning treatment for alcohol, tobacco, cannabis, or opiate addiction. METHODS Ecological Momentary Assessment (EMA) was used over a two-week period. Data were analyzed using hierarchical linear modeling (HLM). RESULTS 159 participants were recruited (67.3% male; M = 36.7 years). The average response rate to the EMA assessments was 83.1%. The findings confirmed the strong predictive role of craving intensity on substance use reported at the next assessment of the day among the alcohol (γ = 0.224; p = .018), tobacco (γ = 0.133; p = .013) and cannabis groups (γ = 0.266; p = .019), but not for opiates (γ = 0.098; p = .142). Craving intensity was itself predicted by greater anxious mood (γ = 0.108; p = 0,029) and event negativity (γ = 0.107; p = .003) among tobacco patients, lower sad mood among cannabis patients (γ = -0.248; p = 0,002), and lower event negativity among opiate patients (γ = -0.201; p = .002). CONCLUSION While these results support the benefit of targeting craving in addiction treatment regardless of substance type, the substance-specific emotional risk factors for craving identified in this study may provide important insights for the development of personalized treatment strategies.
Collapse
|
18
|
Ray LA, Roche DJO. Neurobiology of Craving: Current Findings and New Directions. CURRENT ADDICTION REPORTS 2018. [DOI: 10.1007/s40429-018-0202-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
19
|
Markou A, Li J, Tse K, Li X. Cue-induced nicotine-seeking behavior after withdrawal with or without extinction in rats. Addict Biol 2018; 23:111-119. [PMID: 27894160 DOI: 10.1111/adb.12480] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 10/28/2016] [Accepted: 11/02/2016] [Indexed: 11/28/2022]
Abstract
Exposure to smoking-associated environmental cues during smoke cessation elicits self-reported urge/craving to smoke, which precipitates relapse even after prolonged abstinence. Incubation of cue-induced cigarettes craving during abstinence has been observed in human smokers recently. The present studies assessed cue-induced nicotine-seeking behavior under different withdrawal conditions in rats with a history of nicotine self-administration. We found that non-reinforced operant responding during cue-induced nicotine seeking after different periods of withdrawal from nicotine exhibited an inverted U-shaped curve, with higher levels of responding after 7-21 days of withdrawal than those after 1-day withdrawal. Cue-induced nicotine-seeking responding is long lasting and persists even after 42 days of forced withdrawal in the home cages. Interestingly, repeated testing of cue-induced nicotine seeking at different withdrawal time points (1, 7, 14, 21 and 42 days) in the same individual alleviated responding as compared with the between-subjects assessment. Furthermore, extinction training during nicotine withdrawal significantly decreased cue-induced reinstatement of nicotine-seeking behavior. Together, profound time-dependent incubation of cue-induced craving in nicotine-experienced rats were observed. In addition, repeated cue exposure or extinction training decreases cue-induced craving. The demonstration of incubation of nicotine craving phenomenon in both rat and human studies provides support for the translational potential of therapeutic targets for relapse uncovered through mechanism studies in rats.
Collapse
Affiliation(s)
- Athina Markou
- Department of Psychiatry, School of Medicine; University of California San Diego; La Jolla CA USA
| | - Jie Li
- Department of Psychiatry, School of Medicine; University of California San Diego; La Jolla CA USA
| | - Kearny Tse
- Department of Psychiatry, School of Medicine; University of California San Diego; La Jolla CA USA
| | - Xia Li
- Department of Psychiatry, School of Medicine; University of California San Diego; La Jolla CA USA
| |
Collapse
|
20
|
Rose SW, Anesetti-Rothermel A, Elmasry H, Niaura R. Young adult non-smokers' exposure to real-world tobacco marketing: results of an ecological momentary assessment pilot study. BMC Res Notes 2017; 10:435. [PMID: 28859667 PMCID: PMC5580291 DOI: 10.1186/s13104-017-2758-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 08/23/2017] [Indexed: 11/18/2022] Open
Abstract
Background The aims of this pilot study were to assess and characterize non-current smoking young adults’ exposure to tobacco marketing through an ecological momentary assessment protocol. Methods Ecological momentary assessment (EMA) consists of repeated measurement of momentary phenomena and is well-suited to capture sporadic experiences in the real-world, such as exposure to tobacco marketing. EMA has the potential to capture detailed information about real-world marketing exposures in ways that reduce recall bias and increase ecological validity. In this study, young adults (n = 31; ages 18–25) responded to random prompts regarding their momentary exposure to tobacco marketing via text messages on their smartphones for 14 days (n = 1798 observations). Unadjusted and adjusted analyses were conducted using multilevel logistic regression to assess the odds of exposure accounting for correlation of multiple repeated measures within individuals while controlling for variability between individuals. Results Respondents reported, on average, two momentary exposures to tobacco advertising in the 14-day study period. In adjusted analyses, African–American (aOR 3.36; 95% CI 1.07, 10.54) and Hispanic respondents (aOR 5.08; 95% CI 1.28, 20.13) were more likely to report exposure to tobacco advertising. Respondents were also more likely to report exposure when also exposed to others using tobacco products and when they were at stores compared with at home (aOR 14.82; 95% CI 3.61, 60.88). Conclusion Non-smoking young adults report exposure to tobacco marketing particularly at the point-of-sale, with the highest likelihood of exposure among African-American and Hispanic young people. EMA protocols can be effective in assessing the potential impact of point-of-sale tobacco marketing on young adults. Electronic supplementary material The online version of this article (doi:10.1186/s13104-017-2758-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Shyanika W Rose
- Schroeder Institute at Truth Initiative, Washington, DC, USA.
| | | | - Hoda Elmasry
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Ray Niaura
- Schroeder Institute at Truth Initiative, Washington, DC, USA.,College of Global Public Health, New York University, New York, NY, USA
| |
Collapse
|
21
|
Jensen KP, Smith AH, Herman AI, Farrer LA, Kranzler HR, Sofuoglu M, Gelernter J. A protocadherin gene cluster regulatory variant is associated with nicotine withdrawal and the urge to smoke. Mol Psychiatry 2017; 22:242-249. [PMID: 27067016 PMCID: PMC5390815 DOI: 10.1038/mp.2016.43] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 02/18/2016] [Accepted: 02/22/2016] [Indexed: 01/03/2023]
Abstract
Nicotine withdrawal symptoms contribute to relapse in smokers, thereby prolonging the harm caused by smoking. To investigate the molecular basis for this phenomenon, we conducted a genome-wide association study of DSM-IV nicotine withdrawal in a sample of African American (AA) and European American (EA) smokers. A combined AA and EA meta-analysis (n=8021) identified three highly correlated single nucleotide polymorphisms (SNPs) in the protocadherin (PCDH)-α, -β and -γ gene cluster on chromosome 5 that were associated with nicotine withdrawal (P<5 × 10-8). We then studied one of the SNPs, rs31746, in an independent sample of smokers who participated in an intravenous nicotine infusion study that followed overnight smoking abstinence. After nicotine infusion, abstinent smokers with the withdrawal risk allele experienced greater alleviation of their urges to smoke, as assessed by the Brief Questionnaire on Smoking Urges (BQSU). Prior work has shown that the PCDH-α, -β and -γ genes are expressed in neurons in a highly organized manner. We found that rs31746 mapped to a long-range neuron-specific enhancer element shown previously to regulate PCDH-α, -β and -γ gene expression. Using Braincloud mRNA expression data, we identified a robust and specific association between rs31746 and PCDH-β8 mRNA expression in frontal cortex tissue (P<1 × 10-5). We conclude that PCDH-α, -β and -γ gene cluster regulatory variation influences the severity of nicotine withdrawal. Further studies on the PCDH-α, -β and -γ genes and their role in nicotine withdrawal may inform the development of novel smoking cessation treatments and reduce the harm caused by tobacco smoking.
Collapse
Affiliation(s)
- Kevin P. Jensen
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA and VA Connecticut Healthcare System, West Haven, CT, USA
| | - Andrew H. Smith
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA and VA Connecticut Healthcare System, West Haven, CT, USA
- Interdepartmental Neuroscience Program and Medical Scientist Training Program, Yale University School of Medicine, New Haven, CT, USA
| | - Aryeh I. Herman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA and VA Connecticut Healthcare System, West Haven, CT, USA
| | - Lindsay A. Farrer
- Department of Medicine (Biomedical Genetics), Neurology, Ophthalmology, Epidemiology, and Biostatistics, Boston University School of Medicine and Public Health, Boston, MA, USA
| | - Henry R. Kranzler
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine and the VISN4 MIRECC, Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - Mehmet Sofuoglu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA and VA Connecticut Healthcare System, West Haven, CT, USA
| | - Joel Gelernter
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA and VA Connecticut Healthcare System, West Haven, CT, USA
- Departments of Genetics and Neurobiology, Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
22
|
Piper ME, Vasilenko SA, Cook JW, Lanza ST. What a difference a day makes: differences in initial abstinence response during a smoking cessation attempt. Addiction 2017; 112:330-339. [PMID: 27633341 PMCID: PMC5233552 DOI: 10.1111/add.13613] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/04/2016] [Accepted: 09/15/2016] [Indexed: 12/18/2022]
Abstract
AIMS To (1) identify distinct classes of smokers based on quit day withdrawal symptoms and (2) explore the relations between withdrawal classes and demographics, tobacco dependence, treatment and smoking outcomes. DESIGN Secondary data analysis of participants (n = 1504) in a randomized double-blind placebo-controlled multi-site smoking cessation trial who provided ecological momentary assessments of withdrawal symptoms on their quit day. Participants received smoking cessation counseling and were randomized to receive placebo or one of five active pharmacotherapies. SETTING Research offices in Madison and Milwaukee, Wisconsin, USA. PARTICIPANTS Adult smokers (n = 1236; 58% female, 86% white), recruited from the community via advertisements, who abstained on their quit day. MEASUREMENTS Demographics and tobacco dependence were assessed at baseline and participants carried palmtop computers to record withdrawal symptoms (craving, negative affect, difficulty concentrating, hunger and anhedonia) on their quit day. Point-prevalence abstinence and latency to relapse were assessed at 8 weeks and 6 months post-quit. FINDINGS Latent class analysis identified four withdrawal classes [Akaike information criterion (AIC) = 70.09]: Moderate withdrawal (64% of sample), high craving-anhedonia (8% of sample), affective withdrawal (13% of sample) and hunger (15% of sample). The high craving-anhedonia class reported significantly higher dependence (P < 0.01), were less likely to have received combination nicotine replacement, reported lower week 8 abstinence rates and relapsed sooner than those in the moderate withdrawal class (P < 0.05). The affective withdrawal class reported higher levels of baseline negative affect and life-time psychopathology (P < 0.05) and relapsed more quickly than the moderate withdrawal class (P < 0.01). CONCLUSIONS While the majority of smokers report typical levels of withdrawal symptoms on their quit day, more than one-third report extreme craving or extreme negative affective or extreme hunger responses to initial abstinence. These distinct quit-day withdrawal symptom patterns are related to baseline characteristics, treatment and cessation success.
Collapse
Affiliation(s)
- Megan E. Piper
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison,Department of Medicine, University of Wisconsin, Madison
| | | | - Jessica W. Cook
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison,Department of Medicine, University of Wisconsin, Madison,William S. Middleton Memorial Veterans Hospital
| | - Stephanie T. Lanza
- The Methodology Center, The Pennsylvania State University,Department of Biobehavioral Health and Human Development, The Pennsylvania State University
| |
Collapse
|
23
|
Lydon-Staley DM, Cleveland HH, Huhn AS, Cleveland MJ, Harris J, Stankoski D, Deneke E, Meyer RE, Bunce SC. Daily sleep quality affects drug craving, partially through indirect associations with positive affect, in patients in treatment for nonmedical use of prescription drugs. Addict Behav 2017; 65:275-282. [PMID: 27544697 DOI: 10.1016/j.addbeh.2016.08.026] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/28/2016] [Accepted: 08/13/2016] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Sleep disturbance has been identified as a risk factor for relapse in addiction to a range of substances. The relationship between sleep quality and treatment outcome has received relatively little attention in research on nonmedical use of prescription drugs (NMUPD). This study examined the within-person association between sleep quality and craving in medically detoxified patients in residence for the treatment of NMUPD. METHOD Participants (n=68) provided daily reports of their sleep quality, negative affect (NA), positive affect (PA), and craving for an average of 9.36 (SD=2.99) days. Within-person associations of sleep quality and craving were examined using multilevel modeling. Within-person mediation analyses were used to evaluate the mediating roles of NA and PA in the relationship between sleep quality and craving. RESULTS Greater cravings were observed on days of lower than usual sleep quality (γ10=-0.10, p=0.003). Thirty-one percent of the overall association between sleep quality and craving was explained by PA, such that poorer sleep quality was associated with lower PA and, in turn, lower PA was associated with greater craving. No evidence emerged for an indirect association between sleep quality and craving through NA. CONCLUSIONS Daily fluctuations in sleep quality were associated with fluctuations in craving, an association partially explained by the association between sleep quality and daily PA. These data encourage further research on the relationship between sleep, affect, and craving in NMUPD patients, as well as in patients with other substance use disorders.
Collapse
Affiliation(s)
- David M Lydon-Staley
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States.
| | - H Harrington Cleveland
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
| | - Andrew S Huhn
- Department of Psychiatry, The Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Michael J Cleveland
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
| | - Jonathan Harris
- Department of Psychiatry, The Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Dean Stankoski
- Department of Psychiatry, The Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Erin Deneke
- Caron Treatment Centers, Wernersville, PA, United States
| | - Roger E Meyer
- Department of Psychiatry, The Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Scott C Bunce
- Department of Psychiatry, The Pennsylvania State University College of Medicine, Hershey, PA, United States
| |
Collapse
|
24
|
Cook JW, Baker TB, Beckham JC, McFall M. Smoking-induced affect modulation in nonwithdrawn smokers with posttraumatic stress disorder, depression, and in those with no psychiatric disorder. JOURNAL OF ABNORMAL PSYCHOLOGY 2016; 126:184-198. [PMID: 28004948 DOI: 10.1037/abn0000247] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This research sought to determine whether smoking influences affect by means other than withdrawal reduction. Little previous evidence suggests such an effect. We surmised that such an effect would be especially apparent in posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), 2 disorders that are frequently comorbid with smoking and that involve dysregulated affect. Participants were U.S. veterans who were regular smokers (N = 159): 52 with PTSD (58% with comorbid MDD), 51 with MDD, and 56 controls with no psychiatric disorder. During 3 positive and 3 negative mood induction trials (scheduled over 2 sessions), nonwithdrawn participants smoked either a nicotine-containing cigarette (NIC+), a nicotine-free cigarette (NIC-), or held a pen. Positive and negative affect were each measured before and after mood induction. Results showed a significant 2-way interaction of Smoking Condition × Time on negative affect during the negative mood induction (F(6, 576) = 2.41, p = .03) in those with PTSD and controls. In these groups, both NIC+ and NIC-, relative to pen, produced lower negative affect ratings after the negative mood induction. There was also a 2-way interaction of Smoking Condition × Time on positive affect response to the positive mood induction among those with PTSD and controls (F(6, 564) = 3.17, p = .005) and among MDD and controls (F(6, 564) = 2.27, p = .036). Among all smokers, NIC+ enhanced the magnitude and duration of positive affect more than did NIC-. Results revealed affect modulation outside the context of withdrawal relief; such effects may motivate smoking among those with psychiatric diagnoses, and among smokers in general. (PsycINFO Database Record
Collapse
Affiliation(s)
- Jessica W Cook
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health
| | - Timothy B Baker
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health
| | | | - Miles McFall
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine and Public Health
| |
Collapse
|
25
|
Green R, Bujarski S, Roche DJO, Ray LA. Relationship between negative affect and smoking topography in heavy drinking smokers. Addict Behav 2016; 61:53-7. [PMID: 27240211 PMCID: PMC6090554 DOI: 10.1016/j.addbeh.2016.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 04/29/2016] [Accepted: 05/16/2016] [Indexed: 12/16/2022]
Abstract
Heavy drinking smokers represent a sizeable subgroup of smokers for whom nicotine deprivation and alcohol use increases the urge to smoke in the laboratory and predicts lapses during smoking cessation. The manner in which individuals smoke a cigarette (i.e. smoking topography) provides a reliable index of smoking intensity and reinforcement, yet the effects of affect on smoking topography have not been thoroughly examined in heavy drinking smokers. The current study examined how affect and nicotine deprivation predict smoking behavior as participants (N=27) smoked one cigarette using a smoking topography device after 12-h of nicotine abstinence and after a priming dose of alcohol (target BrAC=0.06g/dl). Primary smoking topography measures were puff volume, velocity, duration, and inter-puff interval (IPI). The effect of nicotine deprivation was measured by the Minnesota Nicotine Withdrawal Scale (MNWS) and the Profile of Mood States (POMS). Measures were obtained at baseline (i.e. 12-h of nicotine abstinence and pre-alcohol) and 30-minutes after alcohol administration (i.e. peak BrAC). Results revealed post-priming negative affect significantly moderated the trajectories of puff volume, puff duration and IPI (p's<0.05) over the course of the cigarette, such that those with greater negative affect had flatter slopes for volume and duration and increasingly infrequent puffs. Our results suggest that baseline and post-priming negative affect following nicotine deprivation alters smoking patterns and increases nicotine exposure throughout a single cigarette. Future studies need to examine differential amounts of nicotine deprivation on response to alcohol and smoking in heavy drinking smokers.
Collapse
Affiliation(s)
- ReJoyce Green
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - Spencer Bujarski
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - Daniel J O Roche
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, United States; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90095, United States.
| |
Collapse
|
26
|
Ecological momentary assessment of affect and craving in patients in treatment for prescription opioid dependence. Brain Res Bull 2016; 123:94-101. [PMID: 26876756 DOI: 10.1016/j.brainresbull.2016.01.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 11/21/2022]
Abstract
Low positive affect (PA) is likely to contribute to risk of relapse; however, it has received relatively little attention in clinical research. This study examined the associations among positive affect, negative affect (NA), and craving in medically withdrawn patients using ecological momentary assessment (EMA). Participants (n=73) provided reports of their PA, NA, and craving 4 times a day for an average of 10.47 (SD=3.80) days. Person- and day-level associations between PA, NA, and craving were examined using multilevel models. A significant interaction emerged between person- and day-level PA such that PA on the day level was negatively associated with craving for individuals experiencing low mean PA throughout the study. No significant interaction emerged between person- and day-level NA. The main effects for both person- and day-level NA were significant. Individuals experiencing high NA throughout the study experienced higher craving overall and on days when NA was higher than usual, craving was also higher. Results suggest that high person- and day-level NA may directly contribute to the risk for relapse via increased craving, whereas low day- level PA may contribute to risk for relapse among individuals exhibiting low person-level PA via increased craving on days with lower than average levels of PA for those individuals. Given that there is a paucity of research relating low PA to craving, continued investigation into how and when low PA creates risk for relapse is warranted.
Collapse
|
27
|
Pike JR, Xie B, Tan N, Sabado-Liwag MD, Orne A, Toilolo T, Cen S, May V, Lee C, Pang VK, Rainer MA, Vaivao DES, Lepule JT, Tanjasiri SP, Palmer PH. Developing an Internet- and Mobile-Based System to Measure Cigarette Use Among Pacific Islanders: An Ecological Momentary Assessment Study. JMIR Mhealth Uhealth 2016; 4:e2. [PMID: 26743132 PMCID: PMC4722229 DOI: 10.2196/mhealth.4437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 08/02/2015] [Accepted: 10/09/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Recent prevalence data indicates that Pacific Islanders living in the United States have disproportionately high smoking rates when compared to the general populace. However, little is known about the factors contributing to tobacco use in this at-risk population. Moreover, few studies have attempted to determine these factors utilizing technology-based assessment techniques. OBJECTIVE The objective was to develop a customized Internet-based Ecological Momentary Assessment (EMA) system capable of measuring cigarette use among Pacific Islanders in Southern California. This system integrated the ubiquity of text messaging, the ease of use associated with mobile phone apps, the enhanced functionality offered by Internet-based Cell phone-optimized Assessment Techniques (ICAT), and the high survey completion rates exhibited by EMA studies that used electronic diaries. These features were tested in a feasibility study designed to assess whether Pacific Islanders would respond to this method of measurement and whether the data gathered would lead to novel insights regarding the intrapersonal, social, and ecological factors associated with cigarette use. METHODS 20 young adult smokers in Southern California who self-identified as Pacific Islanders were recruited by 5 community-based organizations to take part in a 7-day EMA study. Participants selected six consecutive two-hour time blocks per day during which they would be willing to receive a text message linking them to an online survey formatted for Web-enabled mobile phones. Both automated reminders and community coaches were used to facilitate survey completion. RESULTS 720 surveys were completed from 840 survey time blocks, representing a completion rate of 86%. After adjusting for gender, age, and nicotine dependence, feeling happy (P=<.001) or wanting a cigarette while drinking alcohol (P=<.001) were positively associated with cigarette use. Being at home (P=.02) or being around people who are not smoking (P=.01) were negatively associated with cigarette use. CONCLUSIONS The results of the feasibility study indicate that customized systems can be used to conduct technology-based assessments of tobacco use among Pacific Islanders. Such systems can foster high levels of survey completion and may lead to novel insights for future research and interventions.
Collapse
Affiliation(s)
- James Russell Pike
- School of Community and Global Health, Claremont Graduate University, Claremont, CA, United States.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Littel M, van den Hout MA, Engelhard IM. Desensitizing Addiction: Using Eye Movements to Reduce the Intensity of Substance-Related Mental Imagery and Craving. Front Psychiatry 2016; 7:14. [PMID: 26903888 PMCID: PMC4745337 DOI: 10.3389/fpsyt.2016.00014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 01/25/2016] [Indexed: 01/31/2023] Open
Abstract
Eye movement desensitization and reprocessing (EMDR) is an effective treatment for posttraumatic stress disorder. During this treatment, patients recall traumatic memories while making horizontal eye movements (EM). Studies have shown that EM not only desensitize negative memories but also positive memories and imagined events. Substance use behavior and craving are maintained by maladaptive memory associations and visual imagery. Preliminary findings have indicated that these mental images can be desensitized by EMDR techniques. We conducted two proof-of-principle studies to investigate whether EM can reduce the sensory richness of substance-related mental representations and accompanying craving levels. We investigated the effects of EM on (1) vividness of food-related mental imagery and food craving in dieting and non-dieting students and (2) vividness of recent smoking-related memories and cigarette craving in daily smokers. In both experiments, participants recalled the images while making EM or keeping eyes stationary. Image vividness and emotionality, image-specific craving and general craving were measured before and after the intervention. As a behavioral outcome measure, participants in study 1 were offered a snack choice at the end of the experiment. Results of both experiments showed that image vividness and craving increased in the control condition but remained stable or decreased after the EM intervention. EM additionally reduced image emotionality (experiment 2) and affected behavior (experiment 1): participants in the EM condition were more inclined to choose healthy over unhealthy snack options. In conclusion, these data suggest that EM can be used to reduce intensity of substance-related imagery and craving. Although long-term effects are yet to be demonstrated, the current studies suggest that EM might be a useful technique in addiction treatment.
Collapse
Affiliation(s)
- Marianne Littel
- Clinical Psychology, Utrecht University , Utrecht , Netherlands
| | | | | |
Collapse
|
29
|
Emotion differentiation and intensity during acute tobacco abstinence: A comparison of heavy and light smokers. Addict Behav 2015; 47:70-3. [PMID: 25885662 DOI: 10.1016/j.addbeh.2015.03.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 02/04/2015] [Accepted: 03/29/2015] [Indexed: 11/22/2022]
Abstract
The ability to recognize and label discrete emotions, termed emotion differentiation, is particularly pertinent to overall emotion regulation abilities. Patterns of deficient emotion differentiation have been associated with mood and anxiety disorders but have yet to be examined in relation to nicotine dependence. This study employed ecological momentary assessment to examine smokers' subjective experience of discrete emotions during 24-h of forced tobacco abstinence. Thirty daily smokers rated their emotions up to 23 times over the 24-hour period, and smoking abstinence was biologically verified. From these data, we computed individual difference measures of emotion differentiation, overall emotion intensity, and emotional variability. As hypothesized, heavy smokers reported poorer negative emotion differentiation than light smokers (d=0.55), along with more intense negative emotion (d=0.97) and greater negative emotion variability (d=0.97). No differences were observed in positive emotion differentiation. Across the sample, poorer negative emotion differentiation was associated with greater endorsement of psychological motives to smoke, including negative and positive reinforcement motives, while positive emotion differentiation was not.
Collapse
|