Cognitive reappraisal and expressive suppression emotion regulation strategies in cigarette smokers

Emotion Regulation Difficulties and Smoking Behavior among Adults with Chronic Obstructive Pulmonary Diseases

COPD is one of the leading causes of death in the United States and results in increased healthcare costs and disability. Smoking is the main determinant of COPD development and continued use increases mortality as compared to those who have stopped smoking. Research has indicated that cigarette smoking may play a role in attempts to regulate distressing emotional experiences and thus, may be an important transdiagnostic process underlying continued smoking behavior among adults with COPD. The current study investigated the role of ER difficulties in relation to smoking status and cigarettes smoked per day among adults with COPD. This cross-sectional study included a sample was adults with COPD (N = 320). Participants self-reported current smoking status, daily smoking, and the Difficulties in Emotion Regulation Scale. All analyses were adjusted for age, sex, probable depression, probable anxiety, and dyspnea severity. DERS total scores were associated with greater odds of current smoking. With the exception of impulsivity, all other dimensions of emotion regulation were significantly associated with current smoking. Greater difficulties in emotional awareness were associated with greater cigarettes smoked per day. However, neither the DERS total score nor any other dimensions of emotional regulation were significantly associated with cigarettes smoked per day. The present study provides preliminary data linking ER difficulties to smoking behavior among adults with COPD. If corroborated by future research, these findings suggest that ER might be a potential target for smoking cessation programs among adults with COPD.

Emotional dysregulation among English-speaking Hispanic persons who smoke living in the United states

Hispanic/Latinx (hereafter Hispanic) individuals in the United States (US) experience serious tobacco-related disparities and factors contributing to such disparities need to be adequately identified and clinically addressed. Emotion dysregulation is a key transdiagnostic relevant to smoking. The present cross-sectional investigation sought to test if emotion dysregulation was related to more severe problems during smoking quit attempts (e.g., irritability, weight gain), perceptions of difficulty about quitting, as well as negative and positive beliefs about smoking abstinence in a sample of English-speaking Hispanic adults residing in the US who smoke. Participants included 332 Hispanic adults who engaged in daily cigarette smoking (35.46 years old, 37 % identified as female). Emotion dysregulation was significantly related to more severe problems when quitting and perceived barriers for quitting, as well as negative beliefs about smoking abstinence. Additionally, emotion dysregulation was significantly and negatively related to positive outcomes about smoking abstinence. The amount of change in the various smoking criterion variables accounted for by emotion dysregulation was small (sr2 range: 0.028-0.085), but evident in adjusted models that accounted for a wide range of factors (e.g., depression, drug use severity). Overall, this investigation found consistent empirical evidence that individual differences in emotion dysregulation in Hispanic individuals were associated with several clinically significant smoking processes, suggesting this construct may represent an important factor involved in the maintenance and relapse of smoking among this ethnic population.

Context matters: Exploring the adaptive nature of self-regulation skills in predicting abstinence among veterans with alcohol use disorder

BACKGROUND

Alcohol use disorder (AUD) is highly prevalent among veterans in the United States. Self-regulation skills (e.g., coping and emotion regulation) are important biopsychosocial factors for preventing relapse. However, how variation in self-regulation skills supports abstinence based on contextual demands is understudied in veterans with AUD.

METHODS

In a prospective longitudinal design, treatment-seeking veterans (n = 120; 29 females) aged 23-91 with AUD completed the Alcohol Abstinence Self-Efficacy Scale to assess temptation to drink across several high-risk situations (i.e., negative affect, social/positive emotions, physical concerns, and craving/urges) as well as the Brief-COPE and Emotion Regulation Questionnaire to assess self-regulation skills. Abstinence status was assessed at 6 months. T-tests were used to identify self-regulation skills that differed between abstinent and non-abstinent individuals. Multivariate regression with model selection was performed using all possible interactions between each high-risk situation and the self-regulation skills that significantly differed between groups.

RESULTS

Overall, 33.3% of participants (n = 40; nine females) were abstinent at 6 months. Abstinent individuals reported significantly higher use of suppression (p = 0.015), acceptance (p = 0.005), and planning (p = 0.045). Multivariate regression identified significant interactions between (1) planning and physical concerns (p = 0.010) and (2) acceptance, suppression, and craving/urges (p = 0.007). Greater planning predicted abstinence in participants with higher temptation to drink due to physical concerns (e.g., pain). For individuals with lower temptation to drink due to cravings/urges, simultaneous higher suppression and acceptance increased the likelihood of abstinence. Conversely, for participants with higher cravings, greater acceptance with lower suppression was linked to a higher probability of abstinence.

CONCLUSIONS

Results suggest that the adaptiveness of self-regulation skills in predicting AUD recovery is dependent on contextual demands and highlight the need for culturally sensitive treatments. Collectively, these findings indicate that further research on coping and regulatory flexibility may be an important avenue for tailoring AUD treatment for veterans.

Differences by Emotion Regulation in the Association Between Discrimination and Tobacco Use Among Sexual Minority Young Adults

Little research has examined factors, such as emotion regulation strategies, that amplify or mitigate associations between discrimination and tobacco use among sexual minority young adults (SMYAs). SM-identifying YA (ages 18-34) women (N = 450; Mage = 24.11; 31.1% racial or ethnic minority) and men (N = 254; Mage = 24.68; 28.0% racial or ethnic minority) residing in 6 US metropolitan areas were surveyed. Bivariate analyses examined associations of sociodemographics (i.e. age, race, ethnicity, education), discrimination, and emotion regulation strategies (i.e. cognitive reappraisal, expressive suppression) with tobacco use outcomes (i.e. past 30-day cigarette, e-cigarette, other tobacco [aggregated across cigars, hookah] use). Multivariable logistic regressions were built for each tobacco use outcome and included sociodemographic covariates, discrimination and emotion regulation strategies, and interactions between discrimination and emotion regulation strategies. Among SMYA women, a significant interaction of discrimination and cognitive reappraisal indicated that discrimination was associated with greater odds of past 30-day e-cigarette use only among women with lower levels of cognitive reappraisal. Discrimination and emotion regulation were not significantly associated with tobacco use among men. SMYA women with lesser use of cognitive reappraisal may be at heightened risk for e-cigarette use if they experience discrimination. Tobacco cessation programs for SM women should incorporate emotion regulation skills.

Emotion regulation strategies moderate the impact of negative affect induction on alcohol craving in college drinkers: an experimental paradigm

Objectives: Observational studies suggest emotion regulation (ER) as a potential treatment target for problematic college drinking. The primary aim of this laboratory study was to determine whether trait ER strategies would moderate the impact of negative affect induction on alcohol craving in college drinkers. Methods: Participants were randomly assigned to a neutral (n = 74) or a negative affect induction (n = 76) and reported their craving after the affect inductions. Results: Greater use of drinking to cope and less use of cognitive reappraisal predicted greater alcohol craving after the negative affect induction, but not after the neutral condition. In contrast, emotion suppression did not predict alcohol craving in either condition. Conclusion: Our results highlight the role of ER tendencies-particularly the benefits of cognitive reappraisal-on alcohol craving when experiencing emotional distress. Therefore, ER strategies may be an important target for college drinkers to prevent and reduce problematic drinking.

Difficulties in emotion regulation and ad libitum smoking topography: A secondary analysis

INTRODUCTION

Despite the well-known linkages between poor emotion regulation and subjective smoking motives, little is known about the role of emotion regulation in predicting smoking reinforcement behavior. This study examined the relation between difficulties in emotion regulation and puff velocity data, a behavioral index of smoking reinforcement, in adult daily cigarette smokers.

METHOD

The current study was a secondary analysis of data collected from non-treatment seeking daily smokers (N = 124). Participants completed the Difficulties in Emotion Regulation Scale (DERS) followed by an ad libitum smoking period during which puff topography data was collected via a handheld puffing device. Puff velocity served as our puff topography index and was examined at the average and puff-to-puff level using regression and multi-level models, respectively.

RESULTS

Regression analyses showed no significant association between DERS scores and average puff velocity. In contrast, multi-level modeling found a significant quadratic time × DERS effect at the puff-to-puff level, such that those with greater emotion regulation difficulties inhaled more quickly at the initiation of the cigarette, whereas those with lower emotion regulation difficulties evidenced consistent puffing over the course of the cigarette.

DISCUSSION

Smokers with greater difficulties in emotion regulation appear to smoke in a way that maximizes delivery of nicotine, perhaps to self-regulate distress. One's style of puffing may reflect a possible behavioral marker of negative reinforcement smoking, especially in the context of emotional distress.

IMPLICATIONS

This study was the first to explore the relationship between difficulties in emotion regulation and a behavioral measure of smoking reinforcement.

Linking Cognitive Reappraisal and Expressive Suppression to Mindfulness: A Three-Level Meta-Analysis

Cognitive reappraisal and expressive suppression have long been considered the two most important emotion regulation strategies. Increasingly, studies have found that mindfulness has a relationship with them. However, the magnitude and direction of the relationship between them have yet to reach a consistent conclusion. To this end, a three-level meta-analysis was used to explore the relationship between mindfulness, cognitive reappraisal, and expressive suppression. Thirty-six studies were included in the meta-analysis through a literature search, including 36 samples with 83 effect sizes and a total of 12,026 subjects. The three-level random effects model showed that mindfulness was positively correlated with cognitive reappraisal to a low to moderate degree but was not correlated with expressive suppression. The moderating effect analysis showed that the relationship between mindfulness and cognitive reappraisal was slightly closer in males than in females. The study found a relatively stable positive relationship between mindfulness and cognitive reappraisal, an adaptive emotion regulation mode, while the relationship with expressive suppression was insignificant. The finding supported the affect regulation training model and also shed light on potential areas for future studies.

Risk factors of psychological distress during the COVID-19 pandemic: The roles of coping style and emotional regulation

BACKGROUND

When COVID-19 emerged in China in late 2019, most citizens were home-quarantined to prevent the spread of the SARS-CoV-2 virus. Extended periods of isolation have detrimental effects on an individual's mental health. Therefore, the impact of the COVID-19 pandemic should include assessment of psychological distress and its known risk factors, including coping style and emotional regulation.

METHODS

This cross-sectional study surveyed 6,027 Chinese university students recruited from May 25, 2020 to June 10, 2020. In addition to sociodemographic information, participant data were collected using online versions of the 10-item Kessler Psychological Distress Scale (K10), Simplified Coping Style Questionnaire (SCSQ), and Emotion Regulation Questionnaire (ERQ).

RESULTS

The incidence of psychological distress was found to be 35.34%. Negative coping style and expressing panic about COVID-19 on social media were the most important predictors of psychological distress. In addition, being male, being a "left-behind child" or having a monthly household income lower than 5000 CNY or higher than 20,000 CNY were associated with higher psychological distress.

CONCLUSION

The psychological consequences of the COVID-19 pandemic could be serious. Psychological interventions that reduce nervousness and negative coping style need to be made available to home-quarantined university students, especially those who are male, are "left-behind", have a monthly household income lower than 5000 CNY or higher than 20,000 CNY, or express panic on social media.

Emotion regulation and substance use: A meta-analysis

There has been exponential growth in research on emotion regulation and substance use in the past decade. The current meta-analysis evaluated variability in the magnitude of the relation between aspects of emotion regulation and substance use. A search of PsycINFO, Embase, PubMed, CINAHL Plus, and PILOTS in December 2020 resulted in 6642 initial studies, of which 95 met inclusion criteria (association between emotion regulation and substance use was reported, participants were > 18 years old, article was in English). A total of 445 effects were obtained (N = 156,025 participants; weighted M_age = 29.31; 59.5% female; 66.1% White; 76.6% non-clinical). Emotion regulation and substance use were significantly related (r = 0.19; p < 0.001; 95%CI [0.17, 0.20]). Emotion regulation abilities were generally more strongly related to substance use than emotion regulation strategies; this pattern was stronger for behavioral vs. cognitive abilities and extended to both negative and positive emotions. Relations were stronger for older and clinical samples; mixed effects were found for sex and no conclusive effects were found for race. Despite limitations of the existing literature (e.g., cross-sectional, self-reports), results indicated that the magnitude of the relation between emotion regulation and substance use varied considerably as a function of emotion regulation and substance use constructs and sample characteristics.

Acceptance and Commitment Therapy versus Social Support for Smoking Cessation for People with Schizophrenia: A Randomised Controlled Trial

Smoking is prevalent among people with schizophrenia. It has been found that Acceptance and commitment therapy (ACT) is effective for treating psychotic symptoms and addictive behaviours, but the therapy has not been modified to help individuals with schizophrenia to quit smoking. A randomised controlled trial was conducted with the objective of comparing a 10-week, individual, face-to-face ACT programme (n = 65) to a social support programme on smoking cessation, experiential avoidance, and emotion-regulation strategies among people with schizophrenia who smoke (n = 65). The primary outcome was self-reported smoking abstinence for 7 days at 6 months after the start of the intervention. Secondary outcomes were self-reported and biochemically validated quit rates post-intervention. The Avoidance and Inflexibility Scale (AIS), Acceptance and Action Questionnaire II (AAQII), and Emotion Regulation Questionnaire (ERQ) were employed. The self-reported quit rates in the ACT group were higher than in the social support group, although no significant differences were found (6 months: 12.3% vs. 7.7%, p = 0.56, 12 months: 10.8% vs. 7.7%, p = 0.76). We found significantly greater improvements in smoking-specific and ACT-specific experiential avoidance and less reliance on emotion regulation strategies in the ACT group at some time points. Overall, ACT is better than social support at enhancing experiential avoidance and reducing reliance on emotion regulation strategies in adults with schizophrenia who smoke. However, ACT did not produce a much better result than social support in helping them to completely quit smoking.

Executive functions and emotion regulation in substance use disorder

ABSTRACT Objective The executive functions (EF) and emotion regulation (ER) and their relationship with the substance use disorder (SUD) were analyzed. Methods A cross-sectional design was used. The sample consisted of 130 volunteers divided into three groups: group 01 (n = 60), composed of participants who did not meet the diagnostic criteria for any type of SUD; group 02 (n = 51), with users with alcohol and/or tobacco use disorder; group 03 (n = 19), with users with multiple substance use disorder, including at least one illicit substance. Results Group 02 presented worse performance in EF and ER when compared to group 01, and showed a significant correlation between the working memory and the use of maladaptive ER. Group 03 showed great losses in EF and ER when compared to the other groups. Conclusion This study supports the idea that EF, ER and SUD are related. In addition, it was observed that people with SUD had worse performance in EF and ER when compared to people without SUD, greater damage being observed in people with SUD of polysubstances.

Emotion regulation among Lebanese adults: Validation of the Emotion Regulation Questionnaire and association with attachment styles

PURPOSE

Validate the Emotion Regulation Questionnaire (ERQ) and evaluate factors associated with emotion regulation among Lebanese adults.

METHODS

A proportionate random sample of 811 participants was chosen from all Lebanese governorates in this cross-sectional study.

FINDINGS

The principal component analysis of the ERQ items yielded two factors (α_Cronbach  = 0.764 and 0.658 for the Cognitive Reappraisal and Expressive Suppression facets, respectively). Higher secure attachment style was linked to higher cognitive reappraisal and expressive suppression. Higher anxious attachment style and anxiety were associated with lower cognitive reappraisal.

PRACTICAL IMPLICATIONS

The Arabic version of the ERQ is a suitable tool for the assessment of emotion regulation tendencies in clinical practice and research. The study came up with results similar to the ones given by many international studies.

Why Do We Take Risks? Perception of the Situation and Risk Proneness Predict Domain-Specific Risk Taking

Risk taking (RT) is a component of the decision-making process in situations that involve uncertainty and in which the probability of each outcome - rewards and/or negative consequences - is already known. The influence of cognitive and emotional processes in decision making may affect how risky situations are addressed. First, inaccurate assessments of situations may constitute a perceptual bias in decision making, which might influence RT. Second, there seems to be consensus that a proneness bias exists, known as risk proneness, which can be defined as the propensity to be attracted to potentially risky activities. In the present study, we take the approach that risk perception and risk proneness affect RT behaviours. The study hypothesises that locus of control, emotion regulation, and executive control act as perceptual biases in RT, and that personality, sensation seeking, and impulsivity traits act as proneness biases in RT. The results suggest that locus of control, emotion regulation and executive control influence certain domains of RT, while personality influences in all domains except the recreational, and sensation seeking and impulsivity are involved in all domains of RT. The results of the study constitute a foundation upon which to build in this research area and can contribute to the increased understanding of human behaviour in risky situations.

Emotion dysregulation, fatigue, and electronic cigarette expectancies

Emotion dysregulation and the experience of fatigue have both been linked to the maintenance of substance use. However, limited empirical data has evaluated individual differences in these constructs in terms of e-cigarette use expectancies. The present study examined a theoretically relevant model focused on whether the experience of more severe fatigue explains, in part, the relation between individual differences in emotion dysregulation and positive and negative e-cigarette expectancies among 525 adult e-cigarette users (50.9% female, Mage = 35.25 years, SD = 10.10). It was hypothesized that emotion dysregulation, via fatigue severity, would significantly predict greater positive and negative e-cigarette expectancies, which was examined in two separate mediation models. Fatigue severity significantly explained, in part, the relation between emotion dysregulation and positive (b = 0.02, CI [0.01, 0.02]) and negative expectancies of e-cigarette use (b = 0.02, 95% CI [0.02, 0.03]). The current findings suggest that the experience of fatigue helps explain the relation between emotion dysregulation and positive and negative e-cigarette expectancies among adult e-cigarette users. Future work is needed to explicate how reducing fatigue severity in the context of emotion dysregulation may change expectancies about e-cigarette expectancies.

The protective role of emotional intelligence in smoking relapse during a 12-month follow-up smoking cessation intervention

BACKGROUND

Previous literature has shown the relationship between emotional intelligence (EI) and smoking. However, the mechanisms underlying the role of EI in smoking behaviour are still unclear. The aim of the present study was to analyse how EI abilities protect against relapse in a 12-month smoking cessation program.

METHODS

One hundred and seventy-three volunteer smokers were enrolled in a well-established smoking cessation program, accompanied by a 12-month follow-up, through the Spanish Association Against Cancer. Moderation and moderated mediation analyses were conducted to explore the influence of EI abilities on the effect of stress reactivity and nicotine dependence on the likelihood of relapse.

RESULTS

Emotional repair ability moderated the effect of stress reactivity on relapse. Higher levels of stress reactivity were associated with a higher likelihood of relapse, but only in those individuals with lower emotional repair abilities. In addition, the moderated mediation analyses revealed that emotional clarity and emotional repair abilities moderated the indirect effect of nicotine dependence on smoking relapse through its influence on stress reactivity.

CONCLUSIONS

Emotional management is a central concept in explaining smoking behaviour. Our findings suggest that the inclusion of EI training could be particularly useful for improving current smoking cessation programs. A good ability to manage emotions allows smokers to effectively apply psychological coping strategies to deal with stressful situations, thus protecting against relapse.

The association between cognitive coping strategies and treatment outcomes in smokers with PTSD

OBJECTIVE

Numerous researchers have suggested that certain coping styles (e.g., maladaptive cognitive coping strategies) interfere with recovery from traumatic experiences and contribute to the onset/maintenance of posttraumatic stress disorder (PTSD). Further, given that individuals with PTSD have a high rate of smoking (e.g., Mahaffey et al., 2016) and that maladaptive coping strategies in general are associated with lower smoking quit rates, it is possible that use of maladaptive cognitive coping strategies are particularly problematic for the recovery of smokers with PTSD. The present study examined whether specific cognitive coping strategies are associated with poorer outcome among smokers with PTSD following an integrated treatment for both disorders.

METHOD

Patients with chronic PTSD and nicotine dependence (N = 142) received up to 12 sessions of smoking cessation counseling combined with varenicline or integrated prolonged exposure therapy and cessation counseling combined with varenicline. We hypothesized that greater maladaptive, and lower adaptive, cognitive coping strategies at baseline would moderate degree of improvement in smoking and PTSD outcomes through to follow-up.

RESULTS

Multilevel modeling revealed that neither maladaptive nor adaptive cognitive coping strategies moderated smoking abstinence outcomes over the course of the study (ps ≥ .271). However, greater use of catastrophizing and lower use of positive reappraisal at baseline were associated with less improvement in the hyperarousal PTSD symptom cluster over the course of the study (ps ≤ .01).

CONCLUSIONS

These findings suggest that maladaptive cognitive coping strategies are not necessarily a contraindication for overall outcomes in integrated PTSD and smoking treatment, although they may influence improvement in hyperarousal symptoms. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Emotion dysregulation and cigarette dependence, perceptions of quitting, and problems during quit attempts among Spanish-speaking Latinx adult smokers

Latinx smokers in the United States (U.S.) represent an understudied health disparities group in terms of tobacco use. Despite scientific interest to elucidate individual difference risk factors for smoking, there is limited understanding of how emotional dysregulation relates to smoking outcomes among Spanish-speaking Latinx smokers. The purpose of the present investigation was therefore to explore emotion dysregulation in relation to cigarette dependence, perceived barriers for quitting, and severity of problems experienced during prior quit attempts. Participants were 363 Spanish-speaking Latinx daily smokers (58.7% female, M_age = 33.3 years, SD = 9.81). Results indicated that emotion dysregulation was significantly related to cigarette dependence, perceived barriers for quitting, and problems experienced during past quit attempts. Notably, the effects accounted for 7% to 15% of variance and were evident after adjusting for gender, income, education, number of medical conditions, depression symptoms, non-alcohol drug use, and alcohol consumption. The findings provide novel evidence that emotion dysregulation may represent an important individual difference factor for better understanding smoking-related outcomes among Latinx smokers and supports the need for greater attention to this affective vulnerability during smoking cessation treatment.

Inhibitory control of emotional processing: Theoretical and empirical considerations

Although inhibitory control appears to support successful emotion regulation (ER; Joorman and Gotlib, 2010; McCabe et al., 2010), few emotion inhibition studies position themselves in the literature on ER, and even fewer ER studies reference the role of emotion inhibition. Perhaps contributing to this, the ER literature is frequently divided into implicit or "automatic" (which subsumes emotion inhibition) and explicit or "effortful" control (Braunstein et al., 2017; Gyurak et al., 2011). The present paper evaluates relationships among constructs of inhibitory control, emotion inhibition, and ER to assess neural evidence for and against distinctions between implicit and explicit ER. We argue that, whereas the distinction between implicit and explicit ER may appear organizationally or conceptually helpful, such categorical distinctions are not supported by available research and in fact contribute to imbalances in the research literature.

Emotion regulation difficulties and social control correlates of smoking among pregnant women trying to quit

Approximately 15% of US women currently smoke during pregnancy. An important step toward providing effective smoking cessation interventions during pregnancy is to identify individuals who are more likely to encounter difficulty quitting. Pregnant smokers frequently report smoking in response to intrapersonal factors (e.g., negative emotions), but successful cessation attempts can also be influenced by interpersonal factors (i.e., influence from close others). This study examined the association between emotion regulation difficulties, positive and negative social control (e.g., encouragement, criticism), and smoking cessation-related variables (i.e., smoking quantity, withdrawal symptoms) among pregnant smokers. Data were drawn from the pretreatment wave of a smoking cessation trial enrolling low-income pregnant women who self-reported smoking in response to negative affect (N = 73). Greater emotion regulation difficulties were related to greater smoking urges (b = 0.295, p = .042) and withdrawal symptoms (b = 0.085, p = .003). Additionally, more negative social control from close others was related to fewer smoking days (b = -0.614, p = .042) and higher smoking abstinence self-efficacy (b = 0.017, p = .002). More positive social control from close others interacted with negative affect smoking (b = -0.052, p = .043); the association between negative affect smoking and nicotine dependence (b = 0.812, p < .001) only occurred at low levels of positive social control. Findings suggest that emotion regulation difficulties may contribute to smoking during pregnancy by exacerbating women's negative experiences related to smoking cessation attempts. Negative social control was related to lower smoking frequency and greater confidence in quitting smoking, suggesting that it may assist pregnant smokers' cessation efforts. Positive social control buffered women from the effects of negative affect smoking on nicotine dependence. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01163864.

Emotion regulation and alcohol abuse in second-generation immigrant adolescents: The protective role of cognitive reappraisal

The individual predictors of drinking behaviors among second-generation immigrant adolescents are still understudied. This study investigated emotion regulation strategies and alcohol abuse in 472 adolescents (86 second-generation immigrants and 386 Italian natives; age range: 17–18). The Emotion Regulation Questionnaire and the Alcohol Use Disorder Identification Test were used to assess cognitive reappraisal, emotional suppression, and alcohol abuse, respectively. Immigrants reported lower alcohol abuse than natives. A negative relationship between cognitive reappraisal and alcohol abuse was found for immigrants, but not for natives. Specifically, cognitive reappraisal was a protective factor against alcohol abuse only for immigrant adolescents. Clinical and research implications are discussed.

Childhood maltreatment and perceived stress in young adults: The role of emotion regulation strategies, self-efficacy, and resilience

Childhood maltreatment has many deleterious outcomes; however, trait resilience as well as emotion regulation strategies, including suppression and reappraisal, may mediate between childhood maltreatment and later perceived stress. For this study, 267 college students (183 females and 84 males; M age = 19.77, SD = 2.29) completed self-report measures of parental psychological and physical maltreatment, parental emotion neglect, habitual use of suppression and reappraisal strategies, emotion regulation self-efficacy, trait resilience, and recent perceived stress. Analyses were conducted to investigate gender-specific associations. In females, both suppression and reappraisal mediated the relationship between maternal/paternal emotional neglect and perceived stress, and suppression also mediated the relationship between maternal psychological maltreatment and perceived stress. Trait resilience mediated the relationships of all three types of maternal maltreatment, paternal psychological maltreatment, and paternal emotional neglect with perceived stress in females. There were no significant mediation effects in males. Thus, interventions aiming at reducing perceived stress associated with maternal or paternal emotional neglect or maternal psychological maltreatment in women may benefit from targeting both suppression and reappraisal. Such interventions may also be enhanced by efforts to strengthen trait resilience.

Individual differences in emotion dysregulation and trajectory of withdrawal symptoms during a quit attempt among treatment-seeking smokers

OBJECTIVE

Cigarette smoking remains the leading preventable cause of death in the United States, and withdrawal symptoms are central to the maintenance of tobacco use. Previous research suggests that individual differences in the propensity to experience negative affect may be related to more severe withdrawal symptoms. However, little research has examined how individual differences in the ability to regulate affect (emotion dysregulation) may impact withdrawal symptoms over time.

METHOD

Therefore, the current study examined the effects of emotion dysregulation on change in tobacco withdrawal symptoms over 12 weeks following a cigarette quit attempt among 188 (M_age = 38.52, SD = 14.00, 46.8% male) treatment seeking smokers.

RESULTS

Results from the study indicated greater emotion dysregulation was associated with greater quit day withdrawal symptoms as well as with as slower decline in withdrawal symptoms over the 12-week period (B = -0.001, SE = 0.001, p = .046).

CONCLUSION

The current study offers novel evidence into the role of emotion dysregulation in relation to withdrawal symptoms during a quit attempt. Assessing and reducing heightened emotion dysregulation prior to a quit attempt may be a potentially important therapeutic tactic for helping smokers achieve greater success in managing tobacco withdrawal.

PUBLIC HEALTH SIGNIFICANCE STATEMENT

This study emphasizes the ways in which emotional dysregulation may affect tobacco withdrawal symptoms. This study can be utilized to further target smoking cessation programs for those attempting to quit smoking.

Emotion Regulation Difficulties in Relation to Anxiety, Depression, and Functional Impairment Among Treatment-Seeking Smokers

Psychological distress is elevated among smokers and plays a key role in the maintenance of smoking behavior. Although research has implicated emotion regulation (ER) difficulties as a transdiagnostic construct for psychological distress, empirical work has not yet investigated ER difficulties among treatment-seeking smokers. The purpose of the current study was to increase understanding of ER difficulties in relation to depression, anxious arousal, and functional impairment among treatment-seeking smokers. Participants included adult daily treatment-seeking smokers (N = 568; Mage = 37, SD = 13.46; 51.9% male). Results indicated that global ER difficulties were significantly related to depression, anxious arousal, and functional impairment. Analyses focused on the lower-order facets of ER and indicated that limited access to ER strategies, difficulty engaging in goal-directed behavior, and lack of emotional clarity were significantly related to depression; limited access to ER strategies, nonacceptance of emotions, and impulsivity were significantly associated with anxious arousal; and limited access to ER strategies and difficulty engaging in goal-directed behavior were significantly related to functional impairment. The significant ER effects were evident above and beyond the variance accounted for by neuroticism and tobacco dependence. These findings highlight the importance of considering ER difficulties to better understand psychological distress among smokers.

Reappraisal deficits promote craving and emotional distress among chronic pain patients at risk for prescription opioid misuse

Background: A subset of chronic pain patients misuse prescription opioids as a means of regulating negative emotions. However, opioid misuse may result in deficits in emotion regulation strategies like reappraisal by virtue of the deleterious effects of chronic opioid exposure. Aims: The aim of this study was to characterize differences in reappraisal use among chronic pain patients at risk for opioid misuse and those who report taking opioids as prescribed. Methods: A sample of 127 pain patients receiving chronic opioid analgesic pharmacotherapy were classified as at risk for opioid misuse (n = 62) or taking opioids as prescribed (n = 65) using the Current Opioid Misuse Measure (COMM). The Emotion Regulation Questionnaire (ERQ) characterized use of emotion regulation strategies including reappraisal and expressive suppression. Participants also reported levels of opioid craving, emotional distress, and pain severity. Results: Patients at risk for opioid misuse reported significantly less reappraisal use (M = 25.31, SD = 7.33) than those who reportedly took opioids as prescribed (M = 30.28, SD = 7.50), p<.001, but did differ with regard to suppression strategies. Reduced reappraisal use was associated with higher opioid craving and emotional distress that mediated the association between reappraisal deficits and opioid misuse risk. Further, there was a significant indirect effect of opioid misuse on emotional distress via reappraisal use. Discussion: Opioid misuse risk was associated with reduced use of reappraisal, which in turn was associated with dysregulated negative emotions and increased appetitive drive towards consuming opioids. Studying individual differences in emotion regulation may yield efficacious intervention and prevention approaches to stem the rising tide of the prescription opioid crisis.

Cigarette tax rates, behavioral disengagement, and quit ratios among daily smokers

Cigarette taxation is an economics-based policy associated with increased population-level quit ratios. However, the estimated effects of tax increase on smoking behavior vary substantially, underscoring the need to identify moderating variables. We examined whether behavioral disengagement - the tendency to abandon goals when experiencing stress - modified the association between cigarette taxes and daily smoking behavior. We connected state-level cigarette tax rate data with individual-level behavioral data, including a national sample of 725 US adults who smoked daily at baseline and reported follow-up data approximately 10 years later, and 376 who were resampled a third time after another 10 years. Analyses involved multilevel logistic regression (with time as a nested variable and anonymized state codes as a grouping variable), where current smoking status (dichotomous) was regressed on behavioral disengagement, state-level cigarette tax at baseline and current time, and the interaction between disengagement and current tax. Consistent with hypotheses, tax rate interacted with disengagement (OR=0.95, 95% CI=0.90,0.99, p=.0255): Among those one SD above the mean for disengagement, tax rate was unassociated with quit ratio (OR=0.99, 95% CI=0.85,1.16, p=.6975). However, among those one SD below the mean, tax rate was significantly associated with higher quit ratio (OR=1.22, 95% CI=1.04,1.43, p=.0163). Our data suggest the possibility that cigarette taxes may be more effective in facilitating cessation among smokers low in behavioral disengagement or when accompanied by interventions that reduce stress or maintain goal pursuit. Identifying psychological moderators of policy effectiveness holds promise for improving policy design and targeting.

Emotion dysregulation and smoking among treatment-seeking smokers

INTRODUCTION

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

METHOD

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

RESULTS

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

CONCLUSION

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

The moderating role of regulatory emotional self-efficacy on smoking craving: An ecological momentary assessment study

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.

Emotion suppression and food intake in the context of a couple discussion: A dyadic analysis

Using dyadic analysis, this study examined whether emotion suppression is a valid mediator in the relationship between mood change following a stressful couple discussion and subsequent food intake among cohabiting couples. In a laboratory setting, 80 heterosexual couples were presented with a bogus taste test immediately after discussing aspects that they would like each other to change. Mood change, emotion suppression and appetite perceptions were self-reported using visual analogue scales, and BMI was calculated based on objective measures. The moderated-mediation Actor-Partner Interdependence Model revealed a significant indirect conditional effect, showing that mood worsening was significantly associated with higher emotion suppression and that emotion suppression was significantly associated with more food intake among spouses with a high BMI. For spouses with a low BMI, the reverse effect was found, i.e., mood worsening was significantly associated with less food intake through the indirect effect of emotion suppression. Furthermore, an indirect partner effect was observed regardless of BMI, i.e., mood worsening was related to more food intake, which was mediated by the partner's emotion suppression. These results highlight the key role of emotion suppression in the relationship between mood change and food intake in the context of a stressful couple discussion.

An examination of ecological predictors of health literacy in black college students

OBJECTIVE

Health literacy is a determinant of health, but disparities in health literacy persist. This study examined the influence of ecological factors on college students' health literacy.

PARTICIPANTS

During January 2016 a nonrandom sample of black undergraduate students (n = 298) aged 18-24 were recruited from enrollment lists at two urban universities in the Southeastern United States.

METHODS

Information on health literacy as well as numerous intrapersonal, social, and cultural-environment factors was obtained using an electronic questionnaire and then statistically modeled.

RESULTS

Ecological factors accounted for 28.7% of the variance in health literacy. In particular, reappraisal (B = 0.323, p < .001), suppression (B = -0.289, p < .001), campus health education (B = 0.192, p < .05), campus tobacco culture (B = -0.174, p < .05), and perceived norms (B = -0.153, p < .05) directly predicted health literacy.

CONCLUSIONS

Although intrapersonal factors influence health literacy, the sociocultural environment of college can also foster or hinder college students' health literacy.

The relationship between emotion regulation strategies and job search behavior among fourth-year university students

The job search process is a stressful experience. This study investigated the effect of emotion regulation strategies on job search behavior in combination with anxiety and job search self-efficacy among Chinese university fourth-year students (N = 816, mean age = 21.98, 31.5% male, 34.9% majored in science, 18.0% from "211 Project" universities). Results showed that cognitive reappraisal was positively related to job search behavior, while expressive suppression was negatively related to job search behavior. Additionally, anxiety was negatively related to job search behavior, while job search self-efficacy was positively associated with job search behavior. Moreover, both anxiety and job search self-efficacy mediated the relationship between emotion regulation strategies and job search behavior. In general, emotion regulation strategies played an important role in job search behavior. Implications include the notion that emotion regulation interventions may be helpful to increase job search behavior among university students.

Craving for cigarette smoking among male adolescents in Isfahan based on mindfulness and emotional self-regulation

Background Cigarette smoking among adolescents and its consequences are categorized as serious health problems. Cigarette craving is influenced by various psycho-social factors. Objective This study aimed to investigate desire and intention to smoke based on mindfulness and emotional self-regulation in adolescents. Methods In this correlational study conducted based on structural equation modeling, a sample of 350 male students was randomly selected from different schools of education districts in Isfahan. Three questionnaires, including Hooked on Nicotine Checklist, emotional regulation inventory, and Mindful Attention Awareness Scale were employed. Data were analyzed using χ2, correlation coefficient and structural modeling tests. In this regard, SPSS and AMOS software were used. Results The results showed that 62% of male students had experienced cigarette smoking at least once. There was a significant inverse correlation between cigarette craving and emotional reappraisal (r = -0.48), expressive suppression (r = -0.58) and mindfulness (r = -0.55), respectively (p < 0.01). In addition to the direct effect, mindfulness through emotional self-regulation had indirect effects on nicotine craving. A total of 58% of the variance in nicotine craving was explained by the study variables. Conclusion The results showed that the high percentage of male students hooked on smoking is an important issue. In this regard, students' psychological issues such as efficient mechanisms of emotional regulation and their knowledge of the risks of smoking must be addressed by authorities and families.

Emotional Intelligence: Influencing Smoking Behavior in Young Adults

The present study examines the influence of emotional intelligence on smoking behavior (SB) patterns among 219 young adults belonging to the age group of 19–27 years pursuing management studies in India. The study is conducted with an aim to understand the relevance and importance of emotions in human behavior. The primary data collected are analyzed by binomial and multinomial logistic regression analyses. The study suggests that emotional intelligence has a significant impact on SB considering sex and age as moderators. It has been observed among the sample that males have higher tendency to smoke than females, and that age has no impact on the SB pattern. For the study, the reference category taken is non-smokers.

Cigarette smoking and depression comorbidity: systematic review and proposed theoretical model

BACKGROUND AND AIMS

Despite decades of research on co-occurring smoking and depression, cessation rates remain consistently lower for depressed smokers than for smokers in the general population, highlighting the need for theory-driven models of smoking and depression. This paper provides a systematic review with a particular focus upon psychological states that disproportionately motivate smoking in depression, and frame an incentive learning theory account of smoking-depression co-occurrence.

METHODS

We searched PubMed, Scopus, PsychINFO and CINAHL to December 2014, which yielded 852 papers. Using pre-established eligibility criteria, we identified papers focused on clinical issues and motivational mechanisms underlying smoking in established, adult smokers (i.e. maintenance, quit attempts and cessation/relapse) with elevated symptoms of depression. Two reviewers determined independently whether papers met review criteria. We included 297 papers in qualitative synthesis.

RESULTS

Our review identified three primary mechanisms that underlie persistent smoking among depressed smokers: low positive affect, high negative affect and cognitive impairment. We propose a novel application of incentive learning theory which posits that depressed smokers experience greater increases in the expected value of smoking in the face of these three motivational states, which promotes goal-directed choice of smoking behavior over alternative actions.

CONCLUSIONS

The incentive learning theory accounts for current evidence on how depression primes smoking behavior and provides a unique framework for conceptualizing psychological mechanisms of smoking maintenance among depressed smokers. Treatment should focus upon correcting adverse internal states and beliefs about the high value of smoking in those states to improve cessation outcomes for depressed smokers.

Adolescent's respiratory sinus arrhythmia is associated with smoking rate five years later

INTRODUCTION

Vulnerability factors like respiratory sinus arrhythmia (RSA) may help identify adolescents at risk for nicotine dependence. We examined if resting RSA and the acute effects of smoking on RSA was associated with cigarette smoking five years later among adolescents at high risk for smoking escalation and nicotine dependence.

METHODS

Sixty-nine adolescents participated in a baseline laboratory session- RSA was collected before and after smoking a single cigarette ad libitum. Participants were then followed for five years.

RESULTS

Lower pre-smoke resting RSA was related to higher past month smoking rate five years later, even after controlling for baseline smoking rate and other relevant covariates including gender, race/ethnicity, age of initiated use, and frequency of exercise at baseline (p=0.018). Exploratory analyses suggested resting RSA is an independent predictor of increased cigarette rate beyond other baseline predictors.

CONCLUSIONS

Low resting RSA may be a vulnerability factor, helping to identify adolescents at risk for cigarette escalation.

Emotion dysregulation explains relations between sleep disturbance and smoking quit-related cognition and behavior

Poor sleep quality and tobacco use are common and co-occurring problems, although the mechanisms underlying the relations between sleep disturbance and smoking are poorly understood. Sleep disturbance lowers odds of smoking cessation success and increases odds of relapse. One reason may be that sleep loss leads to emotion dysregulation, which in turn, leads to reductions in self-efficacy and quit-related problems. To address this gap, the current study examined the explanatory role of emotion dysregulation in the association between sleep disturbance and smoking in terms of (1) self-efficacy for remaining abstinent in relapse situations, (2) the presence of a prior quit attempt greater than 24h, and (3) the experience of quit-related problems among 128 adults (Mage=40.2; SD=11.0; 52.3% female) seeking treatment for smoking cessation. Results suggested that increased levels of sleep disturbance are related to emotion dysregulation which, in turn, may lead to lower levels of self-efficacy for remaining abstinent, more quit-related problems, and being less likely to have had a quit attempt of 24h or greater. Further, these indirect effects were present above and beyond variance accounted for by theoretically-relevant covariates (e.g., gender and educational attainment), suggesting that they may maintain practical significance. These findings suggest that this malleable emotional risk factor (emotion dysregulation) could serve as a target for intervention among those with poor sleep and tobacco use.

Emotional self-control and dysregulation: A dual-process analysis of pathways to externalizing/internalizing symptomatology and positive well-being in younger adolescents

OBJECTIVES

There is little knowledge about how emotional regulation contributes to vulnerability versus resilience to substance use disorder. With younger adolescents, we studied the pathways through which emotion regulation attributes are related to predisposing factors for disorder.

METHODS

A sample of 3561 adolescents (M age 12.5 years) was surveyed. Measures for emotional self-control (regulation of sadness and anger), emotional dysregulation (angerability, affective lability, and rumination about sadness or anger), and behavioral self-control (planfulness and problem solving) were obtained. A structural model was analyzed with regulation attributes related to six intermediate variables that are established risk or protective factors for adolescent substance use (e.g., academic involvement, stressful life events). Criterion variables were externalizing and internalizing symptomatology and positive well-being.

RESULTS

Indirect pathways were found from emotional regulation to symptomatology through academic competence, stressful events, and deviance-prone attitudes and cognitions. Direct effects were also found: from emotional dysregulation to externalizing and internalizing symptomatology; emotional self-control to well-being; and behavioral self-control (inverse) to externalizing symptomatology. Emotional self-control and emotional dysregulation had independent effects and different types of pathways.

CONCLUSIONS

Adolescents scoring high on emotional dysregulation are at risk for substance dependence because of more externalizing and internalizing symptomatology. Independently, youth with better behavioral and emotional self-control are at lower risk. This occurs partly through relations of regulation constructs to environmental variables that affect levels of symptomatology (e.g., stressful events, poor academic performance). Effects of emotion regulation were found at an early age, before the typical onset of substance disorder.

An evolutionary perspective on the co-occurrence of social anxiety disorder and alcohol use disorder

Social Anxiety Disorder (SAD) commonly co-occurs with, and often precedes, Alcohol Use Disorder (AUD). In this paper, we address the relationship between SAD and AUD by considering how natural selection left socially anxious individuals vulnerable to alcohol use, and by addressing the underlying mechanisms. We review research suggesting that social anxiety has evolved for the regulation of behaviors involved in reducing the likelihood or consequences of threats to social status. The management of potential threats to social standing is important considering that these threats can result in reduced cooperation or ostracism - and therefore to reduced access to coalitional partners, resources or mates. Alcohol exerts effects upon evolutionarily conserved emotion circuits, and can down-regulate or block anxiety (or may be expected to do so). As such, the ingestion of alcohol can artificially signal the absence or successful management of social threats. In turn, alcohol use may be reinforced in socially anxious people because of this reduction in subjective malaise, and because it facilitates social behaviors - particularly in individuals for whom the persistent avoidance of social situations poses its own threat (i.e., difficulty finding mates). Although the frequent co-occurrence of SAD and AUD is associated with poorer treatment outcomes than either condition alone, a richer understanding of the biological and psychosocial drives underlying susceptibility to alcohol use among socially anxious individuals may improve the efficacy of therapeutic interventions aimed at preventing or treating this comorbidity.

Predictors of participation in a telephone-based Acceptance and Commitment Therapy for smoking cessation study

Background

Little is known about factors that influence participation in smoking cessation trials among Chinese populations. The aim of this study is to explore the characteristics of individuals who chose to participate and those who chose not to participate in a proactive telephone-based acceptance and commitment therapy program for smoking cessation within a Chinese sample, and to identify predictors of program participation. Understanding the factors that predict participation in smoking cessation trials may allow researchers and healthcare professionals to target their recruitment efforts to increase the enrollment of smokers in smoking cessation programs.

Methods

Participants were proactively recruited from six primary healthcare centers. Current cigarette smokers were screened for eligibility and then invited to complete a baseline questionnaire for the trial. The differences in characteristics between participants and non-participants as well as factors predictive of participation were analyzed using Chi-square tests and logistics regression.

Results

A total of 30,784 clinic attendees were approached. From these, 3,890 (12.6 %) smokers were screened and identified. Of the 3,890 smokers, 420 (10.8 %) were eligible to participate and completed the baseline questionnaires. The analysis showed that participants (n = 142) and non-participants (n = 278) differed significantly in terms of demographics, smoking-related, and psychological variables. The following characteristics were found to predict program participation: those with a relatively high level of dependence on nicotine (OR = 3.75; 95 % CI = 1.25–11.23), those in the contemplation (OR = 7.86; 95 % CI = 2.90–21.30) or preparation (OR = 24.81; 95 % CI = 8.93–68.96) stages of change, and those who had abstained for one month or less in a previous attempt at quitting (OR = 3.77; 95 % CI = 1.68–8.47).

Conclusions

The study shed light on the factors predictive of participation in a counseling-based smoking cessation program among a Chinese population. The results were encouraging, as most significant predictors (e.g., nicotine dependence, stage of change in smoking cessation) can be feasibly addressed or modified with interventions. No significant predictive relationships were found between psycho-social variables or socio-demographic variables and participation. Efforts should be made to increase the enrollment of smokers who are seemingly not yet ready to quit, and to tailor the program to fit the program’s participants.

Emotion regulation in heavy smokers: experiential, expressive and physiological consequences of cognitive reappraisal

Emotion regulation dysfunctions are assumed to contribute to the development of tobacco addiction and relapses among smokers attempting to quit. To further examine this hypothesis, the present study compared heavy smokers with non-smokers (NS) in a reappraisal task. Specifically, we investigated whether non-deprived smokers (NDS) and deprived smokers (DS) differ from non-smokers in cognitive emotion regulation and whether there is an association between the outcome of emotion regulation and the cigarette craving. Sixty-five participants (23 non-smokers, 22 NDS, and 20 DS) were instructed to down-regulate emotions by reappraising negative or positive pictorial scenarios. Self-ratings of valence, arousal, and cigarette craving as well as facial electromyography and electroencephalograph activities were measured. Ratings, facial electromyography, and electroencephalograph data indicated that both NDS and DS performed comparably to nonsmokers in regulating emotional responses via reappraisal, irrespective of the valence of pictorial stimuli. Interestingly, changes in cigarette craving were positively associated with regulation of emotional arousal irrespective of emotional valence. These results suggest that heavy smokers are capable to regulate emotion via deliberate reappraisal and smokers’ cigarette craving is associated with emotional arousal rather than emotional valence. This study provides preliminary support for the therapeutic use of reappraisal to replace maladaptive emotion-regulation strategies in nicotine addicts.

Negative mood reverses devaluation of goal-directed drug-seeking favouring an incentive learning account of drug dependence

BACKGROUND

Two theories explain how negative mood primes smoking behaviour. The stimulus-response (S-R) account argues that in the negative mood state, smoking is experienced as more reinforcing, establishing a direct (automatic) association between the negative mood state and smoking behaviour. By contrast, the incentive learning account argues that in the negative mood state smoking is expected to be more reinforcing, which integrates with instrumental knowledge of the response required to produce that outcome.

OBJECTIVES

One differential prediction is that whereas the incentive learning account anticipates that negative mood induction could augment a novel tobacco-seeking response in an extinction test, the S-R account could not explain this effect because the extinction test prevents S-R learning by omitting experience of the reinforcer.

METHODS

To test this, overnight-deprived daily smokers (n = 44) acquired two instrumental responses for tobacco and chocolate points, respectively, before smoking to satiety. Half then received negative mood induction to raise the expected value of tobacco, opposing satiety, whilst the remainder received positive mood induction. Finally, a choice between tobacco and chocolate was measured in extinction to test whether negative mood could augment tobacco choice, opposing satiety, in the absence of direct experience of tobacco reinforcement.

RESULTS

Negative mood induction not only abolished the devaluation of tobacco choice, but participants with a significant increase in negative mood increased their tobacco choice in extinction, despite satiety.

CONCLUSIONS

These findings suggest that negative mood augments drug-seeking by raising the expected value of the drug through incentive learning, rather than through automatic S-R control.

Posttraumatic stress and emotion dysregulation: Relationships with smoking to reduce negative affect and barriers to smoking cessation

INTRODUCTION

Many cigarette smokers have experienced a traumatic event, and elevated posttraumatic stress symptoms (PTSS) are associated with increased smoking levels. Previous research has found that elevated PTSS are associated with smoking to cope with negative affect, and it has been posited that perceptions of being unable to cope with the consequences of smoking cessation interfere with smoking cessation in this population. However, the mechanism of the relationship between PTSS and these smoking maintenance factors (i.e., smoking to reduce negative affect and barriers to cessation) has not been established. Emotion dysregulation is one potential mechanism as it is associated with PTSS as well as addictive behavior aimed at avoiding and reducing negative emotional states.

METHODS

We cross-sectionally tested the hypotheses that 1) PTSS and emotion dysregulation would be incrementally associated with smoking to reduce negative affect and barriers to cessation, and 2) that emotion dysregulation would mediate the relationships between PTSS, smoking to reduce negative affect, and barriers to cessation among a community sample of trauma-exposed individuals presenting for smoking cessation treatment (N=315).

RESULTS

Results demonstrated that elevated PTSS were associated with increased smoking to reduce negative affect and barriers to cessation, and that emotion dysregulation mediated these relationships.

CONCLUSION

These findings provide evidence of a mechanism between PTSS and psychological smoking maintenance factors, and suggest that emotion dysregulation may be a useful target for smoking cessation interventions among trauma-exposed individuals.

Difficulties with Emotion Regulation and Psychopathology Interact to Predict Early Smoking Cessation Lapse

There is little knowledge about how emotion regulation difficulties interplay with psychopathology in terms of smoking cessation. Participants (n = 250; 53.2 % female, M_age = 39.5, SD = 13.85) were community-recruited daily smokers (≥8 cigarettes per day) who self-reported motivation to quit smoking; 38.8 % of the sample met criteria for a current (past 12-month) psychological disorder. Emotion regulation deficits were assessed pre-quit using the Difficulties with Emotion Regulation Scale (DERS; Gratz and Roemer in J Psychopathol Behav Assess 26(1):41-54, 2004) and smoking behavior in the 28 days post-quit was assessed using the Timeline Follow-Back (TLFB; Sobell and Sobell in Measuring alcohol consumption: psychosocial and biochemical methods. Humana Press, Totowa, 1992). A Cox proportional-hazard regression analysis was used to model the effects of past-year psychopathology, DERS (total score), and their interaction, in terms of time to lapse post-quit day. After adjusting for the effects of gender, age, pre-quit level of nicotine dependence, and treatment condition, the model revealed a non-significant effect of past-year psychopathology (OR = 1.14, CI_{95 %} = 0.82-1.61) and difficulties with emotion regulation (OR = 1.01, CI_{95 %} = 1.00-1.01) on likelihood of lapse rate. However, the interactive effect of psychopathology status and difficulties with emotion regulation was significant (OR = 0.98, CI_{95 %} = 0.97-0.99). Specifically, there was a significant conditional effect of psychopathology status on lapse rate likelihood at low, but not high, levels of emotion regulation difficulties. Plots of the cumulative survival functions indicated that for smokers without a past-year psychological disorder, those with lower DERS scores relative to elevated DERS scores had significantly lower likelihood of early smoking lapse, whereas for smokers with past-year psychopathology, DERS scores did not differentially impact lapse rate likelihood. Smokers with emotion regulation difficulties may have challenges quitting, and not having such difficulties, especially without psychopathology, decreases the potential likelihood of early lapse.

Emotion Expression and Substance Use in Newly Parenting Adolescents and Young Adults

OBJECTIVE

Deficits in emotion expression skills have been associated with alcohol and substance use, but the mechanisms through which these associations occur are not well understood. The current study investigated (a) associations between emotion expression and substance use (i.e., alcohol, cigarettes, and marijuana) in newly parenting adolescents and young adults and (b) whether symptoms of depression and stress mediate these associations in young mothers and fathers.

METHODS

Participants recruited from obstetrics and gynecology clinics completed the Center for Epidemiological Studies-Depression Scale, Perceived Stress Scale, Emotion Expression Scale for Children, and substance use items.

RESULTS

Path analysis indicated that lower emotion expression at 6 months postpartum was significantly associated with more alcohol and marijuana use at 12 months postpartum for males but not females. Also among males, stress levels at 6 months postpartum partially mediated associations between emotion expression and alcohol and marijuana use at 12 months postpartum.

CONCLUSIONS

Findings suggest that poor emotion expression skills are related to more substance use in young fathers, and levels of stress may partially account for this association.

It depends on when you ask: motives for using marijuana assessed before versus after a marijuana use event

BACKGROUND

Marijuana use motives are typically evaluated retrospectively using measures that summarize or generalize across episodes of use, which may compromise validity. Using Ecological Momentary Assessment data, we examined the main reason for a specific marijuana use event measured both prospectively and retrospectively. We then determined reason types, event characteristics, and user characteristics that predicted change in reason.

METHODS

Thirty-six medical outpatients age 15 to 24 years who used marijuana two times a week or more used a handheld computer to select their main reason for use from the five categories of the Marijuana Motives Measure (Simons, Correia, & Carey, 1998) just before and after each time they used marijuana over two weeks (n=263 events with before/after reason). The reasons were examined individually and according to dimensions identified in motivational models of substance use (positive/negative, internal/external).

RESULTS

The reason assessed before use changed to a different reason after use for 20% of events: 10% of events for pleasure; 21%, to cope; 35%, to be more social; 55%, to expand my mind; and 100%, to conform. In the multivariable model, external and expansion reasons each predicted change in reason for use (p<0.0001 and p=0.001, respectively). Youth were also more likely to change their reason if older (p=0.04), if male (p=0.02), and with weekend use (p=0.002).

CONCLUSION

Retrospective assessments of event-specific motives for marijuana use may be unreliable and therefore invalid for a substantial minority of events, particularly if use is for external or expansion reasons.