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Schadegg MJ, Dixon LJ, Lee AA. Emotion Regulation Difficulties and Smoking Behavior among Adults with Chronic Obstructive Pulmonary Diseases. Psychiatr Q 2024:10.1007/s11126-024-10080-z. [PMID: 39008153 DOI: 10.1007/s11126-024-10080-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2024] [Indexed: 07/16/2024]
Abstract
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.
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Affiliation(s)
- Mary J Schadegg
- Department of Psychiatry, NYU Grossman School of Medicine, One Park Ave, New York, NY, 10016, USA
| | - Laura J Dixon
- Department of Psychology, University of Mississippi, P.O. Box 1848, University, MS, 38677, USA
| | - Aaron A Lee
- Department of Psychology, University of Mississippi, P.O. Box 1848, University, MS, 38677, USA.
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2
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Zvolensky MJ, Clausen BK, Shepherd JM, Redmond BY, Robison JH, Santiago-Torres M, Bricker JB. Emotional dysregulation among English-speaking Hispanic persons who smoke living in the United states. Addict Behav 2024; 152:107959. [PMID: 38309241 PMCID: PMC11195297 DOI: 10.1016/j.addbeh.2024.107959] [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: 11/30/2023] [Revised: 01/08/2024] [Accepted: 01/17/2024] [Indexed: 02/05/2024]
Abstract
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.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center; HEALTH Institute, University of Houston.
| | | | | | | | | | | | - Jonathan B Bricker
- Fred Hutchinson Cancer Center, Division of Public Health Sciences; Department of Psychology, University of Washington
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3
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Weiss NH, Brick LA, Schick MR, Forkus SR, Raudales AM, Contractor AA, Sullivan TP. Posttraumatic stress disorder strengthens the momentary associations between emotion dysregulation and substance use: a micro-longitudinal study of community women experiencing intimate partner violence. Addiction 2022; 117:3150-3169. [PMID: 35792057 DOI: 10.1111/add.15992] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 06/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS A fast-growing body of literature linking emotion dysregulation to substance use has almost exclusively relied on cross-sectional designs and has generally failed to assess dysregulation stemming from positive emotions. The current study measured the momentary associations between both negative and positive emotion dysregulation and substance use, as well as the moderating role of post-traumatic stress disorder (PTSD). DESIGN Micro-longitudinal momentary data were collected three times per day for 30 days using phone-based interactive voice recording. SETTING Northeastern United States. PARTICIPANTS A total of 145 community women (M, age = 40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances were recruited from 2018 until 2020. MEASUREMENTS Momentary surveys assessed negative and positive emotion dysregulation and alcohol, drug, and cigarette use. PTSD diagnosis was derived from a structured diagnostic interview. FINDINGS Between-person relations that remained significant after covariate adjustment and correction for multiple testing were found for negative emotion dysregulation and both number of drinks (internal rate of return [IRR] = 1.45; 95% CI = 1.07, 1.93; β = 0.37) and drug use (OR = 3.78; 95% CI = 1.86, 7.69; β = 1.33), and positive emotion dysregulation and number of cigarettes (OR = 1.40; 95% CI = 1.07, 1.82; β = 0.34). Of six interactions tests, PTSD was only shown to moderate the within-person relation between positive emotion dysregulation and drug use, even after controlling for relevant covariates and adjusting for multiple testing (OR = 1.26; 95% CI = 1.04, 1.51; β = 0.23), such that women experiencing intimate partner violence with versus without PTSD were more likely to use drugs when experiencing periods of elevated positive emotion dysregulation. CONCLUSIONS Women experiencing intimate partner violence with higher levels of negative dysregulation relative to others may use more alcohol and be more likely to use drugs. Women experiencing intimate partner violence with higher levels of positive dysregulation relative to others may use more cigarettes. Women experiencing intimate partner violence who also have posttraumatic stress disorder may be more likely to use drugs when experiencing momentary elevated levels of positive emotion dysregulation than those who do not also have posttraumatic stress disorder.
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Affiliation(s)
| | | | - Melissa R Schick
- University of Rhode Island, Kingston, RI, USA.,Medical University of South Carolina, Charleston, SC, USA
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4
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Weiss NH, Kiefer R, Goncharenko S, Raudales AM, Forkus SR, Schick MR, Contractor AA. Emotion regulation and substance use: A meta-analysis. Drug Alcohol Depend 2022; 230:109131. [PMID: 34864568 PMCID: PMC8714680 DOI: 10.1016/j.drugalcdep.2021.109131] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/26/2021] [Accepted: 09/30/2021] [Indexed: 01/03/2023]
Abstract
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 Mage = 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.
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5
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McDonald HM, Sherman KA, Kasparian NA. A mediated model of mindful awareness, emotion regulation, and maternal mental health during pregnancy and postpartum. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2021. [DOI: 10.1080/00049530.2021.1908846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | - Nadine A. Kasparian
- Cincinnati Children’s Centre for Heart Disease and Mental Health, Heart Institute and the Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children’s Hospital, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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6
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Vinci C, Sawyer L, Yang MJ. Minding the Gap: Leveraging Mindfulness to Inform Cue Exposure Treatment for Substance Use Disorders. Front Psychol 2021; 12:649409. [PMID: 33828515 PMCID: PMC8019935 DOI: 10.3389/fpsyg.2021.649409] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/15/2021] [Indexed: 12/04/2022] Open
Abstract
Despite extinction-based processes demonstrating efficacy in the animal extinction and human anxiety literatures, extinction for substance use disorders (SUD) has shown poor efficacy (i. e., cue exposure treatment [CET]). Reasons for this lack of success include common threats to extinction, such as renewal and reinstatement. In recent decades, research on mindfulness for SUD has flourished, and a key aspect of these mindfulness-based interventions includes teaching individuals to stay present with whatever experience they have, even if unpleasant, without trying to change/escape/avoid it. Similarly, CET teaches individuals to not escape/avoid conditioned responses (e.g., craving) by engaging in drug use behavior. This paper discusses how mindfulness-based research and practices could positively influence CET through future research (e.g., Could mindfulness practice attenuate renewal? Might mindfulness training + CET enhance the ability to extinguish the most salient or motivational cues?), with the long-term goal of improving SUD treatment.
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Affiliation(s)
- Christine Vinci
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Leslie Sawyer
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States.,Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Min-Jeong Yang
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
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Direct and indirect associations between perception of childhood trauma and suicidal ideation through emotion dysregulation in males who use heroin. Addict Behav 2019; 98:106011. [PMID: 31233952 DOI: 10.1016/j.addbeh.2019.05.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 05/30/2019] [Accepted: 05/31/2019] [Indexed: 12/17/2022]
Abstract
Emotion dysregulation is considered as one of the factors related to suicide in individuals with childhood trauma (CT). However, no research has been performed on the role of emotion dysregulation in the relationship between perception of CT and suicidal ideation in individuals who use heroin. This study aimed to evaluate direct and indirect relationships between perception of CT and suicidal ideation through emotion regulation difficulties (ERD) and cognitive emotion regulation strategies (CERSs) in males with a DSM diagnosis of heroin dependence. In a cross-sectional design, 310 males with a DSM diagnosis of heroin dependence completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Difficulties in Emotion Regulation Scale (DERS), the Cognitive Emotion Regulation Questionnaire-Short version (CERQ-Short), the Obsessive-Compulsive Drug Use Scale-Form Heroin (OCDUS-Form Heroin), and the Depression Anxiety Stress Scales (DASS). The results revealed that perception of CT had no direct relation to suicidal ideation. Perception of CT was indirectly associated with suicidal ideation through some ERD dimensions [e.g., non-acceptance of emotional responses (Non-acceptance), limited access to emotion regulation strategies (Strategies), lack of emotional awareness (Awareness)] and the CERS of positive reappraisal. The findings suggest that high suicidal ideation may stem from a perception of CT and subsequently emotion dysregulation in individuals who use heroin. Also, the findings of this research may have implications for the prevention and treatment of suicidal ideation in individuals using heroin with a perception of CT. The results of the present study require further examination through longitudinal studies.
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8
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Jones J, Kauffman B, Rosenfield D, Smits JAJ, Zvolensky MJ. Emotion dysregulation and body mass index: The explanatory role of emotional eating among adult smokers. Eat Behav 2019; 33:97-101. [PMID: 31078948 PMCID: PMC6535346 DOI: 10.1016/j.eatbeh.2019.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 12/21/2022]
Abstract
There is limited understanding of the relationship between emotion dysregulation and weight gain among smokers, although available data suggest there are potential relationships that may be of clinical importance. The present study explored a potential mechanism in the relationship between emotion dysregulation and body mass index (BMI). Specifically, the current study examined the indirect effects of emotional eating on the association between emotion dysregulation and BMI among smokers. Participants included 136 (52.2% female; Mage = 42.25, SD = 11.24) adults who were treatment-seeking smokers. Primary analysis included one regression-based model, wherein emotion dysregulation served as the predictor, emotional eating as the intermediary variable, and BMI as the criterion variable. Covariates were age and gender. Results indicated that emotional dysregulation was significantly associated with BMI through emotional eating (a*b = 0.02, SE = 0.01, CI95% = 0.002, 0.042). The current findings provide initial empirical evidence that greater reported levels of emotion dysregulation may be associated with greater reported levels of emotional eating, which in turn, may be related to higher BMI.
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Affiliation(s)
- Jenna Jones
- Department of Psychology, University of Houston
| | | | | | - Jasper A. J. Smits
- Department of Psychology and Institute of Mental Health Research, The University of Texas at Austin
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA,HEALTH Institute, University of Houston, Houston, TX, USA
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9
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The role of emotion dysregulation in the relation of childhood trauma to heroin craving in individuals with heroin dependence. Drug Alcohol Depend 2019; 195:132-139. [PMID: 30634108 DOI: 10.1016/j.drugalcdep.2018.12.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 12/02/2018] [Accepted: 12/11/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Difficulties in emotion regulation (DER) may be important in heroin craving in individuals with heroin dependence who have experienced childhood trauma (CT). However, no research has been performed on DER in the context of heroin dependence. The aim of this study was to evaluate direct and indirect relations of CT to the subscales of heroin craving (i.e., heroin thoughts and interference, intention to use heroin and control of its consumption, and resistance to thoughts and decisions to use heroin) via DER dimensions in individuals with a DSM diagnosis of heroin dependence. METHODS In a cross-sectional design, 330 males with heroin dependence completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Difficulties in Emotion Regulation Scale (DERS), the Obsessive-Compulsive Drug Use Scale-Form Heroin (OCDUS-Form Heroin), and the Depression Anxiety Stress Scales (DASS). RESULTS The results revealed that CT had no direct relations to the subscales of heroin craving, but it indirectly was related to all three subscales of heroin craving via one of the DER dimensions named limited access to emotion regulation strategies (Strategies) after adjusting for demographic and clinical factors. CONCLUSIONS The findings suggest that Strategies may be related to heroin craving in individuals with heroin dependence who have CT. This proposes that treatment and prevention attempts focused on training the use of effective emotion regulation strategies may be useful to reduce heroin craving in individuals with heroin dependence who have experienced a history of CT.
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10
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Stein AT, Freeman SZ, Smits JAJ. Cognitive Mechanisms Underlying the Link Between Anxiety, Health Behaviors, and Illness Outcomes: Commentary on a Special Issue. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-09999-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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11
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Rogers AH, Bakhshaie J, Viana AG, Manning K, Mayorga NA, Garey L, Raines AM, Schmidt NB, Zvolensky MJ. Emotion dysregulation and smoking among treatment-seeking smokers. Addict Behav 2018; 79:124-130. [PMID: 29289851 PMCID: PMC10041802 DOI: 10.1016/j.addbeh.2017.12.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 12/20/2017] [Accepted: 12/20/2017] [Indexed: 01/07/2023]
Abstract
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, Mage=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.
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12
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Kauffman BY, Farris SG, Alfano CA, Zvolensky MJ. Emotion dysregulation explains the relation between insomnia symptoms and negative reinforcement smoking cognitions among daily smokers. Addict Behav 2017; 72:33-40. [PMID: 28359971 PMCID: PMC5863731 DOI: 10.1016/j.addbeh.2017.03.011] [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] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 02/09/2017] [Accepted: 03/10/2017] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Insomnia co-occurs with smoking. However, mechanisms that may explain their comorbidity are not well known. METHOD The present study tested the hypothesis that insomnia would exert an indirect effect on negative reinforcement smoking processes via emotion dysregulation among 126 adult non-treatment seeking daily smokers (55 females; Mage=44.1years, SD=9.72). Negative reinforcement smoking processes included negative reinforcement smoking outcome expectancies, negative reinforcement smoking motives, and two negative expectancies from brief smoking abstinence (somatic symptoms and harmful consequences). RESULTS Insomnia symptoms yielded a significant indirect effect through emotion dysregulation for negative reinforcement smoking outcome expectancies, negative reinforcement smoking motives, and harmful consequences expectancies from brief smoking abstinence. In contrast to prediction, however, insomnia was not associated with somatic symptom expectancies from brief smoking abstinence through emotion dysregulation. CONCLUSIONS These data may suggest that the indirect effect of emotion dysregulation is more relevant to cognitive-affective negative reinforcement processes rather than somatic states. Overall, the present findings contribute to a growing body of literature linking emotion dysregulation as an explanatory mechanism for insomnia and smoking and uniquely extend such work to an array of clinically significant negative reinforcement smoking processes.
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Affiliation(s)
- Brooke Y Kauffman
- University of Houston, Department of Psychology, Houston, TX, United States
| | - Samantha G Farris
- University of Houston, Department of Psychology, Houston, TX, United States; Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, United States
| | - Candice A Alfano
- University of Houston, Department of Psychology, Houston, TX, United States
| | - Michael J Zvolensky
- University of Houston, Department of Psychology, Houston, TX, United States; The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, Houston, TX, United States.
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13
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Nosratabadi M, Halvaiepour Z, Abootorabi SH. Craving for cigarette smoking among male adolescents in Isfahan based on mindfulness and emotional self-regulation. Int J Adolesc Med Health 2017; 30:/j/ijamh.ahead-of-print/ijamh-2016-0113/ijamh-2016-0113.xml. [PMID: 28586303 DOI: 10.1515/ijamh-2016-0113] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 02/12/2017] [Indexed: 11/15/2022]
Abstract
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.
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Affiliation(s)
- Mehdi Nosratabadi
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zohreh Halvaiepour
- Faculty of Education and Psychology,University of Isfahan, Isfahan, Iran
| | - Seyed Hashem Abootorabi
- Department of Health Services Management, Isfahan University of Medical Sciences, Isfahan, Iran
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Bakhshaie J, Kauffman BY, Viana AG, Garza M, Ochoa-Perez M, Lemaire C, Bogiaizian D, Robles Z, Zvolensky MJ. Synergistic effects of pain intensity and experiential avoidance in relation to anxiety symptoms and disorders among economically disadvantaged latinos in a community-based primary care setting. J Anxiety Disord 2017; 48:54-62. [PMID: 27667748 DOI: 10.1016/j.janxdis.2016.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 08/23/2016] [Accepted: 08/23/2016] [Indexed: 12/17/2022]
Abstract
Latinos are subject to numerous health inequalities, including mental health disparity for anxiety and its disorders. In fact, there is strikingly little understanding of transdiagnostic risk factors for the onset and development of anxiety symptoms and disorders among Latinos. To build knowledge in this domain, the present investigation examined the interactive effects of experiential avoidance and pain intensity in relation to anxious arousal, social anxiety, and anxiety disorders among 361 Latino adults with annual incomes of less than $30,000 (87.5% female; Mage=38.8, SD=11.4, and 98.5% used Spanish as their first language) who attended a community-based primary healthcare clinic. As hypothesized, the interaction between experiential avoidance and pain intensity was significantly related to anxious arousal, social anxiety, and a number of anxiety disorders over and above the effects of other factors. The form of the significant interactions indicated that participants reporting co-occurring higher levels of experiential avoidance and pain intensity evinced the greatest levels of anxious arousal, social anxiety, and anxiety disorders. These data provide novel empirical evidence suggesting that there is clinically-relevant interplay between experiential avoidance and pain intensity in regard to a relatively wide array of anxiety problems among Latinos in a primary care medical setting.
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Affiliation(s)
- Jafar Bakhshaie
- Department of Psychology, University of Houston, United States.
| | | | - Andres G Viana
- Department of Psychology, University of Houston, United States
| | | | | | | | - Daniel Bogiaizian
- Psychotherapeutic Area of "Asociación Ayuda", Anxiety Disorders Clinic, United States
| | - Zuzuky Robles
- Department of Psychology, University of Houston, United States
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, United States; Department of Behavioral Sciences, University of Texas, MD Anderson Cancer Center, United States
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15
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Catalino LI, Arenander J, Epel E, Puterman E. Trait acceptance predicts fewer daily negative emotions through less stressor-related rumination. ACTA ACUST UNITED AC 2017; 17:1181-1186. [PMID: 28406676 DOI: 10.1037/emo0000279] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
People who are more accepting of their thoughts and feelings experience fewer negative emotions. Although several studies document the connection between acceptance and negative emotions, little, if any research, sheds light on how being receptive to one's internal experience results in less negativity in everyday life. In a daily diary study (N = 183), we found that people who were more accepting of their thoughts and feelings experienced fewer daily negative emotions, and this association was partly explained by less daily stressor-related rumination. The strength of this mediational pathway differed depending upon the average perceived severity of daily stressors. When daily stressors were perceived to be more demanding, trait acceptance predicted a stronger inverse association with rumination, and rumination predicted a stronger positive association with negative emotions. These results shed light on one way acceptance of internal experience predicts less negativity, as well as the moderating role of perceived daily stress. (PsycINFO Database Record
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Affiliation(s)
| | | | - Elissa Epel
- Department of Psychiatry, University of California at San Francisco
| | - Eli Puterman
- Department of Psychiatry, University of California at San Francisco
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Manning K, Bakhshaie J, Mcleish AC, Luberto C, Walker RL, Zvolensky MJ. Emotional Nonacceptance and Anxiety Sensitivity in Relation to Anxious Arousal, Social Anxiety, and Depressive Symptoms Among African American Young Adults. JOURNAL OF BLACK PSYCHOLOGY 2016. [DOI: 10.1177/0095798416670780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Past work suggests African American college students may be a segment of the college population at heightened risk for anxiety and depressive symptoms; however, there remains an overarching need to broaden our understanding of individual difference variables that may be related to adverse emotional states. The purpose of the present study was to test a theoretically driven interactive model of two individual difference variables (anxiety sensitivity and emotional nonacceptance) in relation to anxiety and depressive symptoms among 133 African American undergraduate students (76.7% female, Mage = 20.9, SD = 5.6; age range = 18-53 years). Results indicated that anxiety sensitivity was positively associated with anxious arousal symptoms at higher levels of emotional nonacceptance (β = 2.1), and more strongly associated with depressive symptoms among individuals endorsing low levels of emotional nonacceptance (β = 3.8). The present data provide novel evidence suggesting there is clinically relevant interplay between anxiety sensitivity and emotional nonacceptance. These findings aid in better understanding the expression of anxiety and depressive symptoms among this population and may represent transdiagnostic constructs of relevance for early intervention.
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Affiliation(s)
| | | | | | - Christina Luberto
- University of Cincinnati, Cincinnati, OH, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Michael J. Zvolensky
- University of Houston, Houston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Johnson AL, McLeish AC. The indirect effect of emotion dysregulation in terms of negative affect and smoking-related cognitive processes. Addict Behav 2016; 53:187-92. [PMID: 26562677 DOI: 10.1016/j.addbeh.2015.10.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 10/29/2015] [Accepted: 10/30/2015] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Although negative affect is associated with a number of smoking-related cognitive processes, the mechanisms underlying these associations have yet to be examined. The current study sought to examine the indirect effect of emotion regulation difficulties in terms of the association between negative affect and smoking-related cognitive processes (internal barriers to cessation, negative affect reduction smoking motives, negative affect reduction smoking outcome expectancies). METHOD Participants were 126 daily cigarette smokers (70.4% male, Mage=36.5years, SD=13.0; 69.8% Caucasian) who smoked an average of 18.5 (SD=8.7) cigarettes per day and reported moderate nicotine dependence. RESULTS Formal mediation analyses were conducted using PROCESS to examine the indirect effect of negative affect on internal barriers to cessation and negative affect reduction smoking motives and outcome expectancies through emotion regulation difficulties. After accounting for the effects of gender, daily smoking rate, and anxiety sensitivity, negative affect was indirectly related to internal barriers to cessation and negative affect reduction smoking motives through emotion regulation difficulties. There was no significant indirect effect for negative affect reduction smoking outcome expectancies. CONCLUSIONS These findings suggest that greater negative affect is associated with a desire to smoke to reduce this negative affect and perceptions that quitting smoking will be difficult due to negative emotions because of greater difficulties managing these negative emotions. Thus, emotion regulation difficulties may be an important target for smoking cessation interventions.
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Mental health status of varenicline and bupropion users during a quit attempt compared to current smokers, other quitters, and non-smokers. Drug Alcohol Depend 2015; 154:132-8. [PMID: 26169448 DOI: 10.1016/j.drugalcdep.2015.06.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 06/10/2015] [Accepted: 06/16/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Varenicline and bupropion are commonly prescribed non-nicotine containing smoking cessation agents. Post-marketing reports suggest an increased incidence of psychiatric disturbances associated with varenicline and bupropion. However, pre-existing psychiatric disorders may confound the association between these smoking cessation agents and psychiatric disturbances. We compared the mental health status of individuals using varenicline or bupropion to that of people quitting without medication, current smokers, and non-smokers while controlling for pre-existing conditions. METHODS A cross-sectional design was used. Data were from 2006-2011 Medical Expenditure Panel Survey. Mental health status was assessed using the mental component summary (MCS) from the 12-item Short Form survey (SF-12v2), 2-item Patient Health Questionnaire (PHQ-2), and Kessler 6 Scale (K6). Differences in MCS score were compared using linear regression. Logistic regressions were used to compare positive screenings for depression using PHQ-2 and for psychological distress using K6. RESULTS Of 578 use episodes, 453 (78.38%) were bupropion and 125 (21.62%) were varenicline. After adjusting for potential confounders, mental health status of varenicline users was not different from current smokers or people who quit smoking without medication, but worse than non-smokers; bupropion was strongly associated with lower mental health status relative to all groups across all three measures. CONCLUSION Varenicline was not associated with worse mental health compared to smokers or those who quit without medication, after adjusting for pre-existing psychiatric disorders. Bupropion was associated with worse mental health status than smokers, former smokers who quit without medication, and nonsmokers, even after adjusting for pre-existing psychiatric disorders.
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Difficulties with Emotion Regulation and Psychopathology Interact to Predict Early Smoking Cessation Lapse. COGNITIVE THERAPY AND RESEARCH 2015; 40:357-367. [PMID: 27239081 DOI: 10.1007/s10608-015-9705-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
There is little knowledge about how emotion regulation difficulties interplay with psychopathology in terms of smoking cessation. Participants (n = 250; 53.2 % female, Mage = 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, CI95 % = 0.82-1.61) and difficulties with emotion regulation (OR = 1.01, CI95 % = 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, CI95 % = 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.
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Zvolensky MJ, Bakhshaie J, Garza M, Valdivieso J, Ortiz M, Bogiaizian D, Robles Z, Schmidt NB, Vujanovic A. The Role of Anxiety Sensitivity in the Relation Between Experiential Avoidance and Anxious Arousal, Depressive, and Suicidal Symptoms Among Latinos in Primary Care. COGNITIVE THERAPY AND RESEARCH 2015. [DOI: 10.1007/s10608-015-9696-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bakhshaie J, Zvolensky MJ, Allan N, Vujanovic AA, Schmidt NB. Differential Effects of Anxiety Sensitivity Components in the Relation Between Emotional Non-Acceptance and Post-traumatic Stress Symptoms Among Trauma-Exposed Treatment-Seeking Smokers. Cogn Behav Ther 2015; 44:175-89. [DOI: 10.1080/16506073.2015.1004191] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Karyadi KA, VanderVeen JD, Cyders MA. A meta-analysis of the relationship between trait mindfulness and substance use behaviors. Drug Alcohol Depend 2014; 143:1-10. [PMID: 25113434 PMCID: PMC4263033 DOI: 10.1016/j.drugalcdep.2014.07.014] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 07/14/2014] [Accepted: 07/14/2014] [Indexed: 01/17/2023]
Abstract
BACKGROUND The relationship between trait mindfulness and substance use behaviors has been inconsistent across studies. The current meta-analysis aimed at quantifying the magnitude of this relationship, and at determining how this relationship varies in context of (1) mindfulness facets, (2) substance type, (3) sample characteristics, and (4) substance use severity. METHODS Using electronic databases, the literature search yielded 303 articles, but only 39 articles met inclusion criteria to be included in this meta-analysis. The relationship was quantified as a Pearson's r correlation coefficient for all studies. RESULTS Findings indicated a small, negative, and significant trait mindfulness-substance use behaviors relationship (r=-0.13). This relationship varied across substance type, clinical status of the sample, and substance use severity. Mindfulness facet was not a significant moderator; however, only particular facets (e.g., acting with awareness, non-judgment, and non-reactivity) were consistently associated with substance use behaviors. CONCLUSIONS This meta-analysis quantified the trait mindfulness-substance use behaviors relationship, which can be used as future effect size estimates. Findings also indicated that the trait mindfulness-substance use behaviors relationship was more robust: (1) for alcohol and tobacco use compared to marijuana use behaviors; (2) for problematic compared to non-problematic substance use behaviors; and (3) with inpatient compared to outpatient and non-clinical samples. Further work should continue to examine if acting with awareness, non-judgment, and non-reactivity mindfulness facets are more robustly associated with substance use behaviors. Failure to consider these factors, or collapsing across these factors, could explain the smaller or inconsistently reported associations across previous studies.
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Affiliation(s)
- Kenny A Karyadi
- Indiana University-Purdue University, 402 N. Blackford St., LD 124, Indianapolis, IN 46202, United States.
| | - J Davis VanderVeen
- Indiana University-Purdue University, 402 N. Blackford St., LD 124, Indianapolis, IN 46202, United States
| | - Melissa A Cyders
- Indiana University-Purdue University, 402 N. Blackford St., LD 124, Indianapolis, IN 46202, United States
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Bakhshaie J, Zvolensky MJ, Brandt CP, Vujanovic AA, Goodwin R, Schmidt NB. The Role of Anxiety Sensitivity in the Relationship Between Emotional Non-Acceptance and Panic, Social Anxiety, and Depressive Symptoms Among Treatment-Seeking Daily Smokers. Int J Cogn Ther 2014. [DOI: 10.1521/ijct.2014.7.2.175] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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