1
|
Bizier A, Jones A, Businelle M, Kezbers K, Hoeppner BB, Giordano TP, Thai JM, Charles J, Montgomery A, Gallagher MW, Cheney MK, Zvolensky M, Garey L. An Integrated mHealth App for Smoking Cessation in Black Smokers With HIV: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e52090. [PMID: 38657227 DOI: 10.2196/52090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Black adults who smoke and have HIV experience immense stressors (eg, racial discrimination and HIV stigma) that impede smoking cessation success and perpetuate smoking-related health disparities. These stressors also place Black adults who smoke and have HIV at an increased risk of elevated interoceptive stress (eg, anxiety and uncomfortable bodily sensations) and smoking to manage symptoms. In turn, this population is more likely to smoke to manage interoceptive stress, which contributes to worse HIV-related outcomes in this group. However, no specialized treatment exists to address smoking cessation, interoceptive stress, and HIV management for Black smokers with HIV. OBJECTIVE This study aims to test a culturally adapted and novel mobile intervention that targets combustible cigarette smoking, HIV treatment engagement and adherence, and anxiety sensitivity (a proxy for difficulty and responsivity to interoceptive stress) among Black smokers with HIV (ie, Mobile Anxiety Sensitivity Program for Smoking and HIV [MASP+]). Various culturally tailored components of the app are being evaluated for their ability to help users quit smoking, manage physiological stress, and improve health care management. METHODS This study is a pilot randomized controlled trial in which Black combustible cigarette smokers with HIV (N=72) are being recruited and randomly assigned to use either (1) the National Cancer Institute's QuitGuide app or (2) MASP+. Study procedures include a web-based prescreener; active intervention period for 6 weeks; smartphone-based assessments, including daily app-based ecological momentary assessments for 6 weeks (4 ecological momentary assessments each day); a video-based qualitative interview using Zoom Video Communications software at week 6 for participants in all study conditions; and smartphone-based follow-up assessments at 0, 1, 2 (quit date), 3, 4, 5, 6, and 28 weeks postbaseline (26 weeks postquitting date). RESULTS Primary outcomes include biochemically verified 7-day point prevalence of abstinence, HIV-related quality of life, use of antiretroviral therapy, and HIV care appointment adherence at 26 weeks postquitting date. Qualitative data are also being collected and assessed to obtain feedback that will guide further tailoring of app content and evaluation of efficacy. CONCLUSIONS The results of this study will determine whether the MASP+ app serves as a successful aid for combustible cigarette smoking cessation, HIV treatment engagement, and physiological stress outcomes among Black people with HIV infection. If successful, this study will provide evidence for the efficacy of a new means of addressing major mental and physical health difficulties for this high-risk population. If the results are promising, the data from this study will be used to update and tailor the MASP+ app for testing in a fully powered randomized controlled trial that will evaluate its efficacy in real-world behavioral health and social service settings. TRIAL REGISTRATION ClinicalTrials.gov NCT05709002; https://clinicaltrials.gov/study/NCT05709002. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/52090.
Collapse
Affiliation(s)
- Andre Bizier
- University of Houston, Houston, TX, United States
| | | | - Michael Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Krista Kezbers
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States
| | - Bettina B Hoeppner
- Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | | | | | | | - Audrey Montgomery
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States
| | - Matthew W Gallagher
- University of Houston, Houston, TX, United States
- HEALTH Institute, Houston, TX, United States
- Texas Institute for Measurement, Evaluation, and Statistics, Houston, TX, United States
| | - Marshall K Cheney
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - Michael Zvolensky
- University of Houston, Houston, TX, United States
- HEALTH Institute, Houston, TX, United States
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Lorra Garey
- University of Houston, Houston, TX, United States
- HEALTH Institute, Houston, TX, United States
| |
Collapse
|
2
|
Mayorga NA, Manning KF, Viana AG, Buitron V, Argueta S, Zvolensky M. Evaluating the interactive impact of acculturative stress and anxiety sensitivity on behavioral health outcomes among Latinx during a period of high COVID-19 impact. Cogn Behav Ther 2024; 53:87-104. [PMID: 37929588 PMCID: PMC10841410 DOI: 10.1080/16506073.2023.2273794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/17/2023] [Indexed: 11/07/2023]
Abstract
As a multi-systemic disease, COVID-19 infection engendered a rise in co-occurring mental and physical health symptoms, particularly affecting the Latinx population. The current work sought to evaluate the main and interactive influence of acculturative stress and anxiety sensitivity in terms of mental and physical health symptoms among 181 Latinx persons (30.4% female, Mage = 34.1 years, SD = 8.20). Data were collected during a period of high COVID-19 impact (2020-2021) and analyses included five separate, two-step hierarchical regressions that were conducted for each of the criterion variables: (1) fear of coronavirus; (2) somatic symptoms; (3) fatigue severity; (4) anxiety symptoms; and (5) depression symptoms. For all analyses, step 1 covariates included years living in the U.S. COVID-19 impact, gender identity, education, and work life distress and home life distress. Results revealed an interactive effect of anxiety sensitivity and acculturative stress on COVID-19 fear, unique main effects for both anxiety sensitivity and acculturative stress on COVID-19 related fear and somatic symptoms, and main effects for anxiety sensitivity alone in relation to fatigue severity, anxiety, and depression. Overall, this study represents an initial investigation of the associations between acculturative stress, anxiety sensitivity, and a range of salient COVID-19 related outcomes among Latinx persons.
Collapse
Affiliation(s)
- Nubia A Mayorga
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Kara F Manning
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Andres G Viana
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Victor Buitron
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Salma Argueta
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Michael Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
| |
Collapse
|
3
|
Keller PS, Rawn KP, Dunsmore JC, Zvolensky M, El-Sheikh M. Parental drinking and observations of parent-child problem-solving discussions: Do drinking motives matter? J Fam Psychol 2023; 37:993-1004. [PMID: 37561503 PMCID: PMC10528253 DOI: 10.1037/fam0001135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Alcohol is often used for emotion-regulation purposes, yet there has been little research on how emotion-regulation drinking motives relate to parenting. The present study addresses this gap by investigating possible interactions between parent drinking and drinking motives in the prediction of parenting and child affectivity during a problem-solving interaction. Participants included 199 two-parent families with a child between the ages of 6 and 12 years. Mothers and fathers self-reported their drinking and drinking motivations, and each parent separately took part in a 5-min parent-child problem-solving discussion about a topic that the parent identified as a frequent source of conflict. These discussions were later coded for parent rejection and coercion and child positive and negative affectivity. Father enhancement motives were independently related to father harsh parenting and indirectly related to lower child positive affect and greater child negative affect. Mother drinking to regulate positive and negative emotions interacted with mother drinking in association with mother harsh parenting, father harsh parenting, and child positive and negative affect during father-child interactions. Although the pattern of these interactions differed, the combination of mother greater drinking and coping or enhancement motives tended to have higher harsh parenting, child positive affect, and child negative affect. These findings indicate that parents' emotion-regulation motives for drinking warrant greater attention from researchers to understand the impact of parent drinking on parenting and emotional development of children. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Kyle P Rawn
- Department of Psychology, University of Kentucky
| | | | | | | |
Collapse
|
4
|
Bello MS, Pang RD, Colby SM, Cassidy RN, Zvolensky M, Langdon KJ. Interactive effects of financial strain and distress tolerance on prequit tobacco withdrawal symptoms in smokers preparing to initiate a quit attempt. Exp Clin Psychopharmacol 2023; 31:805-816. [PMID: 36649154 PMCID: PMC10349897 DOI: 10.1037/pha0000639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Smokers experiencing greater financial strain are less likely to successfully quit smoking, possibly due to greater severity of tobacco withdrawal. However, limited research has explored whether individual-level psychological factors (i.e., distress tolerance) may buffer the deleterious effects of financial strain on withdrawal. This study examined the main and interactive effects of financial strain and distress tolerance on tobacco withdrawal experienced prior to quitting smoking among smokers preparing to initiate a quit attempt. Fifty-nine adult smokers completed a baseline session including a financial strain measure and subjective and behavioral assessments of distress tolerance. Participants were then instructed to initiate a quit attempt, without any behavioral or pharmacological assistance, 14 days following baseline. Prequit tobacco withdrawal symptoms were assessed once per day for 3 days prior to quit date. Linear regression models tested main and interactive effects between financial strain and distress tolerance on experiences and perceptions of prequit withdrawal. Findings demonstrated significant interactions between financial strain, distress tolerance, and perceptions of tolerating withdrawal. Negative associations found between higher distress tolerance and lower perceptions of tobacco withdrawal and negative mood as being "intolerable" prior to quitting were stronger for those experiencing greater levels of financial strain. Financial strain may negatively impact one's perceived ability to tolerate mood- and tobacco-related withdrawal prior to quitting. Yet, higher distress tolerance may buffer the effects of financial strain on smoking cessation processes. Psychosocial interventions designed to promote tolerance of distress from both internal and external stressors may benefit cessation efforts among smokers experiencing high financial strain. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
- Mariel S. Bello
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Raina D. Pang
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Suzanne M. Colby
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Rachel N. Cassidy
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Michael Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Health Institute, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kirsten J. Langdon
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA
- Brown-Lifespan Center for Digital Health, Providence, RI, USA
| |
Collapse
|
5
|
Broos HC, Stamatis CA, Goodman Z, Llabre MM, Zvolensky M, Timpano KR. Situational uncertainty interacts with anxiety sensitivity and distress intolerance to predict anticipated worry and preparation for a hurricane. Anxiety Stress Coping 2023; 36:241-258. [PMID: 35238689 PMCID: PMC9936893 DOI: 10.1080/10615806.2022.2045013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 02/10/2022] [Accepted: 02/15/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND There is evidence for the impact of emotional intolerance on reactivity to stressors, but it is unknown whether the level of situational uncertainty may moderate this relationship. We examined whether situational uncertainty moderated the relationship between emotional intolerance and anticipated anxious responding to hurricane forecasts, considering three aspects of emotional tolerance: anxiety sensitivity, distress intolerance, and hurricane-specific distress intolerance. METHODS Participants (N = 358) were Florida residents who experienced Hurricane Irma. Participants were presented with two hypothetical storm forecasts that varied in level of uncertainty: 5-day forecast (high uncertainty) and 3-day forecast (low uncertainty). Participants rated their anticipated worry and preparation for each forecast. RESULTS Significant interactions between forecast uncertainty and both anxiety sensitivity and hurricane-specific distress intolerance emerged on anticipated worry, such that there was a stronger relationship in the high uncertainty condition. Forecast uncertainty also moderated the relationship between anxiety sensitivity and anticipated preparation in the same direction. There were no significant interactions between forecast uncertainty and distress intolerance on either anticipated worry or preparation. CONCLUSIONS Specific aspects of emotional intolerance appear to have a stronger influence on anticipated worry and preparatory behavior in high uncertainty situations. These findings suggest that distinct emotional tolerance factors may influence these responses.
Collapse
Affiliation(s)
- Hannah C. Broos
- Department of Psychology, University of Miami, Coral Gables, FL
| | - Caitlin A. Stamatis
- Department of Psychology, University of Miami, Coral Gables, FL
- NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, NY
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Dr, 10th Floor, Chicago, IL, 60611
| | - Zachary Goodman
- Department of Psychology, University of Miami, Coral Gables, FL
| | - Maria M. Llabre
- Department of Psychology, University of Miami, Coral Gables, FL
| | | | | |
Collapse
|
6
|
Mansueto G, Carrozzino D, Sparle Christensen K, Cardellicchio S, Pezzuto A, Abrams K, Zvolensky M, Cosci F. Clinimetric properties of the Smoking Abstinence Expectancies Questionnaire. Addict Behav 2021; 123:107061. [PMID: 34359015 DOI: 10.1016/j.addbeh.2021.107061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/16/2021] [Accepted: 07/23/2021] [Indexed: 10/20/2022]
Abstract
Smoking abstinence expectancies are beliefs about negative and positive short-term psychological and physiological consequences of not smoking. The Smoking Abstinence Expectancies Questionnaire (SAEQ) is a widely used Patient-Reported Outcome Measure (PROM) to assess smoking abstinence expectancies. It has four subscales: negative mood, somatic symptoms, harmful consequences, positive consequences. Although studied from a psychometric perspective, the SAEQ needs further evaluation. Clinimetrics, and its Clinimetric Criteria for Patient-Reported Outcome Measures (CLIPROM), offers a robust method to evaluate the SAEQ. We verified construct validity and sensitivity of the Italian version of the SAEQ applying CLIPROM criteria. A total of 293 adult Italian smokers were consecutively enrolled at two smoking cessation clinics and assessed via the SAEQ. Item Response Theory models (i.e., combining Rasch and Mokken analyses) were used to test construct validity and sensitivity. The total score of the SAEQ was not found to be unidimensional but each SAEQ subscale score was. PSI (0.90) indicated that the total score of the SAEQ could reliably discriminate between respondents with different levels of the trait under assessment, whereas SAEQ subscales on negative mood and harmful consequences could reliably distinguish between different groups but not between different subjects (PSI ranging from 0.77 and 0.78). Overall, the total score of the SAEQ is a sensitive screening PROM and can be used at smoking cessation clinics to discriminate between subjects with different levels of smoking abstinence expectancies. SAEQ subscales should be used to detect severity and subjective burden of a wide range of expected effects of nicotine abstinence.
Collapse
|
7
|
Gold AK, Otto MW, Hoyt DL, Garey L, Smit T, Zvolensky M. Do Pain-Related Anxiety and Difficulties With Emotion Regulation Impact Abstinence Expectancies or Motivation to Quit E-Cigarette Use? J Stud Alcohol Drugs 2021; 82:414-421. [PMID: 34100710 PMCID: PMC8328231 DOI: 10.15288/jsad.2021.82.414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/15/2020] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE Pain-related anxiety is a psychologically based construct that is associated with tobacco dependence and may have important relevance to e-cigarette use. Difficulties with emotion regulation, a relevant construct in motives for cigarette smoking, may interact with pain-related anxiety to yield worsened clinical outcomes among e-cigarette users. We evaluated whether pain-related anxiety and difficulties with emotion regulation independently and in interaction predict e-cigarette users' expectancies surrounding abstinence and their motivation to stop using e-cigarettes. METHOD Daily e-cigarette users (n = 290, mean age= 35.5, SD = 10.9, 56.6% male) completed an online survey about e-cigarette use. We conducted hierarchical multiple regression analyses to evaluate the main and interactive influence of pain-related anxiety and difficulties with emotion regulation on our outcomes. RESULTS Increased pain-related anxiety independently predicted negative abstinence expectancies and increased motivation to quit e-cigarette use (ps < .001). Increased difficulties with emotion regulation predicted only negative abstinence expectancies (ps < .01) when pain-related anxiety was included in the model. The interaction between pain-related anxiety and difficulties with emotion regulation was not significant. CONCLUSIONS As hypothesized, increased pain-related anxiety was associated with both negative expectancies of abstinence and increased motivation to quit e-cigarette use, but contrary to our hypothesis, difficulties with emotion regulation were not significantly associated with increased motivation to quit e-cigarette use when evaluated with pain-related anxiety in the model. These findings may elucidate processes influencing abstinence expectancies and motivation to quit in a sample of e-cigarette users, although replication in a larger, more diverse sample is warranted.
Collapse
Affiliation(s)
- Alexandra K. Gold
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Michael W. Otto
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Danielle L. Hoyt
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, Texas
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, Texas
| | - Michael Zvolensky
- Department of Psychology, University of Houston, Houston, Texas
- University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
8
|
Warren AM, Zolfaghari K, Fresnedo M, Bennett M, Pogue J, Waddimba A, Zvolensky M, Carlbring P, Powers MB. Anxiety sensitivity, COVID-19 fear, and mental health: results from a United States population sample. Cogn Behav Ther 2021; 50:204-216. [PMID: 33595414 DOI: 10.1080/16506073.2021.1874505] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The COVID-19 pandemic has resulted in unprecedented consequences. Transdiagnostic factors, such as anxiety sensitivity, could be an important component to understand how individuals experience COVID-19 specific fear, depression and anxiety. A US representative sample (5,023) completed measures including the Anxiety Sensitivity Index-3, the Fear of COVID-19 Scale, the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-8. Analyses controlled for age, sex, race, marital status, education level, working status, household income, and COVID-19 exposure. Results were consistent with prediction. First, higher ASI-3 Total scores were associated with above average COVID-19 fear (β = 0.19). Second, the ASI-3 physical concerns subscale was the strongest predictor of COVID-19 fear; one SD increase on the ASI-3 physical concerns subscale was associated with almost a twofold risk of reaching above average levels of COVID-19 (OR = 1.93). Third, higher ASI-3 Total scores were associated with higher anxiety (β = 0.22) and depression (β = 0.20). Finally, COVID-19 fear mediated the relationship between ASI-3 Total scores and anxiety (17% of effect mediated) as well as ASI-3 Total scores and depression (16% of effect mediated). These data support the role of anxiety sensitivity in predicting fear of COVID-19 and resulting mental health.
Collapse
Affiliation(s)
- Ann Marie Warren
- Baylor University Medical Center, Dallas, TX, USA.,Baylor Scott & White Research Institute, Dallas, TX, USA
| | | | | | - Monica Bennett
- Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Jamie Pogue
- Baylor University Medical Center, Dallas, TX, USA
| | - Anthony Waddimba
- Baylor Scott & White Research Institute, Dallas, TX, USA.,Health Systems Science, Department of Surgery, Baylor University Medical Center, Dallas, TX, USA
| | | | | | | |
Collapse
|
9
|
Borges AM, Yang MJ, Farris SG, Zvolensky M, Leyro TM. Examining the Role of Emotion Regulation in the Bidirectional Relation between Physiological and Subjective Stress Response among Daily Cigarette Smokers. Pers Individ Dif 2020; 155. [PMID: 32863505 DOI: 10.1016/j.paid.2019.109740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cigarette smoking is associated with autonomic dysregulation and altered stress responsivity. There exists a reciprocal relation between subjective and physiological stress reactivity and recovery in smokers. Emotion regulation may impact the extent to which these domains influence each other. The current study examined the moderating role of lack of emotional awareness, lack of emotional clarity, and nonacceptance of emotions, in the relation between heart rate reactivity to, and subjective recovery from, stress, and vice versa. To determine specificity of cross-domain findings, these relations were also examined within domain. Fifty-six daily smokers (46.4% female; M age = 29.33, SD = 11.92) participated in a biological challenge. Heart rate and subjective distress were assessed continuously before, during, and after the challenge. Individual growth curve models revealed that deficits in emotional clarity significantly moderated the effect of heart rate reactivity on subjective recovery. Lack of emotional awareness also moderated the association between subjective reactivity and heart rate recovery. Emotion regulation processes did not affect relations within the same domain, but altered the relation across domains.
Collapse
Affiliation(s)
| | - Min-Jeong Yang
- Department of Psychology, Rutgers University-New Brunswick
| | | | - Michael Zvolensky
- Department of Psychology, University of Houston; University of Texas MD Anderson Cancer Center; Anxiety and Health Research Laboratory and Substance Use Treatment Clinic
| | - Teresa M Leyro
- Department of Psychology, Rutgers University-New Brunswick
| |
Collapse
|
10
|
Dahne J, Collado A, Lejuez CW, Risco C, Diaz VA, Kustanowitz J, Zvolensky M, Carpenter MJ. ¡Aptívate!: A Spanish-language behavioral activation mobile application for delivery via primary care. Psychol Serv 2019; 16:271-275. [PMID: 30431309 PMCID: PMC6499645 DOI: 10.1037/ser0000304] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Treatment for depression is a core health disparity for Latino/as in the United States. U.S. Latino/as are most likely to report depressive symptoms to primary care physicians, who often have limited resources for providing evidence-based psychological depression treatment. This limited treatment accessibility is further compounded by additional treatment barriers, including stigma related to seeking mental health treatment and limited English proficiency. Mobile technologies, including smartphones and mobile applications (apps) delivered via smartphone, are promising for addressing this treatment need. Herein, we discuss the development of a Spanish-language brief behavioral activation mobile application, ¡Aptívate!, that was developed to disseminate depression-based psychological treatment via primary care to Spanish-speaking Latino/as. This article focuses on the description of (a) rationale for ¡Aptívate! treatment development, (b) treatment components, and (c) a clinical case example describing potential implementation in primary care. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
Affiliation(s)
- Jennifer Dahne
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States
- Hollings Cancer Center, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, United States
| | - Anahi Collado
- Alvord, Baker, and Associates, LLC, 3200 Tower Oaks Blvd, Suite 200, Rockville, MD 20852
| | - C. W. Lejuez
- Department of Psychology and the College of Liberal Arts & Sciences, The University of Kansas, 1450 Jayhawk Blvd., Room 200, Lawrence, KS 66045, United States
| | - Cristina Risco
- Department of Psychology and Center for Addictions, Personality, and Emotion Research, University of Maryland, College Park, 2103 Cole Student Activities Building, College Park, MD 20742, United States
| | - Vanessa A. Diaz
- Department of Family Medicine, Medical University of South Carolina, 5 Charleston Center, Suite 263, Charleston SC 29425, United States
| | - Jacob Kustanowitz
- MountainPass Technology, 2 Wisconsin Circle, Suite 700, Chevy Chase, MD 20815, United States
| | - Michael Zvolensky
- Department of Psychology, University of Houston, Fred J. Heyne Building, Suite 104, Houston, Texas 77204, United States
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Houston, Texas 77030, United States
| | - Matthew J. Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States
- Hollings Cancer Center, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, United States
| |
Collapse
|
11
|
Collado A, Zvolensky M, Lejuez C, MacPherson L. Mental health stigma in depressed Latinos over the course of therapy: Results from a randomized controlled trial. J Clin Psychol 2019; 75:1179-1187. [PMID: 30951609 DOI: 10.1002/jclp.22777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 12/27/2018] [Accepted: 03/15/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The current study examined the course, correlates, and predictors of mental health stigma among depressed, Spanish-speaking Latinos that were receiving treatment. This population faces significant disparities in mental health treatment and carries high levels of mental health stigma. METHOD The study utilized data generated from a randomized clinical trial (N = 46) that evaluated the efficacy of Behavioral Activation and Supportive Counseling for depression among Latinos. RESULTS Mental health stigma decreased over time; these decreases were more pronounced among individuals who were randomized to Supportive Counseling. Mental health stigma was positively associated with depressive symptoms and therapeutic alliance over time. Mental health stigma was not related to treatment attrition. CONCLUSIONS These preliminary findings indicate that mental health stigma continues to be relevant among individuals who are actively participating in treatment. Receiving mental health treatment may be sufficient to dispel some of the stigmatizing views endorsed by underserved clinical populations.
Collapse
Affiliation(s)
- Anahi Collado
- Department of Psychology, Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas
| | | | - Carl Lejuez
- Department of Psychology, University of Kansas, Lawrence, Kansas
| | - Laura MacPherson
- School of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland
| |
Collapse
|
12
|
Rogers A, Bakhshaie J, Buckner J, Orr M, Paulus D, Ditre J, Zvolensky M. (177) Opioid and Cannabis Co-Use among Adults with Chronic Pain: Relations to Substance Misuse, Mental Health, and Pain Experience. The Journal of Pain 2019. [DOI: 10.1016/j.jpain.2019.01.097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
13
|
Zvolensky M, Jardin C, Farris SG, Kauffman B, Bakhshaie J, Garey L, Manning K, Rogers AH, Mayorga NA. Gut interpretations: how difficulties in emotion regulation may help explain the relation of visceral sensitivity with depression and anxiety among young adults with gastrointestinal symptoms. PSYCHOL HEALTH MED 2018; 23:840-845. [DOI: 10.1080/13548506.2018.1455984] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Michael Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Charles Jardin
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Samantha G. Farris
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Centers for Behavioral and Preventative Medicine, The Miriam Hospital, Providence, RI, USA
- Butler Hospital, Providence, RI, USA
| | - Brooke Kauffman
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Jafar Bakhshaie
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Kara Manning
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Andrew H. Rogers
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Nubia A. Mayorga
- Department of Psychology, University of Houston, Houston, TX, USA
| |
Collapse
|
14
|
Mayorga NA, Jardin C, Bakhshaie J, Garey L, Viana AG, Cardoso JB, Zvolensky M. Acculturative stress, emotion regulation, and affective symptomology among Latino/a college students. J Couns Psychol 2018. [DOI: 10.1037/cou0000263] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
15
|
Zvolensky M, Bakhshaie J, Paulus DJ, Garza M, Valdivieso J, Sampogna O, Bogiaizian D, Robles Z, Schmidt NB. The role of negative affect in the relation between subjective social status and mental health among economically disadvantaged Latinos in primary care. IJHRH 2016. [DOI: 10.1108/ijhrh-03-2016-0003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to examine the explanatory role of negative affect in the relation between subjective social status and anxiety/depressive disorders, suicidality symptoms, and disruption in life domains (i.e. disability; work/school, social life, and family life/home responsibilities) among Latinos seeking health services at a primary healthcare facility.
Design/methodology/approach
An experiment was designed using participants including 205 adult Latinos (Mage=39.2; SD=11.4) with annual incomes of less than $30,000. The sample was mostly female (85.9 percent) with a majority (98.5 percent) indicating Spanish as their first language.
Findings
Results indicated that subjective social status was indirectly related to the mental health variables through negative affect. Notably, these observed effects were evident above and beyond the variance accounted for by gender, age, marital status, educational status, employment status, and number of years in the USA.
Research limitations/implications
The present findings suggest that there is merit in focusing further scientific attention on the interplay between subjective social status and negative affect to better understand and possibly intervene to reduce anxiety/depressive vulnerability and disability among Latinos in primary care settings.
Originality/value
The current study sheds light on the relationship between social status and negative affect in the Latino population. Elucidating mental health in a minority population such as the Latino population provides insight into the mental health needs among minorities that have yet to be addressed.
Collapse
|
16
|
Powers MB, Davis ML, Kauffman BY, Baird SO, Zvolensky M, Rosenfield D, Marcus BH, Church TS, Frierson G, Otto MW, Smits JAJ. Anxiety sensitivity and smoking variability among treatment seeking smokers. Addict Disord Their Treat 2016; 15:136-142. [PMID: 27672353 PMCID: PMC5034872 DOI: 10.1097/adt.0000000000000075] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Anxiety sensitivity (AS) is associated with poor smoking cessation outcomes. One reason may be that smokers with high AS smoke differently (i.e., to manage negative affect and uncomfortable bodily sensations) than other smokers, leading to stronger addiction (due to an affect/sensation based and thereby highly variable rather than a regular smoking routine). Thus, we examined the relationship between AS and smoking variability in a group of treatment-seeking smokers. METHODS Participants (N = 136; 52.2% female; Mage = 44.19 years, SD = 11.29) were daily smokers with elevated AS (AS≥20 on the Anxiety Sensitivity Index 16-item at prescreen) recruited as part of a larger randomized controlled trial for smoking cessation. Most participants were Caucasian (73%), educated (with 76% attending some college), unmarried (73%), and employed full-time (56%). They smoked, on average, 17 cigarettes per day. RESULTS Consistent with prediction, a regression analysis of baseline assessments and a longitudinal analysis with multilevel modeling (MLM) both showed higher AS was associated with greater variability in cigarettes smoked per day while controlling for gender, age, ethnicity, and income. CONCLUSIONS This finding encourages investigation of how AS might interact with clinical strategies using a fixed smoking taper as part of quit attempts.
Collapse
Affiliation(s)
- Mark B. Powers
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| | - Michelle L. Davis
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| | - Brooke Y. Kauffman
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| | - Scarlett O. Baird
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| | - Michael Zvolensky
- Department of Psychology, University of Houston, Houston, TX
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - David Rosenfield
- Department of Psychology, Southern Methodist University, Dallas, TX
| | - Bess H. Marcus
- Department of Family Medicine and Public Health, University of California, San Diego, CA
| | | | | | - Michael W. Otto
- Department of Psychological and Brain Sciences, Boston University, Boston, MA
| | - Jasper A. J. Smits
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| |
Collapse
|
17
|
Jardin C, Marais L, Bakhshaie J, Skinner D, Neighbors C, Zvolensky M, Sharp C. Caregiver alcohol use and mental health among children orphaned by HIV/AIDS in South Africa. AIDS Care 2016; 29:399-407. [PMID: 27569763 DOI: 10.1080/09540121.2016.1220477] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Research in the developed world suggests that parental alcohol use negatively impacts child mental health. However, little research has examined these relations among children in the developing world and no studies to date have done so in the context of AIDS-orphanhood. Therefore, the present study tested the interactive effect of AIDS-orphan status with caregiver alcohol use on child mental health. The sample included 742 children (51.2% female; Mage = 9.18; age range: 7-11 years; 29.8 AIDS-orphans; 36.8% orphaned by causes other than AIDS; 33.4% non-orphaned) recruited from Mangaung in the Free State Province of South Africa. Child mental health was assessed via child self-report, caregiver, and teacher reports; and caregiver alcohol use via self-report. Path analyses, via structural equation modeling, revealed significant direct effects for AIDS-orphan status on caregiver-reported child mental health; and for caregiver alcohol-use problems on teacher-reported child mental health. However, the interaction effect of AIDS-orphan status with caregiver alcohol use did not reach significance on all three reports of child mental health problems. These results suggest that orphan status and caregiver alcohol use may independently relate to mental health problems in children and that the effects of both should be considered in the context of the mental health needs of children in AIDS-affected countries.
Collapse
Affiliation(s)
- Charles Jardin
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - Lochner Marais
- b Department of Behavioral Sciences , University of Texas MD Anderson Cancer Center , Houston , TX , USA
| | - Jafar Bakhshaie
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - Donald Skinner
- c Department of Interdisciplinary Health Sciences, Research on Health and Society , University of Stellenbosch , Cape Town , South Africa
| | - Clayton Neighbors
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - Michael Zvolensky
- a Department of Psychology , University of Houston , Houston , TX , USA.,b Department of Behavioral Sciences , University of Texas MD Anderson Cancer Center , Houston , TX , USA
| | - Carla Sharp
- a Department of Psychology , University of Houston , Houston , TX , USA.,d Center for Community Development , University of the Free State , Bloemfontein , South Africa
| |
Collapse
|
18
|
Otto MW, Eastman A, Lo S, Hearon BA, Bickel WK, Zvolensky M, Smits JAJ, Doan SN. Anxiety sensitivity and working memory capacity: Risk factors and targets for health behavior promotion. Clin Psychol Rev 2016; 49:67-78. [PMID: 27611632 DOI: 10.1016/j.cpr.2016.07.003] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 06/03/2016] [Accepted: 07/25/2016] [Indexed: 11/15/2022]
Abstract
Understanding the nature and influence of specific risk profiles is increasingly important for health behavior promotion. The purpose of this article is to document the value of two factors-anxiety sensitivity (AS) and working memory capacity (WMC)-for enhancing risk for the initiation and/or maintenance of a range of negative health behaviors. AS is a distress-related risk factor that potentiates avoidance/coping motivations for negative health behaviors. Stress provides the conditions for negative somatic and affective states, and AS amplifies the aversiveness of these experiences and correspondingly hinders adaptive functioning. In contrast, low WMC is hypothesized to exert its effect by decreasing the capacity to filter out current temptations, attenuating a focus on longer-term goals and impairing the application of relevant coping skills at times of stress. In this review, we provide conceptual models for the separate roles of high AS and low WMC in negative health behaviors, review the influence of these factors on specific health behavior exemplars (eating behaviors/obesity, physical activity, smoking, alcohol use, and sleep promotion), provide preliminary evidence for their value as independent treatment targets for health-behavior promotion, and encourage specific research directions in relation to these variables.
Collapse
Affiliation(s)
- Michael W Otto
- Department of Psychological and Brain Sciences, Boston University, USA.
| | - Abraham Eastman
- Department of Psychological and Brain Sciences, Boston University, USA
| | - Stephen Lo
- Department of Psychological and Brain Sciences, Boston University, USA
| | | | - Warren K Bickel
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, USA
| | - Michael Zvolensky
- University of Houston, USA; The University of Texas MD Anderson Cancer Center, USA
| | - Jasper A J Smits
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, USA
| | - Stacey N Doan
- Department of Psychology, Claremont McKenna College, USA
| |
Collapse
|
19
|
Jardin C, Bakhshaie J, Schmidt NB, Sharp C, Zvolensky M. Examination of smoking inflexibility as a mechanism linking anxiety sensitivity and severity of smoking behavior. Am J Addict 2015; 24:374-81. [DOI: 10.1111/ajad.12203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 01/07/2015] [Accepted: 01/11/2015] [Indexed: 12/17/2022] Open
Affiliation(s)
- Charles Jardin
- Department of Psychology; University of Houston; Houston Texas
| | - Jafar Bakhshaie
- Department of Psychology; University of Houston; Houston Texas
| | - Norman B. Schmidt
- Department of Psychology; Florida State University; Tallahassee Florida
| | - Carla Sharp
- Department of Psychology; University of Houston; Houston Texas
- Adolescent Treatment Program; The Menninger Clinic; Houston Texas
| | - Michael Zvolensky
- Department of Psychology; University of Houston; Houston Texas
- Department of Behavioral Sciences; University of Texas MD Anderson Cancer Center; Houston Texas
| |
Collapse
|
20
|
Abstract
OBJECTIVES The present study evaluated the relative contribution of panic and depressive symptoms in relation to past cessation difficulties and smoking motives among treatment-seeking daily smokers. METHODS The sample included 392 treatment-seeking daily smokers (47.07% female; Mage = 35.48; SD = 13.56), who reported smoking an average of 10 or more cigarettes daily for at least one year. RESULTS Findings indicated that panic and depressive symptoms were significantly associated with quit problems as well as addictive and negative affect motives for smoking. However, depressive symptoms were not associated with habitual smoking motives. CONCLUSIONS Differential patterns of associations with smoking-based processes imply that although panic and depression are related, there are important distinctions. Such data highlight the need for additional research to examine the putative role of panic and depressive symptoms in relation to smoking behaviors to further elucidate the mechanisms through which panic, depression, and smoking impact one another.
Collapse
Affiliation(s)
- Dawn W Foster
- 1Department of Psychiatry, Yale University School of Medicine , New Haven, Connecticut , USA
| | | | | | | |
Collapse
|
21
|
Davis ML, Powers MB, Handelsman P, Medina JL, Zvolensky M, Smits JAJ. Behavioral therapies for treatment-seeking cannabis users: a meta-analysis of randomized controlled trials. Eval Health Prof 2014; 38:94-114. [PMID: 24695072 DOI: 10.1177/0163278714529970] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Narrative reviews conclude that behavioral therapies (BTs) produce better outcomes than control conditions for cannabis use disorders (CUDs). However, the strength and consistency of this effect has not been directly empirically examined. The present meta-analysis combined multiple well-controlled studies to help clarify the overall impact of behavioral interventions in the treatment of CUDs. A comprehensive literature search produced 10 randomized controlled trials (RCTs; n = 2,027) that were included in the final analyses. Analyses indicated an effect of BTs (including contingency management, relapse prevention, and motivational interviewing, and combinations of these strategies with cognitive behavioral therapy) over control conditions (including waitlist [WL], psychological placebo, and treatment as usual) across pooled outcomes and time points (Hedges' g = 0.44). These results suggest that the average patient receiving a behavioral intervention fared better than 66% of those in the control conditions. BT also outperformed control conditions when examining primary outcomes alone (frequency and severity of use) and secondary outcomes alone (psychosocial functioning). Effect sizes were not moderated by inclusion of a diagnosis (RCTs including treatment-seeking cannabis users who were not assessed for abuse or dependence vs. RCTs including individuals diagnosed as dependent), dose (number of treatment sessions), treatment format (either group vs. individual treatment or in-person vs. non-in-person treatment), sample size, or publication year. Effect sizes were significantly larger for studies that included a WL control comparison versus those including active control comparisons, such that BT significantly outperformed WL controls but not active control comparisons.
Collapse
Affiliation(s)
- Michelle L Davis
- Department of Psychology, The University of Texas, Austin, TX, USA
| | - Mark B Powers
- Department of Psychology, The University of Texas, Austin, TX, USA
| | | | - Johnna L Medina
- Department of Psychology, The University of Texas, Austin, TX, USA
| | | | - Jasper A J Smits
- Department of Psychology, The University of Texas, Austin, TX, USA
| |
Collapse
|
22
|
Korte KJ, Capron DW, Zvolensky M, Schmidt NB. The Fagerström test for nicotine dependence: do revisions in the item scoring enhance the psychometric properties? Addict Behav 2013; 38:1757-63. [PMID: 23254226 DOI: 10.1016/j.addbeh.2012.10.013] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 09/02/2012] [Accepted: 10/24/2012] [Indexed: 10/27/2022]
Abstract
Despite widespread use, considerable literature has shown that the Fagerström Test for Nicotine Dependence (FTND; Heatherton, Kozlowski, Frecker, & Fagerström, 1991) has questionable psychometric properties, generally reflecting relatively poor properties of reliability and validity. One factor that may be affecting the psychometric qualities of the scale is the use of a dichotomous, forced-choice response format for certain items, in which respondents are asked to answer each question with a Yes or No response. This scoring approach is especially problematic when used to measure dimensional constructs, such as nicotine dependence, in which a dimensional construct is forced into a categorical construct. The purpose of the current study was to examine whether revising the response format utilized in the FTND would lead to an enhancement in the psychometric properties of this scale. This question was examined by removing the forced-choice response criteria on items 2, 5, and 6 of the FTND and revising the response options to reflect a 4-point Likert response set (0 = never, 1 = sometimes, 2 = most of the time, 3 = always). Participants consisted of 343 smokers from the community. Results revealed that the revised scoring approach resulted in a significant incremental improvement in scale reliability and enhanced convergent validity, showing a stronger association with smoking outcomes than the FTQ or FTND. Findings are discussed in terms of recommendations for scale revision and usage.
Collapse
|
23
|
Johnson K, Mullin JL, Marshall EC, Bonn-Miller MO, Zvolensky M. Exploring the mediational role of coping motives for marijuana use in terms of the relation between anxiety sensitivity and marijuana dependence. Am J Addict 2010; 19:277-82. [PMID: 20525036 DOI: 10.1111/j.1521-0391.2010.00041.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
This study evaluated the prediction that coping motives for marijuana use would mediate the relation between anxiety sensitivity and a marijuana dependence diagnosis after controlling for other co-occurring marijuana use motives. Participants were 136 current marijuana users (47.1% women; M(age)= 21.9, SD = 7.2). Results were consistent with a mediational effect, with the relation between anxiety sensitivity and marijuana dependence being explained by the addition of coping motives into the model. These results provide novel information related to the putative explanatory role of coping motives for marijuana use in the relation between anxiety sensitivity and marijuana dependence.
Collapse
Affiliation(s)
- Kirsten Johnson
- Department of Psychology, University of Vermont, Burlington, Vermont, USA
| | | | | | | | | |
Collapse
|
24
|
|
25
|
Daughters SB, Reynolds EK, MacPherson L, Kahler CW, Danielson CK, Zvolensky M, Lejuez CW. Distress tolerance and early adolescent externalizing and internalizing symptoms: the moderating role of gender and ethnicity. Behav Res Ther 2008; 47:198-205. [PMID: 19135649 DOI: 10.1016/j.brat.2008.12.001] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2008] [Revised: 11/08/2008] [Accepted: 12/04/2008] [Indexed: 11/19/2022]
Abstract
A large body of research has examined the development of internalizing and externalizing symptoms in childhood and early adolescence. Notably, there is significant concomitant impairment associated with early adolescent symptomatology, as well as association of these symptoms with future development of psychopathology, poor physical health, self-destructive thoughts and behaviors, criminal behavior, and HIV risk behaviors. Drawing on negative reinforcement theory, the current study sought to examine the potential role of distress tolerance, defined as the ability to persist in goal-directed activity while experiencing emotional distress, as a potential mechanism that may underlie both internalizing and externalizing symptoms among 231 Caucasian and African American youth (M age=10.9 years; 45.5% female; 54.5% Caucasian ethnicity). A series of regressions resulted in significant moderated relationships, such that low distress tolerance conferred increased risk for alcohol use among Caucasians, delinquent behavior among African Americans, and internalizing symptoms among females. Clinical implications, including the potential role of negative reinforcement models in early intervention with young adolescents, are discussed.
Collapse
Affiliation(s)
- Stacey B Daughters
- School of Public Health, University of Maryland, College Park, MD 20742, USA.
| | | | | | | | | | | | | |
Collapse
|
26
|
Ziedonis D, Hitsman B, Beckham JC, Zvolensky M, Adler LE, Audrain-McGovern J, Breslau N, Brown RA, George TP, Williams J, Calhoun PS, Riley WT. Tobacco use and cessation in psychiatric disorders: National Institute of Mental Health report. Nicotine Tob Res 2008; 10:1691-715. [DOI: 10.1080/14622200802443569] [Citation(s) in RCA: 454] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
27
|
Zvolensky M, Gibson L, Vujanovic A, Gregor K, Bernstein A, Kahler C, Legues CW, Brown R, Feldner M. Impact of Posttraumatic Stress Disorder on early smoking lapse and relapse during a self-guided quit attempt among community-recruited daily smokers. Nicotine Tob Res 2008; 10:1415-27. [DOI: 10.1080/14622200802238951] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
28
|
Gregor K, Zvolensky M, McLeish A, Bernstein A, Morissette S. Anxiety sensitivity and perceived control over anxiety-related events: Associations with smoking outcome expectancies and perceived cessation barriers among daily smokers. Nicotine Tob Res 2008; 10:627-35. [DOI: 10.1080/14622200801978706] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
29
|
Lejuez CW, Aklin W, Daughters S, Zvolensky M, Kahler C, Gwadz M. Reliability and validity of the youth version of the Balloon Analogue Risk Task (BART-Y) in the assessment of risk-taking behavior among inner-city adolescents. J Clin Child Adolesc Psychol 2007; 36:106-11. [PMID: 17206886 DOI: 10.1080/15374410709336573] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study examined the reliability and validity of the youth version of the Balloon Analogue Risk Task (BART-Y) for assessing adolescent risk behaviors among a sample of 98 inner-city African American adolescents (M age = 14.8, SD = 1.5). In addition to a relation with sensation seeking, BART-Y responding evidenced a significant relation with a composite of risk behaviors across substance use, sexual behavior, delinquency, and health domains. BART-Y responding also explained unique variance in a composite of these risk behaviors above and beyond demographic variables and risk-related personality constructs, including sensation seeking and impulsivity.
Collapse
Affiliation(s)
- C W Lejuez
- University of Maryland, College Park, MD 20742, USA.
| | | | | | | | | | | |
Collapse
|
30
|
Lejuez CW, Aklin W, Daughters S, Zvolensky M, Kahler C, Gwadz M. Reliability and Validity of the Youth Version of the Balloon Analogue Risk Task (BART-Y) in the Assessment of Risk-Taking Behavior Among Inner-City Adolescents. Journal of Clinical Child & Adolescent Psychology 2007. [DOI: 10.1207/s15374424jccp3601_11] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|