Distress tolerance, the ability to withstand physical or emotional discomfort, is thought to be associated with cigarette smoking behavior and smoking cessation failure. A systematic review evaluated ...studies that linked distress tolerance to smoking. Central findings suggest that (a) distress tolerance can—but does not always—predict smoking cessation lapse, (b) treatments targeting distress tolerance are promising but need additional research, (c) lower distress tolerance does not seem to be associated with greater smoking frequency or longevity, and (d) limited work evaluates the effect of smoking context on distress tolerance. Gaps in our current knowledge are also identified, most notably the need to evaluate how links between distress tolerance and smoking develop across smoking escalation and maintenance stages, and the need to examine distress tolerance contextually. A model of momentary distress tolerance is proposed, where the key premise is to discuss the factors which could influence state or momentary distress tolerance and how habitual smoking may lower distress tolerance and reinforce the links between heightened distress and smoking behavior. Theoretical and measurement implications are discussed with the aim of extending future research on distress tolerance and smoking.
•This paper synthesizes existing research on distress tolerance (DT) and smoking.•Measurement issues between self-report and behavioral tasks are considered.•Evidence reveals an inconsistent relationship between DT and smoking.•Several key gaps in the research are identified.•A model of momentary distress tolerance is advanced.
•The prevalence rate of clinically significant depression, anxiety, and PTSD symptoms for hospital discharged patients are respectively 19%, 10.4%, and 12.4%.•Disease severity, living with children, ...death of family member, and perceived discrimination are risk factors for PTSD.•Disease severity, living with children, death of family member from COVID, higher total number of symptoms after discharge, and perceiving self has having been target of discrimination are risk factors for clinically significant anxiety.•Higher educational level, living with children, smoking, higher disease severity, higher total number of symptoms after discharge, and perceived discrimination are risk factors for clinically significant depression.
The coronavirus disease 2019 (COVID-19) pandemic can have a profound impact on the mental health of patients who survived the illness. However, little is known about the prevalence rate of mental health disorders among hospital discharged COVID-19 patients and its associated factors. A cross-sectional survey of hospital discharged patients was conducted April 11–22, 2020 in Wuhan, China (where the pandemic began). 675 participants completed the survey, including 90 (13.3%) medical staff (physicians and nurses who had been ill). We used Fisher's exact test and multivariable logistic regression methods to explore the risk factors associated with mental health problems (anxiety, depression, and PTSD symptoms associated with COVID-19 hospitalization). Adverse mental health effects of COVID-19 are evident after discharge from the hospital, with sleep difficulties highlighted as a central issue. As we found that perceived discrimination was a central predictor of mental illness, preventing and addressing social stigma associated with COVID-19 may be crucial for improving mental health for recovered patients.
Abstract The practice of waterpipe smoking (hookah) has rapidly increased in popularity among young adults yet burgeoning research suggests that its use is associated with nicotine dependence and ...other negative smoking-related health consequences. Moreover, descriptive studies indicate that consumers may hold the belief that hookah smoking is safer than smoking cigarettes. The current study extended previous work by conducting a comprehensive assessment of patterns and contexts of hookah use, psychological correlates of use, co-occurring substance use as well as social norms and health perceptions surrounding the practice. Participants were 143 ethnically diverse undergraduate students at a large urban US university. Approximately half of the sample (48%) reported life-time use of hookah and 22% reported use within the past 30 days. Relative to cigarette smoking, hookah smoking was associated with less perceived harm and addiction potential and higher social approval. Participants who reported life-time hookah use, as compared to those who did not, perceived less associated harm, had a greater number of friends who had tried and approved of hookah, were more likely to use cigarettes, marijuana, and alcohol and in higher frequencies and quantities and were at higher risk for problem tobacco and alcohol use. Among participants who were not current smokers, those with hookah experience were more likely to endorse intent to try a cigarette soon. Hookah users did not differ from non-users on measures of trait anxiety, depression and impulsivity though they were more likely to drink alcohol for coping, social and enhancement purposes than non-users. Implications are discussed for public health initiatives to educate young adults about the potential consequences of hookah smoking.
The association of hydration knowledge and health habits with hydration status and fluid intake is rarely examined. We sought to determine whether knowledge or physical health behaviors predict ...physiological hydration status and fluid intake. Ninety-six participants (59 female; 27 ± 10 year) completed the previously validated hydration survey. Participants then recorded total fluids consumed (TFC), collected urine, and tracked void frequency for 24 h. Hydration status was assessed via 24 h urine specific gravity (USG) and osmolality (Uosm). Health behaviors included self-reported physical activity, BMI, smoking, alcoholic drinking, and sleep status. TFC was significantly correlated with 24 h USG (r = −0.390; p < 0.001), Uosm (r = −0.486; p < 0.001), total urine volume (r = 0.675; p < 0.001), and void frequency (r = 0.518; p < 0.001). Hydration knowledge was not correlated with 24 h USG (r = 0.085; p = 0.420), Uosm (r = 0.087; p = 0.419), urine total volume (r = 0.019; p = 0.857), void frequency (r = 0.030; p = 0.771), or TFC (r = 0.027; p = 0.813). Hydration knowledge did not predict 24 h USG (LR+ = 1.10; LR− = 0.90), Uosm (LR+ = 0.81; LR− = 1.35), or TFC (LR+ = 1.00; LR− = 1.00). Health habits did not predict 24 h USG, Uosm, or TFC. In conclusion, self-reported 24 h diet and fluid log recording is comparable to hydration status verification via 24 h urine collection. Hydration knowledge and health habits are not related to, or predictive of, hydration status.
•Motivation to quit smoking was assessed using ecological momentary assessment.•Quit motivation increased alongside lower craving and higher willpower.•More quit motivation and less variability in ...quit motivation predicted intentions.
Due to prior work suggesting dynamic fluctuations in quit motivation over time, the current study used ecological momentary assessment (EMA) to examine contextual predictors of momentary quit motivation, most notably perceived self-regulation. The sample (n = 84) intentionally excluded smokers actively trying to quit and those who plan to never quit, focusing on the group of smokers who are interested in but not yet committed to quitting. Participants completed one week of EMA, where they responded to random prompts 7x/day and logged each cigarette. At each prompt, they completed measures assessing cigarette craving, affect (positive and negative), quit motivation, and perceived momentary self-regulation (i.e., willpower self-efficacy, distress intolerance, craving uncontrollability). Participants also completed a nightly prompt where they reported their quit intentions. Results revealed that the newly developed 4-item index of quit motivation had strong psychometric properties, and demonstrated fluctuations over time and across situations. Quit motivation was higher when craving was ideographically lower than usual, and when willpower was higher than usual. People with higher distress intolerance reported higher quit motivation. In addition, stronger quit motivation and less variability in quit motivation was associated with higher quit intentions. The current study suggests that quit motivation does shift dynamically and speaks to the potential importance of targeting craving and willpower self-efficacy to enhance people’s motivation to quit.
Intrapersonal affective styles and emotion regulation strategies have been studied at length and identified as predictors of affective distress (i.e., depression and anxiety symptoms). Less research ...has evaluated the extent to which distress is predicted by interpersonal factors, like how others respond to people's emotions. Perceived emotion invalidation is one interpersonal factor that occurs when people feel others have negatively evaluated their emotions as unacceptable. Across three studies with both online and college student samples, the current research evaluated perceived invalidation as a predictor of psychological distress while controlling for intrapersonal styles and emotion regulation strategies known to predict distress. Results revealed that perceived emotion invalidation predicted greater affective distress above and beyond: emotional reactivity and expressivity, negative affect, and emotion dysregulation (Study 1); cognitive and behavioral emotion regulation strategies (Study 2); and self-compassion, emotional intelligence, and experiential avoidance (Study 3). These findings suggest that how people perceive others to respond to their emotions contributes to distress more so than simply how people respond to or regulate their own emotions.
•How people respond to and regulate their emotions predicts greater distress.•Perceiving one's emotions to be invalidated by others predicts greater distress.•Perceived invalidation predicts distress when controlling for intrapersonal factors.•Distress may be related to actual or perceived emotion invalidation.
Opioid dependence is a problem of national concern, especially with dramatically increased rates of abuse and dependence of prescription opioids. The current article provides an up-to-date review of ...the literature on opioid dependence treatment, with a focus on conclusions drawn by experts in the field (e.g., Cochrane reviews and meta-analyses) and methodologically rigorous studies (e.g., randomized controlled trials). We describe the major classes of drug treatments available, including opioid agonist (e.g., methadone, buprenorphine, LAAM), antagonist (e.g., naltrexone) and non-opioid pharmacotherapies (e.g., alpha2 adrenergic agonists). These treatments are discussed in the context of detoxification and long term treatment options such as abstinence-based and maintenance strategies. We review the state of the literature as to prevention of opioid overdose and discuss the widespread problem of comorbidity among opioid-dependent populations. We also focus prominently on evidence for inclusion of psychosocial approaches in treatment regimens, either as stand-alone or in conjunction with psychopharmacological options.
When people feel hopeless, they are more likely to think about suicide. Prior work has shown that both hopelessness and suicidal ideation fluctuate over time; however, there are likely other ...contextual factors underlying increased hopelessness and suicidal ideation in moments of time.
In two studies using retrospective recall of a real event (Study 1, n = 268) and an experimental imaginal vignette design (Study 2, n = 356), we examined self-criticism and self-efficacy for self-regulation as crucial factors underlying hopelessness in people vulnerable to suicidal ideation.
In both studies, greater state self-criticism and lower state self-efficacy were associated with greater hopelessness. In Study 2, we also measured suicidal ideation, and found that higher self-criticism and lower self-efficacy for self-regulation scores were associated with greater suicidal ideation, even when controlling for negative affect. Evidence of an interaction between self-criticism and self-efficacy was found with scores in Study 2 but not in Study 1; specifically, lower self-efficacy was associated with greater ideation when self-criticism was high but not when self-criticism was low.
Overall, results support self-criticism and self-efficacy as important contextual factors underlying hopelessness and suicidal ideation and attending to the potential interactive effect between self-criticism and self-efficacy.
Emotion invalidation is theoretically and empirically associated with mental and physical health problems. However, existing measures of invalidation focus on past (e.g., childhood) invalidation ...and/or do not specifically emphasize invalidation of emotion. In this article, the authors articulate a clarified operational definition of emotion invalidation and use that definition as the foundation for development of a new measure of current perceived emotion invalidation across a series of five studies. Study 1 was a qualitative investigation of people's experiences with emotional invalidation from which we generated items. An initial item pool was vetted by expert reviewers in Study 2 and examined via exploratory factor analysis in Study 3 within both college student and online samples. The scale was reduced to 10 items via confirmatory factor analysis in Study 4, resulting in a brief but psychometrically promising measure, the Perceived Invalidation of Emotion Scale (PIES). A short-term longitudinal investigation (Study 5) revealed that PIES scores had strong test-retest reliability, and that greater perceived emotion invalidation was associated with greater emotion dysregulation, borderline features and symptoms of emotional distress. In addition, the PIES predicted changes in relational health and psychological health over a 1-month period. The current set of studies thus presents a psychometrically promising and practical measure of perceived emotion invalidation that can provide a foundation for future research in this burgeoning area.
Self-stigma involves internalized negative evaluation in people with a societally prescribed label (i.e., mental health diagnosis). Thus, measures of self-stigma due to mental illness exclude people ...without a diagnosis who may negatively evaluate themselves because of their emotions-a process we define as self-invalidation due to emotion. In the current research, we introduced a novel measure of self-invalidation due to emotion distinct from measures of self-stigma due to mental illness and perceived emotion invalidation. After expert review of the item pool (Study 1), and principal component (Study 2) and confirmatory factor analysis (Study 3), a 10-item scale for Self-Invalidation Due to Emotion Scale (SIDES) was developed, with subscales of self-invalidation due to high and low emotional experience. A college student and community sample (Study 4) confirmed test-retest reliability and demonstrated that greater self-invalidation due to high emotional experience predicted greater emotion dysregulation, emotional reactivity and expressivity, and beliefs about emotion uncontrollability. In contrast, greater self-invalidation due to low emotional experience predicted less emotional reactivity and expressivity, and greater beliefs about emotion controllability. Finally, in a community sample of people with a history of mental illness (Study 5), greater self-invalidation due to high but not low emotional experience predicted symptoms of borderline personality pathology and distress regardless of self-stigma due to mental illness or perceived emotion invalidation. The current research supports the SIDES as a psychometrically sound, more inclusive measure of self-stigma, relevant for predicting distress and maladaptive emotional tendencies in people with and without a mental illness.
Public Significance Statement
These studies detail the development of the Self-Invalidation Due to Emotion Scale. The research suggests self-invalidation due to emotion is experienced by, and yields consequences for people with and without a mental health diagnosis. It highlights self-invalidation due to emotion as an important process for clinicians to attend to, as it is a risk factor for psychological distress and symptoms of more severe mental illness.
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