The present study examined the affective consequences of response inhibition during a state of anxiety-related physical stress. Forty-eight non-clinical participants were selected on the basis of ...pre-experimental differences in emotional avoidance (high versus low) and subjected to four inhalations of 20% carbon dioxide-enriched air. Half of the participants were instructed to inhibit the challenge-induced aversive emotional state, whereas the other half was instructed to simply observe their emotional response. Participants high in emotional avoidance compared to those low in emotional avoidance responded with greater levels of anxiety and affective distress but not physiological arousal. Individuals high in emotional avoidance also reported greater levels of anxiety relative to the low emotional avoidance group when suppressing compared to observing bodily sensations. These findings are discussed in terms of the significance of emotional avoidance processes during physical stress, with implications for better understanding the nature of panic disorder.
Opioid misuse is a significant public health problem. Chronic pain is one highly prevalent factor that is strongly associated with increased risk for opioid misuse. Anxiety sensitivity (fear of ...anxiety related physical sensations) is an individual difference factor consistently linked to pain experience, and separately, heroin use. The present study examined if anxiety sensitivity may be one factor related to the relationship between pain intensity and opioid misuse among opioid-using adults with chronic pain. Results indicated that anxiety sensitivity total score was significantly associated with the relationship between pain intensity and current opioid misuse, as well as pain intensity and severity of opioid dependence. Overall, results suggest that anxiety sensitivity may be an important assessment and intervention target to ultimately reduce the rates of opioid misuse among adults with chronic pain.
Pain, tobacco cigarette smoking, and prescription opioid misuse are all highly prevalent among persons living with HIV (PLWH). Smoking and pain medication misuse can lead to deleterious outcomes, ...including more severe pain and physical impairment. However, we are not aware of any interventions that have attempted to address these issues in an integrated manner. Participants (N = 68) were recruited from an outpatient infectious disease clinic and randomized to either a computer-based personalized feedback intervention (Integrated PFI) that aimed to increase motivation, confidence, and intention to quit smoking, and decrease intentions to misuse prescription analgesic medications, or a Control PFI. Results indicated that PLWH who received the Integrated PFI (vs. Control PFI) evinced greater post-treatment knowledge of interrelations between pain and tobacco smoking. Moreover, participants who received the Integrated PFI and smoked at least 10 cigarettes per day (but not < 10 CPD) reported greater confidence and readiness/intention to quit smoking. Effects of the Integrated PFI on knowledge of pain and opioid misuse, and attitudes/intentions regarding prescription pain medication misuse were not statistically-significant. Taken together, these results indicate that this novel intervention strategy may offer promise for addressing a critical public health need in a population that is generally underrepresented in clinical research.
•A brief PFI was developed to address cigarette smoking and prescription pain medication misuse.•The computer-based Integrated PFI content was tailored for older PLWH who were prescribed analgesic medication.•The Integrated PFI (vs. Control PFI) resulted in greater knowledge of pain-smoking interrelations.•The Integrated PFI also resulted in greater confidence/readiness to quit, but only among heavier smokers.•Future research should examine the efficacy of this portable integrated treatment.
Background and aims
While cigarette smoking has declined over time, it is not known whether this decline has occurred similarly among individuals with substance use disorders (SUDs) in the United ...States (US). The current study estimated trends in smoking from 2002 to 2014 among US individuals with and without SUDs.
Design
Linear time trends of current smoking prevalence were assessed using logistic regression models.
Setting
United States; data were drawn from the 2002 to 2014 National Household Survey on Drug Use (NSDUH), an annual US cross‐sectional study.
Participants
A representative, population‐based sample of US individuals age 12 yeas and older (total analytical population: n = 723 283).
Measurements
Past‐month current smoking was defined as having smoked at least 100 lifetime cigarettes and reporting smoking part or all of at least one cigarette during the past 30 days. Respondents were classified as having any SUD if they met criteria for abuse or dependence for one or more of the following illicit drugs: cannabis, hallucinogens, inhalants, tranquilizers, cocaine, heroin, pain relievers, simulants and sedatives. A second SUD variable included all drugs listed above excluding cannabis use disorder (CUD). An additional variable included respondents who met criteria for cannabis abuse or dependence.
Findings
Among those with any SUD, the prevalence of smoking did not change from 2002 to 2014 (P = 0.08). However, when CUDs were separated from other SUDs, a significant increase in prevalence of smoking was observed among those with SUDs excluding CUDs (P < 0.001), while smoking decreased among those with CUDs (P < 0.001). Smoking declined among those without SUDs (P < 0.001). In 2014, smoking remained significantly more common among those with any SUD (55.48%), SUDs excluding CUDs (63.34%) and CUDs (51.34%) compared with those without these respective disorders (18.16, 18.55 and 18.64%; P < 0.001).
Conclusions
The prevalence of cigarette smoking in the United States increased from 2002 to 2014 among people with substance use disorders (SUDs) excluding cannabis use disorders (CUDs) and declined among those with CUDs and without SUDs. In 2014, the prevalence of smoking was multifold higher among those with SUDs, including CUDs, compared with those without SUDs.
Abstract The present study evaluated the effect of smoking deprivation on a biobehavioral index of distress tolerance, breath-holding duration, among 43 adult smokers in a repeated measures test ...(Session 1 = smoking-as-usual, Session 2 = 12-h smoking deprivation). We theorized that distress tolerance is a context-dependent individual difference variable whose expression varies prospectively, within-individuals, as a function of smoking context. As predicted, participants' breath-holding duration was significantly shorter during an experimental session that immediately followed a 12-h smoking deprivation period than during a smoking-as-usual session. Furthermore, we theorized that among individuals with a pre-existing diathesis (i.e., psychiatric symptoms), smoking deprivation may activate a vulnerability process that decreases capacity to tolerate distress; in the absence of this stressor, these psychiatrically vulnerable smokers may express variable levels of distress tolerance. As predicted, we observed that level of psychiatric symptoms was significantly negatively correlated with breath-holding duration during the smoking deprivation, but not the smoking-as-usual session. These data advance our understanding of smoking and distress tolerance and the context-dependent phenomenology of distress tolerance.
Introduction:
Despite evidence that expectancies influence the use and effects of drugs, there are no questionnaires that assess abstinence expectancies among smokers. Such a questionnaire may assist ...prediction models of successful quitting, enable clinicians to target specific expectancies, and give researchers a broader understanding of cognitive processes that influence smoking.
Methods:
We aimed to develop a questionnaire that assesses, among daily smokers, expected short-term psychological and physiological consequences to (hypothetically) abstaining from smoking. Initial scale items, completed by 326 smokers, were constructed on the basis of theory, empirical evidence, and expert review.
Results:
The final Smoking Abstinence Expectancies Questionnaire (SAEQ) has 28 items and 4 internally consistent subscales: Negative Mood (e.g., "I would feel grouchy"), Somatic Symptoms (e.g., "My throat would feel dry"), Harmful Consequences (e.g., "I would feel like I'm dying"), and Positive Consequences (e.g., "I would feel calm"). The full scale showed good internal consistency ( = .86), test-retest reliability over a 2-week span (r = .82), as well as convergent and discriminant validity.
Conclusions:
The present study provides preliminary support for the SAEQ as a tool in smoking cessation research and treatment planning.
To investigate the association between nicotine dependence (ND), by cigarette smoking and use of smokeless tobacco (UST), and mental disorders.
Face-to-face surveys (n=43 093) were conducted in the ...2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Nicotine use, ND, and mental disorders were assessed using DSM-IV criteria.
UST-ND was associated with a significantly increased likelihood of any anxiety disorder, specific phobia, alcohol abuse and dependence. Consistent with previous findings, cigarette smoking-ND was associated with an increased likelihood of all mental disorders examined. Among those without ND, cigarette smoking was specifically associated with panic attacks and panic disorder; non-dependent UST was not associated with mental disorders.
Our findings suggest that the association between ND and mental disorders is relatively specific to the mode of nicotine administration. Among those who are nicotine dependent, cigarette use is associated with most major psychiatric disorders, whereas UST is associated with dysthymia and specific phobia. Among those who use tobacco but are not nicotine dependent, cigarette use is associated with dysthymia and panic disorder; UST is not associated with any major mood or anxiety disorders. The link between mental disorders and nicotine is complex, and is associated primarily with dependence, and not with non-dependent use.
Despite the notable prevalence and comorbidity of tobacco cigarette dependence and chronic pain, relatively little is known about potential mechanisms of action. Research has emphasized the utility ...of identifying core underlying dimensions that reflect shared etiological processes, and it has been posited that anxiety-relevant transdiagnostic factors may be particularly important to understanding pain-smoking comorbidity. This review examined the empirical literature linking pain-related fear (fear of pain and activities that elicit pain), pain-related anxiety (anxious responses to pain), and anxiety sensitivity (degree to which the experience of anxiety is expected to have deleterious consequences) to both chronic pain and tobacco cigarette smoking. We then integrated this literature to inform a conceptual model explicating the function of anxiety-relevant transdiagnostic factors in pain-tobacco smoking comorbidity. Finally, we drew upon this conceptual model to highlight novel clinical implications and inform future research.
Despite high rates of co-occurring tobacco use and anxiety among persons living with HIV, evidence-based interventions for these individuals are limited. An existing cognitive-behavioral treatment ...protocol for smoking cessation and anxiety (Norton, P. J., & Barrera, T. L. (2012). Transdiagnostic versus diagnosis-specific CBT for anxiety disorders: A preliminary randomized controlled noninferiority trial. Depression and Anxiety, 29(10), 874-882. https://doi.org/10.1002/da.21974) was modified to address transdiagnostic constructs, such as anxiety sensitivity, distress tolerance, and depressive symptomatology (Labbe, A. K., Wilner, J. G., Kosiba, J. D., Gonzalez, A., Smits, J. A., Zvolensky, M. J., ... O'Cleirigh, C. (2017). Demonstration of an Integrated Treatment for Smoking Cessation and Anxiety Symptoms in People with HIV: A Clinical Case Study. Cognitive and Behavioral Practice, 24(2), 200-214. https://doi.org/10.1016/j.cbpra.2016.03.009). This study examines the feasibility and acceptability of the intervention as determined from qualitative data from structured exit interviews from 10 participants who completed treatment. Results demonstrated that participants were very motivated to quit smoking and enrolled in the program for health-related reasons and to be able to quit. Participants found nearly all the treatment components to be useful for reaching their smoking cessation goal and in managing emotional dysregulation. Last, all participants stated that they would strongly recommend the treatment program. This qualitative study provides initial evidence for the feasibility and acceptability of a modified smoking cessation treatment protocol for HIV+ individuals with anxiety and emotional dysregulation. Future research will focus on evaluating the efficacy of the protocol in a full-scale randomized controlled trial, as well as working to collect qualitative data from participants who discontinue treatment to better understand reasons for treatment attrition.
Research implicates a potentially important relationship between anger and smoking, though extant work suffers from a number of limitations, including the absence of controls for psychiatric ...comorbidity and the use of treatment-seeking samples. The current study sought to examine the unique associations between problematic anger and smoking behavior in a large representative sample.
Participants included 5,692 adults from the National Comorbidity Survey-Replication, a nationally representative survey. Assessments of psychiatric diagnoses, smoking behavior, and problematic anger were administered.
Results indicated that problems of anger experience were significantly associated with past-year daily smoking, heavy smoking, and nicotine dependence. After controlling for demographics and psychiatric comorbidity, anger experience was uniquely associated with each of these outcomes. Anger experience also was uniquely associated with lifetime history of smoking cessation failure.
Overall, these population-based data suggest an important relationship between problematic anger and numerous aspects of smoking behavior.
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