Interplay of dysphoria and anxiety sensitivity in relation to emotion regulatory cognitions of smoking among treatment-seeking smokers
Corresponding Author
Lorra Garey BA
Department of Psychology, University of Houston, Houston, Texas
Address correspondence to Garey or Zvolesnky, at the Anxiety and Health Research Laboratory/Substance Use Treatment Clinic, Department of Psychology, University of Houston, 126 Fred J. Heyne Building, Suite 104, Houston, TX 77204–5502. E-mail: [email protected] (L.G.) or [email protected] (M.J.Z)
Search for more papers by this authorJafar Bakhshaie MD
Department of Psychology, University of Houston, Houston, Texas
Search for more papers by this authorCharles P. Brandt MS
Department of Psychology, University of Houston, Houston, Texas
Search for more papers by this authorKirsten J. Langdon PhD
Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare Center, Boston, Massachusetts
Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
Search for more papers by this authorBrooke Y. Kauffman BS
Department of Psychology, University of Houston, Houston, Texas
Search for more papers by this authorNorman B. Schmidt PhD
Department of Psychology, Florida State University, Tallahassee, Florida
Search for more papers by this authorAdam M. Leventhal PhD
Departments of Preventive Medicine and Psychology, University of Southern California, Los Angeles, California
Search for more papers by this authorCorresponding Author
Michael J. Zvolensky PhD
Department of Psychology, University of Houston, Houston, Texas
Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, Texas
Address correspondence to Garey or Zvolesnky, at the Anxiety and Health Research Laboratory/Substance Use Treatment Clinic, Department of Psychology, University of Houston, 126 Fred J. Heyne Building, Suite 104, Houston, TX 77204–5502. E-mail: [email protected] (L.G.) or [email protected] (M.J.Z)
Search for more papers by this authorCorresponding Author
Lorra Garey BA
Department of Psychology, University of Houston, Houston, Texas
Address correspondence to Garey or Zvolesnky, at the Anxiety and Health Research Laboratory/Substance Use Treatment Clinic, Department of Psychology, University of Houston, 126 Fred J. Heyne Building, Suite 104, Houston, TX 77204–5502. E-mail: [email protected] (L.G.) or [email protected] (M.J.Z)
Search for more papers by this authorJafar Bakhshaie MD
Department of Psychology, University of Houston, Houston, Texas
Search for more papers by this authorCharles P. Brandt MS
Department of Psychology, University of Houston, Houston, Texas
Search for more papers by this authorKirsten J. Langdon PhD
Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare Center, Boston, Massachusetts
Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
Search for more papers by this authorBrooke Y. Kauffman BS
Department of Psychology, University of Houston, Houston, Texas
Search for more papers by this authorNorman B. Schmidt PhD
Department of Psychology, Florida State University, Tallahassee, Florida
Search for more papers by this authorAdam M. Leventhal PhD
Departments of Preventive Medicine and Psychology, University of Southern California, Los Angeles, California
Search for more papers by this authorCorresponding Author
Michael J. Zvolensky PhD
Department of Psychology, University of Houston, Houston, Texas
Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, Texas
Address correspondence to Garey or Zvolesnky, at the Anxiety and Health Research Laboratory/Substance Use Treatment Clinic, Department of Psychology, University of Houston, 126 Fred J. Heyne Building, Suite 104, Houston, TX 77204–5502. E-mail: [email protected] (L.G.) or [email protected] (M.J.Z)
Search for more papers by this authorAbstract
Background and Objectives
There is evidence that anxiety sensitivity (AS) plays a role in the maintenance of smoking, yet there is little understanding of how AS interplays with other affective symptomatology variables that are also related to smoking, such as dysphoria. Therefore, the current cross-sectional study evaluated the interactive effects of AS and dysphoria on emotion regulatory cognitions, including smoking negative affect reduction expectancies, perceived barriers for cessation, and smoking-specific experiential avoidance.
Method
A total of 448 adult treatment-seeking daily smokers, who responded to study advertisements, were recruited to participate in a smoking cessation treatment trial (47.8% female; Mage = 37.2, SD = 13.5). The current study utilized self-report baseline data from trial participants.
Results
After accounting for covariates, simple slope analyses revealed that AS was positively related to negative affect reduction expectancies (β = .03, p = .01), perceived barriers to cessation (β = .22, p = .002), and smoking avoidance and inflexibility (β = .07, p = .04), among smokers with lower (vs. higher) levels of dysphoria.
Conclusions
The current findings suggest that higher levels of dysphoria may mitigate the relation between AS and emotion regulatory cognitions of smoking.
Scientific Significance
The current findings highlight the unique and additive clinical relevance of AS and dysphoria regarding emotion regulatory smoking cognitions that may impede quit success. (Am J Addict 2016;25:267–274)
REFERENCES
- 1 Ziedonis D, Hitsman B, Beckham JC, et al. Tobacco use and cessation in psychiatric disorders: National institute of mental health report. Nicotine Tob Res. 2008; 10: 1691–1715.
- 2 Grant BF, Hasin DS, Chou SP, et al. Nicotine dependence and psychiatric disorders in the United States: Results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry. 2004; 61: 1107–1115.
- 3 Piper ME, Cook JW, Schlam TR, et al. Anxiety diagnoses in smokers seeking cessation treatment: Relations with tobacco dependence, withdrawal, outcome and response to treatment. Addiction. 2011; 106: 418–427.
- 4 Piper ME, Smith SS, Schlam TR, et al. Psychiatric disorders in smokers seeking treatment for tobacco dependence: Relations with tobacco dependence and cessation. J Consult Clin Psychol. 2010; 78: 13.
- 5 Vujanovic AA, Marshall EC, Gibson LE, et al. Cognitive-affective characteristics of smokers with and without posttraumatic stress disorder and panic psychopathology. Addict Behav. 2010; 35: 419–425.
- 6 Leventhal AM, Zvolensky MJ. Anxiety, depression, and cigarette smoking: A transdiagnostic vulnerability framework to understanding emotion–smoking comorbidity. Psychol Bull. 2015; 141: 176–212.
- 7 Reiss S, McNally RJ. Expectancy model of fear-Theoretical issues in behavior therapy. In: S Reiss, RR Bootsin, eds. Theoretical Issues in Behavior Therapy. pp. 107–121. San Diego, CA: Academic Press; 1985.
- 8 Schmidt NB, Zvolensky MJ, Maner JK. Anxiety sensitivity: Prospective prediction of panic attacks and Axis I pathology. J Psychiatr Res. 2006; 40: 691–699.
- 9 Zvolensky MJ, Farris SG, Leventhal AM, et al. Anxiety sensitivity mediates relations between emotional disorders and smoking. Psychol Addict Behav. 2014; 28: 912.
- 10 Brown RA, Kahler CW, Zvolensky MJ, et al. Anxiety sensitivity: Relationship to negative affect smoking and smoking cessation in smokers with past major depressive disorder. Addict Behav. 2001; 26: 887–899.
- 11 Reiss S, Peterson RA, Gursky DM, et al. Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behav Res Ther. 1986; 24: 1–8.
- 12 Watson D, O'Hara MW, Kotov R, et al. Development and validation of the inventory of depression and anxiety symptoms (IDAS). Psychol Assess. 2007; 19: 253–268.
- 13 Leventhal AM, Zvolensky MJ, Schmidt NB. Smoking-related correlates of depressive symptom dimensions in treatment-seeking smokers. Nicotine Tob Res. 2011; 13: 668–676.
- 14 Buckner JD, Farris SG, Zvolensky MJ, et al. Dysphoria and smoking among treatment seeking smokers: The role of smoking-related inflexibility/avoidance. Am J Drug Alcohol Abuse. 2015; 41: 45–51.
- 15 Covinsky KE, Cenzer IS, Yaffe K, et al. Dysphoria and anhedonia as risk factors for disability or death in older persons: Implications for the assessment of geriatric depression. Am J Geriatr Psychiatry. 2014; 22: 606–613.
- 16 Langdon KJ, Leventhal AM, Stewart S, et al. Anhedonia and anxiety sensitivity: Prospective relationships to nicotine withdrawal symptoms during smoking cessation. J Stud Alcohol Drugs. 2013; 74: 469.
- 17 McNally RJ. Anxiety sensitivity and panic disorder. Biol Psychiatry. 2002; 52: 938–946.
- 18 Zvolensky MJ, Forsyth JP. Anxiety sensitivity dimensions in the prediction of body vigilance and emotional avoidance. Cognit Ther Res. 2002; 26: 449.
- 19 Hughes JR, Gust SW, Skoog K, et al. Symptoms of tobacco withdrawal: A replication and extension. Arch Gen Psychiatry. 1991; 48: 52–59.
- 20 Heatherton TF, Kozlowski LT, Frecker RC, et al. The Fagerström test for nicotine dependence: A revision of the Fagerström tolerance questionnaire. Br J Addict. 1991; 86: 1119–1127.
- 21 First MB, Spitzer RL, Gibbon M, et al. Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-Patient Edition (SCIDI/NP). New York, NY: Biometrics Research, New York State Psychiatric Institute; 2007.
- 22 Taylor S, Zvolensky MJ, Cox BJ, et al. Robust dimensions of anxiety sensitivity: Development and initial validation of the anxiety sensitivity index-3. Psychol Assess. 2007; 19: 176–188.
- 23
Brandon TH,
Baker TB.
The smoking consequences questionnaire: The subjective expected utility of smoking in college students.
Psychol Assess.
1991;
3: 484–491.
10.1037/1040-3590.3.3.484 Google Scholar
- 24 Johnson KA, Zvolensky MJ, Marshall EC, et al. Linkages between cigarette smoking outcome expectancies and negative emotional vulnerability. Addict Behav. 2008; 33: 1416–1424.
- 25 Macnee CL, Talsma A. Development and testing of the barriers to cessation scale. Nurs Res. 1995; 44: 214–219.
- 26 Gifford EV, Kohlenberg BK, Hayes SC, et al. Combining Bupropion SR With Acceptance Based Behavioral Therapy for Smoking Cessation. Reno, NV: Association for Advancement of Behavior Therapy; 2002.
- 27 Farris SG, Zvolensky MJ, DiBello AM, et al. Validation of the avoidance and inflexibility scale (AIS) among treatment-seeking smokers. Psychol Assess. 2015; 27: 467–477.
- 28 Pomerleau CS, Carton SM, Lutzke ML, et al. Reliability of the Fagerstrom tolerance questionnaire and the Fagerstrom test for nicotine dependence. Addict Behav. 1994; 191: 33–39.
- 29 Brown RA, Lejuez CW, Kahler CW, et al. Distress tolerance and duration of past smoking cessation attempts. J Abnorm Psychol. 2002; 111: 180–185.
- 30 Zvolensky MJ, Lejuez C, Kahler CW, et al. Nonclinical panic attack history and smoking cessation: An initial examination. Addict Behav. 2004; 29: 825–830.
- 31 Saunders JB, Aasland OG, Babor TF, et al. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption—II. Addiction. 1993; 88: 791–804.
- 32 John OP, Srivastava S. The big five trait taxonomy: History, measurement, and theoretical perspectives. In: LA Pervin, OP John, eds. Handbook of Personality: Theory and Research. pp. 102–138. New York: Guilford; 1999.
- 33 Brose A, Schmiedek F, Koval P, et al. Emotional inertia contributes to depressive symptoms beyond perseverative thinking. Cogn Emot. 2015; 29: 527–538.
- 34 MacPherson L, Tull MT, Matusiewicz AK, et al. Randomized controlled trial of behavioral activation smoking cessation treatment for smokers with elevated depressive symptoms. J Consult Clin Psychol. 2010; 78: 55–61.
- 35 Zvolensky MJ, Bogiaizian D, Salazar PL, et al. An anxiety sensitivity reduction smoking cessation program for Spanish-speaking smokers. Cogn Behav Pract. 2014; 21: 350–363.
- 36 Smits JAJ, Zvolensky MJ, Davis ML, et al. The efficacy of vigorous-intensity exercise as an aid to smoking cessation in adults with high anxiety sensitivity: A randomized controlled trial. Psychosom Med. in press.
