The utility of the MMPI-2-RF to predict the outcome of a smoking-cessation treatment

People with psychopathology experience high rates of smoking and have more trouble quitting. The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF; Tellegen & Ben-Porath, 2008, 2009) is a valid and reliable instrument for the assessment of psychopathology. In this study, we examined the ability of the MMPI-2-RF to assess psychopathology and to predict smoking cessation outcomes in a sample of 281 smokers seeking psychological treatment to stop smoking at the end of treatment and at 6- and 12-month follow-ups. Results showed that T-scores < 65 on Disaffiliativeness (DSF) scale were associated with a higher likelihood of smoking at the end of treatment, and T-scores = 65 on Neurological Complaints (NUC) scale were associated with a higher likelihood of smoking at the 12-month follow-up, after controlling for the effect of age and initial levels of nicotine dependence. The results highlight the usefulness of the MMPI-2-RF in the field of smoking cessation treatment

Attachment and substance use in adolescence: A review of conceptual and methodological aspects

Attachment is currently considered one of the major risk and/ or protective factors for substance use in adolescence. This paper reviews the most important studies published in the last 30 years in this field, focusing on the conceptual and methodological issues that may be making it more difficult to draw conclusions about the impact of attachment – especially attachment to parents – on substance use among youths. In general, the results indicate that secure attachment or stronger attachment between parents and children acts as a protective factor against drug use, even though there is a great variability in relation to the concept of addiction and its assessment. Secondly, most of the research reviewed also covers other factors that may be conditioning the influence of attachment to parents on children’s drug use and which would explain, at least in part, the disparity of the results from different studies. Notable among such factors would be individual characteristics (such as sex, age or self-esteem) and the influence of other sources of attachment, including peers and their circumstances (such as their drug use). Finally, we discuss the importance of taking into account the mentioned conceptual and methodological considerations aspects in research on attachment as a risk and/or protective factor for drug use in adolescence. El apego se considera actualmente uno de los mayores factores de riesgo y/o protección para el consumo de sustancias en la adolescencia. El presente trabajo revisa los estudios más importantes que se han publicado en los últimos 30 años al respecto, centrándose en aquellas cuestiones conceptuales y metodológicas que pueden estar dificultando concluir qué impacto ejerce el apego, sobre todo el apego a los padres, en el consumo de sustancias de los jóvenes. Los resultados indican, en general, que el apego seguro o un mayor apego entre padres e hijos actúa como factor de protección frente al consumo de drogas, si bien existe una gran variabilidad en torno al concepto de apego y su evaluación. En segundo lugar, la mayor parte de los estudios revisados incluyen además otros factores que pueden estar condicionando la influencia del apego a los padres en el consumo de drogas de los hijos y que explicarían, al menos en parte, la disparidad de los resultados en los distintos estudios. Entre estos factores destacarían las características individuales (como el sexo, la edad o la autoestima de los individuos), y la influencia de otras fuentes de apego, como los iguales y sus circunstancias, como por ejemplo el consumo de drogas por parte de éstos. Finalmente, se discute la importancia de tener en cuenta dichas consideraciones conceptuales y metodológicas en la investigación del apego como factor de riesgo y/o protección frente al consumo de drogas en la adolescencia

Gender differences in personality patterns and smoking status after a smoking cessation treatment

Background: The lack of conclusive results and the scarce use of the Millon Clinical Multiaxial Inventory-III (MCMI-III) in the study of the relationship between smoking and personality are the reasons that motivated the study reported here. The aim of the present study was to analyze the influence of personality patterns, assessed with the MCMI-III, and of nicotine dependence on treatment outcomes at the end of the treatment and at 12 months follow-up in men and women smokers receiving cognitive-behavioral treatment for smoking cessation. Methods: The sample was made up of 288 smokers who received cognitive-behavioral treatment for smoking cessation. Personality patterns were assessed with the Millon Clinical Multiaxial Inventory-III (MCMI-III). Abstinence at the end of the treatment and at 12-month follow-up was validated with the test for carbon monoxide in expired air. Results: The results showed significant differences by personality patterns that predict nicotine dependence (Narcissistic and Antisocial in men and Schizoid in women). At the end of the treatment it is more likely that quit smoking males with a Compulsive pattern and less likely in those scoring high in Depressive, Antisocial, Sadistic, Negativistic, Masochistic, Schizotypal and Borderline. In women, it is less likely that quit smoking those with the Schizoid pattern. At 12 months follow-up it is more likely that continue abstinent those males with a high score in the Compulsive pattern. Furthermore, nicotine dependence was an important variable for predicting outcome at the end of the treatment and smoking status at 12 months follow-up in both men and women. Conclusions: We found substantial differences by gender in some personality patterns in a sample of smokers who received cognitive-behavioral treatment for smoking cessation. We should consider the existence of different personality patterns in men and women who seek treatment for smoking cessation

Motivation to quit as a predictor of smoking cessation and abstinence maintenance among treated Spanish smokers

Introduction: Although quitting motivation predicts smoking cessation, there have been inconsistent findings regarding motivation predicting long-term maintenance of abstinence. Moreover, most such research has been conducted in North America and the United Kingdom. The aim of this study was to examine motivation to quit as a predictor of smoking cessation and of abstinence maintenance in a Spanish sample. Method: The sample comprised 286 Spanish smokers undergoing psychological treatment for smoking cessation. Motivation to quit was assessed pre-treatment and post-treatment with the Readiness to Quit Ladder. Abstinence post-treatment and at 6 month follow-up was biochemically verified. Results: Participants with higher levels of pre-treatment and post-treatment motivation were more likely to be abstinent at the end of the treatment (OR. = 1.36) and at 6 month follow-up (OR. = 4.88). Among abstainers at the end of the treatment (61.9%), higher levels of motivation to quit post-treatment predicted maintaining abstinence at 6 months (OR. = 2.83). Furthermore, participants who failed to quit smoking reported higher levels of motivation to quit post-treatment than they had pretreatment (p<. .001). Conclusions: Motivation to quit smoking predicted short and long-term cessation, and also predicted long-term maintenance of abstinence. These results have implications for understanding motivational processes of smoking cessation in general, while extending research to Spanish smokers. They may also help in the design of cessation and relapse-prevention interventions. Specifically, the results suggest that motivational enhancement is important throughout the cessation and maintenance periods

Hazardous Alcohol Drinking as Predictor of Smoking Relapse (3-, 6-, and 12-Months Follow-Up) by Gender

Diverse studies have found a relation between alcohol consumption and smoking relapse. Few studies have analyzed the relation of smoking relapse with pretreatment alcohol consumption and gender differences. The main purpose of this study is to analyze the influence of alcohol consumption in smoking relapse over 12 months (3-, 6-, and 12-months follow-up) and to determine possible gender differences. The sample included 374 smokers who quit smoking by participating in a psychological smoking cessation treatment. We assessed hazardous pretreatment alcohol drinking (AUDIT), cigarette consumption (FTND; number of cigarettes) and sociodemographic variables. Higher scores on hazardous pretreatment alcohol drinking predict smoking relapse at 3-, 6-, and 12-months after smoking cessation. In males, higher scores on hazardous pretreatment alcohol drinking predict relapse at 6 and at 12 months. In females, higher scores on hazardous pretreatment alcohol drinking predict tobacco relapse at 3 months. Hazardous pretreatment alcohol drinking predicts relapse at all intervals after smoking cessation (3-, 6-, and 12-months follow-up). However, the influence of hazardous pretreatment alcohol drinking on smoking relapse differs as a function of gender, as it is a short-term predictor in women (3 months) and a long-term predictor in men (6 and 12 months)

Smoking cessation and depressive symptoms at 1-, 3-, 6-, and 12-months follow-up

Background The relationship between tobacco and depressive symptoms has been examined. However, there is little information on the evolution of these symptoms when an individual quits. The aim of this study was to analyze the evolution of depressive symptoms over time (pre-, post-treatment, 1-, 3-, 6-, and 12-months follow-up) in relation to smoking status 12 months after having received a psychological treatment for smoking cessation. Method The sample was made up of 242 adults who received cognitive-behavioral treatment for smoking cessation (64.4% women; mean age=41.71 years). The BDI-II was used to assess depressive symptomatology. Participants were classified into three groups according to smoking status at 12-months follow-up (abstainers, relapsers, and smokers). Results There were no significant differences in depressive symptoms among the three groups at pretreatment. At the end of treatment, abstainers and relapsers presented less depressive symptomatology than smokers. At follow-up, abstainers continued to present less depressive symptomatology than smokers, whereas in relapsers, symptoms began to increase as the relapses occurred. Regarding the evolution of depressive symptomatology, the abstainer and relapser groups showed a significant reduction at the end of treatment. Only in the group of abstainers did the decrease continue during 12 months follow-up. Limitations The decrease of the initial sample size from 562 to 242 participants. Variables such as self-esteem and self-efficacy were not assessed. Conclusions Smoking cessation is associated with a decrease in depressive symptomatology, that is maintained over time. In contrast, relapse is associated with an increase of such symptoms. These findings signify the potential importance of addressing depressive symptomatology in smoking cessation treatment

Cognitive-behavioral treatment with behavioral activation for smokers with depressive symptomatology: Study protocol of a randomized controlled trial

Background: Smoking is an important risk factor for mental health-related problems. Numerous studies have supported a bi-directional association between cigarette smoking and depression. Despite the advances in understanding the comorbidity between both problems, the most effective psychological treatment that simultaneously targets smoking and depressive symptomatology remains unclear. The objective of this study is to assess the effectiveness of a cognitive-behavioral intervention for smoking cessation with components of behavioral activation for managing depressed mood. Method: A single blind, three-arm, superiority randomized controlled trial is proposed. Participants will be smokers over 18years old, who smoke at least 8 cigarettes per day. Participants will be randomized to one of three conditions, using a 2:2:1 allocation ratio: 1) standard cognitive-behavioral smoking cessation treatment; 2) standard cognitive-behavioral smoking cessation treatment plus behavioral activation; or 3) a three-month delayed treatment control group. The primary outcome measures will be biochemically verified point-prevalence abstinence (carbon monoxide in expired air) and significant change from baseline in depressive symptoms to the end of treatment, and at the 3-, 6-, and 12-month follow-up. Discussion: This study aims to assess the efficacy of a cognitive-behavioral intervention with behavioral activation components for smoking cessation and depressive symptoms, compared to a standard cognitive-behavioral intervention to quit smoking. As the relation between depressive symptoms, even at subclinical levels, and quitting smoking difficulties is well known, we expect that such intervention will allow obtaining higher abstinence rates, lower relapse rates, and mood improvement. Trial registration:ClinicalTrials.gov: NCT02844595. Retrospectively registered 19th July, 2016. The study started in January 2016, and the recruitment is ongoing

Smoking habit profile and health-related quality of life

Background: Few studies have investigated the relationship between smoking and health-related quality of life (HRQOL), and the results are not consistent. The aim of this study is to explore the association between smoking and HRQOL. Method: Cross-sectional study of 714 Spanish adults (44.7% never smokers and 55.3% smokers) without diagnosis of physical or mental disorder. Each participant provided information about different sociodemographic variables and data on HRQOL. Smokers also reported smoking-related information about smoking-related variables. Results: Nicotine dependence was not associated with the physical dimension of HRQOL, but in the mental component, nicotine dependent smokers showed worse HRQOL than never smokers (p = 0.004) and than non-nicotine dependent smokers (p = 0.014). There were no differences between no-nicotine dependent smokers and never smokers. Smoking status (non smokers vs. smokers), number of cigarettes smoked per day, stage of change, quit attempts in the past year or age of smoking onset were not related to HRQOL. Conclusions: In subjects without physical or mental diseases, only nicotine dependent smokers showed a significant impairment in the mental component of HRQOL. Therefore, it is important to consider nicotine dependence in the relationship between smoking and HRQOL. Perfil de tabaquismo y calidad de vida relacionada con la salud. Antecedentes: pocos estudios han investigado la relación entre tabaquismo y calidad de vida relacionada con la salud (CVRS) y los resultados han sido discrepantes. El objetivo de este trabajo es analizar la relación entre consumo de tabaco y CVRS. Método: estudio transversal en el que participaron 714 adultos (44,7% no fumadores y 55,3% fumadores) sin diagnóstico de enfermedad física o mental. De cada participante se recogieron datos sociodemográficos y de CVRS, y de los fumadores también se recogió información sobre distintas variables relacionadas con el consumo de tabaco. Resultados: la dependencia de la nicotina no se asoció a la dimensión física de CVRS, pero en la dimensión mental los fumadores dependientes mostraron peor CVRS que los no fumadores (p= 0.004) y que los fumadores sin dependencia (p= 0.014). No se encontraron diferencias en función del número de cigarrillos fumados diariamente, el estadio de cambio, los intentos de abandono o la edad de inicio en el consumo de tabaco. Conclusiones: en personas sin diagnóstico de enfermedad física o mental solo los fumadores dependientes de la nicotina muestran deterioro en la dimensión mental de la CVRS. Es importante considerar el grado de dependencia de la nicotina en la relación entre consumo de tabaco y CVRS

Health-related quality of life among smoking relapsers

Background: Previous studies have shown that smoking is associated with health-related quality of life (HRQoL) impairment. In order to evaluate HRQoL in a sample of Spanish relapsers, a cross-sectional study was conducted. Method: The sample was made up of 775 smokers who had relapsed after a period of abstinence. HRQoL was evaluated using the Euro-Qol questionnaire (EQ-5D); through the descriptive profile, the EQ-5D index and the visual analogue scale (EQ-VAS). Results: Higher nicotine dependence was related to worse HRQL. According to the EQ-VAS, higher daily cigarette consumption and more years smoking were related to worse perceived health. In the EQ-5D those who had quit smoking in the previous year perceived worse health. Mobility and anxiety/ depression are the dimensions affected by smoking. Those who are more nicotine dependent (OR = 2.29) and have been smoking for longer (OR = 4.12) are more likely to have mobility problems; and those who are nicotine dependent (OR = 1.85) and relapsed more than a year ago (OR = 0.63), are more likely to experience anxiety/ depression. Conclusions: Nicotine dependence demonstrated a determining effect on HRQOL deterioration in smokers who have relapsed

¿Mejora la entrevista motivacional la eficacia del tratamiento psicológico para dejar de fumar?

Several studies show that when using motivational interviewing (MI) added to standard treatment, in order to increase motivation, treatment outcomes improve. The aim of this study was to examine whether smokers who receive an intervention with MI before a cognitive-behavioral psychological treatment to quit smoking they improve adherence and treatment effectiveness, and they reduce the risk of relapse at follow-up compared with smokers who only receive cognitive-behavioral psychological treatment for smoking cessation. We compared the effectiveness of adding or not MI to a psychological treatment to quit smoking in a sample of 58 smokers (46.6% men and 53.4% women). The experimental group received 2 sessions of MI before the beginning of the 6 sessions of the psychological treatment, while the control group received only 6 sessions of treatment. The results showed no statistically significant differences between the two groups in adherence to treatment, and treatment outcomes at the end of treatment and at 6- and 12-month follow-ups. We conclude that intervention with MI does not produce better results compared to the application of cognitive-behavioral psychological treatment alone