The interaction of depressive symptoms and hazardous drinking in relation to tobacco craving among treatment seeking depressed smokers: Sex differences

Objectives: The present study sought to address whether there is sex effect in the interactive effect between depressive symptoms and hazardous drinking in the prediction of smoking craving after cognitive-behavioral smoking cessation treatment among those with at least mild depression. Methods: Participants (n=114, mean age 42.0, SD=9.73, 64% women) were treatment-seeking smokers who attended 6 weekly 1-hour sessions involving psychological treatment for cessation. Participants reported depressive symptoms and alcohol use at baseline and reported craving at baseline and after treatment. Results: Results indicated that there was a statistically significant 3-way interaction (depression by alcohol use by sex) for smoking craving (B=-0.30, standard error [SE]=0.14, P=0.042) and appetitive craving (B=-.21, SE=0.09, P=0.031), but not negative reinforcement craving. The form of the significant interactions indicted that higher levels of depressive symptoms and alcohol use were related to greater levels of craving at the end of treatment only among men. Conclusions: The current findings provide novel empirical evidence suggesting that there is a clinically relevant interplay between depressive symptoms and alcohol use regarding general craving and appetitive craving among male treatment-seeking smokers. Although the present results should be replicated in larger samples, this type of research can inform the development of sex-specific interventions for smoking cessation

Emotional vulnerability as a function of physical activity among individuals with panic disorder

Item does not contain fulltextThis investigation evaluated the association between physical inactivity and emotional vulnerability in panic disorder. Participants were 39 adults (69% females) with a primary diagnosis of panic disorder (with or without agoraphobia), recruited through the community. Consistent with prediction, current physical inactivity was significantly associated with greater levels Of anxiety sensitivity and severity of panic disorder. Results are discussed in relation to the importance of better understanding the role of physical inactivity in panic disorder

Concurrent associations between anxiety sensitivity and perceived health and health disability among young adult daily smokers

Item does not contain fulltextThe aim of this investigation was to evaluate the incremental validity of anxiety sensitivity (fear of arousal-related physical and psychological sensations) relative to health factors (smoking variables, alcohol use and exercise level), in predicting perceived health and disability among a sample of 225 young adult daily smokers (102 females; M(age) = 23.9 years, SD = 8.8). Consistent with prediction, anxiety sensitivity, relative to smoking-relevant variables, alcohol consumption (a single frequency by quantity composite) and exercise activity, predicted lower perceived general health and impairments in mental health and social functioning; no incremental effects were evident for anxiety sensitivity for predicting impairments in physical functioning, role functioning, or increased healthcare usage. These findings are discussed with respect to better understanding cognitive factors that affect perceptions of health status and functioning among daily smokers.11 p

The role of smoking inflexibility/avoidance in the relation between anxiety sensitivity and tobacco use and beliefs among treatment-seeking smokers

Item does not contain fulltextRecent scholarly attention has focused on explicating the nature of tobacco use among anxiety-vulnerable smokers. Anxiety sensitivity (fear of aversive internal anxiety states) is a cognitive-affective individual difference factor related to the development and maintenance of anxiety symptoms and disorders and various smoking processes. The present study examined the cross-sectional associations between anxiety sensitivity and a range of cognitive and behavioral smoking processes, and the mediating role of the tendency to respond inflexibly and with avoidance in the presence of smoking-related distress (i.e., avoidance and inflexibility to smoking [AIS]) in such relations. Participants (n = 466) were treatment-seeking daily tobacco smokers recruited as part of a larger tobacco cessation study. Baseline (pretreatment) data were utilized. Self-report measures were used to assess anxiety sensitivity, AIS, and 4 criterion variables: barriers to smoking cessation, quit attempt history, severity of problematic symptoms reported in past quit attempts, and mood-management smoking expectancies. Results indicated that anxiety sensitivity was indirectly related to greater barriers to cessation, greater number of prior quit attempts and greater mood-management smoking expectancies through the tendency to respond inflexibly/avoid to the presence of distressing smoking-related thoughts, feelings, and internal sensations; but not severity of problems experienced while quitting. The presen

Evaluation of perseveration in relation to panic-relevant responding: An initial test

Background: Perseveration reflects the tendency to engage in a behavior even when it is no longer rewarding nor produces the expected consequences. Method: The current study explored whether (1) individuals endorsing a recent (past 2 years) history of nonclinical panic attacks would report greater levels of perseveration compared to individuals without such a history; (2) whether individuals endorsing higher levels of perseveration would evidence greater panic-relevant responding to a 4-minute 10% carbon dioxide-enriched air challenge. Results: Results indicated that individuals with, compared to without, a positive panic attack history endorsed significantly greater levels of perseveration. Additionally, greater pre-challenge levels of perseveration significantly predicted greater panic attack symptom severity as well as self-reported anxiety; these significant effects were evident above and beyond the variance accounted for by sex, trait-level negative affectivity, panic attack status, and distress tolerance as well as shared variance with the related constructs of persistence and perfectionism. Discussion: Together, the current findings provide initial, albeit preliminary, support for the utlity of investigating perseveration in relation to models of panic psychopathology specifically, and offer a further empirical context for perseveration-psychopathology relations in general

Cognitive behavioral therapy (CBT) for treatment-seeking cannabis users: a meta-analysis of randomized controlled trials

Item does not contain fulltextNarrative 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

Anxiety sensitivity class membership moderates the effects of pre-quit reduction in anxiety sensitivity on quit-day tobacco craving

Item does not contain fulltextBackground: Although anxiety sensitivity has been primarily conceptualized as a dimensional latent construct, empirical evidence suggests that it also maintains a latent class structure, reflecting low-, moderate-, and high-risk underlying classes. The present study sought to explore whether these anxiety sensitivity classes moderated the relations between the degree of pre-quit reductions in anxiety sensitivity and the severity of nicotine withdrawal symptoms and craving experienced on quit-day. Methods: Participants included 195 adult smokers (47% female; Mage = 39.4) participating in a larger "anxiety sensitivity reduction-smoking cessation" intervention trial. Results: Anxiety sensitivity class significantly moderated relations between pre-quit reduction in anxiety sensitivity and quit-day craving. Specifically, smokers within the anxiety sensitivity high-risk class, who also demonstrated lesser pre-quit reductions in anxiety sensitivity, experienced the highest levels of craving on quit-day. Conclusions: These findings highlight the importance of 'high-risk' classes of anxiety sensitivity to better understand the experience of craving on quit day.9 p