Anxiety Sensitivity As Moderator of the Association Between Nicotine withdrawal and Panic-Relevant Responding to a Carbon Dioxide-Enriched Air Laboratory Challenge

Individuals high in anxiety sensitivity (AS), a cognitive risk factor denoting a fear of anxiety-related sensations (Reiss & McNally, 1985), may be at increased risk of misinterpreting nicotine withdrawal-relevant interoceptive cues as harmful, thus amplifying their risk for panic problems. This study tested the moderating role of AS on the association between nicotine withdrawal and panic-relevant responding to a carbon dioxide-enriched air laboratory challenge. Specifically, it was hypothesized that AS moderates the relation between nicotine withdrawal (group status) and responding to a carbon dioxide-enriched air procedure (controlling for anticipatory anxiety, gender, negative affectivity, number of axis I diagnoses, and average daily smoking rate), as indexed by: (1) level of anxiety focused on bodily sensations and intensity of panic attack symptoms; (2) skin conductance reactivity; and (3) level of behavioral avoidance of a future challenge. To test this hypothesis, 90 daily smokers (35 women; Mage = 28.87, SD = 12.12, Range = 18-60 years) were enrolled and enlisted to attend two study sessions. At the conclusion of the first session, participants were randomly assigned to one of two groups (12-hour nicotine deprivation or smoking ‗as usual‘). At the second scheduled session, participants in both groups underwent a 10% carbon dioxide-enriched air laboratory challenge to assess panic-relevant responding. Contrary to hypothesis, the AS by nicotine withdrawal (group status) interactive effect was not significantly predictive of post-challenge anxiety, panic attack symptoms, skin conductance reactivity, or behavioral avoidance. However, post hoc tests indicated that the AS by nicotine withdrawal (group status) interaction was significantly predictive of peri-challenge anxiety ratings. Furthermore, post hoc tests demonstrated that between-group (significant) differences in withdrawal symptoms diminished after the first assessment of the challenge session. Results are discussed in the context of the theoretical and clinical implications of the current work, limitations of the current study, and future directions for work relevant to this line of inquiry

Linkages between Cigarette Smoking Outcome Expectancies and Negative Emotional Vulnerability

The present investigation examined whether smoking outcome expectancies, as measured by the Smoking Consequences Questionnaire (SCQ; [Brandon, T.H., & Baker, T.B., (1991). The Smoking Consequences Questionnaire: The subjective expected utility of smoking in college students. Psychological Assessment, 3, 484–491.]), were incrementally related to emotional vulnerability factors among an adult sample of 202 daily cigarette smokers (44.6% women; Mage= 23.78 years, SD = 9.69 years). After controlling for cigarettes smoked/day, past 30-day marijuana use, current alcohol consumption, and coping style, negative reinforcement/negative affect reduction outcome expectancies were significantly associated with greater levels of negative affectivity, emotional dysregulation, and anxiety sensitivity. The observed effects for negative reinforcement/negative affect reduction also were independent of shared variance with other outcome expectancies. Negative personal consequences outcome expectancies were significantly and incrementally related to anxiety sensitivity, but not negative affectivity or emotional dysregulation. Findings are discussed in terms of the role of negative reinforcement/ negative affect reduction smoking outcome expectancies and clinically-relevant negative emotional vulnerability for better understanding cigarette smoking-negative mood problem

Posttraumatic Stress and Distress Tolerance: Associations With Suicidality In Acute-Care Psychiatric Inpatients

Trauma and posttraumatic stress disorder (PTSD) symptomatology have been associated with suicidality, including ideation and behavior. The current investigation evaluated, in acute-care psychiatric inpatients, the mediating role of perceived (self-reported) distress tolerance in the association between PTSD symptom severity and suicidality, defined as a) suicidal ideation, intent, or behavior leading to current psychiatric hospitalization; b) self-reported severity of suicidal desire; and c) percentage of days of suicidality during current hospitalization. Participants were composed of 105 adults (55.2% women; mean age, 33.9; SD, 10.9) admitted to a public psychiatric acute-care inpatient hospital in a large metropolitan area; 52.3% of the participants were hospitalized for suicidality. Results indicated that PTSD symptom severity (and severity of each PTSD symptom cluster) may exert an indirect effect on suicidality, specifically suicidality as a basis for current hospital admission and self-reported severity of suicidal desire, through perceived distress tolerance. Effects were documented after controlling for theoretically relevant covariates