A prospective examination of distress tolerance and early smoking lapse in adult self-quitters

Abstract

Auditory Serial Addition Test (a psychological challenge task) was not a signifi cant predictor of earlier smoking lapse.Discussion: These results are discussed in relation to refi ning theoretical models of the role of distress tolerance in early smoking lapse and the utility of such models in the development of specialized treatment approaches for smoking cessation. IntroductionAn increased level of theoretical and empirical attention has focused on better understanding the nature of early smoking lapse in the context of smoking cessation ( Brown, Lejuez, Kahler, Strong, & Zvolensky, 2005 ). This scientifi c work has been stimulated, at least in part, by the observation that a signifi cant percentage of smokers attempting cessation lapse to smoking within a matter of days and very few of these individuals recover to achieve abstinence ( Brown, Kahler, Niaura, et al., 2001 ;Cook, Gerkovich, O'Connell, & Potocky, 1995 ;Doherty, Kinnunen, Militello, & Garvey, 1995 ;Garvey, Bliss, Hitchcock, Heinold, & Rosner, 1992 ). It also rests on the larger recognition that the general population contains signifi cant numbers of at-risk, recalcitrant smokers ( Augustson & Marcus, 2004 ) and that targeted efforts to develop specialized treatment for such subgroups of smokers have been inadequate Irvin & Brandon, 2000 ;Lichtenstein & Glasgow, 1992 ;Niaura & Abrams, 2002 ;Shiffman, 1993 ). AbstractIntroduction: A signifi cant percentage of smokers attempting cessation lapse to smoking within a matter of days, and current models of relapse devote insuffi cient attention to such early smoking lapse. Studies attempting to relate severity of nicotine withdrawal symptoms to short-term smoking cessation outcomes have yielded equivocal results. How one reacts to the discomfort of nicotine withdrawal and quitting smoking (i.e., distress tolerance) may be a more promising avenue of investigation with important treatment implications. Methods:The present investigation examined distress tolerance and early smoking lapse using a prospective design. Participants were 81 adult daily smokers recruited through newspaper advertisements targeted at smokers planning to quit smoking without assistance (i.e., no pharmacotherapy or psychosocial treatment; 42 males and 39 females; mean age = 42.6 years, SD = 12.20).Results: As hypothesized, both greater breath-holding duration and carbon dioxide -enriched air persistence were associated with a signifi cantly lower risk of smoking lapse following an unaided quit attempt. These effects were above and beyond the risk associated with levels of nicotine dependence, education, and history of major depressive disorder, suggesting that distress tolerance and task persistence may operate independently of risk factors such as nicotine dependence and depressive history. In contrast to expectation, persistence on the Paced

Multi-Method Evaluation of Distress Tolerance Measures and Construct(s): Concurrent Relations to Mood and Anxiety Psychopathology and Quality of Life

“…Thus, tolerance of the CO 2 -enriched air challenge may not reflect latent individual differences shared by tolerance of the breath-holding and mirror-tracing tasks. The latter effect was unexpected, and is theoretically interesting, in light of the fact that breath-holding and CO 2 -enriched air challenge persistence are conceptually thought to reflect common or related individual differences in tolerance of physiological anxious arousal (Brown et al, 2009). It is possible a higher-order latent variable related to individual differences in behavioral tolerance of various forms of distress (e.g., physiological anxious arousal and psychological frustration) may, in part, account for strong covariation between performance on these tasks.…”

Anxiety Sensitivity and Distress Intolerance as Predictors of Cannabis Dependence Symptoms, Problems, and Craving: The Mediating Role of Coping Motives

“…Breath-holding duration is time to exhalation. This task has frequently been used as measure of physical distress intolerance (Brown et al, 2009;Hajek et al, 1987), with shorter durations of breath-holding indicating greater intolerance of physical distress. Research has suggested that breath-holding duration maintains unique predictive value beyond the effects of physical health conditions, active substance use, and anxiety sensitivity (Hogan et al, 2015).…”

Dependence and Withdrawal-Induced Craving Predict Abstinence in an Incentive-Based Model of Smoking Relapse

“…A 1 -week time frame was chosen to capture the initial volatile period during which most smoking lapses occur ( Brown et al, 2009 ;Garvey, Bliss, Hitchcock, Heinold, & Rosner, 1992 ) and to minimize the burden of daily laboratory assessments. Incentive amounts were selected to maximize intersubject variability in order to examine predictors of outcomes within the model.…”