Distress tolerance and pre-smoking treatment attrition: Examination of moderating relationships

Abstract

This study focused on the understudied group of smokers who commit to a smoking research study and then subsequently drop out before completing even one session of treatment (pre-inclusion attrition). This is an important group typically not examined in their own right, leaving little knowledge about the characteristics that differentiate them from those who complete treatment. As an initial investigation, the current study examined affective risk factors for attrition in a sample of 53 adults (79% African American; median income = $30,000-$39,999) enrolled in a smoking cessation study. Twenty-one (40%) participants never attended a session of treatment. Results indicated lower psychological distress tolerance was related to pre-inclusion attrition, but only among women. Additionally, lower physical distress tolerance corresponded to pre-inclusion attrition, but only among men. These effects remained after including other important affective factors such as anxiety sensitivity and current depressive symptoms. No other predictors examined corresponded with pre-inclusion attrition in the present sample. Results indicate need for more research attention to this at risk group of smokers who do not continue on to cessation intervention.

State, But Not Trait, Measures of Persistence Are Related to Negative Affect

“…Brandon et al (2003) found coeffi cient α to be .92 for the mirror-tracing task. A computerized version of this procedure is also available (e.g., Daughters et al, 2005;MacPherson et al, 2008).…”

Smoking Cessation Program with Exercise Improves Cardiovascular Disease Biomarkers in Sedentary Women

“…Attrition is a critical problem in clinical trials for substance use and dependence; high attrition rates are commonplace and often expected. 37,[61][62][63] Pretreatment attrition among smokers has begun to receive attention only recently. 61,63 Factors associated with early attrition include younger age, lower socioeconomic status, and history of psychotropic medication use.…”

“…37,[61][62][63] Pretreatment attrition among smokers has begun to receive attention only recently. 61,63 Factors associated with early attrition include younger age, lower socioeconomic status, and history of psychotropic medication use. Low motivation, weight concerns, and affective vulnerabilities, such as depression, also have been reported to predict early attrition.…”

Differential relations between delay discounting and distress tolerance as a function of opportunity cost and alcohol use.

“…Thus, the primary dependent measure of the PASAT-C may have provided insufficient variability to detect relations between behavioral distress tolerance and other dependent measures such as delay discounting. Alternatively, behavioral measures of psychological distress tolerance such as the PASAT-C tend to significantly correlate with behavioral outcomes (e.g., dropout from treatment; MacPherson et al, 2008) but not selfreported behaviors (e.g., motivations for drug use). Future studies should explore the relation between persistence in the PASAT-C and degree of opportunity-cost delay discounting when real rewards and delays are arranged.…”

“…For instance, individuals with low levels of distress tolerance exhibit shorter durations of smoking abstinence (Brown, Lejuez, Kahler, Strong, & Zvolensky, 2005;, and tend to drop out of substance abuse treatment early (Daughters, Lejuez, Bornovalova, et al, 2005;MacPherson, Stipelman, Duplinsky, Brown, & Lejuez, 2008). Likewise, self-reported distress tolerance is related to self-reported substance-use frequency and/or duration of drug use and self-reported problems associated with drug use (e.g., Buckner, Keough, & Schmidt, 2007;Howell, Leyro, Hogan, Buckner, & Zvolensky, 2010).…”