Emotion dysregulation explains associations between anxiety sensitivity and hazardous drinking and drinking motives among adult treatment-seeking smokers.

Abstract

Smoking and drinking frequently co-occur. For example, alcohol use is associated with lapses during quit attempts. However, little is known regarding psychological factors explaining drinking among smokers. Anxiety sensitivity is a risk factor associated with hazardous drinking and drinking to cope and/or conform, although little is known about mechanisms underlying such associations. One potential explanatory factor is emotion dysregulation. The current study examined emotion dysregulation as an explanatory factor underlying anxiety sensitivity and five alcohol-related outcomes: hazardous drinking, alcohol consumption, alcohol problems coping-oriented drinking and drinking to conform. Participants for this study were 467 treatment-seeking adult daily smokers (48.2% female; Mage=36.7 years, SD = 13.6) who reported smoking an average of 16.5 cigarettes per day. Results indicated significant indirect effects of anxiety sensitivity via emotion dysregulation in relation to hazardous drinking, alcohol consumption, alcohol problems, drinking to cope, and drinking to conform. Effects were medium sized. Alternative models testing indirect effects of emotion dysregulation via anxiety sensitivity in relation to outcomes and anxiety sensitivity via outcomes in relation to emotion dysregulation were non-significant with small effect sizes. Follow-up tests examined effects of anxiety sensitivity via specific emotion dysregulation sub-factors. Thus, among treatment-seeking smokers, emotion dysregulation may explain the associations of anxiety sensitivity with alcohol-related outcomes. This pattern of findings highlights the potential importance of interventions targeting emotion dysregulation among hazardous drinking smokers.

Anxiety sensitivity components in relation to alcohol and cannabis use, motives, and problems in treatment-seeking cigarette smokers

“…[38,39] Also, in accord with general expectations, AS and its components were related to drinking conformity motives and to expansion, social, and coping motives for cannabis use in the overall sample. These findings are consistent with previous studies that associated general AS with greater drinking conformity motives [20,21,23,25,26] and with greater expansion, [28] social, [27,28] and coping motives for cannabis use. [25,27–29]…”

“…In fact, a growing literature does indicate that AS is related to motivation to use substances to cope with distress and the development of substance use problems. Individuals high in AS often report the expectation that substance use will reduce negative affect as well as report using substances specifically for that purpose, including tobacco, [17–19] alcohol, [20–26] and cannabis. [25,27–29] Identifying malleable risk factors associated with coping-related substance use motives and expectancies is important given consistent findings linking coping-oriented substance use and the development of substance use problems.…”

The indirect effect of panic disorder on smoking cognitions via difficulties in emotion regulation

“…Indeed, research has found that among smokers, lower ER is related to greater motivation to smoke for stimulation, habitual, sensorimotor (Gonzalez, Zvolensky, Vujanovic, Leyro, & Marshall, 2008; Short, Oglesby, Raines, Zvolensky, & Schmidt, 2015), addictive, and negative affect reduction smoking motives (Short et al, 2015), which may develop over the course of smoking. Similar findings have been found for other types of substance use, including alcohol (Paulus et al, In press). Moreover, individuals with PD, compared to those without PD, report greater ER difficulties in general (Tull, Stipelman, Salters-Pedneault, & Gratz, 2009).…”

How does anxiety sensitivity increase risk of chronic medical conditions?

“…A number of studies on undergraduate, community, and clinical samples have shown that AS is associated with greater consumption of alcohol and/or more problems with alcohol use (e.g., Chavarria et al., ; Howell, Leyro, Hogan, Buckner, & Zvolensky, ; Woicik, Stewart, Pihl, & Conrod, ). Two cross‐sectional studies examining the link between AS and alcohol‐related outcomes among adult smokers and people living with HIV/AIDS, respectively, found that difficulties with emotion regulation mediated the relationship between AS and hazardous drinking (Paulus, Jardin, et al., ; Paulus et al., ), suggesting the potential additional role of maladaptive regulation of negative affect in the link between AS and alcohol use in these medical populations. There is also some evidence of a link between AS and increased cannabis use (Paulus, Manning, Hogan, & Zvolensky, ) and increased coping and conformity motives for use (Bonn‐Miller, Zvolensky, & Bernstein, ; Zvolensky, Marshall, et al., ), although a recent cross‐sectional study found that lower distress tolerance was associated with increased cannabis dependence symptoms and stronger coping motives, whereas AS was not (Farris, Metrik, Bonn‐Miller, Kahler, & Zvolensky, ).…”