variance across depressive symptom subdimensions. Dysphoria symptoms, which contain core DSM-IV depression criteria, may be central to depression-smoking comorbidity, whereas other symptoms may play a less prominent role.
IntroductionThe relation between depressive symptoms and cigarette smoking is of considerable scientific and clinical importance, yet the mechanisms underlying this association are not entirely clear. Most studies in the smoking literature typically consider depression as a unidimensional construct that can be assessed by calculating the combined overall severity across all depressive symptoms. However, depressive symptoms are phenomenologically heterogeneous and include sadness, anhedonia (i.e., diminished interest or pleasure), concentration problems, anergia, worthlessness, changes in weight and sleep, suicidality, and psychomotor disturbances as well as other peripheral features (e.g., anger, diminished subjective well-being; Watson et al., 2007). Accordingly, depression may be more aptly characterized as a multidimensional construct involving a collection of several discrete subdimensions. Given that depressive symptom subdimensions are psychometrically distinct and may have unique etiological correlates (Milak et al., 2005;Watson et al., 2007), understanding the unique relation of each depressive subdimension to smoking could shed light on the mechanisms underlying depression-smoking comorbidity.One approach to parsing depressive symptomatology involves computing symptom subscales within existing measures of depression, such as the Center for Epidemiological Studies Depression Scale (CES-D;Radloff, 1977) or Beck Depression Inventory-Second Edition (BDI-II). Studies using that approach in samples of psychiatric patients have found that neither overall symptom severity scores nor cognitive or somatic symptom subdimensions on the BDI-II were associated with stage of change in the smoking cessation process Further validation of the IDAS: Evidence of convergent, discriminant, criterion, and incremental validity. Psychological Assessment, 20, 248-259. doi:10.1037/a0012570) produce 8 distinguishable depressive symptom dimensions: dysphoria (anhedonia, sadness, psychomotor disturbance, worthlessness, worry, and cognitive difficulty), lassitude (anergia and hypersomnia), suicidality (self-harm thoughts/behaviors), ill temper (anger), well-being (positive thinking), appetite loss, appetite gain, and insomnia. The present study examined common and unique relations of IDAS depression subdimensions to (a) smoking rate (cigarettes perday), (b) tobacco dependence, and (c) smoking motivation.Methods: Secondary analysis of cross-sectional associations in baseline data collected from 338 daily smokers enrolled in a larger cessation study.
Results:In individual models examining each symptom dimension in isolation, each symptom dimension was significantly with associated smoking rate, tobacco dependence, and/or various aspects of smoking motivation (e.g., subjective addiction, habit, appetite control, affect...