Multi-method assessment of distress tolerance and smoking-related factors among adult daily smokers.

Abstract

Although distress tolerance (DT) is associated with smoking lapse and relapse outcomes, few studies have conducted a rigorous assessment of DT across domain and method in the context of acute abstinence. In a human laboratory-based study of 106 adult, daily smokers, we examined between multiple indices of DT and smoking lapse, withdrawal processes, and motivation to quit. We expected that low DT would be associated with shorter latency to smoke, greater withdrawal severity, and lower motivation to quit. Following a smoking abstinence period (≥ 6 hours deprived), participants completed an assessment battery including both behavioral (mirror-tracing, serial addition, cold pressor, and breath-holding tasks) and self-report measures of DT (general and smoking-specific), withdrawal processes (craving, negative affect, and positive affect), and motivation to quit. Latency to smoke (range 0-50 minutes) was assessed in a laboratory analogue task in which delaying smoking was monetarily rewarded. Behavioral and self-report DT indices displayed only modest intercorrelations, indicating different facets of this construct by domain and method of assessment. Tolerance of physical pain was uniquely associated with smoking choice. Both self-report DT measures were associated with abstinence-induced increases in negative affect, while only smoking-specific DT was positively associated with craving. Results are discussed within the context of guiding targeted behavioral interventions.

Distress tolerance among emergency department patients in acute pain: Associations with substance use treatment

“…Consistent with national ED samples (Wu et al., 2012), 15% of ED patients with acute pain sought treatment for SUD at some point in their life (either currently or in the past); furthermore, 32% of ED patients used illicit drugs in the past 3 months, similar to prior studies among ED patients (Sanjuan et al., 2014). Although our average DII score was lower than scores reported in previous studies of DT in daily smokers (Mathew et al., 2019) and in chronic pain patients with Prescription Opioid Misuse (McHugh et al., 2016), 73% of patients endorsed at least “a little” DT on the DII. These lower scores may be reflective of the general population versus specific homogenous populations (e.g., pain patients with opioid misuse).…”

Interactive effects of financial strain and distress tolerance on prequit tobacco withdrawal symptoms in smokers preparing to initiate a quit attempt.

“…Hence, this may partially explain the discrepancies in our results where we found consistent associations between subjective distress tolerance and several prequit tobacco withdrawal outcomes, whereas correlations of behavioral distress tolerance with withdrawal-related outcomes were nonsignificant. Thus, consistent with recent evidence (Mathew et al, 2019), our findings demonstrate that distress tolerance evaluated by subjective assessments may provide more utility as a treatment target and may be a more sensitive indicator of an individual’s perceived confidence, self-efficacy, and ability to cope with tobacco withdrawal while preparing for a quit attempt, especially if these individuals are experiencing elevated levels of financial strain.…”

“…We did not find an association or an interaction for behavioral assessments (mirror tracing) of distress tolerance with any of our prequit withdrawal outcomes. In line with theoretical models, our findings suggest the importance of using multimethod assessments of distress tolerance to evaluate the impact of subjective and behavioral distress tolerance on tobacco withdrawal, given that these distinct measures may potentially tap into slightly different constructs (Leyro et al, 2011) and demonstrate differential associations with health behaviors (Leyro et al, 2010) and smoking-related factors (Mathew et al, 2019). For instance, while behavioral distress tolerance assessments, such as mirror tracing task, may offer some relevant information related to an individual’s cognitive intolerance for psychological frustration and related distress (Leyro et al, 2011), these measures may not be sensitive to an individual’s perceptions of their ability to tolerate distress during tobacco withdrawal.…”

“…FINANCIAL STRAIN, DISTRESS TOLERANCE withdrawal, given that these distinct measures may potentially tap into slightly different constructs (Leyro et al, 2011) and demonstrate differential associations with health behaviors (Leyro et al, 2010) and smoking-related factors (Mathew et al, 2019). For instance, while behavioral distress tolerance assessments, such as mirror tracing task, may offer some relevant information related to an individual's cognitive intolerance for psychological frustration and related distress (Leyro et al, 2011), these measures may not be This document is copyrighted by the American Psychological Association or one of its allied publishers.…”

How laboratory studies of cigarette craving can inform the experimental alcohol craving literature

“…Consistent with this idea are studies showing associations between intolerance of abstinence and cigarette craving/withdrawal severity (Mathew et al, 2019;Mathew & Zhou, 2020;but see Germeroth et al, 2018) and laborator smoking behavior (Kahler et al, 2013).…”