Panic-Relevant Cognitive Processes Among Smokers

Abstract

To further understand the frequent co-occurrence of smoking and panic disorder (PD), we examined panic-relevant cognitive processes among heavy smokers, half of whom were in 12-hour withdrawal, and nonsmokers. All participants (N 5 85) underwent a 5-minute carbon dioxide rebreathing challenge. Prior to the challenge, participants completed questionnaires on reasons for smoking, anxiety sensitivity, and suffocation fear. Results are consistent with a model in which smokers with predisposing risk factors (high anxiety sensitivity and high suffocation fear) misappraise bodily sensations and experience panicky symptoms. No evidence was found that being in acute withdrawal heightened this risk. Overall, findings highlight (a) cognitive vulnerabilities that may place smokers at elevated risk for developing PD and hence (b) potential targets for intervention.

Anxiety, depression, and cigarette smoking: A transdiagnostic vulnerability framework to understanding emotion–smoking comorbidity.

“…Some cross-sectional studies have found that smokers report higher levels of AS than non-smokers (McLeish et al, 2008; Morissette, Brown, Kamholz, & Gulliver, 2006; c.f., Abrams, Schlosser, et al, 2011), which provide indirect evidence that AS may be related to smoking initiation. Given AS-smoking status relations extend to a sample of individuals with anxiety disorders (Morissette et al, 2006), it is possible that AS is not solely a proxy for manifest anxiety psychopathology and rather a transdiagnostic factor explains variance in smoking status among the population of anxiety-disordered individuals.…”

“…AS has frequently been linked to stronger smoking outcome expectancies for negative reinforcement (e.g., beliefs smoking will reduce negative affect) across adult treatment-seeking heavy smokers (> 20 cig/day; Brown, Kahler et al, 2001), college student daily smokers (Zvolensky, Feldner, et al, 2004), and adult daily smokers from the community (Abrams, Schlosser, Leger, Donisch, Widmer, & Minkina, 2011; Gonzalez, Zvolensky, Vujanovic, Leyro, & Marshall, 2008; Gregor, Zvolensky, McLeish, Bernstein, & Morrisette, 2008; Guillot, Pang, & Leventhal, 2014). Similarly, AS is correlated with greater expectations that abstinence will exacerbate negative affect and other undesired outcomes in regular smokers (Abrams, Zvolensky, Dorman, Gonzalez, & Mayer, 2011; Guillot et al, 2014).…”

“…For example, two studies have examined the effect of 12-hour tobacco deprivation or ad lib smoking on subjective anxiety during a carbon dioxide (CO 2 ) procedure provocation challenge. Both studies showed that, although AS amplifies response to CO 2 provocation, high-AS (vs. low-AS) smokers do not appear to show an enhanced sensitivity to the subjective effects of CO 2 provocation during abstinence (Abrams, Schlosser, Leger, Donisch, Widmer, & Minkina, 2011; Vujanovic and Zvolensky, 2009). Taken together with results above, high (vs. low) AS smokers may be more susceptible to the anticipated and actual effects of abstinence on sustained (“tonic”) levels of subjective anxiety, yet may not experience an amplification of subjective reaction to anxiogenic stimuli (“phasic” anxiety responses) during abstinent states.…”

The role of distress intolerance for panic and nicotine withdrawal symptoms during a biological challenge

“…Biological challenge paradigms have been utilized in experimental psychopathology research to produce physiological sensations associated with anxiety/panic-like symptoms (e.g. chest discomfort, dizziness, sweating, shortness of breath; Abrams et al, 2008a; 2011a, 2011b). In addition, distress intolerance is most frequently conceptualized as a domain-general trait (Trafton and Gifford, 2011), that an individual’s ability to remain in contact with distress is theoretically situationally indiscriminant.…”

Anxiety, Substance Use, and Their Co-Occurrence: Advances in Clinical Science

“…In the sixth article, Abrams et al (in press) examined panic-relevant cognitive processes among heavy smokers and nonsmokers. Participants underwent a 5-minute carbon dioxide rebreathing challenge.…”