Reactivity to negative affect in smokers: The role of implicit associations and distress tolerance in smoking cessation

Cameron, Amy; Reed, Kathleen M. Palm; Ninnemann, Andrew

doi:10.1016/j.addbeh.2013.08.012

Cited by 22 publications

(18 citation statements)

References 57 publications

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“…These effects are also generally consistent with prior laboratory-based smoking work (e.g., Perkins et al, 2010a). Yet, given withdrawal and craving mediated the effect of anxiety sensitivity on time to smoking initiation, in conjunction with extant literature suggesting the importance of cognitive-affective vulnerabilities for smoking behavior and relapse risk (e.g., Cameron et al, 2013; Correa-Fernandez et al, 2012; Gwaltney et al, 2005; Shiffman, 2005), it is likely that the effects demonstrated in this study, although small, may be likely to impact smoking behavior and thus could be clinically relevant. It is notable that there was no direct effect of elevated anxiety sensitivity on latency to smoking re-initiation, rather only an indirect effect through deprivation-induced withdrawal and urges.…”

Section: Discussionsupporting

confidence: 51%

Anxiety sensitivity as an amplifier of subjective and behavioral tobacco abstinence effects

Zvolensky

Farris

Guillot

et al. 2014

Drug and Alcohol Dependence

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Background Anxiety sensitivity, a transdiagnostic cognitive vulnerability factor described as an amplifier of negative emotional states, is implicated in the maintenance of cigarette smoking and cessation difficulties. The current study aimed to examine the role of anxiety sensitivity in predicting abstinence-induced changes in nicotine withdrawal, smoking urges and smoking behavior during an experimental relapse analogue task (RAT). Method Participants were 258 non-treatment seeking smokers (M [SD] age = 44.0 [10.73]; 69.8% male). Participants attended two counterbalanced experimental sessions including smoking deprivation (16 hours of smoking abstinence) and smoking as usual. The Minnesota Nicotine Withdrawal Scale (MNWS) and Brief Questionnaire of Smoking Urges (QSU) were completed at each session in addition to the RAT. Hierarchical regressions were conducted to examine the predictive impact of anxiety sensitivity on withdrawal and urges during smoking deprivation. Follow-up mediational analyses were conducted to examine whether abstinence-induced withdrawal and urges mediated responding during the RAT. Results Anxiety sensitivity amplified the effects of experimentally manipulated acute abstinence on subjective nicotine withdrawal symptoms and smoking urges. Additionally, higher levels of anxiety sensitivity indirectly predicted shorter latency to smoking initiation after deprivation during the RAT through the effects of greater abstinence-induced nicotine withdrawal and smoking urges. Anxiety sensitivity was unrelated to increased smoking during the RAT, although this may be partially attributed to the type of laboratory assessment employed. Conclusions Elevated anxiety sensitivity appears to impact initiation of smoking after nicotine deprivation through the effects of abstinence-induced withdrawal and smoking urges.

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Section: Discussionsupporting

confidence: 51%

Anxiety sensitivity as an amplifier of subjective and behavioral tobacco abstinence effects

Zvolensky

Farris

Guillot

et al. 2014

Drug and Alcohol Dependence

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“…However, they were not confirmed by Cameron et al (2013) who found no correlation between time to relapse (r ¼ À0.05) and the level of distress induced by the MTPT (n ¼40); and by Zvolensky et al (2001) who found no difference in breath holding duration Contents lists available at ScienceDirect journal homepage: www.elsevier.com/locate/psychres between smokers with a previous quit attempt Z7 days (n ¼ 10) and smokers with a previous quit attempt shorter than 7 days (n ¼12). In addition, none of the aforementioned studies (Brandon et al, 2003;Brown et al, 2002Brown et al, , 2009Hajek et al, 1987) measured distress tolerance in smokers while quitting.…”

Section: Introductioncontrasting

confidence: 61%

Does smoking abstinence influence distress tolerance? An experimental study comparing the response to a breath-holding test of smokers under tobacco withdrawal and under nicotine replacement therapy

Cosci

Aldi

Nardi

2015

Psychiatry Research

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“…There are fairly consistent associations between poor DT and lower ability to sustain abstinence using retrospective reports of quit history (Brown, Lejuez, Kahler, & Strong, 2002), prospective analyses of pre-quit DT as a predictor of cessation outcomes (Brandon et al, 2003; Brown et al, 2009; Cameron et al, 2013; Hajek, 1991; Hajek, Belcher, & Stapleton, 1987; Steinberg et al, 2012), and laboratory experimental analogues of relapse behavior (Kahler et al, 2013). Much of this work documents that low DT increases risk of very early lapse behavior, including within the first several hours or days of abstinence (e.g., Abrantes et al, 2008; Brown et al, 2002; Kahler et al, 2013).…”

Section: Trandiagnostic Emotional Vulnerabilities and Smokingmentioning

confidence: 95%

“…Much of this work documents that low DT increases risk of very early lapse behavior, including within the first several hours or days of abstinence (e.g., Abrantes et al, 2008; Brown et al, 2002; Kahler et al, 2013). Associations of low DT to faster relapse latency generally extend across various measures, including breath holding duration (Brown et al, 2002; Brown et al, 2009; Hajek, 1991; Hajek, Belcher, & Stapleton, 1987; c.f., Steinberg et al, 2012), persistence on a CO 2 challenge (Brown et al, 2002; Brown et al, 2009), and persistence on psychologically stressful and frustrating tasks (Brandon et al, 2003; Brown et al, 2009; Brown et al, 2002; Cameron et al, 2013). They have also been documented in several populations, including a mixed sample of smokers with and without schizophrenia who were provided cessation counseling and pharmacotherapy (Steinberg et al, 2012).…”

Section: Trandiagnostic Emotional Vulnerabilities and Smokingmentioning

confidence: 99%

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

Leventhal

Zvolensky²

2015

Psychological Bulletin

457

294

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Research into the comorbidity between emotional psychopathology and cigarette smoking has often focused upon anxiety and depression’s manifest symptoms and syndromes, with limited theoretical and clinical advancement. This paper presents a novel framework to understanding emotion-smoking comorbidity. We propose that transdiagnostic emotional vulnerabilities—core biobehavioral traits reflecting maladaptive responses to emotional states that underpin multiple types of emotional psychopathology—link various anxiety and depressive psychopathologies to smoking. This framework is applied in a review and synthesis of the empirical literature on three trandiagnostic emotional vulnerabilities implicated in smoking: (1) anhedonia (Anh; diminished pleasure/interest in response to rewards); (2) anxiety sensitivity (AS; fear of anxiety-related sensations); and (3) distress tolerance (DT; ability to withstand distressing states). We conclude that Anh, AS, and DT collectively: (a) underpin multiple emotional psychopathologies; (b) amplify smoking’s anticipated and actual affect enhancing properties and other mechanisms underlying smoking; (c) promote progression across the smoking trajectory (i.e., initiation, escalation/progression, maintenance, cessation/relapse); and (d) are promising targets for smoking intervention. After existing gaps are identified, an integrative model of transdiagnostic processes linking emotional psychopathology to smoking is proposed. The model’s key premise is that Anh amplifies smoking’s anticipated and actual pleasure-enhancing effects, AS amplifies smoking’s anxiolytic effects, and poor DT amplifies smoking’s distress terminating effects. Collectively, these processes augment the reinforcing properties of smoking for individuals with emotional psychopathology to heighten risk of smoking initiation, progression, maintenance, cessation avoidance, and relapse. We conclude by drawing clinical and scientific implications from this framework that may generalize to other comorbidities.

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Reactivity to negative affect in smokers: The role of implicit associations and distress tolerance in smoking cessation

Cited by 22 publications

References 57 publications

Anxiety sensitivity as an amplifier of subjective and behavioral tobacco abstinence effects

Anxiety sensitivity as an amplifier of subjective and behavioral tobacco abstinence effects

Does smoking abstinence influence distress tolerance? An experimental study comparing the response to a breath-holding test of smokers under tobacco withdrawal and under nicotine replacement therapy

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

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