A Prospective Investigation of the Synergistic Effect of Change in Anxiety Sensitivity and Dysphoria on Tobacco Withdrawal

Objective: Prevailing theory and research suggests the psychological and physiological discomfort associated with tobacco withdrawal may play a formative role in the risk of cessation failure. Yet, research elucidating cognitive-affective vulnerability characteristics that contribute to increased tobacco withdrawal severity during periods of planned abstinence is highly limited. In the current study, we explored whether smokers with greater reductions of Anxiety Sensitivity (AS) and dysphoria during a smoking cessation intervention would experience less severe postquit tobacco withdrawal. Method: Specifically, the interactive effect of change (from preintervention baseline to quit day) in AS and dysphoria in relation to postquit withdrawal severity (quit day through 12 weeks postquit) was examined among treatment-seeking adult smokers enrolled in a smoking cessation trial (N = 198; 55.3% female; 86.8% Caucasian; Mage = 38.8, SD = 14.0). Results: Results indicated that the interactive effect of change in AS and dysphoria was related to linear change in postquit withdrawal symptoms. Specifically, larger reductions in AS were associated with a faster decline in the severity of withdrawal symptoms across the 12-week postquit period only for individuals with lower (but not higher) reductions in dysphoria. Additionally, the findings indicated that reducing levels of AS and dysphoria prequit is broadly related to the degree of change in postquit withdrawal symptoms. Conclusion: Collectively, these data suggest there is apt to be clinical merit to employing strategies to address AS and/or dysphoria to more effectively manage emergent withdrawal symptoms following smoking cessation treatment.

[1]  M. Zvolensky,et al.  Anxiety Sensitivity and Nicotine Replacement Therapy Side Effects: Examining the Role of Emotion Dysregulation Among Treatment-Seeking Smokers. , 2017, Journal of Studies on Alcohol and Drugs.

[2]  K. Timpano,et al.  Effects of a brief anxiety sensitivity reduction intervention on obsessive compulsive spectrum symptoms in a young adult sample. , 2016, Journal of psychiatric research.

[3]  M. Zvolensky,et al.  Evaluation of smokers with and without asthma in terms of smoking cessation outcome, nicotine withdrawal symptoms, and craving: Findings from a self-guided quit attempt. , 2016, Addictive behaviors.

[4]  Jasper A. J. Smits,et al.  Anxiety sensitivity and working memory capacity: Risk factors and targets for health behavior promotion. , 2016, Clinical psychology review.

[5]  M. Zvolensky,et al.  Smoking to Regulate Negative Affect: Disentangling the Relationship Between Posttraumatic Stress and Emotional Disorder Symptoms, Nicotine Dependence, and Cessation-Related Problems. , 2016, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[6]  M. Zvolensky,et al.  Interplay of dysphoria and anxiety sensitivity in relation to emotion regulatory cognitions of smoking among treatment-seeking smokers. , 2016, The American journal on addictions.

[7]  Mark B. Powers,et al.  The Efficacy of Vigorous-Intensity Exercise as an Aid to Smoking Cessation in Adults With High Anxiety Sensitivity: A Randomized Controlled Trial , 2016, Psychosomatic medicine.

[8]  M. Zvolensky,et al.  Anxiety sensitivity risk reduction in smokers: A randomized control trial examining effects on panic. , 2016, Behaviour research and therapy.

[9]  Michael Frankfurter,et al.  Applied Longitudinal Data Analysis Modeling Change And Event Occurrence , 2016 .

[10]  J. A. Dani,et al.  Nicotine withdrawal. , 2020, Current topics in behavioral neurosciences.

[11]  M. Zvolensky,et al.  Evaluation of the Anxiety Sensitivity Index-3 among treatment-seeking smokers. , 2015, Psychological assessment.

[12]  M. Zvolensky,et al.  The moderating role of smoking amount per day on the relations between anxiety sensitivity, smoking dependence, and cognitive–affective aspects of smoking among treatment seeking smokers , 2015, Addictive behaviors reports.

[13]  Megan E. Piper,et al.  Anhedonia as a component of the tobacco withdrawal syndrome. , 2015, Journal of abnormal psychology.

[14]  P. Kuppens,et al.  Emotional inertia contributes to depressive symptoms beyond perseverative thinking , 2015, Cognition & emotion.

[15]  Jennifer A. Minnix,et al.  Dysphoria and smoking among treatment seeking smokers: the role of smoking-related inflexibility/avoidance , 2015, The American journal of drug and alcohol abuse.

[16]  M. Zvolensky,et al.  Anxiety, depression, and cigarette smoking: a transdiagnostic vulnerability framework to understanding emotion-smoking comorbidity. , 2015, Psychological bulletin.

[17]  M. Zvolensky,et al.  Anxiety sensitivity as an amplifier of subjective and behavioral tobacco abstinence effects. , 2014, Drug and alcohol dependence.

[18]  M. Zvolensky,et al.  Anxiety sensitivity mediates relations between emotional disorders and smoking. , 2014, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[19]  M. Zvolensky,et al.  An Anxiety Sensitivity Reduction Smoking-Cessation Program for Spanish-Speaking Smokers (Argentina) , 2014 .

[20]  Daniel W Capron,et al.  Randomized clinical trial evaluating the efficacy of a brief intervention targeting anxiety sensitivity cognitive concerns. , 2014, Journal of consulting and clinical psychology.

[21]  C. Patten,et al.  A cognitive behavioral smoking abstinence intervention for adults with chronic pain: a randomized controlled pilot trial. , 2014, Addictive behaviors.

[22]  R. McHugh,et al.  Changes in distress intolerance and treatment outcome in a partial hospital setting. , 2014, Behavior therapy.

[23]  L. Bierut,et al.  A glimpse into the future – Personalized medicine for smoking cessation , 2014, Neuropharmacology.

[24]  M. Zvolensky,et al.  Anhedonia and anxiety sensitivity: prospective relationships to nicotine withdrawal symptoms during smoking cessation. , 2013, Journal of studies on alcohol and drugs.

[25]  M. Zvolensky,et al.  Panic attack history and anxiety sensitivity in relation to cognitive-based smoking processes among treatment-seeking daily smokers. , 2013, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[26]  N. Schmidt,et al.  Refinement of a brief anxiety sensitivity reduction intervention. , 2012, Journal of consulting and clinical psychology.

[27]  M. Zvolensky,et al.  Nature and Role of Change in Anxiety Sensitivity During NRT-Aided Cognitive-Behavioral Smoking Cessation Treatment , 2012, Cognitive behaviour therapy.

[28]  M. Zvolensky,et al.  Smoking-related correlates of depressive symptom dimensions in treatment-seeking smokers. , 2011, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[29]  Megan E. Piper,et al.  Tobacco withdrawal components and their relations with cessation success , 2011, Psychopharmacology.

[30]  H. Chua,et al.  Self-related neural response to tailored smoking-cessation messages predicts quitting , 2011, Nature Neuroscience.

[31]  J. Miles,et al.  Anxiety sensitivity and PTSD symptom severity are reciprocally related: evidence from a longitudinal study of physical trauma survivors. , 2010, Journal of abnormal psychology.

[32]  A. Abrantes,et al.  Impact of bupropion and cognitive-behavioral treatment for depression on positive affect, negative affect, and urges to smoke during cessation treatment. , 2009, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[33]  A. Abrantes,et al.  The role of negative affect in risk for early lapse among low distress tolerance smokers. , 2008, Addictive behaviors.

[34]  S. Battista,et al.  A further investigation of the relations of anxiety sensitivity to smoking motives. , 2008, Addictive behaviors.

[35]  Mark B. Powers,et al.  The efficacy of cognitive-behavioral interventions for reducing anxiety sensitivity: a meta-analytic review. , 2008, Behaviour research and therapy.

[36]  P. Reed,et al.  The relationship between dysphoria and proneness to hallucination and delusions among young adults. , 2008, Comprehensive psychiatry.

[37]  Megan E. Piper,et al.  Time to first cigarette in the morning as an index of ability to quit smoking: implications for nicotine dependence. , 2007, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[38]  C. Lerman,et al.  Associations between Cloninger's temperament dimensions and acute tobacco withdrawal. , 2007, Addictive behaviors.

[39]  D. Watson,et al.  Development and validation of the Inventory of Depression and Anxiety Symptoms (IDAS). , 2007, Psychological assessment.

[40]  Steven Taylor,et al.  Robust dimensions of anxiety sensitivity: development and initial validation of the Anxiety Sensitivity Index-3. , 2007, Psychological assessment.

[41]  J. Hughes.  Measurement of the effects of abstinence from tobacco: a qualitative review. , 2007, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[42]  V. Starcevic.  Dysphoric About Dysphoria: Towards a Greater Conceptual Clarity of the Term , 2007, Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists.

[43]  C. Lerman,et al.  Gender differences in acute tobacco withdrawal: effects on subjective, cognitive, and physiological measures. , 2007, Experimental and clinical psychopharmacology.

[44]  K. Fitzpatrick,et al.  Anxiety Sensitivity Amelioration Training (ASAT): a longitudinal primary prevention program targeting cognitive vulnerability. , 2007, Journal of anxiety disorders.

[45]  Timothy B Baker,et al.  Life before and after quitting smoking: an electronic diary study. , 2006, Journal of abnormal psychology.

[46]  T. Piasecki.  Relapse to smoking. , 2006, Clinical psychology review.

[47]  J. Ablon,et al.  Beyond brand names of psychotherapy: Identifying empirically supported change processes. , 2006, Psychotherapy.

[48]  M. Seligman,et al.  Positive psychology progress: empirical validation of interventions. , 2005, The American psychologist.

[49]  L. Alloy,et al.  Adaptive Inferential Feedback, Depressogenic Inferences, and Depressed Mood: A Laboratory Study of the Expanded Hopelessness Theory of Depression , 2004, Cognitive Therapy and Research.

[50]  Richard A. Brown,et al.  Nonclinical panic attack history and smoking cessation: an initial examination. , 2004, Addictive behaviors.

[51]  C. Beevers,et al.  Attentional Bias and Mood Persistence as Prospective Predictors of Dysphoria , 2003, Cognitive Therapy and Research.

[52]  R. Hays,et al.  Development of the Kidney Disease Quality of Life (KDQOLTM) Instrument , 1994, Quality of Life Research.

[53]  J. Singer,et al.  Applied Longitudinal Data Analysis , 2003 .

[54]  Richard A. Brown,et al.  Distress tolerance and duration of past smoking cessation attempts. , 2002, Journal of abnormal psychology.

[55]  M. Zvolensky,et al.  Anxiety sensitivity: relationship to negative affect smoking and smoking cessation in smokers with past major depressive disorder. , 2001, Addictive behaviors.

[56]  G. A. Miller,et al.  Misunderstanding analysis of covariance. , 2001, Journal of abnormal psychology.

[57]  D. Mant,et al.  Nicotine replacement therapy for smoking cessation. , 2004, The Cochrane database of systematic reviews.

[58]  C. Pomerleau,et al.  Who gets what symptom? Effects of psychiatric cofactors and nicotine dependence on patterns of smoking withdrawal symptomatology. , 2000, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[59]  M. Fiore,et al.  Smoking withdrawal dynamics in unaided quitters. , 2000, Journal of abnormal psychology.

[60]  D. Hatsukami,et al.  Errors in using tobacco withdrawal scale , 1998, Tobacco control.

[61]  N. Ryan,et al.  Cognitive-behavioral therapy of depression and depressive symptoms during adolescence: a review and meta-analysis. , 1998, Journal of the American Academy of Child and Adolescent Psychiatry.

[62]  M. First,et al.  Structured clinical interview for DSM-IV axis I disorders : SCID-I : clinical version : scoresheet , 1997 .

[63]  D. Hatsukami,et al.  Symptomatology and energy intake during the menstrual cycle in smoking women. , 1996, Journal of substance abuse.

[64]  S. Hall,et al.  Mood and depression diagnosis in smoking cessation. , 1995 .

[65]  Stephen W. Raudenbush,et al.  A multivariate hierarchical model for studying psychological change within married couples. , 1995 .

[66]  A. Satorra,et al.  Complex Sample Data in Structural Equation Modeling , 1995 .

[67]  P. O. Smith,et al.  Assessing nicotine dependence: a comparison of the Fagerström Tolerance Questionnaire (FTQ) with the Fagerström Test for Nicotine Dependence (FTND) in a clinical sample. , 1994, Addictive behaviors.

[68]  C. Pomerleau,et al.  Reliability of the Fagerstrom Tolerance Questionnaire and the Fagerstrom Test for Nicotine Dependence. , 1994, Addictive behaviors.

[69]  S D Imber,et al.  Some conceptual and statistical issues in analysis of longitudinal psychiatric data. Application to the NIMH treatment of Depression Collaborative Research Program dataset. , 1993, Archives of general psychiatry.

[70]  S. Hall,et al.  Nicotine, negative affect, and depression. , 1993, Journal of consulting and clinical psychology.

[71]  N. Breslau,et al.  Nicotine withdrawal symptoms and psychiatric disorders: findings from an epidemiologic study of young adults. , 1992, The American journal of psychiatry.

[72]  L. Kozlowski,et al.  The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. , 1991, British journal of addiction.

[73]  J R Hughes,et al.  Symptoms of tobacco withdrawal. A replication and extension. , 1991, Archives of general psychiatry.

[74]  A. Glassman,et al.  Depression and depressive symptoms in smoking cessation. , 1990, Comprehensive psychiatry.

[75]  T. Vogt,et al.  Smoking cessation program: baseline carbon monoxide and serum thiocyanate levels as predictors of outcome. , 1979, American journal of public health.

[76]  L. Tucker.  Comment on a note on a base-free measure of change , 1979 .

[77]  L. Tucker,et al.  A base-free measure of change. , 1966, Psychometrika.

[78]  Satterthwaite Fe.  An approximate distribution of estimates of variance components. , 1946 .

[79]  F. E. Satterthwaite.  An approximate distribution of estimates of variance components. , 1946, Biometrics.