Cognitive deficits specific to depression-prone smokers during abstinence.

Ashare, Rebecca L.; Strasser, Andrew A.; Wileyto, E. Paul; Cuevas, Jocelyn; Audrain-McGovern, Janet

doi:10.1037/a0037072

Cited by 7 publications

(6 citation statements)

References 76 publications

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“…In a general population of smokers, smoking abstinence is associated with impaired sustained attention, working memory and response inhibition , and biases cognition towards the perceived salience of smoking‐related stimuli (, but also see ). Depressed smokers are shown to experience even greater withdrawal‐induced deficits in cognitive performance , which may reflect the overlap (or perhaps additive effect) of cognitive deficits in depression with cognitive deficits induced by smoking abstinence. Accordingly, depressed smokers may maintain smoking behavior in order to attenuate cognitive deficits, especially when engaged in effortful or cognitively demanding tasks .…”

Section: Psychological Mechanisms Promoting Smoking Maintenance and Rmentioning

confidence: 99%

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Cigarette smoking and depression comorbidity: systematic review and proposed theoretical model

et al. 2016

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Background and Aims Despite decades of research on co-occurring smoking and depression, cessation rates remain consistently lower for depressed smokers than for smokers in the general population, highlighting the need for theory-driven models of smoking and depression. This paper provides a systematic review with a particular focus on psychological states that disproportionately motivate smoking in depression, and frame an incentive learning theory account of smoking-depression co-occurrence. Methods We searched PubMed, Scopus, PsychINFO, and CINAHL through December 2014, which yielded 852 articles. Using pre-established eligibility criteria, we identified papers focused on clinical issues and motivational mechanisms underlying smoking in established, adult smokers (i.e., maintenance, quit attempts, and cessation/relapse) with elevated symptoms of depression. Two reviewers independently determined whether articles met review criteria. We included 297 articles in qualitative synthesis. Results Our review identified three primary mechanisms that underlie persistent smoking among depressed smokers: low positive affect, high negative affect, and cognitive impairment. We propose a novel application of incentive learning theory which posits that depressed smokers experience greater increases in the expected value of smoking in the face of these three motivational states, which promotes goal-directed choice of smoking behavior over alternative actions. Conclusions The incentive learning theory accounts for current evidence on how depression primes smoking behavior and provides a unique framework for conceptualizing psychological mechanisms of smoking maintenance among depressed smokers. Treatment should focus on correcting adverse internal states, and beliefs about the high value of smoking in those states, to improve cessation outcomes for depressed smokers.

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Section: Psychological Mechanisms Promoting Smoking Maintenance and Rmentioning

confidence: 99%

“…Importantly, cognitive deficits are associated prospectively with smoking relapse for both smokers in the general population and depression‐prone smokers . Thus, background cognitive deficits in depression may summate with acute withdrawal‐related cognitive deficits to prime smoking .…”

Section: Psychological Mechanisms Promoting Smoking Maintenance and Rmentioning

confidence: 99%

Cigarette smoking and depression comorbidity: systematic review and proposed theoretical model

et al. 2016

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“…Specifically, smokers with current sub-clinical depression symptoms are more sensitive to the motivational effect of negative mood induction on ad libitum smoking behavior (Fucito and Juliano, 2009). Likewise, smokers with depression symptoms are more sensitive to the negative effects of smoking abstinence on affective state (Audrain-McGovern et al, 2014; Leventhal et al, 2013), reward responsiveness (Pergadia et al, 2014) and cognitive performance (Ashare et al, 2014). Finally, smokers with anhedonic traits are more sensitive to the effect of smoking abstinence on craving and willingness to pay for cigarettes (Cook et al, 2004; Leventhal et al, 2014; Leventhal et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Current major depression is associated with greater sensitivity to the motivational effect of both negative mood induction and abstinence on tobacco-seeking behavior

Hogarth

Mathew

Hitsman

2017

Drug and Alcohol Dependence

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Background Although depression and smoking commonly co-occur, the mechanisms underpinning this association are poorly understood. One hypothesis is that depression promotes tobacco dependence, persistence and relapse by increasing sensitivity to acute negative mood and abstinence induced tobacco-seeking behavior. Methods Twenty nine daily smokers of >10 cigarettes per day, nine with major depression and 20 without, completed two laboratory sessions one week apart, smoking as normal prior to session 1 (sated session), and 6 hours abstinent prior to session 2 (abstinent session). In both sessions, tobacco-seeking was measured at baseline by preference to view smoking versus food images. Negative mood was then induced by negative ruminative statements and sad music, before tobacco-seeking was measured again at test. Results In the sated session, negative mood induction produced a greater increase in tobacco choice from baseline to test in depressed (p<.001, ηp2=.782) compared to non-depressed smokers (p=.045, ηp2=.216, interaction: p=.046, ηp2=.150). Abstinence also produced a greater increase in baseline tobacco choice between the sated and abstinent sessions in depressed (p=.002, ηp2=.771) compared to non-depressed smokers (p=.22, ηp2=.089, interaction: p=.023, ηp2=.189). These mood and abstinence induced increases in tobacco choice were positively associated with depression symptoms across the sample as a whole (ps≤.04, ηp2≥.159), and correlated with each other (r=.67, p<.001). Conclusions Current major depression or depression symptoms may promote tobacco dependence, persistence and relapse by increasing sensitivity to both acute negative mood and abstinence induced tobacco-seeking behavior. Treatments should seek to break the association between adverse states and smoking to cope.

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“…In the general population, smokers are at greater risk for neurocognitive deficits (Durazzo et al , 2012; Paul et al , 2006) and subsets of smokers, particularly those with psychiatric comorbidities characterized by neurocognitive deficits, may use nicotine to enhance cognitive function or attenuate withdrawal-related cognitive deficits (Ashare et al , 2014b; Lieberman et al , 2013). Indeed, resuming smoking ameliorates abstinence-induced cognitive deficits (Ashare et al , 2014a; Evans and Drobes, 2009).…”

Section: Introductionmentioning

confidence: 99%

The nature and consequences of cognitive deficits among tobacco smokers with HIV: a comparison to tobacco smokers without HIV

et al. 2017

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HIV-infected smokers lose more years of life to tobacco-related disease than HIV. Since neurocognitive deficits are common among those with HIV and are associated with smoking persistence, these deficits may be a unique barrier to smoking cessation among HIV-infected smokers. Documenting unique differences in and correlates of cognition among HIV-infected smokers is a critical step towards developing a population-specific tobacco cessation treatment. We compared neurocognitive function between HIV-infected (n=103) and HIV-uninfected smokers (n=70), accounting for demographic and smoking-related variables. We also evaluated whether HIV-related health outcomes (e.g., CD4 count, viral load, depression ratings, quality of life [QoL]) and HAART adherence were associated with cognition. Participants completed neurocognitive tasks (N-back and Continuous Performance Task [CPT]) measuring working memory, attention, and processing speed, and intra-individual variability. Stepwise regression models were conducted and validated with resampling techniques. HIV-infected smokers performed worse than HIV-uninfected smokers on working memory, processing speed, and intra-individual variability (all p<0.01). ROC analysis for the model including cognitive measures demonstrated 85% area under the curve, which indicates “good prediction” for distinguishing between HIV-infected and HIV-uninfected smokers. This was a significant improvement over the model including demographic and smoking-related variables only (p=0.0003). Among HIV-infected smokers, neurocognitive performance was negatively associated with QoL and depression ratings. Smoking cessation interventions for HIV-infected smokers should consider cognitive neurorehabilitation as a potential strategy to decrease the likelihood of nicotine relapse and decrease tobacco-related morbidity in this population.

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Cognitive deficits specific to depression-prone smokers during abstinence.

Cited by 7 publications

References 76 publications

Cigarette smoking and depression comorbidity: systematic review and proposed theoretical model

Cigarette smoking and depression comorbidity: systematic review and proposed theoretical model

Current major depression is associated with greater sensitivity to the motivational effect of both negative mood induction and abstinence on tobacco-seeking behavior

The nature and consequences of cognitive deficits among tobacco smokers with HIV: a comparison to tobacco smokers without HIV

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