Examining transdiagnostic vulnerabilities among HIV positive smokers seen at three inner city community based organizations

Abstract

Investigators have proposed a “transdiagnostic vulnerability framework” that examines the relationship between smoking and broader emotional factors, including anhedonia, anxiety sensitivity, and distress tolerance. Because smoking and depression are more common in persons living with HIV and AIDS (PLWHA) than in the general population, understanding the relationship between smoking and mental health is critical. The following study aims to characterize levels of clinically significant depressive symptoms and these broader emotional factors as well as the relationship between these factors and smoking-related variables in a sample of PLWHA. This cross-sectional study employed convenience sampling to survey adult clients who attended one of three AIDS service organizations in New York City. The questionnaires assessed sociodemographic and HIV health care variables, tobacco use, and anxiety- and depression-related constructs. 150 PLWHA completed surveys. Among the 118 smokers, the prevalence of clinically depressive symptoms was 53%. Participants with clinically significant depressive symptoms had significantly higher mean anhedonia scores and anxiety sensitivity scores and lower mean distress tolerance total scores compared to participants without clinically significant depressive symptoms (p<0.001). Smoking cessation treatment for persons with co-morbid psychiatric disorders has been suboptimal and treatment for co-morbid mental health conditions tends to align with disorder-specific treatment. Given that PLWHA are a priority population, further research should address how to best tailor interventions to a group with multiple obstacles to successful tobacco cessation.

Perceived cancer-related benefits of quitting smoking and associations with quit intentions among recently diagnosed cancer patients

“…Similarly, mood and anxiety disorders may interfere with patients' estimates of their own self-efficacy and intentions to quit. Although mood and anxiety disorders were not assessed in the present report, there is mounting evidence that smoking cessation interventions that reduce anxiety and depression prior to a quit attempt enhance cessation success (Leventhal and Zvolensky, 2015;Lubetkin et al, 2018;Smits et al, 2016) and among patients managing chronic illness (OʼCleirigh et al, 2018).…”

Distress tolerance in relation to cessation history and smoking characteristics among adult daily smokers

“…A growing body of research has explored relations between DT and theoretically linked constructs of cessation history, smoking heaviness, and nicotine dependence. Prior investigations have found number of previous quit attempts to be unrelated to perceived general or behavioral DT (Hogan, Farris, Brandt, Schmidt, & Zvolensky, 2015;Kraemer, McLeish, Jeffries, Avallone, & Luberto, 2013;Lubetkin, Guidry, Webb, Ocampo, & Burkhalter, 2018;Sirota, Rohsenow, Dolan, Martin, & Kahler, 2013), while shorter duration of past abstinence is associated with lower perceived smoking-specific DT (Sirota et al, 2010) and behavioral DT (Brown, Lejuez, Kahler, & Strong, 2002). Greater smoking duration is associated with lower perceived general DT (Leyro, Bernstein, Vujanovic, McLeish, & Zvolensky, 2011) but not behavioral task persistence (Brown et al, 2009;Kahler, McHugh, Metrik, Spillane, & Rohsenow, 2012).…”

“…Greater smoking duration is associated with lower perceived general DT (Leyro, Bernstein, Vujanovic, McLeish, & Zvolensky, 2011) but not behavioral task persistence (Brown et al, 2009;Kahler, McHugh, Metrik, Spillane, & Rohsenow, 2012). Smoking heaviness, as indexed by cigarettes per day, is generally unrelated to perceived general DT and behavioral DT (Brown et al, 2009;Farris, Zvolensky, Otto, & Leyro, 2015;Kraemer et al, 2013;Lubetkin et al, 2018), but has displayed unique associations with lower perceived smoking-specific DT (Sirota et al, 2013;Sirota et al, 2010). Nicotine dependence is negatively associated with self-report of both general and smoking-specific DT (Germeroth, Baker, & Saladin, 2018;Leyro et al, 2011;Sirota et al, 2013;Trujillo et al, 2015), but associations with behavioral tasks have been inconsistent across studies (Brandon et al, 2003;Brown et al, 2009;Kahler et al, 2012).…”

A qualitative study of the feasibility and acceptability of a smoking cessation program for people living with HIV and emotional dysregulation

“…Anxiety disorders co-occur with smoking at rates that exceed those found in the general population (Ziedonis et al, 2008), and anxiety and depressive pathology significantly impair cessation success (Piper et al, 2010;Zvolensky et al, 2008;Leventhal & Zvolensky, 2015;Piper et al, 2011). Rates of current anxiety disorders among PLWHA have been estimated as high as 43% (Brandt et al, 2016;Johnson et al 1995;Perkins et al, 1994;Sewell et al, 2000) and rates of depressive symptomatology are higher among PLWHA who smoke (Brandt et al, 2017;Chang et al, 2017;Lubetkin et al, 2018;O'Cleirigh et al, 2015).…”