Neural Basis of Smoking-Related Difficulties in Emotion Regulation

Abstract

Background Negative emotional states contribute to cigarette smoking, and difficulties in regulating these states can hinder smoking cessation. Understanding the neural bases of these difficulties in smokers may facilitate development of novel therapies for Tobacco Use Disorder. Methods Thirty-seven participants (18 smokers, 19 nonsmokers; 16–21 years old) completed the Difficulties in Emotion Regulation Scale (DERS), which is comprised of 6 subscales (lack of emotional clarity, lack of emotional awareness, limited access to emotion regulation strategies, nonacceptance of emotional responses, difficulties engaging in goal-directed behaviors, and impulse control difficulties) that combine to provide a total score. Participants also underwent functional magnetic resonance imaging to determine resting-state functional connectivity of the amygdala. Separate ANOVAs were used to determine group differences in self-reports on the DERS. Voxel-wise linear mixed models were performed to determine whether group influenced relationships between whole-brain functional connectivity of the amygdala and scores on the DERS. Results Compared with nonsmokers, smokers reported greater difficulties in emotion regulation, denoted by higher total scores on the DERS. Group differences were observed on a subscale of lack of emotional clarity, but no other subscale differences on the DERS were observed. Nonsmokers exhibited a greater negative correlation than smokers between lack of emotional clarity scores and connectivity of the amygdala with the left inferior frontal gyrus. Finally, this amygdala-to-left inferior frontal gyrus connectivity was weaker in smokers than in nonsmokers. Conclusions These findings suggest that difficulties in emotion regulation in smokers are at least partially due to lack of emotional clarity. Given the role of the inferior frontal gyrus in understanding emotional states, strengthening connectivity between the amygdala and the inferior frontal gyrus may improve emotional clarity to help smokers regulate their negative emotions, thereby improving their ability to quit smoking.

Meta-Analysis of the Associations Among Constructs of Intrapersonal Emotion Knowledge

“…This is consistent with previous findings that the two major components of alexithymia (i.e., difficulty identifying feelings, difficulty describing feelings), affect labelling, and/or emotional clarity loaded onto a single factor (Coffey et al, 2003;Palmieri et al, 2009). These three constructs have also been linked to changes in amygdala-prefrontal cortex connectivity (e.g., Faulkner et al, 2020;Kim et al, 2020;Torrisi et al, 2013), suggesting that they substantially overlap with one another both at the Giuliano, 1995]). Among the three constructs, only the alexithymia-emotional clarity association could be further investigated for potential moderators, and the inverse association between the two remained strong and significant across different sample types, measure languages, and measures used.…”

Self-Regulation Effects on Smoking Addiction: A Bayesian Approach

“…This result is consistent with Sayette and Creswell (2016), who stated that addictive behavior is caused by self-regulation failure. In the addictive state, an adolescent unlikely to regulate nor control his emotion, behavior, and mind (Faulkner et al, 2020). Sayette and Crewell (2016) argue that there are two models of self-regulation failure, misregulation and under-regulation.…”

“…The most studied variable correlated to smoking addiction is nicotine as the main substance in the cigarette. It is because nicotine affected smokers' brain and promote dependency (Faulkner et al, 2020). Another variable related to smoking addiction is the social factor.…”

Mental Health Symptoms and Associations with Tobacco Smoking, Dependence, Motivation, and Attempts to Quit: Findings from a Population Survey in Germany (DEBRA Study)

“…MHCs and smoking are known to be strongly associated with lower socioeconomic status, but previous studies indicate that the association between MHC and smoking cannot be explained by the association between MHC and socioeconomic status (e.g., [6]). Previous research has highlighted that difficulties in emotion regulation (i.e., reduced capability to adapt to emotional distress) are related to psychological distress, anxiety, and depression and might play a key role in the association between psychological distress and the maintenance of smoking (e.g., [7, 8]). Smokers may use smoking as a maladaptive emotion regulatory function [7, 9].…”