The interaction of nicotine withdrawal and panic disorder in the prediction of panic-relevant responding to a biological challenge.

Leyro, Teresa M.; Zvolensky, Michael J.

doi:10.1037/a0029423

Cited by 16 publications

(28 citation statements)

References 67 publications

(133 reference statements)

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“…81 A study comparing anxiety levels during a biological challenge after 12-hour abstinence found that persons with a current panic disorder responded similarly to those who did not. 82 …”

Section: Resultsmentioning

confidence: 99%

Predicted Impact of Nicotine Reduction on Smokers with Affective Disorders

Gaalema¹,

Miller²,

Tidey³

2015

tobacco reg sci

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Objectives In 2009 the FDA acquired the authority to reduce the nicotine content in cigarettes if appropriate for public health, prompting research to evaluate the implications of this policy scientifically. Studies in non-psychiatric populations show that reducing the nicotine content of cigarettes to non-addictive levels reduces smoking rates and nicotine dependence. However, few studies have examined this hypothesis in vulnerable populations. Methods In this narrative review we examined the extant literature on the effects of nicotine reduction or cessation on symptoms of withdrawal, as well as psychiatric symptoms, among those with affective disorders. Results Following initial withdrawal from nicotine, smokers with affective disorders experience more severe mood disruption than smokers without these disorders. Use of very low nicotine content (VLNC) cigarettes during abstinence may help mitigate the mood-disrupting effects of initial abstinence. Once the initial effects of nicotine withdrawal on mood have passed, longer-term abstinence is associated with psychiatric improvement rather than worsening. Conclusions These findings suggest that if a national nicotine reduction policy were to be implemented, smokers with affective disorders would need additional support to overcome initial withdrawal but that long-term outcomes would likely be positive.

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“…81 A study comparing anxiety levels during a biological challenge after 12-hour abstinence found that persons with a current panic disorder responded similarly to those who did not. 82 …”

Section: Resultsmentioning

confidence: 99%

Predicted Impact of Nicotine Reduction on Smokers with Affective Disorders

Gaalema¹,

Miller²,

Tidey³

2015

tobacco reg sci

View full text Add to dashboard Cite

show abstract

“…The current study also relied solely on self-report measures to assess the examined mediator variables. Given that acute nicotine withdrawal can impact subjective reporting of affect (54), it is important to consider the recency of cigarette use relative to when assessment of state affect is conducted. The present findings could be meaningfully further extended through multi-method laboratory/experimental studies or prospective tests of these relations to further strengthen the present findings.…”

Section: Discussionmentioning

confidence: 99%

Negative affect and smoking motives sequentially mediate the effect of panic attacks on tobacco-relevant processes

Farris

Zvolensky

Blalock³

et al. 2014

The American Journal of Drug and Alcohol Abuse

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Introduction Empirical work has documented a robust and consistent relation between panic attacks and smoking behavior. Theoretical models posit smokers with panic attacks may rely on smoking to help them manage chronically elevated negative affect due to uncomfortable bodily states, which may explain higher levels of nicotine dependence and quit problems. Methods The current study examined the effects of panic attack history on nicotine dependence, perceived barriers for quitting, smoking inflexibility when emotionally distressed, and expired carbon monoxide among 461 treatment-seeking smokers. A multiple mediator path model was evaluated to examine the indirect effects of negative affect and negative affect reduction motives as mediators of the panic attack-smoking relations. Results Panic attack history was indirectly related to greater levels of nicotine dependence (b=0.039, CI95%=0.008, 0.097), perceived barriers to smoking cessation (b=0.195, CI95%=0.043, 0.479), smoking inflexibility/avoidance when emotionally distressed (b=0.188, CI95%=0.041, 0.445), and higher levels of expired carbon monoxide (b=0.071, CI95%=0.010, 0.230) through the sequential effects of negative affect and negative affect smoking motives. Conclusions The present results provide empirical support for the sequential mediating role of negative affect and smoking motives for negative affect reduction in the relation between panic attacks and a variety of smoking variables in treatment-seeking smokers. These mediating variables are likely important processes to address in smoking cessation treatment, especially in panic-vulnerable smokers.

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“…The current study is a secondary data analysis of non-treatment seeking daily smokers who were recruited to participate in a study investigating the interaction of PD and nicotine withdrawal in the prediction of fearful responding to bodily sensations under carbon dioxide (CO 2 )-enriched air biological challenge (Leyro & Zvolensky, 2013). The present analyses are novel and have not been previously published.…”

Section: Methodsmentioning

confidence: 99%

“…As part of the baseline assessment, a self-report battery was completed including RFS, SCQ, and DERS. For additional details of the parent study, see Leyro and Zvolensky (2013).…”

Section: Methodsmentioning

confidence: 99%

The indirect effect of panic disorder on smoking cognitions via difficulties in emotion regulation

Yang

Zvolensky

Leyro

2017

Addictive Behaviors

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Panic disorder (PD) and cigarette smoking are highly comorbid and associated with worse panic and smoking outcomes. Smoking may become an overlearned automatized response to relieve panic-like withdrawal distress, leading to corresponding smoking cognitions, which contribute to its reinforcing properties and difficultly abstaining. Difficulties in emotion regulation (ER) may underlie this relation such that in the absence of adaptive emotion regulatory strategies, smokers with PD may more readily rely upon smoking to manage affective distress. In the current study, the indirect relation between PD status and smoking cognitions through ER difficulties was examined among daily smokers (N=74). We found evidence for an indirect relation between PD status and negative affect, addictive and habitual smoking motives, and anticipating smoking will result in negative reinforcement and personal harm, through self-reported difficulties with ER. Our findings are aligned with theoretical models on anxiety and smoking, and suggest that reports of greater smoking cognitions may be due to ER difficulties.

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The interaction of nicotine withdrawal and panic disorder in the prediction of panic-relevant responding to a biological challenge.

Cited by 16 publications

References 67 publications

Predicted Impact of Nicotine Reduction on Smokers with Affective Disorders

Predicted Impact of Nicotine Reduction on Smokers with Affective Disorders

Negative affect and smoking motives sequentially mediate the effect of panic attacks on tobacco-relevant processes

The indirect effect of panic disorder on smoking cognitions via difficulties in emotion regulation

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