Irritable Bowel Syndrome (IBS) and Smoking: An Evaluation of IBS symptom severity and anxiety sensitivity among adults in the United States.

INTRODUCTION: Irritable bowel syndrome (IBS) is a prevalent disorder of gut-brain function associated with psychological distress as well as work and quality of life impairment. Smoking has been linked to gastrointestinal dysfunction, however, research focused on the prevalence of IBS and smoking is limited. Previous research has shown that anxiety sensitivity is linked to increased risk of aversive bodily experiences and subsequent coping-oriented regulation efforts. Higher anxiety sensitivity has also been associated with processes linked to tobacco cigarette smoking lapse and relapse. There is a need to clarify the explanatory roles of anxiety sensitivity in the context of more severe IBS symptoms among persons with IBS who are current smokers. METHOD: The present investigation evaluated the main and interactive effects of IBS symptom severity and anxiety sensitivity in relation to processes related to the maintenance and relapse of tobacco smoking among adults with IBS. The sample consisted of 263 (52.1 % female; Mage = 44.13 years, SD = 12.71) adults who met criteria for IBS and smoke at least 5 cigarettes per day. RESULTS: Hierarchical regression results indicated that both anxiety sensitivity and IBS symptom severity independently predicted greater perceived barriers to smoking cessation, severity of problems experienced during quitting, and negative reinforcement smoking expectancies. A statistically significant interaction further indicated that IBS symptom severity was more strongly associated with negative reinforcement smoking expectancies among participants with higher, relative to lower, anxiety sensitivity. CONCLUSIONS: This study is the first to show that both IBS symptom severity and anxiety sensitivity are related to greater perceived barriers to smoking cessation, previous difficulty quitting, and negative reinforcement expectancies among adults with IBS. There is a continued need to further scientific understanding of interrelations between anxiety sensitivity, IBS symptom severity, and smoking cessation-related beliefs and processes to identify novel approaches that can best support quitting among this understudied population.

The influence of hope and optimism on trajectories of COVID-19 stress, health anxiety, and wellbeing during the COVID-19 pandemic.

INTRODUCTION: The COVID-19 pandemic posed a threat to public health and psychological functioning, with early studies documenting higher rates of psychopathology within the United States and globally. Hope and optimism promote adjustment and are associated with positive physical and mental health outcomes. Thus, individual differences in hope and optimism may also foster resilience during a global health crisis. AIMS: The current study examined how hope and optimism influenced longitudinal health-focused distress and wellbeing during the pandemic. METHODS: Data were collected from 788 American adults across three periods during Spring-Summer 2020 using MTurk. Latent growth curve modeling examined whether hope and optimism predicted COVID stress, health anxiety, and wellbeing trajectories. RESULTS: COVID stress and health anxiety decreased after the onset of the pandemic, whereas wellbeing was stable. Individually, hope and optimism predicted lower initial COVID stress and health anxiety, along with greater initial wellbeing. When examining the combined influence of hope and optimism, optimism was more strongly related to health-focused distress, though both were strong predictors of wellbeing. CONCLUSIONS: These findings indicate that Americans were resilient and positive expectancies, particularly optimism, predicted better initial adjustment to the early phases of the pandemic. Thus, positive expectancies appear to be protective during a global health crisis.

The Indirect Effects of Negative Affect Reduction Motives on the Relationship Between Sex and Severity of Problems When Trying to Quit Among Black Adults Who Smoke.

BACKGROUND: African American/Black (hereafter referred to as Black) persons who smoke constitute a tobacco disparities group in the United States. Within the Black population, female smokers experience a disproportionate percentage of these disparities and are less likely to quit cigarettes than their male counterparts. Two factors implicated in female smokers' relatively worse quit success are (1) motives to smoke to reduce negative affect and (2) expectancies that smoking will reduce negative affect. OBJECTIVES: The present study sought to test sex differences in these two clinically relevant cognitive constructs and evaluate the indirect effects of sex and severity of problems when trying to quit via smoking motives and expectancies for negative affect reduction among Black adults who smoke. Participants included 103 Black adults who smoke daily (72% male; Mage = 44.5 years, SD = 11.5 years). RESULTS: Results revealed sex differences in both negative affect reduction motives and expectancies, as well as a partial indirect effect for sex on the severity of problems when trying to quit through negative affect reduction motives (a1b1 = 0.18, 95% CI [0.04, 0.38]) but not negative affect reduction expectancies (a2b2 = -0.01, 95% CI [-0.11, 0.09]) in a simultaneous model of indirect effects. CONCLUSIONS: These findings shed light on the complex relationship between race, sex, and severity of problems when trying to quit, particularly when complicated by smoking motives and expectancies. Current data should be considered when developing sex-specific, tailored smoking cessation interventions for Black women.

COVID-19 worry and smoking processes among Hispanic persons in the United States.

Hispanic persons in the United States (US) experienced a disproportionate proportion of adverse health consequences during the pandemic and are a well-established tobacco disparities population. The tendency to worry is one individual difference cognitive-affective construct that is important to smoking behavior and stress-related experiences during the COVID-19 pandemic. However, there is limited understanding of COVID-19 worry in terms of smoking processes among Hispanic persons who smoke during the pandemic. The present investigation examined if COVID-19 worry during the pandemic (February 2021-July 2021) was associated with several processes linked to the maintenance and relapse of smoking among Hispanic persons who smoke. Participants included 337 Hispanic persons who smoke (≥5 cigarettes per day; Mage = 35.5 years old, 37.3% identified as female). Results indicated that in adjusted models covarying for the effects of sex, age, highest level of education, nativity, average number of cigarettes smoked per day, hazardous drinking, drug use problems, and depression, COVID-19 worry was related to increased risk of cigarette dependence, perceived barriers for quitting smoking, and more severe problems when trying to quit. These data are the first to identify an association between heightened COVID-19 worry and risk processes related to the maintenance and relapse of smoking among the Hispanic population in the US.

Approach Bias and Tobacco Craving as Mechanisms of the Effect of Approach Bias Retraining on Smoking Cessation.

INTRODUCTION: Approach bias, the automatic tendency to advance toward, rather than move away from appetitive cues, has been associated with greater tobacco cravings, dependence, and likelihood of smoking relapse. Approach bias retraining (ABR) has emerged as one way to reduce approach bias and promote avoidance toward smoking cues. Yet, additional research is needed to identify the mechanisms that may help explain the effect of ABR on smoking cessation. METHODS: The current study uses data collected as part of a randomized controlled trial to test two unique mechanisms of action ([1] approach bias and [2] tobacco craving) for the efficacy of standard smoking cessation treatment (ST) augmented by ABR on smoking abstinence. Participants were 96 adult daily smokers (Mage=43.1, SD=10.7) motivated to quit smoking. RESULTS: Results showed that lower approach bias and lower cravings at a treatment session were significantly related to next session smoking abstinence (p's<.018). Further, deviations in approach bias partially mediated the effect of ABR on smoking abstinence (ab=-12.17, 95%CI: [-29.67, -0.53]). However, deviations in tobacco craving did not mediate this relation (ab=.40, 95%CI: [-.27, 1.34]). CONCLUSIONS: The current findings add to extant literature by identifying approach bias as a mechanism of action of the effect of ABR on smoking abstinence during smoking cessation treatment. IMPLICATIONS: The current study adds to our knowledge on the effectiveness of approach bias retraining (ABR) as a part of smoking cessation treatment. Results indicate that reductions in approach bias partially mediate the effect of ABR on smoking abstinence. These findings are consistent with previous research on alcohol-dependent adults and underline the potential of ABR to reduce approach bias and promote smoking cessation among smokers. Such findings could inform the development of future research exploring more targeted and effective smoking cessation interventions, ultimately improving outcomes for individuals attempting to quit smoking.

Examining Financial Strain and Subjective Social Status in Terms of Behavioral Health Among Latinx Adults in a Federally Qualified Health Center.

There is a growing recognition that Social Determinants of Health (SDoH) can inform some sources of physical and mental health disparities among the Latinx population. The current study sought to expand previous research by exploring the singular and interactive influence of financial strain and subjective social status-two common and clinically important SDoH factors-on pain intensity, pain disability, general depression, social anxiety, and anxious arousal. The current sample consisted of 155 Latinx adults (81.3% female; Mage = 40.02 years, SD = 10.61) presenting for care at a Federally Qualified Health Center (FQHC). Multivariate results demonstrated that financial strain was statistically significantly associated with greater pain intensity, pain disability, general depression, and anxious arousal, but not social anxiety. Further, lower subjective social status was related to greater general depression, social anxiety, and anxious arousal but not with higher levels of pain indices. An interactive effect was found wherein the combination of higher levels of financial strain and low levels of subjective social status was related to general depression and anxious arousal. This is the first study to empirically evaluate the main and interactive effects of financial strain and subjective social status regarding numerous physical and mental health symptoms. These findings clarify how two prevalent SDoH factors influence health outcomes. Specifically, the results suggest that a multi-risk conceptualization can advance a fine-grained understanding of Latinx health disparities by showing differential associations between SDoH factors and clinical outcomes that are frequently the source of health inequities in the Latinx population.

Exercise and Smoking Cessation.

Smoking is a public health crisis, leading to a multitude of health complications. Exercise is associated with numerous health benefits and is accepted by health professionals and smokers as a potentially effective smoking cessation aid. This chapter discusses the extant literature on the relation between exercise and smoking, including cross-sectional studies, experiments, and randomized clinical trials. There is robust evidence for exercise's efficacy in reducing cigarette craving, tobacco withdrawal symptoms, and negative affect. Further, exercise-based interventions appear to boost short-term abstinence yet may fall short of facilitating long-term abstinence. Methodological limitations of extant work are reviewed. We conclude with a discussion of the next steps in this line of work to fine-tune exercise interventions and their application for smoking cessation.

Combustible cigarette smokers versus dual combustible and electronic users: Evaluation of differences in anxiety, depression, and transdiagnostic constructs among Latinx adults.

Research on dual combustible and electronic nicotine use among Latinx persons is needed to better understand patterns of use because this group is an established tobacco disparities population. Negative emotional symptoms and related processes (e.g., reactive transdiagnostic vulnerabilities) have been among the most prominent factors linked to the onset, maintenance, and relapse of smoking. As such, the current study sought to compare levels of mental health symptoms among combustible users compared to dual combustible and electronic users among Latinx persons who smoke. The current sample consisted of 297 adult Latinx daily cigarette smokers (Mage = 35.90 years; SD = 8.87; age range 18-61; 36.4% female), of which 92 reported current dual use of an e-cigarette (Mage = 33.34 years; SD = 7.75; age range 19-60; 28.3% female). Differences in anxiety, depression, anxiety sensitivity, emotion dysregulation, and distress tolerance were examined, and we hypothesized that dual users would showcase higher mental health problems. Results indicated that adult Latinx dual users evidenced greater levels of anxiety, depression, emotional dysregulation, anxiety sensitivity, and lower levels of distress tolerance compared to combustible users. The current study sheds light on the clinical importance of affective differences among dual versus combustible Latinx smokers.

Anxiety sensitivity in relation to smoking dependence motives among Latinx persons who smoke.

Hispanic/Latinx (hereafter Latinx) persons are an established tobacco disparities population in the United States (US). Past work has suggested that individual differences in anxiety sensitivity, or the fear of arousal-based sensations, is one important cognitive construct for smoking maintenance and relapse among Latinx persons who smoke. However, previous research has not examined if anxiety sensitivity is associated with motivational facets of smoking dependence among this tobacco disparities population. In the current study, anxiety sensitivity was explored in terms of smoking motives for primary, secondary, and overall cigarette dependence. Participants included 336 English-speaking Latinx adults in the US who smoked cigarettes daily (Mage = 35.53, SD = 8.65, 37.3% Female). Results indicated that anxiety sensitivity was statistically significantly and positively related to higher primary and secondary dependence motives and marginally statistically significant to cigarette dependence; findings were evident after adjusting for numerous theoretically relevant variables (e.g., depression). Overall, the current study is the first to document linkages between anxiety sensitivity and numerous motivational bases of tobacco dependence among Latinx persons who smoke from the US.

Responding to Acute Suicidality Among Latinx Youth From Immigrant Families.

According to the US Centers for Disease Control and Prevention, 17% of Latinx high school students report considering attempting suicide within the United States. Given that a large proportion of Latinx youth have an immigrant caregiver, there is a clinical need to address the sociocultural, practical, and resource-related barriers of immigrant Latinx families who have youth experiencing acute suicide risk. To support effective and culturally aligned clinical approaches at the acute, indicated level of care (eg, emergency department, psychiatric hospitalization), we present 3 recommendations contextualized within the flexible and often time-limited nature of clinical responses to acute youth suicidality. The recommendations assume the presence of suicide risk assessment, safety planning, and disposition planning for a level of care that is optimally therapeutic and least restrictive (referred to as standard care).1.

Understanding the role of cannabis use on cigarette dependence severity among individuals with e-cigarette and combustible tobacco dual use.

BACKGROUND AND OBJECTIVES: The use of both electronic and combustible cigarettes is related to greater rates of cannabis use. Further, cannabis use is associated with worse combustible smoking-related outcomes, yet little research has identified mechanisms underlying such relations. It may be that negative-affect-related transdiagnostic factors such as emotion dysregulation, anxiety sensitivity, and/or distress intolerance play a mechanistic role in the cannabis-tobacco interrelations. METHODS: The current study tested this hypothesis among 400 adults who endorsed dual use, 33% of whom endorsed current (past 3 months) cannabis use. We conducted analyses of variance and indirect effects model using the PROCESS v4.1 macro in SPSS version 29. RESULTS: Results indicated that participants who use cannabis reported greater difficulty with emotion regulation, anxiety sensitivity, and cigarette dependence severity. Cannabis use was related to cigarette dependence severity indirectly via difficulty with emotion regulation and anxiety sensitivity. DISCUSSION AND CONCLUSIONS: These results indicate that specific transdiagnostic negative-affect-related factors of difficulty with emotion regulation and anxiety sensitivity are associated with cannabis use among adults who smoke combustible and electronic cigarettes. SCIENTIFIC SIGNIFICANCE: Given that these transdiagnostic factors are malleable, these findings suggest targeting and engaging such mechanisms may offer novel behavioral change strategies for this high-risk population.

Racism and alcohol-related problems among Black adults: The role of negative emotionality to experiencing racism.

INTRODUCTION: Although Black Americans tend to consume less alcohol than non-Hispanic/Latine White Americans, Black Americans who do drink alcohol appear at especially high risk for negative alcohol-related problems. This alcohol-based health disparity indicates a need to identify psycho-sociocultural factors that may play a role in drinking and related problems to inform prevention and treatment efforts. Minority stress-based models posit that stressors such as racism increase negative emotions, which may be associated with using substances such as alcohol to cope with negative emotions. Yet, little research has directly assessed emotional reactions to racism and whether it plays a role in drinking-related behaviors. METHOD: Participants were 164 Black American undergraduates at a racially/ethnically diverse university who endorsed current alcohol use 18-48 (M = 21.7, SD = 4.3). Participants completed an online survey regarding their experiences with racism and alcohol-related behaviors. RESULTS: Experiencing more frequent racism was related to greater negative emotions experienced in response to racism (i.e., negative emotional reactivity to racism) and alcohol-related problems. More frequent racism was related to more alcohol-related problems via the sequential effects of negative emotional reactivity to racism and coping motivated drinking. CONCLUSIONS: These data indicate that the experience of negative emotions that occur after experiencing racism and attempts to cope with those negative emotions by consuming alcohol play important roles in drinking behaviors among Black Americans.

Posttraumatic Stress and Opioid Use and Pain among Individuals with Probable Posttraumatic Stress Disorder and Self-Reported Chronic Pain: The Role of Health Literacy.

BACKGROUND: Chronic pain and opioid misuse are a prevalent comorbidity with deleterious health outcomes. Growing work indicates that posttraumatic stress disorder (PTSD) can increase the risk for chronic pain and opioid misuse and dependence. However, there is little understanding of social determinants of health (SDoH) that may account for interrelations of PTSD with chronic pain and opioid misuse and dependence. Health literacy is one relevant SDoH construct, reflecting the ability to gather, process, and comprehend health-related information required to engage in a healthcare setting. OBJECTIVE: The purpose of the present cross-sectional study was to examine the indirect effect of health literacy in the association between PTSD and opioid misuse, opioid dependence, pain intensity, and pain disability. METHOD: The sample included 142 adults (Mage = 35.2, SD = 9.9; 67.4% female; 70.1% White/Caucasian) with self-reported chronic pain and probable PTSD who were using opioid medication. RESULTS: Results demonstrated that PTSD symptom severity had a small indirect effect on opioid misuse and opioid dependence via health literacy; no indirect effects were evident for pain intensity and disability. CONCLUSION: The present investigation provides evidence that health literacy may serve as an important explanatory factor in associations between PTSD symptom severity and opioid misuse and dependence among adults with co-occurring probable PTSD and chronic pain.

Anxiety sensitivity and COVID-19 mental health, fatigue, and well-being: a longitudinal examination among adults from the United States during March-October 2020.

There is widespread empirical evidence that the COVID-19 pandemic contributed to elevated risk of mental and physical health symptoms and decreased quality of life. The present investigation sought to examine if individual differences in anxiety sensitivity was associated with mental health, psychosomatic, and well-being among a sample of US adults during a 6-month period early in the COVID-19 pandemic. Employing longitudinal research methodology, we tested the hypothesis that the anxiety sensitivity global factor would be related to increased risk of anxiety, depression, fatigue, and lower well-being. Secondary analyses evaluated the lower order anxiety sensitivity factors for the same criterion variables. The sample consisted of 778 participants with an average age of 37.96 (SD = 11.81; range 18-73). Results indicated that, as hypothesized, anxiety sensitivity was associated with increased risk for more severe anxiety, depression, fatigue, and lesser well-being; the observed effects of anxiety sensitivity were relatively robust and evident in adjusted models that controlled for numerous theoretically and clinically relevant factors (e.g. perceived health status). Overall, these results suggest that pandemic functioning could likely be improved via interventions that target elevated anxiety sensitivity as a vulnerability factor for a broad range of aversive psychosomatic symptoms and personal well-being.

Neighborhood Vigilance in Terms of Abstinence Expectancies for Smoking and Severity of Problems When Quitting.

Background: Although social determinants of health (SDoH) have increasingly been understood as clinically important factors in the onset, maintenance, and relapse of substance use behavior, little research has evaluated neighborhood vigilance in terms of smoking. Objectives: The present investigation sought to evaluate the role of neighborhood vigilance in terms of smoking abstinence expectancies (i.e., perceived consequences of refraining from smoking, including negative mood, somatic symptoms, harmful consequences, and positive consequences) and severity of problems when trying to quit among adults who smoke. Results: Participants included 93 treatment-seeking people who smoke (45.2 years of age and 29% identified as female). Results: indicated that greater levels of neighborhood vigilance were associated with negative mood and harmful consequences abstinence expectancies. No effect was evident for somatic symptom abstinence expectancies after Bonferroni correction. Conclusions: As expected, neighborhood vigilance was not predictive of positive abstinence expectancies, offering explanatory specificity. Neighborhood vigilance was also associated with more severe problems when trying to quit smoking. The current findings suggest neighborhood vigilance represents an important contextual factor involved in certain negative beliefs about abstinence and challenges in quitting.

Development of a Personalized Feedback Intervention Targeting Pain-Related Anxiety for Adults Reporting Hazardous Drinking and Chronic Pain: A Randomized Controlled Trial.

OBJECTIVE: Among individuals with chronic pain, the rate of hazardous alcohol use is elevated compared with the general population. Yet, hazardous drinkers with chronic pain remain an underserved group. There is a need to develop and test alternative and complementary interventions to reduce hazardous alcohol use among this high-risk segment of the general population. Targeting pain-related anxiety, a candidate mechanism, is one theoretically informed route. METHOD: Our approach followed a staged model (1A/1B) to develop and test a novel personalized feedback intervention (PFI). Phase 1A collected qualitative feedback from participants (N = 9; 77.8% female, mean age = 33.86 years, SD = 8.75) to refine intervention content and evaluate treatment acceptability and feasibility. For Phase 1B, individuals (N = 118; 57.3% male, mean age = 35.24 years, SD = 11.90) participated in a pilot randomized clinical trial for our novel PFI compared with a health information control condition on alcohol use, intention/motivation to reduce drinking, pain-related anxiety, and expectancies for alcohol analgesia/pain coping for hazardous drinkers with chronic pain. RESULTS: Phase 1A results supported the feasibility of using a PFI to target pain-related anxiety. Results from Phase 1B indicated that participants reduced drinking and primary outcomes changed in the expected directions, but there were no differential effects of the intervention. CONCLUSIONS: The current data provide preliminary evidence for the utility of computer-based brief interventions to encourage behavior change. However, further refinement of the intervention to target pain-related anxiety is warranted.

Coronavirus Anxiety, COVID Anxiety Syndrome and Mental Health: A Test Among Six Countries During March 2021.

The negative impact of the COVID-19 pandemic on mental health outcomes is widely documented. Specifically, individuals experiencing greater degrees of severity in coronavirus anxiety have demonstrated higher levels of generalized anxiety, depression and psychological distress. Yet the pathways in which coronavirus anxiety confers vulnerability are not well known. The present investigation sought to address this gap in the scientific literature by testing the indirect effect of the COVID-19 anxiety syndrome, which centres on the function of detecting and managing the environmental threat of virus exposure and its sequalae. Data were collected during the height of the pandemic (March 2021) and included 5297 adults across six countries. Structural equation modelling techniques revealed that the COVID-19 anxiety syndrome evidenced a statistically significant indirect effect between coronavirus anxiety and generalized anxiety, depression and work/social adjustment. Overall, results suggest there could be public health merit to targeting anxiety related to virus exposure to improve behavioural health for those who are struggling with excessive fear and worry.

The Role of Functional Health Literacy in terms of Harmful Alcohol Use in Adults with Probable Posttraumatic Stress Disorder and Alcohol Use Disorder.

Purpose: The current study examined functional health literacy (FHL) in regard to hazardous drinking among a sample with probable posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Methods: Participants were 565 adults with probable PTSD and hazardous alcohol use (52.2% female, 68.8% Non-Hispanic White, average age = 39.2 years ± 10.9 years). Results: FHL literacy maintained statistically significant role in terms of hazardous drinking (p < .001) even in the context of posttraumatic stress. Conclusion: FHL may be important to better understand hazardous drinking among persons with comorbid PTSD and AUD.

Efficacy and implementation of exercise-based smoking cessation treatment for adults with high anxiety sensitivity (STEP): Study protocol for a randomized controlled trial.

Anxiety sensitivity (AS), reflecting the fear of bodily sensations, is a transdiagnostic vulnerability factor that underpins both affective psychopathology and smoking. Phase II research supports the efficacy of a 15-week community-based intervention (STEP) that combines high-intensity exercise offered by the YMCA with standard smoking cessation treatment (tobacco quitline and nicotine replacement therapy) for sedentary smokers with elevated AS. This Phase III study aims to enroll 360 adults to evaluate whether STEP efficacy for achieving smoking abstinence generalizes to Black and Hispanic smokers with elevated AS.

Evaluating the indirect roles of anxiety and depressive symptoms in the relations between negative emotional reactivity to racial/ethnic stress and cigarette smoking among Hispanic adults who smoke.

There has been increased recognition that Hispanic/Latinx (hereinafter Hispanic) persons are a tobacco disparities group in the United States. Although some past work has found greater exposure to racial/ethnic discrimination is associated with indices of smoking among Hispanic persons, research has not explored the degree of negative emotional reactivity to racial/ethnic stress in terms of smoking processes. The present cross-sectional study served to evaluate the indirect effects of depressive and anxiety symptoms in terms of relations between racial/ethnic stress reactivity and cigarette dependence, severity of problems when trying to quit, and perceived barriers for quitting among Hispanic persons who smoke in the United States. Participants included 329 Hispanic adults who smoked cigarettes daily (Mage = 35.5 years; SD = 8.67; 37.4% female). Results indicated that depressive symptoms exerted a statistically significant indirect effect in the association between negative emotional reactivity to racial/ethnic stress and cigarette dependence and severity of problems when trying to quit, whereas anxiety symptoms maintained an indirect effect for perceived barriers for smoking cessation. The current findings help characterize the intricacies by which negative emotional reactivity to racial/ethnic stress is related to smoking behavior and beliefs among Hispanic persons who smoke. (PsycInfo Database Record (c) 2024 APA, all rights reserved).