Support for incentive-sensitization theory in adolescent ad libitum smokers using ecological momentary assessment.

The incentive-sensitization theory (IST) has emerged as a potentially useful theory in explaining substance addiction. IST postulates that the prolonged use of a substance can alter neural systems that are often involved in incentive motivation and reward processes, leading to an increased "sensitization" to the substance and associated stimuli. However, this increased sensitization is thought to mediate only the individual's craving of the substance (e.g., their "wanting"), not their enjoyment of the substance (e.g., their "liking"), a process that may involve unconscious implicit changes in cognitive networks linked to specific substances. Consequently, IST may better explain the real-world dissonance reported for individuals who want to accomplish long-term substance cessation but fail to do so, a phenomenon that is common in adolescent smokers. Thus, the present study aimed to examine the principles of IST in a sample of 154 adolescent ad libitum smokers (Mage = 16.57, SDage = 1.12, 61.14% male) utilizing ecological momentary assessment. Data were analyzed utilizing a multilevel structural equation model examining changes in positive affect (PA), negative affect (NA), and stress from Time 1 (T1) and Time 2 (T2) as a function of smoking and tested the influence of implicit cognition (specifically, implicit attitudes about smoking [Implicit Association Test (IAT)]) on these associations. Consistent with the principles of IST, results found a modest significant negative association between smoking status at T1 and PA at T2 (B = -0.11, p = .047). This association was further moderated by IAT (B = -0.19, p = .029) and was particularly potentiated at high levels of IAT (B = -0.44, p < .001), compared to low (B = -0.05, p = .663) or mean levels of IAT (B = -0.25, p = .004). Findings from this study provide additional support to the principles underlying IST and indicate that, in adolescents, smoking may result in thwarted PA indicative of a transition from "liking" toward "wanting," and this is especially pronounced among those with stronger implicit smoking cognitions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Time-of-day and day-of-week patterns of binge eating and relevant psychological vulnerabilities in binge-eating disorder.

OBJECTIVE: The present study sought to characterize the temporal patterns of binge eating and theorized maintenance factors among individuals with binge-eating disorder (BED). METHOD: Ecological momentary assessment of 112 individuals and mixed-effects models were used to characterize the within- and between-day temporal patterns of eating behaviors (binge eating, loss of control only eating, and overeating only), positive and negative affect, emotion regulation difficulty, and food craving. RESULTS: Risk for binge eating and overeating only was highest around 5:30 p.m., with additional binge-eating peaks around 12:30 and 11:00 p.m. In contrast, loss of control eating without overeating was more likely to occur before 2:00 p.m. Risk for binge eating, loss of control only eating, and overeating only did not vary across days in the week. There was no consistent pattern of change in negative affect throughout the day, but it decreased slightly on the weekend. Positive affect showed a decrease in the evenings and a smaller decrease on the weekend. The within-day patterns of food craving, and to some extent emotion regulation difficulty, resembled the pattern of binge eating, with peaks around meal times and at the end of the night. DISCUSSION: Individuals with BED appear most susceptible to binge-eating around dinner time, with heightened risk also observed around lunch time and late evening, though the effects were generally small. These patterns appear to most strongly mimic fluctuations in craving and emotion dysregulation, although future research is needed to test the temporal relationships between these experiences directly. PUBLIC SIGNIFICANCE: It is unknown which times of the day and days of the week individuals with binge-eating disorder are most at risk for binge eating. By assessing binge-eating behaviors in the natural environment across the week, we found that individuals are most likely to binge in the evening, which corresponds to the times when they experience the strongest food craving and difficulty with regulating emotions.

Ability to tolerate distress moderates the indirect relationship between emotion regulation difficulties and loss-of-control over eating via affective lability.

INTRODUCTION: Loss-of-control eating (LOCE), inability to refrain from or cease eating, may contribute to significant distress and dysfunction, yet research is lacking specificity on vulnerabilities contributing to LOCE as an independent construct. Preliminary evidence indicates potential roles of distress tolerance, emotion regulation, and affective lability, but the relationship between these variables and LOCE has been under-assessed. MATERIAL AND METHODS: A sample (N = 3968) consisting of university students completed an assessment of pathological eating and affiliated affective vulnerabilities. A latent variable structural equation model (SEM) was generated to predict LOCE by way of affective lability and indirectly, emotion regulation difficulties and low distress tolerance, controlling for general eating pathology. RESULTS: Findings indicated a significant direct effect of affective lability on LOCE, as well as significant indirect effects of emotion regulation difficulties and distress tolerance on LOCE, via affect lability. Additionally, distress tolerance moderated the relationship between emotion regulation difficulties and affective lability, such that lower ability to tolerate distress strengthened the relationship and higher distress tolerance capability attenuated it. DISCUSSION: Findings suggest an influence of distress tolerance on the relationship between poor emotion regulation and affective lability, which in turn may affect LOCE. Clinical implications and suggestions for future research are discussed.

Adherence to low-calorie and low-sugar diets is uniquely associated with distinct facets of appearance/weight-related smoking motivations.

Smokers report weight and appetite control as motivators to smoking continuance. These concerns are particularly salient for smokers who use cigarettes to suppress appetite and manage weight. Dieting may influence weight, shape, and appetite-related smoking motivation; however, this has not yet been examined. This study tested associations between five diet types and smoking motivation to control weight, shape, and appetite among adult daily cigarette smokers (N = 550). A multivariate analysis was used to test the incremental association between diet types and Smoking-Related Weight and Eating Episodes Test (SWEET) subscales, adjusting for age, body mass index, sex, and cigarette dependence. Smokers who diet (n = 83, 15.1%) reported higher scores on all SWEET subscales compared to smokers not on a diet. Low-calorie dieting was associated with greater smoking motivation to cope with body dissatisfaction, and low-sugar dieting was associated with greater motivation for smoking to prevent withdrawal-related appetite increases. Treatment implications for smoking cessation are discussed.

Distress Intolerance in Relation to Reliance on Cigarettes for Weight, Shape, and Appetite Control.

BACKGROUND: Distress intolerance, one's inability to withstand distressing emotional or physical states, is a transdiagnostic vulnerability implicated in affect-based health behaviors, including cigarette smoking and poor weight control. The current study evaluated associations between distress intolerance and the reliance on cigarettes for management of weight, appetite, or body dissatisfaction, which may pose a burden for cessation and increase risk of weight-related health problems. METHOD: Daily smokers (n = 577) completed an online survey assessing distress tolerance and reliance on cigarettes for weight and shape control with the four subscales of the Smoking and Weight Eating Episodes Test (SWEET). Four hierarchical regression models were constructed to test the association between distress intolerance and SWEET scores, accounting for the effect of relevant covarying factors. RESULTS: After adjusting for model covariates, distress intolerance was significantly incrementally associated with greater tendency to rely on cigarettes to suppress appetite (adjR2 = .040), prevent overeating (adjR2 = .034), cope with body dissatisfaction (adjR2 = .046), and cope with nicotine withdrawal-related appetite increases (adjR2 = .030). CONCLUSION: Distress intolerance may play an etiological role in maladaptive use of cigarettes to control appetite, weight, and body dissatisfaction among daily smokers, particularly those with weight- or shape-related concerns. Interventions aimed at increasing perceived ability to withstand distress could potentially reduce reliance on cigarettes for the aforementioned purposes.