Circulating Cell-Free Mitochondrial DNA and Depressive Symptoms Among Low-Active Adults Who Smoke.

OBJECTIVES: Mitochondrial dysfunction is implicated in the pathophysiology of psychiatric disorders. Levels of circulating cell-free mitochondrial DNA (cf-mtDNA) are observed to be altered in depression. However, the few studies that have measured cf-mtDNA in depression have reported conflicting findings. This study examined cf-mtDNA and depressive symptoms in low-active adults who smoke. METHODS: Participants were adults 18 to 65 years old ( N = 109; 76% female) with low baseline physical activity and depressive symptoms recruited for a smoking cessation study. Self-report measures assessed depression severity, positive and negative affect, and behavioral activation. Blood was collected and analyzed for cf-mtDNA. Relationships between depressive symptoms and cf-mtDNA were examined with correlations and linear regression. RESULTS: Levels of cf-mtDNA were associated with categorically defined depression (Center for Epidemiologic Studies Depression Scale score >15), lower positive affect, and decreased behavioral activation ( p < .05). Relationships remained significant after adjustment for age, sex, and nicotine dependence. In a linear regression model including all depressive symptom measures as predictors, Center for Epidemiologic Studies Depression Scale group and lower positive affect remained significant. CONCLUSIONS: This work suggests that mitochondrial changes are associated with depressive symptoms in low-active adults who smoke. Higher levels of cf-mtDNA in association with depression and with lower positive affect and decreased behavioral activation are consistent with a possible role for mitochondrial function in depressive symptoms.

Chronic Pain and Cannabis Use Frequency, Intensity, and Severity in Young Adults.

BACKGROUND: Cannabis use is common among young adults and is associated with many physical and mental health problems. Persons with chronic pain may be particularly susceptible to using cannabis at high rates, including for analgesic purposes, thus exposing themselves to greater risk of cannabis-related problems. However, little research has examined connections between chronic pain and cannabis use in the young adult population. MATERIALS AND METHODS: Participants were young adults from the community who were recruited for a larger health behaviors study. The present sample included 403 persons from this larger sample who reported cannabis use in the past 90 days. Participants completed measures of demographic characteristics, cannabis and alcohol use, and chronic pain. RESULTS: This young adult sample reported using cannabis on an average of 47.1 of the past 90 days, and 20.1% reported chronic pain. Chronic pain was associated with greater cannabis use frequency (IRR = 1.35, 95%CI 1.15; 1.57, p < 0.001), intensity (IRR = 1.61, 95%CI 1.18; 2.21, p = 0.003), and negative consequences (IRR = 1.23, 95%CI 1.02; 1.48, p < 0.030). DISCUSSION: In this sample of young adults who use cannabis, chronic pain was significantly associated with frequent, intense cannabis use, as well as more cannabis-related negative consequences. These findings suggest that chronic pain may be a marker for a particularly high-risk pattern of cannabis use in this age group, thus identifying an especially vulnerable subset of young adults who may require heightened research and clinical attention.

HIV-PASS (Pain and Sadness Support): Randomized Controlled Trial of a Behavioral Health Intervention for Interference Due to Pain in People Living With HIV, Chronic Pain, and Depression.

OBJECTIVE: This study aimed to determine whether HIV-Pain and Sadness Support (HIV-PASS), a collaborative behavioral health intervention based on behavioral activation, is associated with decreased pain-related interference with daily activities, depression, and other outcomes in people living with HIV. METHODS: We conducted a three-site clinical trial ( n = 187) in which we randomly assigned participants to receive either HIV-PASS or health education control condition. In both conditions, participants received seven intervention sessions, comprising an initial in-person joint meeting with the participant, their HIV primary care provider and a behavioral health specialist, and six, primarily telephone-based, meetings with the behavioral health specialist and participant. The intervention period lasted 3 months, and follow-up assessments were conducted for an additional 9 months. RESULTS: Compared with health education, HIV-PASS was associated with significantly lower pain-related interference with daily activities at the end of month 3 (our primary outcome; b = -1.31, 95% confidence interval = -2.28 to -0.34). We did not observe other differences between groups at 3 months in secondary outcomes that included worst or average pain in the past week, depression symptoms, anxiety, and perceived overall mental and physical health. There were no differences between groups on any outcomes at 12 months after enrollment. CONCLUSIONS: A targeted intervention can have positive effects on pain interference. At the end of intervention, effects we found were in a clinically significant range. However, effects diminished once the intervention period ended. TRIAL REGISTRATION: ClinicalTrials.gov NCT02766751.

Strategies Used to Manage Chronic Pain in HIV-Disease: Comparing Persons Prescribed Opioids Versus Persons not Receiving Opioids.

Chronic pain is common in people living with HIV (PLWH), causes substantial disability and is associated with limitations in daily activities. Opioids are commonly prescribed for pain treatment among PLWH, but evidence of sustained efficacy is mixed. There is little information available on how PLWH who have chronic pain use multimodal strategies in pain management. The current cross-sectional study examined background characteristics, self-reported pain, and the use of other pain treatments among 187 PLWH with chronic pain and depressive symptoms who were and were not prescribed opioids. Approximately 20.9% of participants reported using prescription opioids at the time of the study interview. These individuals were significantly more likely to report having engaged in physical therapy or stretching, strengthening or aerobic exercises in the previous 3 months, recent benzodiazepine use, and receiving disability payments. There were no significant differences in pain characteristics (pain-related interference, average pain severity, and worst pain severity) between the two groups. Those not prescribed opioids were more likely to report better concurrent physical functioning and general health, and fewer physical role limitations, but higher depression symptom severity. Our findings suggest that many PLWH with chronic pain and depressive symptoms express high levels of pain with deficits in physical function or quality of life despite their use of opioids. The high rate of co-use of opioids and benzodiazepines (30.8%) is a concern because it may increase risk of overdose. An integrated care approach that includes a variety of effective non-pharmacologic treatment strategies such as physical therapy may be beneficial in reducing the reliance on opioids for pain management.

Anger and substance use in HIV-positive patients with chronic pain.

Chronic pain increases the risk of substance use in people living with HIV (PLWH). Depression and anxiety have also been identified as risk factors for substance use among PLWH. Relatedly, other negative mood states, such as anger, may influence chronic pain among PLWH. The current cross-sectional study examined whether the distinct negative mood state of anger is associated with substance use among 187 PLWH who report chronic pain. Using negative binomial regression analyses, we found higher levels of anger were positively associated with alcohol use. Higher levels of anger were inversely associated with benzodiazepine use. No association was found between anger and marijuana use, and there were no significant interactions between anger and pain severity on substance use. Our findings suggest that anger is an independent risk factor for substance use among PLWH and chronic pain. Addressing anger may be useful when adapting behavioral therapies in the treatment of pain among PLWH.

The relationship between substance use and physical activity among people living with HIV, chronic pain, and symptoms of depression: a cross-sectional analysis.

ABSTRACTChronic pain, depression, and substance use are common among people living with HIV (PLWH). Physical activity can improve pain and mental health. Some substances such as cannabis may alleviate pain, which may allow PLWH to participate in more physical activity. However, risks of substance use include poorer mental health and HIV clinical outcomes. This cross-sectional analysis examined the relationships of self-reported substance use (alcohol, cannabis, and nicotine use), gender, and age with self-reports of walking, moderate physical activity, and vigorous physical activity, converted to Metabolic Equivalent of Task Units (METs), among 187 adults living with HIV, chronic pain, and depressive symptoms in the United States. Women reported less walking, vigorous activity, and total physical activity compared to men. Individuals who used cannabis reported more vigorous physical activity relative to those who did not use cannabis. These findings were partially accounted for by substance use*gender interactions: men using cannabis reported more vigorous activity than all other groups, and women with alcohol use reported less walking than men with and without alcohol use. Research is needed to increase physical activity among women who use substances and to evaluate reasons for the relationship between substance use and physical activity among men.

Randomized Controlled Trial of Aerobic Exercise for Smoking Cessation among Individuals with Elevated Depressive Symptoms.

INTRODUCTION: Adults with depression have higher rates of cigarette smoking and are more likely to relapse than those without depression. Pharmacological, psychological, and combined interventions have largely yielded small improvements in smoking outcomes for adults with depression. Aerobic exercise (AE) may facilitate smoking cessation in this subpopulation. METHODS: This study was a 12-week two-arm randomized controlled trial that evaluated the effect of a moderate-intensity AE program compared to a health education contact (HEC) control on smoking cessation in adults with elevated depressive symptoms (mild to severe). Participants (n=231) were randomized to AE or HEC and received smoking cessation treatment (telephone counseling and nicotine replacement therapy). Primary (biologically confirmed 7-day point prevalence abstinence) and secondary (depressive symptoms, objective and self-reported physical activity, and cardiorespiratory fitness) outcomes were assessed at baseline, 3-, 6-, and 12-months. Data were analyzed with mixed-effects generalized linear models controlling for age, gender, nicotine dependence, history of major depression disorder, and month of follow-up assessment. RESULTS: There were no significant differences in primary or secondary outcomes between the AE and HEC groups. CONCLUSIONS: The AE program was not superior to HEC in facilitating smoking cessation, increases in physical activity, or improved depressive symptoms. Given evidence for the positive acute effects of exercise on mood and smoking urges, future research should consider testing alternative exercise approaches for aiding smoking cessation beyond structured, aerobic exercise programs. IMPLICATIONS: This study found that an adjunctive aerobic exercise (AE) program was not superior to a health education contact control for adults with elevated depressive symptoms, all of whom also received standard smoking cessation treatment. This finding adds to the growing body of literature that structured aerobic exercise programs for smoking cessation may have limited efficacy for cessation outcomes. Future research is needed to test alternative methods of integrating AE into smoking cessation treatment, such as strategically using exercise to manage cravings and low mood in the moment.

Fine-Grained Intoxicated Gait Classification Using a Bilinear CNN.

Consuming excessive amounts of alcohol causes impaired mobility and judgment and driving accidents, resulting in more than 800 injuries and fatalities each day. Passive methods to detect intoxicated drivers beyond the safe driving limit can facilitate Just-In-Time alerts and reduce Driving Under the Influence (DUI) incidents. Popularly-owned smartphones are not only equipped with motion sensors (accelerometer and gyroscope) that can be employed for passively collecting gait (walk) data but also have the processing power to run computationally expensive machine learning models. In this paper, we advance the state-of-the-art by proposing a novel method that utilizes a Bi-linear Convolution Neural Network (BiCNN) for analyzing smartphone accelerometer and gyroscope data to determine whether a smartphone user is over the legal driving limit (0.08) from their gait. After segmenting the gait data into steps, we converted the smartphone motion sensor data to a Gramian Angular Field (GAF) image and then leveraged the BiCNN architecture for intoxication classification. Distinguishing GAF-encoded images of the gait of intoxicated vs. sober users is challenging as the differences between the classes (intoxicated vs. sober) are subtle, also known as a fine-grained image classification problem. The BiCNN neural network has previously produced state-of-the-art results on fine-grained image classification of natural images. To the best of our knowledge, our work is the first to innovatively utilize the BiCNN to classify GAF encoded images of smartphone gait data in order to detect intoxication. Prior work had explored using the BiCNN to classify natural images or explored other gait-related tasks but not intoxication Our complete intoxication classification pipeline consists of several important pre-processing steps carefully adapted to the BAC classification task, including step detection and segmentation, data normalization to account for inter-subject variability, data fusion, GAF image generation from time-series data, and a BiCNN classification model. In rigorous evaluation, our BiCNN model achieves an accuracy of 83.5%, outperforming the previous state-of-the-art and demonstrating the feasibility of our approach.

An examination of the effects of distress intolerance and rating of perceived exertion on changes in mood and anxiety following aerobic exercise among treatment-seeking smokers.

Aerobic exercise is frequently used as an intervention for depression and smoking cessation because of its antidepressant and anxiolytic effects. Distress intolerance (DI) is a proposed individual difference factor that, coupled with a higher rating of perceived exertion during exercise, may significantly impact the acute mood and anxiolytic effects of exercise. The current study examined the interactive effect of maximum rating of perceived exertion (RPE) and DI on change in mood and anxiety. Treatment-seeking smokers (Mage = 45.32; 72% female) with elevated depressive symptoms completed a 1-mile treadmill walk at their preferred intensity and self-reported their RPE during the test. Analyses were conducted to examine whether there was an interactive effect of maximum RPE and DI on change in self-reported mood and anxiety from before to after the walk test. Findings indicate a significant moderating effect of RPE at lower ratings. Individuals reporting a low maximum RPE and higher DI exhibit a greater change in mood over the course of an exercise session, whereas individuals reporting a low maximum RPE and a lower DI exhibit smaller changes in mood. These results indicate that the subjective effects of exercise within a population of cigarette smokers could be improved by tailoring exercise intensity to individual characteristics. Mild to moderate-intensity exercise, as compared to high-intensity exercise, may result in greater changes in mood for individuals endorsing difficulty tolerating affective and physical distress.

Effects of a bout of exercise on mood in people with depression with and without physical pain.

Physical and mental health symptoms can reduce participation in physical activity. The current study assessed the impact of a bout of exercise on mood state in depressed participants with and without current physical pain. We enrolled a community sample of 147 participants (Mage = 45.5; SD = 11.98; 87.1% female) with elevated depressive symptoms. Individuals rated their mood state, completed a 1-mile walk test on a treadmill, and rated their mood state again. Pairwise comparisons between pre- and post-exercise mood ratings were statistically significant (p < .001) and showed improved mood state. People with at least moderate pain showed greater decreases in sadness and irritability from pre- to post- exercise bout. A single bout of exercise was associated with decreased sadness, anxiety, and irritability, and increased energy in a sample of adults with depression. The changes in sadness and irritability were greatest in those who reported at least moderate physical pain.

Quantifying heterogeneity in mood-alcohol relationships with idiographic causal models.

BACKGROUND: Ecological momentary assessment (EMA) studies have provided conflicting evidence for the mood regulation tenet that people drink in response to positive and negative moods. The current study examined mood-to-alcohol relationships idiographically to quantify the prevalence and intensity of relationships between positive and negative moods and drinking across individuals. METHOD: We used two EMA samples: 96 heavy drinking college students (sample 1) and 19 young adults completing an ecological momentary intervention (EMI) for drinking to cope (sample 2). Mood and alcohol use were measured multiple times per day for 4-6 weeks. Mood-alcohol relationships were examined using three different analytic approaches: standard multilevel modeling, group causal modeling, and idiographic causal modeling. RESULTS: Both multilevel modeling and group causal modeling showed that participants in both samples drank in response to positive moods only. However, idiographic causal analyses revealed that only 63% and 21% of subjects (in samples 1 and 2, respectively) drank following any positive mood. Many subjects (24% and 58%) did not drink in response to either positive or negative mood in their daily lives, and very few (5% and 16%) drank in response to negative moods throughout the EMA protocol, despite sample 2 being selected specifically because they endorse drinking to cope with negative mood. CONCLUSION: Traditional group-level analyses and corresponding population-wide theories assume relative homogeneity within populations in mood-alcohol relationships, but this nomothetic approach failed to characterize accurately the relationship between mood and alcohol use in approximately half of the subjects in two samples that were demographically and clinically homogeneous. Given inconsistent findings in the mood-alcohol relationships to date, we conclude that idiographic causal analyses can provide a foundation for more accurate theories of mood and alcohol use. In addition, idiographic causal models may also help improve psychosocial treatments through direct use in clinical settings.

Acceptance of chronic pain in depressed patients with HIV: correlations with activity, functioning, and emotional distress.

Chronic pain is highly prevalent among persons with HIV (PWH), as is depression. Both comorbidities might contribute to, as well as be maintained by, avoidance-based coping. A promising alternative to avoidance-based coping is acceptance. Acceptance of pain is associated with improved functioning and quality of life in chronic pain patients, but this relationship has not been substantially explored among PWH. Cross-sectional data from 187 adult outpatients enrolled in a randomized trial for depressed PWH with chronic pain were analyzed. Controlling for pain severity and demographics, the relationships among pain acceptance and indicators of activity, functioning, and emotional distress (i.e., anxiety and anger) were assessed in seven regression models. No significant relationships were found between self-reported physical activity or objective measurement of mean steps/day with pain acceptance. Results revealed an inverse relationship between chronic pain acceptance and pain-related functional interference (by.x = -.52, p < .01) and a positive relationship with self-reported functioning (by.x = 7.80, p < .01). A significant inverse relationship with anxiety symptoms (by.x = -1.79, p < .01) and pain acceptance was also found. Acceptance of chronic pain can facilitate decreased emotional distress, improved well-being, and better functioning and quality of life. Further investigation of chronic pain acceptance among PWH could inform the development of acceptance-based interventions.

Using Ecological Momentary Assessments and Fitbit Data to Examine Daily Associations Between Physical Activity, Affect and Alcohol Cravings in Patients with Alcohol Use Disorder.

BACKGROUND: Preliminary studies show that structured physical activity (PA) interventions can reduce negative affect and alcohol use in patients recovering from alcohol use disorder (AUD). The current study tested whether the association between PA, affect, and alcohol cravings can be observed in patients' natural environments (i.e., without a structured intervention) as well. METHOD: Twenty-five participants with AUD completed 3 weeks of ecological momentary assessment (EMA) monitoring and wore Fitbit devices to measure physical activity directly after discharge from partial hospitalization treatment for AUD. PA was operationalized as total steps and consecutive 10-min bouts of moderate-intensity exercise (100 steps/minute). RESULTS: Only 56% of participants engaged in any bouts of moderate-intensity physical activity throughout the 3-week study period (mode = 1 bout), and participants logged an average of 8183 steps/day (SD = 5560). Daily steps were associated with a higher positive affect and lower alcohol cravings, and with higher positive affect the next day, but the effects were very small. No relationships were observed between PA and affect or alcohol cravings at the hourly level except a random effect signifying that bouts of PA were either positively associated or not associated with negative affect in the next hour for different participants. CONCLUSIONS: Overall, results suggest that naturalistic PA may be beneficial for a small subset of patients in recovery from AUD, but the majority did not engage in regular exercise or experience improvements in affect and cravings as a result of PA.

Intuitive eating buffers the link between internalized weight stigma and body mass index in stressed adults.

Internalized weight stigma (IWS) is independently associated with less intuitive eating (i.e., eating based on endogenous hunger/satiety cues) and higher Body Mass Index (BMI), and intuitive eating training is commonly conceptualized as protective against the effects of IWS on poor behavioral health. The 3-way relationship between IWS, intuitive eating, and BMI has yet to be examined, and it is unclear whether the link between IWS and BMI is buffered by high intuitive eating. This secondary preliminary analysis examined baseline data of stressed adults with poor diet (N = 75, 70% female, 64.1% White, 42.7% with overweight/obesity) in a parent clinical trial that tested the effects of yoga on diet and stress. Validated self-report surveys of IWS and intuitive eating were analyzed with objectively-assessed BMI. Moderated regression analyses using the SPSS PROCESS macro tested whether intuitive eating moderated the IWS-BMI link. The analysis revealed IWS was positively associated with BMI except among people with high intuitive eating. Results extend observational findings linking intuitive eating to lower BMI, and offer preliminary support for the hypothesis that this link may hold even among those with greater IWS. It's possible that individuals with lower BMI and greater IWS may gravitate more towards intuitive eating than those with greater BMI, and/or intuitive eating may be an important target for ameliorating the adverse association of IWS with behavioral and physical health indicators linked to BMI. Continued work is warranted in larger, more generalizable samples using causal and prospective designs.

Design, synthesis, and antitumor activity evaluation of steroidal oximes.

Steroidal compounds were proven to be efficient drugs against several types of cancer. Oximes are also chemical structures frequently associated with anticancer activity. The main goal of this work was to combine the two referred structures by synthesizing steroidal oximes and evaluating them in several cancer cell lines. Compounds (17E)-5α-androst-3-en-17-one oxime (3,4 - OLOX), (17E)-3α,4α-epoxy-5α-androstan-17-one oxime (3,4 - EPOX), (17E)-androst-4-en-17-one oxime (4,5 - OLOX) and (17E)-4α,5α-epoxyandrostan-17-one oxime (4,5 - EPOX) were synthesized and their cytotoxicity evaluated in four human cancer cell lines, namely colorectal adenocarcinoma (WiDr), non-small cell lung cancer (H1299), prostate cancer (PC3) and hepatocellular carcinoma (HepG2). A human non-tumour cell line, CCD841 CoN (normal colon cell line) was also used. MTT assay, flow cytometry, fluorescence and hemocompatibility techniques were performed to further analyse the cytotoxicity of the compounds. 3,4 - OLOX was the most effective compound in decreasing tumour cell proliferation in all cell lines, especially in WiDr (IC50 = 9.1 µM) and PC3 (IC50 = 13.8 µM). 4,5 - OLOX also showed promising results in the same cell lines (IC50 = 16.1 µM in WiDr and IC50 = 14.5 µM in PC3). Further studies also revealed that 3,4 - OLOX and 4,5 - OLOX induced a decrease in cell viability accompanied by an increase in cell death, mainly by apoptosis/necroptosis for 3,4 - OLOX in both cell lines and for 4,5 - OLOX in WiDr cells, and by necrosis for 4,5 - OLOX in PC3 cells. These compounds might also exert their cytotoxicity by ROS production and are not toxic for non-tumour CCD841 CoN cells. Additionally, both compounds did not induce haemoglobin release, proving to be safe for intravenous administration. 3,4 - OLOX and 4,5 - OLOX might be the starting point for an optimization program towards the discover of new steroidal oximes for anticancer treatment.

Project CHOICE: Choosing healthy options in coping with emotions, an EMA/EMI plus in-person intervention for alcohol use.

Background: Emerging adulthood (18-25 years) represents a risky time for mental health and substance use. Emerging adults are particularly susceptible to problematic patterns of substance use, especially if they experience anxiety and/or depression and use substances as a way to cope with such issues. However, many mental health treatments do not address substance use. We developed an ecological momentary assessment and intervention (EMA/EMI) to specifically target the motive of drinking to cope with anxiety/depression. Methods: Project CHOICE was a 6-week intervention that paired in-person normative feedback with daily EMA and, if an individual reported negative affect and intent to drink, an EMI was immediately sent to their phone (a personally-chosen coping skill). We recruited n = 20 (55% female, mean age 21.74, 85% Caucasian and 75% non-Hispanic/Latino) individuals from a psychiatric partial hospitalization program for a 6-week open trial of the CHOICE intervention and re-assessed at the 6-week follow-up point. Results: Results indicated that drinking variables and coping motives were highly correlated at baseline. Days of drinking, alcohol-related problems, and coping motives significantly decreased over time following the intervention. Results indicated high levels of feasibility and acceptability. Conclusions: This open pilot represents a feasible, acceptable, and promising direction in delivering interventions in the moment when risk is highest, utilizing smartphone capabilities.

A Pilot Randomized Controlled Trial of Distress Tolerance Treatment for Weight Concern in Smoking Cessation Among Women.

INTRODUCTION: The majority of women who smoke cigarettes report that concern about weight gain is a barrier to quitting. We developed an intervention incorporating distress tolerance, appetite awareness, and mindful eating skills to target concerns about post-cessation weight gain and emotional eating (DT-W). In the current study, we conducted a pilot randomized controlled trial of DT-W versus a smoking health education (HE) intervention. METHODS: Participants (N = 69 adult female, weight-concerned smokers) were recruited in cohorts of 4-11. Cohorts were randomized to DT-W or HE. DT-W and HE were matched on format (single individual session followed by eight group sessions), inclusion of cognitive behavioral therapy for smoking cessation (CBT) content, and pharmacotherapy (nicotine patches). Follow-up assessments occurred at 1-, 3-, and 6-months post-treatment. RESULTS: The recruitment goal was met; 61 of the 69 participants attended at least one group session. There were no significant differences between DT-W and HE in the number of group sessions attended (DT-W adjusted M = 5.09, HE adjusted M = 5.03, p = .92), ratings of treatment effectiveness or usefulness of skills, or retention at 6-month follow-up (79% in DT-W vs. 78% in HE) (ps > .05), but comprehension ratings were lower in DT-W than in HE (p = .02). CONCLUSIONS: Overall, these results suggest that the study procedures and interventions were feasible and acceptable, but changes to the DT-W intervention content to improve comprehension should be considered prior to conducting a fully powered trial. IMPLICATIONS: A distress tolerance-based treatment targeting fear of weight gain after smoking cessation and post-cessation emotional eating was feasible and acceptable relative to a smoking HE comparison condition, but changes should be considered before conducting a larger trial. Continued innovation in treatment development for weight-concerned smokers is needed.

An ecological momentary assessment of mood, coping and alcohol use among emerging adults in psychiatric treatment.

Background: Emerging adulthood is a critical period for the onset of both mental health disorders and problematic alcohol use. Coping strategies can play an important role in mitigating the onset and progression of these conditions in emerging adulthood. The current study examined daily mood, coping strategy use, and alcohol use during an individualized, ecological momentary intervention (EMI).Objectives: To examine the within-person relationship between mood, coping strategy use, and alcohol use.Methods: Emerging adults (N = 20, 55% female) in a partial hospital program for anxiety or mood disorders who endorsed drinking to cope completed a 6-week EMI to increase non-substance coping skills. The study also measured mood, coping strategy use, and alcohol use over the course of the intervention.Results: Mood and coping variables did not predict the likelihood of drinking on a given day. On drinking days, the number of pre-consumption coping strategies were related to reduced alcohol use (p =.02) and there was a significant interaction between negative mood and coping in predicting alcohol use (p <.01). When pre-consumption negative mood was high, coping strategies predicted decreased alcohol use (p =.02), but when negative mood was low, this relationship was nonsignificant.Conclusions: Using coping skills was associated with reduced alcohol use on days when negative mood was high. Increasing non-substance coping skills may help emerging adults reduce their alcohol use in response to negative mood.

Anxiety sensitivity and daily cigarette smoking in relation to sleep disturbances in treatment-seeking smokers.

Although the association between anxiety and sleep disturbance is well-documented, the underlying mechanisms are less clear. Anxiety sensitivity (AS), the fear of physiological arousal and bodily sensations, is a risk factor for anxiety and poor sleep. Smoking also contributes to poor sleep and may compound the effects of AS on sleep quality. This study evaluated the main and interactive effects of AS and cigarettes/day on sleep quality among smokers. Participants (n = 190) were adult treatment-seeking daily smokers who completed a baseline assessment as part of a larger smoking cessation trial. Sleep quality was self-reported. Results indicated that AS was significantly correlated with greater disturbance in sleep duration, subjective sleep quality, sleep onset latency, sleep disturbance, daytime dysfunction, and sleep medication use. There was a significant interaction between AS and cigarettes/day in terms of sleep onset latency, but not other sleep quality indices. AS was associated with significantly longer sleep onset latency minutes among heavier smokers, but not lighter smokers. Specifically, the association between AS and sleep onset latency was significant for those who smoked ≥ 33 cigarettes/day. AS is a psychological factor that may contribute to poor sleep quality, especially in heavy smokers, and thus may be a promising intervention target.

Anxiety sensitivity and intentional avoidance of physical activity in women with probable migraine.

INTRODUCTION: Avoidance of physical activity is a common migraine management strategy. Anxiety sensitivity (i.e. fear of anxiety and bodily sensations due to physical, cognitive, or social consequences) is a potential correlate of physical activity avoidance and may strengthen beliefs about physical activity's detrimental effect on migraine. METHOD: Women (n = 100) with probable migraine diagnosis completed an online survey about migraine and physical activity, which included the Anxiety Sensitivity Index-3. RESULTS: Anxiety sensitivity was associated with significantly increased odds of avoiding moderate- and vigorous-intensity physical activity. Anxiety sensitivity, particularly cognitive concerns, was associated with more frequent vigorous and moderate physical activity avoidance. Social concerns about anxiety sensitivity were associated with stronger expected likelihood of vigorous-intensity physical activity as a triggering and worsening factor in migraine. DISCUSSION: Preliminary findings indicate that anxiety sensitivity may contribute to avoidance of moderate and vigorous physical activity and fear-based cognitions about exercise.