Cardiac Vagal Control Among Community Cigarette Smokers with Low to Moderate Depressive Symptoms.

Impairments in cardiac vagal control (CVC) have been independently linked to smoking status and depression and are implicated in self-regulatory processes that may exacerbate depressive symptoms and maintain smoking behavior. Yet, few studies have examined how depressive symptoms, even at low levels, influence CVC reactivity among individuals who smoke. Investigating these relationships may provide novel insights into how depressive symptoms exacerbate existing regulatory vulnerabilities among smokers. This study investigated how depression symptoms affect CVC reactivity as a function of changing situational demands among a community sample of 60 daily adult cigarette smokers. Participants completed a mildly demanding cognitive task while physiological data was recorded. Growth curve modeling was used to examine the main and interactive effects of self-reported depressive symptoms on CVC reactivity over the course of the task. We hypothesized that greater depressive symptoms would be associated with less CVC reactivity, characterized by smaller initial reductions in CVC values and a flatter slope over time. Participants were daily smokers with mild to moderate levels of depression. Final model results, where time was specified as linear and the slope was fixed, showed no significant main or interactive effects of time and depression symptoms on CVC reactivity. Findings suggest that at low to moderate levels, depressive symptom severity is not related to patterns of CVC reactivity among adults who smoke. This is the first study to examine this relationship in this population. Future investigations that examine patterns of CVC reactivity among smokers and non-smokers with more severe depression are needed.

Is Ignorance Bliss? Examining the Effect of News Media Exposure on Anxiety and Depression During the COVID-19 Pandemic.

ABSTRACT: There has been a widespread increase in affective disorders after the emergence of the COVID-19 pandemic. In the current study, we investigated the effects of exposure to and perceived accuracy of news media and demographic characteristics on anxiety and depressive symptoms. We conducted an online survey of US adults (N = 480) using hierarchical linear regression models to understand the predictive roles of duration and frequency of news media exposure, as well as the perceived accuracy of COVID-19 portrayal by the news media, on anxiety and depression. Increased exposure duration predicted greater anxiety, and decreased frequency of exposure and perceived overreaction in the news media coverage of COVID-19 were linked to greater anxiety and depression. Perceived accuracy moderated the relationship of exposure frequency to both affective outcomes. Accordingly, our data support the importance of adequate levels of accurate and trusted information to help mitigate the overall mental health burden of the pandemic.

COVID-19 vaccine acceptance: influential roles of political party and religiosity.

Given recent declines in US vaccination rates and the emergence of COVID-19 vaccines, identifying sociodemographic influencers of vaccine willingness holds importance for developing effective public health campaigns aimed at enhancing nationwide COVID-19 vaccine acceptance. The present study utilized a hierarchical binary logistic regression model to assess demographic variables (age, gender, race/ethnicity, pre-existing medical conditions), political party membership, religious affiliation, level of religiosity, and fear of COVID-19 as predictors of COVID-19 vaccine acceptance ('Yes', would receive a vaccine or 'No', would not receive a vaccine) in a national sample of US adults (N = 249). Participants were recruited from Amazon's Mechanical Turk (MTurk) and completed several online questionnaires pertaining to mental health, health behaviors, and responses to the COVID-19 pandemic. Both Democratic party membership and decreased level of religiosity predicted acceptance of a COVID-19 vaccine. This investigation supports political party membership and religiosity as influencers of COVID-19 vaccine willingness and suggests that these variables could represent potential targets for public health interventions aimed at increasing vaccine adoption.

An investigation of racial and ethnic differences in e-cigarette beliefs and use characteristics.

In this study we provide information on e-cigarette use characteristics in relation to racial and ethnic characteristics in a sample of 535 adult e-cigarette users. We also evaluated how anxiety sensitivity (AS; fear of anxiety) interacted with race/ethnicity to predict vaping outcomes. We found an association between greater AS and higher e-cigarette dependence for White, but not Black, participants. A similar trend was observed for level of risk perception. Also, Hispanic status was associated with higher perception of e-cigarette benefits. Overall, the present study contributes to the understanding of factors linked to e-cigarette use.

Investigation of the predictive influence of personal and gubernatorial politics on COVID-19 related behaviors and beliefs.

Given the varied emotional and behavioral responses to the COVID-19 pandemic across the United States, further attention to the personal and societal influences on such responses is necessary. We investigated the predictive influence of personal political affiliation and the congruity of personal and governor political affiliation on COVID-19 emotional and behavioral responses, with specific attention to the influence of intolerance of uncertainty (IU) on emotional response. These factors were assessed in two studies of adults in the United States (N = 480, N = 272). We utilized a series of hierarchical linear and logistic regressions to assess predictors of 4 outcomes: (1) trust in governor's response to the pandemic, (2) COVID-19 related worry, and the (3) usage and (4) perceived efficacy of protective health behaviors (e.g., wearing a mask). Across these studies, we found that IU predicted increased COVID-19 related worry. Further, age and personal political affiliation, but not concordance with governor affiliation, predicted COVID-19 behavioral responses. These findings are discussed in relation to the potential importance of linking health messaging to personal characteristics.

The role of fear of COVID-19 in motivation to quit smoking and reductions in cigarette smoking: a preliminary investigation of at-risk cigarette smokers.

Preliminary data suggest that cigarette smokers could have an increased mortality risk from the novel coronavirus (SARS-CoV-2), and that certain factors (e.g., increased age, medical comorbidities) can also increase risk of poor coronavirus disease (COVID-19) outcomes. Between April 30th, 2020 and May 28th, 2020, we evaluated self-reported changes in recent smoking patterns and motivation to quit smoking among current daily cigarette smokers (N = 103) on Amazon Mechanical Turk. We also assessed the relationship of these outcomes to age, medical comorbidity status, and fear of COVID-19. Most participants (68.9%) reported smoking less frequently than usual in the last 28 days. Among daily smokers, increased fear of COVID-19 predicted increased motivation to quit smoking and actual smoking reductions (ps < .05). Endorsement of one or more medical comorbidities, but not increased age, predicted increased motivation to quit smoking (p < .05). These data suggest the potentially greater relevance of psychological factors (e.g., fear of COVID-19) over external risk factors (e.g., medical comorbidity, increased age) on motivation to quit smoking and actual reductions in smoking patterns, and may reflect that the pandemic is a suitable time for offering smoking cessation intervention.

Worrying But Not Acting: The Role of Intolerance of Uncertainty in Explaining the Discrepancy in COVID-19-Related Responses.

Research indicates that Intolerance of Uncertainty (IU) is associated with COVID-19 emotional responses, but not necessarily with engaging in COVID-19 preventative behaviors. The current study was designed to further evaluate this discrepancy. Participants (N = 454) completed self-report forms about COVID-19 emotional responses (i.e., fear, worry, sensitivity to symptoms) and COVID-19 behavioral interference/responses (i.e., interference in daily activities, interference due to worry, and engagement in preventative behaviors). IU was positively associated with COVID-19-related emotional responses as well as two of the COVID-19-related behavioral interference/responses (i.e., interference in daily activities and interference due to worry), but negatively predicted engagement in COVID-19 preventative behaviors. Exploratory analyses revealed a significant indirect effect of IU on lower engagement in preventative behaviors through lower belief in the effectiveness of such behaviors. Thus, we further document the role of IU in statistically predicting higher distress but lower levels of adaptive health behaviors. Furthermore, we provide preliminary support for the hypothesis that these relationships may be explained by associations between IU and lower belief in the efficacy of health behaviors. Because some current analyses indicate small effect sizes, future studies should investigate IU alongside other potentially important markers. Supplementary Information: The online version contains supplementary material available at 10.1007/s10608-022-10321-0.

Do Pain-Related Anxiety and Difficulties With Emotion Regulation Impact Abstinence Expectancies or Motivation to Quit E-Cigarette Use?

OBJECTIVE: Pain-related anxiety is a psychologically based construct that is associated with tobacco dependence and may have important relevance to e-cigarette use. Difficulties with emotion regulation, a relevant construct in motives for cigarette smoking, may interact with pain-related anxiety to yield worsened clinical outcomes among e-cigarette users. We evaluated whether pain-related anxiety and difficulties with emotion regulation independently and in interaction predict e-cigarette users' expectancies surrounding abstinence and their motivation to stop using e-cigarettes. METHOD: Daily e-cigarette users (n = 290, mean age= 35.5, SD = 10.9, 56.6% male) completed an online survey about e-cigarette use. We conducted hierarchical multiple regression analyses to evaluate the main and interactive influence of pain-related anxiety and difficulties with emotion regulation on our outcomes. RESULTS: Increased pain-related anxiety independently predicted negative abstinence expectancies and increased motivation to quit e-cigarette use (ps < .001). Increased difficulties with emotion regulation predicted only negative abstinence expectancies (ps < .01) when pain-related anxiety was included in the model. The interaction between pain-related anxiety and difficulties with emotion regulation was not significant. CONCLUSIONS: As hypothesized, increased pain-related anxiety was associated with both negative expectancies of abstinence and increased motivation to quit e-cigarette use, but contrary to our hypothesis, difficulties with emotion regulation were not significantly associated with increased motivation to quit e-cigarette use when evaluated with pain-related anxiety in the model. These findings may elucidate processes influencing abstinence expectancies and motivation to quit in a sample of e-cigarette users, although replication in a larger, more diverse sample is warranted.

Anxiety Sensitivity as a Malleable Mechanistic Target for Prevention Interventions: A Meta-Analysis of the Efficacy of Brief Treatment Interventions.

Anxiety sensitivity (AS) is a transdiagnostic risk factor and potential treatment target for prevention of associated psychopathology and negative health behaviors. We conducted a meta-analysis evaluating the efficacy of brief interventions in at-risk samples for reducing AS and associated clinical/behavioral outcomes (e.g., depression, alcohol use) across 28 studies (1,998 participants). AS targeted interventions, compared to control conditions, evidenced a significant moderate effect size for alleviating AS from pre- to post-treatment (d = 0.54) and approached a large effect size from pre-treatment to short-term follow-up (d = 0.78). The effect size for long-term follow-up did not reach significance (d = 0.29). For clinical/behavioral outcomes, AS interventions demonstrated significant small-to-moderate effect sizes for the three timepoints examined (d's = 0.20-0.41). Our findings help validate AS as a modifiable mechanistic target for prevention efforts.

Respiratory therapy for the treatment of anxiety: Meta-analytic review and regression.

OBJECTIVE: Respiratory abnormalities are a hallmark of anxiety symptomatology and may serve as clinically useful modifiers for alleviating anxiety symptoms. However, gold-standard anxiety treatments (e.g., cognitive-behavioral interventions) often do not directly address respiratory components despite their theoretical utility and clinical accessibility. This review examined the clinical effectiveness of respiratory interventions, interventions that directly target respiration abnormalities and processes, in treating trait anxiety symptoms. METHODS: The final analysis included 40 randomized controlled trials including at least one measure of trait anxiety, a respiratory-focused intervention group, and a non-respiratory control-group (active or inactive treatment). Overall effects of respiratory focused interventions were examined, as well as the effect of hypothesized moderators. RESULTS: Respiratory component interventions yielded significantly greater improvements (moderate to large effect) in anxiety symptoms than controls, with the stronger effects observed in comparison to inactive, rather than active, control conditions. Significant heterogeneity in findings suggests that variability in intervention design, population, and control comparison may obfuscate interpretation of findings. CONCLUSIONS: Evidence supports the clinical utility of respiratory interventions as either an independent anxiety treatment, or as an adjunct to other interventions. Clinical and research implications of findings along with recommendations for ongoing investigations in this domain are discussed.

Does anxiety sensitivity predict addiction severity in opioid use disorder?

Increased anxiety sensitivity (AS), or the fear of anxiety-related cognitive, social, and physical symptoms which are misinterpreted as having harmful implications, has shown a relationship with substance use disorders. People with substance use disorders also experience addiction-related problems across domains of life functioning. However, few studies have evaluated the relationship between elevated AS and addiction-related problems across specific life areas. We evaluated, first, whether AS predicted addiction-related problems in a sample of treatment-refractory outpatients with opioid use disorders and, second, whether sex moderated the relationship between AS and addiction-related problems in this sample. Participants with treatment-refractory opioid use disorders (n = 92, 53.3% male) completed baseline assessments of AS (the Anxiety Sensitivity Index) and addiction-related problems (the Addiction Severity Index). Baseline AS total score was a significant independent predictor of both baseline Addiction Severity Index medical status (ß = 0.29, t = 2.84, p = .006) and psychiatric status (ß = 0.30, t = 2.99, p = .004) composite scores but was not associated with social, employment or legal difficulties. These findings were maintained when controlling for drug use severity, though baseline AS total score became a significant predictor of baseline legal difficulties (ß = -0.23, t = -2.25, p = .027). There was no moderating role of sex on the relationship between baseline AS and addiction-related problems. Our findings suggest that, regardless of sex, elevated AS predicts increased addiction-related medical and psychiatric problems, and decreased legal problems when accounting for drug use severity, in outpatients with opioid use disorders.

A randomized controlled trial protocol for engaging distress tolerance and working memory to aid smoking cessation in low socioeconomic status (SES) adults.

Low income and low educational attainment are among the strongest predictors of both smoking prevalence and lapse (i.e., return) to smoking after cessation attempts. Treatment refinement is limited by inadequate knowledge of the specific lapse- or relapse-relevant vulnerabilities characteristic of populations that should be the target of treatment. In the context of a randomized clinical trial design, we describe an experimental medicine approach for evaluating the role of 2 specific lapse-relevant targets relative to the higher stress characteristic of low-socioeconomic contexts: low distress tolerance and low working memory capacity. Furthermore, we use an innovative approach for understanding risk of smoking lapse in smokers undergoing a quit attempt to examine candidate mechanistic targets assessed not only during nicotine use, but also during the conditions smokers will face upon a cessation attempt-during stressful nicotine-deprivation windows. This study is designed to show the incremental value of assessments during deprivation windows, in part because of the way in which specific vulnerabilities are modified by, and interact with, the heightened stress and withdrawal symptoms inherent to nicotine-deprivation states. Specifically, the study is designed to evaluate whether a novel mindfulness intervention (mindfulness combined with interoceptive exposure) can improve upon existing mindfulness interventions and extend therapeutic gains to the modification of mechanistic targets assessed in high-stress or negative affectivity contexts. The overall goal is to validate mechanistic targets and associated interventions for the purpose of expanding treatment options for at-risk smokers. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Targeting cognitive and emotional regulatory skills for smoking prevention in low-SES youth: A randomized trial of mindfulness and working memory interventions.

Research to date provides striking evidence that youth from low socio-economic status (SES) households are at an increased risk for smoking. Converging evidence from developmental studies, psychopathology studies, intervention studies, and basic research on self-control abilities have identified working memory and distress tolerance as potential crucial modifiable risk factors to prevent smoking onset in this cohort. To confirm the value of these mechanistic targets, this randomized trial was designed to evaluate the influence of working memory and distress tolerance interventions on risk of smoking initiation. Recruiting primarily from low-income community afternoon programs, we randomized 93 adolescents to one of three intervention conditions, all of which were a prelude to a smoking-prevention informational intervention: (1) a working memory intervention, (2) a mindfulness training intervention to target distress tolerance, and (3) a wellness-focused control condition. Despite a number of adherence efforts, engagement in treatment was limited, and under these conditions no significant evidence was found either for differential efficacy for smoking prevention or for intervention effects on mechanistic targets. However, working memory capacity and distress tolerance were found to be negatively related to smoking propensity. As such, our mechanistic targets-working memory and distress tolerance--may well be processes undergirding smoking, despite the fact that our interventions did not adequately engage these targets.