Intolerance of uncertainty, experiential avoidance, and trust in physician: a moderated mediation analysis of emotional distress in advanced cancer.

We tested whether patients' trust in physician moderated the hypothesized indirect association between intolerance of uncertainty (IU; inability to tolerate the unknown) and emotional distress through the mediator, experiential avoidance (EA; efforts to avoid negative emotions, thoughts, or memories), in patients with advanced cancer. The sample included 108 adults with Stage III or IV cancer (53% female; Mage = 63 years) recruited from a metropolitan cancer center. All constructs were measured by standardized self-report instruments. The PROCESS macro for SPSS tested the moderated mediation model. IU evidenced significant direct and indirect relationships with anxiety and depressive symptoms. Trust in physician moderated the indirect relationship between IU and anxiety (not depressive symptoms), albeit in an unexpected direction. Specifically, the indirect relationship between IU and anxiety symptoms through EA was significant for those with moderate to high physician trust but not low trust. Controlling for gender or income did not change the pattern of findings. IU and EA may be key intervention targets, particularly in acceptance-or meaning-based interventions for patients with advanced cancer.

Identifying Frequently Endorsed Benefits and Barriers to Breast Cancer Screening for African-Born Women in the NYC Metropolitan Area: a Pilot Study.

Most cancer screening data report on Black participants without distinguishing nativity, limiting our understanding of the needs of distinct groups within the African diaspora. The purpose of this pilot study was to assess demographic characteristics and perceptions of the benefits of and barriers to mammography among African immigrant women in New York City (NYC). Forty-two women who were 40 years or older, born in Africa, and English and/or French-speaking were recruited from African immigrant communities in NYC to complete a survey. Eighty percent of our sample aged 50 to 73 was adherent to the 2016 USPSTF mammography screening guideline. The most frequently endorsed benefits were that mammography will help find breast cancer early, could help find a breast lump before it is big enough to feel, and that if found early, breast cancer could be successfully treated. The most endorsed barriers were that having a mammogram is painful and that lack of insurance or being treated rudely at the mammogram center would keep participants from having a mammogram. Chi-square analyses assessed relationships between demographic characteristics and perceptions about mammography and revealed that endorsement of barriers to screening (e.g., health issues, transportation problems, pain, and time associated with mammography) varied by educational attainment. Findings suggest that future interventions should be multi-level and (1) support patients in accessing screening via resource sharing, (2) address other commonly cited barriers such as fear of pain during the procedure, and (3) support anti-racist healthcare environments especially in terms of treatment by providers.

HBV screening among West Africans living in the US: Influences of stigma, health literacy, and self-efficacy.

BACKGROUND: Applying theoretically informed constructs using an adaptation of the "Theory of Planned Behavior," this study assessed social-cognitive and sociocultural determinants of HBV screening among West Africans living in the US to inform solutions to testing gaps. METHODS: We developed and administered a theory-based survey in both English (41%) and French (59%) from September 2021 to April 2022 to a sample of West African-born individuals (n = 162). Predictors of HBV screening included: attitudes, perceived behavioral control or self-efficacy, and subjective norms along with health literacy (HL), language proficiency, and stigma of HBV infection. We hypothesized that these constructs would predict HBV testing. We also conducted path analytic modeling to better understand both direct and indirect effects of key factors on HBV screening status. RESULTS: West Africans who completed the survey in English were younger with less education and lower income, whereas those who completed the survey in French reported higher HBV-related stigma. In a bivariate analysis of factors associated with HBV screening by language, less education was associated with lower HBV screening in English speakers. Adequate HL, higher self-efficacy, and higher English language proficiency were independently associated with HBV screening. Path analysis to better understand the interplay between social-cognitive and sociocultural factors revealed HL and stigma both had indirect effects on screening, mediated by differences in self-efficacy. CONCLUSIONS: This study identified HL and stigma as key indirect factors that influence HBV screening by way of self-efficacy in West Africans in the US. This work is a first step to identifying barriers that can lead to the development of an evidence-based intervention aimed at increasing HBV screening of West Africans to address health disparities.

Multimorbidity and Depressive Symptoms in Older Adults: A Contextual Approach.

BACKGROUND AND OBJECTIVES: Among older adults, depressive symptoms increase with each chronic illness; however, specific disease-related stressors (e.g., pain) and contextual moderators (interpersonal, sociocultural, temporal) of this relationship remain understudied. We explored disease-related stressors associated with depressive symptoms and moderating effects of contextual factors on this relationship, guided by a social ecological framework. RESEARCH DESIGN AND METHODS: Adults ≥62 years with multimorbidity (n = 366) completed validated scales assessing diagnoses, disease-related stressors (pain intensity, subjective cognitive function, physical function, somatic symptoms), and depressive symptoms. Moderators included age, expectations regarding aging, perceived social support, and difficulty affording medications. Data were analyzed using structural equation modeling. RESULTS: Participants were 62-88 years old, with several comorbidities (M = 3.5; range: 2-9). As hypothesized, disease-related stressors were associated with depressive symptoms (b = 0.64, SE = 0.04, p < .001). The effect of disease-related stressors on depressive symptoms was greater among those reporting low social support (B = 0.70, SE = 0.06, p < .001) than for those reporting high social support (B = 0.46, SE = 0.06, p < .001). The negative effect of disease-related stressors on depressive symptoms was stronger for those with poorer expectations of aging (B = 0.68, SE = 0.07, p < .001), compared to those with more positive expectations (B = 0.47, SE = 0.06, p < .001). Age and difficulties affording medications were not significant moderators. DISCUSSION AND IMPLICATIONS: Garnering social support and addressing low expectations for aging may prevent the detrimental effect of multimorbidity on mental health.

The indirect influence of 'invisible' support on pulmonary function among adults with chronic obstructive pulmonary disease.

Individuals living with chronic obstructive pulmonary disease (COPD) often require support from family or friends. We examined whether invisible support - support that is provided but goes unnoticed - is related to pulmonary function, and whether this association is mediated by depressive symptoms and illness perceptions. Sixty-six dyads of individuals with COPD and their informal caregivers reported on receipt and provision of support, respectively. Those with COPD completed measures of depressive symptoms, illness perceptions and pulmonary function. Although invisible support was not directly related to pulmonary function, mediation analyses revealed a combined indirect effect through lower depressive symptoms and less negative illness perceptions. Interventions teaching skillful delivery of support to caregivers may reduce depressive symptoms and threatening illness cognitions, which may contribute to improvements in symptom burden among patients with COPD.

Breast arterial calcification rates in a diverse, urban group of screening mammography patients.

PURPOSE: Breast arterial calcifications (BAC), detected by digital mammography are a potential marker of coronary artery disease (CAD). Past BAC research has been limited by having primarily racially and ethnically homogeneous samples, samples at higher risk for CAD, and neglecting to explore the influence of women's health factors. The purpose of this study was to evaluate the prevalence of, and factors associated with, BAC in an ethnically and racially diverse group. METHODS: We conducted a retrospective chart review on 17,237 screening mammography patients. Mammography results and patient responses to a demographic and medical history questionnaire were abstracted. Logistic regression was used. RESULTS: BAC prevalence was 12.3%. Age was a significant risk factor, with the odds of BAC approximately doubling every decade. Age-adjusted analyses showed: 1) higher BAC prevalence among Hispanic and Black women; 2) lower BAC prevalence among Ashkenazi women, nulliparous and pre-menopausal women, those with dense breasts and breast implants, and those currently using HRT; and, 3) no association between BAC prevalence and BMI or age at menarche. CONCLUSIONS: BAC prevalence differs according to age, ethnicity, race, women's health, and breast-specific factors. Communication of BAC information in clinical settings could potentially prompt women to engage in preventive care.

Psychological Distress, Obsessive Compulsive Thoughts about Drinking, and Alcohol Consumption in Young Adult Drinkers.

Psychological distress is an important predictor of heavy drinking, especially among lower-income drinkers. The mechanisms underlying this effect have not been well characterized. One possibility is that distressed individuals are more vulnerable to obsessive and compulsive thoughts about drinking. We hypothesized that: 1) distress would predict obsessive and compulsive thoughts about alcohol, which in turn would predict drinking, and 2) effects would be particularly pronounced among lower-income drinkers. Young adults (n=105) were recruited from an urban university and completed the Brief Symptoms Index (BSI), the Obsessive-Compulsive Drinking Scale (OCDS), and a 90-day timeline follow-back (TLFB) drinking interview. Consistent with the hypotheses, drinkers with higher levels of distress (BSI) exhibited higher levels of obsessive and compulsive drinking-related thoughts, which in turn were related to drinking over the past ninety days (p's <.0001). Path analyses revealed that the BSI had a significant indirect effect on drinking outcomes through increased OCDS. Furthermore, conditional process analyses revealed that effects were particularly pronounced among drinkers with lower household incomes. Findings highlight the importance of psychological distress as a predictor of obsessive and compulsive thoughts about alcohol, as well as drinking behavior, and underscore the critical need to address psychological functioning among lower-income drinkers in particular.

Affective mechanisms of stress-induced cigarette craving: Considerations of gender and race/ethnicity.

OBJECTIVE: Among the major impediments to successful smoking cessation are strong cravings, especially during times of heightened stress. Affective responses to stress (e.g., acute anxious and depressed mood) may serve as important mediators of cigarette cravings that are amenable to intervention. Experimental models have been developed to reliably induce cravings during stress under laboratory conditions, permitting a closer examination of possible changes in affect that may be driving cigarette cravings. A key limitation of the extant research is its reliance on samples of predominantly White males who smoke. Although several recent studies suggest possible gender- and race/ethnicity-based differences in affective responses to acute stress, no studies have explored how such differences may contribute to cigarette cravings. METHOD: To address this gap, we conducted an experimental study in which a diverse sample of healthy volunteer female (n = 163) and male (n = 139) nicotine-dependent individuals who smoked were exposed to a stressor (guided imagery of painful dental work). We assessed negative affect and cigarette craving immediately before and after the imaginal dental stressor. RESULTS: Path analyses revealed that the acute stressor induced increases in negative affect, which, in turn, increased cigarette craving (significant direct and indirect effects, p's < 0.05; R2indirect = 0.5). Interestingly, effects were more pronounced in women and in non-White individuals who smoked. CONCLUSIONS: Results highlight the important roles of stress and affect in craving, and the need to consider gender and race/ethnicity when developing interventions to manage stress-induced cigarette cravings among individuals attempting to quit.

Common paraverbal errors during hypnosis intervention training.

There is growing literature to support the use of hypnosis as an evidence-based behavioral medicine intervention to manage a wide variety of symptoms and side effects associated with cancer and its treatment (e.g., pain, nausea, fatigue). However, formal training in hypnosis is often lacking among cancer care providers. The purpose of this study is to identify common paraverbal errors among hypnosis trainees in order to inform future training efforts. In a sample of 196 hypnosis trainees, paraverbal errors (i.e., tone, pacing, and phrasing) were tracked across hypnotic intervention components. Results revealed that trainees had most difficulty with hypnotic tone, particularly during the Induction, Deepening, and Alerting components. Individual trainee characteristics were unrelated to paraverbal errors.

Effect of a Self-management Support Intervention on Asthma Outcomes in Older Adults: The SAMBA Study Randomized Clinical Trial.

IMPORTANCE: Older adults with asthma have worse control and outcomes than younger adults. Interventions to address suboptimal self-management among older adults with asthma are typically not tailored to the specific needs of the patient. OBJECTIVE: To test the effect of a comprehensive, patient-tailored asthma self-management support intervention for older adults on clinical and self-management outcomes. DESIGN, SETTING, AND PARTICIPANTS: Three-arm randomized clinical trial conducted between February 2014 and December 2017 at primary care practices and personal residences in New York City. Adults 60 years and older with persistent, uncontrolled asthma were identified from electronic medical records at an academic medical center and a federally qualified health center. Of 1349 patients assessed for eligibility, 406 met eligibility criteria, consented to participate, and were randomized to 1 of 3 groups: home-based intervention, clinic-based intervention, or control (usual care). A total of 391 patients received the allocated treatment. INTERVENTIONS: Screening for psychosocial, physical, cognitive, and environmental barriers to asthma control and self-management with actions to address identified barriers. The intervention was delivered in the home or primary care practices by asthma care coaches. MAIN OUTCOMES AND MEASURES: Primary outcomes were the Asthma Control Test, Mini Asthma Quality of Life Questionnaire, Medication Adherence Rating Scale, metered dose inhaler technique, and emergency department visits for asthma care. Primary analyses compared intervention (home or clinic based) with usual care. RESULTS: Of the 391 patients who received treatment, 58 (15.1%) were men, and the mean (SD) age was 67.8 (7.4) years. After accounting for baseline scores, scores on the asthma control test were better in the intervention groups vs the control group (difference-in-differences at 3 months, 1.2; 95% CI, 0.2-2.2; P = .02; 6 months, 1.0; 95% CI, 0.0-2.1; P = .049; 12 months, 0.6; 95% CI, -0.5 to 1.8; P = .28; and overall, χ2 = 13.4, with 4 degrees of freedom; P = .01). Emergency department visits were lower at 12 months for the intervention groups vs the control group (16 [6.2%] vs 17 [12.7%]; P = .03; adjusted odds ratio, 0.8; 95% CI, 0.6-0.99; P = .03). Statistically significant improvements were observed for the intervention vs control patients in quality of life (overall effect: χ2 = 10.5, with 4 degrees of freedom; P = .01), medication adherence (overall effect: χ2 = 9.5, with 4 degrees of freedom; P = .049), and inhaler technique (metered-dose inhaler technique, correctly completed steps at 12 months, median [range]: 75% [0%-100%] vs 58% [0%-100%]). No significant differences in outcomes were observed between patients receiving the intervention in home vs practice settings. CONCLUSIONS AND RELEVANCE: An intervention directed by patients' needs and barriers improved asthma outcomes and self-management behaviors among older adults. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02316223.

Illness Uncertainties Tied to Developmental Tasks Among Young Adult Survivors of Hematologic Cancers.

PURPOSE: Young adulthood is a period of building autonomy, relationships, and careers. Experiencing cancer as a young adult (YA) is an "off-time" event in the normative adult life cycle and may interrupt age-specific goals. The majority of prior research on illness uncertainty centers on medical concerns about recurrence or mortality. The current study identifies how YA survivors of hematologic cancers, an understudied group, experience illness uncertainties related to the developmental tasks of young adulthood. METHODS: This is a qualitative study of 53 YA hematologic cancer survivors, ages 20-39. Participants completed hour-long semistructured interviews about psychological, social, and treatment-related aspects of their cancer experience. Interviews were transcribed and coded using an abductive approach to qualitative analysis. RESULTS: Most participants (80%) spontaneously described at least one illness uncertainty tied to developmental tasks. Fertility was the most commonly reported type of uncertainty (55%), with more women than men reporting it, followed by family and intimate relationships (43%), peers and social life (36%), and academic or career goals (26%). These uncertainties were described with reference to the off-time nature of illness. Example excerpts are provided and interpreted. CONCLUSIONS: These findings have the potential to advance our understanding of the cancer experience of YA survivors by expanding on the notion of illness uncertainty in this population. Given the extent to which uncertainties related to developmental tasks were reported, tailored interventions targeting these concerns may improve quality of life among YAs with hematologic cancers.

Sex differences in affect-triggered lapses during smoking cessation: A daily diary study.

INTRODUCTION: Smoking lapses during a cessation attempt are common and are thought to be a key predictor of full relapse. Positive and negative affective states have been hypothesized as important precipitants of lapses during quit attempts, although findings have been mixed. Accumulating evidence suggests that women may smoke more when experiencing negative affective states, while men may smoke more when experiencing positive affective states. The possibility that these sex differences may play a role in predicting lapses during a smoking cessation attempt, however, has not been well-investigated. In this study, we hypothesized that, during a quit attempt, negative affect would be more strongly associated with lapses among women, and positive affect would be more strongly associated with lapses among men. METHOD: We conducted a prospective study in which male and female nicotine-dependent smokers (n = 60) made an unaided, 'cold-turkey' quit attempt. For fourteen days following the initiation of the quit attempt, participants completed daily diaries in which they recorded the degree to which states of 'good mood' and 'bad mood' preceded smoking lapses. RESULTS: Consistent with the study hypothesis, findings indicated that men reported higher good-mood-induced smoking lapses than women across the 14-day study interval. Conversely, while levels of bad-mood-induced smoking subsided over the 14-day interval among men, levels persisted among women. DISCUSSION: Results further underscore the need to address sex-specific affective triggers when developing smoking cessation strategies.

Mindfulness buffers the effects of cue-induced craving on alcohol demand in college drinkers.

Alcohol consumption among young adult college students represents a significant public health problem. The presence of alcohol-related cues in drinkers' environments can trigger powerful alcohol cravings, which may influence drinking outcomes. Less is known about how this cue-induced craving influences behavioral economic demand for alcohol. In addition, research has suggested that trait mindfulness may be an important buffer of the effects of internal states of craving on drinking decisions. Based on this literature, we hypothesized that cue-induced cravings would be associated with increased alcohol demand, an effect that would be attenuated among drinkers who have higher levels of mindfulness. Young adult college student drinkers (n = 69) completed a laboratory-based cue-induced craving assessment, a self-report assessment of trait mindfulness, and an alcohol purchase task. Findings revealed that cue-induced craving was related to higher alcohol demand. Consistent with the study hypothesis, acceptance, a component of mindfulness, buffered the effects of cue-induced craving on alcohol demand. Results raise the possibility that mindfulness-based interventions may be useful in helping disrupt the link between internal states of craving and drinking decisions in young adult college student drinkers.

Can attitudes about smoking impact cigarette cravings?

Cigarette cravings, especially those in response to environmental stressors and other smoking-related triggers (e.g., passing by a favorite smoking spot), are important contributors to smoking behavior and relapse. Previous studies have demonstrated significant individual differences in such cravings. This study explores the possibility that attitudes about smoking can influence the experience of cigarette craving. Consistent with classical theories of the links between cognition and motivation, we predicted that smokers who exhibit more favorable attitudes towards smoking would have greater cravings. Daily smokers (n=103, mean age=41.8years, 33% female) were instructed to imagine smoking, stress, and neutral scenarios. Cravings were measured prior to and after each exposure. Participants also completed an abridged version of the Smoking Consequence Questionnaire (SCQ) that had them rate the: 1) desirability and 2) likelihood, for eighteen separate negative smoking consequences (e.g., "The more I smoke, the more I risk my health", "People will think less of me if they see me smoking"). Findings revealed that favorable attitudes about the consequences of smoking, as measured by the SCQ-desirability index, significantly predicted cigarette cravings. Findings suggest that individual attitudes toward smoking may play an important role in better understanding cigarette cravings, which may ultimately help identify targets for more efficient and effective cognitive/attitude-based interventions for smoking cessation.

Direct and Indirect Effects of Psychological Distress on Stress-Induced Smoking.

OBJECTIVE: Numerous studies have modeled the effects of stress in the laboratory, demonstrating that smokers who are exposed to experimental stressors exhibit significant increases in acute psychological distress. Whether these stress reactions are predictive of stress-induced smoking during an actual quit attempt, however, has not been examined. Furthermore, the possibility that such effects are particularly strong among smokers with higher ambient levels of distress has not been addressed. METHOD: Nicotine-dependent smokers (N = 60; 40 women, 20 men) completed the Brief Symptoms Index (BSI) and then participated in a laboratory stress task 1 week before a quit attempt. Acute psychological distress was measured immediately before and after exposure to stressful and neutral stimuli. After they quit, participants completed a smoking diary for 14 days in which they recorded the degree to which their smoking was precipitated by emotional stress. RESULTS: Consistent with our hypotheses, BSI scores predicted both exaggerated laboratory stress responses (p < .005) and smoking that was attributable to stress during the 14-day postquit period (p < .01). Laboratory stress reactions were predictive of stress-induced smoking (p < .01), and acute psychological stress reactions mediated the effects of BSI on stress-induced smoking. CONCLUSIONS: Acute psychological stress reactivity is a potential mechanism underlying the effect of stress-induced smoking during a quit attempt.

A Single Session of Attentional Bias Modification Reduces Alcohol Craving and Implicit Measures of Alcohol Bias in Young Adult Drinkers.

BACKGROUND: Attentional bias modification (ABM) techniques for reducing problematic alcohol consumption hold promise as highly accessible and cost-effective treatment approaches. A growing body of literature has examined ABM as a potentially efficacious intervention for reducing drinking and drinking-related cognitions in alcohol-dependent individuals as well as those at-risk of developing problem drinking habits. METHODS: This study tested the effectiveness of a single session of visual probe-based ABM training in a cohort of 60 non-treatment-seeking young adult drinkers, with a focus on examining mechanisms underlying training efficacy. Participants were randomly assigned to a single session of active ABM training or a sham training condition in a laboratory setting. Measures of implicit drinking-related cognitions (alcohol Stroop and an Implicit Association Task) and attentional bias (AB; alcohol visual probe) were administered, and subjective alcohol craving was reported in response to in vivo alcohol cues. RESULTS: Results showed that active ABM training, relative to sham, resulted in significant differences in measures of implicit alcohol-related cognition, alcohol-related AB, and self-reports of alcohol craving. Mediation analysis showed that reductions in craving were fully mediated by ABM-related reductions in alcohol-Stroop interference scores, suggesting a previously undocumented relationship between the 2 measures. CONCLUSIONS: Results document the efficacy of brief ABM to reduce both implicit and explicit processes related to drinking, and highlight the potential intervention-relevance of alcohol-related implicit cognitions in social drinkers.

Attentional bias to alcohol stimuli predicts elevated cue-induced craving in young adult social drinkers.

Considerable evidence has identified biased cognitive processing of alcohol-related stimuli as an important factor in the maintenance of alcohol-seeking and relapse among individuals suffering from alcohol use-disorders (AUDs). In addition, a large body of research has demonstrated that exposure to alcohol cues can elicit powerful alcohol cravings. Little is known, however, about the possible relationship between attentional bias and cue-induced cravings, and even less is known about these processes in social drinkers without a personal history of AUDs. The goal of this study was to examine the possibility that attentional biases toward alcohol-related stimuli would predict elevated cue-induced alcohol craving in this population. Young adult social drinkers (N=30, Mean age=22.8±1.9, 61% female) recruited from an urban university population completed a visual dot probe task in which they were presented with alcohol and neutral stimulus pictures that were immediately followed by a visual probe replacing one of the pictures. Attentional bias was measured by calculating reaction times to probes that replaced alcohol stimuli vs. neutral stimuli. Participants then completed a classic alcohol cue-exposure task and reported cravings immediately before and after alcohol and neutral cue-exposures. Not surprisingly, exposure to alcohol cues elicited significant cravings. Consistent with the study hypothesis, larger attentional biases toward alcohol stimuli predicted higher levels of alcohol craving. Findings demonstrate that heightened attention to alcohol stimuli can significantly impact motivation to consume in healthy young adults, and suggest a possible pathway linking cognitive processes early in the drinking trajectory to the later development of AUDs.

Favorable associations with alcohol and impaired self-regulation: A behavioral economic analysis.

BACKGROUND: Recent research has demonstrated that both poor self-regulation and favorable implicit associations toward alcohol can play important roles in predicting drinking. Less well studied, however, is how the interplay between implicit associations and self-regulation may impact decisions about alcohol consumption. Behavioral economics is one important tool that may provide insight into the cognitive processes that impact demand for alcohol and drinking decisions. METHODS: Healthy young adult participants completed an Implicit Association Task (IAT) that measured the strength of associations between approach/avoid attributes and target alcohol/neutral images. Impaired self-regulation was assessed by a classic delay discounting task. Participants also completed an Alcohol Purchase Task (APT), which yields multiple behavioral economic indices, chief among which are intensity (the number of drinks a participant would consume if the drinks were free) and elasticity (the degree to which an increased per-drink price impacts the number of drinks consumed in a hypothetical drinking situation). Finally, participants completed a timeline follow-back assessment of past-90-day drinking. RESULTS: Findings indicated that implicit approach associations toward alcohol predicted increased demand for alcohol on the APT. Although delay discounting did not have a direct effect on demand for alcohol, there was a significant interaction between IAT and delay discounting, such that higher implicit alcohol approach associations predicted particularly high demand for alcohol among participants with poorer self-regulation. APT and IAT, in turn, predicted self-reported drinking behavior. CONCLUSIONS: These results suggest that favorable attitudes toward alcohol, together with poor self-regulation, can significantly impact drinking decisions in healthy young adults.

Gender and Impulsivity: Effects on Cue-Induced Alcohol Craving.

BACKGROUND: Numerous studies have demonstrated that trait impulsivity is linked to increased risk of developing alcohol-use disorders and other substance abuse. Impulsivity has also been shown in some studies to potentiate cue-induced drug cravings. Despite considerable evidence of gender differences in impulsivity and drug craving among individuals suffering from alcohol dependence and other drug use, little research has focused on these processes in healthy young men and women who may be at risk for developing alcohol-use disorders. The objective of this study was to investigate the relationship between impulsivity and cue-induced craving, as well as possible gender differences in these effects among healthy young adults. METHODS: To that end, female (n = 22) and male (n = 14) social drinkers aged 18 to 25, recruited from an urban university campus, completed the Barratt Impulsiveness Scale and reported their alcohol cravings immediately before and after laboratory exposure to alcohol cues. RESULTS: Findings indicated that exposure to cues elicited increased alcohol cravings, but these effects did not differ by gender. Interestingly, a significant interaction of impulsivity and gender revealed that impulsivity predicted significantly higher cue-induced cravings in women, but not men. CONCLUSIONS: Findings underscore the importance of better understanding the interaction of situational factors (e.g., exposure to alcohol cues) and dispositional factors (e.g., impulsivity) as potential contributors to drinking motivation. Future prospective research is needed to identify gender-specific risk factors for the development of problem drinking.

Impulsivity moderates the relationship between previous quit failure and cue-induced craving.

INTRODUCTION: Poor inhibitory control has been shown to be an important predictor of relapse to a number of drugs, including nicotine. Indeed, smokers who exhibit higher levels of impulsivity are thought to have impaired regulation of urges to smoke, and previous research has suggested that impulsivity may moderate cue-induced cigarette cravings. To that end, we conducted a study to evaluate the interplay between failed smoking cessation, cue-induced craving, and impulsivity. METHODS: Current smokers (n=151) rated their cigarette cravings before and after laboratory to exposure to smoking cues, and completed questionnaires assessing impulsivity and previous failed quit attempts. RESULTS: Findings indicated that shorter duration of previous failed quit attempts was related to higher cue-induced cigarette craving, especially among smokers with higher levels of impulsivity. CONCLUSIONS: Results underscore the importance of considering trait impulsivity as a factor in better understanding the management of cue-induced cravings.