Leventhal Adam M, Ramsey Susan E, Brown Richard A, LaChance Heather R, Kahler Christopher W
Center for Alcohol and Addiction Studies, Brown University, Providence, RI 02912, USA.
Nicotine Tob Res. 2008 Mar;10(3):507-17. doi: 10.1080/14622200801901971.
Because different psychopathologic components of depressive symptoms may have distinct etiologies, examining their differential effects on smoking cessation may elucidate mechanisms underlying the smoking-depression relationship. Negative affect (NA), somatic features (SF), low positive affect/anhedonia (PA), and interpersonal disturbance (IP) have been identified as unique dimensions of depression that can be measured using the Center for Epidemiologic Studies Depression Scale (CESD). This study examined common and unique associations between CESD subscales and baseline smoking characteristics, nicotine withdrawal, and relapse in 157 participants enrolled in a smoking cessation trial for heavy social drinkers. Each dimension was univariately associated with negative and positive reinforcement smoking motives. Only SF had unique relations with tolerance smoking motives and univariate associations with nicotine dependence severity. Only PA predicted cessation-related changes in withdrawal symptoms on quit day. Analyses predicting abstinence at 8, 16, and 26 weeks post quit date showed that NA, SF, and PA each univariately predicted relapse, ps< or =.0083. Only low PA predicted poorer outcomes incrementally to the other dimensions, even when controlling for level of nicotine dependence, smoking frequency, and history of major depression, p = .0018. Interventions targeting anhedonia and low positive affect may be useful for smokers trying to quit.
由于抑郁症状的不同精神病理成分可能有不同的病因,研究它们对戒烟的不同影响可能会阐明吸烟与抑郁关系背后的机制。消极情感(NA)、躯体特征(SF)、低积极情感/快感缺失(PA)和人际困扰(IP)已被确定为抑郁的独特维度,可使用流行病学研究中心抑郁量表(CESD)进行测量。本研究调查了CESD分量表与157名参加重度社交饮酒者戒烟试验的参与者的基线吸烟特征、尼古丁戒断及复吸之间的共同和独特关联。每个维度都与消极和积极强化吸烟动机单变量相关。只有SF与耐受性吸烟动机有独特关系,且与尼古丁依赖严重程度单变量相关。只有PA预测了戒烟日戒断症状的与戒烟相关的变化。对戒烟后8周、16周和26周的戒断情况进行预测的分析表明,NA、SF和PA各自单变量预测复吸,p≤0.0083。即使在控制尼古丁依赖水平、吸烟频率和重度抑郁病史的情况下,只有低PA比其他维度能更显著地预测较差的结果,p = 0.0018。针对快感缺失和低积极情感的干预措施可能对试图戒烟的吸烟者有用。