Ansell Emily B, Gu Peihua, Tuit Keri, Sinha Rajita
Department of Psychiatry, Yale University School of Medicine, Connecticut, USA.
Hum Psychopharmacol. 2012 Mar;27(2):200-8. doi: 10.1002/hup.1269.
The stress-vulnerability model of addiction predicts that environmental factors, such as cumulative stress, will result in individual adaptations that decrease self-control, increase impulsivity, and increase risk for addiction. Impulsivity and cumulative stress are risk factors for tobacco smoking that are rarely examined simultaneously in research.
We examined the indirect and direct effects of cumulative adversity in a community sample consisting of 291 men and women who participated in an assessment of cumulative stress, self-reported impulsivity, and smoking history. Data were analyzed using bootstrapping techniques to estimate indirect effects of stress on smoking via impulsivity.
Cumulative adversity is associated with smoking status via direct effects and indirect effects through impulsivity scores. Additional models examining specific types of stress indicate contributions of traumatic stress and recent life events as well as chronic relationship stressors.
Overall, cumulative stress is associated with increased risk of smoking via increased impulsivity and via pathways independent of impulsivity. These findings support the stress-vulnerability model and highlight the utility of mediation models in assessing how, and for whom, cumulative stress increases risk of current cigarette smoking. Increasing self-control is a target for interventions with individuals who have experienced cumulative adversity.
成瘾的应激易感性模型预测，诸如累积应激等环境因素会导致个体适应性变化，从而降低自我控制能力、增加冲动性并增加成瘾风险。冲动性和累积应激是吸烟的风险因素，但在研究中很少同时进行考察。
我们在一个由291名男性和女性组成的社区样本中，考察了累积逆境的间接和直接影响，这些参与者接受了累积应激、自我报告的冲动性和吸烟史的评估。使用自抽样技术分析数据，以估计应激通过冲动性对吸烟产生的间接影响。
累积逆境通过直接影响以及通过冲动性得分产生的间接影响与吸烟状况相关。考察特定类型应激的其他模型表明了创伤性应激、近期生活事件以及慢性关系应激源的作用。
总体而言，累积应激通过增加冲动性以及通过独立于冲动性的途径与吸烟风险增加相关。这些发现支持了应激易感性模型，并突出了中介模型在评估累积应激如何以及对谁会增加当前吸烟风险方面的效用。提高自我控制能力是针对经历过累积逆境的个体进行干预的一个目标。
