University of Southern California, Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA 90033, USA; University of Southern California, Department of Psychology, Los Angeles, CA 90033, USA.
Drug Alcohol Depend. 2013 Dec 1;133(2):324-9. doi: 10.1016/j.drugalcdep.2013.06.015. Epub 2013 Jul 26.
The complex concordance and discordance across and within anxiety and depressive symptoms complicates understanding of the relation between emotional symptoms and manifestations of tobacco withdrawal. The goal of this study was to parse the broad variation in anxiety and depressive symptoms into conceptually discrete components and explore their relative predictive influence on affective patterns of acute tobacco withdrawal.
We employed a within-participant experimentally manipulated tobacco abstinence design involving: (i) a baseline visit at which past-week depression and anxiety symptoms were assessed and (ii) two counterbalanced experimental visits-one after ad lib smoking and one after 16-h of tobacco abstinence-at which state affect was assessed. Participants were community-dwelling adults (N=187) smoking 10+ cig/day for at least two years without an active mood disorder.
Anxiety-related general distress symptoms (e.g., tension, nervousness) predicted greater abstinence-induced increases in various negative affective states but not changes in positive affect (βs .17-.33). Depression-related general distress symptoms (e.g., sadness, worthlessness) predicted greater abstinence-induced increases in acute depressed affect only (βs .24-.25). Anhedonic symptoms (e.g., diminished interest, lack of pleasure) predicted larger abstinence-induced decreases in acute positive affect only (βs .17-.20). Anxious Arousal symptoms (e.g., shakiness, heart racing) predicted larger abstinence-induced increases in fatigue and depressive affect (βs .15-.24).
Different components of anxiety and depressive symptoms are associated with unique affective patterns of acute tobacco withdrawal. These results provide insight into the affective mechanisms underlying tobacco dependence and could inform smoking cessation treatment approaches tailored to individuals with emotional distress.
焦虑和抑郁症状在不同个体和同一个体内部存在复杂的一致性和不一致性，这使得理解情绪症状与烟草戒断表现之间的关系变得复杂。本研究的目的是将广泛存在的焦虑和抑郁症状分解为概念上离散的成分，并探讨它们对急性烟草戒断时情感模式的相对预测影响。
我们采用了一种基于参与者的实验性、人为控制的烟草戒断设计，包括：（i）基线访视，评估过去一周的抑郁和焦虑症状；（ii）两个平衡的实验访视，一次是在随意吸烟后，一次是在 16 小时的烟草戒断后，评估状态情感。参与者为社区居住的成年人（N=187），每天吸烟 10 支以上，且至少吸烟两年，没有活跃的心境障碍。
与焦虑相关的一般困扰症状（如紧张、神经质）预测了更大的戒断引起的各种负面情感状态的增加，但不预测积极情感的变化（βs.17-.33）。与抑郁相关的一般困扰症状（如悲伤、无价值感）仅预测了戒断引起的急性抑郁情绪的更大增加（βs.24-.25）。快感缺失症状（如兴趣减退、缺乏愉悦感）仅预测了戒断引起的急性积极情感的更大下降（βs.17-.20）。焦虑唤醒症状（如颤抖、心跳加速）预测了更大的戒断引起的疲劳和抑郁情绪的增加（βs.15-.24）。
焦虑和抑郁症状的不同成分与急性烟草戒断的独特情感模式相关。这些结果为理解烟草依赖的情感机制提供了深入的了解，并为针对有情绪困扰的个体的戒烟治疗方法提供了信息。
