Farris Samantha G, Brown Lily A, Goodwin Renee D, Zvolensky Michael J
The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 345 Blackstone Blvd., Providence, RI 02906 USA; The Miriam Hospital, Centers for Behavioral and Preventative Medicine, 164 Summit St., Providence, RI 02906 USA; Butler Hospital, 345 Blackstone Blvd, Providence, RI 02906 USA.
University of Pennsylvania Perlman School of Medicine, Department of Psychiatry, 3535 Market St., Philadelphia, PA 19103, USA.
Drug Alcohol Depend. 2017 Feb 1;171:84-90. doi: 10.1016/j.drugalcdep.2016.11.023. Epub 2016 Nov 24.
Little is known about panic attacks and puffing topography, a behavioral index of the value of smoking reinforcement. This study examined smoking style during the course of smoking of a single cigarette among adult daily smokers with and without a history of panic attacks.
Participants (n=124, M=43.9, SD=9.7; 44.4% female) were non-treatment seeking daily smokers. Lifetime panic attack history was assessed via diagnostic assessment; 28.2% (n=35) of the sample had a panic attack history. Participants smoked one cigarette during an ad libitum smoking trial. Puff volume, duration, and inter-puff interval were measured using the Clinical Research Support System (CReSS) pocket device.
Regression analyses revealed that panic attack status was not associated with significant differences in average puff volume, duration, or inter-puff interval. Multi-level modeling was used to examine puffing trajectories. Puff-level data revealed that there was a significant quadratic time x panic effect for puff volume and duration. Those with a panic attack history demonstrated relatively sustained levels of both puff volume and duration over time, whereas those without a history of panic attacks demonstrated an increase followed by a decrease in volume and duration over time. These effects were not accounted for by the presence of general psychopathology.
Smokers with a panic attack history demonstrate more persistent efforts to self-regulate the delivery of nicotine, and thus may be at risk for continued smoking and dependence. Tailored treatment may be needed to address unique vulnerabilities among this group.
关于惊恐发作与吸烟形态（吸烟强化价值的一种行为指标）知之甚少。本研究调查了有和没有惊恐发作史的成年每日吸烟者在吸一支香烟过程中的吸烟方式。
参与者（n = 124，M = 43.9，SD = 9.7；44.4%为女性）为不寻求治疗的每日吸烟者。通过诊断评估来评定终生惊恐发作史；样本中有28.2%（n = 35）有惊恐发作史。参与者在一次随意吸烟试验中吸一支香烟。使用临床研究支持系统（CReSS）袖珍设备测量吸量、持续时间和吸间间隔。
回归分析显示，惊恐发作状态与平均吸量、持续时间或吸间间隔的显著差异无关。采用多层次建模来研究吸烟轨迹。吸量水平数据显示，吸量和持续时间存在显著的二次时间×惊恐效应。有惊恐发作史的人随着时间推移吸量和持续时间水平相对持续，而没有惊恐发作史的人随着时间推移吸量和持续时间则先增加后减少。这些效应无法用一般精神病理学的存在来解释。
有惊恐发作史的吸烟者在自我调节尼古丁输送方面表现出更持续的努力，因此可能有持续吸烟和成瘾的风险。可能需要量身定制的治疗来解决该群体中的独特易感性问题。
