Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77204, United States.
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI 02912, United States; Department of Psychiatry, Rhode Island Hospital, Providence, RI 02904, United States.
Addict Behav. 2019 Jan;88:15-22. doi: 10.1016/j.addbeh.2018.08.008. Epub 2018 Aug 10.
Scientific evidence suggests that pain-related anxiety may contribute to the maintenance of tobacco addiction among smokers with varying levels of pain. Yet, no work has investigated the relation between pain-related anxiety and cognitive-based smoking processes within an indirect effect model. Dysphoria may explain the relation between pain-related anxiety and cigarette smoking, as it is a construct that relates to both pain and smoking outcomes. Thus, the current cross-sectional study examined the indirect effect of pain-related anxiety and three clinically significant smoking processes: perceived barriers to cessation, negative affect reduction motives, and negative mood abstinence expectancies via dysphoria. Participants included 101 (M = 32.74 years, SD = 13.60; 35.6% female) adult tobacco cigarette smokers with low cigarette dependence. Results indicated that pain-related anxiety had an indirect effect on all dependent variables through dysphoria. The current findings provide evidence that dysphoria may serve to maintain maladaptive smoking processes in smokers who experience pain-related anxiety. This study furthers research on pain-smoking relations by providing initial evidence for a conceptual model in which smokers with elevated pain-related anxiety endorse greater dysphoric symptoms and use smoking to reduce or escape symptoms of their pain-related anxiety and dysphoria, thus contributing to the maintenance of tobacco dependence.
科学证据表明，疼痛相关焦虑可能会导致不同疼痛程度的吸烟者对烟草成瘾的持续存在。然而，目前还没有研究在间接效应模型中，疼痛相关焦虑与基于认知的吸烟过程之间的关系。抑郁可能可以解释疼痛相关焦虑和吸烟之间的关系，因为它是一个与疼痛和吸烟结果都相关的结构。因此，目前的横断面研究通过抑郁检验了疼痛相关焦虑与三种临床显著的吸烟过程（戒烟障碍感知、负性情绪减轻动机和消极情绪戒断预期）之间的间接效应。参与者包括 101 名（M=32.74 岁，SD=13.60；35.6%为女性）有轻度吸烟依赖的成年烟草烟民。结果表明，疼痛相关焦虑通过抑郁对所有因变量产生间接影响。目前的研究结果为一个概念模型提供了证据，即抑郁可能会使那些经历疼痛相关焦虑的吸烟者保持适应不良的吸烟过程。本研究通过提供一个概念模型的初步证据，进一步研究了疼痛与吸烟的关系，在该模型中，疼痛相关焦虑程度较高的吸烟者表现出更多的抑郁症状，并通过吸烟来减轻或逃避与疼痛相关焦虑和抑郁相关的症状，从而导致烟草依赖的维持。
