Lerman C, Audrain J, Orleans C T, Boyd R, Gold K, Main D, Caporaso N
Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA.
Addict Behav. 1996 Jan-Feb;21(1):9-19. doi: 10.1016/0306-4603(95)00032-1.
The present study examined the cognitive-behavioral linkages between depressed mood and level of nicotine dependence in smokers seeking smoking cessation treatment. Prior to treatment, 202 subjects completed validated self-report measures of smoking history, depressive symptomatology, "self medication" processes, "learned helplessness" processes, and nicotine dependence. Results revealed that 48% of the study population scored in the "depressed" range on the Center for Epidemiologic Studies (CESD) depression scale. Further, these smokers reported significantly higher levels of nicotine dependence than other nondepressed smokers. Depressed and nondepressed smokers did not differ with respect to several cognitions related to learned helplessness theory. However, depressed smokers were more likely to report "self medication" processes (i.e., negative affect reduction smoking and stimulation smoking). In addition, multivariable regression and path analyses suggested that negative affect reduction smoking and stimulation smoking are sequential mediators of the depression-nicotine dependence relationship. These results underscore the need to screen for depressive symptomatology among smokers seeking treatment, and to develop cessation treatments that are tailored to the needs of depressed smokers.
本研究考察了寻求戒烟治疗的吸烟者中抑郁情绪与尼古丁依赖水平之间的认知行为联系。在治疗前，202名受试者完成了关于吸烟史、抑郁症状、“自我药物治疗”过程、“习得性无助”过程和尼古丁依赖的有效自我报告测量。结果显示，48%的研究人群在流行病学研究中心（CESD）抑郁量表上的得分处于“抑郁”范围。此外，这些吸烟者报告的尼古丁依赖水平明显高于其他非抑郁吸烟者。抑郁吸烟者和非抑郁吸烟者在与习得性无助理论相关的几种认知方面没有差异。然而，抑郁吸烟者更有可能报告“自我药物治疗”过程（即减少负面情绪吸烟和刺激吸烟）。此外，多变量回归和路径分析表明，减少负面情绪吸烟和刺激吸烟是抑郁与尼古丁依赖关系的连续中介变量。这些结果强调了在寻求治疗的吸烟者中筛查抑郁症状的必要性，并开发针对抑郁吸烟者需求的戒烟治疗方法。
