Negative Affect Relief Research Articles

Caffeine Use and Attentional Engagement in Everyday Life

Caffeine is a common component of various beverages and foods with approximately 80% of the world's population consuming caffeinated products daily. Here we examined how caffeine consumption and different motivations for consuming caffeine (e.g., cognitive enhancement, negative affect relief, reinforcing effects, and weight control) relate to self-reported inattention, mind-wandering, and deep, effortless concentration (i.e., flow) in everyday life in a university student population via two online surveys (N = 224 and N = 234). Our results indicated that, contrary to what one might expect, the amount of caffeine consumed in a typical day (estimated in milligrams) was not related to attention-related experiences in everyday life. However, we found that those who are more likely to ingest caffeine to potentially enhance their cognition, or to experience the reinforcing effects of caffeine, or to help relieve negative affect showed higher levels of inattention in everyday life.

Differences in biobehavioral measures of cigarette smoking by depression symptomology

IntroductionResearch that explores the clinical relevance of subclinical depressive symptoms and smoking is primarily focused on smoking cessation. We examine whether depression symptoms vary across an array of biological (carbon monoxide boost), behavioral (FagerströmTest of Nicotine Dependence, cigarettes per day, smoking topography), and psychological smoking-related outcomes (Questionnaire on Smoking Urges, Withdrawal Symptoms Checklist) in non-treatment-seeking smokers. MethodsBaseline data were pooled from three research trials with identical procedures designed to assess individual smoking behavior using smokers preferred cigarette brands. Depression symptom level (asymptomatic, subsyndromal, syndromal) was defined using established Center for Epidemiological Depression Scale (CES-D) cutpoint criteria. Smokers were instructed to smoke as usual for one-week. At the beginning and end of the baseline period, nicotine dependence, smoking topography, CO boost, desire to smoke, anticipation of positive reinforcement, negative affect, and withdrawal were measured. ResultsOrdinary least squares linear regression models were used to test the association between depression symptom level and outcome measures adjusting for sex and education (N = 355). The results revealed no differences in topography measures, cigarettes per day and FTND. Smoking withdrawal and smoking urges were higher among both individuals with subsyndromal symptoms and syndromal depression symptoms compared to those who were asymptomatic. Individuals with subsyndromal depressive symptoms experienced higher smoke exposure and higher relief from negative affect. ConclusionIncreased smoke exposure, greater withdrawal symptoms and urges to smoke, and anticipation of negative affect relief among smokers with subsyndromal depression symptoms suggest that depression symptoms need not reach syndromal levels to alter smoking-related outcomes.

Perceived Stress and Smoking Cessation: The Role of Smoking Urges.

Despite the fact that perceived stress is related to abstinence smoking outcomes, no studies have investigated the mediational effect of specific tobacco-related variables on this relationship. This study aimed to explore the indirect effect of perceived stress on abstinence at the end of treatment through smoking urges. The sample comprised 260 treatment-seeking smokers (58.5% female; Mage = 46.00; SD = 11.1) who underwent psychological smoking cessation treatment. The brief version of the Questionnaire of Smoking Urges (QSU) and the Perceived Stress Scale (PSS14) were used. Mediation analyses were conducted in which smoking urges and their dimensions were potential mediators in the relationship between perceived stress and abstinence at the end of treatment. The results showed a non-significant direct effect of perceived stress on abstinence. However, a significant indirect effect was found through smoking urges (QSU-total) and, specifically, through smoking urges associated with the expectation of negative affect relief (QSU-Factor 2). A non-significant indirect effect through smoking urges related to the expectation of tobacco use as a pleasurable experience (QSU-Factor 1) was also found. Analyzing possible mediator variables could contribute to understanding previous conflicting data. These findings point to potential interest in including treatment components targeting perceived stress and smoking urges to improve the effectiveness of smoking cessation treatments.

Relationship of negative emotionality, NIAAA recovery, and 3- and 6-month drinking outcomes among adults in treatment for alcohol use disorder

BackgroundThe National Institute of Alcohol Abuse and Alcoholism (NIAAA) recently released a new definition of recovery from alcohol use disorder (AUD). A patient is considered recovered if they are remitted from DSM-5 AUD and report cessation of heavy drinking. The NIAAA has also recently proposed the Addictions Neuroclinical Assessment (ANA) to guide treatment research. Negative emotionality is one of three domains of the ANA and theory proposes that AUD is maintained by negative reinforcement via the relief of negative affect. The purpose of the current study was to examine: (1) the relationship of end-of-treatment negative emotionality and NIAAA recovery, and (2) the ability of NIAAA recovery at the end of treatment to predict three- and six-month drinking outcomes. MethodAt baseline and end-of-treatment, women and men (n = 181) in treatment for AUD completed measures of negative emotionality, drinking, and were assessed for DSM-5 AUD diagnostic criteria. At three- and six-months post-treatment, drinking was re-assessed. Results22.5% (n = 24) of participants met full criteria for NIAAA recovery at end-of-treatment. Lower levels of end of treatment negative emotionality were associated with increased odds of achieving NIAAA recovery. Meeting NIAAA recovery predicted greater percent days abstinent (PDA) and lower percent heavy drinking days (PHDD) at 3-months, but not at 6-months post-treatment. ConclusionsThis study is among the first to report a relationship between the negative emotionality domain of the ANA and NIAAA recovery. Results underscore the importance of addressing negative emotionality in treatment. Findings also suggest that NIAAA recovery predicts positive short term drinking outcomes.

The Motivation for Alcohol Reward: Predictors of Progressive-Ratio Intravenous Alcohol Self-Administration in Humans.

The Progressive Ratio (PR) self-administration paradigm is a common pre-clinical method used to examine the motivation for a drug attributed to a craving, reward, or the relief of negative affect. The Computer-assisted Alcohol Infusion System (CAIS) enables intravenous alcohol self-administration behavior in humans. This system provides the investigator with control over the trajectory of each incremental breath alcohol concentration (BrAC) reward and the maximum BrAC allowed in a session. This paradigm allows participants to earn these alcohol rewards using a sequence of button presses specified by the investigator. The system employs a physiologically-based pharmacokinetic model-based algorithm to achieve the same incremental BrAC exposure in every participant. Participants (n = 11) took part in two identical sessions to examine test-retest reliability, and an additional group (n = 73) completed a single session. Sessions began with a 25 min priming phase: participants were instructed to press a button an increasing number of times per reward, accumulating four standardized incremental BrAC trajectories. The second phase comprised an ad-lib, PR paradigm lasting 125 min. Each reward required an increasing number of button presses. Measures of self-administration included: average and peak BrAC, total rewards earned, total grams of ethanol consumed per unit of total body water, the total number of button presses, and the average rate of button pressing. Self-administration measures were highly correlated both between and within sessions, demonstrating test-retest reliability and internal consistency. Recent drinking history was strongly associated with self-administration measures; heavier drinkers chose greater alcohol self-administration. These results indicate the reliability and sensitivity of this progressive-ratio intravenous alcohol self-administration method for assessing the motivational properties of alcohol, with the potential for improved testing of the efficacy of new medications thought to reduce consumption of alcohol. This method can be used to understand the genetic and environmental determinants of alcohol self-administration in humans.

The Motivation for Alcohol Reward: Predictors of Progressive-Ratio Intravenous Alcohol Self-Administration in Humans

The Progressive Ratio (PR) self-administration paradigm is a common pre-clinical method used to examine the motivation for a drug attributed to a craving, reward, or the relief of negative affect. The Computer-assisted Alcohol Infusion System (CAIS) enables intravenous alcohol self-administration behavior in humans. This system provides the investigator with control over the trajectory of each incremental breath alcohol concentration (BrAC) reward and the maximum BrAC allowed in a session. This paradigm allows participants to earn these alcohol rewards using a sequence of button presses specified by the investigator. The system employs a physiologically-based pharmacokinetic model-based algorithm to achieve the same incremental BrAC exposure in every participant. Participants (n = 11) took part in two identical sessions to examine test-retest reliability, and an additional group (n = 73) completed a single session. Sessions began with a 25 min priming phase: participants were instructed to press a button an increasing number of times per reward, accumulating four standardized incremental BrAC trajectories. The second phase comprised an ad-lib, PR paradigm lasting 125 min. Each reward required an increasing number of button presses. Measures of self-administration included: average and peak BrAC, total rewards earned, total grams of ethanol consumed per unit of total body water, the total number of button presses, and the average rate of button pressing. Self-administration measures were highly correlated both between and within sessions, demonstrating test-retest reliability and internal consistency. Recent drinking history was strongly associated with self-administration measures; heavier drinkers chose greater alcohol self-administration. These results indicate the reliability and sensitivity of this progressive-ratio intravenous alcohol self-administration method for assessing the motivational properties of alcohol, with the potential for improved testing of the efficacy of new medications thought to reduce consumption of alcohol. This method can be used to understand the genetic and environmental determinants of alcohol self-administration in humans.

Translation and psychometric validation of the Persian version of the Questionnaire on Smoking Urges for assessment of craving to smoke among university students.

BackgroundEven though tobacco is one of the most preventable causes of death worldwide, it endangers more than 8 million people yearly. In this context, meta-analyses suggest that a significant part of the general Iranian population over 15 years of age smoke and that there is a need for good screening tools for smoking cravings and urges in Iran. The present study reported the translation and investigated the psychometric properties (i.e., factor structure, validity, and reliability) of the Persian version of the Questionnaire on Smoking Urges (QSU) with 12 items in the Iranian context.MethodThe translation process and content validity of the items were examined entirely in an expert panel using the Content Validity Index. The total sample of participants in which the translated version was tested consisted of 392 (172 female, 220 male, Mage = 22.31 years, SD = 2.90) university students who answered the QSU 12-item at the start of their participation in smoking cessation interventions. The QSU 12-item was firstly translated, then piloted using a subsample of 150 university students and finally validity and reliability of the instrument were investigated using a subsample of 242 participants. We tested the proposed models in the literature, that is, a 1-factor solution and a 2-factor solution with six items on each factor (Factor 1: desire/intention to smoke; Factor 2: relief of negative affect or withdrawal symptoms and anticipation of positive outcome). At last, we tested differences across differences in QSU-scores across different subgroups of individuals based on their demographics.ResultsThe results suggested that, in contrast to past studies, a modified 2-factor model, using five items for Factor 1 and 7 items for Factor 2, was the best fitting model (CFI = .95, RMSEA = .09, CI = 90%). Additionally, the QSU 12-item Persian version showed good convergent and divergent validity, internal consistency (Factor 1 = .94, Factor 2 = .97), ICC (average measure ICC = .95, CI = 95%, F(391, 4301) = 20.54, p < .001), concurrent validity (r = .71, p < .01), and discriminant validity (r = −.04, p > .05). Finally, subgroups based on gender, marital status, (un)employment, and educational level did not differed in their responses to the QSU 12-item.ConclusionThe Persian version of the QSU 12-item has satisfactory psychometric properties and, with a slight modification, it can be considered as a reliable and valid method to estimate smoking urges in the Iranian population. Moreover, the QSU 12-item seems appropriate to measure urge for smoking among groups of individuals with different sociodemographic backgrounds. Importantly, the QSU 12-item differentiates individuals’ desire and intention to smoke from their anticipated relief of negative affect or withdrawal symptoms, which can be important for personalizing interventions targeting individuals who want to quit smoking.

Associations between pain intensity and urge to smoke: Testing the role of negative affect and pain catastrophizing

BackgroundCigarette smokers are more likely to experience pain than nonsmokers, and experimental research indicates that pain is a potent motivator of smoking. Urge to smoke is a predictor of early relapse, yet associations between pain and urge to smoke have yet to be tested among daily smokers. This study aimed to conduct the first crosssectional test of associations between current pain intensity and urge to smoke, and to test the role of negative affect and pain catastrophizing in relations between pain intensity and urge to smoke. MethodsParticipants (N = 229, 42.4% Female, 38.9% black/African American, Mcpd = 21.9) were recruited for a laboratory study of pain and smoking, and these data were collected at the baseline session. Data were analyzed using a series of regressions and conditional process models. ResultsCurrent pain intensity was positively associated with urge to smoke, and urge to smoke for the relief of negative affect. There was an indirect association via state negative affect, such that pain intensity was positively associated with negative affect, which in turn was associated with greater urge to smoke. Further, positive associations between pain intensity and urge to smoke were only evident among smokers who endorsed low (vs high) levels of catastrophizing. ConclusionsThese findings contribute to an emerging literature indicating that pain and related constructs are relevant to the maintenance of tobacco smoking. Future research should examine how painrelevant cognitive-affective factors may influence associations between the experience of pain and motivation to smoke tobacco.

Predictors of urge to smoke under stressful conditions: An experimental investigation utilizing the PASAT-C task to induce negative affect in smokers.

Experimental evidence has demonstrated that the presence of cues previously associated with smoking behavior can increase urges to smoke in abstinent smokers. This study examined the effect of a laboratory-induced negative affective task (paced auditory serial addition task) on smoking urges among a sample of 35 abstinent college smokers (Mage = 20.83 years, SD = 1.71). Emotional states and physiological reactions experienced during the experiment, as well as individual differences in stress intolerance (anxiety sensitivity and experiential avoidance) were examined as predictors of the association between stressful states and smoking cravings. Smoking urges (smoking desire and negative affect relief) and negative emotions (frustration, irritability, stress) significantly increased, whereas positive emotions decreased from pre- to posttask. No significant interactions between individual differences and changes in urge were found. Results suggest that changes in negative affect may in part explain the association between induced stress and smoking cravings. (PsycINFO Database Record

Type A/Type B Alcoholism Predicts Differential Response to Topiramate in a Smoking Cessation Trial in Dually Diagnosed Men.

Babor's A/B typology characterizes alcohol-dependence subtypes, which differ across multiple defining variables; however, differences in cigarette smoking and cessation between these subtypes have not been previously investigated. Topiramate reduces heavy drinking and has separately been found to help non-alcohol-dependent individuals quit smoking. This study tested the hypothesis that topiramate's effects on smoking would be moderated by alcohol-dependence subtype, and explored craving as a mediator of this response. One hundred twenty-nine abstinent alcohol-dependent outpatient male smokers participated in this 12-week, randomized controlled trial comparing topiramate (maximum dosage 200 mg/day) with placebo, both with brief counseling, for smoking cessation. Participants were followed for 24 weeks following end of treatment. Of the 125 participants with sufficient subtyping data, k-means cluster analysis categorized 52 (42%) as Type A alcoholics and 73 (58%) as Type B. Types A and B did not differ on baseline smoking characteristics, urges to smoke, or smoking consequence scores. Longitudinal mixed-effects regression indicated that the effect of treatment on smoking was moderated by the Type × Time interaction. Specifically, during the nontreatment follow-up phase, Type B's treated with topiramate had relative suppressed levels of smoking compared with placebo-treated Type B's. This moderating effect of the Type × Time interaction was mediated by intention to smoke and craving related to relief of negative affect. Type B alcoholics demonstrated suppressed levels of smoking in response to topiramate treatment as compared with placebo, but only during the nontreatment follow-up phase. This effect was mediated, in part, through intention to smoke and craving to smoke to relieve negative affect. Our findings extend other studies demonstrating a differential medication response by alcoholism subtype.

Perceptions of Snus Among US Adult Smokers Given Free Product.

Snus uptake is nominal among US smokers. This longitudinal study examines (1) perceptions of snus among US smokers given free snus for 6 weeks and (2) a method for assessment of an alternative tobacco product at the population level. Adult smokers (n = 543; 69.2% female; Mage = 49.3 years), uninterested in quitting, received free snus for ad libitum use. Based on their snus use during a 6-week sampling period, participants included: (1) never users (18.4%, n = 100); (2) experimenters; that is, used ≥ once, but not during the last week of sampling (33.1%; n = 180); and (3) persistent users; that is, used ≥ once during the final week, and ≥ once during any other week of the sampling period. (48.4%; n = 263). Following the sampling period, those who became persistent users were more likely than experimenters to report that switching to alternative tobacco products would lower their risk for health problems (66.5% vs. 50.0%; p = .006). Persistent users also reported greater negative affect relief and craving reduction (ps < .001) than experimenters. Finally, persistent users were more likely than experimenters to describe snus in favorable terms with respect to ease of use, satisfaction, and liking (ps < .05). Subjective experiences with snus, rather than nicotine dependence, explained experimentation versus persistent use. Even among smokers who became persistent snus users, snus was perceived as a poor substitute for cigarettes. This study design (randomized, yet naturalistic) could be extended to other novel tobacco products, including e-cigarettes, to help understand the role new products may have in the tobacco landscape. This is the first large scale, US-based naturalistic assessment of smokers' reactions to snus during an extended sampling period. This study is directly in line with FDA goals to better understand predictors of initiation, uptake, and use of other tobacco products such as snus, and serves as model for assessment methods of alternative tobacco products at the population level. Most smokers tried the provided sample of snus (approximately 82%). Subjective experiences with snus, rather than nicotine dependence, explained experimentation versus persistent use. Even among smokers who became persistent snus users, snus was perceived as a poor substitute for cigarettes.

Time dependency of craving and response inhibition during nicotine abstinence

Background: Nicotine withdrawal produces increased craving for cigarettes and deficits in response inhibition, and these withdrawal symptoms are predictive of relapse. Although it is well established that these symptoms emerge early during abstinence, there is mixed evidence regarding whether they occur simultaneously. Given the importance of the early withdrawal period, this study examined craving and response inhibition at 24 h and 72 h abstinence. Methods: Twenty-one non-treatment seeking adult smokers were evaluated at baseline, 24 h, and 72 h abstinence for craving (Questionnaire on Smoking Urges – Brief) and response inhibition (Stop Signal Task, Stroop Task, Continuous Performance Task). Generalised linear regression models were used for primary outcomes, and Pearson correlations for examining the association between craving and response inhibition. Results: Factor 2 craving (anticipated relief of negative affect) increased from baseline to 24 h abstinent (p = 0.004), which subsided by 72 h (p = 0.08). Deficits in response inhibition measured by the Stop Signal Task were observed at 72 h (p = 0.046), but not 24 h (p = 0.318). No correlation was found between response inhibition and craving at any time point (p values>0.19), except between the Stroop Task and the factor 1 craving at baseline (p = 0.025). Conclusions: Factor 2 craving peaked at 24 h, whereas deficits in response inhibition did not emerge until 72 h, indicating that need to target craving and cognitive function during early abstinence may not occur simultaneously. Further characterizing the time course of withdrawal symptoms may guide development of targeted treatments for smoking cessation.

Associations of attention-deficit hyperactivity disorder symptom dimensions with smoking deprivation effects in adult smokers.

Identifying relations of attention deficit hyperactivity disorder (ADHD) symptom dimensions to individual facets of the tobacco withdrawal syndrome could elucidate the mechanisms linking ADHD and regular smoking. This study examined the unique relations of inattention (IN) and hyperactivity-impulsivity (HI) symptom dimensions of ADHD to a variety of tobacco withdrawal symptoms. One hundred thirty-two community-dwelling adult smokers recruited without regard to ADHD status completed a self-report measure of ADHD symptoms experienced over the past 6 months at a baseline visit. At two subsequent experimental sessions (one following overnight tobacco deprivation and one nondeprived; order counterbalanced), participants completed measures of tobacco withdrawal symptoms, mood, and desire to smoke. Preliminary analyses showed that higher levels of IN and HI symptoms were both associated with higher levels of negative affect and concentration difficulties during nondeprived ("baseline") states (ps < .01). Over and above nondeprived ratings, higher levels of HI symptoms were associated with larger deprivation-induced increases in negative affect, concentration problems, and desire to smoke, particularly for negative affect relief, during deprived states (ps < .01). ADHD symptoms, particularly HI symptoms, are associated with more severe exacerbations in abstinence-induced withdrawal symptoms, which could be an important mechanism of ADHD-smoking comorbidity. These findings suggest the need for clinical studies examining the role of these unique and potentially more severe withdrawal profiles experienced by smokers with high-levels of ADHD symptoms in smoking reinstatement and cessation outcomes.

Opioid antagonists for smoking cessation.

The reinforcing properties of nicotine may be mediated through release of various neurotransmitters both centrally and systemically. People who smoke report positive effects such as pleasure, arousal, and relaxation as well as relief of negative affect, tension, and anxiety. Opioid (narcotic) antagonists are of particular interest to investigators as potential agents to attenuate the rewarding effects of cigarette smoking. To evaluate the efficacy of opioid antagonists in promoting long-term smoking cessation. The drugs include naloxone and the longer-acting opioid antagonist naltrexone. We searched the Cochrane Tobacco Addiction Group Specialised Register for trials of naloxone, naltrexone and other opioid antagonists and conducted an additional search of MEDLINE using 'Narcotic antagonists' and smoking terms in April 2013. We also contacted investigators, when possible, for information on unpublished studies. We considered randomised controlled trials comparing opioid antagonists to placebo or an alternative therapeutic control for smoking cessation. We included in the meta-analysis only those trials which reported data on abstinence for a minimum of six months. We also reviewed, for descriptive purposes, results from short-term laboratory-based studies of opioid antagonists designed to evaluate psycho-biological mediating variables associated with nicotine dependence. We extracted data in duplicate on the study population, the nature of the drug therapy, the outcome measures, method of randomisation, and completeness of follow-up. The main outcome measure was abstinence from smoking after at least six months follow-up in patients smoking at baseline. Abstinence at end of treatment was a secondary outcome. We extracted cotinine- or carbon monoxide-verified abstinence where available. Where appropriate, we performed meta-analysis, pooling risk ratios using a Mantel-Haenszel fixed-effect model. Eight trials of naltrexone met inclusion criteria for meta-analysis of long-term cessation. One trial used a factorial design so five trials compared naltrexone versus placebo and four trials compared naltrexone plus nicotine replacement therapy (NRT) versus placebo plus NRT. Results from 250 participants in one long-term trial remain unpublished. No significant difference was detected between naltrexone and placebo (risk ratio (RR) 1.00; 95% confidence interval (CI) 0.66 to 1.51, 445 participants), or between naltrexone and placebo as an adjunct to NRT (RR 0.95; 95% CI 0.70 to 1.30, 768 participants). The estimate was similar when all eight trials were pooled (RR 0.97; 95% CI 0.76 to 1.24, 1213 participants). In a secondary analysis of abstinence at end of treatment, there was also no evidence of any early treatment effect, (RR 1.03; 95% CI 0.88 to 1.22, 1213 participants). No trials of naloxone or buprenorphine reported abstinence outcomes. Based on data from eight trials and over 1200 individuals, there was no evidence of an effect of naltrexone alone or as an adjunct to NRT on long-term smoking abstinence, with a point estimate strongly suggesting no effect and confidence intervals that make a clinically important effect of treatment unlikely. Although further trials might narrow the confidence intervals they are unlikely to be a good use of resources.

Low dose nicotine and antagonism of β2 subunit containing nicotinic acetylcholine receptors have similar effects on affective behavior in mice.

Nicotine leads to both activation and desensitization (inactivation) of nicotinic acetylcholine receptors (nAChRs). This study tested the hypothesis that nicotine and a selective antagonist of β2*nAChRs would have similar effects on affective behavior. Adult C57BL/6J male mice were tested in a conditioned emotional response (CER) assay which evaluates the ability of an aversive stimulus to inhibit goal-directed behavior. Mice lever-pressed for a saccharin reinforcer according to a variable schedule of reinforcement during sessions in which two presentations of a compound light/tone conditioned stimulus (CS) co-terminated with a 0.1 or 0.3 mA, 0.5 s footshock unconditioned stimulus (US). During testing in the absence of the US, mice received doses of i.p. nicotine (0, 0.0032, 0.01, 0.032, 0.1 mg/kg) or a selective β2 subunit containing nAChR (β2*nAChR) antagonist dihydro-beta-erythroidine (0, 0.1, 0.3, 1.0, 3.0 mg/kg DHβE). There was a dose-dependent effect of nicotine revealing that only low doses (0.01, 0.032 mg/kg) increased CER suppression ratios (SR) in these mice. DHβE also dose-dependently increased SR at the 3 mg/kg dose. In ethological measures of fear−/anxiety-like behavior, these doses of nicotine and DHβE significantly reduced digging behavior in a marble burying task and 0.3 mg/kg DHβE promoted open-arm activity in the elevated plus maze. Doses of nicotine and DHβE that altered affective behavior had no effect on locomotor activity. Similar to previous reports with anxiolytic drugs, low dose nicotine and DHβE reversed SR in a CER assay, decreased digging in a marble burying assay and increased open arm activity in the elevated plus maze. This study provides evidence that inactivation of β2*nAChRs reduces fear-like and anxiety-like behavior in rodents and suggests that smokers may be motivated to smoke in part to desensitize their β2*nAChRs. These data further identify β2*nAChR antagonism as a potential therapeutic strategy for relief of negative affect and anxiety.

Anxiety and smoking cessation outcomes in alcohol-dependent smokers

Anxiety-related characteristics, including anxiety sensitivity and trait anxiety, are elevated in individuals with alcohol and nicotine dependence and associated with greater difficulties with quitting smoking. However, little is known about how anxiety-related characteristics are related to smoking cessation outcomes in alcohol-dependent smokers. The present study, part of a larger smoking cessation clinical trial, examined associations between anxiety sensitivity, trait anxiety, nicotine withdrawal symptoms, smoking urges, and smoking cessation outcomes in a sample of 83 alcohol-dependent smokers. Participants were enrolled in concurrent alcohol and tobacco treatment as part of a substance-abuse intensive outpatient program. Smoking cessation treatment was administered in a 3-week cognitive-behavioral format that included 8 weeks of open-label nicotine patch treatment. Information on nicotine withdrawal, smoking urges, and CO-confirmed smoking consumption rates was collected at baseline, quit date, end of behavioral treatment, and at a 1-month follow-up. Higher levels of anxiety sensitivity were associated with more smoking urges due to anticipation of negative affect relief at quit date. Higher levels of trait anxiety were associated with more smoking urges due to positive reinforcement and anticipation of relief of negative affect at quit date, as well as more severe nicotine withdrawal symptoms at the end of treatment. Levels of anxiety sensitivity and trait anxiety were not associated with Cox regression survival times to relapse. These results indicate that for alcohol-dependent smokers, levels of anxiety sensitivity and trait anxiety are important to consider in the assessment and treatment of nicotine dependence.

μ-Opioid receptor availability in the amygdala is associated with smoking for negative affect relief

The perception that smoking relieves negative affect contributes to smoking persistence. Endogenous opioid neurotransmission, and the μ-opioid receptor (MOR) in particular, plays a role in affective regulation and is modulated by nicotine. We examined the relationship of MOR binding availability in the amygdala to the motivation to smoke for negative affect relief and to the acute effects of smoking on affective responses. Twenty-two smokers were scanned on two separate occasions after overnight abstinence using [¹¹C]carfentanil positron emission tomography imaging: after smoking a nicotine-containing cigarette and after smoking a denicotinized cigarette. Self-reports of smoking motives were collected at baseline, and measures of positive and negative affect were collected pre- and post- cigarette smoking. Higher MOR availability in the amygdala was associated with motivation to smoke to relieve negative affect. However, MOR availability was unrelated to changes in affect after smoking either cigarette. Increased MOR availability in amygdala may underlie the motivation to smoke for negative affective relief. These results are consistent with previous data highlighting the role of MOR neurotransmission in smoking behavior.

Expectancy for negative affect relief due to smoking may not be predictive under acute mood situations.

Smoking behavior may be more persistent among those who expect that smoking will relieve negative affect (NA). Assessing smoking expectancies temporally close to mood situations could enhance the predictive value of that assessment. Dependent smokers (n = 71; 43 male, 28 female) participated in five laboratory sessions, each involving mood induction. The NA relief scale of the Smoking Consequences Questionnaire-Adult (SCQ-A), a very common measure of smoking expectancies during hypothetical situations, was assessed during initial screening. The SCQ-A was compared with a modified acute version administered each session, in which items asked about immediate expectancy for NA relief by smoking "right now" (termed Immediate Negative Affect Relief, or INAR). Actual NA relief due to smoking was measured each session by change on the NA scale of the Diener & Emmons Mood Form. The five sessions (counterbalanced) involved three different negative mood tasks, the negative mood condition of overnight smoking abstinence, and neutral mood (control). Generalized estimating equations showed that temporal proximity to the mood situation slightly enhanced the ability of expectancy to predict actual change in NA due to smoking, as the interaction with condition was significant for the INAR but marginal for the SCQ-A. However, the acute INAR predicted NA relief due to smoking only after overnight smoking abstinence and not during the other specific mood induction conditions, contrary to expectations, while the SCQ-A was not significant during any of the individual conditions. In sum, assessment of expectancy for NA relief may be of limited use in predicting actual NA relief from smoking during a current mood situation, aside from NA due to overnight abstinence.

Nonsuicidal Self-Injury as a Predictor of Suicidal Behavior in Depressed Adolescents

Nonsuicidal Self-Injury as a Predictor of Suicidal Behavior in Depressed Adolescents

Disruption of maternal parenting circuitry by addictive process: rewiring of reward and stress systems.

Addiction represents a complex interaction between the reward and stress neural circuits, with increasing drug use reflecting a shift from positive reinforcement to negative reinforcement mechanisms in sustaining drug dependence. Preclinical studies have indicated the involvement of regions within the extended amygdala as subserving this transition, especially under stressful conditions. In the addictive situation, the reward system serves to maintain habitual behaviors that are associated with the relief of negative affect, at the cost of attenuating the salience of other rewards. Therefore, addiction reflects the dysregulation between core reward systems, including the prefrontal cortex (PFC), ventral tegmental area (VTA), and nucleus accumbens (NAc), as well as the hypothalamic–pituitary–adrenal axis and extended amygdala of the stress system. Here, we consider the consequences of changes in neural function during or following addiction on parenting, an inherently rewarding process that may be disrupted by addiction. Specifically, we outline the preclinical and human studies that support the dysregulation of reward and stress systems by addiction and the contribution of these systems to parenting. Increasing evidence suggests an important role for the hypothalamus, PFC, VTA, and NAc in parenting, with these same regions being those dysregulated in addiction. Moreover, in addicted adults, we propose that parenting cues trigger stress reactivity rather than reward salience, and this may heighten negative affect states, eliciting both addictive behaviors and the potential for child neglect and abuse.