Marijuana-related problems and social anxiety: the role of marijuana behaviors in social situations

Individuals with elevated social anxiety appear particularly vulnerable to marijuana-related problems. In fact, individuals with social anxiety may be more likely to experience marijuana-related impairment than individuals with other types of anxiety. It is therefore important to determine whether constructs particularly relevant to socially anxious individuals play a role in the expression of marijuana-related problems in this vulnerable population. Given that both social avoidance and using marijuana to cope with negative affect broadly have been found to play a role in marijuana-related problems, the current study utilized a new measure designed to simultaneously assess social avoidance and using marijuana to cope in situations previously identified as anxiety-provoking among those with elevated social anxiety. The Marijuana Use to Cope with Social Anxiety Scale (MCSAS) assessed behaviors regarding 24 social situations: marijuana use to cope in social situations (MCSAS-Cope) and avoidance of social situations if marijuana was unavailable. In Study 1, we found preliminary support for the convergent and discriminant validity and internal consistency of the MCSAS scales. In Study 2, we examined if MCSAS scores were related to marijuana problems among those with (n = 44) and without (n = 44) clinically elevated social anxiety. Individuals with clinically meaningful social anxiety were more likely to use marijuana to cope in social situations and to avoid social situations if marijuana was unavailable. Of importance, MCSAS-Cope uniquely mediated the relationship between social anxiety group status and marijuana-related problems. Results highlight the importance of contextual factors in assessing marijuana-related behaviors among high-risk populations.     

Anxiety sensitivity and daily cigarette smoking in relation to sleep disturbances in treatment-seeking smokers

ABSTRACT

Although the association between anxiety and sleep disturbance is well-documented, the underlying mechanisms are less clear. Anxiety sensitivity (AS), the fear of physiological arousal and bodily sensations, is a risk factor for anxiety and poor sleep. Smoking also contributes to poor sleep and may compound the effects of AS on sleep quality. This study evaluated the main and interactive effects of AS and cigarettes/day on sleep quality among smokers. Participants (n = 190) were adult treatment-seeking daily smokers who completed a baseline assessment as part of a larger smoking cessation trial. Sleep quality was self-reported. Results indicated that AS was significantly correlated with greater disturbance in sleep duration, subjective sleep quality, sleep onset latency, sleep disturbance, daytime dysfunction, and sleep medication use. There was a significant interaction between AS and cigarettes/day in terms of sleep onset latency, but not other sleep quality indices. AS was associated with significantly longer sleep onset latency minutes among heavier smokers, but not lighter smokers. Specifically, the association between AS and sleep onset latency was significant for those who smoked ≥ 33 cigarettes/day. AS is a psychological factor that may contribute to poor sleep quality, especially in heavy smokers, and thus may be a promising intervention target.     

吸烟者感知吸烟社会规范与社交性吸烟行为的关系：身份认同和关系观的作用

考察吸烟者身份认同和关系观在感知吸烟社会规范与社交性吸烟行为关系中的作用。对1016名吸烟者进行问卷调查,结果表明：（1）感知吸烟社会规范显著正向预测社交性吸烟;（2）身份认同对感知吸烟社会规范和社交性吸烟关系起部分中介作用;（3）关系观正向调节感知吸烟社会规范和社交性吸烟的关系,而对感知吸烟社会规范和身份认同关系的调节不显著。研究支持了感知吸烟社会规范影响社交性吸烟的身份认同机制和文化价值观调节机制。     

Implicit associations between smoking and social consequences among smokers in cessation treatment

Explicit expectations of the negative and positive social consequences of smoking are likely to have substantial influence on decisions regarding smoking. However, among smokers trying to quit, success in smoking cessation may be related not only to the content of expectancies about smoking's social effects but also to the ease with which these cognitive contents come to mind when confronted with smoking stimuli. To examine this possibility, we used the implicit association test (IAT) [Greenwald, A. G., McGhee, D. E., & Schwartz, J. L. K. (1998). Measuring individual differences in implicit cognition: The implicit association test. Journal of Personality and Social Psychology, 74, 1464-1480] to assess implicit cognitive associations between smoking and negative vs. positive social consequences among 67 heavy social drinkers seeking smoking cessation treatment in a randomized clinical trial. Results showed that the relative strength of implicit, negative, social associations with smoking at baseline predicted higher odds of smoking abstinence during treatment over and above the effects of relevant explicit measures. The only variable that significantly correlated with IAT scores was the density of smokers in participants' social environment; those with more smoking in their social environment showed weaker negative social associations with smoking. Results suggest implicit cognition regarding the social consequences of smoking may be a relevant predictor of smoking cessation outcome.     

Effects of Smoking Social Cues on Inhibitory Control in Smokers: An Event-Related Potential Study

ObjectiveReduced inhibitory control is a general characteristic of smokers and becomes increasingly pronounced in smoking-related contexts. However, research has rarely considered differences in the effects of various smoking-related cues. To fill this research gap, this study compared the effects of smoking object-related and smoking social-related cues on inhibitory control in smokers.MethodsWe used a visual Go/NoGo paradigm with three types of long-lasting backgrounds (neutral, smoking object, and smoking social background) to record the error rates, reaction times, and amplitudes of the N2 and P3 event-related potentials (ERPs) by 25 smokers and 25 non-smokers.Results(1) Smokers displayed smaller NoGo-N2 amplitudes than controls under the neutral background; (2) smokers displayed smaller NoGo-N2 amplitudes under the smoking social background and smoking object background than they did under the neutral background; (3) relative to neutral and smoking object backgrounds, smokers displayed higher commission error rates, shorter reaction times, and larger NoGo-P3 amplitudes under smoking social background.ConclusionSmoking-related stimuli impair inhibitory control in smokers, especially when these stimuli are socially related.     

Body Mass Index and functional impairment: the explanatory role of anxiety sensitivity among treatment-seeking smokers

Obesity and smoking are highly prevalent public health concerns in the United States. Data indicate that elevated Body Mass Index (BMI) is related to functional impairment. However, there is limited understanding of mechanisms that may explain their comorbidity among smokers. The current study sought to test whether anxiety sensitivity explained the relation between BMI and functional impairment among 420 (46.9% females; M_age = 38 years, SD = 13.42) treatment-seeking, adult smokers. Results indicated that BMI yielded a significant indirect effect through anxiety sensitivity for functional impairment, b = 0.01, SE = .01, 95% CI = [.002, .021]. These findings remained significant after controlling for participant sex, negative affectivity, tobacco dependence, psychopathology, and medical conditions (i.e. hypertension, heart problems, respiratory disease, asthma). Such data provide novel empirical evidence that, among smokers, BMI may be a risk factor for functional impairment indirectly through anxiety sensitivity. Overall, such findings could potentially inform the development of personalized interventions among this particularly vulnerable segment of the smoking population.     

Characteristics of exiled smoking from workplaces

Abstract

This paper explores factors influencing the extent of exiled smoking from workplaces: that is leaving work so as to smoke a cigarette. Exiled smoking may be disruptive to work practices and it is a means by which smokers minimise the effects of workplace smoking bans on their daily consumption. As such it reduces possible health benefits that might have resulted from a greater decrease in consumption. Smokers (n = 145) were recruited while engaging in exiled smoking. The results indicate that among this group (of largely regular exiled smokers), indices of addiction were only loosely related to the extent of exiled smoking, and it did not appear to be primarily driven by social benefits. While most preferred taking breaks with company, the lack of company would only inhibit a minority. Perceived improvements in capacity to work was a common reason, as was the opportunity to discuss work related problems. Enjoyment of the cigarette and the opportunity to break up the day were also important. It appears exiled smoking is multiply determined. To the extent addiction is involved, it is not through strongly felt urges to smoke, but is more due to minor irritation such as reduced ability to concentrate. It is suggested that such experiences provide the extra motivation to take a break that non-smokers may think about but rarely feel sufficiently motivated to do.     

Anxiety, anxiety disorders, tobacco use, and nicotine: a critical review of interrelationships

Smoking is highly prevalent across most anxiety disorders. Tobacco use increases risk for the later development of certain anxiety disorders, and smokers with anxiety disorders have more severe withdrawal symptoms during smoking cessation than smokers without anxiety disorders. The authors critically examined the relationships among anxiety, anxiety disorders, tobacco use, and nicotine dependence and reviewed the existing empirical literature. Future research is needed to better understand the interrelationships among these variables, including predictors, moderators, and mechanisms of action. Increased knowledge in these areas should inform prevention efforts as well as the development and improvement of smoking cessation programs for those with anxiety and other psychiatric disorders.     

Smoking motives in the prediction of affective vulnerability among young adult daily smokers

The primary aim of this study was to examine whether smoking to reduce negative affect was uniquely related to a range of affective vulnerability factors (e.g., anxiety sensitivity, anxious arousal, and negative affectivity) among daily smokers. Participants were 276 young adult daily smokers (124 females; M(age)=25.12, SD=10.37). Partially consistent with prediction, the motivation to smoke to reduce negative affect was significantly related to anxiety sensitivity and negative affectivity, but not anxious arousal; the observed significant effects were above and beyond other theoretically relevant factors (e.g., smoking rate, years smoked, age, gender). In contrast to prediction, habitual smoking motives demonstrated significant incremental associations with anxiety sensitivity and anxious arousal symptoms. These results suggest that there are important associations between certain smoking motives and negative affective states and that such relations are not attributable to other smoking factors (e.g., smoking rate).     

Social anxiety and post-event processing among African-American individuals

Background: Social anxiety is among the most prevalent psychiatric conditions, yet little attention has been paid to whether putative cognitive vulnerability factors related to social anxiety in predominantly White samples are related to social anxiety among historically underrepresented groups.

Design: We tested whether one such vulnerability factor, post-event processing (PEP; detailed review of social event that can increase state social anxiety) was related to social anxiety among African-American (AA; n?=?127) persons, who comprise one of the largest underrepresented racial groups in the U.S. Secondarily, we tested whether AA participants differed from non-Hispanic White participants (n?=?127) on PEP and social anxiety and whether race moderated the relation between PEP and social anxiety.

Method: Data were collected online among undergraduates.

Results: PEP was positively correlated with social anxiety among AA participants, even after controlling for depression and income, pr?=?.30, p?=?.001. AA and White participants did not differ on social anxiety or PEP, β?=??1.57, 95% CI: ?5.11, 1.96. The relation of PEP to social anxiety did not vary as a function of race, β?=?0.00, 95% CI: ?0.02, 0.02.

Conclusions: PEP may be an important cognitive vulnerability factor related to social anxiety among AA persons suffering from social anxiety.     

An Experimental Manipulation of Social Comparison in Social Anxiety

Negative self-appraisal is thought to maintain social anxiety particularly when comparing oneself to others. Work on social comparison suggests that gender may moderate the effects of social comparison in social anxiety. Self-appraisals of the desirability of one's personality may be more important to women, whereas self-appraisal of signs of anxiety may be more important to men. Within each gender, those with high social anxiety are expected to report more negative self-appraisal when comparing themselves to someone else described as high achieving. This study is the first we are aware of that examined gender-based interactive effects after a social comparison manipulation. Participants read a bogus profile of a fellow student's adjustment to college. They were randomly assigned to read a profile suggesting that the fellow student was “high achieving” or more normative in his/her achievements. When comparing to a “high achieving” individual, men with high social anxiety reported the most negative self-appraisals of their signs of anxiety. In addition, greater social anxiety was associated with a poorer self-appraisal of personality only among men. The implications of the findings for conceptualizing the role of social comparison in social anxiety are discussed.     

Smoking and psychological health in relation to country of origin

In English-speaking, Western-Anglo countries, where smoking has become stigmatized in recent decades as a result of widespread anti-smoking campaigns, smokers commonly report poorer psychological health on average than nonsmokers do. This may be indirectly related to the strong pressures to quit in such countries, as poorer psychological health is associated with a reduced likelihood of quitting, thus leading to a selection bias for smokers with relatively poorer psychological health. In the present study, 147 smoker and nonsmoker participants either came from Western-Anglo countries where smoking has become stigmatized (Australia, Canada, USA) or countries in regions where smoking remains relatively more accepted (Asia, Latin America, Europe). Smokers and nonsmokers were assessed on a widely used self-report measure of anxiety, depression, and stress. Multivariate analysis revealed a significant interaction between smoker status (smoker, nonsmoker) and country of origin (Western-Anglo, other) on psychological health ratings, with univariate analysis showing a significant interaction on anxiety scores. Among those from Western-Anglo countries, smokers reported significantly higher levels of anxiety than nonsmokers did, whereas there was no difference in anxiety between smokers and nonsmokers from other countries. There was no difference in the number of cigarettes smoked per day between the samples of smokers, indicating very similar levels of nicotine intake in the two groups. The findings support the notion that a selection bias for smokers with relatively poorer psychological health is occurring in Western-Anglo countries.     

Initiation and Maintenance of Tobacco Smoking: Changing Personality Correlates in Adolescence and Young Adulthood1

Youthful smokers have been described as extroverted and peer-involved, whereas older smokers are often characterized as depressed and withdrawn. Recognizing this contradiction, we examined cross-sectional and prospective associations between smoking and personality and social constructs assessed every 4 years in a sample (N= 461) originally recruited in junior high school. At Time 1, smoking was positively related to good social relations, extroversion, friends' cigarette use, and cheerfulness. At Times 2–4, smoking was positively related to depression and friends' cigarette use, negatively correlated with good Social Relations, and unrelated to extroversion. Cigarette use was stable over time, but least stable between Times 1 and 2. Findings suggest the instability of early social smoking with peers; those who persist may smoke for tension reduction and self-medication.     

Self-focused attention and safety behaviors across group therapies for social anxiety disorder

Background: Self-focused attention (SFA) and safety behaviors are two variables implicated in the maintenance of social anxiety disorder (SAD).

Design: The present study examined SFA and safety behaviors across two therapies for SAD, cognitive behavioral group therapy (CBGT) and mindfulness and acceptance-based group therapy (MAGT).

Method: Participants with symptoms meeting criteria for SAD (N?=?137) were randomly assigned to the 12-week-treatment groups (n?=?53 for each condition) or a waitlist control (n?=?31). Variables were assessed at baseline, midtreatment, posttreatment, and a 3-month follow-up.

Results: Both treatment conditions reported significantly lower SFA and safety behaviors compared to control, but did not differ from one another at posttreatment. Mediation analyses supported the following models: (1) safety behaviors mediating the relationship between SFA and social anxiety, and (2) SFA mediating the relationship between safety behaviors and social anxiety. These models were supported for both treatment groups.

Conclusions: Both treatments may have the potential to reduce the SFA and safety behaviors that serve to maintain SAD.     

Nature and role of change in anxiety sensitivity during NRT-aided cognitive-behavioral smoking cessation treatment

This study evaluated the associations between change in anxiety sensitivity (AS; fear of the negative consequences of anxiety and related sensations) and lapse and relapse during a 4-week group NRT-aided cognitive-behavioral Tobacco Intervention Program. Participants were 67 (44 women; M (age) = 46.2 years, SD = 10.4) adult daily smokers. Results indicated that participants who maintained high levels of AS from pretreatment to 1 month posttreatment, compared to those who demonstrated a significant reduction in AS levels during this time period, showed a significantly increased risk for lapse and relapse. Further inspection indicated that higher continuous levels of AS physical and psychological concerns, specifically among those participants who maintained elevated levels of AS from pre- to posttreatment, predicted significantly greater risk for relapse. Findings are discussed with respect to better understanding change in AS, grounded in an emergent taxonic-dimensional factor mixture model of the construct, with respect to lapse and relapse during smoking cessation.     

A multiple mediation model of trait worry and hazardous drinking among treatment-seeking smokers: the roles of coping and conformity drinking motives

ABSTRACT

Alcohol use is associated with poorer smoking cessation-related outcomes, and smokers with elevated levels of worry experience greater smoking cessation problems. Yet, little is known about the explanatory mechanisms that may underlie the relationship between trait worry and hazardous drinking among smokers. Therefore, this study explored the explanatory roles of coping and conformity drinking motives in the relationship between trait worry and hazardous drinking outcomes including alcohol consumption, alcohol problems, maximum number of drinks, and the number of prior alcohol quit attempts among treatment-seeking smokers. Participants included 377 treatment-seeking smokers who consumed at least one alcoholic drink in the last year (48% female; 86.2% Caucasian; M _age = 34.83 years, SD = 13.38). Results showed a significant indirect effect of trait worry through coping-related drinking motives in relation to alcohol consumption, alcohol problems, maximum number of drinks, and number of prior drinking quit attempts. These findings were evident after controlling for gender, cigarette dependence, and current psychopathology. These findings suggest that coping drinking motives are one mechanism that may explain the relation between trait worry and hazardous drinking outcomes among treatment-seeking smokers.     

A model of situational preference amongst smokers

Seventy-five medium-light smokers rated their performance for smoking in 25 situations covering a range of high- and low-stress situations. Information on personality, age, sex, length of habit, number of cigarettes smoked, amount inhaled and amount of cigarettes smoked was also obtained. Six main factors were extracted by principal-factor analysis which were related respectively to situations involving preparatory activity, attentional stress, neutral relaxation conditions, unpleasant (anxiety) and pleasant (excited) emotional stress and social vs isolated activity. Smokers who scored high on Neuroticism tended to smoke more when experiencing unpleasant emotions; older smokers smoked predominantly in pleasant relaxing conditions; extraverts and low-activity situational smokers, reported inhaling more. A model of smoker motivation is developed which suggests that both pharmacological and psychological factors contribute to habit maintenance. Three basic motivational types of smokers are identified: high-stress smokers for whom smoking is a secondary activity, and who rely on smoking to form a minor distraction for their current task. Low-activity smokers who wish to act, or change their current affective state in some way and who rely on pharmacological factors. Neutral relaxation smokers for whom smoking is a pleasurable activity in its own right.     

尼古丁依赖对男性吸烟者感知戒烟行为控制的预测：社会支持与抱怨批评的作用

考察尼古丁依赖对男性吸烟者感知戒烟行为控制的预测及他人戒烟社会支持和抱怨批评的调节作用。对326名男性吸烟者进行问卷调查,结果显示：（1）尼古丁依赖显著负向预测感知行为控制;（2）社会支持和抱怨批评共同调节两者关系;在高社会支持且低抱怨批评、高抱怨批评且低社会支持的条件下,尼古丁依赖的预测作用不显著。结果说明,高社会支持在尼古丁依赖削弱感知行为控制过程中起缓冲作用,而高抱怨批评削弱社会支持的缓冲作用。     

Quitting smoking: The importance of non-smoker identity in predicting smoking behaviour and responses to a smoking ban

Objective: We examined how ‘smoker’ and ‘non-smoker’ self- and group-identities and socio-economic status (SES) may predict smoking behaviour and responses to antismoking measures (i.e. the Dutch smoking ban in hospitality venues). We validated a measure of responses to the smoking ban.

Design: Longitudinal online survey study with one-year follow-up (N = 623 at T1 in 2011; N = 188 at T2 in 2012) among daily smokers.

Main outcome measures: Intention to quit, quit attempts and ‘rejecting’, ‘victimizing’, ‘socially conscious smoking’ and ‘active quitting’ responses to the smoking ban.

Results: Non-smoker identities are more important than smoker identities in predicting intention to quit, quit attempts and responses to the smoking ban, even when controlling for other important predictors such as nicotine dependence. Smokers with stronger non-smoker identities had stronger intentions to quit, were more likely to attempt to quit between measurements, and showed less negative and more positive responses to the smoking ban. The association between non-smoker self-identity and intention to quit was stronger among smokers with lower than higher SES.

Conclusion: Antismoking measures might be more effective if they would focus also on the identity of smokers, and help smokers to increase identification with non-smoking and non-smokers.     

Social anxiety and interpersonal stress generation: the moderating role of interpersonal distress

Background and Objectives: Existing models of social anxiety scarcely account for interpersonal stress generation. These models also seldom include interpersonal factors that compound the effects of social anxiety. Given recent findings that two forms of interpersonal distress, perceived burdensomeness and thwarted belongingness, intensify social anxiety and cause interpersonal stress generation, these two constructs may be especially relevant to examining social anxiety and interpersonal stress generation together.

Design: The current study extended prior research by examining the role of social anxiety in the occurrence of negative and positive interpersonal events and evaluated whether interpersonal distress moderated these associations.

Methods: Undergraduate students (N?=?243; M?=?20.46 years; 83% female) completed self-report measures of social anxiety, perceived burdensomeness, and thwarted belongingness, as well as a self-report measure and clinician-rated interview assessing negative and positive interpersonal events that occurred over the past six weeks.

Results: Higher levels of social anxiety were associated only with a higher occurrence of negative interpersonal dependent events, after controlling for depressive symptoms. This relationship was stronger among individuals who also reported higher levels of perceived burdensomeness, but not thwarted belongingness.

Conclusions: It may be important to more strongly consider interpersonal stress generation in models of social anxiety.