Patient-Informed Treatment Development of Behavioral Smoking Cessation for People With Schizophrenia

The objective of this study was to use qualitative methodology to tailor and refine an existing smoking cessation intervention for the population of people who use cigarettes and are diagnosed with schizophrenia, schizoaffective, or psychotic disorder. Successive cohort design methodology was used to iteratively modify the treatment in response to qualitative participant, therapist, and consultant feedback on the intervention. Qualitative methodology for participant feedback included analysis of semistructured interviews with participants, visualization of app utilization data, and stakeholder feedback from study therapists and consultants. Using the successive cohort design, a tailored multicomponent mobile health smoking cessation intervention was developed. The intervention included mobile contingency management (i.e., financial compensation for confirmed abstinence from smoking), pharmacotherapy for smoking cessation, cognitive-behavioral counseling sessions, and the Stay Quit app for relapse prevention. Two cohorts (N = 13) were completed in the study; after each cohort, the treatment protocol was revised. The intervention is described, as well as the qualitative findings from each cohort and subsequent changes made to the intervention based upon patient and provider feedback. Metrics of patient engagement included treatment adherence (40% in Cohort 1 and 63% in Cohort 2). Both participants and therapists reported that the intervention was helpful. Over one third of participants self-reported abstinence at posttreatment. Since qualitative methodology is often underutilized in mental health treatment development, this study demonstrates the utility of the successive cohort design for treatment development of behavior change interventions for at-risk, vulnerable populations.     

Technology‐based contingency management and e‐cigarettes during the initial weeks of a smoking quit attempt

Contingency management (CM) interventions are among the most effective behavioral interventions for smoking. This study assessed the effects of CM and electronic cigarettes (ECs) on smoking reductions and abstinence for durations of 30‐36 days. Twelve participants were exposed to Baseline, EC alone, and EC + CM conditions. An internet‐based platform was used to monitor smoking via breath carbon monoxide (CO) and deliver CM for smoking abstinence (CO ≤4 ppm). A Bluetooth‐enabled EC monitored daily EC puffs. Abstinence rates were equivalent between EC (34.4%) and EC + CM (30.4%) conditions. Both conditions promoted smoking reductions. We observed an inverse correlation between smoking and EC puffs (r = ‐.62, p < .05). Results suggest the use of electronic cigarettes can promote smoking reductions and abstinence, and CM did not improve these outcomes. Larger magnitude consequences or tailoring EC characteristics (e.g., flavor) may have improved outcomes. Technology‐based methods to collect intensive, longitudinal measures of smoking and electronic cigarette use may be useful to characterize their environmental determinants.     

Baseline reinforcement rate and resurgence of destructive behavior

Concepts from behavioral momentum theory, along with some empirical findings, suggest that the rate of baseline reinforcement may contribute to the relapse of severe destructive behavior. With seven children who engaged in destructive behavior, we tested this hypothesis in the context of functional communication training by comparing the effects of different baseline reinforcement rates on resurgence during a treatment challenge (i.e., extinction). We observed convincing resurgence of destructive behavior in four of seven participants, and we observed more resurgence in the condition associated with high‐rate baseline reinforcement (i.e., variable‐interval 2 s in Experiment 1 or fixed‐ratio 1 in Experiment 2) compared to a low‐rate baseline reinforcement condition. We discuss the implications of these results relative to schedules of reinforcement in the treatment of destructive behavior and strategies to mitigate resurgence in clinical settings.     

Cigarette smoking and personality change across adulthood: Findings from five longitudinal samples

Personality traits are related to cigarette smoking. However, little is known about the link between smoking and change in personality. Therefore, the present study examined whether current cigarette smoking and smoking cessation are associated with personality change across adulthood. Participants (n = 15,572) aged from 20 to 92 years were drawn from five longitudinal cohorts with follow-ups that ranged from 4 to 20 years. Compared to non-smokers, current smokers were more likely to increase on neuroticism and to decline on extraversion, openness, agreeableness and conscientiousness over time. Compared to the persistent smokers, those who quit had a steeper decline in agreeableness. Cigarette smoking is related to detrimental personality changes across adulthood, and the pattern was not improved by smoking cessation.     

A Systematic Review of Online Response Rates in Four Counseling Journals

This systematic review of articles published in 4 counseling journals found 207 articles that used online recruitment, of which 98 (47.3%) reported a response rate. These 98 studies collectively contained 22,466 individual participants. Results showed that nearly one third of all empirical articles used online recruitment, and the average response rate was 34.2% (SD = 22.6). Response rates are further described by journal, population, research methodology, and recruitment strategy. Researcher‐reported issues with online recruitment and data collection were also analyzed qualitatively, and recommendations for researchers are discussed.     

The relationship between religion and health-related behaviours in patients with borderline personality disorder

With addictive disorders frequently co-occurring among patients with borderline personality disorder (BPD), exploring factors that may influence health-related behaviours, like religious involvement, is important. This study assesses whether religious involvement is associated with smoking and alcohol use disorders (AUDs) in BPD subjects. This study used data from Wave 2 of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), which used the Alcohol Use Disorder and Associated Disabilities Interview Schedule–DSM-IV (AUDADIS-IV) as its assessment instrument. The AUDADIS-IV assessed personality disorders, tobacco usage, the presence of AUDs, and religious involvement. Attending a place of worship and weekly or more frequent worship attendance were significantly associated with reduced likelihood of current smoking and AUDs among BPD subjects. AUDs were also significantly less common in those reporting higher subjective religiousness. In conclusion, people with BPD who are religiously inclined are less likely to engage in addictive behaviours, specifically smoking and AUDs.     

运动员情绪调节心率变异性的影响因素

以183名运动员为被试,以心率变异性为指标,考察不同情绪状态、不同情绪调节策略下运动员自主神经反应的性别、运动年限、运动等级特点。结果发现：（1）快乐情绪状态下的心率变异性显著高于悲伤情绪状态下;表达抑制的心率变异性显著高于认知重评;短运动年限运动员的心率变异性显著高于长运动年限运动员;男性运动员的心率变异性显著高于女性运动员。（2）在快乐情绪状态下采用表达抑制策略时,低运动等级运动员的心率变异性显著高于高运动等级运动员;在悲伤情绪状态下,高运动等级运动员采用表达抑制策略比认知重评策略产生更高的心率变异性     

Depression and resilience mediate the relationship between traumatic life events and ill physical health: results from a population study

We set out to investigate the mediating roles of depression, resilience, smoking, and alcohol use, in the relationship between potentially traumatic life events and objective and subjective, physical and mental health in a single study. A face-to-face, population-based survey was conducted in Hong Kong (N = 1147). Information on health conditions and traumatic life events was obtained, and participants completed measures of subjective physical and mental health, depression, and resilience. Smoking and drinking were not significant mediators of the relationship between life events and both objective and subjective health. Depressive symptomatology was found to mediate the relationship between life threatening illness and subjective physical health, the relationship between abuse (physical and sexual) and subjective mental health, and the relationship between the death of a parent/partner and subjective mental health. Resilience was found to mediate the relationships between multiple traumatic life events and subjective physical and mental health. Our results indicate that psychological factors rather than biological are important mediators of the relationship between life events exposure and health. Our findings provide evidence that depressive symptomatology has a mediating role only in the case of specific potentially traumatic life events and that resilience is only a critical factor in the face of exposure to multiple traumatic events, rather than single events. Our results also indicate that behavioural factors, such as smoking and drinking, are not significant mediators of the relationship between life events and health.     

A measure of perceived pain and tobacco smoking interrelations: pilot validation of the pain and smoking inventory

Mounting evidence indicates that pain can motivate cigarette smoking behavior, smokers have reliably endorsed the use of tobacco to cope with pain, and there is reason to suspect that pain may impede smoking cessation. Smoking-related outcome expectancies are among the best predictors of cigarette consumption and relapse, and the goal of this pilot study was to develop a standardized measure of how tobacco smokers perceive their pain and smoking behavior to be interrelated (i.e. pain as a motivator of smoking, expectancies for smoking as a means of coping with pain, and pain as a barrier to quitting). Participants (N = 75) completed an online survey that was designed to assess interrelations between pain and tobacco smoking. The nine-item Pain and Smoking Inventory (PSI) demonstrated excellent internal consistency (α = .95). As expected, PSI scores were higher among smokers with chronic pain (vs. no pain), and were positively associated with established indices of both pain and tobacco smoking dependence. These results corroborate the notion that smokers can effectively communicate perceptions of interrelations between their pain and smoking behavior. Future research is needed to establish reliability and validity of the PSI among larger, more diverse samples of smokers with varying levels of pain. Future work should also examine PSI scores as predictors of smoking cessation outcomes, and whether PSI data may usefully inform the development of tailored interventions for smokers in pain.     

The influence of speech rate and accent on access and use of semantic information

Circumstances in which the speech input is presented in sub-optimal conditions generally lead to processing costs affecting spoken word recognition. The current study indicates that some processing demands imposed by listening to difficult speech can be mitigated by feedback from semantic knowledge. A set of lexical decision experiments examined how foreign accented speech and word duration impact access to semantic knowledge in spoken word recognition. Results indicate that when listeners process accented speech, the reliance on semantic information increases. Speech rate was not observed to influence semantic access, except in the setting in which unusually slow accented speech was presented. These findings support interactive activation models of spoken word recognition in which attention is modulated based on speech demands.