Trauma-related cognitions predict treatment response in smokers with PTSD: Evidence from cross-lagged panel analyses.
Trauma-related cognitions predict treatment response in smokers with PTSD: Evidence from cross-lagged panel analyses.
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创伤相关认知可预测患有 PTSD 的吸烟者的治疗反应：来自交叉滞后面板分析的证据。
DOI：
10.1016/j.addbeh.2020.106376
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发表时间：
2020
影响因子：
4.4
通讯作者：
Foa,Edna
中科院分区：
文献类型：
--
作者：
Mu,Wenting;Narine,Kevin;Farris,Samantha;Lieblich,Shari;Zang,Yinyin;Bredemeier,Keith;Brown,Lily;Foa,Edna
目的与无创伤后应激障碍(PTSD)的吸烟者相比，患有创伤后应激障碍(PTSD)的吸烟者吸烟更多，戒烟成功率更低。然而，有限的研究检查了这种高度合并症背后的认知途径。本研究首次在接受创伤后应激障碍治疗的吸烟者中同时模拟创伤相关认知和吸烟之间以及创伤相关认知和创伤后应激障碍严重程度之间的横断面和滞后关系。方法 等人(n=Foa等人)寻求戒烟和创伤后应激障碍治疗，这是一项随机对照试验的一部分，该试验使用或不使用辅助性长期暴露(仅限 + PE和varenicline)(Foa等人，2017)。数据可用于创伤认知、吸烟严重程度和创伤后应激障碍症状的基线和治疗结束评估。我们进行了横断面和滞后分析，同时检验了创伤认知与1)吸烟和2)创伤后应激障碍症状的双向关系。结果在只接受varenicline治疗的参与者中，创伤认知(特别是对自我和世界的负面信念)与治疗结束时的香烟/天显著相关。然而，基线创伤认知并不能预测治疗后吸烟/天。基线创伤认知(特别是对自我和世界的负面信念)与基线和治疗结束时的创伤后应激障碍严重程度相关；此外，基线时的负面认知对治疗结束后的创伤后应激障碍严重程度有积极和前瞻性的预测作用，但反之亦然。Wald测试显示，这些交叉滞后关系没有治疗效果。结论这些发现为创伤相关认知在PTSD和吸烟并存的患者戒烟治疗中的重要性提供了新的经验支持。
ObjectiveCompared to smokers without posttraumatic stress disorders (PTSD), smokers with PTSD smoke more heavily and are less successful in quitting smoking. However, limited research has examined the cognitive pathways underlying this heightened comorbidity. The current study is the first to simultaneously model the cross-sectional and lagged relationships between trauma-related cognitions and cigarette smoking, as well as between trauma-related cognitions and PTSD severity, in smokers with comorbid PTSD receiving treatment.MethodParticipants (n= 142) were seeking treatment for smoking cessation and PTSD as part of a randomized controlled trial of varenicline and smoking cessation counseling with or without adjunctive Prolonged Exposure (varenicline + PE vs. varenicline only) (Foa et al., 2017). Data were available for bothbaselineandend-of-treatmentassessments of trauma cognitions severity of cigarette smoking and PTSD symptoms. We conducted both cross-sectional and lagged analysis to simultaneously examine the bidirectional relationship from trauma cognitions and 1) cigarette smoking and 2) PTSD symptoms.ResultsTrauma cognitions (specifically, negative beliefs about the self and the world) were significantly associated with cigarette/day at the end of treatment for participants who received varenicline only. However, baseline trauma cognitions did not predict post-treatment cigarettes/day. Baseline trauma cognitions (specifically negative beliefs about the self and world) were associated with PTSD severity at both baseline and end of treatment; furthermore, these negative cognitions at baseline positively and prospectively predicted end-of-treatment PTSD severity, but not vice versa. Wald tests revealed that there were no treatment effects on these cross-lagged relationships.ConclusionsThese findings provide novel empirical support for the importance of addressing trauma-related cognitions in the smoking cessation treatment efforts for patients with comorbid PTSD and cigarette smoking.