Smoking and Panic Vulnerability

描述(申请人提供)：尽管吸烟仍然是美国死亡和残疾的主要原因，但针对吸烟者中与焦虑相关的个体差异变量的数据非常有限，这些变量可能与患恐慌症和保持吸烟行为的风险增加有关。这种信息的缺乏严重阻碍了识别吸烟者对与恐慌有关的问题的易感性增加的努力，并阻碍了能够有意义地解决他们独特需求的专门预防方案的未来发展。目前修订的R03提案应该有助于填补文献中的这些重要空白，通过检查焦虑敏感性可能调节的程度(1)吸烟水平和对身体感觉的恐惧反应之间的关系，以及(2)负面情绪减少预期和吸烟水平之间的关系。我们将使用二氧化碳挑战程序检查110名当前吸烟者(每天吸烟5至40支或更多，总样本的平均吸烟水平为每天20支)的非临床个体。受试者将完成诊断性访谈，以排除精神病理学(不包括尼古丁依赖)、过期一氧化碳(CO)和丹参可替宁分析，以及一套评估心理和吸烟特征的自我报告措施。在15分钟的休息之后，他们将抽一支标准化的香烟(等同于尼古丁戒断)，然后他们将完成二氧化碳挑战。会议将持续约2.5小时。该项目的结果将提供关键的知识和必要的信息，以帮助未来制定专门的恐慌症预防计划，专门针对吸烟和焦虑敏感的可塑性风险因素。因此，本提案具有创新性，因为它的目的是发展关于一群独特的高风险个人的经验知识，对他们来说，目前没有专门的预防办法来满足他们的具体需要，或正在制定中。这项研究还将有助于我们从理论上理解焦虑、精神病理学和物质使用障碍的共同发病率，并有助于更好地理解吸烟对负面情绪反应影响的调节模型。

DESCRIPTION (provided by applicant): Although smoking remains the leading cause of death and disability in the U.S., data addressing anxiety-related individual difference variables among smokers that may relate to increased risk for developing panic disorder and the maintenance of smoking behavior are highly limited. The absence of such information seriously hinders efforts to identify smokers with increased susceptibility to panic-related problems and stymies the future development of specialized prevention programs that can meaningfully address their unique needs. The present revised R03 proposal should help begin to fill these important gaps in the literature by examining the extent to which anxiety sensitivity may moderate (1) the relation between level of smoking and fear responding to bodily sensations and (2) the relation between negative affect reduction expectancies and level of smoking. We will examine 110 nonclinical individuals who are current smokers (between 5 and 40 or more cigarettes per day, with the average smoking level for the total sample being 20 cigarettes per day) using a CO2 challenge procedure. Subjects will complete a diagnostic interview to rule out psychopathology (excluding nicotine dependence), expired Carbon Monoxide (CO) and salvia cotinine analyses as well as a set of self-report measures assessing psychological and smoking characteristics. After a 15-minute break during which they will then smoke a standardized cigarette (to equate nicotine withdrawal), they will complete the CO2 challenge. The session will last approximately 2.5 hours. The results of this project will provide the critical knowledge and requisite information to assist in future efforts to develop specialized prevention programs for panic disorder that specifically target the malleable risk factors of cigarette smoking and anxiety sensitivity. Thus, the present proposal is innovative in the sense that it is aimed at developing empirical knowledge about a unique group of high-risk individuals, for whom no specialized prevention approach to address their specific needs currently exists or is in development. This research also will uniquely contribute to our theoretical understanding of the co-morbidity of anxiety psychopathology and substance use disorders generally and aid in better understanding moderator models of smoking's effects on negative emotional responding specifically.