The role of anxiety sensitivity and smoking in adolescent panic vulnerability

描述(由申请人提供)：尽管在患有恐慌症和恐慌症的个人中吸烟率很高，但关于吸烟与青少年惊恐相关过程之间的联系的研究很少。事实上，还没有研究在年轻人的实验室范例中将吸烟与公认的与恐慌相关的焦虑敏感性(AS)风险因素结合起来。这种相对程度的忽视是不幸的，因为青春期是一个“高风险”发育期，在这段时间里，日常吸烟和恐慌症发作通常都是首先发生的。因此，本提案旨在通过研究AS是否缓和吸烟史和对青少年中自愿过度换气挑战的恐惧反应之间的关系来填补经验文献中的这一空白。这项拟议的研究是对过度换气挑战的情绪反应的多方法实验室评估。参与者将是180名心理健康的青少年，平均分布在吸烟的不同阶段(即不吸烟者、尝试吸烟者、实验者、经常吸烟者和日常吸烟者)。这项研究包括管理结构化的临床访谈，通过过期的一氧化碳分析验证烟草使用，自我报告评估，以及过度换气挑战程序。据假设，与所有其他变量组合相比，处于吸烟吸收更高级阶段的AS高水平人群，将证明对过度换气挑战的恐慌相关反应水平最高，恢复最慢。这项研究与美国国立卫生研究院的目标相关，因为更全面地了解吸烟和恐慌易感性之间的关系，将提供有关青少年吸烟者中与临床相关的个体差异的关键信息，这些差异与惊恐障碍的发展和吸烟行为的维持增加相关。该项目具有公共卫生意义，因为它关注精神病理学的两个相互关联的可塑性风险因素。因此，它将为青少年中的恐慌和吸烟过程的临床干预努力提供信息。

DESCRIPTION (provided by applicant): Despite the high rates of cigarette smoking among individuals with panic attacks and panic disorder, there is very little research on the association between smoking and panic-relevant processes among youth. Indeed, there is no research that has integrated smoking with the well-established panic-relevant risk factor of anxiety sensitivity (AS) in a laboratory paradigm among youth. This relative degree of neglect is unfortunate, as adolescence is a "high-risk" developmental period during which both daily smoking and panic attacks typically first occur. Accordingly, the present proposal aims to fill this gap in the empirical literature by examining whether AS moderates the relation between smoking history and fearful-responding to a voluntary hyperventilation challenge among adolescents. The proposed study is a multimethod laboratory evaluation of emotional responding to a hyperventilation challenge. Participants will be 180 psychologically healthy adolescents, evenly divided across the various stages of smoking uptake (i.e., Non-smokers, Tried Smoking, Experimenters, Regular Smokers, and Daily Smokers). The study involves the administration of a structured clinical interview, verification of tobacco use via expired CO analyses, self-report assessments, and a hyperventilation challenge procedure. It is hypothesized that persons high in AS who are at more advanced stages of smoking uptake, relative to all other variable combinations, will evidence the highest levels of panic-relevant responding to, and slowest recovery from, the hyperventilation challenge. This research is relevant to NIH objectives because a more comprehensive understanding of the relationship between cigarette smoking and panic vulnerability will provide critical information on clinically- relevant individual differences among adolescent smokers that relate to an increased susceptibility for panic disorder development and the maintenance of smoking behavior This project is has public health significance because it focuses on two inter-related malleable risk factors for psychopathology. As such, it will inform clinical intervention efforts for both panic and smoking processes among youth.