UVM Theses and Dissertations
Format:
Print
Author:
Leyro, Teresa M.
Dept./Program:
Psychology
Year:
2012
Degree:
PhD
Abstract:
Research indicates that smoking onset is significantly and prospectively linked to the development of Panic Disorder (PO) (e.g. Breslau et aI., 2004), and that their combination may put individuals at greater risk for more intense panic-relevant psychopathology (e.g. Zvolensky et aI., 2004a) and poorer smoking-related outcomes (e.g., Covey et aI., 1994, Piper et aI., 2010, Zvolensky, Schmidt et aI., 2005b). However, little is understood regarding potential mechanisms at play in the PO and smoking relationship and associated negative outcomes. One possible mechanism is nicotine withdrawal. Here, associated sensations may serve as a conditioned stimulus for panicrelevant responding (Bouton, Mineka, & Barlow, 2001).
In addition, smokers with PO may over-attend to somatic sensations associated with nicotine withdrawal (Lang & Sarmiento, 2004), and may be more apt to misinterpret such sensations as dangerous or threatening (Clark, 1993). To better understand this potential relationship, the current investigation sought to offer a novel empirical perspective on the role of nicotine deprivation on panic responsivity among daily smokers with and without PD. Specifically, it was hypothesized that smokers with PO who were experiencing greater levels of nicotine withdrawal would experience the greatest levels of fearful responding to, and delayed recovery from, a 10% carbon dioxide-enriched air (C0₂) biological challenge procedure, as measured by.
(1) change in anxiety focused on bodily sensations from pre-to post-challenge and intensity of panic attack symptoms; (2) change in expired tidal levels of carbon dioxide (ETC0₂) from pre-to post-challenge; and (3) rate of recovery from the challenge in terms of anxiety focused on bodily sensations and ETC0₂. Participants were 58 adults (46.6% female; Mage = 29.12, SO = 11.79) who completed a baseline session including a structured clinical interview and a battery of self-report questionnaires and underwent an experimental session, consisting of the CO₂-enriched air biological challenge procedure. On average, participants reported smoking 19.72 cigarettes daily (SO =7.99), and 36.2% met criteria for current PO (SCID-N/P, First, Spitzer, Gibson, & Williams, 1994).
Contrary to hypothesis, the current study did not find evidence for an interaction between nicotine withdrawal and PO status in the prediction of: (1) change in subjective anxiety pre-to post-challenge; (2) rate of recovery from the challenge in terms of subjective anxiety; or (3) change in physiological response as indexed by ETC0₂, pre-to post-challenge. However, consistent with hypothesis, findings indicated that higher levels of nicotine withdrawal and positive PO status interacted to predict: (1) greater post-challenge panic attack symptoms; and (2) greater physiological reactivity to the challenge as indexed by ETC0₂ levels measures in response to, and recovery from, the challenge over time.
In addition, smokers with PO may over-attend to somatic sensations associated with nicotine withdrawal (Lang & Sarmiento, 2004), and may be more apt to misinterpret such sensations as dangerous or threatening (Clark, 1993). To better understand this potential relationship, the current investigation sought to offer a novel empirical perspective on the role of nicotine deprivation on panic responsivity among daily smokers with and without PD. Specifically, it was hypothesized that smokers with PO who were experiencing greater levels of nicotine withdrawal would experience the greatest levels of fearful responding to, and delayed recovery from, a 10% carbon dioxide-enriched air (C0₂) biological challenge procedure, as measured by.
(1) change in anxiety focused on bodily sensations from pre-to post-challenge and intensity of panic attack symptoms; (2) change in expired tidal levels of carbon dioxide (ETC0₂) from pre-to post-challenge; and (3) rate of recovery from the challenge in terms of anxiety focused on bodily sensations and ETC0₂. Participants were 58 adults (46.6% female; Mage = 29.12, SO = 11.79) who completed a baseline session including a structured clinical interview and a battery of self-report questionnaires and underwent an experimental session, consisting of the CO₂-enriched air biological challenge procedure. On average, participants reported smoking 19.72 cigarettes daily (SO =7.99), and 36.2% met criteria for current PO (SCID-N/P, First, Spitzer, Gibson, & Williams, 1994).
Contrary to hypothesis, the current study did not find evidence for an interaction between nicotine withdrawal and PO status in the prediction of: (1) change in subjective anxiety pre-to post-challenge; (2) rate of recovery from the challenge in terms of subjective anxiety; or (3) change in physiological response as indexed by ETC0₂, pre-to post-challenge. However, consistent with hypothesis, findings indicated that higher levels of nicotine withdrawal and positive PO status interacted to predict: (1) greater post-challenge panic attack symptoms; and (2) greater physiological reactivity to the challenge as indexed by ETC0₂ levels measures in response to, and recovery from, the challenge over time.