Alison C. McLeish

Asthma and Cigarette Smoking: A Review of the Empirical Literature

The purpose of this review paper is to present and evaluate the empirical literature on the association between asthma and cigarette smoking. The authors conducted a literature search utilizing electronic search engines (i.e., PsycINFO and MEDLINE) to examine databases using the following key word algorithms: smoking OR nicotine OR tobacco AND asthma. Only articles that focused on active tobacco smoking and analyzed groups with asthma patients only were examined in the present review. Overall, empirical evidence suggests that (1) smoking is more prevalent among individuals with asthma than those without; (2) smoking is a risk candidate for the development of asthma; (3) smoking is associated with decreased asthma control and increased risk of mortality and asthma attacks and exacerbations; (4) smokers with and without asthma may have different risk factors for smoking onset as well as different smoking motives and outcome expectancies; and (5) smoking cessation is associated with improvements in lung functioning and asthma symptoms. Future work in this domain of study will lead to clinically relevant health care advances as well as the development of theoretically driven, methodologically diverse lines of research exploring asthma-smoking comorbidity issues.

Evaluating the Role of Anxiety Sensitivity in Smoking Outcome Expectancies Among Regular Smokers

The present study evaluated the association between the lower-order facets of anxiety sensitivity construct (physical, mental incapacitation, and social concerns) and positive (expectancies about negative affect reduction) and negative (expectancies about negative personal consequences) smoking outcome expectancies. Participants were 90 young adult regular smokers [37 females; Mage = 23.4 years (SD = 8.9); mean number of cigarettes/day = 11.7 (SD = 6.1)] with no history of psychopathology or nonclinical panic attacks recruited from the general population. Anxiety sensitivity physical concerns and mental incapacitation concerns, as indexed by the Anxiety Sensitivity Index (ASI; S. Reiss, R. A. Peterson, M. Gursky, & R. J. McNally, 1986), were significantly and incrementally associated with smoking outcome expectancies, as indexed by the Smoking Consequences Questionnaire (SCQ; T. H. Brandon & T. B. Baker, 1991), for negative affect reduction as well as negative personal consequences; the observed effects were over and above the variance accounted for by theoretically relevant smoking history characteristics, gender, and negative affectivity. Results are discussed in relation to better understanding motivational processes for smoking among groups at heightened risk for developing panic psychopathology.

Incremental validity of anxiety sensitivity in terms of motivation to quit, reasons for quitting, and barriers to quitting among community-recruited daily smokers

The present investigation examined the relationships between anxiety sensitivity and motivation to quit smoking, barriers to smoking cessation, and reasons for quitting smoking among 329 adult daily smokers (160 females; M (age) = 26.08 years, SD = 10.92). As expected, after covarying for the theoretically relevant variables of negative affectivity, gender, Axis I psychopathology, nonclinical panic attack history, number of cigarettes smoked per day, and current levels of alcohol consumption, we found that anxiety sensitivity was significantly incrementally related to level of motivation to quit smoking as well as current barriers to quitting smoking. Partially consistent with the hypotheses, after accounting for the variance explained by other theoretically relevant variables, we found that anxiety sensitivity was significantly associated with self-control reasons for quitting smoking (intrinsic factors) as well as immediate reinforcement and social influence reasons for quitting (extrinsic factors). Results are discussed in relation to better understanding the role of anxiety sensitivity in psychological processes associated with smoking cessation.

Incremental Validity of Mindfulness‐Based Attention in Relation to the Concurrent Prediction of Anxiety and Depressive Symptomatology and Perceptions of Health

This investigation evaluated the role of mindfulness‐based attention in concurrently predicting anxiety and depressive symptomatology and perceived health functioning in a community sample of 170 young adults (95 females; mean age (Mage) = 22.2 years, SD = 7.6). Partially consistent with prediction, results indicated that, relative to negative and positive affectivity and emotional expression and processing associated with approach‐oriented coping, mindfulness‐based attention incrementally predicted anhedonic depressive, but not anxious arousal, symptoms. Additionally, consistent with prediction, mindfulness‐based attention demonstrated incremental validity in relation to perceived health, and the degree of impairment of health in terms of physical and mental functioning. Results are discussed in relation to the construct development of mindfulness‐based attention, and specifically, the role(s) of this factor in emotional and physical health processes.

Anxiety Sensitivity, Asthma Control, and Quality of Life in Adults with Asthma

Objective. The aim of this study was to examine the role of anxiety sensitivity (AS) in terms of asthma control and asthma-related quality of life in a sample of adults with a physician-verified diagnosis of asthma. Methods. Self-report measures assessing psychological and asthma symptoms were mailed to 368 asthma patients from a community allergy and asthma office who had been seen for a physician follow-up visit between 1 January 2009 and 1 January 2010. Participants in the current study were 127 asthma patients (74% female; Mage = 43.4 years, SD = 12.3) who completed and returned the self-report measures. Results. The results indicated that, after controlling for gender, age, negative affect, and number of comorbid medical problems, the physical concerns factor of AS (AS-Physical Concerns) significantly predicted asthma control and all domains of asthma-related quality of life (symptoms, activity limitations, emotional functioning, and environmental stimuli). Conclusions. These findings replicate and extend previous research and indicate that the fear of physical sensations negatively affects both asthma control and quality of life. These findings also suggest that targeting the AS-Physical Concerns may be a novel way to improve asthma control and quality of life.

The Role of Anxiety Sensitivity in terms of Asthma Control: A Pilot Test among Young Adult Asthmatics

The aim of the present pilot investigation was to examine the role of specific subfactors of anxiety sensitivity (physical, cognitive, and social concerns) in terms of asthma control among a young adult sample (N = 56; M age = 20.0; SD = 3.9; Range = 18—45 years). Results indicated that, after controlling for gender, cigarette smoking status, and negative affectivity, the physical concerns factor of anxiety sensitivity, relative to cognitive and social concern factors, significantly predicted asthma control. These findings support the theory that fear of physical sensations is associated with poorer asthma control and suggest that targeting the physical concerns facet of anxiety sensitivity may be a novel way to improve asthma control.

An examination of smoking outcome expectancies, smoking motives and trait worry in a sample of treatment-seeking smokers

The present study examined the role of trait worry in predicting smoking-based cognitive processes (motives, expectancies, and beliefs about quitting) in a sample of 286 treatment-seeking, daily smokers (43.7% female; M(age)=37.25; SD=12.83). Consistent with prediction, trait worry was significantly and uniquely associated with smoking outcome expectancies and motives pertaining to negative affect reduction after controlling for other relevant variables such as negative affectivity, gender, smoking rate and tobacco-related disease. Trait worry also was significantly independently related to greater perceived barriers to quitting smoking. The significant effects remained consistent when adjusted for axis I psychopathology. These findings provide initial evidence of the theoretical and clinical importance of trait worry with regard to tobacco-related motives, outcome expectancies, and beliefs about quitting smoking.

Asthma and Aerobic Exercise: A Review of the Empirical Literature

Objective: The purpose of the present article was to provide a comprehensive review of the empirical literature on the association between asthma and aerobic exercise among adults. Methods: A literature search was conducted utilizing electronic search engines (i.e., PsycINFO and PubMed) using the following keyword algorithms: asthma AND (exercise OR physical activity). Results: These searches resulted in approximately 5665 citations. Only results that were directly relevant were included in the present review. Conclusions: Overall, empirical evidence suggests that (1) individuals with asthma are less likely to engage in physical activity than those without asthma, (2) individuals with asthma are not biased in their subjective reporting of symptoms during aerobic exercise, (3) physical inactivity among individuals with asthma is associated with negative health consequences and increased asthma-related difficulties, and (4) regular aerobic exercise improves asthma symptom management, lung function, and mental health.

The moderating role of distress tolerance in the association between anxiety sensitivity physical concerns and panic and PTSD-related re-experiencing symptoms.

Abstract The present investigation evaluated the moderating role of distress tolerance (DT) in the relation between the physical concerns (PC) dimension of anxiety sensitivity (AS–PC) and panic and posttraumatic stress disorder (PTSD)-related re-experiencing symptoms in a nonclinical, undergraduate sample (n = 416; 300 females; M age=20.3 years, SD = 4.8). Consistent with prediction, there was a significant interactive effect between AS–PC and DT in regard to panic symptoms, such that greater AS–PC and low DT was associated with greater panic symptoms after controlling for the variance accounted for by negative affectivity and the respective main effects. However, contrary to prediction, AS–PC and DT did not significantly interact to predict PTSD-related re-experiencing symptoms. Also consistent with prediction, there was no interactive effect apparent for symptoms of depression or general anxiety, suggesting that the interaction between AS–PC and DT is specific to panic psychopathology.

Anxiety sensitivity and pain-related anxiety in the prediction of fear responding to bodily sensations: A laboratory test

OBJECTIVE The present investigation sought to examine the simultaneous effects of anxiety sensitivity and pain-related anxiety on fear and anxious responding to a 10% carbon dioxide enriched air challenge. METHODS Participants included 247 adults (53% women; mean age=21.91 years, S.D.=8.41) recruited from the community. At the laboratory, participants were administered a structured clinical interview, completed a battery of self-report measures, and underwent a 10% carbon dioxide enriched air challenge. RESULTS Both anxiety sensitivity and pain-related anxiety were significantly and uniquely predictive of post-challenge panic attacks, total post-challenge panic attack symptoms, and intensity of cognitive panic attack symptoms. Anxiety sensitivity, but not pain-related anxiety, also was predictive of post-challenge physical panic symptoms. The observed significant effects for both anxiety sensitivity and pain-related anxiety were evident above and beyond the variance accounted for by gender, age, current level of nonspecific bodily pain, and negative affectivity. Neither anxiety sensitivity nor pain-related anxiety was significantly predictive of change in anxiety focused on bodily sensations or heart rate. CONCLUSION Results suggest that anxiety sensitivity and pain-related anxiety, although related to one another, may be independently important variables underlying fear reactivity to bodily sensations.