Emily R. Jeffries

Robust impact of social anxiety in relation to coping motives and expectancies, barriers to quitting, and cessation-related problems.

Although social anxiety is related to smoking and nicotine dependence, few researchers have sought to identify factors that contribute to these relations. The current study examined whether social anxiety was associated with cognitive vulnerability factors related to smoking: perceived barriers for quitting, cessation-related problems, negative-affect-reduction-outcome expectancies, and negative-affect-reduction motives. Further, we tested whether social anxiety was robustly related to these factors after controlling for cigarettes smoked per day, gender, alcohol-use frequency, lifetime cannabis-use status, panic attack frequency, anxiety sensitivity, and negative affectivity. The sample consisted of 580 (38.6% female) treatment-seeking smokers. Social anxiety was associated with perceived barriers for quitting, cessation-related problems, negative-affect-reduction-outcome expectancies, and negative-affect-reduction motives. After controlling for covariates, social anxiety was robustly related to perceived barriers for quitting, cessation-related problems, and negative-affect-reduction-outcome expectancies. Social anxiety was robustly related to negative-affect-reduction motives among men, but not women. Results indicate that social anxiety is robustly related to cognitive vulnerability factors associated with poorer cessation outcomes, suggesting that social anxiety may be an important therapeutic target during smoking cessation.

The Role of Distress Tolerance in the Use of Specific Emotion Regulation Strategies

The present study evaluated the role of distress tolerance (DT), defined as the ability to tolerate negative emotional states, in the use of four specific emotion regulation strategies (suppression, avoidance, rumination, and reappraisal). Undergraduate psychology students (N = 431, 71.7% female; Mage = 19.80 years, SD = 3.71) completed self-report measures online for course credit. It was hypothesized that, after controlling for the effects of anxiety sensitivity and negative affectivity, DT would be negatively associated with suppression, avoidance, and rumination, and positively associated with reappraisal. Consistent with prediction, low DT significantly predicted greater use of suppression, avoidance, and rumination. However, contrary to prediction, DT did not significantly predict reappraisal. These results suggest that individuals who are unable to withstand negative emotions are more likely to use maladaptive regulation strategies.

Distress Tolerance and Perceived Barriers to Smoking Cessation

ABSTRACT. Background: The present study examined the role of emotional distress tolerance (DT) in predicting barriers to smoking cessation and number of quit attempts. Methods: The sample consisted of regular daily smokers (N = 126; 37 females; M age = 36.51, SD = 13.05) who completed self-report measures on affect and smoking. Results: After controlling for daily smoking rate and anxiety sensitivity, emotional DT significantly predicted internal barriers to cessation (6.9% unique variance) but not external or addiction-related barriers to cessation. Inconsistent with prediction, emotional DT did not significantly predict number of quit attempts. Conclusions: These results suggest that individuals who are low in emotional DT believe that quitting smoking will be difficult because it takes away an important affect regulation strategy, and there may be utility in targeting emotional DT in smoking cessation interventions.

Asthma and its relation to smoking behavior and cessation motives among adult daily smokers

Despite the negative effects of smoking on lung functioning and overall health, smoking is more prevalent among individuals with asthma compared to those without asthma. The purpose of this study was to examine the predictive ability of asthma diagnosis in terms of smoking behavior and reasons for quitting. Participants were 251 regular daily smokers: 125 smokers with self-reported, physician-diagnosed asthma and 126 smokers without asthma. Asthma diagnosis significantly predicted age of regular smoking onset, number of quit attempts, and reasons for quitting related to self-control suggesting that smokers with asthma may have more difficulty quitting and unique reasons for quitting.

Cannabis craving in response to laboratory-induced social stress among racially diverse cannabis users: The impact of social anxiety disorder

Social anxiety disorder appears to be a risk factor for cannabis-related problems. Although it is presumed that increases in cannabis craving during elevated social anxiety reflect an intent to cope with greater negative affectivity, it is unclear whether increases in physiological arousal during social stress are related to cannabis craving, especially among those with social anxiety disorder. Similarly, no studies have assessed motivational reasons for cannabis use during elevated social stress. Thus, the current study tested whether increases in state social anxiety (measured subjectively and via physiological arousal) were related to greater cannabis craving among 126 current cannabis users (88.9% with cannabis use disorder, 31.7% with social anxiety disorder, 54.0% non-Hispanic Caucasian) randomly assigned to either a social interaction or reading task. As predicted, cannabis users in the social interaction condition reported greater cannabis craving than those in the reading condition. This effect was particularly evident among those with social anxiety disorder. Although physiological arousal did not moderate the relationship between condition and craving, coping motives were the most common reasons cited for wanting to use cannabis and were reported more among those in the social interaction task. These experimental results uniquely add to a growing literature suggesting the importance of elevated state social anxiety (especially among those with social anxiety disorder) in cannabis use vulnerability processes.

The role of mindfulness skills in terms of distress tolerance: a pilot test among adult daily smokers.

BACKGROUND AND OBJECTIVES Low distress tolerance is associated with difficulties quitting smoking. Mindfulness is associated with improved cessation outcomes and may be one method by which to increase distress tolerance. The purpose of the current study was to examine the relationship between mindfulness skills and distress tolerance among regular smokers. METHODS Daily smokers (n=125; Mage=37.5, 70% male) completed self-report measures assessing smoking and emotions. RESULTS After controlling for age, gender, and nicotine dependence, and education the mindfulness skills of acting with awareness and accepting without judgment significantly predicted distress tolerance. DISCUSSION AND CONCLUSIONS For smokers, being able to pay attention to present moment vents and accept negative events without judgment is associated with a greater ability to withstand such events. SCIENTIFIC SIGNIFICANCE These findings suggest that mindfulness-based approaches to smoking cessation may be effective because of improvements in distress tolerance. However, future prospective and laboratory-based studies are needed to better understand the mindfulness-distress tolerance link among smokers.

Distress Tolerance Among Students Referred for Treatment Following Violation of Campus Cannabis Use Policy Relations to Use, Problems, and Motivation

Students referred to treatment after violating campus drug policies represent a high-risk group. Identification of factors related to these students’ cannabis use could inform prevention and treatment efforts. Distress tolerance (DT) is negatively related to substance-related behaviors and may be related to high-risk cannabis use vulnerability factors that can impact treatment outcome. Thus, the current study tested whether DT was related to cannabis use frequency, cannabis-related problems, and motivation to change cannabis use among 88 students referred for treatment after violating campus cannabis policies. DT was robustly, negatively related to cannabis use and related problems. DT was also significantly, negatively correlated with coping, conformity, and expansion motives. DT was directly and indirectly related to cannabis problems via coping (not conformity or expansion) motives. Motives did not mediate the relation of DT to cannabis use frequency. DT may be an important target in treatment with students who violate campus cannabis policies.

Social anxiety and suicidal ideation: Test of the utility of the interpersonal-psychological theory of suicide ☆

Social anxiety is related to greater suicidality, even after controlling for depression and other psychopathology. The Interpersonal-Psychological Theory of Suicide (IPTS; Joiner, 2005) proposes that people are vulnerable to wanting to die by suicide if they experience both perceived burdensomeness (sense that one is a burden to others) and thwarted belongingness (a greater sense of alienation from others). Socially anxious persons may be especially vulnerable to these interpersonal factors. The current study tested whether interpersonal IPTS components independently and additively mediate the social anxiety-suicidal ideation (SI) relation among 780 (80.5% female) undergraduates. Social anxiety was significantly, robustly related to SI and to thwarted belongingness and perceived burdensomeness. Social anxiety was indirectly related to SI via thwarted belongingness and perceived burdensomeness. The sum of these indirect effects was significant. Moderated mediation analyses indicated that perceived burdensomeness only mediated the relation between social anxiety and SI at higher levels of thwarted belongingness. Findings highlight that difficulties in interpersonal functioning may serve as potential pathways through which social anxiety may lead to greater suicidality. Findings highlight that difficulties in interpersonal functioning may serve as potential pathways through which social anxiety may lead to greater suicidality.

Anxiety and cannabis-related problem severity among dually diagnosed outpatients: The impact of false safety behaviors

Cannabis use disorder (CUD) co-occurs with anxiety disorders at high rates. Little is known about the mechanisms linking CUD and anxiety disorders. One theoretically-driven perspective is that individuals with anxiety disorders may be more apt to use FSBs (i.e., behaviors that may be effective in decreasing anxiety in the short-term, but can maintain and even exacerbate anxiety in the long-term), which can perpetuate cannabis use despite cannabis-related problems. The present study tested whether FSB use explained the relation of anxiety symptom severity with cannabis quantity and related problems among 77 adults with CUD and comorbid anxiety disorders seeking outpatient CUD treatment. Results indicated that FSB frequency was significantly related to anxiety symptom severity and cannabis problem severity, but not cannabis quantity. Anxiety symptom severity was indirectly (via FSB frequency) related to cannabis problem severity, but not to cannabis quantity. These novel findings suggest that more frequent use of FSBs may play an important role in cannabis problem severity among individuals with CUD and anxiety disorders.

The impact of university sanctions on cannabis use: Individual difference factors that predict change in cannabis use.

Over one third of college students use cannabis, yet the majority of students experiencing cannabis-use problems are not interested in seeking treatment. Therefore, the campus judicial process following a violation of university cannabis policies may be an important point of intervention. This study examined whether cannabis use decreased following being sanctioned by the university for violation of campus drug policy. We also identified individual difference factors related to changes in postinfraction use. University students (N = 98, 73.1% White, 88.2% Male) were referred to participate in a brief motivational intervention study as a component of their sanctions following violation of campus cannabis policies. Data were collected during the intake appointment. Approximately 91% of participants reported decreased postinfraction cannabis use and 58% of the sample reported abstinence in the month prior to intake. The following variables were significantly related to both abstinence or to reducing frequent use (from at least four times per month to less frequently): using less frequently prior to their infraction, descriptive friend norms, and enhancement motives. The following variables were significantly related only to reducing frequent use: injunctive norms regarding parents and expansion motives. Students sanctioned for cannabis violations appear to decrease cannabis use postinfraction. Thus, results support campus efforts to sanction students for violation of campus cannabis use policies. Identification of individual difference variables that predict postinfraction change in cannabis use can inform treatment and prevention efforts.