Whitney L. Heppner

Mindfulness as a Means of Reducing Aggressive Behavior: Dispositional and Situational Evidence

Recent research and theory suggest that mindfulness, or enhanced attention and awareness in the present moment [Brown and Ryan, 2003], may be linked to lower levels of ego-involvement and, as a result, may have implications for lowering hostility and aggressive behavior. Accordingly, we conducted two studies to examine the potential aggression-mitigating role of mindfulness. In Study 1, we found that dispositional mindfulness correlated negatively with self-reported aggressiveness and hostile attribution bias. In Study 2, participants made mindful before receiving social rejection feedback displayed less-aggressive behavior than did rejected participants not made mindful. Discussion centers on potential mechanisms by which mindfulness operates to reduce aggressive behavior.

Within-Person Relationships Among Daily Self-Esteem, Need Satisfaction, and Authenticity

This study examined the within-person relationships among daily self-esteem, felt authenticity (i.e., the operation of ones “true self”), and satisfaction of psychological needs for autonomy, competence, and relatedness. We also included measures of affect to control for the variance these constructs might share with affect. Over a 2-week period, 116 participants responded daily to measures of these variables. Multilevel random-coefficients modeling revealed that authenticity, autonomy, competence, and relatedness were all positively and significantly related to daily reports of self-esteem, even when we controlled for the contributions of pleasant and unpleasant affect. We discuss the roles of authenticity and psychological needs in daily feelings of self-worth.

High Self-Esteem: Multiple Forms and Their Outcomes

Self-esteem has been empirically investigated extensively and has become deeply ingrained in the social and popular conscience. Varied definitions of self-esteem across disciplines and perspectives and inconsistent empirical findings with self-esteem have yielded a messy research literature and have produced many lingering questions. In this chapter, we briefly review the “mess” of self-esteem, first focusing on its inconsistent empirical findings. Then, we propose a differentiated view of high self-esteem as being either fragile or secure, and how this differentiated view can help “clear the waters” of self-esteem research. Next, we highlight self-esteem’s importance in personal and cultural identity processes, examining in particular potential cultural changes influenced by the concept of high self-esteem. Finally, we discuss where self-esteem comes from and how we can cultivate “healthy” self-esteem, and we discuss two individual difference measures—authenticity and mindfulness—that relate to secure self-esteem processes.

Mediators of the association of major depressive syndrome and anxiety syndrome with postpartum smoking relapse.

OBJECTIVE Based on conceptual models of addiction and affect regulation, this study examined the mechanisms linking current major depressive syndrome (MDS) and anxiety syndrome (AS) to postpartum smoking relapse. METHOD Data were collected in a randomized clinical trial from 251 women who quit smoking during pregnancy. Simple and multiple mediation models of the relations of MDS and AS with postpartum relapse were examined using linear regression, continuation ratio logit models, and a bootstrapping procedure to test the indirect effects. RESULTS Both MDS and AS significantly predicted postpartum smoking relapse. After adjusting for MDS, AS significantly predicted relapse. However, after adjusting for AS, MDS no longer predicted relapse. Situationally based self-efficacy, expectancies of controlling negative affect by means other than smoking, and various dimensions of primary and secondary tobacco dependence individually mediated the effect of both MDS and AS on relapse. In multiple mediation models, self-efficacy in negative/affective situations significantly mediated the effect of MDS and AS on relapse. CONCLUSIONS The findings underscore the negative impact of depression and anxiety on postpartum smoking relapse and suggest that the effects of MDS on postpartum relapse may be largely explained by comorbid AS. The current investigation provided mixed support for affect regulation models of addiction. Cognitive and tobacco dependence-related aspects of negative and positive reinforcement significantly mediated the relationship of depression and anxiety with relapse, whereas affect and stress did not. The findings emphasize the unique role of low agency with respect to abstaining from smoking in negative affective situations as a key predictor of postpartum smoking relapse.

The role of prepartum motivation in the maintenance of postpartum smoking abstinence

OBJECTIVE Motivation plays an important role in a variety of behaviors, including smoking cessation, and is integral to theory and treatment of smoking. For many women, pregnancy offers a motivational shift that helps them stop smoking and maintain abstinence during pregnancy. However, womens motivation to maintain smoking abstinence postpartum is not well-understood and may play a role in high postpartum relapse rates. The current study utilized multiple measures of prepartum motivation to maintain smoking abstinence to predict postpartum smoking abstinence. METHODS As part of a randomized clinical trial on postpartum smoking relapse prevention, pregnant women who quit smoking during pregnancy reported their motivation to continue smoking abstinence at a prepartum baseline session. Biochemically verified continued smoking abstinence was assessed at 8 and 26 weeks postpartum. RESULTS Direct relationships among multiple measures of motivation were significant, and ranged in strength from weak to moderate. All motivation measures individually predicted continuous smoking abstinence, after controlling for treatment group, demographics, and prequit tobacco use. When tested simultaneously, a global motivation measure and parenthood motives for quitting remained significant predictors of abstinence. Backward selection modeling procedures resulted in a reduced model of prepartum predictors of postpartum abstinence including global motivation, parenthood motives, and stage of change. CONCLUSIONS Global motivation for smoking abstinence and parenthood motives for quitting are particularly important motivational constructs for pregnant womens continued smoking abstinence.

Differential Effects of Depression on Smoking Cessation in a Diverse Sample of Smokers in Treatment

BACKGROUND Recent cross-sectional evidence suggests that the effect of depression on smoking prevalence and quit ratios differs by race/ethnicity. PURPOSE This study prospectively examined the main and interactive effects of race/ethnicity and depressive symptoms on smoking cessation during a specific quit attempt among smokers receiving cessation treatment. METHODS Data from a longitudinal study of smokers in treatment were examined using continuation ratio logit modeling. Continuous abstinence across Weeks 1, 2, and 4 post-quit was the outcome variable. Data were collected between March 2005 and November 2007, and the current study analyses were conducted in April 2010. RESULTS Depressive symptoms predicted significantly lower cessation rates for whites and African Americans. In contrast, among Latinos there was no relationship between depression and cessation. CONCLUSIONS This research is the first to prospectively demonstrate a racially/ethnically differentiated effect of depressive symptoms on smoking cessation, and it has implications for targeted smoking-cessation treatments as it indicates that depression may not be a key treatment target for Latinos.

Mindfulness and Emotion Regulation

In this chapter, we begin to explore the wealth of research and theory on the implications of mindfulness for emotional experience by examining a variety of models of mindfulness and how they inform mindful emotion regulation. Then, we provide an empirical overview of the role of mindfulness in general emotional states, emotional reactions to stimuli and events, and emotions over time. Within this overview, we provide evidence for several distinct avenues through which mindfulness benefits emotion regulation, including increased willingness to experience negative emotions, reduced reactivity to emotional stimuli and situations, a decentered perspective, and increased emotional stability; we also highlight some research which suggests the neurological underpinnings of mindful emotion regulation. Finally, we link the impact of mindfulness on emotion regulation to behavioral change. Specifically, by highlighting research on smoking, alcohol use, and other addictive behaviors, we demonstrate that emotion regulation serves as a key mechanism in the relationship between mindfulness and some domains of behavioral regulation.

A cross-lagged path analysis of five intrapersonal determinants of smoking cessation

BACKGROUND Prominent theories of drug use underscore the importance of considering the inter-relationships (e.g., reciprocal relations, indirect effects) of determinants of drug use behavior. In the area of smoking, few studies have examined multiple determinants of cessation in this way, and in prospective analyses. The current study is an examination of the prospective cross-lagged relationships among five intrapersonal determinants of cessation. METHODS Data from a longitudinal cohort study on racial differences in the process of smoking cessation were used to examine reciprocal relations among abstinence motivation, abstinence self-efficacy, positive affect, negative affect, and craving. Each of these five measures assessed on the quit day were regressed onto the same measures assessed 1-2 weeks pre-quit. The relationships of these variables at quit day with 1-week post-quit abstinence from smoking were also examined. RESULTS When the five variables were examined simultaneously in a cross-lagged path analysis, motivation and self-efficacy, and self-efficacy and positive affect showed cross-lagged relations. Only self-efficacy on the quit day uniquely predicted 1-week post quit abstinence. There were significant indirect effects of motivation and positive affect on cessation via self-efficacy. CONCLUSIONS The current study reaffirms the importance of motivation and self-efficacy in smoking cessation, and suggests that positive affect may play a role in smoking cessation.

Nonjudging facet of mindfulness predicts enhanced smoking cessation in Hispanics.

Although most smokers express interest in quitting, actual quit rates are low. Identifying strategies to enhance smoking cessation is critical, particularly among underserved populations, including Hispanics, for whom many of the leading causes of death are related to smoking. Mindfulness (purposeful, nonjudgmental attention to the present moment) has been linked to increased likelihood of cessation. Given that mindfulness is multifaceted, determining which aspects of mindfulness predict cessation could help to inform interventions. This study examined whether facets of mindfulness predict cessation in 199 Spanish-speaking smokers of Mexican heritage (63.3% male, mean age of 39 years, 77.9% with a high school education or less) receiving smoking cessation treatment. Primary outcomes were 7-day abstinence at weeks 3 and 26 postquit (biochemically confirmed and determined using an intent-to-treat approach). Logistic random coefficient regression models were utilized to examine the relationship between mindfulness facets and abstinence over time. Independent variables were subscales of the Five Facet Mindfulness Questionnaire (Observing, Describing, Acting With Awareness, Nonjudging, and Nonreactivity). The Nonjudging subscale (i.e., accepting thoughts and feelings without evaluating them) uniquely predicted better odds of abstinence up to 26 weeks postquit. This is the first known study to examine whether specific facets of mindfulness predict smoking cessation. The ability to experience thoughts, emotions, and withdrawal symptoms without judging them may be critical in the process of quitting smoking. Results indicate potential benefits of mindfulness among smokers of Mexican heritage and suggest that smoking cessation interventions might be enhanced by central focus on the Nonjudging aspect of mindfulness.

Mindfulness predicts lower affective volatility among African Americans during smoking cessation.

Recent research suggests that mindfulness benefits emotion regulation and smoking cessation. However, the mechanisms by which mindfulness affects emotional and behavioral functioning are unclear. One potential mechanism, lower affective volatility, has not been empirically tested during smoking cessation. This study examined longitudinal associations among mindfulness and emotional responding over the course of smoking cessation treatment among predominantly low-socioeconomic status (SES) African American smokers, who are at high risk for relapse to smoking and tobacco-related health disparities. Participants (N = 399, 51% female, mean age = 42, 48% with annual income <