Browsing by Author "Garey, Lorra"
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Item Personalized Feedback for Smokers with Elevated Anxiety Sensitivity(2019-08) Garey, Lorra; Zvolensky, Michael J.; Neighbors, Clayton; Gallagher, Matthew W.; Blalock, Janice A.Objective: Cigarette smoking is the leading cause of preventable death and disability. The majority of smokers report a desire to quit and most make a serious quit attempt each year. Unfortunately, more than 95% of cessation attempters relapse within 6 months. Clinical and laboratory studies have identified negative affect as a potent precipitant of relapse and more severe smoking behavior. Yet, limited brief, accessible treatments exist to address the range of negative affective symptoms. One promising, integrative approach to address this need is to focus on underlying transdiagnostic processes that capture negative mood states and are related to smoking. Anxiety sensitivity (AS), the tendency to fear anxiety-related sensations, is a core transdiagnostic vulnerability factor for the etiology and maintenance of anxiety disorders and other emotional disorders, and is also related to smoking maintenance and relapse. Progress has been made in developing intensive, integrated treatments that address AS in the context of smoking treatment. However, limited efforts have focused on developing brief (single session) interventions for AS and smoking. The current study was conducted to develop, refine, and test a brief, integrated personalized feedback intervention (PFI) for smoking and AS. Method: Participants (N=95; 63.2% male; Mage = 46.20 years, SD = 10.90) included general smokers in the early stage of quitting who received either a single session, computer-delivered PFI or smoking treatment as usual. The primary aims focused on examining the effects of PFI on (1) quit attempts, (2) cigarette reduction, and (3) trajectories of affective vulnerability assessed at 2- and 4-week follow-ups. Results: Results indicated 48.3% of participants at 2-week follow-up and 53.4% at 4-week follow-up engaged in a self-defined quit attempt. Substantial smoking reduction was observed in 21.8% and 28.4% of participants at 1-week post-baseline and 1-week pre 4-week follow-up. Treatment condition did not significantly predict quit attempt or smoking reduction. PFI had a significant effect on symptoms of anxiety arousal over time (β = -.32, p = .04). Conclusions: Current data provide preliminary evidence for the utility of a PFI to encourage behavior change related to smoking and address physical manifestations of anxiety. The effects, however, were limited in magnitude. Nevertheless, the initial ‘signal’ observed in this small trial provides a strong rationale for continued work within this domain.Item PSYCHOMETRIC PROPERTIES OF THE SMOKING CONSEQUENCES QUESTIONNAIRE ACROSS SEX AND DURING SMOKING CESSATION TREATMENT(2016-05) Garey, Lorra; Zvolensky, Michael J.; Neighbors, Clayton; Blalock, Janice A.Cigarette smoking is the leading cause of preventable death and disability in the United States. There has been a growing interest to understand cognitive processes that may influence smoking. One promising cognitive process linked to smoking behavior is smoking outcome expectancies. Although there is no standard instrument for assessing smoking outcome expectancies, perhaps the most commonly used instrument is the Smoking Consequences Questionnaire (SCQ). Despite the wide use of this measure, little work has been devoted to examining its psychometric properties and no work has examined its construct stability across sex or during smoking cessation treatment. Therefore, the current study aimed to replicate and extent psychometric testing of the SCQ by examining the assumed multi-factor structure, reliability, convergent/discriminant validity, and predictive validity, as well as assessing measurement invariance across sex at baseline, quit week, 1-month follow-up, and 3-month follow-up and longitudinal measurement invariance among baseline, quit week, 1-month follow-up, and 3-month follow-up with a sample of treatment seeking daily cigarette smokers. Results indicated that the originally proposed four-factor SCQ does not adequately explain covariance among items, particularly across the Negative Consequences and Positive Reinforcement/Sensory Satisfaction subscales. Using item reduction techniques, adequate model fit was obtained for a refined, four-factor solution. Construct validity of the refined measure was demonstrated, however limited predictive validity was observed. Finally, although measurement invariance was not appropriate to examine across the full measure, the original SCQ Negative Reinforcement/Negative Affect Reduction and Appetite-Weight Control subscales demonstrated measurement invariance across sex at two time points, as well as longitudinally across two time points. Overall, the present findings provide initial evidence for an item reduced model structure of the SCQ and suggests divergent model structures across sex.Item The sequential pathway between trauma-related symptom severity and cognitive-based smoking processes through perceived stress and negative affect reduction expectancies among trauma exposed smokers(American Journal on Addictions, 10/01/16) Garey, Lorra; Cheema, Mina K.; Otal, Tanveer K.; Schmidt, Norman B.; Neighbors, Clayton; Zvolensky, Michael J.Background and Objectives: Smoking rates are markedly higher among trauma-exposed individuals relative to non-trauma exposed individuals. Extant work suggests that both perceived stress and negative affect reduction smoking expectancies are independent mechanisms that link trauma-related symptoms and smoking. Yet, no work has examined perceived stress and negative affect reduction smoking expectancies as potential explanatory variables for the relation between trauma-related symptom severity and smoking in a sequential pathway model. Methods: Thus, the present study utilized a sample of treatment-seeking, trauma-exposed smokers (n = 363; 49.0% female) to examine perceived stress and negative affect reduction expectancies for smoking as potential sequential explanatory variables linking trauma-related symptom severity and nicotine dependence, perceived barriers to smoking cessation, and severity of withdrawal-related problems and symptoms during past quit attempts. Results: As hypothesized, perceived stress and negative affect reduction expectancies had a significant sequential indirect effect on trauma-related symptom severity and criterion variables. Conclusions and Scientific Significance: Findings further elucidate the complex pathways through which trauma-related symptoms contribute to smoking behavior and cognitions, and highlight the importance of addressing perceived stress and negative affect reduction expectancies in smoking cessation programs among trauma-exposed individuals.Item Treatment attrition: Associations with negative affect smoking motives and barriers to quitting among treatment-seeking smokers(Addictive Behaviors, 2016) Garey, Lorra; Kauffman, Brooke Y.; Neighbors, Clayton; Schmidt, Norman B.; Zvolensky, Michael J.Introduction: Pre-treatment attrition and perceived barriers for quitting are clinically important processes involved in early phases of quitting smoking. However, less is known about the constructs that may contribute to these processes such as negative affect reduction smoking motives. Method: The current study sought to evaluate the relation between negative affect reduction smoking motives with pre-treatment attrition and perceived barriers for quitting in a sample of 425 treatment-seeking smokers (48.5% female; Mage = 37.69; SD = 13.61) enrolled in a smoking cessation study examining the efficacy of a transdiagnostic panic-smoking cessation treatment relative to a standard smoking cessation treatment. Results: Results indicated that greater negative affect reduction smoking motives was associated with an increased likelihood of treatment initiation (Odds Ratio = 1.49, CI: 1.09, 2.04). Additionally, negative affect reduction smoking motives was associated with greater perceived barriers for cessation among pre-treatment drop-outs and treatment initiators. Conclusions: This initial investigation provides evidence for the possible clinical utility in addressing negative affect reduction smoking motives during early stages of quitting. Additionally, such findings could potentially inform the development of personalized, early stages of quitting interventions for smoking cessation.