title: Posttraumatic stress symptoms and cognitive-based smoking processes among trauma-exposed, treatment-seeking smokers: the role of dysphoria.
abstract: OBJECTIVE
  Despite the co-occurrence and clinically significant relationship between trauma exposure and smoking, there is little understanding of the mechanisms underlying the posttraumatic stress symptoms-smoking relationship. This study examined whether dysphoria (ie, a psychopathologic symptom dimension that reflects depression's core affective, cognitive, and psychomotor features) accounted for the covariance between posttraumatic stress symptom severity and an array of smoking processes among trauma-exposed daily smokers.
  
  
  METHODS
  Participants (n = 189; 47.6% female; Mage = 41.15; SD = 12.47) were trauma-exposed, treatment-seeking daily cigarette smokers who completed measures of posttraumatic stress symptom severity, dysphoria, and 4 cognitive-based smoking processes that interfere with smoking cessation-avoidance/inflexibility to smoking, perceived barriers to smoking cessation, negative affect reduction motivation for smoking, and negative affect reduction/negative reinforcement expectancies from smoking.
  
  
  RESULTS
  Dysphoria indirectly and significantly accounted for the relationship between posttraumatic stress symptom severity and smoking outcomes.
  
  
  CONCLUSIONS
  The present results provide initial empirical support that dysphoria accounts for the covariance between posttraumatic symptom severity and various clinically relevant smoking variables in trauma-exposed, treatment-seeking smokers. The findings suggest the potential importance of targeting dysphoria during smoking cessation among trauma-exposed individuals.
authors.affiliation: From the Department of Psychology (LG, JB, MJZ), University of Houston, Houston, TX; Department of Psychiatry and Behavioral Sciences (AAV), University of Texas Health Science Center, Houston, TX; Department of Preventive Medicine and Psychology (AML), University of Southern California, Los Angeles, CA; Department of Psychology (NBS), Florida State University, Tallahassee; and Department of Behavioral Sciences (MJZ), University of Texas MD Anderson Cancer Center, Houston.
authors.forename: Lorra
authors.initials: L
authors.lastname: Garey
authors.forename: Jafar
authors.initials: J
authors.lastname: Bakhshaie
authors.forename: Anka A
authors.initials: AA
authors.lastname: Vujanovic
authors.forename: Adam M
authors.initials: AM
authors.lastname: Leventhal
authors.forename: Norman B
authors.initials: NB
authors.lastname: Schmidt
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Zvolensky
mesh_terms: D000328:Adult; D003863:Depression / Q000150:complications* / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D012907:Smoking / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000175:diagnosis / Q000523:psychology*; D063189:Symptom Assessment; D055815:Young Adult