title: The indirect effect of panic disorder on smoking cognitions via difficulties in emotion regulation.
abstract: Panic disorder (PD) and cigarette smoking are highly comorbid and associated with worse panic and smoking outcomes. Smoking may become an overlearned automatized response to relieve panic-like withdrawal distress, leading to corresponding smoking cognitions, which contribute to its reinforcing properties and difficultly abstaining. Difficulties in emotion regulation (ER) may underlie this relation such that in the absence of adaptive emotion regulatory strategies, smokers with PD may more readily rely upon smoking to manage affective distress. In the current study, the indirect relation between PD status and smoking cognitions through ER difficulties was examined among daily smokers (N=74). We found evidence for an indirect relation between PD status and negative affect, addictive and habitual smoking motives, and anticipating smoking will result in negative reinforcement and personal harm, through self-reported difficulties with ER. Our findings are aligned with theoretical models on anxiety and smoking, and suggest that reports of greater smoking cognitions may be due to ER difficulties.
authors.affiliation: Rutgers, The State University of New Jersey, Department of Psychology, Tillett Hall, 53 Avenue E., Piscataway, NJ 08854, USA.
authors.forename: Min-Jeong
authors.initials: MJ
authors.lastname: Yang
authors.affiliation: University of Houston, Department of Psychology, 126 Fred J. Heyne Building, Suite 104, Houston, TX 77204, USA; The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, 1155 Pressler Street, Houston, TX 77030, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Zvolensky
authors.affiliation: Rutgers, The State University of New Jersey, Department of Psychology, Tillett Hall, 53 Avenue E., Piscataway, NJ 08854, USA. Electronic address: teresa.leyro@rutgers.edu.
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Leyro
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001008:Anxiety Disorders / Q000523:psychology; D000073865:Cigarette Smoking; D003071:Cognition; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000523:psychology*; D012907:Smoking / Q000523:psychology*; D055815:Young Adult
keywords: Anxiety; Emotion regulation; Panic disorder; Smoking; Smoking motive; Smoking outcome expectancy