دانلود رایگان مقاله عدم تحمل پریشانی در طول درمان ترک سیگار

Abstract

Distress intolerance is a key vulnerability factor implicated in the maintenance and relapse of cigarette smoking. Yet, past work has not examined changes in these processes during smoking cessation treatment or their relation to smoking cessation outcomes. The aim of the present study was to examine the effect of two smoking cessation interventions on changes in self-report and behavioral distress intolerance indices during treatment, and whether these changes are associated with smoking cessation outcomes. Treatment-seeking smokers (N ¼ 384) were randomly assigned to one of two 4-session smoking cessation treatment programs: Standard Cessation Program (SCP) or Smoking Treatment and Anxiety Management Program (STAMP). Quit dates were scheduled to coincide with the final treatment session. Physical domains of distress intolerance were assessed at baseline and at each weekly session, via the Discomfort Intolerance Scale (DIS; higher scores indicate more intolerance for discomfort) and Breath Holding Duration Task (shorter durations indicate more intolerance for respiratory distress). The STAMP condition produced a greater rate of reduction in DIS scores than did the SCP condition. Changes in DIS scores during treatment mediated the effect of STAMP treatment on 7-day point prevalence abstinence at Month 3 post-quit attempt. There were no treatment conditions differences in changes in Breath-Holding duration. Data suggest self-reported distress intolerance is malleable in the context of stress sensitivity reduction treatment, but not standard smoking cessation treatment, and such reductions may result in promotion of smoking abstinence.

3. Discussion

Findings indicated that daily smokers randomized to participate in a brief four-session smoking cessation treatment specifically designed to additionally improve the management of anxietyrelated symptoms, as compared to a standard cessation intervention, evidenced a significant decrease in self-reported distress intolerance over the course of treatment. Specifically, for smokers in the STAMP condition, scores on the DIS decreased from baseline to session 4, whereas scores increased for individuals in the SCP condition. Overall, the significant difference in the DIS slope by treatment condition suggests that smokers assigned to the anxiety-reduction intervention evidenced a greater rate of reduction in discomfort intolerance over the course of four treatment sessions, relative to the non-significant change for smokers assigned to standard smoking cessation treatment. Interestingly, a similar pattern of results was not found utilizing the bio-behavioral index of intolerance to respiratory distress states. Thus, the current findings suggest explanatory specificity of distress intolerance indices such that perceived, versus actual, physical distress intolerance, uniquely changes during smoking cessation treatment. Together, these findings provide initial evidence for within individual malleability of perceived distress intolerance to physical states in the context of a cognitive-behavioral smoking cessation treatment designed to include specific features purportedly relevant to distress intolerance (e.g., interoceptive exposure exercises prior to quit day).