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The Relationship Between Anxiety Sensitivity and Posttraumatic Stress Disorder: What is the Impact of Nicotine Withdrawal?

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Abstract

Anxiety sensitivity (AS) is related to the development and maintenance of posttraumatic stress disorder (PTSD) among cigarette smokers, and is also implicated in the amplification of acute nicotine withdrawal symptoms. The present study sought to examine the role of nicotine withdrawal in moderating the association between AS and PTSD symptom severity among a sample of treatment-seeking smokers with PTSD. Participants (n = 117) were enrolled in a randomized controlled trial for the treatment of PTSD and nicotine dependence. Cross-sectional data were randomly sampled from three different study time points. A series of multiple regression models were tested. Results revealed main effects of both AS and withdrawal severity on PTSD severity after controlling for gender, assessment time-point, negative affectivity, and biochemically verified smoking (expired carbon monoxide). The interaction of AS and withdrawal was also significant, and appeared to be specific to PTSD avoidance and hyperarousal symptoms. However, contrary to expectations, the association between AS and PTSD symptoms was only significant at relatively lower levels of nicotine withdrawal. These findings highlight the complex interplay between AS, nicotine withdrawal, and their synergistic effect in terms of the exacerbation of PTSD symptomology.

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Acknowledgments

The authors express their sincerest appreciation to the study nurse Patricia Imms, research assistants on this study Michelle Capozzoli, Janice Paton, Catherine Coogan and Elizabeth Alpert, and to the patients who were brave enough to share their struggles with our research team by participating in this study.

Conflict of Interest

Dr. Edna B. Foa received funding for this study by a National Institute of Drug Abuse grant (R01-DA023507-01A1). Ms. Samantha Farris received support from a pre-doctoral National Research Service Award from the National Institute of Drug Abuse (F31-DA035564). Dr. Anu Asnaani, Mr. Joseph Carpenter, and Dr. Laurie Zandberg have no conflict of interest.

Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. All participants provided written informed consent prior to initiating any study procedures and the study protocol was approved by Institutional Review Board at the University of Pennsylvania and the Philadelphia VAMC.

Animal Rights

No animal studies were carried out by any of the authors for this paper.

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Authors and Affiliations

  1. Department of Psychiatry, Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market St, Suite 600 North, Philadelphia, PA, 19104, USA

    Anu Asnaani, Joseph K. Carpenter, Laurie J. Zandberg & Edna B. Foa

  2. University of Houston, Houston, TX, USA

    Samantha G. Farris

  3. Boston University, Boston, MA, USA

    Joseph K. Carpenter

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  1. Anu Asnaani
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  2. Samantha G. Farris
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  3. Joseph K. Carpenter
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  4. Laurie J. Zandberg
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  5. Edna B. Foa
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Correspondence to Anu Asnaani.

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Asnaani, A., Farris, S.G., Carpenter, J.K. et al. The Relationship Between Anxiety Sensitivity and Posttraumatic Stress Disorder: What is the Impact of Nicotine Withdrawal?. Cogn Ther Res 39, 697–708 (2015). https://doi.org/10.1007/s10608-015-9685-5

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