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Predicting Initiation of Smoking Cessation Treatment and Outcome Among Adolescents Using Stressful Life Events and Coping Style.

ABSTRACT: Adolescent smoking is a major public health concern, and current treatments are only somewhat effective in promoting abstinence. One way to improve treatments is to identify psychosocial characteristics that impede cessation, allowing development of targeted treatments. This study examined the influence of 2 such characteristics, life event stressors and coping, on initiation of cessation treatment and end-of-treatment abstinence status.One hundred five adolescent smokers were eligible to participate in a validated contingency management (CM) and cognitive-behavioral (CBT) cessation treatment; of those, 72 completed at least 1 treatment session. Data included sociodemographic characteristics, questionnaires assessing past-year life events and coping behavior use, and abstinence status at the end of the 4-week treatment. Logistic regression was used to predict treatment initiation and abstinence status, with life event stressor number, coping, or their interaction as predictors.Higher levels of cognitive and peer support coping predicted treatment initiation, whereas life events were unrelated. End-of-treatment abstinence was predicted by higher numbers of life events and greater use of avoidant coping. The interaction of helpless coping and life events also predicted abstinence, with greater increases in helpless coping as total life events rose in abstinent but not nonabstinent participants. Finally, greater use of behavioral coping predicted abstinence in participants exposed to only CM treatment, whereas lesser use of behavioral coping predicted abstinence in participants receiving combined CM/CBT treatment.Exposure to life event stressors may promote cessation by forcing use of self-control resources prior to the quit attempt, which may strengthen such resources. Techniques that improve self-control resources may improve cessation outcome, and prevention programs may want to emphasize behavioral coping to improve rates of treatment initiation.

SUBMITTER: Schepis TS

PROVIDER: S-EPMC5507612 | biostudies-other | 2015 Oct-Dec

REPOSITORIES: biostudies-other

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Project description:Based on the animal's reaction to environmental challenges, consistent but different coping styles can be identified, which in turn may have consequences for health and welfare. Therefore, profound knowledge of the complex interrelationships between individual behavioral response patterns, underlying neurobiological mechanisms and immunological effects is required. The aim of this study was to examine whether pigs with different coping styles exhibit distinct behavioral, neurobiological and immune responses to stressful situations. Therefore, pigs (n = 40) were classified as proactive, reactive or intermediate animals according to a repeatedly-performed backtest, and behavioral, neuroendocrine and immune alterations were analyzed without any stress before weaning on day 28 and after a stress treatment on day 32. Our results show that the behavioral responses in an open-field/novel-object test characterized proactive pigs as more active. There were no significant differences in adrenocorticotropic hormone and cortisol concentrations between pigs with different coping characteristics. However, we found that proactive pigs displayed significantly increased plasma noradrenaline levels in response to stress, which may reflect a higher sympathetic reactivity of these animals. Furthermore, the present study revealed coping style differences in mRNA expression of mineralocorticoid, glucocorticoid, oxytocin and arginine vasopressin receptors and the immediate early gene c-fos in stress-related brain regions. While proactive pigs responded to stress with higher mRNA expression of arginine vasopressin, mineralocorticoid and glucocorticoid receptors, reactive pigs displayed higher oxytocin receptor and c-fos mRNA expression, indicating different neurobiological mechanisms of distinct coping styles in response to stressful challenges. Moreover, we also found humoral immune differences between proactive, intermediate and reactive animals. Proactive pigs had a higher total serum IgA concentration before and after stress treatment, with a significant increase in response to stress compared to reactive and intermediate pigs. In contrast, stress-induced IgM concentrations only increased in reactive and intermediate animals, suggesting that the effects of coping style on humoral immunity may differ depending on the specific function of the immunoglobulin classes. In conclusion, this multidisciplinary study expands the concept of coping style in farm animals, particularly in terms of individual stress reactivity and disease susceptibility, and thus contributes to the understanding of the biology of animal welfare.

Project description:Aimto examine whether the severity of different categories of stressful events is associated with continued smoking and alcohol consumption during mid-pregnancy. Also, we explored the explanation of these associations by anxiety and depressive symptoms during pregnancy. Finally, we studied whether the severity of stressful events was associated with the amount of cigarettes and alcohol used by continued users.MethodWe conducted a cross-sectional analysis using data from a population-based prospective cohort study. Pregnant women were recruited via midwifery practices throughout The Netherlands. We analyzed women who continued smoking (n = 113) or quit (n = 290), and women who continued alcohol consumption (n = 124) or quit (n = 1403) during pregnancy. Smoking, alcohol consumption, and perceived severity of stressful events were measured at 19 weeks of gestation. The State Trait Anxiety Inventory and the Edinburgh Postnatal Depression Scale were filled out at 14 weeks of gestation. Odds ratios were calculated as association measures and indicated the relative increase for the odds of continuation of smoking and alcohol consumption for the maximum severity score compared to the minimum score.FindingsSeverity of the following stressful event categories was associated with continued alcohol consumption: 'conflict with loved ones' (OR = 10.4, p<0.01), 'crime related' (OR= 35.7, p<0.05), 'pregnancy-specific' (OR = 13.4, p<0.05), and the total including all events (OR = 17.2, p<0.05). Adjustment for potential confounders (age, parity and educational level) did not notably change the estimates. There was no association of anxiety and depressive symptoms with continued smoking or alcohol consumption. No associations emerged for continued smoking and severity of stressful events. The amount of cigarettes and alcohol consumption among continued users was not associated with severity of stressful events.ConclusionsOur findings may be relevant for health care providers, in particular midwives and general practitioners. The impact of stressful events may be considered when advising pregnant women on smoking and alcohol consumption.

Project description:AimsMost cigarette smokers want to quit smoking and more than half make an attempt every year, but less than 10% remain abstinent for at least 6 months. Evidence-based tobacco use treatment improves the likelihood of quitting, but more than two-thirds of individuals relapse when provided even the most robust treatments. Identifying for whom treatment is effective will improve the success of our treatments and perhaps identify strategies for improving current approaches.MethodsTwo cohorts (training: N = 90, validation: N = 71) of cigarette smokers enrolled in group cognitive-behavioral therapy (CBT). Generalized estimating equations were used to identify baseline predictors of outcome, as defined by breath carbon monoxide and urine cotinine. Significant measures were entered as candidate variables to predict quit status. The resulting decision trees were used to predict cessation outcomes in a validation cohort.ResultsIn the training cohort, the decision trees significantly improved on chance classification of smoking status following treatment and at 6-month follow-up. The first split of all decision trees, which was delay discounting, significantly improved on chance classification rates in both the training and validation cohort. Delay discounting emerged as the single best predictor of group CBT treatment response with an average baseline discount rate of ln(k) = -7.1, correctly predicting smoking status of 80% of participants at posttreatment and 81% of participants at follow-up.ConclusionsThis study provides a first step toward personalized care for smoking cessation though future work is needed to identify individuals that are likely to be successful in treatments beyond group CBT.ImplicationsThis study provides a first step toward personalized care for smoking cessation. Using a novel machine-learning approach, baseline measures of clinical and executive functioning are used to predict smoking cessation outcomes following group CBT. A decision point is recommended for the single best predictor of treatment outcomes, delay discounting, to inform future research or clinical practice in an effort to better allocate patients to treatments that are likely to work.

Project description:BackgroundMobile phone addiction has become a social problem that affects the healthy growth of adolescents, and it may be correlated with coping style. The aim of this study was to investigate the relationship between mobile phone addiction and coping style and the influencing factors for adolescents.MethodsA meta-analysis was conducted by searching China National Knowledge Infrastructure (CNKI), WANFANG DATA and Chongqing VIP Information Co., Ltd. (VIP), PubMed, Web of Science, Embase, and PsycINFO. Stata 16.0 was used to analyse the overall effect and test the moderating effect.ResultsThirty-three studies were included, involving a total of 20,349 subjects. There was no significant correlation between adolescents' mobile phone addiction and positive coping style (r = - 0.02, 95% CI = - 0.06 to 0.02, P > 0.05), but there was a moderate positive correlation between adolescents' mobile phone addiction and negative coping style (r = 0.31, 95% CI = 0.26 to 0.36, P < 0.001). The moderating effect analysis showed that the effect of dissertations on mobile phone addiction and positive coping style among adolescents was significantly larger than that of journal articles. The Smartphone Addiction Scale for College Students (SAS-C) showed the largest effect on mobile phone addiction and positive coping style among adolescents. The time of publication significantly positively moderated the relationship between mobile phone addiction and negative coping style among adolescents. The Simplified Coping Style Questionnaire (SCSQ) showed the largest effect on adolescents' mobile phone addiction and negative coping style. However, the correlation between adolescents' mobile phone addiction and coping style was not affected by age or gender.ConclusionsThere was a close relationship between mobile phone addiction and coping style among adolescents. In the future, longitudinal research should be carried out to better investigate the dynamic changes in the relationship between mobile phone addiction and coping style.

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Predicting Initiation of Smoking Cessation Treatment and Outcome Among Adolescents Using Stressful Life Events and Coping Style.

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