The overarching aim of the current application is to examine whether a 12-hour nicotine withdrawal period (versus no withdrawal) among daily smokers results in greater fearful responding to induced bodily sensations among those with Panic Disorder (PD), as compared to those without PD. Specifically, we will examine whether smokers with PD compared to those without PD experience increased fearful responding to, and delayed recovery from, a 10% carbon dioxide-enriched air (CO2) laboratory procedure, as measured by: (1) post-challenge level of anxiety focused on bodily sensations and intensity of panic attack symptoms;(2) change in expired pCO2 from pre- to post-challenge;and (3) rate of recovery from the challenge in terms of anxiety focused on bodily sensations and expired pCO2.

Public Health Relevance

The results of the study will directly inform smoking-panic comorbidity models, and serve more generally as an illustration of how unhealthy behaviors (smoking) affect and maintain mental health impairment. Overall, the proposed investigation represents a clinically significant test for a program of research aimed at understanding the mechanisms underlying highly prevalent panic-smoking comorbidity problems, which ultimately will inform the development of novel specialized interventions, with the goal of improving mental and physical health simultaneously via smoking cessation efforts that specifically address issues of such comorbidity among this difficult-to-treat population.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Predoctoral Individual National Research Service Award (F31)
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Special Emphasis Panel (ZRG1-HOP-T (29))
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Lin, Yu
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University of Vermont & St Agric College
Schools of Arts and Sciences
United States
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Yang, Min-Jeong; Zvolensky, Michael J; Leyro, Teresa M (2017) The indirect effect of panic disorder on smoking cognitions via difficulties in emotion regulation. Addict Behav 72:126-132
Farris, Samantha G; Zvolensky, Michael J; Otto, Michael W et al. (2015) The role of distress intolerance for panic and nicotine withdrawal symptoms during a biological challenge. J Psychopharmacol 29:783-91
Leyro, Teresa M; Zvolensky, Michael J (2013) The interaction of nicotine withdrawal and panic disorder in the prediction of panic-relevant responding to a biological challenge. Psychol Addict Behav 27:90-101
Leyro, Teresa M; Berenz, Erin C; Brandt, Charles P et al. (2012) Evaluation of perseveration in relation to panic-relevant responding: an initial test. Behav Cogn Psychother 40:205-19
Leyro, Teresa M; Bernstein, Amit; Vujanovic, Anka A et al. (2011) Distress Tolerance Scale: A Confirmatory Factor Analysis Among Daily Cigarette Smokers. J Psychopathol Behav Assess 33:47-57
Marshall-Berenz, Erin C; Gonzalez, Adam; Leyro, Teresa M et al. (2011) Examination of mask disturbance behavior during a carbon dioxide-enriched air challenge. J Behav Ther Exp Psychiatry 42:253-7
Leyro, Teresa M; Zvolensky, Michael J; Bernstein, Amit (2010) Distress tolerance and psychopathological symptoms and disorders: a review of the empirical literature among adults. Psychol Bull 136:576-600