Category: Trauma and Stressor Related Disorders and Disasters

Symposium

Role of Negative Emotion Regulation Strategies in Treatment for Comorbid PTSD and Nicotine Dependence

Sunday, November 19
10:15 AM - 11:45 AM
Location: Cobalt 500, Level 5, Cobalt Level

Keywords: Emotion Regulation | Stress | Smoking
Presentation Type: Symposium

Although clinical lore suggests that emotion regulation (ER) impairments may be a contraindication for confronting traumatic memories in PTSD treatment (Wolfsdorf & Zlotnick, 2001), empirical evidence suggests otherwise (e.g., Jerud et al., 2016). However, given the high prevalence of smoking among individuals with PTSD (Stewart, 2014), as well as evidence suggesting that affective disturbances are associated with lower smoking quit rates (Leventhal et al., 2011), it is possible that in smokers with PTSD, poor ER can impact treatment outcome. This study therefore examined whether greater baseline negative ER strategies predicted worse PTSD and smoking outcomes following treatment for PTSD and smoking cessation. Patients with chronic PTSD and nicotine dependence (N = 142) received up to twelve sessions of smoking cessation counseling plus varenicline (VARCC) or integrated prolonged exposure therapy and VARCC. Pre-treatment ER was assessed using the Cognitive Emotion Regulation Questionnaire (Garnefski & Spinhoven, 2001) and PTSD and smoking outcomes were measured at pre/post-treatment and three-month follow-up using the Posttraumatic Symptom Scale Interview (Foa et al., 1993) and biologically-confirmed abstinence rates, respectively. We hypothesized that individuals reporting higher baseline negative ER strategies would improve more slowly than individuals reporting lower use of these strategies. Multilevel modeling revealed that higher baseline negative ER strategies did not moderate change in overall PTSD symptoms (p = .07) or PTSD symptoms of re-experiencing (p = .87), but, in line with our hypothesis, did moderate change in PTSD symptoms of avoidance (B = .02, SE = .01, t(152.79) = 2.11, p = .04) and hyperarousal (B = .01, SE = .01, t(153.41) = 2.10, p = .04). Baseline negative ER strategies did not moderate smoking abstinence outcomes (p = .71). These findings suggest that pre-treatment ER impairments should not be seen as a contraindication for integrated PTSD and smoking treatment, though they may slow improvements in avoidance and hyperarousal symptoms.

Alissa B. Jerud

Postdoctoral Fellow
University of Pennsylvania, Center for the Treatment and Study of Anxiety

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Role of Negative Emotion Regulation Strategies in Treatment for Comorbid PTSD and Nicotine Dependence



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