Acoustic startle and prepulse inhibition predict smoking lapse in posttraumatic stress disorder (original) (raw)
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Psychopharmacology, 2011
Rationale Exaggerated startle response is a prominent feature of posttraumatic stress disorder (PTSD) although results examining differences in the acoustic startle response (ASR) between those with and without PTSD are mixed. One variable that may affect ASR among persons with PTSD is smoking. Individuals with PTSD are more likely to smoke and have greater difficulty quitting smoking. While smokers with PTSD report that smoking provides significant relief of negative affect and PTSD symptoms, the effects of smoking or nicotine deprivation on startle reactivity among smokers with PTSD are unknown.
Biological Psychiatry, 2007
Background-Evidence suggests that the transition from experimental to regular smoking is facilitated by the influence of tobacco on affective and attentional mechanisms. The objective of this study was to examine affective and attentional responses in young adult smokers using fearpotentiated startle and prepulse inhibition. Methods-Participants were 56 college non smokers, non-abstinent smokers, and overnightabstinent smokers. The fear-potentiated startle test examined phasic responses to imminent threat cues and more sustained responses to unpredictable aversive events. Prepulse inhibition investigated responses to attended and ignored prepulse stimuli. Results-Abstinent and non-abstinent smokers showed increased sustained potentiation of startle to contextual cues, compared to controls. Abstinent smokers showed increased fear-potentiated startle to threat cues, compared to non-smokers. PPI did not discriminate between abstinent or nonabstinent smokers and controls. Conclusion-These findings suggest that negative affectivity or anxiety is associated with smoking, particularly during withdrawal. Potentiated startle may provide a valuable tool in understanding the biologic mechanisms underlying nicotine withdrawal and inform cessation and prevention efforts.
Studies that have investigated the effect of motivation to change on the startle reflex have been limited to comparisons among smokers with low and high motivation, but differences in the startle reflex throughout all stages of change have not been studied. Therefore, the aim of the present study was to identify differences in the startle reflex in response to tobacco-related cues in smokers in the initial, intermediate, and final stages of change. The startle reflex was recorded in 67 smokers and ex-smokers while they viewed pleasant, neutral, unpleasant, and tobaccorelated pictures. The results showed that the pattern of the startle reflex in response to tobacco-related pictures varied according to the motivation to change. In smokers in the initial stages, the magnitude of the startle reflex was similar between tobacco-related pictures and pleasant pictures. In smokers in intermediate stages, the magnitude of the startle reflex was similar between tobacco-related pictures and unpleasant pictures. In ex-smokers in the final stages, the magnitude of the startle reflex was similar between tobacco-related pictures and neutral pictures. These results suggest that motivational systems that are activated by tobacco-related cues vary according to smokers' motivation to change.
The influence of stress on the affective modulation of the startle response to nicotine cues
Applied psychophysiology and biofeedback, 2014
Recent research suggesting that nicotine cues are appetitive in nature promotes the affective modulation of the startle reflex (AMSR) paradigm as a potentially valuable psychophysiological tool for elucidating mechanisms involved in nicotine addiction. Despite numerous studies indicating stress as a key factor in nicotine dependence, specific behavioral mechanisms linking stress and smoking have yet to be explicated. The current study aimed to determine the effects of stress, a negative affective state intimately linked with nicotine use, on the psychophysiological responding of nicotine dependent individuals during smoking cues. Twenty-nine nicotine dependent individuals were randomly assigned to the trier social stress test or control condition directly prior to administration of the AMSR paradigm, which examined their physiological responses to appetitive, neutral, aversive, and nicotine cue images. Both groups evinced significantly decreased startle magnitudes in response to nic...
Rationale Cue reactivity and startle reflex modulation paradigms have been used in addiction research to determine the affective motivational state of craving induced by viewing drug-related cues. However, recent studies suggest that cue reactivity and startle reflex modulation in people with addictions can be suppressed, or even reversed, depending on context. Objective The present study looked at the contextual specificity of smoking cue startle modulation by examining individuals with low and high motivation to quit smoking. Materials and methods Emotional modulation of the startle reflex was examined in 32 female smokers exposed to affective stimuli and tobacco cues. The sample was divided into high and low motivation to quit smoking groups using the Processes of Change Questionnaire. Results The tobacco cues produced a greater startle magnitude in the group with high motivation to quit smoking than the group with low motivation, which was independent of craving level. Conclusion Motivation to be abstinent is a relevant contextual factor accounting for variance in cue reactivity in individual smokers.
Startle cue-reactivity differentiates between light and heavy smokers
Addiction, 2009
Aims It is assumed that the startle amplitude in smokers is reduced while viewing pictures of smoking, suggesting that smoking cues are appetitive. The goal of the present study was to investigate (1) whether smoking scenes induce appetitive cue effects in smokers, and (2) whether smoking intensity is related to cue reactivity. Design Smokers and non-smokers participated in a single session. Participants A total of 62 individuals participated: 36 smokers and 26 non-smokers. Measurements Participants took part in an acoustic startle experiment using standardised pleasant, neutral and unpleasant scenes from the International Affective Picture System (IAPS), as well as pictures of smoking. The effect of smoking cues was assessed by comparing neutral and smoking scenes (termed cue-related startle suppression, CSS). Findings While there was no overall difference between smokers and non-smokers regarding the CSS, the light smokers showed statistically increased cue reactivity towards smokingrelated cues, as compared with heavy smokers and non-smokers. In addition, light smokers also displayed stronger appetitive responses towards positive stimuli. Conclusions This novel finding supports recent theories which discriminate between habitbased and incentive-based drug abuse. This distinction may have consequences for the assessment and treatment of drug-addicted subjects. Furthermore, incentive-based light smoking seems to have general effects on the reward system.
Differential cigarette-related startle cue reactivity among light, moderate, and heavy smokers
Addictive Behaviors, 2012
In this study, we examined the relationship between the level of daily cigarette consumption and the startle response to affective and cigarette-related cues among treatment-seeking smokers. Before receiving any behavioral or pharmacological treatment, 136 smokers attended a baseline laboratory session, during which we recorded their reflexive eyeblink responses to acoustic startle probes while they were viewing pleasant, unpleasant, neutral, and cigarette-related pictures. We found that 1) cigarette-related and pleasant pictures similarly reduced the startle magnitude compared to neutral pictures; 2) the magnitude of startle modulation rendered by pleasant or unpleasant pictures did not differ among light, moderate, and heavy smokers; and 3) startle attenuation by cigarette-related pictures was greater in heavy smokers than in light smokers. These results suggest that similar to pleasant stimuli, cigarette-related cues are motivationally salient for smokers, and that this salience increases with nicotine dependence.
Experimental and Clinical Psychopharmacology, 2012
Much effort has been devoted to examining the differences in postcessation affective experience between smoking abstainers and relapsers. However, little attention has been given to the affective changes of smokers who, despite their motivation to quit, fail to achieve even a brief period of abstinence. Using affect-modulated startle response and self-report questionnaires, we measured the postcessation affective changes of 115 smokers (60 men, 55 women) who participated in a laboratory investigation of affective reactivity during smoking cessation. Among our participants, 34 were abstainers (16 men, 18 women), 16 were never-quitters (8 men, 8 women), 19 were relapsers (8 men, 11 women), and 46 were controls (28 men, 18 women). We found a significant Stimulus Valence ϫ Session ϫ Group interaction effect on startle responses, which suggested that while abstainers, relapsers, and control exhibited the prototypical affect-modulated startle response across postcessation sessions, never-quitters displayed an atypical response pattern in which emotional pictures no longer modulated the startle response. Never-quitters also reported increasingly higher negative and lower positive affect across postcessation sessions. Using affect-modulated startle response and self-report questionnaires, this study found a significant difference in the affective reactivity between smokers who could and smokers who could not establish an initial abstinence of 24 hours.
Addictive Behaviors, 2010
The present study evaluated differences among daily smokers with posttraumatic stress disorder (PTSD), panic disorder (PD), panic attacks (PA), and no axis I psychopathology (past 6 months) in terms of several cognitive-affective variables implicated in both the onset and maintenance of anxiety psychopathology and cigarette smoking. The sample consisted of 123 daily smokers (62% women: M age = 29.7, SD = 11.9). Compared to the PA and no psychopathology groups, the PTSD group reported significantly higher levels of anxiety sensitivity, discomfort intolerance, negative affectivity, anxious arousal, and anhedonic depression; and, the PTSD group reported significantly lower levels of perceived control over anxiety-related events than the PA group. The PD group, compared to those in the PA and no psychopathology groups, reported significantly higher levels of anxiety sensitivity, negative affectivity, and anxious arousal; and significantly lower levels of perceived control over anxiety-related events. No significant differences were evident between the PTSD and PD groups. Theoretical and clinical implications of the present findings are discussed in terms of smoking and emotional vulnerability.