Abstract Objective: Approaches for effectively treating smoking in those with posttraumatic stress disorder (PTSD) and with major depressive disorder (MDD) could be improved by identifying motivational processes underlying their tobacco dependence. The goal of this study was to identify the motivational processes influencing smoking dependence among smokers with PTSD and with MDD relative to non-diagnosed controls. Methods: Participants were United States (US) veterans who smoked daily (N = 162) and met DSM-IV criteria for either PTSD (n = 52), MDD (n = 52), or no current psychiatric disorder (controls; n = 58). Smoking dependence motives were assessed via the Brief Wisconsin Inventory for Smoking Dependence Motives (Brief WISDM). The 11 Brief WISDM subscales are categorized into two major factors: Primary Dependence Motives and Secondary Dependence Motives. Results: Smokers with PTSD scored higher than non-diagnosed controls on the following Primary Dependence Motives subscales: Automaticity, Craving, and Tolerance (all p-values <.05). Smokers with PTSD, relative to controls, also scored higher on the overall Secondary Dependence Motives subscale, and on five of the seven Secondary Dependence Motives subscales: Cue Exposure/Associative Processes, Affective Enhancement, Affiliative Attachment, Cognitive Enhancement, and Weight Control (all p-values < .05). Smokers with MDD scored significantly higher than controls on one Primary Dependence Motives subscale: Craving and on four of seven Secondary Dependence Motives subscales: Affective Enhancement, Affiliative Attachment, Cognitive Enhancement, and Weight Control (all p-values <.05). Finally, exploratory analyses directly contrasting the PTSD group with the MDD group showed that smokers with PTSD were higher than those with MDD in the overall Secondary Dependence Motives subscale and one of the seven Secondary Dependence Motives subscales: Cue Exposure/Associative Processes (all p-values < .05). Conclusions: Results suggest that both Primary Dependence Motives and Secondary Dependence Motives play a meaningful role in motivation to use tobacco in smokers with PTSD; smoking dependence in those with MDD may be primarily influenced by Secondary Dependence Motives.

中文翻译：

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患有创伤后应激障碍、抑郁症且没有精神疾病的人吸烟的动机

摘要 目的：通过识别烟草依赖背后的动机过程，可以改进有效治疗创伤后应激障碍 (PTSD) 和重度抑郁症 (MDD) 患者吸烟的方法。本研究的目的是确定相对于非诊断对照，影响患有 PTSD 和 MDD 的吸烟者吸烟依赖的动机过程。方法：参与者是美国 (US) 退伍军人，他们每天吸烟 (N = 162) 并符合 DSM-IV 的 PTSD (n = 52)、MDD (n = 52) 或目前没有精神疾病（对照组；n = 58)。吸烟依赖动机通过威斯康星州吸烟依赖动机简要清单（Brief WISDM）进行评估。11 个简短的 WISDM 分量表分为两个主要因素：主要依赖动机和次要依赖动机。结果：患有 PTSD 的吸烟者在以下主要依赖动机分量表上的得分高于未确诊的对照：自动性、渴望和耐受性（所有 p 值 <.05）。与对照组相比，患有 PTSD 的吸烟者在整体次要依赖动机分量表和七个次要依赖动机分量表中的五个分量表上得分也更高：提示暴露/联想过程、情感增强、附属依恋、认知增强和体重控制（所有p 值 < .05）。患有 MDD 的吸烟者在一个主要依赖动机分量表：渴望和七个次要依赖动机分量表中的四个分量表上得分明显高于对照组：情感增强、附属依恋、认知增强和体重控制（所有 p 值 <.05）。最后，将 PTSD 组与 MDD 组直接对比的探索性分析表明，在整体二级依赖动机分量表和七个二级依赖动机分量表之一：提示暴露/联想过程（所有 p-值 < .05）。结论：结果表明，主要依赖动机和次要依赖动机在患有 PTSD 的吸烟者使用烟草的动机中都发挥着有意义的作用；MDD 患者的吸烟依赖可能主要受次要依赖动机的影响。提示暴露/关联过程（所有 p 值 < .05）。结论：结果表明，主要依赖动机和次要依赖动机在患有 PTSD 的吸烟者使用烟草的动机中都发挥着有意义的作用；MDD 患者的吸烟依赖可能主要受次要依赖动机的影响。提示暴露/关联过程（所有 p 值 < .05）。结论：结果表明，主要依赖动机和次要依赖动机在患有 PTSD 的吸烟者使用烟草的动机中都发挥着有意义的作用；MDD 患者的吸烟依赖可能主要受次要依赖动机的影响。