MEDIATOR ROLE OF METACOGNITION IN THE RELATIONSHIP BETWEEN NICOTINE ADDICTION AND EMOTION DYSREGULATION IN ADULT SMOKERS
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Keywords

Nicotine addiction
emotion regulation
metacognitive beliefs
cognitive regulation

Abstract

Objective: Examining the psychological factors underlying nicotine addiction seems important in understanding the maintenance of addiction. This study examined the association between severity of nicotine addiction, difficulties in emotion regulation (DER) and metacognitive beliefs (MCBs).
Method: The sample consisted of 255 people at the age of 18 and over, smoking at least one cigarette daily. The data were collected online by using the Turkish versions of Fagerström Test for Nicotine Dependence, Difficulties in Emotion Regulation Scale-Short Form, Metacognitions About Smoking Questionnaire, and Demographic Information Form.
Results: A significant positive relationship was found between daily cigarette consumption and the severity of nicotine addiction. Among difficulties in emotion regulation, nonacceptance emerged as a significant predictor. Additionally, both positive metacognitive beliefs related to cognitive regulation and negative metacognitive beliefs regarding uncontrollability significantly predicted nicotine dependence. Findings also showed that metacognitive beliefs had a mediating role in the relationship between difficulties in emotion regulation and addiction severity. While the initial model accounted for 40% of the variance, the inclusion of metacognitive beliefs increased the explained variance to 58%, underscoring their substantial explanatory power.
Conclusion: The substantial increase in the expained variance reflects the strong explanatory contribution of metacognitive beliefs in understanding the severity of nicotine addiction.

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References

Gross JJ. Emotion regulation: conceptual and empirical foundations. Handbook of Emotion Regulation 2014; 2: 3-20.

Weiss NH, Kiefer R, Goncharenko S, et al. Emotion regulation and substance use: a meta-analysis. Drug Alcohol Depend 2022; 230:109131.

Adams GE, Matthew TT, Gratz KL. The role of emotional nonacceptance in the relation between depression and recent cigarette smoking. Am J Addict 2012; 21 (4): 293-301.

Rogers AH, Bakhshaie J, Viana AG, et al. Emotion dysregulation and smoking among treatment-seeking smokers. Addict Behav 2018; 79:124-130.

Zvolensky MJ, Shepherd JM, Bakhshaie J, et al. Emotion dysregulation and smoking outcome expectancies among Spanish-speaking Latinx adult cigarette smokers in the United States. Psychol Addict Behav 2019; 33(6): 574-579.

Hitsman B, Borrelli B, McChargue DE, et al. History of depression and smoking cessation outcome: a meta- analysis. J Consult Clin Psychol 2003; 71: 657-663.

Wells A, Capobianco L. Metacognition. In: Abramowitz JS, Blakey SM, editors. Clinical Handbook of Fear And Anxiety: Maintenance Processes And Treatment Mechanisms. Washington (DC): American Psychological Association; 2020. p. 171-182.

Wells A. Metacognitive therapy for anxiety and depression. New York: Guilford Press; 2009.

Khosravani V, Zandifar A, Bastan FS, et al. Psychometric properties of the Persian versions of the Positive Alcohol Metacognitions Scale (Persian-PAMS) and the Negative Alcohol Metacognitions Scale (Persian-NAMS) in alcoholdependent individuals. Addict Behav 2020; 101:106113.

Marino C, Canale N, Vieno A, et al. Social anxiety and Internet gaming disorder: the role of motives and metacognitions. J Behav Addict 2020; 9(3): 617-628.

Izadpanah M, Najafi M, Khosravani V. Anxiety in social interactions and nicotine dependence in nicotinedependent men: the role of metacognitions about smoking. Addict Behav 2021; 112:106656.

Alma L, Spada MM, Fernie BA, et al. Metacognitions in smoking: evidence from a cross-cultural validation of the Metacognitions about Smoking Questionnaire in a Turkish sample. Psychiatr Res 2018; 259:160-168.

Niköevic AV, Caselli G, Wells A, et al. The Metacognitions about Smoking Questionnaire: development and psychometric properties. Addict Behav 2015; 44:102-107.

Poormahdy H, Najafi M, Khosravani V, et al. The effects of emotion dysregulation and negative affect on urge to smoke and nicotine dependence: the different roles of metacognitions about smoking. Addict Behav 2022; 124: 107108.

Spada MM, Niköevic AV, Moneta GB, et al. Metacognition as a mediator of the relationship between emotion and smoking dependence. Addict Behav 2007; 32(10): 2120-2129.

Carver DS, Johnson SL, Joormann J, et al. Serotonergic function, two-mode models of self-regulation, and vulnerability to depression: what depression has in common with impulsive aggression. Psychol Bull 2008; 134: 912-943.

Pardo Y, Aguilar R, Molinuevo B, et al. Alcohol use as a behavioral sign of disinhibition: evidence from J. A. Gray's model of personality. Addict Behav 2007; 32: 2398-2403.

Heatherton TF, Kozlowski LT, Frecker RC, et al. The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict 1991; 86:1119-1127.

Uysal MA, Kadakal F, Karşıdağ Ç, et al. Fagerstrom Test for Nicotine Dependence: reliability in a Turkish sample and factor analysis. Tüberküloz Toraks Derg 2004; 52(2): 115-121.

Bjureberg J, Ljotsson B, Tull MT, et al. Development and validation of a brief version of the Difficulties in Emotion Regulation Scale: the DERS-16. J Psychopathol Behav Assess 2016; 38(2): 284-296.

Yiğit!, Güzey-Yiğit M. Psychometric properties of Turkish version of Difficulties in Emotion Regulation Scale-Brief Form (DERS-16). Curr Psychol 2017; 1-9.

Lanza ST, Vasilenko SA. New methods shed light on age of onset as a risk factor for nicotine dependence. Addict Behav 2015; 50:161-164.

Öncel SY, Gebizlioğlu ÖL, Alioğlu FA, et al. Risk factors for smoking behavior among university students. Turk J Med Sci 2011; 41 (6): 1071-1080.

Antonuccio DO, Mosier JM, et al. Smoking (nicotine dependence). In: Fisher JE, O’Donohue WT, editors. Practitioner’s guide to evidence-based psychotherapy. Boston (MA): Springer; 2006.

Balfour DJK. The psychobiology of nicotine dependence. Eur Respir Rev 2008; 17(110): 172-181.

Velotti P, Rogier G, Zobel SB, et al. Association between gambling disorder and emotion (deregulation: a systematic review and meta-analysis. Clin Psychol Rev 2021; 87:102037.

Fucito LM, Juliano LM, Toll BA, et al. Cognitive reappraisal and expressive suppression emotion regulation strategies in cigarette smokers. Nicotine Tob Res 2010; 12(11): 1156-1161.

Bakhshaie J, Zvolensky MJ, Langdon KJ, et al. Reduction of anxiety sensitivity in relation to nicotine withdrawal symptoms during smoking cessation: an examination among successful quitters. Cog Behav Ther 2018; 47(4): 301-314.

Stasiewicz PR, Bradizza CM, Gudleski GD, et al. The relationship of alexithymia to emotional dysregulation within an alcohol dependent treatment sample. Addict Behav 2012; 37(4): 469-476.

Özdemir S, Tunç P. The effects of borderline personality and sociodemographic traits on self-harm and suicidal behavior in substance use disorder. J Psychiatr Nurs 2022; 13(1): 15-23.

Richardson CM. Emotion regulation in the context of daily stress: impact on daily affect. Pers Individ Dif 2017; 112:150-156.

Gonzalez A, Zvolensky MJ, Vujanovic AA, et al. An evaluation of anxiety sensitivity, emotional dysregulation, and negative affectivity among daily cigarette smokers: relation to smoking motives and barriers to quitting. J Psychiatr Res 2009; 43(2): 138-147.

Najafi M, Khosravani V, Shahhosseini M, et al. The psychometric properties of the Persian version of the Metacognitions about Smoking Questionnaire among smokers. Addict Behav 2018; 84:62-68.

Spada MM, Caselli G, Niköevic AV, et al. Metacognition in addictive behaviors. Addict Behav 2015; 44:9-15.

Alma-Uzuntuna L, Yılmaz AE. Sigara bağımlılığına üstbilişsel yaklaşım: güncel duruma ilişkin bir gözden geçirme. Addicta 2019; 6(4): 30-48.

Niezabitowska A, Rokosz M, Poprawa R, et al. Distress tolerance is indirectly related to nicotine use through the smoking motives. Subst Use Misuse 2022; 57(5): 751-758.

Spada MM, Wells A. A metacognitive model of problem drinking. Clin Psychol Psychother 2009; 16(5): 383-393.

Wells A. Emotional disorders and metacognition: innovative cognitive therapy. Chichester: Wiley; 2000. 100— 236.

Niköevic AV, Alma L, Marino C, et al. Modelling the contribution of negative affect, outcome expectancies and metacognitions to cigarette use and nicotine dependence. Addict Behav 2017; 74:82-89.

Özer D, Şahin Alton Ö, Kayaoğlu K, et al. Evaluation of metacognition, difficulties in emotion regulation and addiction severity levels of individuals diagnosed with substance use disorder. J Subst Use 2024; 30(3): 498- 504.

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