Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-24T16:28:13.008Z Has data issue: false hasContentIssue false
  • English
  • Français

Are social fears and DSM-IV social anxiety disorder associated with smoking and nicotine dependence in adolescents and young adults?

Published online by Cambridge University Press:  16 April 2020

H. Sonntag ,
H.U. Wittchen ,
M. Höfler ,
R.C. Kessler  and
M.B. Stein
H. Sonntag
Affiliation:
Max Planck Institute of Psychiatry, Clinical Psychology and Epidemiology,Munich, Germany
H.U. Wittchen
Affiliation:
Max Planck Institute of Psychiatry, Clinical Psychology and Epidemiology,Munich, Germany
M. Höfler
Affiliation:
Max Planck Institute of Psychiatry, Clinical Psychology and Epidemiology,Munich, Germany
R.C. Kessler
Affiliation:
Department of Health Care Policy, Harvard Medical School Boston,MA, USA
M.B. Stein
Affiliation:
Department of Psychiatry, University of California at San Diego,La Jolla, CA, USA
Get access

Summary

To investigate associations between social anxiety and smoking behaviour in order to explore whether social anxiety predicts the first onset of cigarette smoking, regular smoking and the development of nicotine dependence.

Baseline and four-year follow-up data from the Early Developmental Stages of Psychopathology Study (EDSP), a prospective-longitudinal community study of 3,021 adolescents and young adults, are used. Smoking behaviour and psychopathology were assessed with the M-CIDI and its DSM-IV algorithms. At baseline, 35.7% of the sample were regular smokers, and 18.7% fulfilled criteria for DSM-IV nicotine dependence. Twenty-seven point two percent reported at least one social fear, and 7.2% met criteria for DSM-IV social phobia, most of whom reported first onset of social fear problems clearly prior to smoking initiation. Cross-sectional retrospective baseline analyses based on retrospective reports revealed that social fears and DSM-IV social phobia were both significantly associated with higher rates of nicotine dependence. Prospective-longitudinal analyses that were conducted in an attempt to confirm cross-sectional retrospective results showed that baseline non-users with social fears (OR = 3.85) and baseline non-dependent users with social fears (OR = 1.5) had an increased risk of onset of nicotine dependence during the follow-up period of four years. These findings remained significant even when controlling for co-morbid depressive disorders. Social anxiety was found to be significantly associated with nicotine dependence in both cross-sectional retrospective and prospective-longitudinal analyses. It is suggested that social fears could lead to heavy tobacco use as smoking is a socially acceptable behaviour that relieves anxiety in social situations. Possible differential effects of social anxiety on the early stages of smoking behaviour compared to effects on nicotine dependence are discussed. These findings should stimulate a continued search into potentially causal links between social fear symptoms and the development of tobacco consumption and nicotine dependence in adolescence.

Keywords

nicotine dependencesmokingsocial anxietysocial fearssocial phobia
Type
Original article
Information
European Psychiatry , Volume 15 , Issue 1 , 2000 , pp. 67 - 74
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Breslau, N.Kilbey, M.Andreski, P.DSM-III-R nicotine dependence in young adults: prevalence, correlates, and associated psychiatric disorders. Addiction 1994; 89: 743–754CrossRefGoogle ScholarPubMed
Glassman, A.H.Helzer, J.E.Covey, L.S.Cottler, L.B.Stetner, F.Tipp, J.E.Smoking, smoking cessation, and major depression. JAMA 1990; 264: 1546–1549CrossRefGoogle ScholarPubMed
Nelson, C.B.Wittchen, H.-U.Smoking and nicotine dependence. Results from a sample of 14- to 24-year-olds in Germany. Eur Addict Res 1998; 4: 42–49CrossRefGoogle ScholarPubMed
Robins, L.A.Regier, D.N.eds. Psychiatric disorders in America: the Epidemiologic Catchment Area Study. 1991 New York: The Free PressGoogle Scholar
Breslau, N.Peterson, E.L.Schultz, L.R.Chilcoat, H.D.Andreski, P.Major depression and stages of smoking. Arch Gen Psychiatry 1998; 55: 161–166CrossRefGoogle ScholarPubMed
Brown, R.A.Lewinsohn, P.M.Seeley, J.R.Wagner, E.F.Cigarette smoking, major depression, and other psychiatric disorders among adolescents. J Am Acad Child Adolesc Psychiatry 1996; 35: 1602–1610CrossRefGoogle ScholarPubMed
Covey, L.S.Glassman, A.H.Stetner, F.Major depression following smoking cessation. Am J Psychiatry 1997; 154: 263–265Google ScholarPubMed
Peres-Stable, E.J.Marin, G.Marin, B.V.Depressive symptoms and cigarette smoking among Latinos in San Francisco. Am J Publ Health 1990; 80: 1500–150210.2105/AJPH.80.12.1500CrossRefGoogle Scholar
Breslau, N.Psychiatric comorbidity of smoking and nicotine dependence. Behav Gen 1995; 25: 95–101CrossRefGoogle ScholarPubMed
Gilbert, D.G.Gilbert, B.O.Personality, psychopathology, and nicotine response as mediators of the genetics of smoking. Behav Gen 1995; 25: 133–147CrossRefGoogle ScholarPubMed
Breslau, N.Kilbey, M.Andreski, P.Nicotine dependence, major depression, and anxiety in young adults. Arch Gen Psychiatry 1991; 48: 1069–1074CrossRefGoogle ScholarPubMed
Wittchen, H.U.Stein, M.B.Kessler, R.C.Social fears and social phobia in a community sample of adolescents and young adults: prevalence, risk factors and co-morbidity. Psychol M 1999; 29: 309–323CrossRefGoogle Scholar
Kessler, R.C.Stein, M.B.Berglund, P.Social phobia subtypes in the National Comorbidity Survey. Am J Psychiatry 1998; 155: 613–619CrossRefGoogle ScholarPubMed
Stein, M.B.Chavira, D.A.Subtypes of social phobia and comorbidity with depression and other anxiety disorders. J Affect Dis 1998; 50: S11–S1610.1016/S0165-0327(98)00092-5CrossRefGoogle ScholarPubMed
Stein, M.B.Walker, J.R.Forde, D.R.Setting diagnostic thresholds for social phobia: considerations from a community survey of social anxiety. Am J Psychiatry 1994; 151: 408–412Google ScholarPubMed
Stein, M.B.Walker, J.R.Forde, D.R.Public speaking fears in a community sample: Prevalence, impact on functioning, and diagnostic classification. Arch Gen Psychiatry 1996; 53: 169–174CrossRefGoogle Scholar
Wittchen, H.U.Nelson, C.B.Lachner, G.Prevalence of mental disorders and psychosocial impairments in adolescents and young adults. Psychol M 1998; 28: 109–126CrossRefGoogle ScholarPubMed
Wittchen, H.U.Perkonigg, A.Lachner, G.Nelson, C.B.Early Developmental Stages of Psychopathology Study (EDSP) - Objectives and design. Eur Addict Res 1998; 4: 18–27CrossRefGoogle ScholarPubMed
Lee, E.S.Forthofer, R.N.Lorimor, R.J.Analyzing complex survey data.Sage University paper series on quantitative applications in the social sciences. Series no. 07-071. 1989 Beverly Hills: SageGoogle Scholar
Perkonigg, A.Lieb, R.Höfler, M.Schuster, P.Sonntag, H.Wittchen, H.-U.Patterns of cannabis use, abuse and dependence over time: incidence, and stability in a sample of 1228 adolescents. Addiction 1999; 94: 1663–1678CrossRefGoogle Scholar
Wittchen, H.U.Pfister, H.eds. DIA-X-Interview: Manual für Screening-Verfahren und Interview; Interviewheft Längsschnittuntersuchung (DIA-X-Lifetime); Ergänzungsheft (DIA-X-Lifetime); Interviewheft Querschnittuntersuchung (DIA-X-12 Monate); Ergänzungsheft (DIA-X-12 Monate); PC-Programm zur Durchführung des Interviews (Längs- und Querschnittuntersuchung)Auswertungsprogramm 1997 Frankfurt: Sweets & ZeitlingerGoogle Scholar
World Health Organization. The Composite International Diagnostic Interview (CIDI). 1990 Geneva: World Health Organization, Division of Mental HealthGoogle Scholar
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th 1994 Washington, DC: APAGoogle Scholar
World Health Organization. International Classification of Disease. 10th rev. 1994 Geneva: World Health Organization, Division of Mental HealthGoogle Scholar
Pfister, H.Wittchen, H.U.M-CIDI Computerprogramm. 1995 München: Max-Planck-Institut für Psychiatrie, Klinisches InstitutGoogle Scholar
Wittchen, H.U.Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): A critical review. J Psychiatr Res 1994; 28: 57–84CrossRefGoogle ScholarPubMed
Kessler, R.C.Wittchen, H.U.Abelson, J.M.McGonagle, K.Schwarz, N.Kendler, K.S.Methodological studies of the Composite International Diagnostic Interview (CIDI) in the US National Comorbidity Survey (NCS). Int J Meth Psychiatr Res 1998; 7: 33–55CrossRefGoogle Scholar
Wittchen, H.U.Lachner, G.Wunderlich, U.Pfister, H.Test-retest reliability of the computerized DSM-IV version of the Munich-Composite International Diagnostic Interview (M-CIDI). Soc Psychiatry Psychiatr Epidemiol 1998; 33: 568–578CrossRefGoogle ScholarPubMed
Lachner, G.Wittchen, H.U.Perkonigg, A.Holly, A.Schuster, P.Wunderlich, U.Structure, content and reliability of the Munich-Composite International Diagnostic Interview (M-CIDI). Substance use sections. Eur Addict Res 1998; 4: 28–41CrossRefGoogle ScholarPubMed
Reed, V.Gander, F.Pfister, H.Steiger, A.Sonntag, H.Trenkwalder, C.To what degree the Composite International Diagnostic Interview (CIDI) correctly identifies DSM-IV Disorders. Testing validity issues in a clinical sample. Int J Meth Psychiatr Res 1998; 7: 142–155CrossRefGoogle Scholar
StataCorp. Stata Statistical Software: Release 6.0. 1999 College Station, TX: Stata CorporationGoogle Scholar
Royall, R.M.Model robust confidence intervals using maximum likelihood estimators. Int Statist Rev 1986; 54: 221–226CrossRefGoogle Scholar
McCullagh, P.Nelder, F.Generalized Linear Models. 2nd 1989 London: Chapman & HallCrossRefGoogle Scholar
Wittchen, H.U.Fuetsch, M.Sonntag, H.Müller, N.Liebowitz, M.Disability and quality of life in pure and comorbid social phobia. Findings from a controlled study. Eur Psychiatry 2000; 15: 46–5810.1016/S0924-9338(00)00211-XCrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.