Emotional Self-regulation, Impulsivity, 5-HTTLPR and Tobacco Use Behavior Among Psychiatric Inpatients

Overview

Journal J Affect Disord

Date 2022 May 27

PMID 35623482

Authors

A V Wilkinson

A C Swann

D P Graham

M A Patriquin

R Salas

D A Nielsen

T R Kosten

Affiliations

Soon will be listed here.

Abstract

Background: While the serotonin transporter (SLC6A4) gene, 5-HTTLPR, interacts with the social environment to influence both emotional self-regulation and smoking behavior, less is known about interactions between emotional self-regulation and 5-HTTLPR or their joint influence on tobacco use. Here, we examined such interactions among psychiatric inpatients, the population with the highest rates of smoking.

Methods: Participants (506 adults) were psychiatric inpatients at The Menninger Clinic in Houston TX between 2012 and 16. Most were white (89%), male (55%), with a mean age of 32.3 years. Participants completed the Difficulties in Emotional Regulation Scale (DERS) at admission. We examined interactions with smoking among three DERS subscales and 5-HTTLPR, controlling for sex, race and age.

Results: Smoking rates were higher among those with the 5-HTTPLR L'L' genotype compared to peers carrying an S' allele (47.9% vs. 37.4%, respectively). Among S' allele carrying participants, impulse control difficulties (OR = 1.09; 95%CI: 1.03-1.14) and lack of emotion clarity (OR = 1.06; 95%CI: 1.00-1.11) increased risk for ever using tobacco, while accessing more ways to regulate emotion (OR = 0.95; 95%CI: 0.92-0.99) offered a protective effect against ever using tobacco. Neither demographic nor DERS covariates were associated with using tobacco among the L'L' group.

Limitations: This ethnically homogenous sample limits generalizability and using a binary outcome can over-estimate a gene environment interaction effect.

Conclusions: Emotional self-regulation exerts a stronger influence on using tobacco among carriers of an S' allele of 5-HTTLPR than peers with the L'L' genotype. Promoting emotional self-regulatory skills may have benefits for preventing tobacco use.

References

Nakamura M, Ueno S, Sano A, Tanabe H . The human serotonin transporter gene linked polymorphism (5-HTTLPR) shows ten novel allelic variants. Mol Psychiatry. 2000; 5(1):32-8. DOI: 10.1038/sj.mp.4000698. View

Lesch K, Bengel D, Heils A, Sabol S, Greenberg B, Petri S . Association of anxiety-related traits with a polymorphism in the serotonin transporter gene regulatory region. Science. 1996; 274(5292):1527-31. DOI: 10.1126/science.274.5292.1527. View

Lipsky R, Hu X, Goldman D . Additional functional variation at the SLC6A4 gene. Am J Med Genet B Neuropsychiatr Genet. 2008; 150B(1):153. PMC: 2716041. DOI: 10.1002/ajmg.b.30766. View

Swann A, Graham D, Wilkinson A, Kosten T . Nicotine Inhalation and Suicide: Clinical Correlates and Behavioral Mechanisms. Am J Addict. 2021; 30(4):316-329. DOI: 10.1111/ajad.13171. View

Heinz A, Jones D, Mazzanti C, Goldman D, Ragan P, Hommer D . A relationship between serotonin transporter genotype and in vivo protein expression and alcohol neurotoxicity. Biol Psychiatry. 2000; 47(7):643-9. DOI: 10.1016/s0006-3223(99)00171-7. View

Nielsen D, Deng H, Patriquin M, Harding M, Oldham J, Salas R . Association of TPH1 and serotonin transporter genotypes with treatment response for suicidal ideation: a preliminary study. Eur Arch Psychiatry Clin Neurosci. 2019; 270(5):633-642. DOI: 10.1007/s00406-019-01009-w. View

Perkins K, Karelitz J, Giedgowd G, Conklin C, Sayette M . Differences in negative mood-induced smoking reinforcement due to distress tolerance, anxiety sensitivity, and depression history. Psychopharmacology (Berl). 2010; 210(1):25-34. PMC: 2882096. DOI: 10.1007/s00213-010-1811-1. View

Zvolensky M, Feldner M, Eifert G, BROWN R . Affective style among smokers: understanding anxiety sensitivity, emotional reactivity, and distress tolerance using biological challenge. Addict Behav. 2002; 26(6):901-15. DOI: 10.1016/s0306-4603(01)00242-8. View

Wilkinson A, Bondy M, Wu X, Wang J, Dong Q, DAmelio Jr A . Cigarette experimentation in Mexican origin youth: psychosocial and genetic determinants. Cancer Epidemiol Biomarkers Prev. 2011; 21(1):228-38. PMC: 3382046. DOI: 10.1158/1055-9965.EPI-11-0456. View

10.

Bataineh B, Wilkinson A, Case K, Clendennen S, Sumbe A, Chen B . Emotional symptoms and sensation seeking: Implications for tobacco interventions for youth and young adults. Tob Prev Cessat. 2021; 7:37. PMC: 8138947. DOI: 10.18332/tpc/133571. View

11.

Carson K, Brinn M, Labiszewski N, Esterman A, Chang A, Smith B . Community interventions for preventing smoking in young people. Cochrane Database Syst Rev. 2011; (7):CD001291. PMC: 11384554. DOI: 10.1002/14651858.CD001291.pub2. View

12.

Jiang F, Li S, Pan L, Zhang N, Jia C . Association of anxiety disorders with the risk of smoking behaviors: a meta-analysis of prospective observational studies. Drug Alcohol Depend. 2014; 145:69-76. DOI: 10.1016/j.drugalcdep.2014.10.022. View

13.

Hu X, Lipsky R, Zhu G, Akhtar L, Taubman J, Greenberg B . Serotonin transporter promoter gain-of-function genotypes are linked to obsessive-compulsive disorder. Am J Hum Genet. 2006; 78(5):815-826. PMC: 1474042. DOI: 10.1086/503850. View

14.

Park J, Naragon-Gainey K . Is more emotional clarity always better? An examination of curvilinear and moderated associations between emotional clarity and internalising symptoms. Cogn Emot. 2019; 34(2):273-287. PMC: 6874711. DOI: 10.1080/02699931.2019.1621803. View

15.

Kobiella A, Reimold M, Ulshofer D, Ikonomidou V, Vollmert C, Vollstadt-Klein S . How the serotonin transporter 5-HTTLPR polymorphism influences amygdala function: the roles of in vivo serotonin transporter expression and amygdala structure. Transl Psychiatry. 2012; 1:e37. PMC: 3309509. DOI: 10.1038/tp.2011.29. View

16.

McCaffery J, Bleil M, Pogue-Geile M, Ferrell R, Manuck S . Allelic variation in the serotonin transporter gene-linked polymorphic region (5-HTTLPR) and cardiovascular reactivity in young adult male and female twins of European-American descent. Psychosom Med. 2003; 65(5):721-8. DOI: 10.1097/01.psy.0000088585.67365.1d. View

17.

Folkman S, Lazarus R . Stress-processes and depressive symptomatology. J Abnorm Psychol. 1986; 95(2):107-13. DOI: 10.1037//0021-843x.95.2.107. View

18.

Hughes J . Effects of abstinence from tobacco: valid symptoms and time course. Nicotine Tob Res. 2007; 9(3):315-27. DOI: 10.1080/14622200701188919. View

19.

Kosten T, Domingo C, Hamon S, Nielsen D . DBH gene as predictor of response in a cocaine vaccine clinical trial. Neurosci Lett. 2013; 541:29-33. PMC: 3631430. DOI: 10.1016/j.neulet.2013.02.037. View

20.

Pampel F, Boardman J, Daw J, Stallings M, Smolen A, Haberstick B . Life events, genetic susceptibility, and smoking among adolescents. Soc Sci Res. 2015; 54:221-32. PMC: 4607932. DOI: 10.1016/j.ssresearch.2015.08.001. View