Identifying Shared Latent Dimensions of Psychological Symptoms: Implications for the Psychological Correlates of Smoking

Abstract

Shared latent dimensions may account for the co-occurrence of multiple forms of psychological dysfunction. However, this conceptualization has rarely been integrated into the smoking literature, despite high levels of psychological symptoms in smokers. In this study, we used confirmatory factor analysis to compare three models (1-factor, 2-factor [internalizing-externalizing], and 3-factor [low positive affect-negative affect-disinhibition]) of relations among nine measures of affective and behavioral symptoms implicated in smoking spanning depression, anxiety, happiness, anhedonia, ADHD, aggression, and alcohol use disorder symptoms. We then examined associations of scores from each of the manifest scales and the latent factors from the best-fitting model to several smoking characteristics (i.e., experimentation, lifetime established smoking [≥100 cigarettes lifetime], age of smoking onset, cigarettes/day, nicotine dependence, and past nicotine withdrawal). We used two samples: (1) College Students (N =288; mean age =20; 75 % female) and (2) Adult Daily Smokers (N=338; mean age=44; 32 % female). In both samples, the 3-factor model separating latent dimensions of deficient positive affect, negative affect, and disinhibition fit best. In the college students, the disinhibition factor and its respective indicators significantly associated with lifetime smoking. In the daily smokers, low positive and high negative affect factors and their respective indicators positively associated with cigarettes/day and nicotine withdrawal symptom severity. These findings suggest that shared features of psychological symptoms may be parsimonious explanations of how multiple manifestations of psychological dysfunction play a role in smoking. Implications for research and treatment of co-occurring psychological symptoms and smoking are discussed.

Keywords: Disinhibition; Negative affect; Positive affect; Smoking.

Fig. 1

Hypothesized 1-factor model of psychological scales. b. Hypothesized 2-factor model of psychological scales. c. Hypothesized 3-factor model of psychological scales. SHS Subjective Happiness Scale, CESD:ANH Center for Epidemiologic Studies Depression-Anhedonia Scale, MASQ Mood and Anxiety Symptom Scale AD Anhedonic Depression Scale, GDD General Distress Depression Scale, GDA General Distress Anxious Scale, AA Anxious Arousal Scale, AQR:PA Aggression Questionnaire Revised-Physical Aggression Scale, ASRS Adult ADHD Self-Report Scale, AUDIT Alcohol Use Disorders Identification Test. Error terms associated with each psychological scale are not shown

Fig. 2

a. Best-fitting model of psychological symptom scales, factor loadings, and factor correlations in Study Sample 1: College Students (N=288). b. Best-fitting model of psychological symptom scales, factor loadings, and factor correlations in Study Sample 2: Adult Daily Smokers (N=338). SHS Subjective Happiness Scale, CESD:ANH Center for Epidemiologic Studies Depression-Anhedonia Scale. MASQ Mood and Anxiety Symptom Scale, AD Anhedonic Depression Scale, GDD General Distress Depression Scale, GDA General Distress Anxious Scale, AA Anxious Arousal Scale, AQR:PA Aggression Questionnaire Revised-Physical Aggression Scale, ASRS Adult ADHD Self-Report Scale, AUDIT Alcohol Use Disorders Identification Test. All factor loadings and factor correlations are standardized. Error terms associated with each psychological scale are not shown *p<.05, **p<.01, †p<.001

Fig. 3

a. Second-order factor model of psychological scales, factor loadings, and factor correlations in Study Sample 1: College Students (N=288). b. Second-order factor model of psychological scales, factor loadings, and factor correlations in Study Sample 2: Adult Daily Smokers (N=338). SHS Subjective Happiness Scale, CESD:ANH Center for Epidemiologic Studies Depression-Anhedonia Scale, MASQ Mood and Anxiety Symptom Scale, AD Anhedonic Depression Scale, GDD General Distress Depression Scale, GDA General Distress Anxious Scale, AA Anxious Arousal Scale, AQR:PA Aggression Questionnaire Revised-Physical Aggression Scale, ASRS Adult ADHD Self-Report Scale, AUDIT Alcohol Use Disorders Identification Test. All factor loadings and factor correlations are standardized. Error terms associated with each psychological scale are not shown*<.05, **<.01, †<.001