, 2003; Ginsberg, Hall, Reus, & Mu?oz, 1995; Haas, Mu?oz, Humfleet, Reus, & Hall, 2004; Hitsman et al., 1999; Japuntich et al., selleckbio 2007; Killen, Fortmann, Davis, Strausberg, & Varady, 1999; Kinnunen, Doherty, Militello, & Garvey, 1996; Leventhal, Ramsey, Brown, LaChance, & Kahler, 2008; Niaura et al., 2001; Rausch, Nichinson, Lamke, & Matloff, 1990; Swan et al., 2003). A common account of this effect is that depressed smokers are more prone to relapse because they have high levels of negative affect (NA) and find it difficult to cope without using cigarettes to alleviate aversive emotions. However, research has not consistently supported this explanation (McChargue, Spring, Cook, & Neumann, 2004; Spring et al., 2008). It is often overlooked that depressive symptomatology is a multifactorial construct that includes several distinct subdimensions (Shafer, 2006).

Most multifactorial models of depressive symptoms include independent dimensions of anhedonia and NA and sometimes retain additional nonaffective dimensions (Shafer, 2006). Anhedonia involves deficient levels of positive emotions (e.g., feelings of joy, interest, and alertness) and a lack of hedonic responsiveness to pleasant stimuli. In contrast, NA is associated with the experience of aversive emotions (e.g., sadness, irritability, anxiety, and agitation) and hyperresponsiveness to aversive stimuli. These two dimensions are psychometrically distinct (Watson & Clark, 1997), associate with different neural underpinnings (Davidson, Ekman, Saron, Senulis, & Friesen, 1990), and have unique psychosocial correlates (Watson & Clark, 1997).

Anhedonia is also conceptually and psychometrically distinct from other affective constructs related to low emotional reactivity, including alexithymia (i.e., the inability to identify and describe emotions; Loas, Fremaux, & Boyer, 1997) and affective flattening (i.e., blunting of both positive and negative emotions; Loas, Salinas, Pierson, & Guelfi, 1994). To isolate the domains of affective disturbance that play the strongest role in smoking cessation, we previously studied the influence of empirically distinct subdimensions of depressive symptoms among individuals participating in a cessation treatment study (Leventhal, Ramsey, et al., 2008). Results showed that higher precessation levels of NA, anhedonia, and somatic features (i.e.

, a dimension indicative of physical symptoms) each predicted lower cessation success, with anhedonia having the strongest influence. However, when the dimensions were considered concomitantly, only anhedonia predicted poorer outcomes incrementally to the Dacomitinib other dimensions. Furthermore, anhedonia��s effect was incremental to other relevant clinical characteristics, such as tobacco dependence severity, cigarettes per day, and history of major depression. Additional studies have found that anhedonia, or low positive affect, predicts poorer cessation outcomes (Carton, Le Houezec, Lagrue, & Jouvent, 2002; Doran et al.