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The handle http://hdl.handle.net/1887/25815 holds various files of this Leiden University
dissertation.
Author: Jamal, Mumtaz
Title: Smoking and the course of anxiety and depression
Issue Date: 2014-05-22
Smoking and the Course of
Anxiety and Depression
Mumtaz Jamal
Jamal, M.
Smoking and the Course of Anxiety and Depression.
Dissertation Leiden University, the Netherlands.
ISBN: 978-94-6203-587-4
Printing: Ipskamp Drukkers
Financial support for this research project was provided by the Higher Education Commission
(HEC) of Pakistan in the form of a fellowship.
© 2014 by Mumtaz Jamal, Leiden, the Netherlands. All rights reserved.
Smoking and the Course of Anxiety
and Depression
Proefschrift
ter verkrijging van
de graad van Doctor aan de Universiteit Leiden,
op gezag van Rector Magnificus prof. mr. C.J.J.M. Stolker,
volgens besluit van het College voor Promoties
te verdedigen op donderdag 22 mei 2014
klokke 11:15 uur
door
Mumtaz Jamal
geboren te Pakistan
in 1978
Promotiecommissie
Promotors
Prof. dr. A.J.W. van der Does
Prof. dr. B.W.J.H. Penninx (Vrije Universiteit)
Overige leden
Prof. dr. Ph. Spinhoven
Prof. dr. A.M. van Hemert
Dr. M. Bot (VU Medisch Centrum)
To my beloved and inspiring parents (late)
‫ِِعقاب‬
ِ‫ِمخالفِسےِنہِگهبراِاے‬
ِِِِ ِِ ِ ِِ ِِِ ِ ِِ ِِِ ِ ِِِِِ
‫تندئِِبا ِد‬
ِ ِِِ
‫یہِتوچلتیِہےِتجهےِاونچاِاڑانےِکےِلئے‬
Fear not O falcon bright,
the gusty wind 'gainst your flight,
That seeks to make you try,
even higher to fly
Table of Contents
Contents
1.
2.
3.
4.
General Introduction
1
1.1. Background
2
1.1.1. Smoking-Psychopathology Association Studies
2
1.1.2. Developmental Pathways to the Co-occurrence of Smoking / Psychopathology 4
1.2. Theories Explaining Smoking-Depression / Anxiety Association
9
1.2.1. Causal Theories
9
1.2.2. Non-Causal Theories
9
1.2.2.1. Shared Vulnerability Factors Explaining Smoking-Depression / Anxiety
Association
10
1.2.2.2. Other Risk Factors
11
1.3. Smoking-Depression / Anxiety Possible Linking Mechanisms
13
1.3.1. BDNF Val66Met Polymorphism
13
1.3.2. Serum Brain-Derived Neurotrophic Factor
14
1.3.3. Attentional Control
16
1.4. Aims and Outlines of the Thesis
17
References
19
Age at Smoking-Onset and the Onset of Depression and Anxiety Disorders
29
2.1. Abstract
30
2.2. Introduction
31
2.3. Methods
34
2.3.1. Participants and Data
34
2.3.2. Measures
35
2.3.3. Statistical Analyses
36
2.4. Results
38
2.5. Discussion
44
References
47
Association of Smoking and Nicotine Dependence with Severity and Course of Symptoms in
Patients with Depressive or Anxiety Disorder
53
3.1. Abstract
54
3.2. Introduction
55
3.3. Methods
58
3.3.1. Participants and Data
58
3.3.2. Measures
59
3.3.3. Statistical Analyses
60
3.4. Results
63
3.4.1. Sample Characteristics
63
3.4.2. Symptom Severity at Baseline
64
3.4.3. Smoking Status and the Course of Depression and Anxiety
68
3.5. Discussion
70
References
74
Effect of Variation in BDNF Val66Met Polymorphism, Smoking, and Nicotine Dependence on
Symptom Severity of Depressive and Anxiety Disorders
81
4.1. Abstract
82
4.2. Introduction
83
4.3. Methods
86
4.3.1. Participants and Data
86
4.3.2. Measures
87
4.3.3. Statistical Analyses
89
Table of Contents
4.4.
Results
90
4.4.1. Sample Characteristics
90
4.4.2. Association of BDNF Genotype with Smoking, and with Symptom Severity
90
4.4.3. Interaction Effect of BDNF Genotype and Smoking on Symptom Severity
92
4.4.4. Predictors of Symptom Severity
94
4.5. Discussion
96
References
100
5. Effect of Smoking, Nicotine Dependence and BDNF Val66Met Polymorphism on serum BDNF 107
5.1. Abstract
108
5.2. Introduction
109
5.3. Methods
112
5.3.1. Participants and Data
112
5.3.2. Measures
112
5.3.3. Statistical Analyses
115
5.4. Results
116
5.4.1. Sample Characteristics
116
5.4.2. Association of Smoking and BDNF Genotype with Serum BDNF
118
5.4.3. Predictors of Serum BDNF
119
5.5. Discussion
120
References
122
6. Attentional Bias and Attentional Control across Information Processing Phases in Smokers and
Non-Smokers: A Dot-Probe Study
127
6.1. Abstract
128
6.2. Introduction
129
6.3. Methods
133
6.3.1. Participants
133
6.3.2. Materials
133
6.3.3. Procedure
135
6.3.4. Data Reduction and Statistical Analyses
135
6.4. Results
138
6.4.1. Group Differences in Attentional Bias to Smoking-Related Pictures
139
6.4.2. The Relationship Between Attentional Control and Attentional Bias
140
6.5. Discussion
143
References
147
7. General Discussion
151
7.1. Summary of the Findings
152
7.2. Explaining Smoking-Psychopathology Linking Mechanisms/ Risk Factors
156
7.2.1. Age at the Time of Nicotine Exposure
156
7.2.2. Nicotine Dependence
159
7.2.3. Candidate Genes
159
7.2.4. Nicotine Acetylcholine Receptors
161
7.2.5. Attentional Control
161
7.3. Methodological Considerations
163
7.4. Clinical Implications
165
7.5. Future Research Directions
166
7.6. Conclusion
169
7.7. References
171
8. Nederlandse Samenvatting
181
9. Curriculum Vitae
187
10. Acknowledgements
189
11. Publications
191

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