General Hospital Psychiatry
Volume 32, Issue 5 , Pages 492-498, September 2010

Family factors are associated with psychological distress and smoking status in chronic obstructive pulmonary disease☆

  • Kristen E. Holm, Ph.D.

      Affiliations

    • Department of Medicine, National Jewish Health, Denver, CO 80206, USA
    • Corresponding Author InformationCorresponding author. National Jewish Health, Division of Psychosocial Medicine, B101a, Denver, CO 80206, USA. Tel.: +1 303 398 1509.
    • ,
  • Heather R. LaChance, Ph.D.

      Affiliations

    • Department of Medicine, National Jewish Health, Denver, CO 80206, USA
    • Department of Psychiatry, University of Colorado Denver, Denver, CO, USA
    • ,
  • Russell P. Bowler, M.D., Ph.D.

      Affiliations

    • Department of Medicine, National Jewish Health, Denver, CO 80206, USA
    • Department of Medicine, University of Colorado Denver, Denver, CO, USA
    • ,
  • Barry J. Make, M.D.

      Affiliations

    • Department of Medicine, National Jewish Health, Denver, CO 80206, USA
    • Department of Medicine, University of Colorado Denver, Denver, CO, USA
    • ,
  • Frederick S. Wamboldt, M.D.

      Affiliations

    • Department of Medicine, National Jewish Health, Denver, CO 80206, USA
    • Department of Psychiatry, University of Colorado Denver, Denver, CO, USA

Received 17 March 2010; accepted 29 June 2010. published online 11 August 2010.

Abstract 

Objective

The objective of this study was to test three hypotheses in a sample of individuals with chronic obstructive pulmonary disease (COPD): (1) unsupportive family relationships are associated with psychological distress, (2) psychological distress is associated with smoking status and (3) unsupportive family relationships are indirectly associated with smoking status via psychological distress.

Method

Cross-sectional data were collected via self-report questionnaires completed by 455 individuals with COPD who had at least a 10-pack-year smoking history. The hypotheses were tested with structural equation modeling.

Results

All three hypotheses were supported. Unsupportive family relationships were associated with psychological distress (β=.67, P<.001), psychological distress was associated with smoking status (β=.40, P<.001), and unsupportive family relationships were indirectly associated with smoking status via psychological distress (β=.27, P<.001).

Conclusion

Results of this study suggest that family relationships are an important factor to include in future longitudinal research that attempts to elucidate social and psychological influences on smoking behavior.

Keywords: Depression, Anxiety, Smoking, Chronic obstructive pulmonary disease

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☆ Funding/Support: This project was supported by funding from the National Institutes of Health [grants F32 HL083687, K23 HL091049], a Postdoctoral Research Fellowship Grant from the Alpha-1 Foundation, and the Flight Attendant Medical Research Institute.

PII: S0163-8343(10)00136-2

doi:10.1016/j.genhosppsych.2010.06.007

General Hospital Psychiatry
Volume 32, Issue 5 , Pages 492-498, September 2010

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