Posttraumatic stress disorder and anxious and fearful reactivity to bodily arousal: a test of the mediating role of nicotine withdrawal severity among daily smokers in 12-hr nicotine deprivation.

Posttraumatic stress disorder (PTSD) is associated with high rates of smoking and fear of bodily perturbation. The current study examined the role of nicotine withdrawal in the association between PTSD and responding to bodily arousal among 52 participants (27 women; M-sub(age) = 30.50 years). Compared to participants without current axis I psychopathology, persons with current PTSD responded to a 3-min voluntary hyperventilation procedure with greater increases in anxiety and more intense cognitive and physical panic symptoms, despite no group differences in physiological arousal. Nicotine withdrawal demonstrated significant mediational effects in the relations between diagnostic group and panic symptoms elicited by the hyperventilation procedure. Findings suggest nicotine withdrawal is an important factor to consider in terms of better understanding the nature of fear responding to bodily sensations among persons with PTSD.