History of major depressive disorder among smokers in cessation treatment: Associations with dysfunctional attitudes and coping

We examined baseline differences in dysfunctional attitudes and coping associated with a history of major depressive disorder (MDD) among 435 smokers participating in a smoking cessation trial. Consistent with expectations, MDD history was associated with greater dysfunctional attitudes, greater use of maladaptive coping, less use of adaptive coping, and greater dysphoria and negative mood. The effects of MDD history on cognition and coping were independent from the effects of a history of alcohol dependence (AD), indicating that MDD history is a unique risk factor for variables associated with vulnerability to depression. Finally, regression analyses showed that the effects of MDD history on depressive symptoms and negative mood were mediated by dysfunctional attitudes and by both adaptive and maladaptive coping. Results indicate that smokers with an MDD history seeking cessation treatment possess characteristics that may be targets for cognitive-behavioral treatments (CBT) aimed at addressing vulnerability to depression and negative moods during smoking cessation.