Evaluation of the mood and physical symptoms scale (MPSS) to assess cigarette withdrawal

Abstract

Rationale

The mood and physical symptoms scale (MPSS) was developed in the early 1980s to assess cigarette withdrawal symptoms, and variants of it have been used for 20 years. To date, no paper has been published on the properties of the scale.

Objectives

To evaluate psychometric properties of MPSS and the interrelationship between the key tobacco withdrawal symptoms.

Methods

The core elements of the MPSS involve 5-point ratings of depressed mood, irritability, restlessness, difficulty concentrating and hunger and 6-point ratings of strength of urges to smoke and time spent with these urges. The data set chosen for analysis was well suited to the task in that it involved a relatively large sample, abstinence was defined as “not a puff” for 24 h biochemically verified, participants were not using any medication that would have reduced withdrawal discomfort (e.g. nicotine patch), the abstinence rate was very high resulting in minimal bias due to attrition, and ratings were provided on three occasions prior to abstinence. The study involved 111 smokers setting a target quit date of whom 106 attempted abstinence and 96 achieved it.

Results

The MPSS items were stable prior to abstinence and sensitive to abstinence. Post-abstinence increases in mood and physical symptoms demonstrated a high level of internal coherence. Ratings of urges to smoke correlated highly with changes in mood and other symptoms. Ratings of hunger correlated less well with the scale as a whole and may involve some distinct processes.

Conclusions

The MPSS meets the key requirements of a cigarette withdrawal scale. Although urge to smoke/craving was not included in the list of DSM-IV withdrawal symptoms, it should be regarded as forming part of the withdrawal syndrome.

Appendix 1: Mood and physical symptoms scale (MPSS)

Please show for each of the items how you have been feeling over the past 24 h (circle one number for each item).

	Not at all	Slightly	Somewhat	Very	Extremely
Depressed	1	2	3	4	5
Irritable	1	2	3	4	5
Restless	1	2	3	4	5
Hungry	1	2	3	4	5
Poor concentration	1	2	3	4	5

How much of the time have you felt the urge to smoke in the past 24 h? (circle one number).

All the time	Almost all the time	A lot of the time	Some of the time	A little of the time	Not at all
5	4	3	2	1	0

How strong have the urges been? (circle one number).

Extremely strong	Very strong	Strong	Moderate	Slight	No urges
5	4	3	2	1	0

1. The timescale referred to in the header to the scale can vary. Usually it is 24 h or 1 week. In this study, all questions were with reference to the past 24 h