Mood changes after indoor tanning among college women: associations with psychiatric/addictive symptoms
Indoor tanning (IT) has been linked with psychiatric and addictive symptoms, and frequent tanning may indicate tanning dependence (addiction). The current study evaluated the effects of an IT episode on mood states and the association of these effects with psychiatric and addictive symptoms among young adult female indoor tanners. One-hundred thirty-nine female university students aged 18-25 years who had indoor tanned completed an online survey including the Positive and Negative Affects Scales and a standardized psychiatric interview (the MINI International Neuropsychiatric Interview) via telephone. Psychiatric and addictive symptoms were relatively common among these young adult female indoor tanners. Overall, partici pants reported significant decreases in both negative (upset, scared, irritable, nervous, jittery, afraid) and positive (feeling interested) mood states after their most recent tanning episode. Multivariable lin ear regression analyses showed that more frequent indoor tanning in the past month and symptoms of illicit drug use disorders were asso ciated with decreases in negative mood, and symptoms of generalized anxiety disorder were associated with a decrease in feeling interested. In summary, indoor tanners report relatively high rates of psychiatric and substance use symptoms, including symptoms of tanning depend ence, and indoor tanning appears to alter mood. Women with certain substance use and psychiatric characteristics may be more vulnerable to such mood changes after tanning indoors. Further research is need ed to clarify the relationships among these variables.
1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association.
2. Asvat, Y., Cafri, G., Thompson, J. K., & Jacobsen, P. B. (2010). Appearance-based tanning motives, sunbathing intentions, and sun protection intentions in adolescents. Archives of dermatology, 146, 445-446.
3. Bagdasarov, Z., Banerjee, S., Greene, K., & Campo, S. (2008). Indoor tanning and problem behavior. Journal of American college health, 56, 555-561.
4. Benjamini, Y., & Hochberg, Y. (1995). Controlling the false discovery rate: a practical and powerful approach to multiple testing. Journal of the Royal Statistical Society: Series B, 57, 289-300.
5. Cokkinides, V., Weinstock, M., Lazovich, D., Ward, E., & Thun, M. (2009). Indoor tanning use among adolescents in the US, 1998 to 2004. Cancer, 115, 190-198.
6. Colantonio, S., Bracken, M. B., & Beecker, J. (2014). The association of indoor tanning and melanoma in adults: systematic review and meta-analysis. Journal of the American academy of dermatology, 70, 847-857.
7. Feldman, S. R., Liquori, A., Kucenic, M., Rapp, S. R., Fleischer, A. B. Jr, Lang, W., & Kaur, M. (2004). Ultraviolet exposure is a reinforcing stimulus in frequent indoor tanners. Journal of the American academy of dermatology, 51, 45-51.
8. Gardner, J. S., Szpunar, C. A., O'Connell, M. J., Facklam, D. P., Mariano, J. P., Borden, E. K., & Leinweber, F. B. (1996). Cohort maintenance and comparability in a pharmacoepidemiologic study using a commercial consumer panel to recruit comparators. Pharmacoepidemiology and drug safety, 5, 207-214.
9. Guy, G. P. Jr., Berkowitz, Z., Tai, E., Holman, D. M., Everett Jones, S., & Richardson, L. C. (2014). Indoor tanning among high school students in the United States, 2009 and 2011. JAMA Dermatology, 150, 501-511.
10. Harrington, C. R., Beswick, T. C., Leitenberger, J., Minhajuddin, A., Jacobe, H. T., & Adinoff, B. (2010). Addictive-like behaviours to ultraviolet light among frequent indoor tanners. Clinical and experimental dermatology, 36, 33-38.
11. Heckman, C. J., Cohen-Filipic, J., Darlow, S., Kloss, J. D., Manne. L., & Munshi, T. (2014). Psychiatric and addictive symptoms of young adult female indoor tanners. American journal of health promotion: AJHP, 28, 168-174.
12. Heckman, C. J., Darlow, S., Kloss, J. D., Cohen-Filipic, J., Manne, S. L., Munshi, T., ..., Perlis, C. (2014). Measurement of tanning dependence. Journal of the European Academy of Dermatology and Venereology: JEADV, 28, 1179-1185.
13. Hillhouse, J., Stapleton, J., & Turrisi, R. (2005). Association of frequent indoor UV tanning with seasonal affective disorder. Archives of dermatology, 141, 1465.
14. Hillhouse, J., Turrisi, R., Jaccard, J., & Robinson, J. (2012). Accuracy of self-reported sun exposure and sun protection behavior. Prevention science: the official journal of the Society for Prevention Research, 13, 519-531.
15. Hillhouse, J., Turrisi, R., Stapleton, J., & Robinson, J. (2010). Effect of seasonal affective disorder and pathological tanning motives on efficacy of an appearance-focused intervention to prevent skin cancer. Archives of dermatology, 146, 485-491.
16. Ingledew, D. K., Ferguson, E., & Markland, D. (2010). Motives and sun-related behaviour. Journal of health psychology, 15, 8-20.
17. Kaur, M., Liguori, A., Lang, W., Rapp, S. R., Fleischer, A. B. Jr, & Feldman, S. R. (2006). Induction of withdrawal-like symptoms in a small randomized, controlled trial of opioid blockade in frequent tanners. Journal of the American academy of dermatology, 54, 709-711.
18. Kourosh, A. S., Harrington, C. R., & Adinoff, B. (2010). Tanning as a behavioral addiction. American journal of drug and alcohol abuse, 36, 284-290.
19. Leary, M. R., Saltzman, J. L., & Georgeson, J. C. (1997). Appearance motivation, obsessive-compulsive tendencies and excessive suntanning in a community sample. Journal of health psychology, 2, 493-499.
20. Lecrubier, Y., Sheehan, D. V., Weiller, E., Amorim, P., Bonora, I., Harnett Sheehan, K., ..., Dunbar G. C. (1997). The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. European psychiatry, 12, 224-231.
21. Lepage, M. L., & Crowther, J. H. (2010). The effects of exercise on body satisfaction and affect. Body image, 7, 124-130.
22. Lin, K. H., Guo, N. W., Liao, S. C., Kuo, C. Y., Hu, P. Y., Hsu, J. H., ..., Guo, Y. L. (20). Psychological outcome of injured workers at 3 months after occupational injury requiring hospitalization in Taiwan. Journal of occupational health, 54, 289-298.
23. Lostritto, K., Ferrucci, L. M., Cartmel, B., Leffell, D. J., Molinaro, A. M., Bale, A. E., & Mayne, S. T. (2012). Lifetime history of indoor tanning in young people: a retrospective assessment of initiation, persistence, and correlates. BMC public health, 12, 118.
24. Magnusson, A., Friis, S., & Opjordsmoen, S. (1997). Internal consistency of the Seasonal Pattern Assessment Questionnaire (SPAQ). Journal of Affective Disorders, 42, 113-116.
25. Matthews, N., Farnsworth, B., & Griffiths, M. D. (2009). A pilot study of problem gambling among student online gamblers: mood states as predictors of problematic behavior. Cyberpsychology & Behavior, 12, 741-745.
26. Mosher, C. E., & Danoff-Burg, S. (2010a). Addiction to indoor tanning: relation to anxiety, depression, and substance use. Archives of dermatology, 146, 412-417.
27. Mosher, C. E., & Danoff-Burg, S. (2010b). Indoor tanning, mental health, and substance use among college students: the significance of gender. Journal of health psychology, 15, 819-827.
28. Phillips, K. A., Conroy, M., Dufresne, R. G., Menard, W., Didie, E. R., Hunter-Yates, J., ..., & Pagano, M. (2006). Tanning in body dysmorphic disorder. Psychiatric quarterly, 77, 129-138.
29. Poorsattar, S. P., & Hornung, R. L. (2007). UV light abuse and high-risk tanning behavior among undergraduate college students. Journal
30. Reed, D. D. (2015). Ultra-violet indoor tanning addiction: a reinforcer pathology interpretation. Addictive Behaviors, 41, 247-251.
31. United States Department of Health and Human Services. (2014). The Surgeon General's Call to Action to Prevent Skin Cancer. Washington, DC: United States Department of Health and Human Services.
32. Reed, K. B., Brewer, J. D., Lohse, C. M., Bringe, K. E., Pruitt, C. N., & Gibson, L. E. (2012). Increasing incidence of melanoma among young adults: an epidemiological study in Olmsted County, Minnesota. Mayo Clin Proceedings, 87, 328-334.
33. Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of personality and social psychology, 54, 1063-1070.
34. Rosenthal, N. E., Genhart, M. Jack, D. A., Skwerer, R. G., & Wehr, T. A. (1987). Seasonal affective disorder and its relevance for the understanding and treatment of bulimia. In: J. I. Hudson, H. G. Pope (Eds), The psychology of bulimia (pp 205-228). Washington, DC: American Psychiatric Press.
35. Wehner, M. R., Shive, M. L., Chren, M. M., Han, J., Qureshi A. A., & Linos E. (2012). Indoor tanning and non-melanoma skin cancer: systematic review and meta-analysis. B British medical journal, 345, e5909.
36. Shvartzman, P., Weiner, Z., Vardy, D., Friger, M., Sherf, M., & Biderman, A. (2005). Health services utilization by depressive patients identified by the MINI questionnaire in a primary care setting. Scandinavian Journal of Primary Health Care, 23, 18-25.
37. West, R., Gilsenan, A., Coste, F., Zhou, X., Brouard, R., Nonnemaker, J., ..., Sullivan, S. D. (2006). The ATTEMPT cohort: a multi-national longitudinal study of predictors, patterns and consequences of smoking cessation; introduction and evaluation of internet recruitment and data collection methods. Addiction, 101, 1352-1361.
38. Spring, B., Cook, J. W., Appelhans, B., Maloney, A., Richmond, M., Vaughn, J., ..., Hedeker, D. (2008). Nicotine effects on affective response in depression-prone smokers. Psychopharmacology (Berl), 196, 461-471.
39. Zhang, M., Qureshi, A. Z., Geller, A. C., Frazier, L., Hunter, D. J., & Han, J. (2012). Use of tanning beds and incidence of skin cancer. Journal of Clinical Oncology, 30, 1588-1593.