title: The impact of alcohol dependence and posttraumatic stress disorder on cold pressor task response.
abstract: OBJECTIVE
  Posttraumatic stress disorder (PTSD) is commonly comorbid with alcohol-use disorders. Abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis response are common in both disorders. The objective of this study was to investigate HPA axis reactivity to the cold pressor task (CPT) among individuals with alcohol dependence, PTSD, and comorbid alcohol dependence and PTSD.
  
  
  METHODS
  Participants were 119 individuals with alcohol dependence only (n = 31), comorbid alcohol dependence and PTSD (n = 28), PTSD without alcohol dependence (n = 30), and a control group (n = 30). Subjective response, adrenal corticotropic hormone (ACTH), and cortisol were measured before, immediately after, and for 120 minutes after each subject completed the CPT.
  
  
  RESULTS
  There were significant group and gender differences found in the subjective and ACTH response, with significantly higher subjective stress ratings and decreased ACTH response in the alcohol-dependent, PTSD, and comorbid alcohol dependent-PTSD groups compared with the control group.
  
  
  CONCLUSIONS
  There were differences in the HPA axis and subjective response to the CPT between the control group and both the alcohol and PTSD groups. The HPA response in the comorbid alcohol-PTSD group was not significantly different than that of the alcohol-only or PTSD-only groups.
authors.affiliation: Division of Clinical Neuroscience, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Box 250861, Charleston, South Carolina 29425, USA. bradyk@musc.edu
authors.forename: Kathleen T
authors.initials: KT
authors.lastname: Brady
authors.forename: Angela E
authors.initials: AE
authors.lastname: Waldrop
authors.forename: Aimee L
authors.initials: AL
authors.lastname: McRae
authors.forename: Sudie E
authors.initials: SE
authors.lastname: Back
authors.forename: Michael E
authors.initials: ME
authors.lastname: Saladin
authors.forename: Himanshu P
authors.initials: HP
authors.lastname: Upadhyaya
authors.forename: Raymond F
authors.initials: RF
authors.lastname: Anton
authors.forename: Patrick K
authors.initials: PK
authors.lastname: Randall
mesh_terms: D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000437:Alcoholism / Q000188:drug therapy* / Q000453:epidemiology*; D003080:Cold Temperature; D015897:Comorbidity; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D011597:Psychomotor Performance; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D014110:Touch
chemical_list: D009292:Narcotic Antagonists; D009271:Naltrexone; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone