Enhanced negative emotion and alcohol craving, and altered physiological responses following stress and cue exposure in alcohol dependent individuals.
Chronic alcohol abuse is associated with changes in stress and reward pathways that could alter vulnerability to emotional stress and alcohol craving. This study examines whether chronic alcohol abuse is associated with altered stress and alcohol craving responses. Treatment-engaged, 28-day abstinent alcohol-dependent individuals (ADs; 6F/22M), and social drinkers (SDs; 10F/18M) were exposed to a brief guided imagery of a personalized stressful, alcohol-related and neutral-relaxing situation, one imagery condition per session, presented in random order across 3 days. Alcohol craving, anxiety and emotion ratings, behavioral distress responses, heart rate, blood pressure, and salivary cortisol measures were assessed. Alcohol patients showed significantly elevated basal heart rate and salivary cortisol levels. Stress and alcohol cue exposure each produced a significantly enhanced and persistent craving state in alcohol patients that was marked by increased anxiety, negative emotion, systolic blood pressure responses, and, in the case of alcohol cue, behavioral distress responses, as compared to SDs. Blunted stress-induced cortisol responses were observed in the AD compared to the SD group. These data are the first to document that stress and cue exposure induce a persistent negative emotion-related alcohol craving state in abstinent alcoholics accompanied by dysregulated HPA and physiological arousal responses. As laboratory models of stress and negative mood-induced alcohol craving are predictive of relapse outcomes, one implication of the current data is that treatments targeting decreases in stress and alcohol cue-induced craving and regulation of stress responses could be of benefit in improving alcohol relapse outcomes.
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA. rajita.sinha@yale.edu
Rajita
R
Sinha
Helen C
HC
Fox
Kwangik A
KA
Hong
Keri
K
Bergquist
Zubin
Z
Bhagwagar
Kristen M
KM
Siedlarz
D000328:Adult; D019973:Alcohol-Related Disorders / Q000503:physiopathology* / Q000523:psychology; D016739:Behavior, Addictive / Q000523:psychology*; D001794:Blood Pressure; D003463:Cues; D003627:Data Interpretation, Statistical; D004644:Emotions / Q000187:drug effects / Q000502:physiology*; D005260:Female; D006339:Heart Rate; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis; D008297:Male; D008875:Middle Aged; D012463:Saliva / Q000737:chemistry; D013315:Stress, Psychological / Q000503:physiopathology*; D055815:Young Adult
D006854:Hydrocortisone